It has been observed that the active-passive classification of adult learning can be viewed in terms of a systolic-diastolic model. This model represents an analogy to the cardiac cycle and the work done by the heart during these two phases of the cycle. The determinants of systolic and diastolic learning can be compared to the determinants of cardiac function: preload, afterload and contractility. Similarly, dysfunction in these two phases of learning can be compared to cardiac dysfunction from a pathophysiologic perspective.