Thirteen male patients with cardiac disease lpar;50 to 61 years of agerpar; were studied by Doppler echocardiography to determine the effects of arm exercise and leg exercise on heart rate lpar;HRrpar;, stroke volume lpar;SVrpar; and cardiac output lpar;COrpar;. Subjects were divided into two groups, low and normal ejection fraction, depending upon resting left ventricular ejection fraction values taken from previous left ventricular angiograms. Symptomhyphen;limited graded arm exercise tests and leg exercise tests in the upright seated position were performed on each subject on different days. Heart rate, blood pressure, and Doppler measurements were taken and recorded after each 3hyphen;minute stage of exercise. All exercise test results were negative for ischemic changes. At submaximal absolute workloads, normalhyphen;and lowhyphen;ejection fraction patients had similar responses to both arm and leg exercisecolon; HR and CO increased significantly lpar;P 0.05rpar; with small or nonhyphen;significant increases noted in SV. At relative maximum workloads, there were significant differences between normalhyphen; and lowhyphen;ejection fraction subjects during both arm and leg exercise. Normalhyphen;ejection fraction subjects showed significant lpar;P 0.05rpar; increases in HR, SV, and CO with exercisesemi; and lowhyphen;ejection fraction patients showed significant increases in HR and CO but no significant change in SV at maximal workloads. It was concluded that resting ejection fraction values in nonhyphen;ischemic patients may be predictive of the hemodynamic response to exercise, as demonstrated by the significant differences seen in SV response between patients with low ejection fraction and normal ejection fraction during relative maximum arm or leg exercise. This finding is of clinical importance to those involved in exercise prescription for cardiac patients.
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