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Preload failure
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'''Preload failure''' or '''PLF''' occurs when the maximal exercise-induced cardiac output (CO) is decreased without an accompanying increase in right heart or pulmonary vascular pressures.{{Citation needed|reason=See discussion page for citations}} In [[Heart|cardiac]] physiology, preload is the end diastolic volume that stretches the right or left ventricle of the heart to its greatest dimensions under variable physiologic demand.{{Citation needed|reason=See discussion page for citations}} It is defined as the length of the heart muscle just before it starts to pump and is measured clinically by the volume of blood in the left ventricle, the main pumping chamber, when it is most relaxed.{{Citation needed|reason=See discussion page for citations}} Preload can be influenced by [[blood volume]], heart rhythm, left ventricular relaxation, and alterations in afterload.{{Citation needed|reason=See discussion page for citations}} ==ME/CFS== Preload failure is associated with [[exercise intolerance]] inΒ [[myalgic encephalomyelitis]]/[[chronic fatigue syndrome]], [[orthostatic hypotension]], and [[Postural orthostatic tachycardia syndrome|postural orthostatic tachycardia]].<ref name="Oliverira2016" /> ==Treatments== [[David Systrom]] at Brigham Women's Hospital in Boston is currently conducting phase III trials of [[Mestinon]] in patients with preload failure.<ref>{{Cite web|url=https://clinicaltrials.gov/ct2/show/NCT03674541 | title = The Exercise Response to Pharmacologic Cholinergic Stimulation in Preload Failure - ClinicalTrials.gov|website=clinicaltrials.gov|language=en|access-date=2019-04-08}}</ref> [[Pyridostigmine]] (the generic name for Mestinon) has been investigated previously.<ref name="Oliverira2016" /> ==Notable studies and publications == * Pyridostigmine for Exercise Intolerance Treatment in Preload Failure<ref name="Oliverira2016">{{Cite web | last = Oliveira | first = Rudolf K. | author-link = Rudolph Oliveira | last2 = Tracy | first2 = Julie A. | authorlink2 = Julie Tracy | last3 = Karin | first3 = Abbey L. | authorlink3 = Abbey Karin | last4 = Waxman | first4 = Aaron | authorlink4 = Aaron Waxman | last5 = Systrom | first5 = David | author-link5 = David Systrom | authorlink6 = | date = 2016-05-01 | title = Pyridostigmine for Exercise Intolerance Treatment in Preload Failure|url=https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts.A5664 | website = American Thoracic Society International Conference Abstracts|publisher=American Thoracic Society|pages=A5664βA5664|doi=10.1164/ajrccm-conference.2016.193.1_meetingabstracts.a5664|quote=|via=}}</ref> - [https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts.A5664 Meeting abstract)] ==See also== *[[Pyridostigmine]] *[[Mestinon]] *[[Invasive cardiopulmonary exercise test]] (iCPET) *[[Post-exertional malaise]] *[[Exercise intolerance]] == Learn more == *2018, [https://youtu.be/FMaKfv8peww Advancements in ME/CFS Research, David M. Systrom, MD; Brigham and Women's Hospital | ME/CFSAlert 98] (Interview) == References == {{Reflist}} [[Category:Cardiac signs and symptoms]] [[Category:Cardiology]]
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