OBJECTIVE: To prospectively assess the prognostic value of the stress recovery index (SRI) following coronary bypass surgery. DESIGN AND PATIENTS: Two hundred seventy-eight patients who had undergone coronary bypass surgery and participated in a secondary prevention program were exercise tested and prospectively followed up for a median of 36 months. ...

Role of exercise ECG Testing has become controversial with the emergence of so many non-invasive imaging modalities. In spite of that, Exercise ECG Testing still remains the best modality as an initial test for evaluation of chest pain, prognostication and risk stratification of coronary artery disease, rehabilitation following myocardial infarction ...

Short-term exercise training has been shown to improve cardiovascular function, whereas long-term effects of a physically active lifestyle, on coronary artery function in particular, are still not well studied. We explored possible relationships between physical exercise capacity and coronary and peripheral vascular function in healthy young adults. Twenty-nine healthy young ...

It is not known whether the metabolic syndrome is associated with poor exercise capacity among patients who have established coronary heart disease. We evaluated the association of the metabolic syndrome with treadmill exercise capacity and heart rate recovery among patients who had coronary heart disease. We measured treadmill exercise capacity ...

Coronary artery occlusion-induced tachyarrhythmias that culminate in ventricular fibrillation are the leading cause of death in developed countries. The intrinsic adenosine receptor system protects the heart from an ischemic insult. Thus the increased functional demands made on the heart during exercise may produce protective adaptations mediated by endogenous adenosine. Therefore, ...

We found that interval training provides an effective means to improve the cardiovascular fitness and health status of highly functional patients with coronary artery disease. We also revealed that interval training improves anaerobic tolerance to a greater extent than the traditional exercise training model without increasing the risk to the ...

OBJECTIVE: To specify the diagnostic value of treadmill tests conducted in primary health care by trained GPs for working-aged patients. DESIGN: A two-year follow-up study. SETTING: Kangasala Health Centre, Finland. SUBJECTS: All patients under the age of 60 (n = 348) examined by exercise treadmill test carried out by trained ...

Physician-supervised exercise testing in asymptomatic patients with aortic stenosis allows an objective assessment of the hemodynamic response to exercise and it provides a measure of exercise capacity. Exercise testing cannot be used to determine the presence or absence of coronary artery disease, but limited data indicate that exercise testing can ...

OBJECTIVES: The link between coronary flow reserve (CFR) and Duke treadmill score (DTS) in patients with microvascular angina remains elusive. METHODS: We studied 108 subjects (M/F=48:60, mean age 54+/-9 years) with chest pain and normal coronary angiogram. ETT was performed by Bruce's protocol and the equation for calculating DTS was ...

We compared exercise electrocardiograms with myocardial perfusion images and coronary angiograms in 186 patients who had been referred to coronary angiography for stable angina pectoris. All had normal electrocardiographic findings at rest, and none had undergone coronary revascularization. Sensitivity, specificity, and positive and negative predictive values with the exercise electrocardiogram ...

STUDY OBJECTIVE: To determine if comfortably applied, whole-body, periodic acceleration releases significant amounts of nitric oxide (NO) into the circulation of healthy subjects and patients with inflammatory diseases. MATERIALS: Fourteen healthy adults and 40 adult patients with inflammatory diseases underwent single 45-min trials of whole-body, periodic acceleration with a new ...

The effect of six weeks garlic oil administration was observed on cardiac performance and exercise tolerance in 30 patients of coronary artery disease. After initial treadmill stress test, they were administered garlic oil in the dose of four capsules twice a day for 6 weeks and treadmill stress test was ...

Exercise testing commonly used by clinicians to characterize cardiovascular risk by detecting myocardial ischemia and assessing response to exercise. However, a consensus has not previously existed regarding the significance of exercise test-induced arrhythmias due to conflicting results from the available studies. Recent studies with longer follow-up and improved technology have ...

It has been proposed that alpha-adrenoceptor vasoconstriction in coronary resistance vessels results not from alpha-adrenoceptors on coronary smooth muscle but from alpha-adrenoceptors on cardiac myocytes that stimulate endothelin (ET) release. The present experiments tested the hypothesis that the alpha-adrenoceptor-mediated coronary vasoconstriction that normally occurs during exercise is due to endothelin. ...

It was previously shown that red blood cells release ATP when blood oxygen tension decreases. ATP acts on microvascular endothelial cells to produce a retrograde conducted vasodilation (presumably via gap junctions) to the upstream arteriole. These observations form the basis for an ATP hypothesis of local metabolic control of coronary ...

The rate at which coronary artery revascularization procedures are performed remains inconsistent, and their risks may be greater and long-term benefits less than imagined by the general public and open to considerable inter-individual variation. However, these risks and benefits can be explicitly estimated for an individual patient from a brief ...

Coccidioidomycosis is a common fungal infection acquired in the southwestern United States. This is the first study in over 2 decades to determine the seroincidence of Coccidioides immitis infections among U.S. military members performing training exercises in an area of endemicity. Only 8% of participants were aware of coccidioidomycosis, despite ...

