Preload is affected by venous blood pressure and the rate of venous return. These are affected by venous tone and volume of circulating blood. Preload is related to the ventricular end-diastolic volume; a higher end-diastolic volume implies a higher preload.
What causes increased afterload?
Afterload is increased when aortic pressure and systemic vascular resistance are increased, by aortic valve stenosis, and by ventricular dilation. When afterload increases, there is an increase in end-systolic volume and a decrease in stroke volume.
How do you reduce cardiac preload?
Diuretics are effective in preload reduction by increasing urinary sodium excretion and decreasing fluid retention, with improvement in cardiac function, symptoms, and exercise tolerance.