title: Relationship of exercise capacity and left ventricular dimensions in patients with a normal ejection fraction. An exploratory study.
abstract: OBJECTIVE
  Extreme endurance exercise is known to be associated with an enlargement of the left ventricular (LV) chamber, whereas inactivity results in inverse changes. It is unknown if these dimensional relationships exist in patients.
  
  
  METHODS
  We analyzed the relationship of exercise capacity and LV dimension in a cohort of sequential patients with a normal ejection fraction undergoing stress echocardiography. In a total of 137 studies the following questions were addressed: (a) is there a difference in LV dimensions of patients with an excellent exercise capacity versus patients with a poor exercise capacity, (b) how is LV dimension and exercise capacity affected by LV wall thickness and (c) how do LV dimensions of patients who are unable to walk on a treadmill compare to the above groups.
  
  
  RESULTS
  Patients with a poor exercise capacity or who are unable to physically exercise have a 34 percent smaller LV cavity size when compared to patients with an excellent exercise capacity (p<0.001). This reduction in LV chamber size is associated with concentric LV hypertrophy and a reciprocal increase in resting heart rate. In addition, cardiac output reserve is further blunted by chronotropic incompetence and a tachycardia-induced LV volume reduction. In conclusion the relationship of exercise capacity and cardiac dimensions described in extreme athletes also applies to patients. Our exploratory analysis suggests that patients who cannot sufficiently exercise have small LV cavities.
authors.affiliation: Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont, United States of America.
authors.forename: Markus
authors.initials: M
authors.lastname: Meyer
authors.affiliation: Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont, United States of America.
authors.forename: Rachel K
authors.initials: RK
authors.lastname: McEntee
authors.affiliation: Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont, United States of America.
authors.forename: Iwan
authors.initials: I
authors.lastname: Nyotowidjojo
authors.affiliation: Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont, United States of America.
authors.forename: Guoxiang
authors.initials: G
authors.lastname: Chu
authors.affiliation: Division of Cardiology, University of Vermont College of Medicine, Burlington, Vermont, United States of America.
authors.forename: Martin M
authors.initials: MM
authors.lastname: LeWinter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002302:Cardiac Output; D025401:Echocardiography, Stress; D017079:Exercise Tolerance; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D013318:Stroke Volume; D016276:Ventricular Function