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Recovery mismatch between myocardial blood flow and cardiac workload after physical exercise: a positron emission tomography study


Siegrist, Patrick T; Koepfli, Pascal; Namdar, Mehdi; Pazhenkottil, Aju P; Nkoulou, Rene; Lüscher, Thomas F; Kaufmann, Philipp A (2014). Recovery mismatch between myocardial blood flow and cardiac workload after physical exercise: a positron emission tomography study. European Heart Journal. Cardiovascular Imaging, 15(12):1386-1390.

Abstract

AIMS We studied the interrelation between oxygen consumption and myocardial blood flow (MBF) during recovery. MBF is directly dependent on oxygen consumption. The latter is linearly related to the heart rate-blood pressure product (RPP, bpm × mmHg), an index reflecting external cardiac work. In the immediate post-exercise period, cardiac output decreases considerably. This is expected to be paralleled by a rapid fall in oxygen demand, rendering ischaemia unlikely. Thus, the phenomenon of ST-segment depression during recovery remains unexplained.
METHODS AND RESULTS (15)O-labelled water and positron emission tomography were used to measure MBF in 14 young healthy volunteers (mean age 27 ± 3 years) during the following study conditions: (i) at rest, (ii) during a steady submaximal supine bicycle exercise stress within the scanner, and (iii) during recovery immediately after cessation of exercise. During recovery, RPP decreased by 43% (18 768 ± 1337 vs. 11 652 ± 3224, P < 0.001). In contrast, the associated decrease in MBF (2.52 ± 0.52 vs. 1.93 ± 0.50 mL/min/g, P < 0.001) and perfusion reserve (2.68 ± 0.51 vs. 2.03 ± 0.42, P < 0.001) was significantly less pronounced (-24%, P < 0.01), indicating a relative delay in MBF recovery compared with cardiac work load.
CONCLUSION The mismatch between a rapid decrease in cardiac workload but preserved hyperaemic response early after cessation of physical exercise suggests an uncoupling of cardiac work and MBF during recovery.

Abstract

AIMS We studied the interrelation between oxygen consumption and myocardial blood flow (MBF) during recovery. MBF is directly dependent on oxygen consumption. The latter is linearly related to the heart rate-blood pressure product (RPP, bpm × mmHg), an index reflecting external cardiac work. In the immediate post-exercise period, cardiac output decreases considerably. This is expected to be paralleled by a rapid fall in oxygen demand, rendering ischaemia unlikely. Thus, the phenomenon of ST-segment depression during recovery remains unexplained.
METHODS AND RESULTS (15)O-labelled water and positron emission tomography were used to measure MBF in 14 young healthy volunteers (mean age 27 ± 3 years) during the following study conditions: (i) at rest, (ii) during a steady submaximal supine bicycle exercise stress within the scanner, and (iii) during recovery immediately after cessation of exercise. During recovery, RPP decreased by 43% (18 768 ± 1337 vs. 11 652 ± 3224, P < 0.001). In contrast, the associated decrease in MBF (2.52 ± 0.52 vs. 1.93 ± 0.50 mL/min/g, P < 0.001) and perfusion reserve (2.68 ± 0.51 vs. 2.03 ± 0.42, P < 0.001) was significantly less pronounced (-24%, P < 0.01), indicating a relative delay in MBF recovery compared with cardiac work load.
CONCLUSION The mismatch between a rapid decrease in cardiac workload but preserved hyperaemic response early after cessation of physical exercise suggests an uncoupling of cardiac work and MBF during recovery.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:3 September 2014
Deposited On:25 Sep 2014 14:45
Last Modified:21 Feb 2017 08:04
Publisher:Oxford University Press
ISSN:2047-2404
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/ehjci/jeu141
PubMed ID:25187616

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