Moderate intensity supine exercise causes decreased cardiac volumes and increased outer volume variations: a cardiovascular magnetic resonance study

Background: The effects on left and right ventricular (LV, RV) volumes during physical exercise remains controversial. Furthermore, no previous study has investigated the effects of exercise on longitudinal contribution to stroke volume (SV) and the outer volume variation of the heart. The aim of this study was to determine if LV, RV and total heart volumes (THV) as well as cardiac pumping mechanisms change during physical exercise compared to rest using cardiovascular magnetic resonance (CMR). Methods: 26 healthy volunteers (6 women) underwent CMR at rest and exercise. Exercise was performed using a custom built ergometer for one-legged exercise in the supine position during breath hold imaging. Cardiac volumes and atrio-ventricular plane displacement were determined. Heart rate (HR) was obtained from ECG. Results: HR increased during exercise from 60 +/- 2 to 94 +/- 2 bpm, (p<0.001). LVEDV remained unchanged (p=0.81) and LVESV decreased with -9 +/- 18% (p<0.05) causing LVSV to increase with 8 +/- 3% (p<0.05). RVEDV and RVESV decreased by -7 +/- 10% and -24 +/- 14% respectively, (p<0.001) and RVSV increased 5 +/- 17% during exercise although not statistically significant (p=0.18). Longitudinal contribution to RVSV decreased during exercise by -6 +/- 15% (p<0.05) but was unchanged for LVSV (p=0.74). THV decreased during exercise by -4 +/- 1%, (p<0.01) and total heart volume variation (THVV) increased during exercise from 5.9 +/- 0.5% to 9.7 +/- 0.6% (p<0.001). Conclusions: Cardiac volumes and function are significantly altered during supine physical exercise. THV becomes significantly smaller due to decreases in RVEDV whilst LVEDV remains unchanged. THVV and consequently radial pumping increases during exercise which may improve diastolic suction during the rapid filling phase.