Noninvasive assessment of changes in myocardial perfusion and ventricular performance following exercise training

Tubau, Julio F.; Witztum, Kathryn F.; Froelicher, Victor F.; Jensen, David G.; Atwood, Emily N.; McKirnan, M. Dan; Reynolds, J. Russell; Ashburn, William L.

doi:10.1016/0002-8703(82)90199-5

Cited by 24 publications

(5 citation statements)

References 44 publications

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“…Some studies have investigated the effect of cardiac rehabilitation on myocardial perfusion in CAD patients, but obtained no significant results. [18][19][20] An assessment of patients by Froelicher et al 18 with 201 Tl scintigraphy following 3-13 months of exercise indicated a subtle improvement in 6 of the patients, but this was not quantified. In 1990, Nohara et al reported an improvement in myocardial perfusion on 201 Tl early images in 7 of 18 CAD patients (39%) and on the delayed image in 5 of the 18 patients (28%).…”

Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Exercise Training on Regional Myocardial Perfusion Changes in Patients With Coronary Artery Disease

Linxue

Nohara²,

Makita³

et al. 1999

Jpn Circ J

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Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Exercise Training on Regional Myocardial Perfusion Changes in Patients With Coronary Artery Disease

Linxue

Nohara²,

Makita³

et al. 1999

Jpn Circ J

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“…24 Briefly, after in vivo red blood cell labeling with technetium-99m radionuclide, angiographic studies were performed in the left anterior oblique projection that best separated both ventricles and the left ventricle from the left atrium. Scintigrams were obtained in list mode and reformatted into 20-msec frames that included only sinus beats within 10% of the average heart rate.…”

Section: Radionuclide Angiographymentioning

confidence: 99%

“…25 The EF response to exercise was considered abnormal if it did not increase by 5 units or if there was a decrease in patients with a resting EF equal to or greater than 70%. 24 …”

Section: Radionuclide Angiographymentioning

confidence: 99%

Impaired left ventricular functional reserve in hypertensive patients with left ventricular hypertrophy.

et al. 1989

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To determine whether patients with hypertension and especially those with left ventricular hypertrophy have subtle changes in cardiac function, we measured the increase in left ventricular ejection fraction and in systolic blood pressure to end-systolic volume index ratio with exercise in 40 hypertensive patients and 16 age-matched normotensive volunteers. Twenty-two hypertensive patients without hypertrophy had normal end-systolic wall stress at rest and exercise responses. In contrast, the 18 patients with echocardiographic criteria for left ventricular hypertrophy demonstrated a significant increase in end-systolic wall stress at rest compared with normal subjects (69 +/- 16 vs. 55 +/- 15 10(3) x dyne/cm2, p less than 0.05) despite having normal resting left ventricular size and ejection fraction. In patients with left ventricular hypertrophy, the increase in ejection fraction with exercise was less than in the normotensive control subjects (7 +/- 7 vs. 12 +/- 8 units, p less than 0.05), and delta systolic blood pressure to end-systolic volume with exercise was reduced (3.3 +/- 3.8 vs. 8.3 +/- 7.7 mm Hg/ml/m2, p less than 0.05). The hypertensive patients with hypertrophy displayed a shift downward and to the right in the relation between systolic blood pressure to end-systolic volume ratio and end-systolic wall stress compared with control subjects and hypertensive patients without left ventricular hypertrophy. Thus, hypertensive patients with left ventricular hypertrophy by echocardiography and normal resting ejection fraction exhibit abnormal ventricular functional responses to exercise. This finding may have implications in identifying patients at higher risk for developing heart failure.

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“…Exercise-based rehabilitation programs have a demonstrated beneficial effect on clinical status, as evidenced by improved work capacity,2' 3reduction in incidence of attacks of angina pectoris,4 and indications of a reduction in rates of morbidity/mortality.5 6 Their effect on left ventricular function, which is an important prognosticator of sur-vival in coronary disease,' is not clear. Verani 12 have demonstrated that LVEF fails to change as a result of exercise training, despite a large change in work capacity. Also, the effect of exercise-based rehabilitation in an increasing number of patients after myocardial revascularization surgery (MRS) has been very inadequately documented.…”

mentioning

confidence: 99%

Work capacity and left ventricular function during rehabilitation after myocardial revascularization surgery.

Foster¹,

Pollock²,

Anholm³

et al. 1984

Circulation

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A prospective randomized trial was conducted to evaluate the effects of exercise-based cardiac rehabilitation after myocardial revascularization surgery (MRS) on work capacity (measured in mets) and left ventricular function as determined from ejection fraction (LVEF). Twenty-eight patients undergoing MRS were randomly assigned to experimental (aerobic exercise, n = 19) or control (muscle relaxation and low-level exercise, n = 9) groups. Patients were studied before surgery (T1) and 2 (T2), 8 (T3), and 24 (T4) weeks after surgery with first-pass radionuclide angiography both while they were at rest and during maximal upright cycle ergometric exercise. Subsets of patients were also studied at T2, T3, and T4 at a standard workload of 75 W, and during maximal exercise 1 year after surgery (T5). Work capacity improved in both groups although significantly more so in the experimental group (3.9, 3.8, 6.0, and 7.3 mets and 3.7, 3.7, 4.9, and 5.7 mets at TI, T2, T3, and T4 in the experimental and control groups, respectively). The differences between groups were significant by T3. Peak exercise LVEF increased significantly in both groups from T1 to T2 then decreased at T3 and remained unchanged through T5. Peak exercise LVEF at T3 to T5 remained significantly above that observed at T 1. LVEF responses were not related to the exercise program. During a standard workload, heart rate decreased, blood pressure increased, and LVEF did not change in either group. After conclusion of the formal protocol (T4), work capacity and LVEF did not change for either group throughout an additional 6 months (T5). We conclude that exercise training significantly enhances both the magnitude and rate of the increase in work capacity after MRS, but that peak exercise LVEF is not influenced by the exercise program. Circulation 69, No. 4, 748-755, 1984. THE GROWTH of rehabilitation programs for patients with cardiovascular disease has been impressive during the 25 years since Hellerstein and Ford first presented "an orderly plan for the rehabilitation of the patient with heart disease. "' Exercise-based rehabilitation programs have a demonstrated beneficial effect on clinical status, as evidenced by improved work capacity,2' 3reduction in incidence of attacks of angina pectoris,4 and indications of a reduction in rates of morbidity/mortality.5 6 Their effect on left ventricular function, which is an important prognosticator of sur-

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Noninvasive assessment of changes in myocardial perfusion and ventricular performance following exercise training

Cited by 24 publications

References 44 publications

Effect of Long-Term Exercise Training on Regional Myocardial Perfusion Changes in Patients With Coronary Artery Disease

Effect of Long-Term Exercise Training on Regional Myocardial Perfusion Changes in Patients With Coronary Artery Disease

Impaired left ventricular functional reserve in hypertensive patients with left ventricular hypertrophy.

Work capacity and left ventricular function during rehabilitation after myocardial revascularization surgery.

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