Regional left ventricular mechanical function during isometric exercise in patients with coronary artery disease

Correlation with regional coronary blood flow changes

Nicola Ferrara, Carlo Vigorito, Dario Leosco, Arturo Giordano, Pasquale Abete, Giancarlo Longobardi, Franco Rengo

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The effects of isometric exercise on regional left ventricular mechanical function and regional coronary blood flow were evaluated in 17 patients with significant proximal stenosis of the left anterior descending coronary artery and 10 patients with normal coronary arteriograms. All patients had normal myocardial contractility in the basal condition. All performed isometric handgrip exercise at 50% of the maximal voluntary contraction for 3 min during two-dimensional echocardiographic monitoring and hemodynamic evaluation of great cardiac vein flow by thermodilution technique. During isometric exercise, 7 of the 17 patients with left anterior descending coronary stenosis developed asynergy in the anterior territory (anterior or septal segment, or both) (group I); the remaining 10 showed normal myocardial contraction during the test (group II). The 10 normal subjects manifested no regional asynergy during the test (control group). The increase in great cardiac vein flow at peak isometric exercise was significantly smaller (p <0.01) in group I (+15 ± 8%) than that in group II (+98 ± 48%) and the control group (+64 ± 22%). Anterior coronaryvascular resistance decreased in group II (-32 ± 13%) and in the control group (-25 ± 8%) bus increased in group I (+6 ± 8%, p <0.01 versus group II and control group). These data demonstrate that handgrip-induced myocardial asynergy is associated, in our study patients, with an abnormal response of the regional coronary circulation. The increase in coronary vascular resistance in group I patients with asynergy demonstrates that functional mechanisms play a dominant role in left ventricular mechanical dysfunction induced by isometric exercise.

Original languageEnglish
Pages (from-to)1215-1221
Number of pages7
JournalJournal of the American College of Cardiology
Volume12
Issue number5
DOIs
Publication statusPublished - 1988

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Regional Blood Flow
Left Ventricular Function
Coronary Artery Disease
Exercise
Control Groups
Veins
Myocardial Contraction
Thermodilution
Coronary Circulation
Coronary Stenosis
Left Ventricular Dysfunction
Motor Vehicles
Vascular Resistance
Coronary Vessels
Pathologic Constriction
Hemodynamics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Regional left ventricular mechanical function during isometric exercise in patients with coronary artery disease : Correlation with regional coronary blood flow changes. / Ferrara, Nicola; Vigorito, Carlo; Leosco, Dario; Giordano, Arturo; Abete, Pasquale; Longobardi, Giancarlo; Rengo, Franco.

In: Journal of the American College of Cardiology, Vol. 12, No. 5, 1988, p. 1215-1221.

Research output: Contribution to journalArticle

Ferrara, Nicola ; Vigorito, Carlo ; Leosco, Dario ; Giordano, Arturo ; Abete, Pasquale ; Longobardi, Giancarlo ; Rengo, Franco. / Regional left ventricular mechanical function during isometric exercise in patients with coronary artery disease : Correlation with regional coronary blood flow changes. In: Journal of the American College of Cardiology. 1988 ; Vol. 12, No. 5. pp. 1215-1221.
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abstract = "The effects of isometric exercise on regional left ventricular mechanical function and regional coronary blood flow were evaluated in 17 patients with significant proximal stenosis of the left anterior descending coronary artery and 10 patients with normal coronary arteriograms. All patients had normal myocardial contractility in the basal condition. All performed isometric handgrip exercise at 50{\%} of the maximal voluntary contraction for 3 min during two-dimensional echocardiographic monitoring and hemodynamic evaluation of great cardiac vein flow by thermodilution technique. During isometric exercise, 7 of the 17 patients with left anterior descending coronary stenosis developed asynergy in the anterior territory (anterior or septal segment, or both) (group I); the remaining 10 showed normal myocardial contraction during the test (group II). The 10 normal subjects manifested no regional asynergy during the test (control group). The increase in great cardiac vein flow at peak isometric exercise was significantly smaller (p <0.01) in group I (+15 ± 8{\%}) than that in group II (+98 ± 48{\%}) and the control group (+64 ± 22{\%}). Anterior coronaryvascular resistance decreased in group II (-32 ± 13{\%}) and in the control group (-25 ± 8{\%}) bus increased in group I (+6 ± 8{\%}, p <0.01 versus group II and control group). These data demonstrate that handgrip-induced myocardial asynergy is associated, in our study patients, with an abnormal response of the regional coronary circulation. The increase in coronary vascular resistance in group I patients with asynergy demonstrates that functional mechanisms play a dominant role in left ventricular mechanical dysfunction induced by isometric exercise.",
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