Exercise training improves functional capacity and reduces clinical symptoms in patients with coronary artery disease. However, such patients are at increased risk for cardiovascular complications during exercise; therefore, appropriate safeguards should be employed to minimize these risks. Based on the documented benefits and risks of exercise for patients with coronary ...

We examined the impeding effects of exercise on coronary blood flow by analyzing exercise-induced changes in the pressure-flow relationship during maximal coronary vasodilation with adenosine in chronically instrumented dogs and assessed the individual contributions produced by heart rate, contractility, and alpha 1-adrenergic vasoconstriction. Treadmill exercise that increased heart rate from ...

Treadmill and clinical data were gathered prospectively on consecutive patients who underwent exercise testing for evaluation for coronary artery disease in a 1,200 bed Veterans Affairs Medical Center. From 3,609 men referred for exercise testing from 1984 to 1990, 3,134 patients remained after excluding those with significant valvular heart disease ...

BACKGROUND: Both plasma potassium ([K]) and epinephrine concentrations have been known to increase during exercise and decrease rapidly shortly after exercise; in addition, it is also known that exercise can promote coronary thrombosis in human and animal subjects. Many studies have shown that epinephrine has a stimulatory effect on coronary ...

BACKGROUND: Evaluation of patients with possible coronary artery disease is a challenge to clinicians who face conflicting pressures in the current practice environment. Sensitivity, accuracy, cost, and access have become considerations in the appropriate selection of diagnostic studies. OBJECTIVE: To review and compare the strengths and shortcomings of commonly employed ...

No reasonable guidelines exist for evaluating an asymptomatic individual (without evidence for ischemic heart disease on history or electrocardiography) with a positive exercise ECG. Available data indicate that persons with a strongly positive test should undergo a coronary angiography. In persons with mild to moderately positive results, cinefluoroscopy is indicated ...

OBJECTIVE: The aim was to test the hypothesis that nitric oxide (or a related compound) contributes to the coronary vasodilatation during physiological increases of myocardial O2 consumption that occur with exercise. METHODS: Active hyperaemia associated with graded treadmill exercise and coronary reactive hyperaemia were examined in chronically instrumented awake dogs ...

To determine the independent incremental value of exercise capacity (METS) concerning the presence and extent of coronary artery disease, we analyzed data from 800 patients with suspected coronary disease who underwent both exercise testing and coronary angiography. We performed logistic regression analysis of clinical and exercise test data with an ...

Forty-two patients with angiographically documented left main coronary artery (LM) disease (luminal occlusion > or = 50%) and 30 patients with left main equivalent (LMEQ) disease (> or = 70% luminal occlusion of both the proximal left anterior descending artery and proximal left circumflex artery) were studied to determine the ...

BACKGROUND: The purpose of this investigation was to compare the magnitude of change in myocardial perfusion and function during exercise with that obtained during total coronary artery occlusion. Radionuclide studies are widely used for the diagnosis and determination of prognosis in patients with suspected or known coronary artery disease. These ...

The objective of this study was to investigate the effect of myocardial ischemia on the QRS duration in patients with coronary artery disease since acute myocardial ischemia decreases conduction velocity through the ischemic myocardium and may produce QRS prolongation on the surface electrocardiogram. One hundred fifty patients who underwent cardiac ...

BACKGROUND: The objective of this study was to determine whether coronary angiographic findings and survival could be predicted using standard clinical and exercise-test data. METHODS: Five hundred and ninety-five men who had undergone both exercise treadmill testing and cardiac catheterization were followed for up to 5 years. Left main (LM) ...

BACKGROUND: It has been shown that there is impairment of the vasodilatory response to acetylcholine in patients with hypercholesterolemia and angiographically normal coronary arteries. Moreover, in patients with angiographically smooth coronary arteries, the number of coronary risk factors is associated with a loss of endothelium-dependent vasodilation. The purpose of the ...

Whether endothelium-derived relaxing factor (EDRF)/nitric oxide (NO) plays a role in the dilation of the left circumflex coronary artery during acute exercise and whether endothelium-mediated dilation of this artery is altered after chronic exercise training have not been determined previously. Nine dogs were chronically instrumented for measurements of systemic hemodynamics, ...

The Asymptomatic Cardiac Ischemia Pilot (ACIP) and modified ACIP treadmill exercise protocols were developed to test patients with coronary artery disease and to linearly increase work load between stages. The physiologic changes that occurred with ACIP and modified ACIP were compared to those with the Bruce and Cornell protocols in ...

OBJECTIVES: This study was designed to define the effect of different levels of leisure time physical activity on cardiorespiratory fitness and progression of coronary atherosclerotic lesions in unselected patients with coronary artery disease. BACKGROUND: It has been shown in various studies that regression of coronary atherosclerotic lesions can be achieved ...

