4
Figure 3. Pressure–volume Relations in Patients with
HFrEF vs. those with HFpEF
In those with HFrEF, the LV volume is increased and the slope of the end-systolic pressure
volume relationship (End systolic elastance [Ees], straight line) is shallow. Reduction in
arterial elastance ([Ea], dashed lines) in this setting leads to marked improvement in SV
(reduction in end systolic volumes, dotted lines) with minimal drop in arterial pressure.
In contrast, patients with HFpEF do not display increased heart volume, but typically
display increased Ees(steep ESPVR, straight black line). In this setting, the same degree
of vasodilation is coupled with much more dramatic blood pressure lowering with less
increase in SV. us, vasodilators used in the catheterization lab will be expected to have
much greater hypotensive effects in patients with HFpEF and much greater improvement
in CO with less BP effect in HFrEF. Adapted with permission from Schwartzenberg et al.
J Am Coll Cardiol. 2012 Jan 31;59(5):442-51.
