Chest
Clinical Investigations: CardiologyRelation Between Depressed Cardiac Response to Exercise and Autonomic Nervous Activity in Mildly Symptomatic Patients With Idiopathic Dilated Cardiomyopathy
Section snippets
Subjects
We studied 27 mildly symptomatic patients with DCM (14 men, 13 women; 58±10 years of age) and 7 normal control subjects (4 men, 3 women; 60±6 years). Normal control subjects had no history, symptoms, or signs of cardiovascular disease and had normal 12-lead ECGs at rest and during exercise and normal M-mode, two-dimensional, and Doppler echocardiograms at rest. None of the control subjects had a history of hypertension, diabetes mellitus, or hyperlipidemia. In the group with DCM, 10 patients
Hemodynamic Measurements at Rest and During Exercise
The resting systolic BP and the resting heart rate were similar in both groups (Table 1). The systolic BP during exercise was also similar in both groups, but the heart rate during exercise was significantly lower in patients than in normal control subjects (p<0.05). The maximum workload was significantly lower in patients than in normal control subjects. LVEF increased during exercise by more than 5% in normal control subjects, but 17 (63%) of 27 patients failed to show a greater than 5%
Discussion
The cardiac response to exercise was attenuated in patients with DCM with mild symptoms. Resting clinical and hemodynamic parameters did not appear to be associated with the residual myocardial contractile reserve. Autonomic function was significantly different in the two groups, as indicated by a blunted circadian rhythm, and accelerated sympathetic activity and reduced vagal tone during sleep in patients with DCM with mild symptoms. The left ventricular response to exercise, which reflects
References (29)
- et al.
Beta-adrenergic contractile reserve as a predictor of clinical outcome in patients with idiopathic dilated cardiomyopathy
Am Heart J
(1992) - et al.
Response of the beta-adrenergic system to maximal dynamic exercise in congestive heart failure secondary to idiopathic dilated cardiomyopathy
Am J Cardiol
(1989) - et al.
Myocardial beta-adrenoceptor changes in heart failure: concomitant reduction in betal- and beta2-adrenoceptor function related to the degree of heart failure in patients with mitral regurgitation
J Am Coll Cardiol
(1989) - et al.
Effect of cardiac vagal and sympathetic nerve activity on heart rate in rhythmic fluctuations
J Auton Nerv Syst
(1985) - et al.
Heart rate variability as an index of sympathovagal interaction after acute myocardial infarction
Am J Cardiol
(1987) - et al.
Decreased spontaneous heart rate variability in congestive heart failure
Am J Cardiol
(1989) - et al.
Assessment of autonomic regulation in congestive heart failure by heart rate spectral analysis
Am J Cardiol
(1988) - et al.
Comparison of different methods for assessing sympathovagal balance in chronic congestive heart failure secondary to coronary artery disease
Am J Cardiol
(1992) - et al.
Left ventricular volume and ejection fraction response to exercise in chronic congestive heart failure: difference between dilated cardiomyopathy and previous myocardial infarction
Am J Cardiol
(1985) - et al.
Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure
Am J Cardiol
(1981)
Dynamic limitation of coronary vasodilator reserve in patients with dilated cardiomyopathy and chest pain
J Am Coll Cardiol
Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy
J Am Coll Cardiol
Sustained augmentation of parasympathetic tone with angiotensin-converting enzyme inhibition in patients with congestive heart failure
J Am Coll Cardiol
Effect of captopril on cardiac parasympathetic activity in chronic cardiac failure secondary to coronary artery disease
Am J Cardiol
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