Sex-related differences in the normal cardiac response to upright exercise.

Abstract:

:In previous studies from this laboratory, we found that approximately 30% of women with chest pain and normal coronary arteries demonstrated either a decrease in or a failure to increase radionuclide ejection fraction during exercise. To examine the hypothesis that this apparent abnormality in left ventricular function represents a physiologic difference between men and women, we prospectively studied central and peripheral cardiovascular responses to exercise in 31 age-matched healthy volunteers (16 women and 15 men). A combination of quantitative radionuclide angiography and expired-gas analysis was used to measure ejection fraction and relative changes in end-diastolic counts, stroke counts, count output, and arteriovenous oxygen difference during symptom-limited upright bicycle exercise. Normal male and female volunteers demonstrated comparable baseline left ventricular function and similar aerobic capacity, as determined by weight-adjusted peak oxygen consumption (22.1 +/- 5.1 and 22.6 +/- 4.3 ml/kg/min, respectively). However, their cardiac responses to exercise were significantly different. Ejection fraction increased from 0.62 +/- 0.09 at rest to 0.77 +/- 0.07 during exercise in men (p less than .001), but was unchanged from 0.63 +/- 0.09 at rest to 0.64 +/- 0.10 during exercise in women. The ejection fraction increased by 5 points or more in 14 of 15 men, but in only seven of the 16 women. End-diastolic counts increased by 30% in women (p less than .001), but was unchanged in men. Because decreases in ejection fraction were matched by increases in end-diastolic counts, relative increases in stroke counts and count output were the same for men and women. These data demonstrate a basic difference between men and women with respect to the mechanism by which they achieve a normal response of stroke volume to exercise; these differences must be taken into account when measurements of cardiac function during exercise stress are used for diagnostic purposes.

journal_name

Circulation

journal_title

Circulation

authors

Higginbotham MB,Morris KG,Coleman RE,Cobb FR

doi

10.1161/01.cir.70.3.357

subject

Has Abstract

pub_date

1984-09-01 00:00:00

pages

357-66

issue

3

eissn

0009-7322

issn

1524-4539

journal_volume

70

pub_type

杂志文章
  • Cerebral protection with filter devices during carotid artery stenting.

    abstract:BACKGROUND:Distal embolization of debris during percutaneous carotid artery stenting may result in neurological deficit. Filter devices for cerebral protection potentially reduce the risk of embolization. METHODS AND RESULTS:Elective carotid stent implantation using 3 different types of distal filter protection device...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/hc2601.092495

    authors: Reimers B,Corvaja N,Moshiri S,Saccà S,Albiero R,Di Mario C,Pascotto P,Colombo A

    更新日期:2001-07-03 00:00:00

  • Circulating transforming growth factor-beta in Marfan syndrome.

    abstract:BACKGROUND:Marfan syndrome (MFS) is caused by mutations in the fibrillin-1 gene and dysregulation of transforming growth factor-beta (TGF-beta). Recent evidence suggests that losartan, an angiotensin II type 1 blocker that blunts TGF-beta activation, may be an effective treatment for MFS. We hypothesized that dysregula...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.108.841981

    authors: Matt P,Schoenhoff F,Habashi J,Holm T,Van Erp C,Loch D,Carlson OD,Griswold BF,Fu Q,De Backer J,Loeys B,Huso DL,McDonnell NB,Van Eyk JE,Dietz HC,GenTAC Consortium.

    更新日期:2009-08-11 00:00:00

  • Real-time inferior vena caval ultrasonography: normal and abnormal findings and its use in assessing right-heart function.

    abstract::We studied the inferior vena cava (IVC) as an index of right-heart function in 111 patients. A two-dimensional echocardiographic sector was used to visualize the IVC, and its M-mode cursor was used to generate a time-motion record of the IVC size and pulsation. Normal subjects had a small presystolic A wave (less than...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.64.5.1018

    authors: Mintz GS,Kotler MN,Parry WR,Iskandrian AS,Kane SA

    更新日期:1981-11-01 00:00:00

  • Lack of Ability to Present Antigens on Major Histocompatibility Complex Class II Molecules Aggravates Atherosclerosis in ApoE-/- Mice.

