Comparison of isometric exercise and angiotensin infusion as stress test for evaluation of left ventricular function

Isometric handgrip exercise and the angiotensin infusion test were compared to determine their relative usefulness in the assessment of ventricular reserve as adjuncts to cardiac catheterization. Both tests appeared to distinguish accurately normal from abnormal cardiac reserve. In all patients cardiac output, heart rate and minute work index were significantly higher with isometric exercise than with angiotensin infusion. Isometric exercise has a potential advantage over angiotensin infusion, since it evaluates function during a physiologic stress. Angiotensin infusion is more easily utilized in debilitated, sedated or uncooperative patients, but results may be more difficult to interpret because the drug may affect myocardial contractility and elicit reflex hemodynamic alterations. It is concluded that isometric stress testing is a useful and reliable method for the determination of cardiac reserve during cardiac catheterization.