Regulation of coronary vasomotor tone during exercise is incompletely understood. We investigated the contributions of K+ ATP channels and adenosine to the coronary vasodilation that occurs during exercise in the normal heart and in the presence of a coronary artery stenosis. Dogs that were chronically instrumented with a Doppler flow ...

BACKGROUND: Outcome after coronary artery bypass grafting is usually evaluated by exercise stress testing. Increased exercise capacity and reduced angina pectoris have been equated with improved quality of life, but this represents a limited view. OBJECTIVE: To prospectively evaluate the effects of coronary artery bypass grafting on quality of life ...

Exercise is becoming more widely used to prevent and treat the diseases that are most prevalent in the United States: coronary artery disease, stroke, hypertension, diabetes, arthritis, osteoporosis, dyslipidemia, obesity, depression, cancer, and chronic obstructive pulmonary disease. However, physicians need more training in how to make best use of this ...

The purpose of this study was to test the applicability of exercise echocardiography in the diagnosis of coronary artery disease. The results were compared to findings of coronary angiography. 118 patients, 100 males and 18 females, who were all referred to coronary angiography for suspected ischaemic heart disease, underwent exercise ...

BACKGROUND: The interpretation of exercise stress testing for coronary artery disease detection is affected by the many differences in chosen variables and mathematical methods. We conducted a prospective trial to evaluate a global muscle fatigue parameter--the blood lactate level achieved at maximal exercise--as a method of distinguishing between diseased and ...

Abstract The effects of a 12-week exercise-training program on cognitive, somatic, and behavioral anxiety and on heart rate responses to evaluative stress were scrutinized in 89 subjects randomly assigned to an experimental (exercise) or a control group. The training program consisted of exercises that were aimed to the improvement of ...

OBJECTIVES: This study was designed to assess the angiographic and prognostic implications of an exaggerated systolic blood pressure response to exercise ("exercise hypertension") in adults undergoing evaluation for suspected coronary artery disease. BACKGROUND: The clinical implications of exercise hypertension are unclear. METHODS: Subjects for this prospective cohort study were derived ...

OBJECTIVES: We attempted to determine whether the coronary vasomotor response to exercise improves after cholesterol-lowering drug therapy with bezafibrate. BACKGROUND: Hypercholesterolemia and other coronary risk factors are associated with impaired endothelium-dependent coronary vasomotor response to physiologic or pharmacologic stimuli, even in the absence of overt coronary atherosclerosis. It is still ...

The purpose of the present study is to assess the effect of nicorandil, a coronary vasodilator with a mechanism of potassium channel opening, on the abnormal myocardial 201Tl perfusion evoked by exercise. Eleven patients who had a history of typical angina, positive exercise electrocardiograms, positive 201Tl scintigraphy, nearly normal coronary ...

Although functions of dehydroepiandrosterone (DHEA) and its sulfate ester are unknown, investigators have found an inverse relation between DHEA-sulfate levels and coronary artery disease, suggesting its importance as an inverse coronary risk factor. In previous studies, where behavioral therapy was used to try to reduce stress and social isolation, DHEA ...

OBJECTIVES: This study sought to determine whether having a cardiologist as a regular source of care influences likelihood of undergoing necessary coronary angiography. BACKGROUND: An important element of the current health policy debate is the respective roles of primary care and specialist physicians. However, there are few data on interspecialty ...

Increasing numbers of women are undergoing stress testing for coronary artery disease evaluation. Limited study is available as to its efficacy in women. Four hundred nineteen patients with coronary artery disease (74 women and 345 men) referred for exercise radionuclide ventriculography between 1979 and 1986 were evaluated in a prospective ...

OBJECTIVES: This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests. BACKGROUND: Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established. METHODS: Using the volume ...

The effects of (7,8-dimethoxy 3-[3-([(1S)-(4,5-dimethoxybenzocyclobutan-1-yl)methyl]methylamino) - propyl]1,3,4,5-tetrahydro-2H-benzapin 2-one hydrochloride) (S 16257), a new bradycardic agent acting through inhibition of the hyperpolarization-activated I(f) current in the sino-atrial node, on arterial blood pressure, cardiac output, left ventricular pressure and dP/dt, epicardial coronary artery diameter and coronary blood flow velocity were investigated at ...

To elucidate the role of adenosine in coronary vasoregulation, we studied the effects of adenosine antagonism (by theophylline) on coronary blood flow at different levels of adenosine formation (stimulated by hypoxia and exercise). Six healthy subjects were studied. Coronary sinus (CS) blood flow (thermodilution) and cardiac oxygen extraction [(A-CS)O2D] were ...