    abstract:BACKGROUND:Hypercholesterolemic mice lacking factors required for activation of CD4+ T cells are characterized by reduced development of atherosclerosis. Consequently, it has been assumed that atherosclerosis involves loss of tolerance against modified self-antigens generated in response to hypercholesterolemia and tha...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.118.039288

    authors: Wigren M,Rattik S,Yao Mattisson I,Tomas L,Grönberg C,Söderberg I,Alm R,Sundius L,Ljungcrantz I,Björkbacka H,Fredrikson GN,Nilsson J

    更新日期:2019-05-28 00:00:00

  • Immunoglobulin M type of autoantibodies to oxidized low-density lipoprotein has an inverse relation to carotid artery atherosclerosis.

    abstract:BACKGROUND:Lipoprotein oxidation plays an important part in atherogenesis. Autoantibodies to oxidation-specific epitopes of LDL occur in plasma and atherosclerotic lesions of humans and animals. The potential role of these autoantibodies in atherogenesis still remains unsolved. We studied the relationship between diffe...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000092891.55157.A7

    authors: Karvonen J,Päivänsalo M,Kesäniemi YA,Hörkkö S

    更新日期:2003-10-28 00:00:00

  • Chronic congestive heart failure elicits adaptations of endurance exercise in diaphragmatic muscle.

    abstract:BACKGROUND:During rest and exercise, patients with heart failure hyperventilate; therefore, the diaphragm can be viewed as undergoing constant moderate-intensity exercise. Accordingly, we hypothesized that heart failure elicits adaptations in the diaphragm similar to those elicited by endurance exercise in the limb mus...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.95.4.910

    authors: Tikunov B,Levine S,Mancini D

    更新日期:1997-02-18 00:00:00

  • Local platelet activation causes vasoconstriction of large epicardial canine coronary arteries in vivo. Thromboxane A2 and serotonin are possible mediators.

    abstract::The goal of the present study was to demonstrate that intracoronary platelet deposition may trigger intense vasoconstriction of large epicardial coronary arteries in vivo and that this is largely mediated by thromboxane A2 and serotonin released by activated platelets. Cyclic flow variations (progressive declines in b...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.79.1.154

    authors: Golino P,Ashton JH,Buja LM,Rosolowsky M,Taylor AL,McNatt J,Campbell WB,Willerson JT

    更新日期:1989-01-01 00:00:00

  • Aortic valvuloplasty for acquired aortic stenosis.

    abstract::With the advent of reliable prosthetic valves, the number of aortic valvuloplastic procedures performed in adults has decreased significantly. This is in contradistinction to patients with congenital aortic stenosis, in whom aortic valvuloplasty remains the primary approach. Although only a 25% to 50% incidence of lon...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Mindich BP,Guarino T,Goldman ME

    更新日期:1986-09-01 00:00:00

  • Aprotinin prevents cardiopulmonary bypass-induced platelet dysfunction. A scanning electron microscope study.

    abstract:BACKGROUND:Administration of aprotinin during extracorporeal circulation reduces blood loss and improves platelet function. METHODS AND RESULTS:To evaluate the protective effect of aprotinin on platelets, 50 patients undergoing cardiopulmonary bypass were randomized before surgery to one of three groups. Seventeen pat...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Mohr R,Goor DA,Lusky A,Lavee J

    更新日期:1992-11-01 00:00:00

  • Hemodynamic and exercise performance with pulsatile and continuous-flow left ventricular assist devices.

    abstract:BACKGROUND:Continuous-flow rotary pumps with axial design are increasingly used for left ventricular assist support. The efficacy of this design compared with pulsatile, volume displacement pumps, with respect to characteristics of left ventricular unloading, and exercise performance remains largely unstudied. METHODS...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.106.677898

    authors: Haft J,Armstrong W,Dyke DB,Aaronson KD,Koelling TM,Farrar DJ,Pagani FD

    更新日期:2007-09-11 00:00:00

  • Sustained improvement after combined anterior mitral leaflet extension and myectomy in hypertrophic obstructive cardiomyopathy.

