Left ventricular volumes during exercise in endurance athletes assessed by contrast echocardiography

Sundstedt, Milena; Hedberg, Pär; Jonason, Tommy; Ringqvist, Ivar; Brodin, Lärs-Åke; Henriksen, Egil

doi:10.1111/j.1365-201x.2004.01304.x

Cited by 35 publications

(28 citation statements)

References 19 publications

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“…The inconsistent results of previous studies [4-7,11,12,14,26] may be explained by differences in imaging modalities and, perhaps most important, body position. The results of this study are in line with other studies of supine exercise showing unchanged LVEDV [5,9,10,27,28].…”

Section: Discussionmentioning

confidence: 83%

Moderate intensity supine exercise causes decreased cardiac volumes and increased outer volume variations: a cardiovascular magnetic resonance study

Steding‐Ehrenborg

Jablonowski

Arvidsson

et al. 2013

Journal of Cardiovascular Magnetic Resonance

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BackgroundThe effects on left and right ventricular (LV, RV) volumes during physical exercise remains controversial. Furthermore, no previous study has investigated the effects of exercise on longitudinal contribution to stroke volume (SV) and the outer volume variation of the heart. The aim of this study was to determine if LV, RV and total heart volumes (THV) as well as cardiac pumping mechanisms change during physical exercise compared to rest using cardiovascular magnetic resonance (CMR).Methods26 healthy volunteers (6 women) underwent CMR at rest and exercise. Exercise was performed using a custom built ergometer for one-legged exercise in the supine position during breath hold imaging. Cardiac volumes and atrio-ventricular plane displacement were determined. Heart rate (HR) was obtained from ECG.ResultsHR increased during exercise from 60±2 to 94±2 bpm, (p<0.001). LVEDV remained unchanged (p=0.81) and LVESV decreased with −9±18% (p<0.05) causing LVSV to increase with 8±3% (p<0.05). RVEDV and RVESV decreased by −7±10% and −24±14% respectively, (p<0.001) and RVSV increased 5±17% during exercise although not statistically significant (p=0.18). Longitudinal contribution to RVSV decreased during exercise by −6±15% (p<0.05) but was unchanged for LVSV (p=0.74). THV decreased during exercise by −4±1%, (p<0.01) and total heart volume variation (THVV) increased during exercise from 5.9±0.5% to 9.7±0.6% (p<0.001).ConclusionsCardiac volumes and function are significantly altered during supine physical exercise. THV becomes significantly smaller due to decreases in RVEDV whilst LVEDV remains unchanged. THVV and consequently radial pumping increases during exercise which may improve diastolic suction during the rapid filling phase.

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Section: Discussionmentioning

confidence: 83%

Moderate intensity supine exercise causes decreased cardiac volumes and increased outer volume variations: a cardiovascular magnetic resonance study

Steding‐Ehrenborg

Jablonowski

Arvidsson

et al. 2013

Journal of Cardiovascular Magnetic Resonance

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“…A previous study reported that the O2 pulse was equivalent to the stroke volume calculated echocardiographically at the maximal HR during ramp exercise. 18 Therefore, we believe that the O2 pulse substantially reflects the stroke volume and is a parameter of cardiac function during exercise. It is generally known that HR is 2-to 3-fold higher at maximum exercise than at rest, despite only 1.5-to 2-fold increase in stroke volume.…”

Section: Discussionmentioning

confidence: 99%

Influence of Autonomic Nervous Dysfunction Characterizing Effect of Diabetes Mellitus on Heart Rate Response and Exercise Capacity in Patients Undergoing Cardiac Rehabilitation for Acute Myocardial Infarction

