Document Detail

Left ventricular systolic performance during upright bicycle exercise in patients with essential hypertension.
MedLine Citation:
PMID:  6226194     Owner:  NLM     Status:  MEDLINE    
Left ventricular performance was evaluated at rest and during maximal upright bicycle exercise in 51 patients with chronic essential hypertension. Twenty-eight of these patients had no clinical or electrocardiographic evidence of coronary artery disease and comprise the primary study population. The remaining 23 patients had coronary artery disease and represent a comparison group. First-pass radionuclide angiocardiograms were obtained at rest and during maximal upright bicycle exercise, allowing evaluation of global left ventricular ejection fraction and regional wall motion. At the time of the radionuclide studies, all patients were hypertensive, defined as a diastolic blood pressure 90 mm Hg or greater and/or a systolic blood pressure 140 mm Hg or greater with the patient at rest and sitting. In the primary study group, the left ventricular functional response to upright bicycle exercise was normal in 26 of 28 patients. Left ventricular ejection fraction averaged (+/- standard error) 65 +/- 2 percent at rest and increased significantly to 76 +/- 2 percent with exercise (p less than 0.001). Regional wall motion was normal both at rest and during exercise in all patients. Seventeen patients had electrocardiographic evidence of left ventricular hypertrophy, and 14 were receiving propranolol therapy. The left ventricular functional response also was normal in these subgroups. In contrast to the nearly uniform normal left ventricular responses noted in the patients with hypertension alone, the group with concomitant coronary artery disease had a markedly higher incidence of abnormal left ventricular reserve (19 of 23 versus two of 28, p less than 0.001) during exercise. Thus, in most patients with essential hypertension but without concomitant coronary artery disease, left ventricular reserve during exercise was normal. Hypertension, even with left ventricular hypertrophy, should not be viewed as the cause for an abnormal left ventricular response to exercise in a patient undergoing diagnostic exercise radionuclide angiocardiography.
C K Francis; M Cleman; H J Berger; R A Davies; R W Giles; H R Black; N Vita; R A Zito; B L Zaret
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of medicine     Volume:  75     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1983 Sep 
Date Detail:
Created Date:  1983-11-23     Completed Date:  1983-11-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  40-6     Citation Subset:  AIM; IM    
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MeSH Terms
Blood Pressure
Cardiomegaly / etiology,  physiopathology
Coronary Disease / physiopathology,  radionuclide imaging
Exercise Test*
Heart / radionuclide imaging
Heart Ventricles / physiopathology*
Hypertension / physiopathology*,  radionuclide imaging
Middle Aged
Propranolol / therapeutic use
Stroke Volume
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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