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The adaptive mechanisms may be short term ones which come into play within minutes or hours of the onset of myocardial dysfunction. These are:
Frank-Starling Mechanism
In the Frank-Starling mechanism increased preload helps in sustaining cardiac performance. Starling's law essentially means that stroke volume is related to the end-diastolic volume. Frank proposed that the greater initial left ventricular volume leads to more rapid rate of rise of pressure, greater peak pressure and faster rate of relaxation. So the Frank-Starling law accounts for increased inotropic state and increased diastolic filling.
Neuro Hormones
Activation of neurohumoral systems resulting in release of noradrenaline leading to augmentation of myocardial contractility.
Renin-Angiotensin-Aldosterone System
Activation of renin-angiotensin-aldosterone system which helps in maintaining arterial pressure and perfusion of vital organs.
Alkaline Phosphatases use water as a second substrate. Why do we still treat their kinetics as if they were for a single-substrate reaction?
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