Ventriculo-arterial decoupling in acutely altered hemodynamic states

Th e dynamic interaction between the heart and the systemic circulation allows the cardiovascular system to be effi cient in providing adequate cardiac output and arterial pressures necessary for suffi cient organ perfusion Th e cardiovascular system provides adequate pressure and fl ow to the peripheral organs in diff erent physiological (rest and exercise) and pathological conditions because of the continuous modulation of the arterial system compliance, stiff ness and resistance with respect to left ventricular (LV) systolic performance Card iac output is the fi nal result of this dynamic modulation. Because LV stroke volume depends on myocardial contractility and loading conditions (preload and afterload), both cardiac and arterial dysfunction can lead to acute hemodynamic decompensation and shock. According to the underlying pathophysiological mechanisms, altered hemodynamic profi les can be classifi ed as primarily refl ecting cardiogenic, hypovolemic, obstructive or distributive shock.