In critically ill patients, effective arterial elastance may be reliably estimated at bedside. We support the use of this validated estimate of effective arterial elastance when coupled with an index of left ventricular contractility for studying the ventricular-arterial coupling. Conversely, effective arterial elastance should not be used in isolation as an index of left ventricular afterload. According to the “cardiocentric” view, end-systolic pressure was considered the classic index of left ventricular afterload. 50 hemodynamically stable and spontaneously breathing patients equipped with a femoral or radial catheter were entered in a study. 30 ventilated patients with invasive hemodynamic monitoring, in whom fluid administration was planned were entered in the study.

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