Radionuclide absolute left ventricular volumes during upright exercise: validation in normal subjects by simultaneous hemodynamic measurements

Abstract

A nongeometric radionuclide technique for the determination of absolute left ventricular volumes was validated during exercise in nine normal subjects. Simultaneous reference stroke volume and cardiac output measurements were obtained by the Fick method. The reference left ventricular volumes were calculated by combining the Fick stroke volume and the isotopic ejection fraction. Data were collected at rest in the supine and upright positions and during 60 degrees upright exercise, at three levels of increasing severity. At rest, from supine to upright position, the reference end-diastolic volume decreased significantly from 182 +/- 24 ml to 154 +/- 21 ml (mean +/- SD, P less than 0.005); during upright exercise of low intensity, end-diastolic volume increased to 176 +/- 24 ml (P less than 0.05); at maximal exercise, end-diastolic volume was not different from the resting value in upright position. The end-systolic volume gradually decreased at rest from 67 +/- 11 ml in the supine position to 54 +/- 8 ml in the upright position (P less than 0.05). Compared with these reference data, the scintigraphic measurements were significantly lower on average by 23% for stroke volume, 21% for cardiac output, 22% for end-diastolic volume, and 23% for end-systolic volume. The overall changes in stroke volume (P less than 0.05) and end-systolic volume (P less than 0.001) occurring at rest and during exercise were correctly detected by the scintigraphic method but the smaller changes in end-diastolic volume (less than 15%) were not (P less than 0.15) because they were within the range of the precision of the technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of Rest and Exercise on Cardiac Blood Volume Determinations

“…Most of the previous reports dealing with the determination of changes in LV volumes in response to exercise, using radionuclide count-based method and peripheral blood sampling have often ignored the possible effects of exercise or intervention on blood activity (1,4,8,25,26). On the other hand, some investigators have taken into account the changes in blood activity during time and exercise (13,17,30,40), whereas others have found that blood activity does not change with exercise (28,36).…”