To assess the effect of afterload on the left ventricular pressure (LVP) fall during isovolumic relaxation period (IRP) in man, we examined the peak (-)dP/dt, (-)dP/dt upstroke pattern in IRP, and time constant (T) in 15 patients [normal (N): 5 valvular heart disease (VHD): 5, dilated cardiomyopathy (DCM): 5]. LVP and echocardiographic internal diameter were measured simultaneously at rest and after about 30 mmHg increment of LV peak systolic pressure (PSP) by drip infusion of angiotensin (20 ng/kg/min). After augmentation in afterload, heart rate (HR) increased slightly in VHD. T increased significantly (p less than 0.05) in N (from 32 +/- 3 to 39 +/- 4 ms) and DCM (from 56 +/- 18 to 72 +/- 12 ms), but not in VHD (from 41 +/- 5 to 46 +/- 8 ms) probably due to increased HR. LV end-systolic dimension had the same trend as T. Although there was no significant change in peak (-)dP/dt in N (from 1937 +/- 385 to 1945 +/- 189 mmHg/s), VHD (from 1521 +/- 210 to 1730 +/- 462 mmHg/s), or DCM (from 814 +/- 143 to 814 +/- 131 mmHg/s), the (-)dP/dt upstroke pattern during IRP became nonexponential in N and more downward convex in VHD or DCM. Thus, these changes of T and (-)dP/dt upstroke pattern suggest the afterload dependence of LVP fall during IRP in normal and diseased hearts.