Refractory period (sex) after orgasm in which further sexual stimulation does not produce excitement. While the refractory period varies widely among individuals, ranging from minutes to days, most men cannot achieve or maintain an erection during this time, and many perceive a psychological feeling of satisfaction and are temporarily uninterested in further sexual activity; the penis may be hypersensitive and further sexual stimulation may feel painful during this time frame. An increased infusion of the hormone oxytocin during ejaculation is believed to be chiefly responsible for the male refractory period, and the amount by which oxytocin is increased may affect the length of
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