The effect of exercise-induced myocardial ischemia on postischemic left ventricular diastolic filling.
To determine whether exercise-induced ischemia impairs left ventricular diastolic filling in the postischemic period in humans, 101 men (mean age 57 +/- 10 years) were studied before and 2 h after a symptom-limited thallium-201 tomographic treadmill with pulsed Doppler echocardiography of mitral valve inflow. In the postischemic period 2 h after exercise, diastolic filling was significantly impaired in the ischemia group (reversible thallium defect; n = 24) as reflected by a decrease in the peak early filling velocity (44.5 +/- 10.1 to 39.9 +/- 9.9 cm/s, p less than 0.01), peak early to atrial filling velocity ratio (0.91 +/- 0.27 to 0.76 +/- 0.25, p less than 0.001), and deceleration rate of early filling (281 +/- 104 to 245 +/- 86 cm/s2, p less than 0.01). Similar alterations in the postischemic period occurred in the myocardial infarction-ischemia group (partially reversible defect; n = 28) as seen by a decrease in the peak early filling velocity (47.6 +/- 11.6 to 41.8 +/- 12.0 cm/s, p less than 0.001), peak early to atrial filling velocity ratio (0.84 +/- 0.21 to 0.68 +/- 0.18, p less than 0.001), and early time-velocity integral (7.06 +/- 1.78 to 5.64 +/- 2.07 cm, p less than 0.001). In the control group (no defects; n = 33) and myocardial infarction group (fixed defect; n = 16), diastolic filling was unchanged in the postexercise period. Heart rate and blood pressure were unchanged post-exercise in all groups. Exercise-induced ischemia impairs diastolic filling in the postischemic period in humans.(ABSTRACT TRUNCATED AT 250 WORDS)
Stoddard
M F
MF
Cardiovascular Divsion, University of Louisville School of Medicine, Kentucky 40292.
Johnstone
J
J
Dillon
S
S
Kupersmith
J
J
D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left / Q000502:physiology*
D013794:Thallium Radioisotopes