    abstract:BACKGROUND:Mitral leaflet extension (MLE) combined with septal myectomy is a new surgical approach to treat hypertrophic obstructive cardiomyopathy (HOCM) and an enlarged mitral leaflet area. The study presents the long-term clinical results and outcome of this technique. METHODS AND RESULTS:MLE entails grafting a glu...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.CIR.0000092912.57140.14

    authors: van der Lee C,Kofflard MJ,van Herwerden LA,Vletter WB,ten Cate FJ

    更新日期:2003-10-28 00:00:00

  • iNOS expression and nitrotyrosine formation in the myocardium in response to inflammation is controlled by the interferon regulatory transcription factor 1.

    abstract:BACKGROUND:Production of NO by inducible NO synthase (iNOS) has been implicated in the pathology of spontaneous and antigen-induced autoimmune diseases, and iNOS is expressed in the myocardium of patients with heart failure. It is not clear whether inflammatory murine autoimmune heart disease, an experimental model for...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Bachmaier K,Neu N,Pummerer C,Duncan GS,Mak TW,Matsuyama T,Penninger JM

    更新日期:1997-07-15 00:00:00

  • Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000.

    abstract:BACKGROUND:Peripheral arterial disease (PAD) is associated with significant morbidity and mortality and is an important marker of subclinical coronary heart disease. However, estimates of PAD prevalence in the general US population have varied widely. METHODS AND RESULTS:We analyzed data from 2174 participants aged 40...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000137913.26087.F0

    authors: Selvin E,Erlinger TP

    更新日期:2004-08-10 00:00:00

  • Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk.

    abstract:BACKGROUND:Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement. METHODS AND RESULTS:We performed 24-hour ABP monitoring in 5682 participants (mean age 59.0 years; ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.106.662254

    authors: Kikuya M,Hansen TW,Thijs L,Björklund-Bodegård K,Kuznetsova T,Ohkubo T,Richart T,Torp-Pedersen C,Lind L,Ibsen H,Imai Y,Staessen JA,International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcom

    更新日期:2007-04-24 00:00:00

  • The United States preventive services task force recommendation statement on screening for peripheral arterial disease: more harm than benefit?

    abstract::Under the auspices of the Agency for Healthcare Research and Quality, the United States Preventive Services Task Force (USPSTF) recently released an update to its 1996 Peripheral Arterial Disease (PAD) Screening Recommendation Statement. The USPSTF recommended against PAD screening, giving the practice a "D" level rec...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.105.607846

    authors: Beckman JA,Jaff MR,Creager MA

    更新日期:2006-08-22 00:00:00

  • Creation of anastomoses between an extracardiac artery and the coronary circulation. Proof that myocardial angiogenesis occurs and can provide nutritional blood flow to the myocardium.

    abstract::The purpose of this investigation was to determine whether blood vessels could develop de novo between an extracardiac artery and a collateral-dependent zone of the heart and to quantify the nutritive blood flow afforded by the new vessels. We also adapted the preparation so that angiogenically active agents could be ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.82.4.1449

    authors: Unger EF,Sheffield CD,Epstein SE

    更新日期:1990-10-01 00:00:00

  • Aortic valve replacement and concomitant mitral valve regurgitation in the elderly: impact on survival and functional outcome.

    abstract:BACKGROUND:The impact of mitral regurgitation (MR) on elderly patients (> or = 70 years) undergoing isolated aortic valve replacement (AVR) is not clearly defined. This study investigates the long-term effects of preoperative, moderate MR on survival and functional outcome in elderly AVR patients. METHODS AND RESULTS:...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.104.526046

    authors: Barreiro CJ,Patel ND,Fitton TP,Williams JA,Bonde PN,Chan V,Alejo DE,Gott VL,Baumgartner WA

