Abstract
To elucidate factors influencing responses of right ventricular systolic function to exercise stress, we evaluated the right ventricular ejection fraction and peak ejection rate with two different loading conditions, atrial septal defect and mitral stenosis, at rest and during exercise by means of gated equilibrium blood pool radionuclide ventriculography. In both atrial septal defect and mitral stenosis, strong correlations between changes in the right ventricular ejection fraction with exercise and pulmonary vascular resistance at rest (r = −0.97, p < 0.001; r = −0.86, p < 0.0005: respectively) were found. Significant correlations between changes in the right ventricular peak ejection rate with exercise and pulmonary vascular resistance at rest (r = −0.85, p < 0.05; r = −0.75, p < 0.01: respectively) were found in atrial septal defect and mitral stenosis. Both the right ventricular ejection fraction and peak ejection rate were lower during exercise than at rest when pulmonary vascular resistance at rest was more than 200 dynes·sec·cm−5·m2 in both atrial septal defect and mitral stenosis. In conclusion, right ventricular systolic function responding to exercise stress was influenced by the pulmonary vascular resistance in both atrial septal defect and mitral stenosis.
Similar content being viewed by others
References
Berger HJ, Johnstone DE, Sands JM, Gottschalk A, Zaret BL. Response of right ventricular ejection fraction to upright bicycle exercise in coronary artery disease.Circulation 60: 1292–1300, 1979.
Maddahi J, Bermen DS, Matsuoka DT, Waxman AD, Forrester JS, Swan HCJ. Right ventricular ejection fraction during exercise in normal subjects and in coronary artery disease patients: assessment by multiple gated equilibrium scintigraphy.Circulation 62: 133–140, 1980.
Slutsky R, Hooper W, Gerber K, Battler A, Froelicher V, Ashburn W, et al. Assessment of right ventricular function at rest and during exercise in patients with coronary artery disease: A new approach using equilibrium radionuclide angiography.Am J Cardiol 45: 63–71, 1980.
Lee SJK, McClelland AR, Zaragoza AJ. The right ventricular function during exercise in patients with and without right ventricular failure.Acta Cardiol (Brux) 25: 313–325, 1970.
Cohen M, Horowitz SF, Machac J, Mindich BP, Fuster V. Response of the right ventricle to exercise in isolated mitral stenosis.Am J Cardiol 55: 1054–1058, 1958.
Johnston DL, Kostuk WJ. Left and right ventricular function during symptom-limited exercise in patients with isolated mitral stenosis.Chest 89: 186–191, 1986.
Peter CA, Bowyer K, Jones RH. Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects.Am Heart J 105: 428–435, 1983.
Caro CG, Pedley TJ, Schroter RC, Seed WA.The Mechanics of the Circulation. Oxford University Press, pp. 213–214, 1981.
Konishi T, Koyama T, Aoki T, Makino K, Yamamuro M, Nakai K, et al. Influence of age on left ventricular performance during exercise in normal Japanese subject: Assessment by radionuclide ventriculography.Ann Nucl Med 4: 19–27, 1990.
Bacharach SL, Green MV, Borer JS, Hyde JE, Farkas SP, Johnston GS. Left ventricular peak ejection rate, filling rate, and ejection fraction—Frame rate requirement at rest and exercise: Concise communication.J Nucl Med 20: 189–193, 1979.
Kanaya T, Watanabe Y, Tonooka I, Satoh S, Tsuiki K, Yasui S, et al. Clinical evaluation of right ventricular function using first-pass radionuclide angiocardiography—Assessment of cardiac performance in patients with heart disease by radionuclide and hemodynamic parameters.KAKU IGAKU (Jpn J Nucl Med) 21: 125–132, 1984.
Grose R, Strain J, Yipintosoi T. Right ventricular function in valvular heart disease: Relation to pulmonary artery pressure.J Am Coll Cardiol 2: 225–232, 1983.
Morrison D, Goldman S, Wright AL, Henry R, Sorenson S, Caldwell J, et al. The effect of pulmonary hypertension on systolic function of the right ventricle.Chest 84: 250–257, 1983.
Wroblewski E, James F, Spann JF, Bove AA. Right ventricular performance in mitral stenosis.Am J Cardiol 47: 51–55, 1981.
Morrison D, Sorensen S, Caldwell J, Wright AL, Ritchie J, Kennedy JW, et al. The normal right ventricular response to supine exercise.Chest 82: 686–691, 1982.
Barnard D, Alpert JS. Right ventricular function in health and disease.Curr Probl Cardiol 12: 423–449, 1987.
Maddahi J, Berman DS, Matsuoka DT, Waxman AD, Stankus KE, Forrester JS, et al. A new technique for assessing right ventricular ejection fraction using multiplegated equilibrium cardiac blood pool scintigraphy. Description, validation and findings in chronic coronary artery disease.Circulation 60: 581–589, 1979.
Henze E, Schelbert HR, Wisenberg G, Ratib O, Schon H. Assessment of regurgitation fraction and right and left ventricular function at rest and during exercise. A new technique for determination of right ventricular stroke counts from gated eqilibrium blood pool studies.Am Heart J 104: 953–962, 1982.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hirata, N., Shimazaki, Y., Sakakibara, T. et al. Response of right ventricular systolic function to exercise stress: Effects of pulmonary vascular resistance on right ventricular systolic function. Ann Nucl Med 8, 125–131 (1994). https://doi.org/10.1007/BF03165017
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03165017