Ventricular response to isometric and isotonic exercise. Echocardiographic assessment

The effects of supine isometric handgrip and graded isotonic bicycle ergometer exercise on left ventricular performance were studied echocardiographically in 20 normal subjects, aged 18 to 36. Measurements of the left ventricular minor axis diameter were taken from recordings performed at rest, during each form of exercise, and during recovery. At the completion of isometric exercise, the pressure-rate product increased significantly. There was no significant change in percentage of fractional shortening (%deltaD), while there was a small but significant fall in peak velocity of circumferential fibre shortening (peak Vcf). Isotonic exercise resulted in a significant increase in %deltaD and peak Vcf. The pressure-rate product also increased and showed a positive correlation with peak Vcf. Isotonic exercise produced a much greater stimulus to left ventricular contractility than isometric exercise and may be a useful means of detecting latent left ventricular dysfunction echocardiographically.