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The left panel shows a schematized left ventricular (LV) pressure–volume loop from a patient with primary systolic failure. A normal LV pressure–volume
loop (solid loop) is shown on the left portion of the curve; the transition to inotropic failure (dashed loop) is shown on the right. Systolic failure is manifest as
an increase in LV end-systolic volume and as a reduction in the extent of shortening (stroke volume). LV end-diastolic pressure (LVEDP) is increased
because LV volume is increased. As indicated by the arrow, the diastolic portion of the pressure–volume loop has simply shifted to the right, along the
same diastolic pressure–volume relationship; thus, no change in the distensibility of the left ventricle has occurred. The right panel shows an LV pressure–
volume loop from a patient with primary diastolic failure (dashed loop). Note that the LVEDP is the same as that in the patient with primary inotropic failure,
Source: Chapter 26. Pathophysiology of Heart Failure, Hurst's The Heart, 13e
as denoted by the heavy dots on both pressure–volume loops. In the right panel, however, this is caused by an upward shift of the LV diastolic pressure–
Citation:(arrows),
Fuster V,which
Walsh
RA, Harrington
RA. in
Hurst's
The Heart,
13e; 2011
Available
at: http://mhmedical.com/
May
08, 2017
volume relationship
indicates
a decrease
LV diastolic
distensibility
such
that a higher
diastolic pressure isAccessed:
required to
achieve
the same
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2017
McGraw-Hill
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diastolic volume. In this patient, no change in end-diastolic volume or systolic shortening has occurred. From Lorell BH. Left ventricular diastolic pressurevolume relations: understanding and managing congestive heart failure. Heart Failure. 1988;4:206-223. Copyright 2011. Reprinted with permission of John
Wiley & Sons, Inc.