Epilogue

Developing the cardiovascular simulation app is a time consuming undertaking. With a working app: what are the goals achieved?

These are the most important inferences:

The heart is in essence a volume pump

Circulation means pumping blood volume from a capacitance at low pressure to a capacitance at high pressure

The theory of arterial acceleration explains why the pulse wave does not fade out over the arterial tree's most distal branches

Short term regulation of circulation combines humoral and mechanical mechanisms

Cardiac output depends on heart frequency and venous capacity

Venous capacitance is hypothetically governed by the CNS ischemic response

Cerebral autoregulation is the net result of the metabolic response and the CNS ischemic response

Arterial biomechanics changes with age with arteries becoming wider and stiffer thereby reducing the effect of arterial acceleration 

The most important achievement of the cardiovascular simulation app is to illustrate the complexity of the different regulatory mechanisms, humoral and mechanical. The model confines itself to only the mechanisms working in the short term. The model ignores all mechanisms ensuring adequate blood volume and blood content for the long term such as glucose regulation, regulation of electrolytes, regulation of pH, regulation of blood osmolality, etc. etc. Biological systems based upon hundreds of million years of evolution are layered systems that provide homeostasis in a highly complex and chaotic way, with their efficiency mainly based upon so many years of trial-and-error.

Evolution is based upon variation in large populations and a single individual is of little or no importance. It is a striking paradox how much Western communities invest in health care for the individual.