Adenosine has been suggested to have a role in regulation of the tone of the cardiac resistance vessels. To elucidate the coronary vasoregulatory role of endogenous adenosine in man, we studied the effects of adenosine receptor antagonism by theophylline on coronary blood flow at rest and during light exercise. However, ...

This randomized study was performed to assess the effects of > 3 hours of physical exercise per week and low-fat diet on collateral formation in nonselected patients with coronary artery disease (intervention group, n = 56). Results were compared with those of patients in a control group (n = 57), ...

Exercise stress tests are useful in many areas of medical practice and research. The results extend the clinical significance of information obtained from other sources (ie, detailed history, thorough physical examination, resting electrocardiogram, chest radiograph, and basic laboratory analyses) and serve as a diagnostic, prognostic, and therapeutic guide. Leg or ...

OBJECTIVES: Our aim was to evaluate the influence of a calcium channel blocking agent of the dihydropyridine group (nicardipine) on coronary vasomotion during dynamic exercise. BACKGROUND: Coronary vasomotion plays an important role in the pathophysiology of myocardial ischemia. METHODS: Twenty-nine patients with coronary artery disease were studied at rest and ...

This study was designed to assess the vasomotor response of coronary arteries to exercise and the cold pressor test, and its relationships with the endothelium-mediated dependent mechanism. Twenty-two patients were entered in the study. Group I was composed of 12 patients with a total cholesterol level < 200 mg/dl associated ...

OBJECTIVE: To evaluate whether prophylactic treatment with metoprolol for two years after coronary artery bypass grafting improves working capacity and reduces the occurrence of myocardial ischaemia in patients with coronary artery disease. METHODS: After coronary artery bypass grafting, patients were randomised to treatment with metoprolol or placebo for two years. ...

We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings ...

BACKGROUND: The retrocervical area of the pelvis is a particularly strategic location for dyspareunia-producing endometriotic lesions. Because this area is often hidden from view by the cervical bulge, it is necessary that close attention be paid to locating occult disease. CASE: A 35-year-old, white female underwent repeat laparoscopy for persistent ...

OBJECTIVES: This study compared the accuracy and cost implications of using exercise echocardiography and exercise electrocardiography for detection of coronary artery disease in women. BACKGROUND: The specificity of exercise electrocardiography in women is lower than in men. Exercise echocardiography accurately identifies coronary artery disease in women, but its utility in ...

To reduce the risk of ischaemic heart disease, vigorous exercise has to be maintained over time. This suggests that the benefit is at least partly due to a short-term effect, such as an influence on the haemostatic system and thrombogenic potential. A high plasma fibrinogen level is strongly and independently ...

Our goal was to assess the incremental value of exercise testing in men and women for the diagnosis and extent of coronary artery disease. With data from one center, incremental logistic algorithms were developed and evaluated in a separate set of 865 patients from four centers. Variables included were pretest ...

There is increasing evidence that a raised blood level of homocysteine (HC) is a risk factor for premature atherosclerosis. With a gene frequency between one in 70 and one in 200 this condition may be more common than previously thought. It should be suspected especially in young patients in whom ...

Exercise tests have been an integral part of the extended PULHHEEMS examination since its inception in 1983. In the first 10 years a total of 240 individuals have been examined and 180 (75%) have had normal exercise tests. Individuals with an abnormal test who wished further assessment (58) were subjected ...

OBJECTIVES: We used intravascular ultrasound imaging of the epicardial vessels to assess coronary morphology, vasomotor response to exercise and exercise-vasomotion after beta-adrenoceptor blockade in patients with syndrome X. BACKGROUND: Syndrome X is defined as chest pain, abnormal exercise test results and normal coronary angiographic findings. Because of the limitations of ...

Many prior studies involving a predominantly male population have demonstrated the importance of exercise test results in determining the outcome of patients with coronary artery disease. The prognostic significance of exercise testing in women is unknown. In our study, a total of 3,086 men and 747 women underwent maximal treadmill ...

We studied by means of probability analysis the role of exercise ECG in identifying coronary restenosis. A total of 213 patients were independently evaluated by clinical history, conventional assessment of the exercise ECG ('yes or no' statement), D score (a discriminant function derived from exercise ECG), and coronariography, 5.4 +/- ...

Exercise-associated cardiac asystole (EACA) in patients without structural heart disease is uncommonly encountered. Two patients who developed prolonged asystolic arrest associated with exercise are described; both demonstrated a positive head-up tilt table response, absence of underlying heart disease, and a history of vagotonia. A review of this condition in the ...

The midcalf muscles of eight patients who had peripheral arterial occlusive disease were evaluated by exercise MRI before and after bypass surgery or percutaneous transluminal angioplasty. MRI showed a high intensity of these muscles, especially the posterior muscles, after exercise in all patients before intervention. The mean T2 relaxation time ...

