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Am J Physiol Heart Circ Physiol (February 13, 2009). doi:10.1152/ajpheart.01069.2008
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Submitted on October 6, 2008
Revised on January 23, 2009
Accepted on February 11, 2009

Cardiac systolic and diastolic function during whole-body heat stress

R. Matthew Brothers1, Paul S. Bhella2, Shigeki Shibata, Jonathan E. Wingo2, Benjamin D. Levine3, and Craig G. Crandall2*

1 Institute for Exercise and Environmental Medicine
2 Presbyterian Hospital of Dallas
3 University of Texas Southwestern

* To whom correspondence should be addressed. E-mail: craigcrandall{at}texashealth.org.

During a whole-body heat stress, stroke volume is either maintained or slightly elevated despite reduced ventricular filling pressures and central blood volume, suggestive of improved cardiac diastolic and / or systolic function. Heat stress improves cardiac systolic and diastolic function in patients with congestive heart failure, although it remains unknown whether similar responses occur in healthy individuals, which is the hypothesis to be tested. Nine male volunteers underwent a whole-body heat stress. Echocardiographic indices of diastolic and systolic function were performed following a supine resting period, and again following an increase in internal temperature of ~ 1.0 °C via passive heat stress. Despite previous reports of heat stress induced decreases in ventricular filling pressures and central blood volume, no changes in indices of diastolic function were identified during heating (i.e. unchanged early diastolic mitral annular tissue velocity (E`), mitral inflow during the early diastolic phase (E), the E/E` ratio, and isovolumetric relaxation time). Heat stress increased late diastolic septal (P=0.03) and lateral (P=0.01) mitral annular tissue velocities (A`), mitral inflow velocity during atrial contraction (P<0.001), and the relative contribution of atrial contraction to left ventricular filling during diastole (P=0.01), all indicative of improved atrial systolic function. Furthermore, indices of systolic function were increased by heat stress (i.e., increased septal (P=0.001) and lateral mitral annular systolic velocities (P=0.01) and isovolumic acceleration at the septal (P=0.03) and lateral (P<0.001) mitral annulus). These data are suggestive of improved atrial and ventricular systolic function by the heat stress. Together these data support previous findings that used the less precise measure of ejection fraction, that heat stress improves indices of systolic function, while diastolic function is maintained.




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