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Published in: Journal of Medical Ultrasonics 1/2019

01-01-2019 | Original Article

Changes in cardiac contractility during graded exercise are greater in subjects with smaller body mass index, and greater in men than women: analyses using wave intensity and force–frequency relations

Authors: Midori Tanaka, Motoaki Sugawara, Kiyomi Niki, Yasuo Ogasawara

Published in: Journal of Medical Ultrasonics | Issue 1/2019

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Abstract

Introduction and purpose

Estimation of the contractility of the left ventricle during exercise is an important part of the rehabilitation protocol. It is known that cardiac contractility increases with an increase in heart rate. This phenomenon is called the force–frequency relation (FFR). Using wave intensity, we aimed to evaluate FFR noninvasively during graded exercise.

Methods

We enrolled 83 healthy subjects. Using ultrasonic diagnostic equipment, we measured wave intensity (WD), which was defined in terms of blood velocity and arterial diameter, in the carotid artery and heart rate (HR) before and during bicycle ergometer exercise. FFRs were constructed by plotting the maximum value of WD (WD1) against HR. We analyzed the variation among FFR responses of individual subjects.

Results

WD1 increased linearly with an increase in HR during exercise. The average slope of the FFR was 1.0 ± 0.5 m/s3 bpm. The slope of FFR decreased with an increase in body mass index (BMI). The slopes of FFRs were steeper in men than women, although there were no differences in BMI between men and women.

