The heart rate performance curve and left ventricular function during exercise in patients after myocardial infarction

• Published in: Medicine and science in sports and exercise Vol. 30; no. 10; p. 1475
• Main Authors: Pokan, R, Hofmann, P, von Duvillard, S P, Beaufort, F, Smekal, G, Gasser, R, Klein, W, Eber, B, Bachl, N, Schmid, P
• Format: Journal Article
• Language: English
• Published: United States 01.10.1998
• Subjects: Anaerobic Threshold - physiology; Analysis of Variance; Blood Pressure - physiology; Echocardiography; Echocardiography, Doppler, Color; Exercise Test; Gated Blood-Pool Imaging; Heart Rate - physiology; Humans; Lactates - blood; Male; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Oxygen Consumption - physiology; Physical Exertion - physiology; Stroke Volume - physiology; Ventricular Function, Left - physiology
• ISSN: 0195-9131
• DOI: 10.1097/00005768-199810000-00002

The aim of the study was to investigate the heart rate turn point (HRTP) in the time course of the heart rate performance curve (HRPC) in patients after myocardial infarction, and the relationship between the HRTP, the left ventricular function, and the second lactate turn point (LTP2). We studied the degree and the direction of the HRPC and the left ventricular ejection fraction (LVEF) in 49 male patients 57 +/- 8 d after their first posterior wall infarction (MI). An incremental cycle ergometer test was performed and three phases of energy supply were defined (I: aerobic; II: aerobic-anaerobic transition; III: anaerobic) via blood lactate LA concentration. HRTP and LVEF-turn points (LVEFTP) were assessed by linear turn point analysis. The degree and direction of the deflection of HRPC were described as factor k (k > 0.1: downward deflection; -0.1 < k < 0.1: linear time curse; k < -0.1: upward deflection). The LVEF was determined by RNA. The difference between Pmax and LTP2 was calculated for LVEF (delta LVEF). An HRTP could be found in 44 and a LVEFTP in 47 cases. The HRTP occurred at 85 +/- 17 Watt (W), which correlated (r = 0.95; P < 0.001) with the LTP2 (84 +/- 17 W) and the LVEFTP (84 +/- 17 W, r = 0.93; P < 0.001). From LTP2 to Pmax a significant decrease in LVEF was found. There was a correlation between the percentage of HRmax at the HRTP and k (r = 0.70), as well as delta LVEF (r = 0.56). To prevent myocardial overloading, it seems to be useful to determine the HRTP, which indicate the workload where LVEF decreases.