HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Peter, C. A. Articles by Jones, R. H. Search for Related Content PubMed PubMed Citation Articles by Peter, C. A. Articles by Jones, R. H.

Effects of Isometric Handgrip and Dynamic Exercise on Left-Ventricular Function

Howard Hughes Medical Institute and Duke University Medical Center, Durham, North Carolina

Correspondence: For reprints contact: Robert H. Jones, MD, P. O. Box 2986, Duke Univ. Medical Ctr., Durham, NC 27710.

ABSTRACT

Radionuclide angiocardiography was used to assess cardiac function during isometric handgrip and bicycle exercise in ten normal volunteers and on 20 patients with documented coronary artery disease. Handgrip stress evoked a small increase in cardiac output that resulted from a concomitant increase in heart rate and no change in left-ventricular function. The most reliable criterion for diagnosis of coronary artery disease by handgrip was development of a new wall-motion abnormality. However, abnormal wall motion was observed in only 45% of patients with coronary artery disease and in one of the ten normal subjects. In normal subjects, left ventricular function during bicycle exercise was characterized by an increase in left-ventricular ejection fraction with little change in cardiac volumes. The failure to increase left-ventricular ejection fraction by at least 0.05 identified 19 of 20 patients with coronary artery disease with no false positives. Therefore, bicycle exercise evokes a more dramatic cardiovascular response than handgrip stress and is the preferable stress modality for inducing abnormalities of left-ventricular function for detection of coronary artery disease.