Tissue Doppler assessment of ventricular function during cycling in 7- to 12-yr-old boys

Studies utilizing submaximal supine exercise have indicated that tissue Doppler imaging (TDI) may be useful for assessing ventricular systolic and diastolic function during exercise and might offer a means of detecting patients with early myocardial dysfunction. This investigation of 14 healthy boys ages 7-12 yr was designed to assess measures of inotropic and lusitropic function during maximal upright cycle exercise.

Color tissue Doppler imaging (S and E' waves, indicative of systolic and diastolic function, respectively), stroke volume, and mitral peak inflow velocity (E wave) were recorded at rest and during a progressive upright cycle test to exhaustion.

Values of TDI-S and TDI-E' were obtained at exhaustive exercise in all but one subject. Mean value of S rose 163% (3.8+/-1.2 to 10.0+/-2.5 cm.s), and average E' increased by 92% (-6.3+/-2.2 to -12.1+/-3.2 cm.s). No significant changes were observed in the ratio of E' to mitral peak flow velocity (E), suggesting that left ventricular end-diastolic pressure remained stable.

These data indicate that measurement of TDI is feasible during maximal upright exercise, and velocities obtained may provide insights into ventricular systolic and diastolic functional capacity.