What question did this study set out to answer?

To assess the hemodynamic effects of isometric exercise and determine whether sustained handgrip can reliably evaluate left ventricular reserve in patients with heart disease.

December 1, 1971Circulation

Effects of Isometric Exercise on Cardiac Performance

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Why the study?

Does sustained handgrip isometric exercise provide a simple test for evaluating left ventricular reserve in patients with heart disease?

Population

22 patients with heart disease undergoing diagnostic cardiac catheterization

Comparison

Standard isometric exercise for at least 4… vs Control state (baseline before handgrip)

Design

Cross-sectional

Authors

CKCharles F KivowitzCedars-Sinai Medical Center WPWilliam W. ParmleyHeart Failure & Transplant RDROBERTO DONOSOCedars-Sinai Medical Center

Discussion

Member takes

Implication

Sustained handgrip may support LV reserve evaluation during catheterization; leaves open prospective validation before clinical adoption.

Key Points

To assess the hemodynamic effects of isometric exercise and determine whether sustained handgrip can reliably evaluate left ventricular reserve in patients with heart disease.
Assessed 22 patients with heart disease performing a sustained handgrip exercise during diagnostic cardiac catheterization.
Measured mean arterial pressure, coronary sinus blood flow, myocardial oxygen consumption, systemic vascular resistance, stroke-work index, and left ventricular end-diastolic pressure (LVEDP) at baseline and during the fourth minute of exertion.
Mean arterial pressure increased from an average of 87 to 104 mm Hg, while coronary sinus blood flow and myocardial oxygen consumption increased by an average of 45% in all monitored patients.
Systemic vascular resistance increased in 19 patients during sustained isometric exertion.
Left ventricular function curves correlated with NYHA functional classification: patients with good reserve showed increased stroke-work with minimal change in LVEDP, while patients with poor reserve exhibited reduced stroke-work alongside substantial increases in LVEDP.

Structured PICO

Does sustained handgrip isometric exercise provide a simple test for evaluating left ventricular reserve in patients with heart disease?

Population

22 patients with heart disease undergoing diagnostic cardiac catheterization

Intervention

Standard isometric exercise (sustained handgrip) for at least 4 minutes during cardiac catheterization

Comparator

Control state (baseline before handgrip)

Outcome

Left ventricular reserve (relation between left ventricular stroke-work index and left ventricular end-diastolic pressure [LVEDP])surrogate

Sustained handgrip during cardiac catheterization provides a simple and effective physiological stress test for evaluating left ventricular reserve in patients with heart disease.

Cite This Study

Kivowitz et al. (1971) studied this question.

synapsesocial.com/papers/6a858067fc70cb81dc202cb2 https://doi.org/10.1161/01.cir.44.6.994

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Effects of Isometric Exercise on Cardiac Performance

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Effects of Isometric Exercise on Cardiac Performance

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider