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. 2020 Oct;10(5):1646–1658. doi: 10.21037/cdt-20-450

Figure 3.

Figure 3

Right ventricular-pulmonary vascular coupling. The pressure-volume diagram is used to calculate right ventricular (RV)-pulmonary vascular coupling. The pressure-volume diagram allows for the determination of RV end-systolic elastance (EES). EES is unaffected by changes to RV afterload (dashed line) and, therefore, is the best possible load-independent measurement of contractility. By contrast, arterial elastance (Ea) is proportional to pulmonary vascular resistance and is a measurement of RV afterload. The ratio of EES to Ea is a measure of the coupling of the respective ventricular and arterial loads. Thus, a decrease in EES (blue arrow) or an increase in Ea (green arrow) due to elevations in pulmonary vascular resistance, for example, disrupts normal coupling. Reproduced with permission from Maron et al., Pulm Circ 2014;4(4):705-716.