Figure 71-11 The normal Starling relationship of the heart is depicted on the upper line, where increasing left ventricular filling pressure (LVFP) increases stroke volume (SV). In the presence of ventricular dysfunction, this curve is shifted downward and to the right. The depressed curve can be shifted toward normal by inotropic drugs (I) or vasodilator drugs (V). Infusion of both (V + I) produces a synergistic effect. Diuretics (D) reduce filling pressure without increasing output. The dashed line suggests that SV may rise later. (Redrawn from Cohn JN, Franciosa JA: Vasodilator therapy of cardiac failure. N Engl J Med 297:27, 1977.)