Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women

1995 ◽  
Vol 78 (3) ◽  
pp. 890-900 ◽  
Author(s):  
J. L. Fleg ◽  
F. O'Connor ◽  
G. Gerstenblith ◽  
L. C. Becker ◽  
J. Clulow ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Cardiovascular Response ◽  
Stroke Volume Index ◽  
Left Ventricular ◽  
Cardiac Response ◽  
Volume Index ◽  
Left Ventricular Volumes ◽  
Stroke Work ◽  
Cycle Exercise ◽  
Men And Women

To examine whether age differentially modifies the physiological response to exercise in men and women, we performed gated radionuclide ventriculography with measurement of left ventricular volumes at rest and during peak upright cycle exercise in 200 rigorously screened healthy sedentary volunteers (121 men and 79 women) aged 22–86 yr from the Baltimore Longitudinal Study of Aging. At rest in the sitting position, age-associated declines in heart rate (HR) and increases in systolic blood pressure occurred in both sexes. Whereas resting cardiac index (CI) and total systemic vascular resistance (TSVR) in men did not vary with age, in women resting CI decreased 16% and TSVR increased 46% over the six-decade age span. Men, but not women, demonstrated an age-associated increase of approximately 20% in sitting end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and stroke volume index over this age span. Peak cycle work rate declined with age approximately 40% in both sexes, but at any age it was greater in men than in women even after normalization for body weight. At peak effort, ejection fraction (EF), HR, and CI were reduced similarly with age while ESVI and TSVR were increased in both sexes; EDVI increased 35% with age and stroke work index (SWI) rose 19% in men, but neither was related to age in women; and stroke volume index did not vary with age in either sex. When hemodynamics were expressed as the change from rest to peak effort as an index of cardiovascular reserve function, both sexes demonstrated age-associated increases in EDVI and ESVI and reductions in EF, HR, and CI. However, the exercise-induced reduction in ESVI and the increases in EF, CI, and SWI from rest were greater in men than in women. Thus, age and gender each have a significant impact on the cardiac response to exhaustive upright cycle exercise.

scholarly journals Stress Echocardiography in Hyperthyroidism

1999 ◽  
Vol 84 (7) ◽  
pp. 2308-2313 ◽  
Author(s):  
George J. Kahaly ◽  
Stephan Wagner ◽  
Jana Nieswandt ◽  
Susanne Mohr-Kahaly ◽  
Thomas J. Ryan
Keyword(s):  
Heart Rate ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Stress Echocardiography ◽  
Maximal Exercise ◽  
Stroke Volume Index ◽  
Work Load ◽  
Left Ventricular ◽  
Volume Index ◽  
Systolic Volume

Exertion symptoms occur frequently in subjects with hyperthyroidism. Using stress echocardiography, exercise capacity and global left ventricular function can be assessed noninvasively. To evaluate stress-induced changes in cardiovascular function, 42 patients with untreated thyrotoxicosis were examined using exercise echocardiography. Studies were performed during hyperthyroidism, after treatment with propranolol, and after restoration of euthyroidism. Twenty- two healthy subjects served as controls. Ergometry was performed with patients in a semisupine position using a continuous ramp protocol starting at 20 watts/min. In contrast to control and euthyroidism, the change in end-systolic volume index from rest to maximal exercise was lower in hyperthyroidism. At rest, the stroke volume index, ejection fraction, and cardiac index were significantly increased in hyperthyroidism, but exhibited a blunted response to exercise, which normalized after restoration of euthyroidism. Propranolol treatment also led to a significant increase of delta (Δ) stroke volume index. Maximal work load and Δ heart rate were markedly lower in hyper- vs. euthyroidism. Compared to the control value, systemic vascular resistance was lowered by 36% in hyperthyroidism at rest, but no further decline was noted at maximal exercise. The Δ stroke volume index, Δ ejection fraction, Δ heart rate, and maximal work load were significantly reduced in severe hyperthyroidism. Negative correlations between free T3 and diastolic blood pressure, maximal work load, Δ heart rate, and Δ ejection fraction were noted. Thus, in hyperthyroidism, stress echocardiography revealed impaired chronotropic, contractile, and vasodilatatory cardiovascular reserves, which were reversible when euthyroidism was restored.

scholarly journals P1754 Regional left ventricular longitudinal myocardial dysfunction in mitral valve prolapse could be primary

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P Barbier ◽  
O A Annoh ◽  
G Liu ◽  
M Scorsin ◽  
S Moriggia ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Myocardial Dysfunction ◽  
Stroke Volume Index ◽  
Volume Overload ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Volume Index ◽  
Maximum Strain

