Operation Everest II: Cardiac filling pressures during cycle exercise at sea level

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Abstract

To examine the relationship between cardiac filling pressures during exercise in man and oxygen transport, we examined sea level data from Operation Everest II. The results showed that, (1) both right atrial and wedge pressures rose with heavy exercise in normal man, (2) the magnitude of the rise in these filling pressures related both to stroke volume and maximum exercise capacity, (3) wedge pressure was tightly coupled to right atrial pressure, with each mm Hg increase in right atrial pressure resulting in a 1.4 mm Hg increase in wedge pressure, and (4) very high wedge pressures occurred (in some subjects > 30 mm Hg), which contributed to an elevation of pulmonary arterial pressure. Thus direct measurements indicate right heart filling pressure increases with exertion in normal man, probably providing the necessary right heart output to fill the left heart. We speculated that the high cardiac filling pressures might be needed to maintain oxygen transport during heavy exercise, and that such pressures could contribute both to elevated pulmonary arterial pressure and to increased filtration of water into the lung.

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Presented at the symposium ‘Factors Determining V̇O2max in Humans’, 73rd Annual Meeting of the Federation of American Societies for Experimental Biology, New Orleans LA, March 19–23, 1989.

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