OBJECTIVE: To assess the safety and value of an exercise electrocardiography service for the diagnosis of suspected ischaemic heart disease to which general practitioners have direct access. DESIGN: Direct access to a hospital exercise electrocardiography service was offered on a trial basis to 122 general practitioners in a defined urban ...

Clinical exercise testing has become an essential tool used in the early diagnosis, in the monitoring of treatment effectiveness, and in the assessment of impairment owing to ILD. Despite the assorted causes, the responses to exercise demonstrated by these diseases are generally similar. Although much has been learned about how ...

BACKGROUND: The aim of this study was to identify specific characteristics associated with modifications of symptoms and to evaluate the presence of a pathophysiological link between radionuclide abnormalities and delayed run-off of coronary contrast dye in patients with angina and normal coronary arteries. METHODS: We followed up 53 patients (21 ...

Treadmill exercise test was performed in 100 patients, 50 were hypertensive who were not having any clinical or electrocardiographic manifestation of coronary artery disease and 50 were controls. The test was positive in 28% of hypertensive patients as compared to 6% in controls. This study therefore suggests that hypertension is ...

BACKGROUND: Practitioners often assume a close relation between angiographic coronary artery stenosis and patient functional capacity. To test this unproven hypothesis, we analyzed the relation between coronary artery stenosis measured by different methods and maximal treadmill exercise tolerance in patients with single-vessel disease before and after intervention by percutaneous transluminal ...

A recent examination of the relationship between O2 uptake (M(dot)O2) and diffusive sodium loss (JNaout) in a freshwater fish showed that Na+ losses after exhaustive exercise exceeded those expected on the basis of M(dot)O2, probably due to distortion of the paracellular tight junctions (the primary site of diffusive ion loss) ...

A number of psychosomatic studies have suggested that alexithymia, impairment in identifying and expressing inner feelings, might somehow affect the course of various illnesses. However, none of these studies have distinguished between an impact of alexithymia on actual pathophysiological change versus an impact only on illness behavior. In the present ...

OBJECTIVE: To examine how exercise testing on background medical treatment affects the ability of the test to predict prognostically important patterns of coronary anatomy in patients with a high clinical probability of coronary artery disease but who are well controlled on medication. DESIGN: Prospective study. SETTING: Regional cardiothoracic centre and ...

Several studies have shown that coronary vasodilator reserve is impaired in some patients with chest pain and angiographically normal coronary arteries. In a subgroup of these patients, who additionally show ST depression on the electrocardiogram during exercise and are generally labelled as having Syndrome X, the impairment of coronary flow ...

Risk assessment is a central activity in virtually all aspects of the examination and treatment of patients. Methods to standardize this process and improve its accuracy can only improve the quality of medical care. Since health care is undergoing reform in this country, it seems likely that physicians will increasingly ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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: 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 ...

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) ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...