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Prolonged decrease in cardiac volumes after maximal upright bicycle exercise.

D G Renlund1, E G Lakatta, J L Fleg

  • 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore 21205.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|November 1, 1987
PubMed
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Sequential cardiac blood pool scintigraphy requires equivalent exercise periods. Studies show heart rate increases and cardiac volumes decrease between closely spaced exercise sessions, challenging assumptions of equivalence.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Exercise Physiology

Background:

  • Sequential exercise-gated cardiac blood pool scintigraphy is used to assess therapeutic interventions.
  • The validity of this technique relies on the equivalence of sequential exercise periods.

Purpose of the Study:

  • To determine if two maximal upright exercise periods, separated by 60 minutes, yield equivalent cardiac volumes and function in healthy subjects.
  • To investigate the influence of sympathetic tone on cardiac parameters following exercise.

Main Methods:

  • 14 healthy subjects underwent gated blood pool scintigraphy during two maximal upright exercise periods.
  • Cardiac volumes (end-systolic volume and end-diastolic volume) and heart rate were measured before, between, and during exercise.
  • A second group of 22 subjects received propranolol after the initial exercise to assess the role of sympathetic tone.

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Main Results:

  • Resting heart rate was significantly higher and cardiac volumes were lower 60 minutes after the first exercise period compared to baseline.
  • These differences persisted at low exercise levels but not at maximal workloads.
  • Propranolol administration prevented these post-exercise changes, suggesting sympathetic nervous system involvement.

Conclusions:

  • The assumption that cardiac volumes and function are similar during two closely spaced sequential exercise studies is not always valid.
  • Higher sympathetic tone after exercise may be responsible for persistently elevated heart rate and decreased cardiac volumes.
  • Careful consideration of exercise protocol and subject recovery is necessary for accurate assessment of cardiac function using sequential scintigraphy.