Atherosclerosis is a progressive disease that is the most important single contributor to human cardiovascular morbidity and mortality. Epidemiologic studies show that physical activity, or routine exercise, reduces the risk of developing cardiovascular disease. The mechanisms through which exercise may function in primary or secondary prevention of atherosclerosis remain largely ...

Familial amyloidotic polyneuropathy (FAP) is a dominantly inherited systemic amyloidosis caused by mutated transthyretin (TTR). Liver transplantation is currently the only available treatment that halts the progress of the disease. Cardiovascular complications are common in FAP, and cardiac arrhythmias are typical complications in FAP Val30Met. For patients with late onset ...

The present case showed gradual increase of QRS duration from 100 ms up to 180 msec during an ergometer exercise test along with the heart rate increase. After exercise, QRS duration shortened and normalized. Laboratory test showed hyperkalemia (K = 8.0 mEq/l). T1 myocardial scintigraphy revealed exercise-induced transient ischemia in ...

Five sudden cardiac deaths in male adolescents (age 14-18 years) were detected in a 5-year period in Croatia. Two of them had been engaged in physical exercise at school, one as a professional soccer player, one in recreational swimming, and the fifth had just finished secondary school and was working ...

BACKGROUND: Exercise intolerance of the hand after harvest of the radial artery is not well understood, although mild reductions of blood flow to the hand are reported. To ascertain its prevalence, patient symptoms implying potential exercise intolerance were evaluated by measuring transcutaneous oxygen pressure of the hand during grip exercise. ...

We studied the effect of pravastatin on coronary perfusion after percutaneous transluminal coronary angioplasty. An exercise test performed within 2 weeks after percutaneous transluminal coronary angioplasty induced reversible perfusion defects in 66% of patients taking pravastatin and 64% of those taking placebo. At follow-up, the exercise test still induced reversible ...

The aim of this study was to derive and validate a model for predicting mortality by combining clinical, exercise testing, and echocardiographic data in patients with known or suspected coronary artery disease. We studied 5,679 patients (aged 62 +/- 12 years; 3,231 men) who were followed for a mean of ...

Exercise Q, R, and S wave amplitude changes, called the QRS score, have been reported to be a marker of exercise-induced myocardial ischemia. Therefore, in this study, using the exercise QRS score, we sought to determine if slow coronary flow (SCF) phenomenon is associated with the exercise-induced myocardial ischemia. This ...

BACKGROUND: Coronary heart disease is the leading cause of morbidity and mortality in the United States. Exercise tolerance testing has been proposed as a means of better identifying asymptomatic patients at high risk for coronary heart disease events. PURPOSE: To review the evidence on the use of exercise tolerance testing ...

BACKGROUND: Several clinical and observational studies have established that exercise capacity and activity status are strong predictors of cardiovascular and overall mortality. We aimed to evaluate the relationship between exercise tolerance test (ETT) indices and occurrence of coronary heart disease (CHD), in patients with heterozygous Familial Hypercholesterolemia (eFH). METHODS: During ...

BACKGROUND: Endothelial dysfunction leads to atherosclerosis and the hypothesis of the present study was that the systemic circulatory response during exercise would be a manifestation of endothelial dysfunction. METHODS AND RESULTS: The circulatory response to exercise of 1,214 apparently healthy people (946 men, mean age 51.2 +/- 10.3; 268 women, ...

BACKGROUND: Regular exercise in patients with stable coronary artery disease has been shown to improve myocardial perfusion and to retard disease progression. We therefore conducted a randomized study to compare the effects of exercise training versus standard percutaneous coronary intervention (PCI) with stenting on clinical symptoms, angina-free exercise capacity, myocardial ...

OBJECTIVE: To test the hypothesis that the association of amyloid load with clinical Alzheimer disease (AD) and cognitive impairment is mediated through neurofibrillary tangles. DESIGN: Longitudinal clinicopathologic cohort study. PARTICIPANTS AND SETTING: Forty-four individuals with clinically diagnosed AD and 53 without dementia who participated in the Religious Orders Study underwent ...

This study tested whether alpha-adrenoceptor-mediated coronary vasoconstriction is augmented during exercise in diabetes mellitus. Experiments were conducted in dogs instrumented with catheters in the aorta and coronary sinus and with a flow transducer around the circumflex coronary artery. Diabetes was induced with alloxan monohydrate (n = 8, 40 mg/kg i.v.). ...

OBJECTIVES: This study seeks to further characterize the role of exercise testing in the elderly for prognosis and diagnosis of coronary artery disease. BACKGROUND: Recent exercise testing guidelines have recognized that statements regarding the elderly do not have an adequate evidence-based quality because the studies they are based on have ...

The aim of this study was to investigate the angiographic predictors of exercise induced ischemia in patients with isolated coronary ectasia. We have prospectively analysed coronary angiograms of 1521 consecutive patients undergoing cardiac catheterisation. The overall incidence of coronary ectasia was 6.7% (102 patients). Forty-six patients (3%) with non-obstructive, diffuse ...

