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  • Title: [Filling pressures (pulmonary capillary pressure, indwelling catheter) in combined static (handgrip) and dynamic (bicycle ergometer) stress in postinfarct patients].
    Author: Kottmann W, Jette M, Schrader M, Claus J, Blümchen G.
    Journal: Z Kardiol; 1988 May; 77(5):291-8. PubMed ID: 3407273.
    Abstract:
    79 male post-MI patients (mean age 50 years) underwent Swan-Ganz catheterization using handgrip (1.5 min using both hands at 1/3 of the maximum voluntary capacity), bicycle ergometry and a combination of both: handgrip added after 4 min of ergometry at each level of ergometry, a mean of 3 months after MI. Our aim was to determine to which level of dynamic exercise the chosen handgrip exercise could be compared; furthermore, to examine the left ventricular reaction (PCP) under these combined conditions, because it mimics daily life situations. Using this combination of tests, it should be possible to identify patients who should avoid static work. Our findings were as follows: 48 of the 79 patients showed pathological PCPs. Comparing the same level of double product, no significant differences of PCP were found between dynamic and combined static + dynamic exercise. Our handgrip exercise can replace dynamic exercise of 40 W. 19 patients showed highly pathological PCP reactions with delta PCP greater than or equal to 10 mm Hg following handgrip exercise. This extreme PCP reaction did not correlate with the appearance of ST-segment depression in the exercise ECG, nor with either infarction scar size nor heart volume as estimated by X-ray. These findings demonstrate the importance of a staticdynamic exercise combination in evaluating PCP reactions in post-MI patients. The test allows one to select those MI patients who should avoid isometric work.
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