Dysphoric milk ejection reflex to nipple/areolar stimulation, thoughts of the baby or of breastfeeding, or overfull breasts, travels through both brain and bloodstream, causing emotional changes in the brain and the release of milk in the breast. Prolactin, released in a gradual wave that peaks after the beginning of a feeding, is responsible for continued milk production. Dopamine inhibits the release of prolactin, so dopamine levels must drop in order for prolactin levels to rise. Some speculate that the necessary dopamine drop is similar to (and timed with) the oxytocin spike – a sort of negative image – but that in D-MER mothers it
Heart failure with preserved ejection fraction echocardiographic parameters to diagnose diastolic heart failure. There are four basic Echocardiographic patterns of diastolic heart failure, which are graded I to IV: Grade III and IV diastolic dysfunction are called "restrictive filling dynamics". These are both severe forms of diastolic dysfunction, and patients tend to have advanced heart failure symptoms: The presence of either class III and IV diastolic dysfunction is associated with a significantly worse prognosis. These patients will have left atrial enlargement, and many will have a reduced left ventricular ejection fraction that indicates a combination of systolic and diastolic dysfunction. Imaged volumetric definition of systolic heart