Sensitivity of the physiologically hypertrophied heart to isoproterenol

Cardiovascular reactions to isoproterenol stimulation (2 and 4 micrograms/min for 12 min each) were evaluated in seven endurance-trained athletes (marathon runners, VO2 max 66.0 +/- 3.7 ml/kg) and seven untrained subjects (VO2 max 54.4 +/- 3.6 ml/kg). At rest and during stimulation, the heart rate, blood pressure as well as one-dimensional (end-diastolic and end-systolic dimensions, shortening fraction) and two-dimensional (end-diastolic and end-systolic volumes, ejection fraction, stroke volume, cardiac output) echocardiographic parameters were determined. The increase in the heart rate of the endurance-trained athletes (28%; 2 micrograms/min) (58%; 4 micrograms/min) was less than in the untrained controls (34%/76%). The blood pressure behaved similarly in both groups. The stroke volume of the endurance-trained subjects rose during stimulation (14%, 4 micrograms/min); the end-diastolic volume remained nearly constant as the end-systolic emptying increased. The stroke volume of the untrained subjects tended to decrease as the end-diastolic and end-systolic volumes were reduced. In absolute terms, the shortening fraction and ejection fraction were identical. Referring to the heart rate, however, they were elevated in the endurance-trained subjects. Hence, under isoproterenol the rise in heart rate was weaker and the increase in ventricular performance seemed to be stronger in the trained subjects compared to the untrained controls. The causes appear to be different regulative effects of the autonomic nervous system on the sinus node and the ventricular myocardium; intrinsic cardiac mechanisms remain to be discussed.