Left Ventricular Diastolic Function During Acute Increase in After-Load in Men With Coronary Artery Disease

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Hemodynamic and left ventricular diastolic filling were studied by Echo-Doppler in male subjects: 16 healthy subjects (53 ± 3 yrs) and 18 patients with coronary artery disease (50.5 ± 3 yrs), at rest and during upright isometric exercise, which involved the hands, hips, legs, and lower back muscle groups (deadlift) at 30% of maximum voluntary contraction for 3 min. Mitral peak early diastole (E) did not differ significantly between the two groups. At rest, patients with coronary artery disease showed significantly (P < 0.001) higher values for presystolic maximal velocity (A) 66 ± 15 cm · sec−1 than the healthy subjects 49.1 ± 20.2 cm · sec−1. The E/A ratio was reduced significantly (P < 0.001) in the coronary artery disease patients. During exercise, the different patterns found at rest between the two groups were more prominent; healthy subjects maintained a significantly (P < 0.001) higher E/A ratio 1.16 ± 0.4 compared to coronary artery disease patients 0.82 ± 0.3 and lower atrial filling fraction (25.7 ± 4.1% and 48.9 ± 10% respectively). These data indicate that isometric deadlift exercise stress increased the reliance on atrial support in both groups, especially in exercise-trained men with coronary artery disease. However, the test did not help in separating the two groups in a convincing manner.

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