Since we can simulate the heart’s function within the arterial tree model, we can also determine cardiac afterload — and even preload. The afterload refers to the pressure prevailing in the aorta and represents the resistance against which the heart must pump continuously. The preload, in turn, is subject to venous return to the heart. If both — that is, the volume and pressure load on the heart — are permanently elevated, this leads to long-term damage, such as left ventricular hypertrophy (LVH). This occurs strikingly often in dialysis patients and leads to alarmingly high mortality rates in this patient group. LVH is directly related to coronary artery disease and is considered a cardiovascular high-risk factor for myocardial infarction, heart failure, or sudden cardiac death. Close monitoring with VASCASSIST, applying Model-based Pulse Wave Analysis (mbPWA), ensures that the cardiovascular system of dialysis patients, which is working under increased pressure as a result of dialysis, is protected from damage by close monitoring.