    更新日期:2005-08-30 00:00:00

  • Sex differences in perioperative and long-term cardiac event-free survival in vascular surgery patients. An analysis of clinical and scintigraphic variables.

    abstract:BACKGROUND:Little information is available regarding the occurrence of perioperative and late cardiac events in women with vascular disease. The current study was performed to examine whether sex-specific differences exist in these outcomes in a large population of vascular surgery patients and to determine the value o...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.91.4.1044

    authors: Hendel RC,Chen MH,L'Italien GJ,Newell JB,Paul SD,Eagle KA,Leppo JA

    更新日期:1995-02-15 00:00:00

  • Severe pulmonary hypertension associated with a small ventricular septal defect.

    abstract::A case of progressive pulmonary hypertension in a child with a small ventricular septal defect is presented. Natural history studies have indicated that children with small ventricular septal defects can be followed conservatively. This case represents a contradiction to that rule and suggests that further study must ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.67.2.470

    authors: Bisset GS 3rd,Hirschfeld SS

    更新日期:1983-02-01 00:00:00

  • Intermediate-density lipoproteins and progression of carotid arterial wall intima-media thickness.

    abstract:BACKGROUND:Although LDL cholesterol (LDL-C) is generally accepted to be a major risk factor for progression of atherosclerosis, the traditional measurement of LDL-C includes measurement of IDL. Little is known about the relationship between IDL and progression of atherosclerosis. Therefore, we investigated the associat...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.95.8.2022

    authors: Hodis HN,Mack WJ,Dunn M,Liu C,Liu C,Selzer RH,Krauss RM

    更新日期:1997-04-15 00:00:00

  • Morning increase in platelet aggregability. Association with assumption of the upright posture.

    abstract::The frequencies of onset of myocardial infarction and sudden cardiac death are increased between 6 AM and 12 noon. Platelet aggregability, which may play a role in the cause of these disorders, has been observed to increase after the normal morning activities of awakening, arising, and ambulating. To determine which m...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.78.1.35

    authors: Brezinski DA,Tofler GH,Muller JE,Pohjola-Sintonen S,Willich SN,Schafer AI,Czeisler CA,Williams GH

    更新日期:1988-07-01 00:00:00

  • Medical Therapy for Systemic Right Ventricles: A Systematic Review (Part 1) for the 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on

    abstract::Patients with systemic morphological right ventricles (RVs), including congenitally corrected transposition of the great arteries and dextro-transposition of the great arteries with a Mustard or Senning atrial baffle repair, have a high likelihood of developing systemic ventricular dysfunction. Unfortunately, there ar...

    journal_title:Circulation

    pub_type: 杂志文章,meta分析

    doi:10.1161/CIR.0000000000000604

    authors: Zaragoza-Macias E,Zaidi AN,Dendukuri N,Marelli A

    更新日期:2019-04-02 00:00:00

  • Evidence for a direct renal stimulating effect of prostaglandin E2 on renin release in patients with congestive heart failure.

    abstract::The reduced responsiveness of the renin-angiotensin system to hemodynamic changes in patients with congestive heart failure (CHF) could be due to a defect of the juxtaglomerular apparatus. To test this hypothesis, the responses to viprostol, an analog of prostaglandin E2 (PGE2) that is known to stimulate both the macu...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.74.6.1203

    authors: Olivari MT,Levine TB,Cohn JN

    更新日期:1986-12-01 00:00:00

  • Predictors of disease course in patients with acute myocarditis.

    abstract:BACKGROUND:Clinical manifestations of acute myocarditis, with distinct onset, vary from asymptomatic to fatal. The predictors of the course of the disease in patients with acute myocarditis at initial presentation have not yet been established. In this study, we examined the predictive values of various parameters in t...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.23.2829

    authors: Fuse K,Kodama M,Okura Y,Ito M,Hirono S,Kato K,Hanawa H,Aizawa Y

    更新日期:2000-12-05 00:00:00

  • Effect of Empagliflozin on Left Ventricular Volumes in Patients with Type 2 Diabetes, or Prediabetes, and Heart Failure with Reduced Ejection Fraction (SUGAR-DM-HF).

