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We thank Drs Heffernan and Lefferts1 for their interesting comments and request to expand on the implications of the late-systolic forward decompression (suction) wave (FDW) during exercise. Parker et al2 were the first to suggest that the FDW generated by the left ventricle is related to left ventricular (LV) performance and that wave reflections from the peripheral circulation were less likely to play a dominant role in the modulation of the central blood pressure waveform. Other work has shown that the FDW is closely related to LV mechanics during mid-to-late systole3 and that FDW generation is attributed to LV relaxation and storage of energy in the left ventricle …

Response to A New Exercise Central Hemodynamics Paradigm: Time for Reflection or Expansion?