Influences on Ventricular EDV Through Stretching of the Myocardium and the Contractile State of the Myocardium
Levels of ventricular end-diastolic volume (EDV) associated with filling pressures that result in dyspnea and pulmonary edema are shown on the abscissa. Levels of ventricular performance required during rest, light activity (walking), and maximal activity are on the ordinate. The dashed lines are the descending limbs of the ventricular performance curves, which are rarely seen during life but show the level of ventricular performance if EDV could be elevated to very high levels. A = normal at rest; B = normal walking; C = normal maximal exercise; D = heart failure at rest; E = heart failure while walking.
Reprinted with permission from Braunwald E: Normal and abnormal myocardial function. In Braunwald E, et al. [eds]: Harrison’s Principles of Internal Medicine, 15th ed. New York: McGraw-Hill, 2001:1309–18, as modified from Braunwald E, Ross J Jr., Sonnenblick EH: Mechanisms of Contraction of the Normal and Failing Heart. Boston: Little, Brown; 1978.