8
Figure 8. Exercise-induced Changes in LV Filling Pressures
in Patients with Heart Failure and Normal EF
Patients with normal EF and exertional dyspnea displayed normal ventricular filling
pressures (i.e., LV end-diastolic pressure [arrows] and PCWP) at rest (le) but marked
elevation on exercise (right), making the positive diagnosis of heart failure with preserved
EF as the cause of dyspnea.
Figure 9. Pressure Volume Loops in Cardiogenic Shock
A: e slope of the FS curves represent LV contractility. Under steady-state conditions
(Curve 1), an increase in LV end-diastolic pressure (LVEDP) or end-diastolic volume
(LVEDV) will increase LV SV and CO. During cardiogenic shock (Curve 2), the slope
of the FS curve is lowest, therefore an increase in LV end-diastolic pressure (LVEDP) or
end-diastolic volume (LVEDV) will not greatly increase LV SV.
B: An illustration of corresponding PV loops for each condition. Compared with steady-
state conditions (Loop 1), cardiogenic shock (Loop 3) is associated with reduced end-
systolic elastance (Ees) and a high LVEDV and LVEDP.
