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Exercise Stress Test (exercise + stress_test)

Distribution by Scientific Domains

Medical Sciences	94%

Distribution within Medical Sciences

Cardiovascular Disease	55%
General & Internal Medicine	11%

Selected Abstracts

Prognostic Value of Exercise Stress Test and Dobutamine Stress Echo in Patients with Known Coronary Artery Disease

ECHOCARDIOGRAPHY, Issue 1 2009
Francesca Innocenti M.D.
Background: The aim of this study was to compare the feasibility of dobutamine stress echocardiography (DSE) and exercise stress test (EST) between patients in different age groups and to evaluate their proportional prognostic value in a population with established coronary artery disease (CAD). Methods: The study sample included 323 subjects, subdivided in group 1 (G1), comprising 246 patients aged <75 years, and group 2 (G2), with 77 subjects aged ,75 years. DSE and EST were performed before enrollment in a cardiac rehabilitation program; for prognostic assessment, end points were all-cause mortality and hard cardiac events (cardiac death or nonfatal myocardial infarction). Results: During DSE, G2 patients showed worse wall motion score index (WMSI), but the test was stopped for complications in a comparable proportion of cases (54 G1 and 19 G2 patients, P = NS). EST was inconclusive in similarly high proportion of patients in both groups (76% in G1 vs. 84% in G2, P = NS); G2 patients reached a significantly lower total workload (6 ± 1.6 METs in G1 vs. 5 ± 1.2 METs in G2, P < 0.001). At multivariate analysis, a lower peak exercise capacity (HR 0.566, CI 0.351,0.914, P = 0.020) was associated with higher mortality, while a high-dose WMSI >2 (HR 5.123, CI 1.559,16.833, P = 0.007), viability (HR 3.354, CI 1.162,9.678, P = 0.025), and nonprescription of beta-blockers (HR 0.328, CI 0.114,0.945, P = 0.039) predicted hard cardiac events. Conclusion: In patients with known CAD, EST and DSE maintain a significant prognostic role in terms of peak exercise capacity for EST and of presence of viability and an extensive wall motion abnormalities at peak DSE. [source]

Psychosocial Correlates of Cardiovascular Reactivity to Anticipation of an Exercise Stress Test Prior to Attending Cardiac Rehabilitation: A Preliminary Test,

JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 1 2008
Shawn N. Fraser
We examined social and psychological correlates of cardiovascular reactivity (CVR), or exaggerated heart rate (HR) and blood pressure (BP) responses to mental stress, in 45 men (mean age = 60.1, SD = 9.9) and 17 women (mean age = 9.9, SD = 11.8) prior to cardiac rehabilitation. HR and BP increased from rest to anticipation, and women had higher resting and preexercise BP. Anxiety was positively related to HR reactivity. HR reactivity was negatively related to self-efficacy in women and positively related to self-efficacy in men. Men and women with more self-efficacy had lower systolic blood pressure (SBP) reactivity, and anxiety was positively related to SBP reactivity in women. Results suggest that the relationship among psychosocial factors and CVR might differ among men and women. [source]

Heart Rate Variability in Arrhythmogenic Right Ventricular Cardiomyopathy Correlation with Clinical and Prognostic Features

