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February 1989

Left Ventricular Response to Exercise and Autonomic Control Mechanisms in End-Stage Renal Disease

Author Affiliations

From the Divisions of Cardiology (Drs Blake and Herman) and Nephrology (Drs Solangi, Goodman, and Meggs), Department of Medicine, New York Medical College, Valhalla.

Arch Intern Med. 1989;149(2):433-436. doi:10.1001/archinte.1989.00390020127027

• Left ventricular (LV) function during rest and during exercise was evaluated in patients with end-stage renal disease (ESRD) in whom other causes of LV dysfunction were eliminated through rigid selection criteria. Autonomic function was also assessed in these patients with Valsalva's maneuver and plasma catecholamine determinations. Echocardiography and radionuclide ventriculography in the group with ESRD revealed no abnormalities of LV wall motion or ejection fraction. During graded exercise, patients with ESRD achieved 85% of age-predicted heart rate, and no differences in exercise tolerance or LV function were observed. Valsalva's response was abnormal in patients with ESRD, and post exercise the norepinephrine level was markedly increased (12.5±1.43 vs 8.28 ±0.82 nmol/L). Our results fail to indicate an independent adverse effect of ESRD on LV function.

(Arch Intern Med 1989;149:433-436)

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