where V0 is a constant reference volume.
The ventricle produces maximal external work to the arterial load when the ventricular and arterial elastances are equalized. In normal subjects, the ventricular elastance is nearly twice as large as arterial elastance, thereby affording maximal efficiency. However, in moderate heart failure, the two elastance values are almost identical, thereby maximizing stroke work from a given end-diastolic volume but at the expense of work efficiency. Finally, in severe failure, ventricular elastance is less than half arterial elastance values, resulting in increased potential energy and an inability to maintain either stroke work or work efficiency properly.
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