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2002
ANTONIO FRANCO FOLINO
FOLINO, A.F., et al.: Heart Rate Variability in Arrhythmogenic Right Ventricular Cardiomyopathy Correlation with Clinical and Prognostic Features. The identification of subjects with arrhythmogenic right ventricular cardiomyopathy (ARVC) at higher risk for sudden death is an unresolved issue. An influence of the autonomic activity on the genesis of ventricular arrhythmias was postulated. Heart rate variability (HRV) analysis provides a useful method to measure autonomic activity, and is a predictor of increased risk of death after myocardial infarction. For these reasons, the aim of the study was to evaluate HRV and its correlations with ventricular arrhythmias, heart function, and prognostic outcome in patients with ARVC. The study included 46 patients with ARVC who were not taking antiarrhythmic medications. The diagnosis was made by ECG, echocardiography, angiography, and endomyocardial biopsy. Exercise stress test and Holter monitoring were obtained in all patients. Time-domain analysis of HRV was expressed as the standard deviation of all normal to normal NN intervals (SDNN) detected during 24-hour Holter monitoring. Thirty healthy subjects represented a control group for HRV analysis. The mean follow-up was 10.8 ± 1.86 years. SDNN was reduced in patients with ARVC in comparison with the control group (151 ± 36 vs 176 ± 34, P = 0.00042). Moreover, there was a significant correlation of this index with the age of the patients (r =,0.59, P < 0.001), with the left (r = 0.44, P = 0.002) and right (r = 0.47, P = 0.001) ventricle ejection fraction, with the right ventricular end diastolic volume (r =,0.62, P < 0.001), and with the ventricular arrhythmias, detected during the same Holter record used for HRV analysis (patients with isolated ventricular ectopic beats < 1,000/24 hours, 184 ± 34; patients with isolated ventricular ectopic beats > 1,000/24 hours and/or couplets, 156 ± 25; patients with repetitive ventricular ectopic beats (,3) and/or ventricular tachycardia, 129 ± 25; P < 0.001). During follow-up two patients showed a transient but significant reduction of SDNN and a concomitant increase of the arrhythmic events. In eight patients an episode of sustained ventricular tachycardia occurred, but the mean SDNN of this subgroup did not differ from the mean value of the remaining patients (152 ± 15 vs 150 ± 39; P = NS). Only one subject died after heart transplantation during follow-up (case censored). Time-domain analysis of HRV seems to be a useful method to assess the autonomic influences in ARVC. A reduction of vagal influences correlates with the extent of the disease. The significant correlation between SDNN and ventricular arrhythmias confirmed the influences of autonomic activity in the modulation of the electrical instability in ARVC patients. However, SDNN was not predictive of spontaneous episodes of sustained ventricular tachycardia. [source]

Prognostic Value of Exercise Stress Test and Dobutamine Stress Echo in Patients with Known Coronary Artery Disease

Impact of genetic defects on coronary atherosclerosis in patients suspected of having familial hypercholesterolaemia

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2003
O. S. Descamps
Abstract Background In the present study we assessed whether the presence of genetic mutations typical of familial hypercholesterolaemia (FH) was associated with greater atherosclerosis in the coronary vessels in patients with severe hypercholesterolaemia and a family history of early cardiovascular disease. Materials and methods Two hundred and thirty-five patients selected for having severe hypercholesterolaemia and a family history of cardiovascular disease were classified as FH (57 men and 38 women) or non-FH (84 men and 56 women) according to a genetic analysis of the LDL-R or ApoB genes. Coronary atherosclerosis was evaluated by performing a thoracic CT scan and exercise stress testing. Results Familial hypercholesterolaemia individuals had a significantly higher prevalence of coronary calcification than the non-FH patients from among both the men (OR = 3·90; 95% CI 1·86,8·19; P < 0·001) and the women (OR = 2·34; 95% CI 1·01,5·48; P = 0·05). In exercise stress testing, ECG abnormalities suggestive of cardiac ischaemia were found with a higher prevalence in the FH patients than the non-FH patients from among both the men (OR 6·15; 95% CI 2·16,17·5; P < 0·001) and the women (OR 4·76; 95% CI 0·91,24·6; P = 0·06). All differences were statistically significant after adjusting for age and cholesterol and for most classical risk factors that differed between the FH and non-FH groups. Conclusion Among patients with severe hypercholesterolaemia and a family history of early cardiovascular disease, the presence of a genetically ascertained FH is associated with a higher prevalence of coronary artery calcifications and a positive exercise stress test. These results suggest that despite a similar phenotype, patients carrying mutations suggestive of FH may have a greater cardiovascular risk than patients without these mutations. [source]

Could exercise be a new strategy to revert some patients with atrial fibrillation?

INTERNAL MEDICINE JOURNAL, Issue 1 2010
P. Gates
Abstract Background: This study is the result of the anecdotal observation that a number of patients with atrial fibrillation (AF) had noted reversion to sinus rhythm (SR) with exercise. We aimed to evaluate the potential role of exercise stress test (EST) for the reversion of AF. Methods: Patients with AF who were scheduled to undergo electrical cardioversion (DCR) underwent EST using a modified Bruce protocol. Results: Eighteen patients (16 male); aged 36,74 years (mean 58 years) were studied. Five patients (27.7%) had successful reversion with exercise (group 1). Thirteen patients remained in AF (group 2). No patient who failed to revert with exercise did so spontaneously before DCR 3 h to 7 months later (median 20 days). Comparison between group 1 and group 2 did not reveal any significant difference Conclusion: This small preliminary study suggests that in some patients it may be possible to revert AF to SR with exercise and avoid DCR and concomitant general anaesthesia. The authors suggest that a larger multicentre randomized trial is warranted to confirm or refute these initial results and if correct identify those who might benefit. [source]

