DOPPLER INDEXES OF LEFT-VENTRICULAR FILLING AFTER EXERCISE IN 50-YEAR-OLD HEALTHY-PERSONS

Exercise-induced myocardial ischemia has been shown to alter left vent ricular (LV) diastolic filling. An abnormal response of Doppler indexe s of LV filling during and after exercise testing has been demonstrate d to be a sensitive marker of coronary artery disease. A paucity of da ta is available regarding reference values and the physiological varia tion in LV filling indexes after exercise in healthy subjects of simil ar age. We therefore evaluated 77 healthy subjects (33 men and 44 wome n) aged 50 years by Doppler echocardiography at rest and 15 and 60 min utes after exercise testing. The peak velocity of early diastolic fill ing (E-wave), the peak velocity of atrial filling (A-wave), the early to atrial peak velocity (E/A) ratio and the deceleration time of early velocity were measured. There was a decrease in the E/A ratio 15 minu tes after exercise compared with the E/A ratio at rest in women (1.13 +/- 0.23 vs 1.23 +/- 0.27; p < 0.001) and men (1.03 +/- 0.22 vs 1.15 /- 0.20; p < 0.001). The E/A ratio 60 minutes after exercise did not d iffer significantly from rest in women (1.23 +/- 0.27 vs 1.18 +/- 0.24 ; p = NS), but men had a tower E/A ratio 60 minutes after than before exercise (1.04 +/- 0.23 vs 1.15 +/- 0.20;p < 0.001). There was no diff erence in deceleration time of the E-wave before and after exercise. M ultivariate analysis revealed that the E/A ratio 15 and 60 minutes aft er exercise was strongly independently associated with the E/A ratio a t rest (p < 0.001) and heart rate 15 and 60 minutes after exercise (p < 0.005) in both women and men. It is concluded that there is a physio logical decrease in the El A ratio 15 minutes after exercise In health y subjects, and Doppler LV filling indexes after exercise are strongly associated with LV filling indexes at rest and with heart rate. (C) 1 997 by Excerpta Medico, Inc.