Clinical Note

In the failing heart with diminished stroke volume and cardiac output, an important therapeutic strategy involves diminution of afterload with vasodilating drugs. A decreased afterload would result in a greater stroke volume, which in turn would help to alleviate symptoms of heart failure.

Diastolic Compliance

Although the body can change the heart's contractility from moment to moment, no such control system exists for changing the diastolic compliance curve, because in the normal heart the myocytes are fully relaxed and their stiffness is determined wholly by the structures that make up their parallel elastic element. In some patients, e.g., those with inadequate coronary blood flow, the heart may be slow to relax during systole and further impede filling as shown in Fig. 9.

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