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At least 541 records · Page 30Linked to original sources
PubMed1963

Indirect measurement of left ventricular function during exercise.

The electrocardiogram, phonocardiogram and carotid pulse curve were recorded during increasing work loads on an electrically braked bicycle. Heart rate increased linearly with increasing work loads while total systole and tension period decreased. In contrast, during the first periods of light work, systolic ejection time increased. As work load increased, the ejection period also decreased. The findings were interpreted as indicating an early increase in stroke volume with exercise and a later increase in the velocity of ejection.

Electrocardiography↗
PubMed2001

Muscle ergoreceptor overactivity reflects deterioration in clinical status and cardiorespiratory reflex control in chronic heart failure.

BACKGROUND: In chronic heart failure (CHF), overactivation of ergoreceptors (afferents sensitive to the metabolic effects of muscular work) may be a link between peripheral changes, sympathetic overactivation, and increased hemodynamic and ventilatory responses to exercise. The relationship between ergoreceptors, autonomic changes, and the progression of the syndrome has not yet been studied. METHODS AND RESULTS: Thirty-eight stable CHF patients (age, 57+/-1 years; ejection fraction, 26+/-2%) were compared with 12 age-matched normal control subjects. The ergoreflex contribution to the ventilatory and hemodynamic responses to exercise, together with peripheral and central chemoreceptor sensitivity, arterial baroreflex sensitivity, plasma norepinephrine, epinephrine, and heart rate variability, were measured. Enhanced ergoreflex effects on ventilation (78+/-2% versus 50+/-8%), peripheral chemosensitivity (0.6+/-0.4 versus 0.2+/-0.1 L/min per percent SaO(2)), and central chemosensitivity (2.9+/-0.2 versus 2.0+/-0.2 L. min(-1). mm Hg(-1)) and an impaired baroreflex function (4.1+/-0.6 versus 9.1+/-5.6 ms/mm Hg) were confirmed in CHF compared with control subjects (P<0.01 in all comparisons). Ergoreceptor overactivity was associated with a worse symptomatic state (NYHA class, P<0.05), lower exercise tolerance (peak VO(2), P<0.05), and pronounced exercise hyperventilation (VE/VCO(2), P<0.01). It was also a strong predictor of increased central chemosensitivity (independently of clinical parameters), baroreflex impairment, and sympathetic activation (plasma catecholamines and heart rate variability indexes; all P<0.05). In multivariate analysis, among all reflexes studied, the ventilatory component of the ergoreflex was the only independent predictor of peak VO(2) and VE/VCO(2). CONCLUSIONS: In CHF, overactivation of the ergoreflex is associated with abnormal cardiorespiratory reflex control, independently of clinical severity. Among impaired reflexes, overactivation of the ergoreflex is an important determinant of exercise hyperventilation and reduced exercise tolerance.

Autonomic Nervous System↗
PubMed1975

Cardiac evaluation of a physical rehabilitation program for patients with ischemic heart disease.

A reconditioning exercise program that was applied to group of 12 coronary patients resulted in an increase of their tolerance to physical work and of their maximal working capacity. In some instances the improvement in physical condition was accompanied by changes in indicators of cardiac function which suggest that an improvement in myocardial performance also occurred. Although some evidence of this has been presented, more studies are needed for substantiation. It is believed, on the other hand, that to explain the improvement of the patient, it is not necessary to invoke an improvement of myocardial performance. An improvement of patient's tolerance to physical work may also be explained by extracardiac mechanisms that produce changes in arterial peripheral resistance, regional blood flow distribution, overall mechanical efficiency, muscle capillarization, fiber size and mitochondrial enzymatic activity, patterns of sweating, adaptation between pulmonary ventilation and circulation, work of breathing efficiency, autonomic nervous system balance and in the adaptive responses of the neuroendocrine system which mediate between psychic and physiological behavior. All of these changes have been observed in healthy individuals submitted to physical training. It is plausible to assume that they may also occur in the patient with ischemic heart disease. What is to be shown is which one or which ones of these mechanisms prevail in a given individual.

Adult↗
PubMed1988

Functional cardiac assessment before and after left ventricular anterior aneurysm repair, especially as related to work capacity.

Clinical, angiographic and hemodynamic parameters were assessed preoperatively and 12-20 weeks (mean +/- SD: 14 +/- 2) after left ventricular anterior aneurysmectomy in 31 consecutive patients. In 18 patients, associated coronary artery bypass surgery was necessary (1.4 grafts/patient). One patient with mitral valve insufficiency postoperatively required mitral valve replacement. No other complications and no deaths arose. The working capacity of the patients, as measured by bicycle exercise testing, compared a stage of exercise that the patient reached to the expected level of exercise for a normal person of the same sex, age and body surface. Expressed as percent of normals it increased from 39.3 +/- 28.9% (mean +/- SD) to 60.8 +/- 15.5% (p less than 0.001), angina-pectoris-free working capacity increased from 52.6 +/- 41.4 to 89.2 +/- 33.2 W (p less than 0.001). Left ventricular end-diastolic volume was determined by simultaneous biplane angiography and decreased from 277.1 +/- 84.7 to 191.0 +/- 49.1 ml (p less than 0.001). Ejection fraction increased from 35.4 +/- 12.4 to 41.0 +/- 9.6% (p less than 0.05). Left ventricular end-diastolic pressure after angiography decreased from 24.6 +/- 9.2 to 21.1 +/- 11.3 mm Hg (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Long term use of enalapril in the treatment of patients with congestive heart failure.

Fifty-five patients of both sexes, aged 39-72, suffering from congestive heart failure of varying aetiology were admitted to a double blind study in which enalapril given in a dose of 5-10 mg twice daily or placebo was added to existing medication. A significant increase in exercise performance (P less than 0.004) was seen in the group treated with enalapril, an improvement which was still evident after 24 weeks of therapy. No significant difference was seen between the mean ejection fractions but subjective assessment suggested improvement in the enalapril-treated group.

Adult↗