Cardiac Cycle and Hemodynamics · USMLE Step 1

What does preload most directly reflect in the context of cardiac function?

  1. Arterial pressure the ventricle must overcome to eject blood
  2. Ventricular end-diastolic volume and fiber stretch before contraction
  3. Contractile strength of myocytes independent of fiber length
  4. Ventricular end-systolic volume after contraction
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Correct answer: Ventricular end-diastolic volume and fiber stretch before contraction

Preload refers to the degree of stretch of myocardial fibers at end-diastole, which is proportional to the end-diastolic volume (or pressure) — determining how much the ventricle is filled before contraction.

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