Circulation, Vol 60, 1292-1300, Copyright © 1979 by American Heart Association
HJ Berger, DE Johnstone, JM Sands, A Gottschalk and BL Zaret
The right ventricular (RV) response to exercise was assessed in 32 patients
with angiographically documented coronary artery disease and in 14 normal
controls without cardiopulmonary disease. The relationships between
exercise RV reserve, exercise left ventricular (LV) reserve, and the
presence of proximal right coronary stenosis were also evaluated. RV and LV
ejection fractions were determined using first-pass radionuclide
angiocardiograms. The normal response to exercise was at least a 5%
absolute increase in RV and LV ejection fractions. In the group with
coronary artery disease, RV ejection fraction either decreased or remained
the same with exercise (abnormal exercise RV reserve) in 19 of 32 patients.
LV exercise reserve was abnormal in 26 of 32 patients. All 19 patients with
abnormal exercise RV reserve had abnormal exercise LV reserve, and all six
patients with normal LV reserve had normal RV reserve. There was a
significant linear relationship between the direction and magnitude of
change from rest to exercise of LV ejection fraction and RV ejection
fraction (r = 0.77). In contrast, the RV response to exercise was not
primarily dependent upon the presence or absence of proximal right coronary
stenosis. These data suggest that abnormal exercise RV reserve occurs
frequently in coronary artery disease and that the concomitant LV response
to exercise appears to be its major determinant.
ARTICLES
Response of right ventricular ejection fraction to upright bicycle exercise in coronary artery disease
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