Chesler Roseann M, Stein Richard A
State University of New York Downstate Medical Center, Brooklyn 11203, USA.
J Am Soc Echocardiogr. 2004 Apr;17(4):361-6. doi: 10.1016/j.echo.2003.12.002.
Two-dimensional exercise echocardiography is commonly performed in the supine (SUP) left lateral posture (SLL) to optimize imaging quality.
To assess the clinical use of SLL cycle ergometry, we determined the metabolic, cardiovascular, and hemodynamic responses during graded leg cycle ergometry in women, performed in SLL, commonly used during exercise echocardiography, and compared our findings with those obtained during upright (UP) and SUP leg cycle ergometry.
A total of 21 apparently healthy women performed leg cycle ergometry in 3 distinct postures (UP, SUP, and SLL).
Peak oxygen consumption and peak achieved workload during SLL cycle ergometry were significantly lower compared with UP cycle ergometry, indicating that in SLL physical work capacity would be underestimated compared with that obtained for the UP and SUP postures. The peak heart rate was significantly lower in SLL and the peak systolic blood pressure higher, compared with UP. Maximal rate pressure product was not significantly different among the postures, indicating the equivalent value of SLL with regard to augmenting myocardial oxygen demand during exercise. Stroke volume (calculated from aortic Doppler flow integral) was higher at rest, and increased to a smaller extent during exercise, in the SUP posture and SLL compared with UP. Similar peak values were attained for the 3 postures.
SLL is not a suitable modality for the assessment of functional status or for the derivation of target heart rates for exercise training in UP posture. However, SLL leg cycle ergometry exercise provokes a comparable stimulus for the detection of coronary artery disease, as it will increase myocardial oxygen demand to the same extent as UP leg cycle exercise.
二维运动超声心动图通常在仰卧位（SUP）左侧卧位（SLL）下进行，以优化成像质量。
为评估SLL踏车运动试验的临床应用，我们测定了女性在SLL（运动超声心动图常用姿势）下进行分级腿部踏车运动试验时的代谢、心血管和血流动力学反应，并将我们的研究结果与直立位（UP）和SUP腿部踏车运动试验时获得的结果进行比较。
共有21名表面健康的女性在3种不同姿势（UP、SUP和SLL）下进行腿部踏车运动试验。
与UP踏车运动试验相比，SLL踏车运动试验期间的峰值耗氧量和达到的峰值工作量显著更低，这表明与UP和SUP姿势相比，SLL姿势下的体力工作能力会被低估。与UP相比，SLL时的峰值心率显著更低，而峰值收缩压更高。各姿势之间的最大心率血压乘积无显著差异，表明SLL在运动期间增加心肌需氧量方面具有同等价值。与UP相比，SUP姿势和SLL在静息时的每搏输出量（根据主动脉多普勒血流积分计算）更高，且运动期间增加的幅度更小。3种姿势达到的峰值相似。
SLL不适用于评估功能状态或推导UP姿势下运动训练的目标心率。然而，SLL腿部踏车运动试验在检测冠状动脉疾病方面能引发相当的刺激，因为它将使心肌需氧量增加到与UP腿部踏车运动相同的程度。