Abstract Background Regional left ventricular dysfunction in patients with mitral valve prolapse (MVP) and normal ejection fraction has been described by different Authors, and recent data point to a dysfunction (prevalently longitudinal strain) of the myocardium of the LV base secondary to dilatation of the mitral annulus. Purpose To investigate degree and extent of regional LV dysfunction and its mechanisms in patients with MVP, severe regurgitation and normal global systolic function, compared to patients with equivalent degree of regurgitation but functional etiology (FMR). Methods Speckle-tracking echocardiography was performed in 30 controls (N), and in severe primary (MVP, n= 50) or functional (FMR, n= 20) mitral regurgitation, to measure global, regional and segmental longitudinal peak systolic strain (LPSS, %), and time delay of peak maximum strain (TTPd, ms, calculated as time to peak maximum strain - time of aortic valve closure). Maximum and minimum mitral annulus diameters and area were measured with 3D echo. We also evaluated as recommended: LV end-diastolic volume index (EDVi, ml/m2), ejection fraction (EF, %), and left atrial end-systolic volume index (LAESVi, ml/m2) with 2D echo; LV stroke volume index, and non-invasive pulmonary systolic (PSP, mmHg) and diastolic pressures (PDP), mmHg) with Doppler echo. Results Age, heart rate, BSA and systolic blood pressure were similar between groups. Atrial fibrillation was present in 34% of MVP and 71% of FMR patients. LV EF was normal in MVP and reduced in FMR (43 ± 14 % vs N, p<.001). LV EDVi (MVP: 77 ± 20 ml/m2; FMR: 107 ± 35, both p<.001 vs N) and LAESVi (MVP: 91 ± 26 ml/m2; FMR: 80 ± 30, both p<.001 vs N) were similarly increased (volume overload) in MVP and FMR, as were PSP (MVP: 42 ± 23 ml/m2; FMR: 52 ± 25, both p<.001 vs N) and PDP (MVP: 16 ± 6 ml/m2; MVP: 15 ± 5, both p<.001 vs N). In FMR, LPSS was reduced globally (-12.8 ± 3.3, p<.001 vs N and MVP) and similarly at LV base, papillary and apical levels. In contrast, in MVP global (-19.4 ± 3.7%) and apical (-23.4 ± 4.5%) LPSS were normal, whereas LV base (-12.3 ± 5.8%, p=.003 vs N) and papillary (-17.1 ± 4%, p=.024 vs N) LPSS were reduced; further, LPSS reduction was localized to the anterior (-16 ± 4, p=.028 vs N), lateral (-17 ± 5, p=.006 vs N) and posterior (-16 ± 6, p=.007 vs N) segments, and was associated with an increased TTPd in the same segments in MVP but not in FMR patients. At multivariate analysis, degree and localisation of regional myocardial dysfunction in patients with MVP was not related to the prolapsing scallop, dimension of the mitral annulus, degree of volume overload or pulmonary pressures, or stroke volume index. Conclusions In patients with MVP, severe regurgitation and normal EF, there is a specific dysfunction pattern of regional LV longitudinal function which appears to be primary and not dependent on the degree of preload increase, mitral annulus dilatation, or localization of the prolapsing scallop.

Prediction of Stroke Volume From Oxygen Pulse Measurements in Untrained and Trained Men

1994 ◽  
Vol 19 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Yagesh Bhambhani ◽  
Stephen Norris ◽  
Gordon Bell
Keyword(s):  
Stroke Volume ◽  
Stroke Volume Index ◽  
Volume Index ◽  
Regression Equations ◽  
Cycle Exercise ◽  
Oxygen Pulse ◽  
Difference Formula ◽  
Relationship Of ◽  
The Relationship ◽  
Oxygen Difference

This study examined the relationship of oxygen pulse (O2 pulse) to stroke volume (SV) and arterio-venous oxygen difference [[Formula: see text] diff] during submaximal cycle exercise in untrained (UG) and trained (TG) males. Fourteen volunteers in each group completed an incremental [Formula: see text] max test and a submaximal test at 60% [Formula: see text] max to determine cardiac output (Q) via CO2 rebreathing. [Formula: see text], Q, and heart rate (HR) were used to calculate SV and [Formula: see text] diff. There were no significant differences (p >.05) between the two groups for O2 pulse, SV, and [Formula: see text] diff during submaximal exercise. Stroke volume index (SVI) was significantly higher (p <.05) in the TG. O2 pulse was significantly related to SV and SVI (p <.05) but not to [Formula: see text] diff in both groups. Regression equations for predicting SV from O2 pulse for UG and TG were Y = 6.81X + 26.7, SE = 21.4, r = 0.84, and Y = 10.33X - 32.3, SE = 14.2, r = 0.71, respectively. These results suggest that O2 pulse can be used to predict SV during submaximal cycle exercise in untrained and trained men. Key words: cardiac performance, exercise, training status

scholarly journals The Effects of Levosimendan and Sodium Nitroprusside Combination on Left Ventricular Functions After Surgical Ventricular Reconstruction in Coronary Artery Bypass Grafting Patients

