[Simultaneous determination of hemodynamics and plasma catecholamines in trained and untrained subjects and patients with contraction disorders of the heart during rest and physical activity].

6 trained (TS) and 7 untrained (US) subjects and 16 patients (P) with left ventricular dysfunction were investigated by means of a Swan-Ganz floating catheter during graded bicycle ergometry in a supine position. 9 P suffered from a myocardial infarction and 10 were known to be hypertensive; 10 suffered from acute coronary insufficiency during exercise. Hemodynamic values, free plasma catecholamines, and heart volume at rest were determined in all cases. The relative heart volume was increased training-dependent in the TS as compared with US and P. In TS stroke volume increased more than in US, whereas in P a heart-rate-dependent adaptation of cardiac output was observed during exercise. In P cardiac output was slightly reduced during exercise and the arteriovenous oxygen difference augmented. Systolic and diastolic pulmonary artery pressure, pulmonary wedge pressure, and peripheral diastolic arterial pressure rose more in P during exercise than in TS and US. TS showed reduced, whereas P showed increased levels of circulating free plasma catecholamines (norepinephrine and epinephrine). Training-dependent changes in hemodynamic values and catecholamine levels were seen as an economic adaptation of the heart to physical stress, and the results in the patients were interpreted as indicating an uneconomic stress adaptation. In patients with disturbed left ventricular function, extracardiac compensatory mechanisms such as enhanced sympathetic activity and increased arteriovenous oxygen difference are necessary for the adaptation to physical stress.