Document Detail

Exercise tolerance test for predicting coronary heart disease in asymptomatic individuals: A review.
MedLine Citation:
PMID:  19217620     Owner:  NLM     Status:  MEDLINE    
In symptom-free subjects, exercise tolerance testing (ETT) has a doubtful utility for detecting latent coronary heart disease (CHD) because of frequent false positives, but it may be valuable for predicting future CHD. To clarify the latter question, we calculated CHD incidence associated with presence or absence of ETT-induced abnormalities of ST-segment depression, exercise capacity, and heart rate using published prospective ETT studies in primary prevention populations. Based on 5-23 years of follow-up, yearly incidence of fatal and non-fatal CHD ranged from 0.9 to 5.8% in the presence of ST-segment depression and from 1.2 to 1.7% in the presence of impaired maximal heart rate, and pooling of all data provided a linear positive relationship between pre- and post-test CHD incidence. Yearly incidence of CHD death was 0.8% in the presence of ST-segment depression, 0.2-0.3% in the presence of impaired heart rate recovery, and 0.5% in the presence of low exercise capacity. Absence of ST-segment depression was associated with <1.5% yearly incidence of fatal and non-fatal CHD events, except for one study and <0.2% yearly incidence of CHD or CVD death in all populations analyzed. Lastly ETT-induced ST-segment depression conveys a CHD risk superior to that associated with ETT-induced heart rate and exercise capacity abnormalities. This may be due to difference in pretest CHD incidences in ETT studies.
Jean-Louis Mégnien; Alain Simon
Publication Detail:
Type:  Journal Article; Review     Date:  2008-12-31
Journal Detail:
Title:  Atherosclerosis     Volume:  205     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  579-83     Citation Subset:  IM    
Centre de Médecine Préventive Cardiovasculaire, Université Paris Descartes, France.
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MeSH Terms
Cardiology / methods
Cardiovascular Diseases / diagnosis,  physiopathology
Coronary Disease / diagnosis,  physiopathology*
Exercise Test*
False Positive Reactions
Heart / physiopathology
Heart Rate
Middle Aged

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