Effects of Isometric Handgrip Exercise on Coronary Sinus Blood Flow in Idiopathic Cardiomyopathy

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Abstract
Coronary sinus blood flow (CSBF) was measured by the dye dilution method in 18 patients with idiopathic cardiomyopathy, including 13 with hypertrophic type and 5 with congestive type. The capacity for increasing CSBF in response to handgrip exercise was studied in 14 patients. CSBF at rest ranged from 41-236 ml/min per m2. Average CSBF of 114 .+-. 12 ml/min per m2 (112 .+-. 14 in hypertrophic type and 119 .+-. 25 in congestive type) was significantly larger than control value of 77 .+-. 6 presented previously (P < 0.01). Handgrip exercise at 30% maximal effort for 3 min resulted in increase in CSBF averaging 23 .+-. 8 ml/min per m2 (22 .+-. 8%). In about 1/2 of the cases, the percent increase in CSBF was much smaller than the percent increase in effort index which represents myocardial O2 demand. The change of CSBF was not correlated with changes of left ventricular systolic pressure, cardiac output and stroke work. The diminished response of CSBF to isometric handgrip exercise was ascribed to the decreased coronary vascular reserved in this disorder.

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