Figure 2: In systolic dysfunction, LV contractile function decreases and gets smaller. Meanwhile, the end-diastolic pressure-volume relationship shifts downwards rather than remaining unchanged. To maintain cardiac output, the pressure-volume loop shifts right due to increase in preload. Therefore, the LV pressure-volume loop operates on the steep part of the end-diastolic pressure-volume curve, consequently causing end-diastolic pressure to rise. LV: left ventricular.