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Pronounced reduction of aortic flow velocity and acceleration during heavy isometric exercise in coronary artery

E Z Fisman1, E Ben-Ari, A Pines

  • 1Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Hashomer, Israel.

The American Journal of Cardiology
|August 15, 1991
PubMed

Insights

Isometric exercise reveals distinct aortic flow patterns in men with coronary artery disease (CAD). These Doppler-derived changes, particularly reduced peak flow velocity and stroke work, can help identify CAD extent.

Area of Science:

  • Cardiovascular Physiology
  • Diagnostic Imaging
  • Exercise Cardiology

Background:

  • Coronary artery disease (CAD) affects cardiac function during exertion.
  • Non-invasive Doppler ultrasound can assess hemodynamic responses.

Purpose of the Study:

  • To identify Doppler-derived aortic flow parameters that differentiate men with CAD from healthy controls during isometric exercise.
  • To explore the relationship between exercise-induced Doppler patterns and the severity of CAD.

Main Methods:

  • Pulsed Doppler ultrasound at the suprasternal notch was used.
  • 48 men with CAD and 48 healthy controls performed 50% maximal voluntary contraction isometric exercise.
  • Key parameters analyzed included peak flow velocity, acceleration time, stroke volume index, and cardiac index.

Main Results:

  • Resting parameters showed no significant group differences.
  • Mean acceleration and stroke work were significantly lower in the CAD group.
  • During exercise, CAD patients exhibited significantly greater reductions in peak flow velocity, flow velocity integral, mean acceleration, and stroke volume index compared to controls.
  • Acceleration time increased significantly more in CAD patients during exercise.

Conclusions:

  • Doppler-derived aortic flow parameters during isometric exercise can distinguish between men with and without CAD.
  • The magnitude of exercise-induced hemodynamic changes correlates with CAD severity, particularly in multi-vessel disease.
  • These findings suggest Doppler assessment during exertion is valuable for evaluating CAD.

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