Filling pressures in post-myocardial infarction patients: comparison between isometric and dynamic exercise

The purpose of this study was to determine if isometric exercise (handgrip) using a substantial muscle mass and intensity could be substituted for dynamic exercise in the assessment of left ventricular function in myocardial infarct (MI) patients. Forty patients with documented MI were assigned, on the basis of their previous exercise ECG responses, to either an exercise-induced ischaemic group (Group 1) or to a non-exercise ischaemic group (Group 2). Eight apparently healthy males served as controls. Pulmonary capillary pressure (PCP) was measured at rest, during volume loading and during isometric and dynamic exercise. Mean PCP in Group 1 increased progressively from 7.5 +/- 2.9 mmHg at rest, to 11.6 +/- 3.8 mmHg during volume loading, to 18.8 +/- 10.2 mmHg during the isometric exercise and to 25.2 +/- 10.1 mmHg during the dynamic exercises. For Group 2, the respective values were 9.6 +/- 6.3, 13.1 +/- 6.4, 18.7 +/- 13.7 and 18.4 +/- 9.8 and for the controls 8.9 +/- 1.9, 11.3 +/- 1.2, 13.3 +/- 3.3 and 11.8 +/- 3.6 mmHg. The results of this study indicate that isometric exercise of 50% MVC using both hands can adequately replace dynamic exercise in the diagnosis of left ventricular function in post MI patients.