2016 ◽  
Vol 10 (1) ◽  
pp. 138-147 ◽  
Author(s):  
Zeki Temizturk ◽  
Davut Azboy ◽  
Atakan Atalay ◽  
Hakan Atalay ◽  
Omer Faruk Dogan
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Stroke Volume ◽  
Sodium Nitroprusside ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Stroke Volume Index ◽  
Left Ventricular ◽  
Volume Index ◽  
Bypass Grafting

Objective:The aim of our study was to research the effects of levosimendan (LS) and sodium nitroprusside (SNP) combination on systolic and diastolic ventricular function after coronary artery bypass grafting (CABG) who required endoventricular patch repair (EVPR).Patients and Methods:We studied 70 patients with ischemic dilated cardiomyopathy. LS and SNP combination was administered in 35 patients (study group, SG). In the remaining patients, normal saline solution was given (placebo group, PG). Levosimendan (10µgr/kg) started 4 h prior to operation and we stopped LS before the initiation of extracorporeal circulation (ECC). During the rewarming period, we started again levosimendan (10µgr/kg) in combination with SNP (0.1-0.2 µgr/kg/min). If mean blood pressure decreased by more than 25% compared with pre-infusion values, for corrected of mean arterial pressure, the volume loading was performed using a 500 ml ringer lactate. Hemodynamic variables, inotrophyc requirement, and laboratory values were recorded.Results:Five patients died (7.14%) post-surgery (one from SG and 4 from PG) due to low cardiac out-put syndrome (LOS). At the postoperative period, cardiac output and stroke volume index was higher in SG (mean±sd;29.1±6.3vs. 18.4±4.9 mL/min−1/m−2(P<0.0001)). Stroke volume index (SVI) decreased from 29±10mL/m2preoperatively to 22±14mL/m2in the early postoperative period in group 1. This difference was statistically significant(P=0.002). Cardiac index was higher in SG (320.7±37.5vs. 283.0±83.9 mL/min−1/m−2(P=0.009)). The postoperative inotrophyc requirement was less in SG (5.6±2.7vs. 10.4±2.0 mg/kg,P< 0.008), and postoperative cardiac enzyme levels were less in SG (P< 0.01). Ten patients (28.5%) in SG and 21 patients (60%) in PG required inotrophyc support(P<0.001). We used IABP in eight patients (22.8%) in SG and 17 patients (48.5%) in CG(P=0.0001).Conclusion:This study showed that LS and SNP combination impressive increase in left ventricular systolic and diastolic functions including LVEF. The use of this combination achieved more less inotrophics and IABP requirement. We therefore suggest preoperative and peroperative levosimendan and SNP combination.

Clinical Evaluation Gf Right Ventricular Function in Patients with Left Ventricular Assist Device (Lvad)

1992 ◽  
Vol 15 (2) ◽  
pp. 109-113 ◽  
Author(s):  
G.B.W.E. Bennink ◽  
H. Noda ◽  
J.M. Duncan ◽  
O.H. Frazier
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Heart Function ◽  
Venous Pressure ◽  
Stroke Volume Index ◽  
Left Ventricular ◽  
Volume Index ◽  
Stroke Work ◽  
Bridge To Transplant

Right ventricular function (RVF) during LVAD support can be a threat for patient survival. Despite extensive research, RVF and its interference with left heart function is unclear. This study examines RVF in a retrospective analysis of 14 patients. Hemodynamic data were collected, including heart rate (HR), central venous pressure (CVP), mean pulmonary artery pressure (mPAP), total cardiac output (CO), calculated stroke volume index (SVI) and right ventricular stroke work index (RVSWI). In all patients, CO increased gradually throughout the study period; CVP showed no significant decrease; mPAP and PCWP decreased significantly over the time period; SVI improved and RVSWI increased from the starting level prior to implantation of the LVAD. We conclude that the CO improved with a lowering of the right ventricular afterload combined with a decrease in total circulating volume. The improvement of RVF with LV assist makes this device an option as a bridge to transplant.

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