MethodsParticipants. 7 male patients with a history of prostate cancer (age: ## ± # yr (means ± SD); stature: ### ± # cm; mass: ## ± ## kg; body mass index: ## ± # kg/m) completed the protocol. Patients were eligible based on their age (21-80), medicinally controlled hypertension, non-diabetic, and a negative history of heart failure and smoking. This non-randomized study was approved by the Kansas State University Institutional Review Board for research involving human subjects, and the ethical standards conformed to the Declaration of Helsinki. All patients underwent a preliminary session to obtain written informed consent and complete a general health history questionnaire.Left Ventricular Mechanics Protocol (Test #1)Rest. On the day of the protocol, following a ~4-hr dietary/physical activity fast, patients were measured for accurate height and weight before being laid supine on an echocardiographic table.
This table, specifically designed for echocardiographic use, utilizes a unique tilt function to place the patient into the 45° left-lateral decubitus position, while supporting the torso, hips, and legs. Beat-by-beat systolic, diastolic, and mean blood pressures (SBP, DBP, and MAP, respectively) were recorded using continuous finger plesmythography (Finometer Pro; Finapress Medical Systems, Amsterdam, The Netherlands) following 10-min of calibration and baseline. The Finometer Pro is accepted by the field as a validated instrument to assess MAP and Q in elderly populations (#). Three-lead ECG measured continuous heart rate. Two- and four-chamber ultrasound echocardiographic images were obtained in 2D in standard and doppler functions (#).Submaximal Exercise. To obtain work rate-determined cardiovascular data, patients were attached to a supine cycle-ergometer on the same echocardiographic table.
A mouthpiece connected to a metabolic cart was inserted to obtain Gas Exchange Threshold Data. A ramp of 20 W/min was used to elevate heart rate. Once the subject reached a heart rate of 100BPM, the ramp was maintained, the patient continued to cycle as they were tilted into the 45° left-lateral decubitus position, and all plesmythographic, ECG, and echocardiographic measurements were obtained once again. For both rest and exercise, baseline blood pressure and heart rate values were averaged into 30 sec bins over the entire baseline period. Echocardiographic images were obtained by a trained sonographer, according to the standards of the American Society of Echocardiography using a commercially available system (Vivid S6; GE Health Care) with a 1.
9- to 3.8-mHz phased array transducer. Ultrasound system settings were unchanged between participants, and all images were recorded such that the longitudinal movement was in direct line with the ultrasound probe beam. Two-dimensional images were recorded at 50 frames/sec, and doppler velocity data were recorded at 100 frames/sec. Interventricular Septal Strain (S) and Strain Rate (SR) were obtained at both rest and exercise and averaged over the last 3 R-R intervals of the protocol, and then were time-aligned to the Finometer Pro data.
The ? in tissue velocity from rest to exercise was calculated for systolic SR, diastolic (early filling) SR, and systolic S from the apical four-chamber images. Systolic Reserve Index (SRI) was calculated from Systolic Interventricular Septal Tissue Velocities (Sm) at both rest and exercise following this equation (SRI = ?Sm ? (1-(1/resting Sm))). Diastolic Reserve Index (DRI) was calculated from Diastolic Early Filling Interventricular Septal Tissue Velocities (Em) at both rest and exercise following this equation (DRI = ?Em ? (1-(1/resting Em))). Left ventricular end-diastolic volume (LVEDV) and end-systolic volume (LVESV) were traced and calculated using *ultrasound software name*.