Calcium Channel Antagonism Reduces Exercise-Induced Ventricular Arrhythmias in Catecholaminergic Polymorphic Ventricular Tachycardia Patients with RyR2 Mutations

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2005
HEIKKI SWAN M.D.
Introduction: Recently, gain-of-function mutations of cardiac ryanodine receptor RyR2 gene have been identified as a cause of familial or catecholaminergic polymorphic ventricular tachycardia. We examined the influence of the calcium channel blockers, verapamil and magnesium, on exercise-induced ventricular arrhythmias in patients with RyR2 mutations. Methods and Results: Six molecularly defined catecholaminergic polymorphic ventricular tachycardia patients, all carrying a RyR2 mutation and on ,-adrenergic blocker therapy, underwent exercise stress test four times: at baseline, after verapamil and magnesium sulphate infusions, and finally, without interventions. The number of isolated and successive premature ventricular complexes during exercise ranged from 40 to 374 beats (mean 165 beats) at baseline, and was reduced during verapamil by 76 ± 17% (P < 0.05). Premature ventricular complexes appeared later and at higher heart rate during verapamil than at baseline (119 ± 21 vs. 127 ± 27 min,1, P < 0.05). Magnesium did not inhibit the arrhythmias. Results in the fourth exercise stress test without interventions were similar to those in the first baseline study. Conclusions: This study provides the first in vivo demonstration that a calcium channel antagonist, verapamil, can suppress premature ventricular complexes and nonsustained ventricular salvoes in catecholaminergic polymorphic ventricular tachycardia caused by RyR2 mutations. Modifying the abnormal calcium handling by calcium antagonists might have therapeutic value. [source]

Exercise-Attenuation of Q-Waves in II, III, and aVF, and R-Waves in V1 and V2 in a Patient with an Inferior Infarction and Anterior Wall Ischemia

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2008
JOHN E. MADIAS M.D.
A 63-year-old male patient with inferior infarction revealed transient attenuation of the Q-waves in II, III, and aVF, and R-waves in V1,V3 during an exercise stress test. Myocardial scintigraphy disclosed ischemia of the anterior wall and coronary arteriography, a 90% stenosis of the left main coronary artery (LMCA). The mechanism involved appears to be a transient failure of the anterior wall to generate adequate depolarization forces for the genesis of Q-waves in the inferior leads and R-waves in the anterior leads. This electrocardiogram sign is diagnostic of severe anterior wall ischemia due to left anterior descending or LMCA stenosis. [source]

Usefulness of a program of hospital-supervised physical training in patients with cystic fibrosis

PEDIATRIC PULMONOLOGY, Issue 2 2004
Attilio Turchetta MD
Abstract Exercise is an important part of normal childhood, but the ability to exercise may be impaired in chronic lung diseases such as cystic fibrosis (CF). Improving exercise performance by training is very attractive. The aim of the present study was the evaluation of the effects of a physical aerobic training program, performed in the Children's Hospital and Research Institute "Bambino Gesù" (Rome, Italy) in outpatient CF children, supervised by a physician. Twelve patients (mean forced expiratory flow in 1 sec (FEV1), 71%), age range 12,24 years (16.7 ± 4.4 years), were enrolled. They performed a maximal exercise stress test on the treadmill (modified Bruce protocol) with breath-by-breath determination of oxygen consumption (VO2) to maximum at end-exercise; we measured time of exercise (TE), maximal heart rate (Hrmax) in beats per minute (bpm), and maximal systolic blood pressure (SBPm) in mmHg. The program consisted of 12 weeks of training twice a week. Each training session consisted of walking or running on the treadmill for 30 min at the speed that allowed the child to attain 60% of the maximal heart rate obtained during a baseline stress test for 4 weeks, 70% in the following 4 weeks, and 80% in the last 4 weeks, under strict medical supervision. HR was continously monitored. There was no change in FEV1 and forced vital capacity after the treatment period. Hrmax and SBPm also remained the same (P,=,0.37 and P,=,0.25, respectively). There was a significant increase in TE (P,<,0.002), VO2, VO2/kg, and pulmonary ventilation (VE) (P,<,0.0001, P,<,0.001, and P,<,0.001, respectively). This pilot study showed that a simple training program improves short-term cardiopulmonary fitness in children with CF. Further studies with a larger sample and for a more prolonged time are necessary to assess if sport can have a long-term effect on lung function or survival in CF patients. Pediatr Pulmonol. 2004; 38:115,118. © 2004 Wiley-Liss, Inc. [source]

