Right and Left Ventricular Exercise Performance in Chronic Obstructive Pulmonary Disease: Radionuclide Assessment

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Abstract
Right and left ventricular pump performance was assessed at rest and during upright bicycle exercise in 30 patients with chronic obstructive pulmonary disease and in 25 normal control subjects. Right ventricular and left ventricular ejection fractions were ascertainted noninvasively using 1st-pass quantitative radionuclide angiocardiography. The normal ventricular response to exercise was at least a 5% absolute increase in the ejection fraction of either ventricle. In patients the predominant cardiac abnormality involved performance of the right ventricle. Righ ventricular ejection fraction was abnormal at rest in 8 patients. Twenty-three patients demonstrated an abnormal right ventricular response to submaximal exercise. Airway obstruction and arterial hypoxemia were significantly more severe in patients with abnormal right ventricular exercise reserve than in those with normal reserve. Anbnormal left ventricular performance was infrequent either at rest (4 patients) or during exercise (6 patients). This radionuclide technique allows noninvasive assessment of biventricular exercise reserve in chronic obstructive pulmonary disease.