Left ventricular performance during prolonged exercise: absence of systolic dysfunction

We assessed left ventricular systolic and diastolic performance during and after prolonged exercise under controlled conditions in a group of healthy, trained men. Previous studies have examined the effects of prolonged effort on left ventricular function, yet it remains unclear whether or not left ventricular dysfunction (e.g. cardiac fatigue) can be produced under such conditions. We studied 15 healthy men, aged 27 +/- 1 years (mean +/- S.E.M.). Subjects exercised on bicycles at a constant work rate (60% of maximum oxygen uptake per min) for 150 min. Measurements of gas exchange, blood pressure and haematocrit were obtained, concurrent with the assessment of left ventricular function using equilibrium radionuclide angiography, at rest, during exercise (every 30 min) and after 30 min of recovery. Fluid replacement was provided and monitored during the exercise period. The baseline resting and exercise ejection fractions were 66 +/- 2% and 78 +/- 2% respectively. During exercise, subjects consumed 1816 +/- 136 ml of fluid, and the haematocrit had increased at 120 min of exercise (from 47.2% +/- 0.6 to 49.9 +/- 0.8%; P < 0.05). There was no change in either systolic or diastolic blood pressure throughout the exercise period, but heart rate drifted upwards from 141 +/- 2 beats/min after 30 min to 154 +/- 3 beats/min after 150 min (P < 0.05). There was a small decline (8%; P < 0.05) in end-diastolic volume at 150 min. No changes were observed in left ventricular ejection fraction, the pressure/volume ratio or end-systolic volume. After 30 min of sitting in recovery, heart rate was still higher than the pre-exercise value (84 +/- 3 compared with 69 +/-2 beats/min; P < 0.05), as were measures of peak filling rate and time to peak filling (P < 0.05). The ejection fraction in the post-exercise recovery period was similar to the pre-exercise value. The results indicate that prolonged exercise of moderate duration may not induce abnormal left ventricular systolic function or cardiac fatigue during exercise.