Cardiac Cycle and Hemodynamics · USMLE Step 1

Which of the following best explains why an increased heart rate alone may not substantially increase cardiac output under certain conditions?

  1. Because reduced filling time lowers stroke volume
  2. Because preload automatically increases with HR
  3. Because afterload decreases at high heart rates
  4. Because contractility falls with increased HR
Show answer and explanation

Correct answer: Because reduced filling time lowers stroke volume

With a very high heart rate, diastole shortens and there is less time for ventricular filling, reducing preload and stroke volume, which may offset the gain in output from increased beats per minute.

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