To assess the influence of isometric handgrip exercise on left ventricular function by radionuclide ventriculogrphy in patients with coronary artery disease (CAD). Using gated equilibrium radionuclide ventriculography

parameters of left ventricular function were andalyzed at rest and during 30% sustained handgrip (HNG) for 5—10 minuets in 8 normal control subjects and 38 consecutive CAD patients. All investigated subjects were also performed coronary arteriography within 2 weeks. Results showed that at rest

left ventricular ejection fraction (LVEF)

peak filling rate (PFR)

end-diastolic volume (EDV)

end-systolic volume (ESV) and heart rate (HR) were reduced in one-vessel

two-vessel and three-vessel of stenosis patient group (53.67±5.0)%

(52.47±8.26)%

(52.81±8.89)%;2.87±0.29

2.71±0.88

3.07±0.71 end-diastolic volume per second (EDV/s); 1.36±0.05

1.34±0.06

1.34±0.06; 0.62±0.06

0.66±0.06

0.65±0.1; 69.67±8.14

72.85±10.5

76.56±18.04(min -1 )

respecively

as compared with controls (57±10.45)%

p=NS;2.94±0.44 (EDV/s)

p=NS;1.38±0.15

p=NS;0.59±0.11

p=NS;72.88±8.25 (min -1 )

p=NS

respectively. During HNG exercise using both hands

the indexes were reduced in CAD patients (54.44±5.66)%

(48.84±8.70)%

(45.25±8.69)%;2.75±0.39

2.50±0.68

2.22±0.58 (EDV/s);1.36±0.05

1.31±0.06

1.26±0.07;0.61±0.07

0.69±0.06

0.71±0.09;81.33±8.92

84.46±14.29

90.56±26.54 (min -1

respectively

as compared with controls (59.38±9.44)%

p=NS;<0.05

<0.01;3.52±0.33 (EDV/s)

P <0.001

P <0.001

P <0.001;1.41±0.16

p=NS;NS

<0.05;0.56±0.11

p=NS;<0.01/<0.01;83.75±7.56 (min -1 )

p=NS

respectively. The four protocols of CAD diagnosis were 1.LVEF<55% and ΔPFR<0 EDV/s at rest (Δ value=during HNG value-rest value);2.LVEF<55% during HNG and ΔPFR<0 EDV/s;3. ΔLVEF<0% and ΔPFR<0 EDV/s;4.ΔEF<0%. Their sensitivity

specificity and accuracy were 45%

53%

66%

76%;100%

100%

87.5%

87.5%;54%

61%

70%

78%

respectively. The isomeric exercise radionuclide ventriculogrphy is a safte

accurate

simple and effective method to evaluate CAD.