Healthy male and female adults who visited the Japanese Red Cross Health Care Center were undertaken to the study of hematological examination, blood chemistry, electrocardiography and exercise loading test by bicycle ergometer. We attempted to evaluate the medical check up system for decision making of exercise prescription and useful exercise ...

The effects of celiprolol (1 mg/kg), a selective beta 1-adrenoceptor antagonist with partial agonist activity (PAA), on large and small coronary arteries and on systemic hemodynamics were investigated and compared with those of atenolol (1 mg/kg) and saline at rest and during three levels of treadmill exercise in the same ...

Activity progression of persons with physical disabilities and accompanying cardiovascular disease in medical rehabilitation centers is traditionally based on cardiac precautions derived from acute care settings. Concern that these guidelines were too conservative and restrictive led to exercise testing and evaluation of 64 physically disabled male patients with a history ...

This article has related the value of exercise in preventing coronary atherosclerotic heart disease. This disease is multifactorial in origin and is prevented primarily by modifying risk factors. Proper exercise does not imply high-level physical fitness or conditioning; it may be occupational or leisure-time activity, recreational activity, or regular aerobic ...

We studied 10 regular exercising men with Parkinson's disease on levodopa (LD) under two conditions--no exercise and vigorous exercise started 1 hour after LD ingestion. We compared LD levels and motor scores on the Unified Parkinson's Disease Rating Scale (UPDRS). There was a high degree of agreement between plasma LD ...

OBJECTIVE: To develop prediction rules from clinical and exercise test data identifying patients at high and low risk for cardiovascular events among a group of male veterans. DESIGN: Prognostic study with prospective gathering of data and routine follow-up of consecutive patients referred for exercise testing. Patients only underwent noninvasive evaluation ...

Exercise produces changes in circulating levels of potassium and free fatty acids which may provoke arrhythmias in patients with coronary artery disease. Twenty patients participating in 6 weeks of training were studied; 9 of these patients took part in 4 more weeks of training and a third exercise test. After ...

Cardiac disability ratings in workers' compensation cases currently lack any consistent scientific basis, with varying medical evidence used by different examiners in the same case. Opinions about the extent of disability may differ with the same patient, delaying resolution and the delivery of benefits. We describe guidelines for determining cardiac ...

Impedance cardiography may be a simple way of assessing left ventricular performance during exercise. Measurements were therefore made during exercise testing in 102 consecutive male patients with suspected coronary disease prior to cardiac catheterization. These were subsequently divided into four groups: group A, normal; group B, 1- or 2-vessel disease; ...

OBJECTIVES: The aim of this study was to determine which quantitative angiographic variable best describes functional status 6 months after coronary balloon angioplasty. BACKGROUND: Several angiographic restenosis criteria have been developed. These can be divided into those that describe the change in lesion severity and those that merely describe lesion ...

We investigated the effects of recombinant human erythropoietin (rHuEPO) therapy on exercise capacity by symptom-limited maximal treadmill exercise testing in 9 patients with coronary artery disease who were receiving maintenance hemodialysis. The initial hemoglobin concentration of 7.9 +/- 0.7 g/dl, (mean +/- S.D.) rose to 10.4 +/- 1.1 g/dl, (p ...

The aim of this study was to determine the relative roles of alpha 1-and alpha 2-adrenoceptors at the level of large epicardial and small resistance coronary arteries when sympathetic tone is increased by exercise in conscious dogs. The responses of left circumflex coronary artery diameter and blood flow were investigated ...

It has been shown recently that the handgrip-apexcardiographic test (HAT) represents a new mode of stress test, which shows a high sensitivity in identifying coronary patients by assessing exercise-induced ischemic left ventricular diastolic abnormalities. To assess the prevalence of left ventricular diastolic abnormalities and the usefulness of HAT as a ...

Data of clinical examination, exercise testing and exercise radionuclide angiography in 102 patients referred for assessment of chest pain was included in a logistic regression to optimize the diagnosis of coronary artery disease with coronary arteriography as the reference investigation. None of the patients had other cardiac problems or previous ...

The treadmill exercise score has been used to stratify patients into low-, moderate-, and high-risk groups. This score is derived from ST segment depression, angina, and exercise duration. To determine the coronary arteriographic and exercise thallium perfusion correlates of the score, we examined the extent of coronary artery disease and ...

OBJECTIVES: Our goals were to develop and validate a multivariate algorithm for estimating the incremental probability of the presence of coronary artery disease. BACKGROUND: Multivariate methods, including logistic regression analysis, have been extensively applied to diagnostic exercise testing. However, few previous studies have included both an incremental design and external ...

We studied the effect of exercise using cycle ergometry on levodopa absorption in ten patients with Parkinson's disease. Oral levodopa was administered during exercise and at rest on separate days. Exercise delayed levodopa absorption in five patients, increased it in three, and did not influence it in two. We conclude ...

