Mild supine leg exercise in patients with severe angina significantly increased left ventricular end-diastolic pressure from 19 to 30 mm Hg (P≤0.001) without significantly increasing stroke volume.
Observational (n=19)
Does mild supine leg exercise alter left ventricular performance in patients with severe coronary artery disease?
In patients with severe coronary artery disease, mild exercise induces a significant rise in left ventricular end-diastolic pressure without a corresponding increase in stroke volume, demonstrating impaired left ventricular performance.
Absolute Event Rate: 30% vs 19%
p-value: p=≤0.001
Left ventricular (LV) performance was studied during mild exercise (100 kg-m/min for 3 minutes) in 19 cases of coronary artery disease (CAD). Each patient suffered from a severe anginal syndrome. None had ventricular aneurysm, cardiomegaly, or clinical heart failure. Mean resting values follow: LV end-diastolic pressure (LVEDP), 19 ± 7 mm Hg; LV systolic pressure (LVSP), 150 ± 16 mm Hg; stroke volume index (SVI), 48 ± 10 ml/beat/m 2 ; and LV stroke work index (LVSWI), 81 ± 19 g-m/m 2 . During exercise LVEDP rose to 30 ± 8 mm Hg ( P ≤0.001) and LVS to 160 ± 20 (not significant NS); SVI diminished to 46 ± 11 (NS) and LVSWI, to 76 ± 24 (NS). Patients with decreased or asynchronous areas of LV myocardium identified on cine left ventriculograms had higher mean LVEDPs during exercise than did those with normal ventriculograms (34 ± 10 versus 26 ± 4 mm Hg; P ≤0.05). The difference between responses to exercise of patients who experienced angina during the study and of those who did not was NS. Administration of nitroglycerin reduced the increase in LVEDP during exercise. An abnormality in LV performance-a significant rise in LVEDP without a significant increase in SVI or LVSWI-was observed in 13 of 19 cases of CAD.
McCallister et al. (Sat,) conducted a observational in Coronary artery disease with severe anginal syndrome (n=19). Mild supine leg exercise vs. Resting state was evaluated on Left ventricular end-diastolic pressure (LVEDP) (p=≤0.001). Mild supine leg exercise in patients with severe angina significantly increased left ventricular end-diastolic pressure from 19 to 30 mm Hg (P≤0.001) without significantly increasing stroke volume.
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