Differences in myocardial velocities during supine and upright exercise stress echocardiography in healthy adults

Abstract

Summary Background: Tissue Velocity Imaging (TVI) is a method for quantitative analysis of longitudinal myocardial velocities, which can be used during exercise and pharmacological stress echocardiography. It is of interest to evaluate cardiac response to different types of stress tests and the differences between upright and supine bicycle exercise tests have not been fully investigated. Therefore, the aim of this study was to compare cardiac response during supine and upright exercise stress tests. Method: Twenty young healthy individuals underwent supine and upright stress test. The initial workload was set to 30 W and was increased every minute by a further 30 W until physical exhaustion. Tissue Doppler data from the left ventricle were acquired at the end of every workload level using a GE Vivid7 Dimension system (>200 frames s−1). In the off‐line processing, isovolumic contraction velocity (IVCV), peak systolic velocity (PSV), isovolumic relaxation velocity (IVRV), peak early diastolic velocity (E’) and peak late diastolic velocity (A’) were identified at every workload level. Result: No significant difference between the tests was found in PSV. On the contrary, E’ was shown to be significantly higher (P<0·001) during supine exercise than during upright exercise and IVRV was significantly lower (P<0·001) during supine exercise compared to upright exercise. Conclusion: Upright and supine exercise stress echocardiography give a comparable increase in measured systolic velocities and significant differences in early diastolic velocities.

CME. Orthostatic Effects on Echocardiographic Measures of Ventricular Function

“…Moving to an upright position in the present study also affected significant declines in values of both TDI‐E′ and TDI‐S (−44% and −20%, respectively). The changes in absolute measures of Doppler tissue velocities in this study by assuming the sitting position mimic those reported by Bjallmark et al in their study of 10 women and 10 men 11 . In that investigation, average TDI‐S lateral velocities were 9.7 ± 2.3 cm/sec supine and 8.0 ± 2.6 cm/sec sitting on a cycle ergometer, while respective mean values for TDI‐E′ were 14.0 ± 4.2 and 8.1 ± 2.2 cm/sec.…”

“…The changes in absolute measures of Doppler tissue velocities in this study by assuming the sitting position mimic those reported by Bjallmark et al in their study of 10 women and 10 men. 11 In that investigation, average TDI-S lateral velocities were 9.7 ± 2.3 cm/sec supine and 8.0 ± 2.6 cm/sec sitting on a cycle ergometer, while respective mean values for TDI-E were 14.0 ± 4.2 and 8.1 ± 2.2 cm/sec. These Doppler echocardiographic alterations reflect the combined effects of a mixed array of hemodynamic effects on myocardial function.…”

Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise

“…We found that the peak velocity of systolic LV contraction was higher in the endurance athletes during exercise of moderate-to-maximal intensity, but not at rest. The highest PSV values (i.e., in the EG group during performance at VO 2max ) observed here are among the highest reported to date (Støylen et al 2003;Saha et al 2004;Bjällmark et al 2009). Furthermore, endurance athletes demonstrated an increase in PSV during exercise.…”

Quantitative Analysis of Stress Echocardiograms in Healthy Horses with 2-Dimensional (2D) Echocardiography, Anatomical M-Mode, Tissue Doppler Imaging, and 2D Speckle Tracking

“…The significant increase in S m is in accordance to studies in people, indicating an increase in LV systolic performance during and after exercise. [40][41][42][43] The significant increase in PEP/ET can be explained with the increase in HR and the slight but not significant decrease in preload (reflected by LVIVd). 16,44 None of the other TDI variables changed consistently and significantly after exercise.…”