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Background: Although the Guyton's concept of venous return (VR) revolutionized circulatory physiology,
the pulmonary circulation was not explicitly incorporated in its original framework.
Since the pulmonary circulation is the critical element in understanding left heart
failure, we extended the Guyton's original concept and characterized the VR as a surface
described by both right (PRA) and left atrial pressures (PLA) as VR=VRmax−(GSPRA+GPPLA) (AJP 2004). The baroreflex system is known to powerfully modulate systemic and pulmonary
vascular systems and thereby capable of changing the circulatory equilibrium. However
how baroreflex impacts the VR surface remains unknown.
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