Left ventricular responses to upright isometric handgrip and deadlift in men with coronary artery disease.

Isometric exercise is usually discouraged for patients with coronary artery disease (CAD) because of the possible adverse effects of increased blood pressure on left ventricular (LV) function. Cardiovascular and LV responses to upright handgrip and deadlift were compared in 10 normal men (mean age 52 years) and 14 men (mean age 54 years) with documented CAD or myocardial infarction who were in a supervised exercise program. Handgrip and deadlift were each performed at 30% maximal effort for 3 minutes. LV technetium-99m multigated radionuclide angiograms, electrocardiogram and blood pressure were measured during the final 60 seconds. CAD patients had a significantly lower LV ejection fraction at rest (41%) than normal subjects (57%). Both groups showed equal and significant increases in heart rate, systolic and diastolic pressure during handgrip and deadlift. These responses were all significantly greater in both groups during deadlift. No significant changes in LV ejection fraction occurred in either group during handgrip or deadlift. LV wall motion abnormalities were present in 9 of 14 CAD patients at rest and increased with handgrip (11 men) and deadlift (13 men). No LV abnormalities occurred in normal subjects. These data indicate cardiovascular responses are similar in normal and exercise-trained CAD patients during upright submaximal isometric exercise using small or large muscle groups. Radionuclide measurements of global LV function remain stable in both groups, during similar conditions of increased systolic pressure afterload. However, LV wall motion abnormalities are aggravated in CAD patients during isometric exercise.