title: Effects of isometric handgrip and dynamic exercise on left-ventricular function.
abstract: Radionuclide angiocardiography was used to assess cardiac function during isometric handgrip and bicycle exercise in ten normal volunteers and in 20 patients with documented coronary artery disease. Handgrip stress evoked a small increase in cardiac output that resulted from a concomitant increase in heart rate and no change in left-ventricular function. The most reliable criterion for diagnosis of coronary artery disease by handgrip was development of a new well-motion abnormality. However, abnormal wall motion was observed in only 45% of patients with coronary artery disease and in one of the ten normal subjects. In normal subjects, left ventricular function during bicycle exercise was characterized by an increase in left-ventricular ejection fraction with little change in cardiac volumes. The failure to increase left-ventricular ejection fraction by at least 0.05 identified 19 to 20 patients with coronary artery disease with no false positives. Therefore, bicycle exercise evokes a more dramatic cardiovascular response than handgrip stress and is the preferable stress modality for inducing abnormalities of left-ventricular function for detection of coronary artery disease.
mesh_terms: D000328:Adult; D000790:Angiocardiography; D001794:Blood Pressure; D002302:Cardiac Output; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005121:Extremities; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011877:Radionuclide Imaging; D013318:Stroke Volume