Document Detail

Exposure to extreme cold lowers the ischemic threshold in coronary artery disease patients.
MedLine Citation:
PMID:  20151059     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cold temperature is known to commonly precipitate angina pectoris in patients with symptomatic coronary artery disease (CAD). It was previously shown that the ischemic threshold was lower during exercise testing at -8 degrees C than at +20 degrees C in patients with a history of cold-induced angina, whereas it was unchanged in patients without cold-induced angina. Few data exist on the impact of more severe cold exposure on myocardial ischemia.
OBJECTIVE: To determine the effect of extreme cold exposure (-20 degrees C) on the ischemic threshold among CAD patients.
METHODS: Thirteen men with CAD and documented exercise-induced ischemia performed two treadmill exercise tests, one at +20 degrees C and one at -20 degrees C, in random order. Electrocardiograms were recorded every 30 s and analyzed separately in random order by two experienced readers blinded to temperature.
RESULTS: The mean (+/- SD) time to ischemic electrical threshold was 53+/-60 s lower at -20 degrees C than at +20 degrees C (P=0.008), corresponding to a relative change of -8.0+/-10.5%. All other exercise parameters, including total exercise time and rate-pressure product, were unchanged during exposure to extreme cold.
CONCLUSION: Exposure to extreme cold (-20 degrees C) lowers the ischemic threshold during exercise testing in patients with CAD, even if asymptomatic or without a history of cold-induced angina. Patients with CAD and evidence of exertional angina or myocardial ischemia wishing to perform exercise at extremely low temperatures should discuss this matter with their physicians.
Philippe Meyer; Thibaut Guiraud; Daniel Curnier; Martin Juneau; Mathieu Gayda; Anna Nozza; Anil Nigam
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  26     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-03-11     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e50-3     Citation Subset:  IM    
Montreal Heart Institute, Belanger Street 5000 East, Montreal, Quebec, Canada.
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MeSH Terms
Cold Temperature / adverse effects*
Coronary Artery Disease / diagnosis,  etiology,  physiopathology*
Disease Progression
Environmental Exposure / adverse effects
Exercise Test
Exercise Tolerance / physiology*
Follow-Up Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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