The exercise training workload for cardiac patients is determined from the peak heart rate achieved safely during a stress test. Circadian rhythms may play a key role in changing physiological responses to the stress test. Therefore, the purpose of this study was to evaluate the influence of the time of ...

Life-style habits such as diet and exercise can have powerful affects on the development and progression of coronary heart disease. This article presents evidence supporting the use of these two modalities in the treatment of coronary heart disease. Diet is discussed in terms of cholesterol, obesity, fiber, fish oils, and ...

BACKGROUND: This study compared the effects of a formal exercise conditioning program of 3 and 12 months duration to spontaneous recovery in a population of older, post-coronary event patients. METHODS: Indices of peak exercise and submaximal exercise performance such as oxygen consumption, treadmill work capacity, minute ventilation, heart rate, and ...

The mechanism of coronary vasodilation produced by exercise is not understood completely. Recently, we reported that blockade of vascular smooth muscle K(ATP)+ channels decreased coronary blood flow at rest, but did not attenuate the increments in coronary flow produced by exercise. Adenosine is not mandatory for maintaining basal coronary flow, ...

OBJECTIVE: To assess the incremental value and cost-effectiveness of exercise tomographic thallium-201 imaging compared with clinical and exercise electrocardiographic variables for detecting three-vessel or left main coronary artery disease in patients with normal at-rest electrocardiograms. DESIGN: Prospective cohort study. PARTICIPANTS: 411 patients (77 [19%] had three-vessel or left main disease) ...

The purpose of this initial study was to evaluate a new wheelchair ergometer (WCE) and exercise test protocol for the detection of coronary artery disease in men with lower limb disabilities. Forty-nine patients (63 +/- 9 yr) completed WCE tests without complications. Peak heart rate was 84 +/- 15% (mean ...

We performed a sequential fatty acid exercise-rest scintigraphy in 18 patients with an initially successful percutaneous transluminal coronary angioplasty (PTCA) to study the concordance of trends in symptoms, exercise tolerance and myocardial metabolism. Eleven patients stopped the exercise because of angina pectoris in the preoperative test; 2 days after PTCA ...

Coronary vascular adaptations to exercise training have been extensively studied at the microscopic level in animals and correlated with direct and indirect measurements of myocardial blood flow in patients with coronary artery disease. Animals have permitted more extensive study. These findings have generally supported an increased blood flow to the ...

The purpose of this symposium was to evaluate the hypothesis that the beneficial effects of training are the result of training-induced adaptations in the coronary circulation. The approach is to review, summarize, and evaluate data concerning the effects of exercise training on the coronary circulation. Results indicate that aerobic exercise ...

The objective of this study was to measure effects of exercise training on coronary flow heterogeneity, microvascular transport, and hemodynamics. Five miniature swine were trained on a treadmill (ET) for 16 wk; five control pigs (C) were confined to cages for the same period. At the end of that period ...

Numerous studies have examined the effects of exercise training on coronary angiogenesis. Although the conclusions drawn from these studies are sometimes conflicting, variabilities in training (magnitude, type and intensity), age and other factors need to be closely examined. Most studies on young animals indicate that capillary growth occurs providing that ...

For primary care physicians, exercise testing is a cost-effective tool to evaluate patients presenting with symptoms. It helps to stratify those with probable coronary artery disease into a high-risk group needing referral and a low-risk group that can be observed. Each of the five main responses--the presence of myocardial ischemia, ...

A growing number of physicians are performing exercise tests in their offices for the purposes of diagnosing cardiopulmonary disease and assessing exercise capacity in patients with heart disease. Methodology of testing is important in making the most effective use of the information gathered from the test. Selecting an approach that ...

In coronary patients, emotional disturbances in the sense of increased anxiety and depression have often been documented. Over the last years, there has been a growing interest in the effects of exercise on emotion. This meta-analysis, based on 13 to 15 studies on psychological effects of exercise programmes in coronary ...

Normal values for simple and rate-corrected measures of the duration and dispersion of electrocardiographic (ECG) repolarization during treadmill exercise were obtained in 94 clinically normal men, and the behavior of these measures during ischemia was examined in 79 men with catheterization-proven disease or with stable angina, all of whom had ...

OBJECTIVES: This study examined the ability of exercise echocardiography to identify multivessel coronary artery disease and ascertain its incremental value when combined with clinical and exercise test variables. BACKGROUND: Although exercise echocardiography has been shown to be accurate for the detection of coronary artery disease, little is known about its ...

We have previously found a statistically significant correlation between some exercise ECG variables and angiocardiographic scores used to evaluate the extent and type of coronary heart disease (CHD). In the present study we examined the effects of digitalis, beta-adrenergic blockers, slow release nitrates, calcium channel blockers, presence of arterial hypertension ...