Effects of exercise training on left ventricular function in normal subjects: A longitudinal study by radionuclide angiography

Rerych, Stephen K.; Scholz, Peter; Sabiston, David C.; Jones, Robert H.

doi:10.1016/0002-9149(80)90642-6

Cited by 156 publications

(64 citation statements)

References 29 publications

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“…These included biplanar chest x-ray with ECG-triggered exposure,1l epicardial and midmyocardial silver-tantalum markers,'2 13 dye dilution," contrast ventriculography,15 echocardiographic measurements"'8 17 and geometric calculation of left ventricular volume from ventricular silhouettes obtained during first-pass nuclear angiography. 18 The conflicting data obtained studies that used x-ray measurement of total heart veral attempts to assess this, using gated nuclear volume in trained athletes during exercise. ' Whatever the mechanism, trained subjects do not rely on the Frank-Starling mechanism during exercise.…”

Section: Resultsmentioning

confidence: 99%

Left ventricular function in trained and untrained healthy subjects.

Bar-Shlomo¹,

Druck²,

Morch³

et al. 1982

Circulation

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SUMMARY Left ventricular function was compared in 18 normal sedentary controls (mean age 28 years, range 22-34 years) and nine endurance-trained athletes (mean age 19 years, range 15-25 years) at rest and during supine bicycle exercise. Gated radionuclide angiocardiograms were performed at rest and at each level of graded maximal supine bicycle exercise. Heart rate, blood pressure, left ventricular ejection fraction and the relative changes in left ventricular end-diastolic and end-systolic volumes were assessed. Athletes attained a much greater work load than controls (mean 22.1 kpm/kg body weight vs 13 kpm/kg body weight). Both groups achieved similar increases in heart rate, blood pressure and ejection fractions. In the controls, the mean end-diastolic volume increased to 124% of that at rest (p < 0.02) during exercise and the mean end-systolic volume decreased to 81% of the rest level (p < 0.02). In contrast, the mean end-diastolic volume did not significantly change during exercise in the athletes, and the mean end-systolic volume decreased to 64% of rest (p < 0.05). Thus, although trained and untrained healthy subjects had similar increases in the left ventricular ejection fraction during exercise, different mechanisms were used to achieve these increases. Untrained subjects increased end-diastolic volumes, whereas trained subjects decreased the end-systolic volumes. The ability of athletes to exercise without increasing preload may be an effect of training and might have important implications in reducing myocardial oxygen demand during exercise.ALTHOUGH the human left ventricular response to exercise has been the focus of many studies in the last several decades, the data on some aspects of this subject conflict. Until computer-assisted gated radionuclide cardiac angiography became available, accurate serial assessment of left ventricular volume at rest and during exercise was not technically possible.To address the question of normal left ventricular volume and ejection fraction response to exercise, we studied 18 healthy untrained subjects at rest and during supine bicycle exercise. We also studied nine endurance-trained athletes to determine whether exercise training alters the left ventricular response to exercise. Materials and Methods SubjectsThe study population consisted of 18 normal sedentary control subjects and nine endurance-trained

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Section: Resultsmentioning

confidence: 99%

Left ventricular function in trained and untrained healthy subjects.

Bar-Shlomo¹,

Druck²,

Morch³

et al. 1982

Circulation

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“…Determination of the level of radioactivity in the 5 ml sample and assessment of the total radioactive dose administered (correcting for the amount initially in the syringe and the amount remaining after administration) allowed for the measurement of total blood volume by the dilution principle (Rerych et al 1980).…”

Section: Radionuclide Assessment Of Blood Volumementioning

confidence: 99%

“…Recent investigations and previously overlooked findings (Rerych et al 1980;Spriet et al 1986;Gledhill et al 1994;Di Bello et al 1996;Krip et al 1997;Wiebe et al 1998;Warburton et al 1998Warburton et al , 1999a have challenged this notion and indicate that endurance-trained athletes may rely on different mechanisms to increase their ÿ during the later stages of vigorous exercise. For instance, investigations using highly trained endurance athletes (i.e.…”

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confidence: 99%

Myocardial Response to Incremental Exercise in Endurance‐Trained Athletes: Influence of Heart Rate, Contractility and the Frank‐Starling Effect

