Doppler indexes of left ventricular filling after exercise in 50-year-old healthy persons

Exercise-induced myocardial ischemia has been shown to alter left ventricular (LV) diastolic filling. An abnormal response of Doppler indexes of LV filling during and after exercise testing has been demonstrated to be a sensitive marker of coronary artery disease. A paucity of data is available regarding reference values and the physiological variation in LV filling indexes after exercise in healthy subjects of similar age. We therefore evaluated 77 healthy subjects (33 men and 44 women) aged 50 years by Doppler echocardiography at rest and 15 and 60 minutes after exercise testing. The peak velocity of early diastolic filling (E-wave), the peak velocity of atrial filling (A-wave), the early to atrial peak velocity (E/A) ratio and the deceleration time of early velocity were measured. There was a decrease in the E/A ratio 15 minutes after exercise compared with the E/A ratio at rest in women (1.13 +/- 0.23 vs 1.23 +/- 0.27; p <0.001) and men (1.03 +/- 0.22 vs 1.15 +/- 0.20; p <0.001). The E/A ratio 60 minutes after exercise did not differ significantly from rest in women (1.23 +/- 0.27 vs 1.18 +/- 0.24; p = NS), but men had a lower E/A ratio 60 minutes after than before exercise (1.04 +/- 0.23 vs 1.15 +/- 0.20; p <0.001). There was no difference in deceleration time of the E-wave before and after exercise. Multivariate analysis revealed that the E/A ratio 15 and 60 minutes after exercise was strongly independently associated with the E/A ratio at rest (p <0.001) and heart rate 15 and 60 minutes after exercise (p <0.005) in both women and men. It is concluded that there is a physiological decrease in the E/A ratio 15 minutes after exercise in healthy subjects, and Doppler LV filling indexes after exercise are strongly associated with LV filling indexes at rest and with heart rate.