Document Detail

"Warm-up" phenomenon detected by electrocardiographic ambulatory monitoring in adult and older patients.
MedLine Citation:
PMID:  10484256     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Inducing tolerance to myocardial ischemia by repeated brief episodes of ischemia has been called "ischemic preconditioning." "Warm-up" phenomenon refers to patients with coronary heart disease improving performance after a first exertion and may represent a clinical counterpart to ischemic preconditioning. The goal of this study was to assess whether the severity of myocardial ischemia would be attenuated by two repeated walking-induced ischemic episodes in adult and older patients. SUBJECTS: Thirty-eight adults (51 +/- 5 years) and 39 older patients (76 +/- 4 years) with stable angina and angiographic evidence of coronary stenosis. MEASUREMENTS: Holter monitoring was performed in adult and older patients walking on two consecutive occasions, with a 5-minute rest between walks, a distance known to have previously caused myocardial ischemia. RESULTS: Computer-assisted analysis recorded by ambulatory Holter monitoring revealed that the mean maximal ST-segment depression (P < .001) and ischemia duration decreased (P < .001), whereas the ischemic threshold increased (P < .001), from the first to the second walk in the adult but not in the older group. CONCLUSIONS: Myocardial ischemia is attenuated and ischemic threshold is increased between two brief ischemic episodes in adult but not in older patients. These results indicate that the "warm-up" phenomenon, involved in increasing myocardial ischemic tolerance, is absent in the aging heart.
C Napoli; A Liguori; F Cacciatore; F Rengo; G Ambrosio; P Abete
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  47     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-09-28     Completed Date:  1999-09-28     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1114-7     Citation Subset:  IM    
Dipartimento di Medicina Clinica e Sperimentale, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy.
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MeSH Terms
Aging / physiology*
Analysis of Variance
Angina Pectoris / physiopathology*
Chronic Disease
Electrocardiography, Ambulatory / methods
Ischemic Preconditioning, Myocardial / methods*
Middle Aged
Signal Processing, Computer-Assisted
Walking / physiology*

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