The effects of isometric stress on left ventricular filling in athletes with isometric or isotonic training compared to hypertensive and normal controls

Hypertrophy of the left ventricle may be associated with altered left ventricular filling dynamics. To test whether isometric and isotonic training affect left ventricular filling differently at rest and during isometric stress, 38 males, 13 long distance runners, eight weight-lifters, eight hypertensive patients and nine age-matched healthy male controls with a mean age of 30 +/- 7 years, were studied before and after 90 s of 50% maximal handgrip force. Left ventricular Doppler filling parameters were compared in the four groups while they were resting and during isometric stress testing, and the results assessed in relation to left ventricular mass index and wall stress. All subjects had normal resting filling patterns except for hypertensive patients, and peak meridional wall stress was low in both athletic groups at rest. Weight-lifters had a hypertensive response during isometric stress testing, associated with a reduction in peak E velocity and a marked increase in peak A velocity, resembling the filling pattern in hypertensive subjects. In runners the filling pattern remained normal. Thus, while the resting left ventricular pattern was normal in all athletes, isometric stress testing was associated with a hypertensive filling pattern only in weight-lifters compared to normal filling in runners.