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Left ventricular function during sudden strenuous exercise

C Foster, J D Anholm, C K Hellman

    Circulation
    |March 1, 1981
    PubMed
    Summary
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    Sudden strenuous exercise (SSE) can cause ischemia-like changes in healthy individuals. This study found that while SSE may induce subendocardial ischemia, it appears to be a physiological response rather than pathological.

    Area of Science:

    • Cardiology
    • Exercise Physiology

    Background:

    • Strenuous exercise without warm-up can induce ischemia-like electrocardiographic (ECG) abnormalities.
    • These changes are linked to myocardial supply/demand imbalance and decreased coronary blood flow.
    • Subendocardial ischemia is a proposed mechanism for the response to sudden strenuous exercise (SSE).

    Purpose of the Study:

    • To investigate if SSE alters left ventricular (LV) pump performance, indicative of ischemia.
    • To evaluate LV function during rest, graded exercise, and SSE in well-trained athletes.

    Main Methods:

    • First-pass radionuclide angiography was used to assess LV function in nine young, well-trained male volunteers.
    • LV function was measured at rest, during graded exercise, and during SSE.
    • Parameters assessed included LV ejection fraction and ejection rate, and segmental wall motion.

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    Main Results:

    • During graded exercise, LV ejection fraction and rate increased significantly.
    • During SSE, LV ejection fraction decreased markedly, while ejection rate remained relatively constant.
    • No segmental wall motion abnormalities were observed during SSE, though diffuse hypokinesis was noted.
    • Few ECG abnormalities were observed during SSE, contrasting with previous reports.

    Conclusions:

    • The findings support subendocardial ischemia as a mechanism in the response to SSE.
    • The absence of significant ECG changes and segmental wall motion abnormalities suggests a physiological rather than pathological basis for any ischemia during SSE.