Coupling of the left ventricular and arterial system

We investigated the coupling of the left ventricle (LV) and the arterial system in eight conscious dogs, instrumented to measure LV pressure and determine LV volume from three ultrasonically determined dimensions. The LV end-systolic pressure (PES)-volume (VES) relation was determined by caval occlusion. Its slope (EES) was compared to the arterial elastance (EA), determined as PES/stroke volume. At rest, with intact reflexes, EES/EA was 0.9 +/- 0.20. EES/EA was varied over a wide range (0.18-2.59) by the infusion of graded doses of phenylephrine and nitroprusside and dobutamine. Maximum LV SW, at constant inotropic state and end-diastolic volume, occurred when EES/EA = 0.99 +/- 0.15. However, SW was within 20% of its maximum value when EES/EA was between 0.56 and 2.29. As EES/EA decreased below 0.59, SW fell precipitously. The shape of the observed relation of SW to EES/EA was similar to that predicted by the theoretical consideration of linear LV PES-VES and arterial PES-stroke volume relations. We conclude that the LV and arterial system produce maximum SW at constant VED when EES and EA are equal; however, the relation of SW to EES/EA has a broad plateau.