Circulation, Vol 69, 1182-1189, Copyright © 1984 by American Heart Association
GE Billman, PJ Schwartz and HL Stone
The purpose of this study was to investigate the effects of daily exercise
on susceptibility to sudden cardiac death. A 2 min coronary occlusion was
initiated during the last minute of an exercise stress test and continued
for 1 min after cessation of exercise in chronically instrumented dogs with
a healed anterior wall myocardial infarction. Thirteen dogs developed
ventricular fibrillation (VF; susceptible), while five did not (resistant).
Before the exercise plus ischemia test, the baroreflex was evaluated with a
bolus injection of phenylephrine (10 micrograms/kg). The changes in heart
rate caused by a 30 mm Hg increase in systolic arterial pressure as well as
the slopes of either heart rate or RR interval plotted against systolic
arterial pressure were significantly lower in dogs that developed VR
(resistant, -49.6 +/- 7.8; susceptible, -15.3 +/- 6.4 beats/min; p less
than .001). Four resistant and eight susceptible animals were then placed
on a 6 week daily exercise program, while eight susceptible dogs had an
equal period of rest. At the end of the 6 week period the exercise plus
ischemia test was repeated; no susceptible animal that performed daily
exercise developed VF, and all but one of the rested animals did. Daily
exercise improved baroreflex control of heart rate in the susceptible group
but not in the resistant group. Rest did not alter baroreflex function
(change in heart rate after 30 mm Hg increase in systolic arterial
pressure: after 6 weeks of exercise, resistant -43.3 +/- 18.9 beats/min,
susceptible -60.8 +/- 16.6 beats/min; after 6 weeks of rest, susceptible
27.4 +/- 11.0 beats/min). We conclude that daily exercise prevents VF
induced by acute myocardial ischemia in a subpopulation of dogs that were
previously identified as susceptible to sudden cardiac death. Exercise also
altered the autonomic control of the heart, possibly decreasing sympathetic
and/or increasing parasympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
The effects of daily exercise on susceptibility to sudden cardiac death
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