In equal sized samples, a strong association between a positive Family History of Early Coronary Heart Disease (FamHx) and early Age at Initial Diagnosis (AAID) was found only for males, and thus all further analyses were restricted to males. All three scales of the self-report version of the Ketterer Stress ...

BACKGROUND: Decreased right ventricular (RV) function is a known echocardiographic finding after coronary artery bypass grafting (CABG). For patients with heart failure, RV dysfunction is a predictor of poor exercise capacity. The significance and time course of RV dysfunction and its relation to exercise capacity after CABG have not been ...

The exercise test has a high yield of diagnostic, prognostic, and functional information and continues to have an integral place in cardiovascular medicine. Its two most common clinical uses are to estimate the probability of a patient having coronary disease and to estimate the likelihood of future coronary events. Although ...

A software tool has been developed to support the objective diagnosis of patients with Parkinson's Disease (PD). Patients completed hand exercises using a personal computer mouse and data has been gathered for further studies. We have analyzed different parameters and suggest using a particular parameter vector containing median and standard ...

BACKGROUND: Maximal exercise capacity is limited in patients after heart transplantation. The extent to which transplant coronary artery disease contributes to exercise intolerance in these patients has not been well defined. METHODS: This prospective study examined exercise capacity among 174 heart transplant recipients who underwent 358 exercise tests 0.3 to ...

BACKGROUND: An early invasive approach after an episode of unstable coronary artery disease has beneficial effects on mortality and myocardial infarction, but its effects on exercise capacity and ischemia have not been investigated. METHODS: In the Fast Revascularisation during InStability in Coronary disease (FRISC) II trial, 2457 patients with unstable ...

We investigated whether the second wind phenomenon (ie, a decrease in heart rate and perceived exertion during exercise) is pathognomonic for McArdle's disease. Twenty-four patients with McArdle's disease, 17 healthy subjects, and 25 patients with other inborn errors of muscle metabolism cycled a constant workload for 15 minutes. In McArdle's ...

ABSTRACT Barley yellow dwarf virus (BYDV) damage to winter cereals and population dynamics of the aphid Rhopalosiphum padi during fall were monitored in fields during 10 years at various locations in the northern half of France. Logistic regression was used to examine whether a simple risk probability algorithm based only ...

OBJECTIVE: This study was performed to determine the effect of homocysteine-lowering therapy (HLT) on endothelium-dependent vasodilation (EDD) and exercise performance in patients with coronary artery disease. METHODS AND RESULTS: Among the patients who were on the waiting list for coronary intervention, 26 male patients (plasma homocysteine (Hcy) levels > 15 ...

OBJECTIVES: To determine how well recently developed multivariables scores assess for all-cause mortality in patients with suspected coronary disease presenting for exercise electrocardiography (ExECG). BACKGROUND: Recently revised American College of Cardiology/American Heart Association guidelines for ExECG have suggested that ExECG scores be used to assist in management decisions in patients ...

Physicians routinely recommend hand squeezing exercises for end-stage renal disease patients with newly placed arteriovenous fistulae (AVF) to increase the rate of fistula maturation. However, this practice has never been shown to actually work. To determine whether hand squeezing has an acute effect on fistula diameter, we examined 23 patients ...

In this review the evidence for structural adaptations of the coronary circulation in the healthy adult heart in response to exercise and training is examined. Previously, it was thought that expansion of the coronary arteries and resistance vasculature occurred without angiogenesis. Detailed studies of the time course of coronary vascular ...

OBJECTIVES: Exercise-induced vasodilation is thought to be mediated through various vasodilator substances, but blunting the influence of vasoconstrictors such as ET may also play a role. However, the role of ET and its receptors in the regulation of systemic, pulmonary and coronary vascular resistance is incompletely understood. The aim of ...

RATIONALE AND OBJECTIVES: To compare scoring threshold and calibration method-dependent accuracy and variability of coronary calcium measurements by multidetector computed tomography (MDCT). METHODS: Ninety-five subjects were scanned with MDCT. We calculated Agatston score and volume score. Mineral mass (MM) was calculated using patient-based and scanner-based calibration methods. Accuracy of calibration ...

AIMS: Although peak exercise echocardiography has been reported for both bicycle and treadmill exercise and has shown higher sensitivity than post-exercise imaging, little is known about its utility for identifying multivessel involvement. We sought to compare feasibility and accuracy of peak treadmill exercise echocardiography vs post-exercise echocardiography for identification of ...

Recent diagnostic and therapeutic advances have been questioning the role of exercise electrocardiography (ECG) for risk stratification of patients recovering from an acute coronary syndrome. The aim of this review was to verify whether evidence still exists supporting the use of exercise ECG as first choice stress testing modality in ...

There are compelling epidemiologic and clinical data demonstrating that regular physical activity reduces the incidence of atherosclerotic vascular disease. The hypothesis that exercise decreases atherosclerotic coronary heart disease has never been directly tested in a randomized, controlled clinical trial. Nevertheless, there are sufficient data to recommend that adults should routinely ...