Conclusions

The FFR was obtained noninvasively by carotid arterial wave intensity (WD1) and graded exercise. The slope of the FFR decreased with an increase in BMI, and was steeper in men than women.
Literature
1.
go back to reference Alpert NR, Leavitt BJ, Ittleman FP, et al. A mechanistic analysis of the force–frequency relation in non-failing and progressively failing human myocardium. Basic Res Cardiol. 1998;93:23–32.CrossRefPubMed Alpert NR, Leavitt BJ, Ittleman FP, et al. A mechanistic analysis of the force–frequency relation in non-failing and progressively failing human myocardium. Basic Res Cardiol. 1998;93:23–32.CrossRefPubMed
2.
go back to reference Hove-Madsen L, Gesser H. Force frequency relation in the myocardium of rainbow trout. Effects of K+ and adrenaline. J Comp Physiol B. 1989;159:61–9.CrossRefPubMed Hove-Madsen L, Gesser H. Force frequency relation in the myocardium of rainbow trout. Effects of K+ and adrenaline. J Comp Physiol B. 1989;159:61–9.CrossRefPubMed
3.
go back to reference Kambayashi M, Miura T, Oh BH, et al. Enhancement of the force–frequency effect on myocardial contractility by adrenergic stimulation in conscious dogs. Circulation. 1992;86:572–80.CrossRefPubMed Kambayashi M, Miura T, Oh BH, et al. Enhancement of the force–frequency effect on myocardial contractility by adrenergic stimulation in conscious dogs. Circulation. 1992;86:572–80.CrossRefPubMed
4.
go back to reference Miura T, Miyazaki S, Guth BD, et al. Influence of the force–frequency relation on left ventricular function during exercise in conscious dogs. Circulation. 1992;86:563–71.CrossRefPubMed Miura T, Miyazaki S, Guth BD, et al. Influence of the force–frequency relation on left ventricular function during exercise in conscious dogs. Circulation. 1992;86:563–71.CrossRefPubMed
5.
go back to reference Ross J Jr, Miura T, Kambayashi M, et al. Adrenergic control of the force–frequency relation. Circulation. 1995;92:2327–32.CrossRefPubMed Ross J Jr, Miura T, Kambayashi M, et al. Adrenergic control of the force–frequency relation. Circulation. 1995;92:2327–32.CrossRefPubMed
6.
go back to reference Bhargava V, Shabetai R, Mathiasen RA, et al. Loss of adrenergic control of the force–frequency relation in heart failure secondary to idiopathic or ischemic cardiomyopathy. Am J Cardiol. 1998;81:1130–7.CrossRefPubMed Bhargava V, Shabetai R, Mathiasen RA, et al. Loss of adrenergic control of the force–frequency relation in heart failure secondary to idiopathic or ischemic cardiomyopathy. Am J Cardiol. 1998;81:1130–7.CrossRefPubMed
7.
go back to reference Kass DA. Force–frequency relation in patients with left ventricular hypertrophy and failure. Basic Res Cardiol. 1998;93:108–16.CrossRefPubMed Kass DA. Force–frequency relation in patients with left ventricular hypertrophy and failure. Basic Res Cardiol. 1998;93:108–16.CrossRefPubMed
8.
go back to reference Maier LS, Schwan C, Schillinger W, et al. Gingerol, isoproterenol and ouabain normalize impaired post-rest behavior but not force–frequency relation in failing human myocardium. Cardiovasc Res. 2000;45:913–24.CrossRefPubMed Maier LS, Schwan C, Schillinger W, et al. Gingerol, isoproterenol and ouabain normalize impaired post-rest behavior but not force–frequency relation in failing human myocardium. Cardiovasc Res. 2000;45:913–24.CrossRefPubMed
9.
go back to reference Morimoto R, Okumura T, Bando YK, et al. Biphasic force–frequency relation predicts primary cardiac events in patients with hypertrophic cardiomyopathy. Circulation. 2017;81:368–75.CrossRef Morimoto R, Okumura T, Bando YK, et al. Biphasic force–frequency relation predicts primary cardiac events in patients with hypertrophic cardiomyopathy. Circulation. 2017;81:368–75.CrossRef
10.
go back to reference Mulieri LA, Hasenfuss G, Leavitt B, et al. Altered myocardial force–frequency relation in human heart failure. Circulation. 1992;85:1743–50.CrossRefPubMed Mulieri LA, Hasenfuss G, Leavitt B, et al. Altered myocardial force–frequency relation in human heart failure. Circulation. 1992;85:1743–50.CrossRefPubMed
11.
go back to reference Mulieri LA, Leavitt BJ, Wright RK, et al. Role of cAMP in modulating relaxation kinetics and the force–frequency relation in mitral regurgitation heart failure. Basic Res Cardiol. 1997;92:95–103.CrossRefPubMed Mulieri LA, Leavitt BJ, Wright RK, et al. Role of cAMP in modulating relaxation kinetics and the force–frequency relation in mitral regurgitation heart failure. Basic Res Cardiol. 1997;92:95–103.CrossRefPubMed
12.
go back to reference Mulieri LA, Tischler MD, Martin BJ, et al. Regional differences in the force–frequency relation of human left ventricular myocardium in mitral regurgitation: implications for ventricular shape. Am J Physiol Heart Circ Physiol. 2005;288:H2185–91.CrossRefPubMed Mulieri LA, Tischler MD, Martin BJ, et al. Regional differences in the force–frequency relation of human left ventricular myocardium in mitral regurgitation: implications for ventricular shape. Am J Physiol Heart Circ Physiol. 2005;288:H2185–91.CrossRefPubMed
13.
go back to reference Mullens W, Bartunek J, Tang WH, et al. Early and late effects of cardiac resynchronization therapy on force–frequency relation and contractility regulating gene expression in heart failure patients. Heart Rhythm. 2008;5:52–9.CrossRefPubMed Mullens W, Bartunek J, Tang WH, et al. Early and late effects of cardiac resynchronization therapy on force–frequency relation and contractility regulating gene expression in heart failure patients. Heart Rhythm. 2008;5:52–9.CrossRefPubMed
14.
go back to reference Pieske B, Kretschmann B, Meyer M, et al. Alterations in intracellular calcium handling associated with the inverse force–frequency relation in human dilated cardiomyopathy. Circulation. 1995;92:1169–78.CrossRefPubMed Pieske B, Kretschmann B, Meyer M, et al. Alterations in intracellular calcium handling associated with the inverse force–frequency relation in human dilated cardiomyopathy. Circulation. 1995;92:1169–78.CrossRefPubMed
15.
go back to reference Schmidt U, Schwinger RH, Bohm M, et al. Alterations of the force–frequency relation depending on stages of heart failure in humans. Am J Cardiol. 1994;74:1066–8.CrossRefPubMed Schmidt U, Schwinger RH, Bohm M, et al. Alterations of the force–frequency relation depending on stages of heart failure in humans. Am J Cardiol. 1994;74:1066–8.CrossRefPubMed
16.
go back to reference Schotten U, Voss S, Wiederin TB, et al. Altered force–frequency relation in hypertrophic obstructive cardiomyopathy. Basic Res Cardiol. 1999;94:120–7.CrossRefPubMed Schotten U, Voss S, Wiederin TB, et al. Altered force–frequency relation in hypertrophic obstructive cardiomyopathy. Basic Res Cardiol. 1999;94:120–7.CrossRefPubMed
17.
go back to reference Schwinger RH, Bohm M, Koch A, et al. Force–frequency relation in human heart failure. Circulation. 1992;86:2017–8.CrossRefPubMed Schwinger RH, Bohm M, Koch A, et al. Force–frequency relation in human heart failure. Circulation. 1992;86:2017–8.CrossRefPubMed
18.
go back to reference Vollmann D, Luthje L, Schott P, et al. Biventricular pacing improves the blunted force–frequency relation present during univentricular pacing in patients with heart failure and conduction delay. Circulation. 2006;113:953–9.CrossRefPubMed Vollmann D, Luthje L, Schott P, et al. Biventricular pacing improves the blunted force–frequency relation present during univentricular pacing in patients with heart failure and conduction delay. Circulation. 2006;113:953–9.CrossRefPubMed
19.
go back to reference Miao DM, Ye P, Zhang JY, et al. Clinical usefulness of carotid arterial wave intensity in noninvasively assessing left ventricular performance in different hypertensive remodeling hearts. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2011;27:136–9.PubMed Miao DM, Ye P, Zhang JY, et al. Clinical usefulness of carotid arterial wave intensity in noninvasively assessing left ventricular performance in different hypertensive remodeling hearts. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2011;27:136–9.PubMed
20.
go back to reference Niki K, Sugawara M, Chang D, et al. A new noninvasive measurement system for wave intensity: evaluation of carotid arterial wave intensity and reproducibility. Heart Vessels. 2002;17:12–21.CrossRefPubMed Niki K, Sugawara M, Chang D, et al. A new noninvasive measurement system for wave intensity: evaluation of carotid arterial wave intensity and reproducibility. Heart Vessels. 2002;17:12–21.CrossRefPubMed
21.
go back to reference Ohte N, Narita H, Sugawara M, et al. Clinical usefulness of carotid arterial wave intensity in assessing left ventricular systolic and early diastolic performance. Heart Vessels. 2003;18:107–11.CrossRefPubMed Ohte N, Narita H, Sugawara M, et al. Clinical usefulness of carotid arterial wave intensity in assessing left ventricular systolic and early diastolic performance. Heart Vessels. 2003;18:107–11.CrossRefPubMed
22.
go back to reference Sugawara M, Niki K, Ohte N, et al. Clinical usefulness of wave intensity analysis. Med Biol Eng Comput. 2009;47:197–206.CrossRefPubMed Sugawara M, Niki K, Ohte N, et al. Clinical usefulness of wave intensity analysis. Med Biol Eng Comput. 2009;47:197–206.CrossRefPubMed
23.
go back to reference Vriz O, Favretto S, Jaroch J, et al. Left ventricular function assessed by one-point carotid wave intensity in newly diagnosed untreated hypertensive patients. J Ultrasound Med. 2017;36:25–35.CrossRefPubMed Vriz O, Favretto S, Jaroch J, et al. Left ventricular function assessed by one-point carotid wave intensity in newly diagnosed untreated hypertensive patients. J Ultrasound Med. 2017;36:25–35.CrossRefPubMed
24.
go back to reference Wang Z, Jalali F, Sun YH, et al. Assessment of left ventricular diastolic suction in dogs using wave-intensity analysis. Am J Physiol Heart Circ Physiol. 2005;288:H1641–51.CrossRefPubMed Wang Z, Jalali F, Sun YH, et al. Assessment of left ventricular diastolic suction in dogs using wave-intensity analysis. Am J Physiol Heart Circ Physiol. 2005;288:H1641–51.CrossRefPubMed
25.
go back to reference Zhang H, Zheng R, Qian X, et al. Use of wave intensity analysis of carotid arteries in identifying and monitoring left ventricular systolic function dynamics in rabbits. Ultrasound Med Biol. 2014;40:611–21.CrossRefPubMed Zhang H, Zheng R, Qian X, et al. Use of wave intensity analysis of carotid arteries in identifying and monitoring left ventricular systolic function dynamics in rabbits. Ultrasound Med Biol. 2014;40:611–21.CrossRefPubMed
26.
go back to reference Tanaka M, Sugawara M, Ogasawara Y, et al. Noninvasive evaluation of left ventricular force–frequency relationships by measuring carotid arterial wave intensity during exercise stress. J Med Ultrason. 2015;42:65–70.CrossRef Tanaka M, Sugawara M, Ogasawara Y, et al. Noninvasive evaluation of left ventricular force–frequency relationships by measuring carotid arterial wave intensity during exercise stress. J Med Ultrason. 2015;42:65–70.CrossRef
27.
go back to reference Seo JS, Jin HY, Jang JS, et al. The relationships between body mass index and left ventricular diastolic function in a structurally normal heart with normal ejection fraction. Cardiovasc Ultrasound. 2017;25:5–11.CrossRef Seo JS, Jin HY, Jang JS, et al. The relationships between body mass index and left ventricular diastolic function in a structurally normal heart with normal ejection fraction. Cardiovasc Ultrasound. 2017;25:5–11.CrossRef
Metadata
Title
Changes in cardiac contractility during graded exercise are greater in subjects with smaller body mass index, and greater in men than women: analyses using wave intensity and force–frequency relations
Authors
Midori Tanaka
Motoaki Sugawara
Kiyomi Niki
Yasuo Ogasawara
Publication date
01-01-2019
Publisher
Springer Singapore
Published in
Journal of Medical Ultrasonics / Issue 1/2019
Print ISSN: 1346-4523
Electronic ISSN: 1613-2254
DOI
https://doi.org/10.1007/s10396-018-0888-8

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