Kasahara

Izawa

Omiya

et al. 2006

Circ J

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ype 2 diabetes mellitus (DM) is not only an independent risk factor for the development of coronary artery disease, but also contributes to mortality through the induction of arrhythmias or sudden death after acute myocardial infarction (AMI). 1 Furthermore, recent epidemiological surveys have shown that the morbidity of DM has rapidly increased in Japan in the past decade and in consequence the incidence of AMI complicated by DM has also increased remarkably. 2 Because exercise capacity is reduced after AMI in patients with DM in comparison with similar patients without DM, comprehensive cardiac rehabilitation (CR) should be instituted in these patients after the onset of AMI. 3,4 It is important to clarify the mechanisms underlying the decline of exercise capacity after AMI in patients with DM, in order to offer the appropriate exercise training program to them.Heart rate (HR) response to exercise is regulated by the balance between sympathetic and parasympathetic nerve (SN and PN) activities in the human body. 5 An insufficient HR response to exercise caused by autonomic nervous dysfunction seems to be an important mechanisms in patients with DM who show decreased exercise capacity. 3,6 It is well known that norepinephrine (NE) secretion from the terminals of the SNs decreases during exercise in patients with DM, as compared with normal subjects. 7 A previous study concerning the relationship between HR response and SN activity during exercise showed that the HR response corresponding to NE secretion is reduced in AMI patients with DM, resulting in a decline in exercise capacity. 3 In addition, it has been reported that patients with DM have not only SN dysfunction but also PN dysfunction, which is shown by a decrease in the high-frequency power (HF) in HR variability (HRV). 8 However, there are few reports evaluating the influence of PN activity separately from SN activity on the HR response to exercise and exercise capacity of patients with AMI, and moreover, the impact of DM in causing insufficient HR response to exercise. It is very important to clarify the mechanism of HR response to exercise regulated by SN and PN activities in order to prescribe appropriate CR that takes in to account the decreased exercise capacity in AMI patients with DM. It is reported that an imbalance of autonomic nervous activities causes excessive elevation of blood pressure and HR during exercise training in patients with AMI 9 and that the marked activation of SN induces ventricular arrhythmias in patients with coronary artery disease. 10 Background The aim of this study was to clarify the influence of sympathetic and parasympathetic nerve (SN and PN) dysfunction on the heart rate (HR) response to exercise and the exercise capacity of patients with acute myocardial infarction (AMI) and diabetes mellitus (DM). Methods and ResultsFifty-two male patients who underwent cardiopulmonary exercise testing (CPX) 1 month after onset of AMI were divided into 2 groups: (DM (+) group, n=20; DM (-) group, n=32). HR, peak oxygen uptake (V •...

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“…The athletes also participated in a third exercise test for volume measurements, which has been described previously (Sundstedt et al, 2004). To summarize, LV volume measurements were performed from the apical view by using contrast echocardiography.…”

Section: Volume Measurementsmentioning

confidence: 99%

“…volume per time, was calculated by dividing the stroke volume, assessed in a previous study (Sundstedt et al, 2004), by the filling time. volume per time, was calculated by dividing the stroke volume, assessed in a previous study (Sundstedt et al, 2004), by the filling time.…”

Section: Filling Ratementioning

confidence: 99%

Echocardiographic Doppler assessments of left ventricular filling and ejection during upright exercise in endurance athletes

Sundstedt

Hedberg

Jonason

et al. 2006

Clin Physio Funct Imaging

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Doppler echocardiography was used to describe left ventricular filling and ejection during upright bicycle exercise in 24 healthy male endurance athletes. The transmitral pressure gradient was estimated and isovolumetric relaxation, filling and ejection time and transmitral and aortic flow velocities were measured at rest and during exercise. From rest to peak exercise (at a heart rate of 160 bpm), the mean left ventricular filling time was shortened by 73%, the ejection time by 31%, while the isovolumetric relaxation time was shortened by 62%. At peak exercise, the maximum aortic flow velocity almost doubled and the maximum transmitral flow velocity more than doubled, with a tenfold increase in the mean transmitral pressure gradient. The increase was significant (P<0.001) at each level of exercise. The left ventricular filling rate measured as volume per time was 185 +/- 62 ml s(-1) at rest and it increased to 986 +/- 192 ml s(-1) at peak exercise. This study demonstrates large changes in diastolic filling indices during upright exercise and it shows that the heart is able to increase its filling rate five times from rest to peak exercise.

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Left ventricular volumes during exercise in endurance athletes assessed by contrast echocardiography

Abstract: By using contrast echocardiography, a large increase in stroke volume in endurance athletes could be explained by an almost linear increase in end-diastolic volume and an initial small decrease in end-systolic volume during incremental upright exercise.

Cited by 35 publications

References 19 publications

Moderate intensity supine exercise causes decreased cardiac volumes and increased outer volume variations: a cardiovascular magnetic resonance study

Moderate intensity supine exercise causes decreased cardiac volumes and increased outer volume variations: a cardiovascular magnetic resonance study

Influence of Autonomic Nervous Dysfunction Characterizing Effect of Diabetes Mellitus on Heart Rate Response and Exercise Capacity in Patients Undergoing Cardiac Rehabilitation for Acute Myocardial Infarction

Echocardiographic Doppler assessments of left ventricular filling and ejection during upright exercise in endurance athletes

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