Left ventricular volume and ejection fraction response to exercise in chronic congestive heart failure: difference between dilated cardiomyopathy and previous myocardial infarction |
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| Authors: | W F Shen G S Roubin K Hirasawa C Y Choong B F Hutton P J Harris P J Fletcher D T Kelly |
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| Affiliation: | 1. Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, IN, United States;2. Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States;3. Norwegian University Science and Technology and St Olavs University Hospital, Trondheim, Norway;4. Clinical Exercise Physiology Program, College of Health, Ball State University, Muncie, IN, United States;5. Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States;6. School of Medicine, Stanford University, Palo Alto, CA, United States;7. School of Kinesiology and Health Studies, Department of Medicine, Division of Endocrinology and Metabolism, Queens University, Ontario, Canada |
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| Abstract: | ![]()
To determine if cause influences the left ventricular (LV) volume and ejection fraction (EF) response to exercise, 24 patients with chronic congestive heart failure (CHF) (13 dilated cardiomyopathy [DC], CHF-DC group; 11 previous myocardial infarction [MI], CHF-MI group) and 6 age-matched control subjects underwent simultaneous hemodynamic monitoring and radionuclide ventriculography during semiupright bicycle exercise. Both CHF groups had similar hemodynamic values, LV volumes and EF at rest. Exercise hemodynamics were also similar, but LV volume and EF responses to exercise were different. In the CHF-DC group LV end-diastolic volume increased by 15% during exercise, significantly less (p less than 0.01) than the 44% increase in CHF-MI group. During exercise, EF increased in CHF-DC group, but did not change in CHF-MI group because of a larger increase in end-systolic volume. The slope of mean pulmonary wedge pressure-LV end-diastolic volume relation was steeper in CHF-DC group than in CHF-MI group (p less than 0.01). The study suggests that LV volume and EF response to exercise in patients with CHF depends on the origin of the CHF. |
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