Evaluation of left ventricular function during upright exercise: correlation of exercise Doppler with postexercise two-dimensional echocardiographic results.

Abstract

The relationship of regional and global left ventricular function to aortic flow dynamics during exercise was determined in 14 normal subjects and 14 patients with coronary artery disease. Doppler and two-dimensional echocardiographic studies were performed before, during, and immediately after an exercise test by the Bruce protocol. Two-dimensional echocardiography was used to determine the ejection fraction and new wall motion abnormalities. The peak ejection velocity, stroke index, and cardiac index were calculated from the pulsed Doppler tracing. In normal subjects the ejection fraction increased significantly (p < .001) from rest (0.51 ± 0.07) to peak exercise (0.61 + 0.07), while the response in coronary patients was blunted (0.49 ± 0.11 vs 0.48 ± 0.16). Similarly, the change in peak ejection velocity throughout exercise in normal subjects (from 0.71 + 0.12 to 1.50 + 0.35 m/sec) was significantly (p < .01) greater than that in patients with coronary artery disease (from 0.61 ± 0.13 to 0.90 0.29 m/sec). There was a good correlation between the percent change in peak ejection velocity and the percent change in ejection fraction from rest to peak exercise in the entire study group (rs = .64) and in the patients with coronary artery disease (rs = .84). These preliminary data suggest that exercise-induced changes in Doppler echocardiographic variables may offer a potential adjunct in the evaluation of patients with ischemic heart disease. Circulation 75, No. 2, 413-419, 1987. RECENT STUDIES have shown that pulsed Doppler velocity measurements can accurately estimate stroke volume and cardiac output at rest.1-5 In addition, the technique is reported to reflect changes in blood flow during exercise in normal subjects.`However, little data are available that assess the Doppler-derived variables of aortic flow during exercise in patients with coronary artery disease.9'-Two-dimensional echocardiography has been shown to increase the sensitivity of exercise testing in the detection of coronary artery disease when used either during 2-17 or immediately after exercise18-20 by demonstrating the percent From

Myocardial infarction and remodeling in mice: effect of reperfusion

“…For permanent occlusion (n and dotted line, n ϭ 8), regression line was y ϭ ax ϩ b, r ϭ 0.85, P Ͻ 0.007; for reperfusion (s, n ϭ 7), there was inadequate distribution for regression analysis; for combined permanent occlusion and reperfusion (solid line) regression, r ϭ 0.675, P ϭ 0.006; ϭ sham Ϯ SD (n ϭ 9). H666 MOUSE HEART ISCHEMIA AND EFFECTS OF REPERFUSION coronary artery disease, diverged significantly in response to exercise or dipyridamole stress (22,26). At the present time, we have not developed a satisfactory, standardized stress test for the highly labile mice used in the present study, but we would anticipate that stress might uncover ventricular dysfunction in the reperfused mice in a manner similar to that found by others (22,26).…”

“…Similarly, peak aortic flow velocity and ejection fraction may vary independently. There are reports of overlap between peak aortic flow velocity values at rest for normal subjects and those with considerable heart disease, reduced ejection fractions, or experimental ischemia (16,17,26,38). Peak aortic flow velocities for normal patients, and those with Fig.…”

Exercise‐induced aortic flow parameters in early postmenopausal women and middle‐aged men

“…Exercise Doppler echocardiography is a relatively new technique that enables an accurate assessment of left ventricular function [1][2][3][4][5], and may also offer valuable information in the evaluation of coronary artery disease patients [1,[3][4][5][6]. Although gender is known to affect hemodynamic parameters during exercise [7][8][9], little information exists on possible gender differences in Doppler-derived aortic flow parameters [10][11][12].…”

“…It is not known whether this decrease is accompanied by changes in exercise Doppler-derived variables. Therefore, the aims of this study were twofold: (1) to compare basal ejection Doppler indexes in healthy early postmenopausal women with those of healthy men of an age matched group, and (2) to assess the effects of isometric and dynamic exercises on these parameters.…”

Continuous-Wave Doppler Echocardiographie Evaluation of Patients with Coronary Artery Disease

“…Therefore, an assessment of left ventricular function during exercise may be useful in evaluating such patients. To assess the left ventricular function during exercise, many studies have been done using invasive or noninvasive techniques [1-4], More recently, the development of Doppler echocardiography offers a reliable method with which to measure cardiac output, both noninvasively and instantaneously [5,6], Few data are available regarding the application of this technique in patients with CAD during dynamic exercise [7,8]. In the present study, we recorded the ascending aortic blood flow using the continuous-wave (CW)…”