1. “ Heart as a pump ”

2. Cardiac cycle Systole of atriums Systole of ventricles Діастола передсердь Діастола шлуночків

3. Cardiac cycle: Systole 1. Period of tension 1. Period of tension asynchrony contraction asynchrony contraction isometric contraction isometric contraction (all valves are closed) (all valves are closed) 2. Period of ejection 2. Period of ejection protosphigmic interval (opening of semilunear valves) protosphigmic interval (opening of semilunear valves) fast ejection fast ejection slow ejection slow ejection

4. Systole of ventricles 1. Period of tension phases of : - asynchrony contraction - isometric contraction (all valves are closed) RA RV LA LV AortaAorta A. p u l m

5. Systole of ventricles 1. Period of tension phases of : - asynchrony contraction - isometric contraction (all valves are closed)

6. Cardiac cycle: Diastole 1. Period of relaxation 1. Period of relaxation protodiastolic interval (closing of semilunear valves) protodiastolic interval (closing of semilunear valves) phase of isometric relaxation (opening of AV-valves is end of this phase) phase of isometric relaxation (opening of AV-valves is end of this phase) 2. Period of filling 2. Period of filling phase of rapid filling phase of rapid filling phase of slow filling phase of slow filling phase of filling by help of atrium systole phase of filling by help of atrium systole

7. Systole of ventricles 2. Period of ejection protosphigmic interval (opening of semilunear valves fast ejection slow ejection)

8. Period of relaxation: protodiastolic interval (closing of semilunear valves) phase of isometric relaxation (opening of AV- valves is end of this phase) Diastole of ventricles

9. Period of filling: - phase of rapid filling - phase of slow filling

10. The cardiac cycle

15. Heart sounds. Components I tone. 1. Valve component (AV valves) I tone. 1. Valve component (AV valves) 2. Muscle component 2. Muscle component 3. Vessels component (opening of semilunear valves) 3. Vessels component (opening of semilunear valves) 4. Atrium component 4. Atrium component II tone. 1. Valve component (closing of semilunear valves) II tone. 1. Valve component (closing of semilunear valves) 2. Vessels component 2. Vessels component

18. Heart sounds

19. Phonocardiogram ECG PhCG Q R S T І tone ІІ tone Interval Q-І tonInterval Т-ІІ ton

20. Echocardiography is a method of investigation of structure and mechanical functioning of the heart which is base on registration of reflected ultrasonic signals

21. Echocardiography 1. M-measure 1. M-measure 2. D-measure 2. D-measure 3. Doppler 3. Doppler 4. Contrasting 4. Contrasting

24. The positions of echolocation in M- mode 1, 2, 3, 4 – position of echolocation; D - ultrasonic sensor; Th - chest D - breast; RV - right ventricle; LV - left ventricle; LA - left atrium, AV - aortic valve; FMV - front mitral valve; PMV - posterior mitral valve.

25. II position

26. АО

32. EDV ( = 7,0 (2,4 + EDS) · EDS³, ESV (end-systolic volume) = 7,0 (2,4 + ESS) · ESS³, Normally, in adults, EDV is 108-140 ml, and ESV within 38-50 ml. Stroke volume (SV) of the left ventricle is calculated by the formula: SV = EDV - ESV. Normally, in adults, the SV is 70-90 ml. Minute volume flow (MVF) is defined as the product of SV and heart rate. Normally, in adults, MVF is 4,0-6,5 l / min. Contractile activity of left ventricular ejection fraction characterizes (EF), defined as follows: EF = SV : EDV · 100%. Normally, in adults, EF is 54-64%. Also indexed rates of left ventricular are set indexed. For this goal obtained values of indexes should be divided by body surface area of ​​ the subject, which can be calculated by the formula of Du Bois. EDV ( end-diastolic volume) = 7,0 (2,4 + EDS) · EDS³, ESV (end-systolic volume) = 7,0 (2,4 + ESS) · ESS³, Normally, in adults, EDV is 108-140 ml, and ESV within 38-50 ml. Stroke volume (SV) of the left ventricle is calculated by the formula: SV = EDV - ESV. Normally, in adults, the SV is 70-90 ml. Minute volume flow (MVF) is defined as the product of SV and heart rate. Normally, in adults, MVF is 4,0-6,5 l / min. Contractile activity of left ventricular ejection fraction characterizes (EF), defined as follows: EF = SV : EDV · 100%. Normally, in adults, EF is 54-64%. Also indexed rates of left ventricular are set indexed. For this goal obtained values of indexes should be divided by body surface area of ​​ the subject, which can be calculated by the formula of Du Bois. End- diastolic (EDI), end-systolic (ESI) indices are calculated by the following formulas: EDI = EDV: P ESI = ESV: P where the EDI - end-diastolic index, EDV - end-diastolic volume, ESI - end-diastolic index, ESV - end-sistolic volume, P - body surface area.

33. Thank you! Thank you!