Hemodynamic Predictors of Myocardial Oxygen Consumption During Static and Dynamic Exercise

Nelson, Richard R.; Gobel, Fredarick L.; Jorgensen, Charles R.; Wang, Kyuhyun; Wang, Yan; Taylor, Henry L.

doi:10.1161/01.cir.50.6.1179

Cited by 459 publications

(193 citation statements)

References 56 publications

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“…We noticed that either positive or negative stimulation of the beta-adrenergic receptor led to a decrease in mean systemic blood pressure, although with dobutamine, this effect did not reach statistical significance (p = 0.08). Nevertheless, the RPP, which is known to be well correlated with the oxygen consumption [23], was found to hold true even when the blood pressure was decreased through pharmacological manipulation. In the current study, we were therefore able to confirm the relationship between the RPP and myocardial oxygen consumption.…”

Section: Discussionmentioning

confidence: 94%

“…Among the various parameters that have been proposed to measure the oxygen demand in healthy subjects [8], the heart rate-pressure product (RPP) (heart rate × systolic pressure) is recognized to be a good index of MVO 2 [8,[21][22][23]. In the validation experiment, we were able to calculate the RPP using the heart rate and the measurements of the systolic pressure obtained with the arterial pressure analyzer.…”

Section: Correlation Of the Index Of Myocardial Oxygen Consumptionmentioning

confidence: 99%

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[11C]Acetate rest–stress protocol to assess myocardial perfusion and oxygen consumption reserve in a model of congestive heart failure in rats

Croteau¹,

Gascon²,

Bentourkia³

et al. 2012

Nuclear Medicine and Biology

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This study describes an [ 11 C]acetate rest/stress method to obtain an indirect estimate of myocardial blood flow (MBF) and myocardial oxygen consumption (MVO 2 ) in rats. Doxorubicin cardiotoxicity was used to test the usefulness of this approach for the assessment of congestive heart failure. Methods-[11 C]acetate rest-stress have been used in clinical research to assess the capacity of the coronary arteries to respond to stress. In this article we used this approach to assess the cardiotoxicity of doxorubicin in a rat model. The method was first validated in a group of healthy rats and then used to follow the effect of doxorubicin chemotherapy on cardiac function. The effect of doxorubicin on myocardial perfusion and oxygen consumption reserve was measured at rest and under dobutamine stimulation.Results-Validation of the protocol showed a good correlation between the MBF and MVO 2 (r 2 = 0.68). The doxorubicin treated group showed a significant (p=0.04) decrease in cardiovascular perfusion reserve at 1.3 ± 0.2 compared to the control animals at 1.6 ± 0.2. Similar results were obtained for the myocardial oxygen consumption reserve (treated 1.8 ± 0.4 vs controls 2.3 ± 0.3; p=0.02).Conclusions-We describe an [ 11 C]acetate PET rest/stress protocol for the assessment of cardiotoxicity in rat and its application to the follow-up of doxorubicin chemotherapy. This is a CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript rapid and reliable approach to the measurement of cardiac perfusion and oxygen consumption reserve that could be applied to the development of new strategies to reduce the cardiotoxicity of anthracycline.

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Section: Discussionmentioning

confidence: 94%

Section: Correlation Of the Index Of Myocardial Oxygen Consumptionmentioning

confidence: 99%

[11C]Acetate rest–stress protocol to assess myocardial perfusion and oxygen consumption reserve in a model of congestive heart failure in rats

Croteau¹,

Gascon²,

Bentourkia³

et al. 2012

Nuclear Medicine and Biology

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“…20) Hornsten and Bruce 20) demonstrated that 74% of the total variation in HR was at the first stage of exercise in AF patients. Other studies 8,[17][18][19][20] have found that the increase in HR was maximal at the lowest stage of workload (for example: at 3.0 mph, 0% grade, and under anaerobic conditions) compared to the values at rest; and that less of an increase in HR compared to the first increase occurred at the maximal stage. Therefore, they reported that exercise tests can be used to evaluate the activities of pharmacologic agents for controlling HR in AF patients.…”

Section: Resultsmentioning

confidence: 92%

“…HR increases directly proportional to oxygen uptake and the applied workload. 3) It has been reported that a rapid ventricle response beyond normal was seen at the first stage of static exercise in AF patients 8,[17][18][19] and that this response was higher than in normal subjects. 20) Hornsten and Bruce 20) demonstrated that 74% of the total variation in HR was at the first stage of exercise in AF patients.…”

