Negishi K, et al. - A prospective observational study is done to clarify the alterations in cardiac performance amid preload reduction with progressive upright tilt that is relevant both for space exploration and the upright posture, especially the preload dependence of various parameters of cardiovascular performance. Preload modification with gravitational loading alters most hemodynamic and echocardiographic parameters including e' velocity, Global longitudinal strain (GLS), and Global circumferential strain (GCS). However, end-systolic elastance and strain rate seems to be more load-independent measures to investigate alterations in the cardiovascular function amid postural and preload changes, including microgravity.