The Difference of Heart Rate Recovery between Males with and without Erectile Dysfunction

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2010
M. Tolga Dogru M.D.
Aim: In this study, we aimed to investigate the relationship between heart rate recovery (HRR) time and Chronotropic Index (CHIND) parameters, which also reflect autonomic function, after exercise stress test (EST) in males with or without erectile dysfunction (ED), and we investigated the relationship between HRR and CHIND and serum steroid hormone levels. Material and Methods: A total of 135 participants (mean age: 45.0 ± 11.8 years) were enrolled into the study. Detailed biochemical and hormonal analyses, 12-lead electrocardiography and EST (Treadmill) were performed in all participants. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire form. Patients were categorized into two groups according to their IIEF scores as ED (+) (IIEF < 26) and ED (,) (IIEF , 26). Afterward, statistical analyses were performed to evaluate the correlations between ED and HRR and CHIND. Results: A total of 65 patients were ED (+) (mean age 44.9 ± 6.4 years), while 70 patients (mean age 43.7 ± 7.7 years) had normal erectile status. There were statistically significant differences in CHIND (P = 0.015) and HRR time (P = 0.037) between ED (+) and ED (,) patients. In correlation analysis, IIEF score was found positively correlated with HRR and metabolic equivalent (MET) values (rHRR= 0.293, P = 0.037; rMETs= 0.388, P = 0.011, respectively). Linear regression analysis revealed that METs value and total exercise time had a more linear relationship with IIEF score compared to the other EST parameters (pMETs= 0.002 and pTET= 0.015, respectively). Conclusion: Chronotropic incompetence and dynamic postexercise autonomic dysfunction are present in ED patients. This condition may reflect decreased functional capacity and exercise intolerance in these patients. Ann Noninvasive Electrocardiol 2010;15(3):223,229 [source]

Exercise-Induced ST-Segment Elevation in Patients with a Recent Acute Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 4 2007
Fabio Infusino M.D.
Objectives: To get insight in the mechanism of exercise-induced ST-segment elevation (STE) in patients with Q/QS waves at the electrocardiogram (ECG). Methods: We performed exercise stress test in 13 patients with anterior acute myocardial infarction treated by successful primary percutaneous coronary intervention (PCI). Results: Compared to rest, an additional STE >1 mm in one or more precordial ECG leads during exercise occurred in nine patients (69%), in the absence of symptoms. Conclusions: In acute myocardial infarction (MI) patients, treated by primary PCI and showing optimal coronary blood flow restoration at angiography, STE can still be induced by exercise in Q/QS wave ECG leads. This finding lends further support to the theory that exercise-induced STE in this clinical context is unlikely to represent by itself transient myocardial ischemia or viability. [source]

Correlation between the 6-min walk test and exercise stress test

ACTA PAEDIATRICA, Issue 7 2010
Alisa Limsuwan
No abstract is available for this article. [source]

Correlation between 6-min walk test and exercise stress test in healthy children

ACTA PAEDIATRICA, Issue 3 2010
A Limsuwan
Abstract Aim:, To investigate the correlation between 6-min walk test (SMWT) and incremental treadmill exercise stress test (EST) as indicators for the functional capacity in children. Methods:, Healthy children aged 9,12 years were included. The anthropometric data, SMWT and EST were prospectively measured using the standard protocols. Various parameters were analysed to define the correlation between SMWT and EST. Results:, A total of 100 subjects (53 boys) aged 10.3 ± 1.0 years participated in the study. The SMWT distance was 586.1 ± 44.0 m. Height (r = 0.59, R2 = 35%), length of the leg (r = 0.64, R2 = 41%), heart rate at the end of SMWT (r = 0.59, R2 = 35%) and heart rate difference at the end of SMWT (r = 0.71, R2 = 50%) were found to have significant correlation with SMWT distance. The estimated maximal oxygen consumption (eVO2) obtained during the EST tended to be greater in boys than in girls. Among the parameters obtained during EST, maximal heart rate (r = 0.33, R2 = 11%) and the eVO2 (r = 0.54, R2 = 53%) were found to have significant correlation with SMWT. Conclusions:, SMWT distance is significantly correlated with the eVO2 obtained during the EST. This indicates that SMWT is also one of the predictive markers for EST performance. [source]

