Effect of habitual exercise on left ventricular response to exercise

To evaluate the effects of chronic physical exercise on left ventricular ejection fraction (LVEF) and ejection rate (LVER), radionuclide angiography was performed at rest and during upright-bicycle exercise in 45 healthy men. The subjects varied widely in exercise habits and working capacity. They were divided into three subgroups on the basis of habitual physical activity. Aerobic training was done more than 7, 2-4, and less than 1 h/wk by subgroups of athletes, trained, and untrained men, respectively. The results indicate marked differences in work capacity (298, 233, and 181 W in the athletes, trained, and untrained groups, respectively). Resting LVEF (72, 69, and 68%) and LVER (4.1, 3.4, and 3.6 s-1) were not significantly different among the groups. With maximal exercise, however, small but statistically significant differences in LVEF (75, 69, and 68%; P less than 0.05 athletes vs. trained and athletes vs. untrained) and in LVER (7.5, 6.3, and 5.2 s-1; P less than 0.05 among all groups) were observed. Work capacity was, however, poorly correlated with exercise LVEF (r = 0.18) and LVER (r = 0.47). The results of this study indicate that the enhanced working capacity observed secondary to increases in habitual physical activity can be attributed to differences in LVEF and LVER only in the most general terms. Accordingly the results agree with previous suggestions based primarily on echocardiographic data that the primary cardiac adaptation to exercise is dimensional rather than functional in character.