    abstract:BACKGROUND:Sodium-glucose cotransporter 2 inhibitors reduce the risk of heart failure hospitalization and cardiovascular death in patients with heart failure and reduced ejection fraction (HFrEF). However, their effects on cardiac structure and function in HFrEF are uncertain. METHODS:We designed a multicenter, random...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.120.052186

    authors: Lee MMY,Brooksbank KJM,Wetherall K,Mangion K,Roditi G,Campbell RT,Berry C,Chong V,Coyle L,Docherty KF,Dreisbach JG,Labinjoh C,Lang NN,Lennie V,McConnachie A,Murphy CL,Petrie CJ,Petrie JR,Speirits IA,Sourbron S,Wel

    更新日期:2020-11-13 00:00:00

  • Vascular endothelial cell growth-activated XBP1 splicing in endothelial cells is crucial for angiogenesis.

    abstract:BACKGROUND:Vascular endothelial cell growth factor plays a pivotal role in angiogenesis via regulating endothelial cell proliferation. The X-box binding protein 1 (XBP1) is believed to be a signal transducer in the endoplasmic reticulum stress response. It is unknown whether there is crosstalk between vascular endothel...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.112.001337

    authors: Zeng L,Xiao Q,Chen M,Margariti A,Martin D,Ivetic A,Xu H,Mason J,Wang W,Cockerill G,Mori K,Li JY,Chien S,Hu Y,Xu Q

    更新日期:2013-04-23 00:00:00

  • Adiponectin specifically increased tissue inhibitor of metalloproteinase-1 through interleukin-10 expression in human macrophages.

    abstract:BACKGROUND:Vascular inflammation and subsequent matrix degradation play an important role in the development of atherosclerosis. We previously reported that adiponectin, an adipose-specific plasma protein, accumulated to the injured artery and attenuated vascular inflammatory response. Clinically, high plasma adiponect...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000127953.98131.ED

    authors: Kumada M,Kihara S,Ouchi N,Kobayashi H,Okamoto Y,Ohashi K,Maeda K,Nagaretani H,Kishida K,Maeda N,Nagasawa A,Funahashi T,Matsuzawa Y

    更新日期:2004-05-04 00:00:00

  • Effect of pulse separation between two sequential biphasic shocks given over different lead configurations on ventricular defibrillation efficacy.

    abstract:BACKGROUND:Two sequential biphasic shocks delivered over separate lead configurations markedly improve defibrillation efficacy compared with a single shock alone. We investigated the effect of varying the intershock interval between sequential biphasic shocks on defibrillation. METHODS AND RESULTS:Defibrillation thres...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.85.6.2267

    authors: Johnson EE,Alferness CA,Wolf PD,Smith WM,Ideker RE

    更新日期:1992-06-01 00:00:00

  • Pooling in chronic orthostatic intolerance: arterial vasoconstrictive but not venous compliance defects.

    abstract:BACKGROUND:Orthostatic intolerance is characterized by postural tachycardia syndrome (POTS) with exaggerated tachycardia, orthostatic symptoms, and "pooling" (which comprises acrocyanosis and dependent edema when upright). My colleagues and I tested the hypothesis that pooling results from increased venous compliance i...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.0000016348.55378.c4

    authors: Stewart JM

    更新日期:2002-05-14 00:00:00

  • National study of physician awareness and adherence to cardiovascular disease prevention guidelines.

    abstract:BACKGROUND:Few data have evaluated physician adherence to cardiovascular disease (CVD) prevention guidelines according to physician specialty or patient characteristics, particularly gender. METHODS AND RESULTS:An online study of 500 randomly selected physicians (300 primary care physicians, 100 obstetricians/gynecolo...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000154568.43333.82

    authors: Mosca L,Linfante AH,Benjamin EJ,Berra K,Hayes SN,Walsh BW,Fabunmi RP,Kwan J,Mills T,Simpson SL

    更新日期:2005-02-01 00:00:00