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Left ventricular function during exercise testing and training

C Foster1, R A Gal, P Murphy

  • 1Milwaukee Heart Institute, WI 53201-0342, USA. cfoster@facstaff.wics.edu

Medicine and Science in Sports and Exercise
|March 1, 1997
PubMed
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Mild ischemia may not worsen left ventricular function during steady-state exercise, unlike during graded exercise tests. This finding is crucial for understanding exercise tolerance in coronary heart disease patients undergoing training.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Left ventricular ejection fraction (LVEF) typically declines during maximal incremental exercise in patients with ischemia.
  • The impact of steady-state exercise, common in cardiac rehabilitation, on LVEF in these patients remains unclear.

Purpose of the Study:

  • To compare left ventricular (LV) functional response, specifically LVEF, during both graded exercise testing (GXT) and steady-state exercise.
  • To investigate differences in LV function between patients with coronary heart disease (CHD) and ischemia (+ISCH), without ischemia (-ISCH), and healthy controls (CONTROL).

Main Methods:

  • First-pass radionuclide angiography (RNA) was used to measure LVEF and wall motion (WM) during upright cycle GXT (rest, ventilatory threshold [VT], maximal exercise [Max]).
  • RNA was also performed during steady-state exercise at the VT workload for 30 minutes.

Related Experiment Videos

  • Patients with +ISCH experienced mild ischemia and angina, managed by brief workload reductions.

    • Main Results:

    • Patients with +ISCH showed expected LVEF decline during GXT (58% to 54%) with abnormal WM.
    • However, during steady-state exercise, LVEF in +ISCH patients remained stable (56% to 54%) despite mild ischemia.
    • -ISCH and CONTROL groups exhibited normal LVEF responses during both GXT and steady-state exercise.

    Conclusions:

    • Mild ischemia appears to be tolerated during steady-state exercise at training intensities without causing progressive deterioration of LV function.
    • These findings suggest that carefully monitored steady-state exercise may be safe for patients with CHD and mild ischemia.