Figure 1

Schematic representations of three possible relations between myocardial efficiency and left-ventricular afterload. Myocardial efficiency as a function of afterload proposed for the control heart (thin line) and for the diabetic heart (thick line). The diabetic heart could have (A) a lower value of peak efficiency (which occurs at the optimal afterload as indicated by the broken line labelled ‘O’) but can pump to the same peak afterload (the broken line labelled ‘P’), lower peak efficiency and lower peak afterload (B), or same peak efficiency but lower peak afterload (C).