The healthy heart does not control a specific cardiac output: a plea for a new interpretation of normal cardiac function

Abstract

The current evidence suggests that the healthy heart does not sense the optimal cardiac output (Q̇) because the different organ systems that influence cardiac function do not interact to adjust their individual responses toward a specific Q̇. Consequently, it is conceivable that the complex cycle of cardiac contraction and relaxation must occur for reasons other than to produce a specific target Q̇ and that there is likely a yet undiscovered overarching principle in the cardiovascular system that explains the combined effects of the prevailing preload, afterload, and contractility. Future research should embrace the possibility of a different purpose to cardiac function than previously assumed and examine the biological capacity of this fascinating organ accordingly.

Keywords: cardiac output; exercise; heart failure; hypertension; twist.