Right ventricular ejection fraction during exercise in patients with coronary artery disease (2023)

Abstract

The effect of the location of right coronary artery (RCA) lesions upon right ventricular ejection fraction (RVEF) during exercise was investigated using first-pass radionuclide angiography. Thirty-seven patients were studied at rest and during upright bicycle exercise: 11 controls (group 1) and 26 patients with significant (> 70%) coronary artery stenosis, divided into those without lesions of the RCA proximal to the acute margin (group 2, n = 14) and those with proximal RCA lesions (group 3, n = 12). In group 1, left ventricular ejection fraction (LVEF) increased from 0.68 ± 0.07 (SD) at rest to 0.76 ± 0.06 during exercise (p < 0.01), and RVEF increased from 0.47 ± 0.04 to 0.57 ± 0.06 (p < 0.01). In group 2, LVEF fell from 0.63 ± 0.13 to 0.58 ± 0.11 during exercise (p < 0.01), while RVEF increased from 0.49 ± 0.06 to 0.58 ± 0.09 (p < 0.01). The LVEF response to exercise in group 2 was significantly different from that in group 1 (p < 0.01); the RVEF response did not differ significantly. When group 2 was subdivided into patients without RCA lesions and those with distal RCA lesions, there was no significant difference in the RVEF response to exercise. In group 3, LVEF fell from 0.53 ± 0.17 at rest to 0.45 ± 0.14 during exercise (p < 0.01), while RVEF did not change significantly (0.50 ± 0.07 at rest and 0.46 ± 0.10 during exercise). In LVEF response to exercise in group 3 was not significantly different from that in group 2; however, the RVEF response differed significantly from that in groups 1 and 2 (p < 0.01). Proximal RCA lesions are associated with a fall in LVEF and no change in RVEF during exercise, while coronary artery disease that does not involve the proximal RCA results in a fall in LVEF and a rise in RVEF. Thus, there can be a dissociation of the exercise response of the right and left ventricles, determined by the location of coronary artery lesions.

Original languageEnglish
Pages (from-to)1284-1291
Number of pages8
JournalCirculation
Volume60
Issue number6
DOIs
Publication statusPublished - 1979
Externally publishedYes

ASJC Scopus Subject Areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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Johnson, L. L., McCarthy, D. M., Sciacca, R. R., & Cannon, P. J. (1979). Right ventricular ejection fraction during exercise in patients with coronary artery disease. Circulation, 60(6), 1284-1291. https://doi.org/10.1161/01.CIR.60.6.1284

Right ventricular ejection fraction during exercise in patients with coronary artery disease. / Johnson, L. L.; McCarthy, D. M.; Sciacca, Robert R. et al.

In: Circulation, Vol. 60, No. 6, 1979, p. 1284-1291.

Research output: Contribution to journalArticlepeer-review

(Video) Exercise and Heart Failure

Johnson, LL, McCarthy, DM, Sciacca, RR & Cannon, PJ 1979, 'Right ventricular ejection fraction during exercise in patients with coronary artery disease', Circulation, vol. 60, no. 6, pp. 1284-1291. https://doi.org/10.1161/01.CIR.60.6.1284

Johnson LL, McCarthy DM, Sciacca RR, Cannon PJ. Right ventricular ejection fraction during exercise in patients with coronary artery disease. Circulation. 1979;60(6):1284-1291. doi: 10.1161/01.CIR.60.6.1284

Johnson, L. L. ; McCarthy, D. M. ; Sciacca, Robert R. et al. / Right ventricular ejection fraction during exercise in patients with coronary artery disease. In: Circulation. 1979 ; Vol. 60, No. 6. pp. 1284-1291.

