Modification of left ventricular diastolic behavior by isometric handgrip exercise.

Ludbrook, Philip A.; Byrne, Joseph D.; Reed, Frank R.; McKnight, Robert C.

doi:10.1161/01.cir.62.2.357

Cited by 30 publications

(17 citation statements)

References 76 publications

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“…Similar effects of IME have been reported in patients with hypertension and patients with ischaemic heart disease [14,15]. IME has been shown to induce LV diastolic dysfunction as determined by Doppler echocardiography in non-diabetic patients with exertional angina and significant coronary artery lesions who have normal LV diastolic function at rest [16].…”

Section: Introductionmentioning

confidence: 59%

Impaired left ventricular diastolic function during isometric exercise in asymptomatic patients with hyperlipidaemia

Salmasi

Fröst

Dancy

2004

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 59%

Impaired left ventricular diastolic function during isometric exercise in asymptomatic patients with hyperlipidaemia

Salmasi

Fröst

Dancy

2004

International Journal of Cardiology

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“…Such changes can be used as an indicator for LV diastolic properties and reserve [6,[13][14][15]. There are only minor changes in peripheral resistance in patients with valvular heart disease or coronary artery disease during isometric exercise.…”

Section: Discussionmentioning

confidence: 99%

Isometric exercise for the evaluation of vasodilatory therapy in severe congestive heart failure

Hertrich

Winkelmann

Leinberger

1988

Cardiovasc Drug Ther

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There are few data available about the hemodynamic effects of isometric handgrip in severe congestive heart failure and its role in the evaluation of vasodilatory therapy. Therefore, we studied 20 patients with dilated cardiomyopathy at rest, during isometric handgrip, and during supine bicycle exercise before and after a single 25-mg dose of captopril. During handgrip, heart rate (p less than 0.001); systemic vascular resistance (p less than 0.01); systolic, mean, and diastolic pulmonary artery pressure (p less than 0.01) increased significantly; stroke volume index fell (p less than 0.05); whereas mean arterial pressure showed only a small increase, and cardiac index did not change. In contrast, mean arterial pressure and cardiac index increased during dynamic exercise (p less than 0.001), and peripheral resistance decreased (p less than 001). During both handgrip and bicycle exercise, captopril induced a decrease of arterial pressure (p less than 0.01 and p less than 0.001; respectively), peripheral resistance (p less than 0.001 and p less than 0.01; respectively), and systolic (p less than 0.01 and p less than 0.001, respectively) mean (p less than 0.001), and diastolic pulmonary artery pressure (p less than 0.001). Captopril induced and increase in stroke volume index (p less than 0.01) and cardiac index (p less than 0.001 and p less than 0.01 respectively) during both types of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…The average peak magnitude of ST-segment depression was not significantly different among dynamic, combined static-dynamic and postprandial dynamic effort, -0.09 ± 0.13, -0.11 ± 0.13 and -0.11i± 0.14 mV, respectively. Exercise-induced angina pectoris or ischemic ST-segment depression was noted in 16 patients (67%) during at least one of the three exercise conditions and in 12 rate-pressure product measured during exercise. The presence or absence of exercise-induced ischemic STsegment depression and angina pectoris was as negatively correlated with peak heart rate alone (r = -0.28, -0.22, and -0.36) as with peak rate-pressure product (r = -0.26, -0.22 and -0.37) during dynamic, static-dynamic and postprandial dynamic effort, respectively.…”

Section: Ischemic Responsesmentioning

confidence: 99%

“…Counts gated to the patient's ECG were collected in 16 equal time frames within each cardiac cycle and summed to produce a single composite cycle of 16 frames for each minute. For each successive cycle of 16 frames, a normalization program was used to compensate for variations in the number of counts in each frame due to alterations of cycle length.…”

Section: Patient Testing Protocol (Fig 1) Visit 1 -Pretestmentioning

confidence: 99%

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Comparison of cardiovascular response to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone in patients with chronic ischemic heart disease.

Hung¹,

McKillip²,

Savin³

et al. 1982

Circulation

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SUMMARY The cardiovascular responses to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone were evaluated by upright bicycle ergometry during equilibrium-gated blood pool scintigraphy in 24 men, mean age 59 ± 8 years, with chronic ischemic heart disease. Combined static-dynamic effort and the postprandial state elicited a peak cardiovascular response similar to that of dynamic effort alone: work load 643 ± 156 and 638 ± 161 vs 650 i 153 kg-m/min, respectively; heart rate 147 ± 14 and 145 ± 14 vs 143 ± 17 beats/min; systolic pressure 195 i 26 and 200 ± 25 vs 197 ± 25 mm Hg; and rate-pressure product 286 ± 48 and 292 ± 55 vs 282 ± 52. Heart rate, intraarterial systolic and diastolic pressures, ratepressure product and ejection fraction were similar for the three test conditions at the onset of ischemia and at peak effort. The prevalence and extent of exercise-induced ischemic left ventricular dysfunction, ST-segment depression, angina pectoris and ventricular ectopic activity were also similar during the three test conditions. Direct and indirect measurements of systolic and diastolic blood pressure were highly correlated. The onset of ischemic ST-segment depression and angina pectoris correlated as strongly with heart rate alone as with the rate-pressure product during all three test conditions. The cardiovascular response to combined static-dynamic effort and to postprandial dynamic effort becomes more similar to that of dynamic effort alone as dynamic effort reaches a symptom limit. If significant ischemic and arrhythmic abnormalities are absent during symptom-limited dynamic exercise testing, they are unlikely to appear during combined static-dynamic or postprandial dynamic effort. This simplifies the task of formulating guidelines for physical effort in patients with chronic ischemic heart disease, especially in providing "clearance" to perform avocational and vocational tasks involving combined static-dynamic and postprandial dynamic effort.EXERCISE TESTING for the detection of ischemic ST-segment depression or angina pectoris is usually performed in the fasting state, with care to avoid the static effort involved in gripping of handrails or of handlebars. Although such testing accurately reflects the cardiovascular response to isolated dynamic effort, it does not simulate the superimposition of static on dynamic effort or of dynamic effort in the postprandial state -circumstances to which patients with ischemic heart disease are exposed during their customary activities.Patients with ischemic heart disease are usually advised to avoid dynamic activities in which there is a significant static component, but we' and others2' 3 have noted a lower incidence of exercise-induced ischemic ST-segment depression or angina pectoris when patients performed combined static-dynamic effort than when they performed dynamic effort alone. Haissly et al.2 measured a higher diastolic blood pressure during combined static-dynamic effort than during dynamic effort alone and attributed the lower...

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Modification of left ventricular diastolic behavior by isometric handgrip exercise.

Cited by 30 publications

References 76 publications

Impaired left ventricular diastolic function during isometric exercise in asymptomatic patients with hyperlipidaemia

Impaired left ventricular diastolic function during isometric exercise in asymptomatic patients with hyperlipidaemia

Isometric exercise for the evaluation of vasodilatory therapy in severe congestive heart failure

Comparison of cardiovascular response to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone in patients with chronic ischemic heart disease.

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