| What induces the warm-up ischemia/angina phenomenon: exercise or myocardial ischemia? | |
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MedLine Citation:
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PMID: 12665486 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The relation of the warm-up ischemia phenomenon to the presence and intensity of initial myocardial ischemia is unclear. We sought to determine whether the warm-up ischemia phenomenon requires initial myocardial ischemia or can be induced by exercise without ischemia and whether there is a relation between the intensity of initial ischemia and the attenuation of ischemia on reexercise. METHODS AND RESULTS: Twelve subjects with exertional myocardial ischemia performed 2 exercise ECG tests (1 and 2) at a +/-10-minute interval on 3 occasions (A, B, C) 1 month apart. A1 and A2 were symptom-limited. B1 was kept as long as A1, but its intensity was held under the ischemic threshold (heart ratexsystolic pressure at 1-mm ST depression [STD]) noted at A1. B2 was symptom-limited. C1 was also kept as long as A1 but with an intensity adjusted to maintain one-half maximum STD of A1. C2 was symptom-limited. Exercise duration of A2, B2, and C2 increased similarly compared with A1 (P=0.009). However, the ischemic threshold (x10-3) increased at A2 (23.5+/-6.0) compared with A1 (20.3+/-4.8; P<0.0001) but not at B2 (19.8+/-5.0) or C2 (21.5+/-5.8). Similarly, maximum STD adjusted to the highest heart rate-systolic pressure product common to A1, A2, B2, and C2 decreased at A2 (1.4+/-0.7 mm) compared with A1 (2.5+/-0.9 mm; P<0.0001) but not at B2 (2.7+/-0.9 mm) or C2 (2.3+/-0.9 mm). CONCLUSIONS: Exercises under the ischemic threshold and of intermediate ischemic intensity increase short-term exercise capacity, but myocardial ischemia of more than moderate intensity is needed to induce the warm-up ischemia phenomenon. |
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Authors:
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Peter Bogaty; Paul Poirier; Luce Boyer; Jean Jobin; Gilles R Dagenais |
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Publication Detail:
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Type: Journal Article Date: 2003-03-10 |
Journal Detail:
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Title: Circulation Volume: 107 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-15 Completed Date: 2003-05-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1858-63 Citation Subset: AIM; IM |
Affiliation:
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Quebec Heart Institute/Laval Hospital, 2725 Chemin Ste-Foy, Ste-Foy, Quebec, Canada G1V 4G5. peter.Bogaty@med.ulaval.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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diagnosis,
etiology*,
prevention & control Electrocardiography Exercise* Exercise Test Female Humans Male Middle Aged Myocardial Ischemia / diagnosis, etiology*, prevention & control Recurrence / prevention & control |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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