Effect of quinapril on the attenuated heart rate recovery of type 2 diabetic subjects without known coronary artery disease

CLINICAL CARDIOLOGY, Issue 8 2004
Ilke Sipahi M.D.
Abstract Background: Heart rate (HR) recovery at 1 minis a measure of the vagal reactivation that occurs after cessation of exercise. Despite ample evidence about the association of attenuated HR recovery with increased mortality, pharmacologic modification of this predictor has not been shown. On the other hand, angiotensin-converting enzyme (ACE) inhibitors are known to have vagomimetic activity. Hypothesis: We hypothesized that ACE inhibition would increase HR recovery in a group of subjects known to have reduced HR recovery, namely diabetics. Methods: Maximal treadmill exercise stress test was performed in 31 type 2 diabetic and 31 nondiabetic male subjects with similar age, body mass index, and hypertensive status. None of the subjects had known heart disease or evidence of myocardial ischemia during the test. The diabetic subjects, after 2 weeks of treatment with quinapril, underwent a second exercise test. A third test was performed 2 to 3 weeks after cessation of quinapril treatment. Results: At baseline, despite similar exercise capacity, the diabetics had a lower HR recovery at 1 min than nondiabetics (25 ± 8 vs. 31 ± 8 beats/min, p<0.01). Quinapril significantly increased HR recovery at 1 min in diabetics (25 ± 8 beats/min at baseline vs. 28 ± 8 beats/min with quinapril vs. 25 ± 7 beats/min off-therapy, p < 0.01 by analysis of variance). Conclusions: The attenuated HR recovery of type 2 diabetics can be improved by quinapril. Whether the improvement in HR recovery with ACE inhibition can lead to decreased mortality is currently unknown. [source]

ORIGINAL RESEARCH,ERECTILE DYSFUNCTION: Independent Determinants of Coronary Artery Disease in Erectile Dysfunction Patients

THE JOURNAL OF SEXUAL MEDICINE, Issue 4pt1 2010
Shih-Tai Chang MD
ABSTRACT Introduction., There is growing evidence of a link between erectile dysfunction (ED) and coronary artery disease (CAD). Aims., The purpose of this study was to explore the independent determinants of CAD in ED outpatients. Methods., This study enrolled 243 patients, ranging in age from 21 to 81 years old, suffering from ED as diagnosed by the International Index of Erectile Function (IIEF) scores. All patients underwent exercise stress tests or thallium-201 single-photon emission computed tomography perfusion imagings. Based on examination results, patients were divided into study (22 patients with a positive finding) and control groups (221 patients with a negative finding). Main Outcome Measures., The differences of demographic characteristics, biochemical profiles, pro-inflammatory and inflammatory markers, and echocardiographic characteristics between study and control group were compared. Results., The age, presence of DM and current smoking status were significant high in the study group. A significant lower high-density lipoprotein (HDL) cholesterol level, a higher percentage of HDL cholesterol level < 40 mg/dL, and a higher apo-lipoprotein B/A1, high sensitive C-reactive protein (hs-CRP) and homocysteine found in the study group. The Framingham cardiac risk scores, the ratio of mitral inflow velocity to early diastolic velocity in the annulus derived by tissue Doppler imaging (E/Et), the ratio of E/Et , 15, the value of carotid intima-media thickness (IMT), and IMT , 1 mm were higher in study group than in the control group. In stepwise multiple logistic regression analysis, a high waist-to-hip ratio (WHR), high IMT, high E/Et, hs-CRP levels, LDL cholesterol , 130 mg/dL, smoking status, and the presence of DM and metabolic syndrome (MS) were independent determinants of CAD in ED patients. Conclusions., This study first shows the independent determinants of CAD in ED outpatients. This novel finding may improve the screening of low-risk ED patients for CAD. Chang S-T, Chu C-M, Hsu J-T, Hsiao J-F, Chung C-M, Ho C, Peng Y-S, Chen P-Y, and Shee J-J. Independent determinants of coronary artery disease in erectile dysfunction patients. J Sex Med 2010;7:1478,1487. [source]