Matching between ventricle and arterial load. An evolutionary process.

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Abstract
The hemodynamic properties of the ventricle are related to those of the arterial load. However, the precise nature of this relation is not known. At least three different matching criteria have been described in the literature: optimization of heart rate, of power output, and of external efficiency. Although these suggestions are based on experimental findings, there is little understanding of the underlying principles. We now suggest that the balance between the ventricle and its load is a result of the evolutionary process. To support our view, three simple assumptions are proposed regarding the evolutionary determinants underlying the relation between ventricle and arterial load: 1) Arterial pressure and flow to be generated by the ventricular pump under normal (control) conditions are set by the demands of the body. 2) Mechanical properties of contractile machinery and arterial wall material are given. 3) The heart and arterial system should have minimum size. On the basis thereof, we argue that heart rate is related to maintenance of diastolic pressure and show that the ventricle operates close to optimum power and efficiency to attain minimum size.