Hemodynamic response to treadmill exercise in normal volunteers: An assessment by Doppler ultrasonic measurement of ascending aortic blood velocity and acceleration

Mehta, N.; Boyle, Gregory J.; Bennett, David; Gilmour, Susan; Noble, Mark I. M.; Mills, C.; Pugh, S.

doi:10.1016/0002-8703(88)90455-3

Cited by 31 publications

(14 citation statements)

References 25 publications

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“…Metoprolol 50 mg decreased peak acceleration at rest and the proportionate reduction in acceleration increased with increasing exercise workload in keeping with the data of Clifton et al [15]. Metoprolol reduced peak velocity both at rest and at 75 watts exercise (P < 0.05 respectively); in accord with the data of Clifton on propranolol 80 mg [15] but not Mehta who demonstrated altered velocity only during exercise following atenolol [24]. Celiprolol 200 mg at rest increased systolic arterial pressure, peak acceleration and velocity (compatible with cardiostimulating properties).…”

Section: Resultssupporting

confidence: 84%

A placebo controlled comparison of the effects of metoprolol and celiprolol on echo‐Doppler measurements of cardiovascular function in normal volunteers.

Silke

Thompson

Leitch

et al. 1995

Brit J Clinical Pharma

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1 This study used a continuous-wave echo-Doppler method (Exerdop) to investigate the effects of ,-adrenoceptor antagonism and partial agonism on cardiovascular responses at rest and during dynamic exercise. 2 A double-blind, randomised, placebo controlled comparison of metoprolol (50 mg) and celiprolol (200 mg) was undertaken in nine normal volunteers; single oral doses of medication were administered at weekly intervals. Rest and exercise (supine bicycle) haemodynamics were assessed at 0, 2, 4, 6 and 8 h following dosing. 3 Before dosing and after placebo, the aortic flow velocity, acceleration and velocity integral increased progressively during exercise, as did heart rate, blood pressure and cardiac output. 4 Following metoprolol 50 mg, heart rate was significantly reduced without change in systolic or diastolic blood pressure. Echo-Doppler peak acceleration and velocity decreased at rest. On exercise, heart rate and systolic blood pressure fell significantly; the increase in acceleration was significantly blunted compared with placebo (a decrease of 15.2% at rest and 22.9% at 75 watts; P < 0.01 vs placebo). Peak velocity fell significantly by 75 watts exercise. 5 Celiprolol 200 mg at rest significantly increased systolic blood pressure, peak acceleration and velocity. On exercise celiprolol, in contrast to metoprolol, did not reduce peak acceleration or peak velocity; however exercise heart rate and systolic blood pressure were significantly reduced. The difference between celiprolol and metoprolol in respect of peak acceleration persisted over the 8 h of the study. 6 These differences between metoprolol and celiprolol are compatible with the partial agonism of celiprolol. The Exerdop parameter of peak acceleration appeared to be the most sensitive indicator of inotropic differences between metoprolol and celiprolol.

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Section: Resultssupporting

confidence: 84%

A placebo controlled comparison of the effects of metoprolol and celiprolol on echo‐Doppler measurements of cardiovascular function in normal volunteers.

Silke

Thompson

Leitch

et al. 1995

Brit J Clinical Pharma

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“…This discrepancy may be explained in part by the age criterion in the different studies. Van Dam et al [11] and Mehta et al [12] examined a wide range of ages (1-65 and 22-64 years, respectively), whilst we focused on the range of 48-60 years -the early postmenopause -a span in which the gender differences may be more evident, as suggested by Voutilainen et al's study [19]. How can the higher aortic flow and hemodynamic parameters in early postmenopausal women as compared with age-matched men be explained?…”

Section: Doppler Flow Parametersmentioning

confidence: 99%

“…Although gender is known to affect hemodynamic parameters during exercise [7][8][9], little information exists on possible gender differences in Doppler-derived aortic flow parameters [10][11][12]. In women, a gradual and consistent decrease in resting Doppler aortic flow parameters takes place during the first years of menopause, probably as a result of estrogen decline [13].…”

Section: Introductionmentioning

confidence: 99%

Exercise‐induced aortic flow parameters in early postmenopausal women and middle‐aged men

