Key result
Altered loading conditions and excessive afterload can produce serious heart failure even when myocardial contractility is not depressed.
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Design
Review
Supports afterload assessment in unexplained heart failure; leaves open prospective validation of targeted interventions.
Altered loading conditions can sometimes produce serious heart failure, even though myocardial contractility is not depressed. The role of afterload in some forms of heart failure is emphasized, as are the conditions termed afterload mismatch, in which afterload is excessive "absolutely" or relative to diminished contractility. A related aspect is the role of the peripheral circulation.
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John Ross (1983) studied this question. Altered loading conditions and excessive afterload can produce serious heart failure even when myocardial contractility is not depressed.
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