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Transcript
Hemodynamic responses to pharmacologic interventions in heart failure. The relationships between diastolic filling pressure (preload) and stroke volume (ventricular performance) are illustrated for a normal heart (green line; the Frank-Starling relationship) and for a patient with heart failure due to predominant systolic dysfunction (red line). Note that positive inotropic agents (I), such as cardiac glycosides or dobutamine, move patients to a higher ventricular function curve (lower dashed line), resulting in greater cardiac work for a given level of ventricular filling pressure. Vasodilators (V), such as angiotensin-converting enzyme (ACE) inhibitors or nitroprusside, also move patients to improved ventricular function curves while reducing cardiac filling pressures. Diuretics (D) improve symptoms of congestive heart failure by moving patients to lower cardiac filling pressures along the same ventricular Source: Pharmacotherapy of Congestive Heart Failure, Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 12e function curve. Citation: Brunton LL, Chabner BA, Knollmann BC. Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 12e; 2011 Available at: http://mhmedical.com/ Accessed: May 02, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved