The Clinical Research Of Exercise Cardiac Contractility Monitor In Cardiac Reserve Evaluation

Objective1.To observe the effects of gender、age、heart rate、hypertension、coronary heart disease、diabetes to cardiac reserve;2.To study the relation of index of exercise cardiac contractility monitor, color Doppler ultrasound and noninvasive cardiac hemodynamics monitor;to explore the value of exercise cardiac contractility monitor in assessment of cardiac contractility and cardiac reserve.Method359individuals were selected of which218cases were men and141cases were women,mean age was56.6±11.3. years old. According to the diagnostic standards of WHO, we took hypertension group54cases, CAD group30cases, DM group20cases, hypertension with CAD group54cases, hypertension with DM group16cases, CAD with DM group8cases, hypertension with CAD and DM17cases, healthy group112cases of subjects above40years old. There were134healthy subjects of all the cases.We collected the medical history、height、weight、blood pressure and so on. Heart rate(HR)、the ratio of first heart sound and second heart sound(S1/S2)、the ratio of diastole and systole(D/S) both at rest and after exercise and cardiac reserve index (CRI) were measured by Exercise cardiac contractility monitor.Heart rate(HR)、stroke volume(SV)、cardiac output(CO)、cardiac work index(CWI) were measured by noninvasive hemodynamic monitor. Ejection fraction(EF)、left ventrical end of diastole diameter(LVDd、interventricular septum thickness(IVS、left ventrical posterior wall thickness(LVPW)、E/A were measured by Color Doppler echocardiography.Results1.Compared with the male group, HR at rest and after exercise, S1/S2after exercise、CRI2of the female group are higher,D/S at rest and after exercise are smaller (p<0.05or0.01).2.Compared with the youth group, S1/S2at rest increases and HR after exercise、CRI1、CRI2> and CRI reduce with age (p<0.05or0.01).3.Along with the HR at rest, S1/S2at res、HR、S1/S2after exercise and CRI increase, D/S at rest、D/S after exercise、CRI1、CRI reduce (p<0.05or0.01);CRI2reduces when heart rate is above100/min.4.Along with HR after exercise, D/S after exercise reduces,Sl/S2afterexercise、 CRI1、CRI2、CRI increase (p<0.05or0.01).5.Compared with the health group, HR afterexercise、CRI1、CRI2and CRI of hypertension group are smaller (p=0.001,p=0.000,p=0.049, p=0.002);S1/S2at rest of CADgroup is higher, HR afterexercise、CRI1、CRI of CAD group are smaller (p=0.027,p=0.006, p=0.001,p=0.077);HR at rest of DM group is higher,D/S at rest、HR afterexercise、CRI1、CRI are smaller (p=0.004,p=0.001,p=0.038, p=0.000,p=0.000)6.There is a negative correlation between D/S and heart rate both at rest and after exercise(r=-0.437,-0.397,p=0.000,0.000).7.There is a positive correlation between LVEF and CRI2,LVEF and CRI (r=0.522,0.652,p<0.01)8.SV and CO are the highest when cardiac reserve is mild damaged, and the smallest when cardiac reserve is severe damaged; CWI is the smallest when cardiac reserve is mild damaged, and the highest when cardiac reserve is severe damaged (p<0.05)9.Compared with the group of LV EF<o.5, HR.S1/S2afterexercise、CRI1、CRI2、 CRI are smaller than the group of LVEF>0.5(p=0.006,p=0.043, p=0.014, p=0.008, p=0.015)10.Compared with IVS>12mm, HR、S1/S2afterexercise、CRI1、CR12are higher than the group of IVS<12mm (p=0.000, p=0.012,p=0.033,p=0.002); Compared with group of LVPW>12mm, HR、S1/S2afterexercise、CRI2are higher than the group of LVPW<12mm (p=0.006,p=0.026, p=0.019)11.Compared with group of E/A<1, HR afterexercise、CRI1、CRI2、CRI are smaller than the group of E/A>1(p=0.021,p=0.004, p=0.047,p=0.022)Conclusions1. Heart reserve、cardiac contractility and cardiac reserve reduce with age.2.Cardiac contractility reserve of female is higher than the male.3.Along with age, cardiac contractility reserve increases first and then reduces, heart and cardiac reserve reduce.4. Heart reserve、cardiac contractility and cardiac reserve increase with the HR afterexercise.5.The disease of hypertension can decline heart reserve、cardiac contractility and cardiac reserve;CAD and DM can decline heart reserve and cardiac reserve, and they have little effect on cardiac contractility.6. There is a negative correlation between cardiac diastolic time and heart rate.7.There is a positive correlation between LVEF and cardiac reserve.8.Cardiac contractility reserve reduces when myocardium is hypertrophy.9.The cardiac pump function increases and then reduces along with the decreasing of cardiac reserve.lO.There is a certain relevance between exercise cardiac contractility monitoring and Color Doppler echocardiography、noninvasive hemodynamics testing at estimating cardiac systolic、diastolic and pump function...