Afterload sensitivity of nonlinear end-systolic pressure-volume relation vs preload recruitable stroke work in conscious dogs.

The observations in vivo of a non-linear, afterload-sensitive end-systolic pressure-volume relation (ESPVR) and a linear, load-insensitive preload recruitable stroke work (PRSW) relation may be reconciled by considering the PRSW as a product of both the ventricular ESPVR and the arterial elastance (Ea). We obtained pressure-volume data from eight conscious dogs. The ESPVR was nonlinear, and its trajectory was afterload-dependent. The PRSW was linear and load-independent. Arterial elastance changed with both acute reductions in preload and steady-state changes in afterload. The PRSW relation thus describes both myocardial function and ventricular-arterial interaction and is a useful index of cardiovascular performance in patients.