Document Detail


Exercise above the ischemic threshold and serum markers of myocardial injury.
MedLine Citation:
PMID:  19812806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Current guidelines for exercise training in coronary patients state that in the presence of exercise-induced ischemia, the heart rate during exercise should be at least 10 beats/min below the heart rate associated with an ST segment depression of 1 mm or greater. For patients with a relatively low ischemic threshold, this recommendation does not allow for a sufficient training stimulus.
OBJECTIVE: To document the effects of a single session of exercise above the ischemic threshold on biochemical markers of myocardial injury in stable coronary patients with exercise-induced ischemia. Because creatine kinase (CK) and its MB isoenzyme (CK-MB) can both increase after exercise because of skeletal muscle injury, troponin T was also measured.
METHODS: Twenty-one patients with documented coronary artery disease underwent two 20 min exercise sessions. The intensity of the first exercise training session was fixed at a heart rate below the ischemic threshold (ie, approximately 10 beats/min lower than the heart rate associated with the appearance of an ST segment depression of 1 mm or greater). The intensity of the second exercise session was fixed at a heart rate above the ischemic threshold.
RESULTS: Blood test measurements at baseline, 6 h after and 24 h after the exercise sessions did not show any increase in total CK, CK-MB or troponin. The value of all measurements remained well below the lower limits associated with myocardial damage.
CONCLUSION: A 20 min period of exercise above the ischemic threshold did not result in myocardial necrosis.
Authors:
Martin Juneau; Nathalie Roy; Anil Nigam; Jean Claude Tardif; Lucie Larivée
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  25     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-08     Completed Date:  2009-10-27     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e338-41     Citation Subset:  IM    
Affiliation:
Department of Medicine, Montreal Heart Institute, Montreal, Canada. martine.juneau@icm-mhi.org
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Coronary Artery Disease / blood,  physiopathology,  rehabilitation*
Creatine Kinase / blood*
Creatine Kinase, MB Form / blood*
Electrocardiography
Exercise Test / methods*
Exercise Therapy / methods*
Exercise Tolerance / physiology*
Follow-Up Studies
Heart Rate / physiology
Humans
Male
Middle Aged
Prognosis
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin T; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form
Comments/Corrections

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