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European Heart Journal 1984 5(9):756-761;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Right and left ventricular ejection fraction and left ventricular volume changes at rest and during exercise in normal subjects

I. BRYNJOLF, H. KELBÆK, O. MUNCK, J. GODTFREDSEN, S. LARSEN, J. ERICKSON and OTHER MEMBERS OF THE ALCAMY-GROUP*

Department of Anesthesia, Department of Clinical Physiology and Nuclear Medicine, Department of Cardiology, Herlev Hospital, University of Copenhagen DK-2730 Herlev Hvidore Hospital, DK-2920 Klampenborg
Department of Medicine B, Frederiksberg Hospital, University of Copenhagen DK-2000 Frederiksberg, Denmark

Received 25 April 1984; revised 18 June 1984; .

Correspondece to: Ingelise Brynjolf, Department of Anesthesia. Herlev Hospital, DK-2730 Herlev, Denmark.

Abstract

The effect of exercise upon right and left ventricular ejection fractions (RVEF and LVEF) as well as the changes upon left ventricular end-diastolic and end-systolic volume indices (LVEDVI and LVESVI) were investigated. Twenty-two normal subjects were studied at rest and during upright submaximal exercise. RVEF was determined using a first-pass method. LVEF was measured using multiple gated blood pool imaging.

During the exercise test ECGs remained normal. HR and BP increased significantly (P<0.01). RVEF increased from 44%±4 (mean±SD) to 60%±6 (P<0.001). LVEF increased from 62%±6 to 76±5 (P<0.001). A wider scatter was observed in {Delta}RVEF than in {Delta}LVEF. There was a 14% increase in LVEDV-index and a 14% decrease in LVESV-index (P<0.001). A multiple regression analysis with {Delta}RVEF as the dependent variable and {Delta}HR, {Delta}systolic BP, {Delta}LVEF, {Delta}LVEDV-index and LVESV-index as independent variables showed a significant correlation between {Delta}RVEF and {Delta}LVEF and {delta}systolic BP (P<0.05). Our data provide insight into the mechanisms by which the pump performance is increased in normal subjects. The central mechanisms observed are the Starling effect and an increase in contractility of the myocardium. This is connected in the general circulation to an increase in afterload, indicating a redistribution of blood from the vascular beds to the muscles and to the heart.

Key Words: Right and left ventricular ejection fraction • Exercise • Left ventricular volume changes


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