Left ventricular diastolic pressure/volume relationships

The LV pressure/volume relationships at rest and during exercise at early-, mid-, and end-diastole are shown. The simultaneous measurements of LV diastolic pressure and volume define distensibility or compliance. In the normal individual with normal compliance (left panel), exercise causes a downward shift of the diastolic pressure/volume curve in early diastole, indicating an increase in LV distensibility; the increase in cardiac output occurs without an increase in LV diastolic pressure. In a patient with ischemia (middle panel), exercise causes a marked upward shift in the curve, indicating a reduction in LV distensibility, or diastolic dysfunction, and there is a significant increase in LV and pulmonary capillary wedge pressures as LV volume or cardiac output increases. This may result in the development of pulmonary congestion and respiratory symptoms.