Orgasm men are capable of achieving them is supported by men who have reported having multiple, consecutive orgasms, particularly without ejaculation. Males who experience dry orgasms can often produce multiple orgasms, as the refractory period is reduced. An increased infusion of the hormone oxytocin during ejaculation is believed to be chiefly responsible for the refractory period, and the amount by which oxytocin is increased may affect the length of each refractory period. Another chemical which is considered to be responsible for the male refractory period is prolactin, which represses dopamine, which is responsible for sexual arousal. Because of this, there is
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