Clinical Note

The diastolic compliance can be altered by disease. When the heart becomes hypertrophied, as often occurs with persistent hypertension (high blood pressure), the walls of the ventricle become very thick as the myocytes increase their diameter and connective tissue is deposited within the heart wall. The thickened wall reduces compliance and opposes filling during diastole. Figure 9 shows how a reduced diastolic compliance reduces stroke volume. This diastolic dysfunction greatly reduces the efficiency of the hypertro-phied heart often with fatal consequences.

in the pulmonary veins, raising the pulmonary venous pressure. This rise in venous pressure raises the end-diastolic volume of the left ventricle and, thus, the left ventricular stroke volume. At the same time, the reduced output of the left ventricle will reduce systemic venous return and thus the filling pressure for the right ventricle will fall. An equilibrium will soon be met at which the stroke volume will again be equal on both sides.

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