Warburton

Haykowsky

Quinney

et al. 2002

Experimental Physiology

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Recent evidence indicates that endurance-trained athletes are able to increase their stroke volume (SV) throughout incremental upright exercise, probably due to a progressively greater effect of the Frank-Starling mechanism. This is contrary to the widely held belief that SV reaches a plateau at a submaximal heart rate (irrespective of fitness level), owing to a limitation in the time for diastolic filling. The purpose of this investigation was to evaluate whether endurance-trained athletes rely on a progressively greater effect of the Frank-Starling mechanism throughout incremental exercise. A secondary purpose was to evaluate the effects of postural position on the cardiovascular responses to incremental exercise. Ten male cyclists participated in this investigation. Left ventricular function was assessed throughout incremental exercise in the supine and upright positions (counterbalanced) using radionuclide ventriculography. Stroke volume increased in a linear fashion during incremental exercise in both the upright and supine positions. The increases in cardiac output (ÿ) throughout incremental to maximal exercise (in both the supine and upright positions) were significantly related to changes in heart rate, myocardial contractility and the Frank-Starling mechanism. Percentage changes in end-diastolic volume and SV were significantly greater in the upright position versus the supine position, reflecting an increased reliance on the Frank-Starling effect to increase ÿ. We conclude from this investigation that highly trained endurance athletes are able to make progressively increasing usage of the Frank-Starling effect throughout incremental exercise. Postural position has a significant effect on the relative contribution of heart rate, myocardial contractility and the Frank-Starling mechanism to the increase in ÿ during exercise conditions. Experimental Physiology (2002) 87.5, 613-622.

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“…Exercise acutely raises cardiac output through tachycardia, augmented stroke volume, and increased ejection fraction (1). Systemic and pulmonary arterial pressures increase and vascular resistances decrease.…”

mentioning

confidence: 99%

Physical Activity and Right Ventricular Structure and Function: The MESA-Right Ventricle Study.

Aaron¹,

Tandri²,

Barr³

et al. 2009

C27. Right Ventricular Function and Exercise

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Rationale: Intense exercise in elite athletes is associated with increased left ventricular (LV) and right ventricular (RV) mass and volumes. However, the effect of physical activity on the RV in an older community-based population is unknown. Objectives: We studied the association between levels of physical activity in adults and RV mass and volumes. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac magnetic resonance imaging on community-based participants without clinical cardiovascular disease. RV volumes were determined from manually contoured endocardial margins. RV mass was determined from the difference between epicardial and endocardial volumes multiplied by the specific gravity of myocardium. Metabolic equivalent-minutes/day were calculated from the selfreported frequency, duration, and intensity of physical activity. Measurements and Main Results: The study sample (n 5 1,867) was aged 61.8 6 10 years, 48% male, 44% white, 27% African American, 20% Hispanic, and 9% Chinese. Higher levels of moderate and vigorous physical activity were linearly associated with higher RV mass (P 5 0.02) after adjusting for demographics, anthropometrics, smoking, cholesterol, diabetes mellitus, hypertension, and LV mass. Higher levels of intentional exercise (physical activity done for the sole purpose of conditioning or fitness) were nonlinearly associated with RV mass independent of LV mass (P 5 0.03). There were similar associations between higher levels of physical activity and larger RV volumes. Conclusions: Higher levels of physical activity in adults were associated with greater RV mass independent of the associations with LV mass; similar results were found for RV volumes. Exercise-associated RV remodeling may have important clinical implications.Keywords: exercise; pulmonary heart disease; pulmonary hypertension; magnetic resonance imaging Physical activity has many physiologic effects on the cardiovascular system, both acutely and chronically. Exercise acutely raises cardiac output through tachycardia, augmented stroke volume, and increased ejection fraction (1). Systemic and pulmonary arterial pressures increase and vascular resistances decrease. Long-term high-intensity physical activity is associated with increased left ventricle (LV) mass, volume, and wall thickness (2-6), a constellation of changes known as the ''athlete's heart.'' Most studies of the cardiac effects of physical activity focus on LV morphology in small cohorts of young male endurance athletes.The substantial differences in embryology, morphology, perfusion, workload, and downstream vascular beds (and the diseases which affect them) make extrapolation of findings from the LV to the right ventricle (RV) difficult. The small number of studies performed have shown significant effects of intense exercise on RV mass and volumes (3-6). However, because RV structure and function are difficult to measure with standard transthoracic echocardiography, little is known about the relationship between physical activity and RV str...

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Effects of exercise training on left ventricular function in normal subjects: A longitudinal study by radionuclide angiography

Cited by 156 publications

References 29 publications

Left ventricular function in trained and untrained healthy subjects.

Left ventricular function in trained and untrained healthy subjects.

Myocardial Response to Incremental Exercise in Endurance‐Trained Athletes: Influence of Heart Rate, Contractility and the Frank‐Starling Effect

Physical Activity and Right Ventricular Structure and Function: The MESA-Right Ventricle Study.

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