Exercise stress testing is often performed following percutaneous transluminal coronary angioplasty (PTCA) in order to evaluate the efficacy of the procedure. Together with thallium-201 (Tl-201) scintigraphy, these noninvasive tests provide valuable data for predicting the recurrence of angina and restenosis. However, concerns regarding the safe timing of exercise testing post-PTCA ...

This study was designed to test the hypothesis that the oxygen free radical scavengers superoxide dismutase (SOD) and catalase may reduce myocardial "stunning" after exercise-induced ischemia. To test this hypothesis, 8 mongrel dogs performed treadmill exercise for 10 min in the presence of a flow-limiting coronary artery stenosis. Regional left ...

To assess the natural history of Kawasaki syndrome and its effect on maximal voluntary work and cardiorespiratory fitness, we performed cycle ergometry testing in 47 patients who had had the syndrome. Forty-one patients performed maximal effort as judged by achievement of 95% predicted heart rate response. Oxygen consumption, carbon dioxide ...

The role of collaterals in influencing postischemic recovery after exercise testing has not been investigated previously. We studied 54 patients (mean age 59 +/- 6 years) with effort-induced angina and documented coronary disease who underwent exercise testing and thallium-201 myocardial scintigraphy. On angiography, 30 patients (group A) exhibited visible collaterals ...

Treadmill stress tests provide useful noninvasive prognostic information in patients with coronary heart disease (CHD). The present study has prospectively analysed the long term prognostic value of exercise tolerance as measured by exercise time during treadmill stress test in 335 consecutive patients with stable CHD. 161 had exercise time of ...

Coronary vasomotion of two stenoses in series (i.e., tandem lesion) was studied in 10 patients with coronary artery disease. Percent area stenosis was 69% +/- 23% for the first (S1) lesion and 70% +/- 37% for the second (S2). Quantitative coronary arteriography was carried out at rest, during two levels ...

Despite public health efforts, heart disease remains a leading cause of death and disease in the United States. There is sufficient evidence to justify the inclusion of regular exercise in efforts to reduce overall coronary heart disease (CHD) morbidity and mortality. This paper reviews the supportive evidence for this stance ...

To evaluate both the safety and clinical use of predischarge symptom-limited exercise testing after successful uncomplicated percutaneous transluminal coronary angioplasty (PTCA), 100 patients were randomized to undergo exercise testing (n = 50) or no exercise testing (n = 50). There were no differences in clinical or angiographic characteristics between the ...

We report a patient with Prinzmetal's angina with nearly normal coronary angiogram who not only developed severe myocardial ischemia during exercise, documented both electrocardiographically (ST elevation) and scintigraphically (with thallium-201), but also did so intermittently as the graded exercise progressed. Diagnostic coronary angiography showed spontaneous focal spasm of the proximal ...

BACKGROUND: It is generally believed that exercise-induced hypotension is the result of severe left-main or triple-vessel disease. Since this is not invariably so, and since most studies were performed in male populations, this study was done to determine the frequency of, and the significance of, exercise-induced hypotension in a more ...

The majority of US patients with clinical evidence of coronary heart disease are elderly. Appropriately prescribed and designed exercise training can improve physical and psychologic functional status and encourage maintenance of an independent life-style. Exercise testing, in addition to helping identify elderly coronary patients at high risk of recurrent events ...

Two multivariate methods, a logistic regression-derived algorithm and a Bayesian independence-assuming method (CADENZA), were compared concerning their abilities to estimate posttest probability of coronary disease in patients with suspected coronary disease. All patients underwent exercise testing within 3 months prior to coronary angiography. Coronary disease was defined as the presence ...

Twenty-six patients with "chest pain" syndrome were subjected to radionuclide ventriculography during exercise and dobutamine infusion. All 10 patients with normal coronaries were identified correctly by normal ventriculographic responses to both tests. Of 16 patients with significant coronary arterial disease, dobutamine stress identified 15 patients correctly, whereas only 12 of ...

BACKGROUND: Exercise-induced dilation of coronary resistance vessels is limited by alpha-adrenergic mechanisms. However, the effect of alpha-adrenergic mechanisms on large coronary arteries during exercise is not known. METHODS AND RESULTS: In the present study, sonomicrometry was used to measure circumflex coronary arterial diameter during treadmill exercise before and after alpha ...

Because coronary artery disease is the most common cause of death in the United States, much effort is being focused on research into prevention of this killer. Dr. Lush reviews positive and negative aspects of recent trends and summarizes the results of studies on the prophylactic potential of maintenance of ...

Hypercholesterolemia is a major risk factor in coronary heart disease (CHD) and ischemic stroke. However, there is no general agreement on the usefulness of systematic screening of patients with hyperlipidemia by stress exercise electrocardiogram (ECG). The feasibility of this approach would depend on selecting patients with a high risk of ...

In view of the significant influence of potassium on the heart, a decision was made to study the effect of exercise on this important ion in two exercise groups of different intensity. The first group consisted of 44 individuals with known coronary artery disease participating in a supervised cardiac rehabilitation ...