Section: Resultsmentioning

confidence: 97%

<b>Comparison of Cardiovascular Responses to Isometric (Static) and Isotonic (Dynamic) Exercise Tests in Chronic Atrial Fibrillation</b>

et al. 2002

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SUMMARYThe aim of the present study was to evaluate the tolerance to various exercises by determining the cardiovascular response to static and dynamic exercises in patients with nonvalvular atrial fibrillation.Fifty patients (mean age: 63.6±10.3 years; male: 25, female: 25) with chronic (more than one year) nonvalvular atrial fibrillation were included in the study. All patients underwent exercise tests, adjusted appropriately according to their symptoms, as dynamic exercise on a Marquette Case 15 device according to a modified Bruce protocol. Heart rate, and systolic and diastolic arterial pressures were measured at rest and at all stages of the exercise; and the heart rate-pressure products were evaluated. A handgrip test was also conducted as static exercise. The measurements were made before, at the 1 st , 2 nd and 3 rd minutes, and in the recovery periods of the exercise.The percent values of the changes of the 1 st , 2 nd and 3 rd minute measurements in relation to the initial values for both exercises were compared. In addition, the maximal responses to the exercise tests and the post exercise values were also compared. For statistical evaluations, the paired Student-t test was used.Heart rate and pressure-heart rate product values obtained at 1, 2, and 3 minutes during the treadmill exercise test were significantly high compared to the handgrip values (P<0.0001). The arterial systolic and diastolic pressure values in the 1 st minute were also significantly higher during the handgrip test (P=0.0100 and P=0.0320, respectively). The values of diastolic arterial pressure at the 2 nd minute during the handgrip test, and systolic arterial pressure at the 3 rd minute during the treadmill test were found to be statistically significant (P=0.0240, P=0.0340, respectively). The mean exercise time and MET value during the treadmill exercise test were 7.18±2.65 minutes and 5.32±1.38 mL.kg -1 .dk -1 , respectively.During the recovery period, the 5 th minute, heart rate and pressure-heart rate product values were significantly high after the treadmill test (P<0.0001).In this study, we revealed that the heart rate response to static exercise was lower and the patients tolerated the static exercise better. Therefore, we decided that the short dura-

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“…Neither the extent of STsegment depression nor the attainment of a target heart rate was used as an end point. Maximal voluntary contraction (MVC) for handgrip was determined in the right hand using a Jaymar hand dynamometer 15 mCi of technetium-99m labeled to human serum albumin was injected 2 hours later.…”

Section: Patient Testing Protocol (Fig 1) Visit 1 -Pretestmentioning

confidence: 99%

Comparison of cardiovascular response to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone in patients with chronic ischemic heart disease.

Hung¹,

McKillip²,

Savin³

et al. 1982

Circulation

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SUMMARY The cardiovascular responses to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone were evaluated by upright bicycle ergometry during equilibrium-gated blood pool scintigraphy in 24 men, mean age 59 ± 8 years, with chronic ischemic heart disease. Combined static-dynamic effort and the postprandial state elicited a peak cardiovascular response similar to that of dynamic effort alone: work load 643 ± 156 and 638 ± 161 vs 650 i 153 kg-m/min, respectively; heart rate 147 ± 14 and 145 ± 14 vs 143 ± 17 beats/min; systolic pressure 195 i 26 and 200 ± 25 vs 197 ± 25 mm Hg; and rate-pressure product 286 ± 48 and 292 ± 55 vs 282 ± 52. Heart rate, intraarterial systolic and diastolic pressures, ratepressure product and ejection fraction were similar for the three test conditions at the onset of ischemia and at peak effort. The prevalence and extent of exercise-induced ischemic left ventricular dysfunction, ST-segment depression, angina pectoris and ventricular ectopic activity were also similar during the three test conditions. Direct and indirect measurements of systolic and diastolic blood pressure were highly correlated. The onset of ischemic ST-segment depression and angina pectoris correlated as strongly with heart rate alone as with the rate-pressure product during all three test conditions. The cardiovascular response to combined static-dynamic effort and to postprandial dynamic effort becomes more similar to that of dynamic effort alone as dynamic effort reaches a symptom limit. If significant ischemic and arrhythmic abnormalities are absent during symptom-limited dynamic exercise testing, they are unlikely to appear during combined static-dynamic or postprandial dynamic effort. This simplifies the task of formulating guidelines for physical effort in patients with chronic ischemic heart disease, especially in providing "clearance" to perform avocational and vocational tasks involving combined static-dynamic and postprandial dynamic effort.EXERCISE TESTING for the detection of ischemic ST-segment depression or angina pectoris is usually performed in the fasting state, with care to avoid the static effort involved in gripping of handrails or of handlebars. Although such testing accurately reflects the cardiovascular response to isolated dynamic effort, it does not simulate the superimposition of static on dynamic effort or of dynamic effort in the postprandial state -circumstances to which patients with ischemic heart disease are exposed during their customary activities.Patients with ischemic heart disease are usually advised to avoid dynamic activities in which there is a significant static component, but we' and others2' 3 have noted a lower incidence of exercise-induced ischemic ST-segment depression or angina pectoris when patients performed combined static-dynamic effort than when they performed dynamic effort alone. Haissly et al.2 measured a higher diastolic blood pressure during combined static-dynamic effort than during dynamic effort alone and attributed the lower...

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Hemodynamic Predictors of Myocardial Oxygen Consumption During Static and Dynamic Exercise

Cited by 459 publications

References 56 publications

[11C]Acetate rest–stress protocol to assess myocardial perfusion and oxygen consumption reserve in a model of congestive heart failure in rats

[11C]Acetate rest–stress protocol to assess myocardial perfusion and oxygen consumption reserve in a model of congestive heart failure in rats

<b>Comparison of Cardiovascular Responses to Isometric (Static) and Isotonic (Dynamic) Exercise Tests in Chronic Atrial Fibrillation</b>

Comparison of cardiovascular response to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone in patients with chronic ischemic heart disease.

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