What the Frank-Starling mechanism describes
The Frank-Starling law of the heart states that, within physiological limits, the more the heart muscle is stretched by incoming blood during filling, the more forcefully it contracts. Plotted as a curve, stroke volume rises with end-diastolic volume (the amount of blood in the ventricle at the end of filling, which reflects preload). The mechanism arises because greater stretch of cardiac muscle fibers improves the overlap of contractile filaments up to an optimal length.
This intrinsic property lets the heart automatically match its output to the volume of blood returning to it, balancing the two sides of the heart beat to beat without external signals.
How the curve shifts in heart failure
The position of the curve depends on contractility. Increased contractility, such as from sympathetic stimulation, shifts the curve upward, producing more stroke volume at the same filling. A failing heart shifts the curve downward and flatter, so it generates less stroke volume for any given end-diastolic volume.
This downward shift helps explain why heart failure can lead to congestion: the ventricle handles less volume effectively, and pressure backs up. Interpretation of cardiac function is a clinical matter requiring evaluation by qualified medical professionals.