Radionuclide angiographic assessment of left ventricular function during exercise in patients with a severely reduced ejection fraction

Schoolmeester, W. Lawrence; Simpson, Alastair; Sauerbrunn, Bertram J. L.; Fletcher, Ross D.

doi:10.1016/0002-9149(81)90177-6

Cited by 29 publications

(2 citation statements)

References 17 publications

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“…Although our heart failure group presented lower resting ejection fraction, they were able to improve left ventricular systolic function at the anaerobic threshold. Previous studies on heart failure patients as well as normal subjects reported significant increase in left ventricular ejection fraction at the anaerobic threshold intensity, with the exception of those who had exercise-induced myocardial ischemia (6,7,16,17). Thus, our heart failure patients presented an appropriate left ventricular systolic function response to exercise, while our post-left ventriculotomy patients did not increase left ventricular ejection fraction at the anaerobic threshold intensity.…”

Section: Discussionsupporting

confidence: 49%

Abnormal response of left ventricular systolic function to submaximal exercise in post-partial left ventriculotomy patients

Herdy¹,

Moritz²,

Assis³

et al. 2007

Braz J Med Biol Res

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Patients with heart failure who have undergone partial left ventriculotomy improve resting left ventricular systolic function, but have limited functional capacity. We studied systolic and diastolic left ventricular function at rest and during submaximal exercise in patients with previous partial left ventriculotomy and in patients with heart failure who had not been operated, matched for maximal and submaximal exercise capacity. Nine patients with heart failure previously submitted to partial left ventriculotomy were compared with 9 patients with heart failure who had not been operated. All patients performed a cardiopulmonary exercise test with measurement of peak oxygen uptake and anaerobic threshold. Radionuclide left ventriculography was performed to analyze ejection fraction and peak filling rate at rest and during exercise at the intensity corresponding to the anaerobic threshold. Groups presented similar exercise capacity evaluated by peak oxygen uptake and at anaerobic threshold. Maximal heart rate was lower in the partial ventriculotomy group compared to the heart failure group (119 ± 20 vs 149 ± 21 bpm; P < 0.05). Ejection fraction at rest was higher in the partial ventriculotomy group as compared to the heart failure group (41 ± 12 vs 32 ± 9%; P < 0.0125); however, ejection fraction increased from rest to anaerobic threshold only in the heart failure group (partial ventriculotomy = 44 ± 17%; P = nonsignificant vs rest; heart failure = 39 ± 11%; P < 0.0125 vs rest; P < 0.0125 vs change in the partial ventriculotomy group). Peak filling rate was similar at rest and increased similarly in both groups at the anaerobic threshold intensity (partial ventriculotomy = 2.28 ± 0.55 EDV/s; heart failure = 2.52 ± 1.07 EDV/s; P < 0.0125; P > 0.05 vs change in partial ventriculotomy group). The abnormal responses demonstrated here may contribute to the limited exercise capacity of patients with partial left ventriculotomy despite the improvement in resting left ventricular systolic function. Correspondence

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Section: Discussionsupporting

confidence: 49%

Abnormal response of left ventricular systolic function to submaximal exercise in post-partial left ventriculotomy patients

Herdy¹,

Moritz²,

Assis³

et al. 2007

Braz J Med Biol Res

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“…Mitral regurgitation, unlike IDC, is associated with well preserved LV ejection fraction until far advanced and causes elevated resting and exercise pulmonary wedge pressure "V" waves (Greenberg et ul., 1982). Ischemic heart disease causing heart failure also produces lowered resting LV ejection fraction, but usually causes a further reduction in ejection fraction with exercise (Schoolmeester et al, 1981).…”

Section: Discussionmentioning

confidence: 99%

The exercise response in idiopathic dilated cardiomyopathy

Kirlin

Das

Zijnen

et al. 1984

Clinical Cardiology

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Summary:In order to more clearly define the exercise response of idiopathic dilated cardiomyopathy (IDC), 20 patients in this study with strictly defined IDC were evaluated with radionuclide ventriculography and invasive hemodynamic monitoring. Severe cardiovascular impairment was present at rest, and peak supine exercise produced progressive left ventricular (LV) dilatation in both diastole and systole (meanf SEM from 172 f 14 to 212f22 ml/m2 at end-diastole and from 137f14 to 170 f 22 d / m 2 at end-systole; both p < 0.03). There were marked increases in LV and right ventricular filling pressure (from 17 f 2 to 36 f 3 mmHg and from 7 f 2 to 15 f 2 mmHg, respectively; both p O.8), but individual patients demonstrated substantial variability. Cardiac output rose less than in normals and increases were brought about primarily by subnormal heart rate increases. High resting and exercise systemic and pulmonary vascular resistance were indicative of limited vasodilator reserve. Despite marked hemodynamic abnormalities, 10 of the 20 subjects had well preserved exercise capacity ( 2 12 min exercise duration). These patients as a group had significantly lower resting heart rate and higher exercise cardiac output and lower exercise systemic vascular resistance. However, they did not differ from the other patients with respect to resting LV function. Thus, the exercise response in IDC has specific characteristics that distinguish it from normal and from the exercise response of other causes of LV dysfunction. An interesting subset of patients with IDC has well preserved exercise capacity associated with greater chronotropic and vasodilator reserve. This finding suggests less sympathetic activation in these subjects.

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Multiple Gated Equilibrium Blood Pool Imaging (MUGA)

Kumar

Integrating Cardiology for Nuclear Medicine Physicians

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Radionuclide angiographic assessment of left ventricular function during exercise in patients with a severely reduced ejection fraction

Cited by 29 publications

References 17 publications

Abnormal response of left ventricular systolic function to submaximal exercise in post-partial left ventriculotomy patients

Abnormal response of left ventricular systolic function to submaximal exercise in post-partial left ventriculotomy patients

The exercise response in idiopathic dilated cardiomyopathy

Multiple Gated Equilibrium Blood Pool Imaging (MUGA)

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