Pines

Drory

et al. 1998

Journal of Internal Medicine

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Objective. Exercise Doppler echocardiography has been recognised as an accurate method for the assessment of left ventricular function in patients with coronary artery disease. Gender differences in aortic flow parameters during exercise have not been well established. The aims of this study were to compare basal ejection Doppler indexes in healthy early postmenopausal women with those of men, and to assess the effects of both isometric and dynamic exercises on these parameters. Design. Intergroup comparison between early postmenopausal women and middle-aged men Subjects. Fifteen healthy women with a mean age of 55 (SD 5) years and 15 healthy men aged 52 (SD 4) were evaluated.Setting. Women were recruited from a menopause clinic and men from a primary cardiovascular prevention program at a cardiac rehabilitation institute. Interventions. Isometric exercise was performed with a 2-hand bar dynamometer, and dynamic exercise with a supine ergometer. Echo Doppler examination was performed at rest and at peak isometric and dynamic exercise with a pulsed Doppler transducer. Results. Both types of exercise resulted in higher values of hemodynamic parameters in the women, with most figures reaching statistical significance. Most aortic flow parameters during rest and exercise were also significantly higher in the women. Conclusions. The unexpected higher values in hemodynamic and aortic flow parameters in early postmenopausal women as compared with middle aged men may shed light on a peculiar aspect of gender differences in cardiovascular function, perhaps specific to this age group and related to menopausal transition.

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“…Aortic peak flow velocity and acceleration are well-established Doppler-derived aortic flow parameters of systolic function [14, 15, 16]. In normal individuals, these parameters increase with aerobic exercise, with vasodilator-induced reductions in afterload and with administration of inotropic agents such as dobutamine.…”

Section: Discussionmentioning

confidence: 99%

Attenuated Responses of Doppler-Derived Hemodynamic Parameters during Supine Bicycle Exercise in Heart Transplant Recipients

Auerbach¹,

Tenenbaum²,

Motro³

et al. 1999

Cardiology

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The aim of this study was to characterize Doppler-derived hemodynamic parameters in heart transplant recipients at rest and during symptom-limited supine bicycle exercise. Eighteen sedentary patients aged 54.0 ± 2 years, 1.6 ± 1.0 years following cardiac transplantation, and 18 sedentary healthy volunteers aged 51.8 ± 4 years were investigated. Basic hemodynamic parameters and Doppler-derived parameters were recorded at rest and at peak dynamic exercise. Resting heart rate, blood pressure and rate-pressure product were higher in the transplanted patients (p < 0.001). However, in comparison with the resting state, the increase in these parameters at exercise was lower in heart transplant recipients. In the healthy, dynamic exercise induced an increase in peak flow velocity, mean acceleration, flow velocity integral, stroke volume, cardiac output and cardiac index (p < 0.001 for all) while systemic vascular resistance, ejection time and acceleration time decreased (p < 0.001 for all). The following parameters increased in the transplanted patients at dynamic exercise: peak flow velocity, cardiac output and cardiac index (p < 0.001), mean acceleration (p < 0.01) and flow velocity integral (p < 0.05). Ejection time decreased (p < 0.05) and acceleration time and systemic vascular resistance remained unchanged. In conclusion, at rest peak flow velocity, mean acceleration, flow velocity integral and stroke volume are lower in the transplanted than in the healthy controls, while cardiac output, cardiac index and systemic vascular resistance are equal. Our study demonstrates attenuated responses of basic hemodynamic parameters and Doppler-derived cardiovascular indices at symptom-limited supine bicycle exercise in heart transplant recipients compared to healthy volunteers.

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Hemodynamic response to treadmill exercise in normal volunteers: An assessment by Doppler ultrasonic measurement of ascending aortic blood velocity and acceleration

Cited by 31 publications

References 25 publications

A placebo controlled comparison of the effects of metoprolol and celiprolol on echo‐Doppler measurements of cardiovascular function in normal volunteers.

A placebo controlled comparison of the effects of metoprolol and celiprolol on echo‐Doppler measurements of cardiovascular function in normal volunteers.

Exercise‐induced aortic flow parameters in early postmenopausal women and middle‐aged men

Attenuated Responses of Doppler-Derived Hemodynamic Parameters during Supine Bicycle Exercise in Heart Transplant Recipients

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