The Rate-Pressure Product as an Index of Myocardial Oxygen Consumption during Exercise in Patients with Angina Pectoris

SUMMARYIn order to evaluate hemodynamic predictors of myocardial oxygen consumption (MVO,), 27 normotensive men with angina pectoris were studied at rest and during a steady state at symptom-tolerated maximal exercise (STME). Myocardial blood flow (MBF) was measured by the nitrous oxide method using gas chromatography. MBF increased by 71% from a resting value of 57.4 ± 10.2 to 98.3 ± 15.6 ml/100 g LV/min (P < 0.001) during STME while MVO, increased by 81% from a resting value of 6.7 ± 1.3 to 12.1 ± 2.8 ml O,/100 g LV/min (P < 0.001). MVO2 correlated well with heart rate (HR) (r = 0.79), with HR X blood pressure (BP) (r = 0.83), and, adding end-diastolic pressure and peak LV dp/dt as independent variables, slightly improved this correlation (r = 0.86). Including the ejection period (tension-time index) did not improve the correlation (r = 0.80). Thus, HR and HR X BP, both easily measured hemodynamic variables, are good predictors of MVO, during exercise in normotensive patients with ischemic heart disease. Including variables reflecting the contractile state of the heart and ventricular volume may further improve the predictability.

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