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[Changes in left ventricular function with effort in the coronary patient. l].

J C Quiret, J L Rey, M T Courbet

    Archives Des Maladies Du Coeur Et Des Vaisseaux
    |July 1, 1977
    PubMed
    Summary

    Coronary patients exhibit altered heart function during exercise. Angina patients show exercise-induced left ventricular dysfunction, while healed infarct patients have a rigid ventricle, and those with sequelae experience heart failure.

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    Area of Science:

    • Cardiology
    • Cardiovascular Physiology
    • Exercise Medicine

    Background:

    • Coronary artery disease significantly impacts cardiac hemodynamics.
    • Understanding left ventricular function in patients with coronary artery disease is crucial for diagnosis and management.

    Purpose of the Study:

    • To investigate the altered hemodynamics in coronary patients at rest and during maximal exercise.
    • To differentiate left ventricular function changes based on infarction history and sequelae.

    Main Methods:

    • Study included 30 coronary patients.
    • Hemodynamic parameters were assessed at rest and during maximal exercise using a bicycle ergometer.
    • Exercise electrocardiogram was performed under standard conditions.

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    Main Results:

    • Patients with angina of effort (no prior infarction) showed normal resting left ventricular function but acute dysfunction (reduced cardiac output, elevated end-diastolic pressure, altered compliance) during exercise-induced ischemia.
    • Patients with healed infarcts (no sequelae) presented with a rigid left ventricle, normal contractility indices (dP/dt max), but abnormal myocardial compliance (negative peak dP/dt, elevated end-diastolic pressure, reduced deltaP/deltaV).
    • Patients with infarction and sequelae (angina, heart failure) exhibited elevated resting filling pressures and exercise-induced cardiac failure.

    Conclusions:

    • Left ventricular dysfunction during exercise is a key feature in coronary patients, varying with infarction history.
    • Myocardial compliance is a sensitive indicator of subclinical left ventricular abnormality in healed infarcts.
    • Exercise stress testing effectively unmasks latent or worsening cardiac failure in patients with coronary artery disease and sequelae.