The heart's job is to pump enough blood to meet the metabolic needs of the organs. Cardiac systolic function is affected by preload, afterload and contractility. (Coordinated contraction seen with ischemic heart disease and distensibility-a factor indiastolic function-will not be discussed here.) As cardiac disease processes affect the heart, changes in preload, afterload and contractility affect the ability of the heart to do its job. Here we will look at how these parameters affect the ability ofthe heart to function properly, and how we can observe and evaluate these changes using echocardiography.
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