Detection of left ventricular functional reserve by supine exercise hemodynamics in patients with severe, chronic heart failure

Hemodynamic changes during exercise were evaluated in 20 patients with severe, chronic congestive heart failure. Two groups were identified by their stroke work response to maximal exercise. Group I (eight patients) showed an increase in stroke work index. This occurred because the stroke volume inc...

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Veröffentlicht in:The American journal of cardiology 1979-11, Vol.44 (6), p.1062-1067
Hauptverfasser: Gelberg, Harris J., Rubin, Stanley A., Ports, Thomas A., Brundage, Bruce H., Parmley, William W., Chatterjee, Kanu
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container_end_page 1067
container_issue 6
container_start_page 1062
container_title The American journal of cardiology
container_volume 44
creator Gelberg, Harris J.
Rubin, Stanley A.
Ports, Thomas A.
Brundage, Bruce H.
Parmley, William W.
Chatterjee, Kanu
description Hemodynamic changes during exercise were evaluated in 20 patients with severe, chronic congestive heart failure. Two groups were identified by their stroke work response to maximal exercise. Group I (eight patients) showed an increase in stroke work index. This occurred because the stroke volume increased and the difference between mean systolic pressure and left ventricular filling pressure increased. Group II (12 patients) showed a decrease in stroke work index. This occurred because stroke volume decreased while the difference between mean systolic pressure and left ventricular filling pressure did not change. Despite hemodynamic differences, the groups could not be distinguished by the usual clinical criteria for heart failure including etiology, New York Heart Association functional class, heart size on chest X-ray film or duration of heart failure. Clinical criteria are relatively insensitive in predicting the exercise hemodynamics of any given patient with chronic severe heart failure. Determining the exercise hemodynamics may be helpful as a means of assessing left ventricular functional reserve in heart failure. Prognostic implications, drug therapy and prescription of activities may require adjustment based on this spectrum of hemodynamic response to exercise in patients with chronic heart failure.
doi_str_mv 10.1016/0002-9149(79)90170-X
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Determining the exercise hemodynamics may be helpful as a means of assessing left ventricular functional reserve in heart failure. Prognostic implications, drug therapy and prescription of activities may require adjustment based on this spectrum of hemodynamic response to exercise in patients with chronic heart failure.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>495499</pmid><doi>10.1016/0002-9149(79)90170-X</doi><tpages>6</tpages></addata></record>
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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Adult
Aged
Blood Pressure
Cardiac Output
Female
Heart Failure - physiopathology
Heart Rate
Hemodynamics
Humans
Male
Middle Aged
Myocardial Contraction
Oxygen Consumption
Pulmonary Circulation
Stroke Volume
title Detection of left ventricular functional reserve by supine exercise hemodynamics in patients with severe, chronic heart failure
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