Circulation, Vol 90, 2324-2332, Copyright © 1994 by American Heart Association
A Koike, M Hiroe, H Adachi, T Yajima, Y Yamauchi, A Nogami, H Ito, Y Miyahara, M Korenaga and F Marumo
BACKGROUND--Resting cardiac function does not necessarily affect exercise
capacity. However, to determine whether it affects early dynamics of oxygen
uptake (VO2) during exercise, we measured VO2 during a constant work rate
and during incremental exercise testing in patients with a history of
myocardial infarction. VO2 kinetics and exercise capacity were compared
between patients with relatively high left ventricular ejection fractions
(LVEF > or = 35%, group 1) and those with lower ejection fractions (LVEF
< 35%, group 2). METHODS AND RESULTS--Forty patients with a history of
prior myocardial infarction (age, 57 +/- 10 years) were monitored during 6
minutes of moderate constant work rate testing (40 +/- 8 W) and during
symptom-limited incremental exercise testing with a cycle ergometer. VO2
was calculated from respired gas analysis on a breath-by-breath basis.
Cardiac output determinations were made with a computerized cadmium
telluride detector every 10 seconds during exercise. The VO2 time constant
during constant work rate exercise was slower in group 2 (58.0 +/- 7.6
seconds) compared with group 1 (45.8 +/- 10.5 seconds, P = .0002),
indicating slower kinetics in group 2. The time constant for the rise in
cardiac output during exercise was also slower in patients with lower EFs
(63.0 +/- 12.8 versus 50.0 +/- 12.2 seconds). However, there were no
differences in exercise capacity parameters, such as the VO2 or cardiac
output at peak exercise, obtained during incremental exercise testing among
the two groups. CONCLUSIONS--The prolonged time constant of VO2, which is
primarily determined during early parts of exercise, reflects delayed
cardiac output response in patients with severely impaired LV function. The
time constant of VO2 during submaximal constant work rate exercise can be
used as a sensitive and discriminant measure of impaired cardiac reserve in
these patients.
ARTICLES
Oxygen uptake kinetics are determined by cardiac function at onset of exercise rather than peak exercise in patients with prior myocardial infarction
Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
This article has been cited by other articles:
 |
|
 |
|
  M. Fischler, M. Maggiorini, L. Dorschner, J. Debrunner, A. Bernheim, S. Kiencke, H. Mairbaurl, K. E. Bloch, R. Naeije, and H. P. B.-L. Rocca Dexamethasone But Not Tadalafil Improves Exercise Capacity in Adults Prone to High-Altitude Pulmonary Edema Am. J. Respir. Crit. Care Med., August 15, 2009; 180(4): 346 - 352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. C. Kemps, E. J. M. Thijssen, G. Schep, B. T. H. M. Sleutjes, W. R. De Vries, A. R. Hoogeveen, P. F. F. Wijn, and P. A. F. M. Doevendans Evaluation of two methods for continuous cardiac output assessment during exercise in chronic heart failure patients J Appl Physiol, December 1, 2008; 105(6): 1822 - 1829. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G H Markovitz, J W Sayre, T W Storer, C B Cooper, and D A Gordon On issues of confidence in determining the time constant for oxygen uptake kinetics * Commentary Br. J. Sports Med., October 1, 2004; 38(5): 553 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Koike, H. Itoh, R. Oohara, M. Hoshimoto, A. Tajima, T. Aizawa, and L. T. Fu Cerebral Oxygenation During Exercise in Cardiac Patients Chest, January 1, 2004; 125(1): 182 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Taniguchi, K. Ueshima, I. Chiba, I. Segawa, N. Kobayashi, M. Saito, and K. Hiramori A New Method Using Pulmonary Gas-Exchange Kinetics To Evaluate Efficacy of {beta}-Blocking Agents in Patients With Dilated Cardiomyopathy Chest, September 1, 2003; 124(3): 954 - 961. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Schalcher, H. Rickli, M. Brehm, D. Weilenmann, E. Oechslin, W. Kiowski, and H. P. Brunner-La Rocca Prolonged Oxygen Uptake Kinetics During Low-Intensity Exercise Are Related to Poor Prognosis in Patients With Mild-to-Moderate Congestive Heart Failure Chest, August 1, 2003; 124(2): 580 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Rickli, W. Kiowski, M. Brehm, D. Weilenmann, C. Schalcher, A. Bernheim, E. Oechslin, and H. P. Brunner-La Rocca Combining low-intensity and maximal exercise test results improves prognostic prediction in chronic heart failure J. Am. Coll. Cardiol., July 2, 2003; 42(1): 116 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, N. Shimizu, A. Tajima, T. Aizawa, L. T. Fu, H. Watanabe, and H. Itoh Relation Between Oscillatory Ventilation at Rest Before Cardiopulmonary Exercise Testing and Prognosis in Patients With Left Ventricular Dysfunction Chest, February 1, 2003; 123(2): 372 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E.R. Diederich, B.J. Behnke, P. McDonough, C.A. Kindig, T.J. Barstow, D.C. Poole, and T.I. Musch Dynamics of microvascular oxygen partial pressure in contracting skeletal muscle of rats with chronic heart failure Cardiovasc Res, December 1, 2002; 56(3): 479 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, H. Itoh, M. Kato, H. Sawada, T. Aizawa, L. T. Fu, and H. Watanabe Prognostic Power of Ventilatory Responses During Submaximal Exercise in Patients With Chronic Heart Disease* Chest, May 1, 2002; 121(5): 1581 - 1588. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, K. Kobayashi, H. Adachi, N. Shimizu, H. Itoh, M. Hiroe, and K. Wasserman Effects of Dobutamine on Critical Capillary PO2 and Lactic Acidosis Threshold in Patients With Cardiovascular Disease Chest, October 1, 2001; 120(4): 1218 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Adachi, A. Koike, A. Niwa, A. Sato, T. Takamoto, F. Marumo, and M. Hiroe Percutaneous Transluminal Coronary Angioplasty Improves Oxygen Uptake Kinetics During the Onset of Exercise in Patients With Coronary Artery Disease Chest, August 1, 2000; 118(2): 329 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Tanabe, M. Takahashi, Y. Hosaka, M. Ito, E. Ito, and K. Suzuki Prolonged recovery of cardiac output after maximal exercise in patients with chronic heart failure J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1228 - 1236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kano, A. Koike, T. Yajima, Y. Koyama, F. Marumo, and M. Hiroe Mechanism of Overshoot in Cardiac Function During Recovery From Submaximal Exercise in Man Chest, October 1, 1999; 116(4): 868 - 873. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N M Picozzi, A L Clark, K A Lindsay, G P McCann, and W S Hillis Responses to constant work exercise in patients with chronic heart failure Heart, October 1, 1999; 82(4): 482 - 485. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Bauer, J. G. Regensteiner, E. P. Brass, and W. R. Hiatt Oxygen uptake kinetics during exercise are slowed in patients with peripheral arterial disease J Appl Physiol, August 1, 1999; 87(2): 809 - 816. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H P B.-L. Rocca, D Weilenmann, F Follath, M Schlumpf, H Rickli, C Schalcher, F E Maly, R Candinas, and W Kiowski Oxygen uptake kinetics during low level exercise in patients with heart failure: relation to neurohormones, peak oxygen consumption, and clinical findings Heart, February 1, 1999; 81(2): 121 - 127. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. Koike, T. Yajima, H. Adachi, N. Shimizu, H. Kano, K. Sugimoto, A. Niwa, F. Marumo, and M. Hiroe Evaluation of Exercise Capacity Using Submaximal Exercise at a Constant Work Rate in Patients With Cardiovascular Disease Circulation, March 15, 1995; 91(6): 1719 - 1724. [Abstract] [Full Text]
|
|