| 85% of maximal age-predicted heart rate is not a valid endpoint for exercise treadmill testing. | |
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MedLine Citation:
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PMID: 21922347 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Exercise testing should be symptom-limited. Nevertheless, 40% of clinical laboratories applying for ICANL accreditation use 85% of maximal age-predicted heart rate (MPHR) as the primary exercise endpoint. We hypothesized that this approach importantly may underestimate exercise capacity and inducible ischemia. METHODS: Two patient cohorts were studied. 1. A prospective registry of patients referred for exercise testing. 2. A retrospective cohort of patients with positive exercise ECG. RESULTS: Of 306 registry patients, 211 (69%) continued exercising after reaching 85% MPHR to maximal HR of 101% ± 7% of MPHR. Forty-two patients (14%) stopped <1 minute after achieving 85% MPHR; 53 (17%) did not achieve 85% MPHR. More women (75%) than men (64%) achieved >85% MPHR (P = .02). Of 300 patients with positive ECG, 232 patients (77%) exercised to >85% MPHR. At 85% MPHR 144 patients (62%) had positive ECG (1.2 ± .7 mm ST depression) compared to 232 patients (100%) at peak exercise (2.3 ± .9 mm ST depression, P < .001). Mean workload at 85% MPHR was 7.3 ± 2.4 METs compared to 10.6 ± 2.8 METs at peak exercise (P < .001). CONCLUSION: Achievement of 85% MPHR is not a valid diagnostic or functional exercise endpoint because it significantly underestimates exercise capacity and inducible ischemia. |
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Authors:
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Mohit Jain; Chileshe Nkonde; Ben A Lin; Alerice Walker; Frans J Th Wackers |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-16 |
Journal Detail:
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Title: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Volume: - ISSN: 1532-6551 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423534 Medline TA: J Nucl Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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The Section of Cardiovascular Medicine, Department of Internal Medicine and the Cardiovascular Nuclear Imaging and Stress Laboratories, Yale University School of Medicine, 333 Cedar Street Fitkin-3, New Haven, CT, 06510, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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