Key result
Peak intraventricular pressure difference at early diastole increased significantly from 2.83 mmHg at rest to 5.31 mmHg at 100-W exercise loading, and correlated with torsional deformation.
Why the study?
Does supine bicycle exercise increase early diastolic intraventricular pressure difference (IVPD) and alter its relationship with left ventricular deformation in healthy men?
Observational (n=22)
No
Does supine bicycle exercise increase early diastolic intraventricular pressure difference (IVPD) and alter its relationship with left ventricular deformation in healthy men?
During exercise, torsional deformation plays a critical role in generating early diastolic intraventricular pressure difference (IVPD), which enhances left ventricular sucking force to accommodate increased loading conditions.
Supports torsional deformation driving exercise-augmented early diastolic IVPD; hypothesis-generating for stress imaging in diastolic assessment.
Objective: The aim of this study was to investigate the mechanism underlying the increase in intraventricular pressure difference (IVPD) during exercise. Background: Although left ventricular sucking force during early diastole plays an important role in exercise tolerance, the mechanism by which sucking force increases during exercise remains unclear. Methods: Twenty-two healthy men (age range, 22-37 years) underwent echocardiography at rest and while performing "supine bicycle" exercises that included four workload stages at 25 W, 50 W, 75 W, and 100 W. IVPD was calculated with a one-dimensional Euler equation using color Doppler M-mode data, and its relationship with ventricular wall motion patterns was assessed. Results: Peak IVPD observed at early diastole increased from 2.83±0.65 mmHg at rest to 5.31±0.78 mmHg at 100-W loading (p<0.001). Peak IVPD correlated positively with heart rate and cardiac output and negatively with isovolumic relaxation time and diastolic duration (p<0.001 for all). Only lengthening of circumferential strain during early diastole correlated with IVPD at rest (p=0.046). In all loading conditions, all deformation parameters except for left ventricular length strain significantly correlated with IVPD. Conclusions: IVPD plays an important role in generating diastolic sucking force to adjust to loading conditions during exercise. At rest, only circumferential dilatation generated a pressure gradient, but during exercise, torsional deformation also played an important role in causing IVPD. These results provide new insight into diastolic function during exercise.
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Matsui et al. (2016) conducted an observational in Healthy volunteers (n=22). Supine bicycle exercise vs. Rest was evaluated on Peak intraventricular pressure difference (IVPD) at early diastole (p=<0.001). Peak intraventricular pressure difference at early diastole increased significantly from 2.83 mmHg at rest to 5.31 mmHg at 100-W exercise loading, and correlated with torsional deformation.
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