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abstract = "The effect of the location of right coronary artery (RCA) lesions upon right ventricular ejection fraction (RVEF) during exercise was investigated using first-pass radionuclide angiography. Thirty-seven patients were studied at rest and during upright bicycle exercise: 11 controls (group 1) and 26 patients with significant (> 70%) coronary artery stenosis, divided into those without lesions of the RCA proximal to the acute margin (group 2, n = 14) and those with proximal RCA lesions (group 3, n = 12). In group 1, left ventricular ejection fraction (LVEF) increased from 0.68 ± 0.07 (SD) at rest to 0.76 ± 0.06 during exercise (p < 0.01), and RVEF increased from 0.47 ± 0.04 to 0.57 ± 0.06 (p < 0.01). In group 2, LVEF fell from 0.63 ± 0.13 to 0.58 ± 0.11 during exercise (p < 0.01), while RVEF increased from 0.49 ± 0.06 to 0.58 ± 0.09 (p < 0.01). The LVEF response to exercise in group 2 was significantly different from that in group 1 (p < 0.01); the RVEF response did not differ significantly. When group 2 was subdivided into patients without RCA lesions and those with distal RCA lesions, there was no significant difference in the RVEF response to exercise. In group 3, LVEF fell from 0.53 ± 0.17 at rest to 0.45 ± 0.14 during exercise (p < 0.01), while RVEF did not change significantly (0.50 ± 0.07 at rest and 0.46 ± 0.10 during exercise). In LVEF response to exercise in group 3 was not significantly different from that in group 2; however, the RVEF response differed significantly from that in groups 1 and 2 (p < 0.01). Proximal RCA lesions are associated with a fall in LVEF and no change in RVEF during exercise, while coronary artery disease that does not involve the proximal RCA results in a fall in LVEF and a rise in RVEF. Thus, there can be a dissociation of the exercise response of the right and left ventricles, determined by the location of coronary artery lesions.",

author = "Johnson, {L. L.} and McCarthy, {D. M.} and Sciacca, {Robert R.} and Cannon, {P. J.}",

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(Video) Right Ventricular Adaptation to Exercise: The Weak Link of the Athletic Heart?

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(Video) Right Ventricular Function Across the Spectrum of Health and Disease

Y1 - 1979

N2 - The effect of the location of right coronary artery (RCA) lesions upon right ventricular ejection fraction (RVEF) during exercise was investigated using first-pass radionuclide angiography. Thirty-seven patients were studied at rest and during upright bicycle exercise: 11 controls (group 1) and 26 patients with significant (> 70%) coronary artery stenosis, divided into those without lesions of the RCA proximal to the acute margin (group 2, n = 14) and those with proximal RCA lesions (group 3, n = 12). In group 1, left ventricular ejection fraction (LVEF) increased from 0.68 ± 0.07 (SD) at rest to 0.76 ± 0.06 during exercise (p < 0.01), and RVEF increased from 0.47 ± 0.04 to 0.57 ± 0.06 (p < 0.01). In group 2, LVEF fell from 0.63 ± 0.13 to 0.58 ± 0.11 during exercise (p < 0.01), while RVEF increased from 0.49 ± 0.06 to 0.58 ± 0.09 (p < 0.01). The LVEF response to exercise in group 2 was significantly different from that in group 1 (p < 0.01); the RVEF response did not differ significantly. When group 2 was subdivided into patients without RCA lesions and those with distal RCA lesions, there was no significant difference in the RVEF response to exercise. In group 3, LVEF fell from 0.53 ± 0.17 at rest to 0.45 ± 0.14 during exercise (p < 0.01), while RVEF did not change significantly (0.50 ± 0.07 at rest and 0.46 ± 0.10 during exercise). In LVEF response to exercise in group 3 was not significantly different from that in group 2; however, the RVEF response differed significantly from that in groups 1 and 2 (p < 0.01). Proximal RCA lesions are associated with a fall in LVEF and no change in RVEF during exercise, while coronary artery disease that does not involve the proximal RCA results in a fall in LVEF and a rise in RVEF. Thus, there can be a dissociation of the exercise response of the right and left ventricles, determined by the location of coronary artery lesions.

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(Video) Maladaptation of the Right Ventricle in Athletes - Dr Guido Claessen

ER -

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