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R W Squires

Publications and source records attributed to R W Squires.

43 records · Page 3Linked to original sources
PubMed1982

Effects of propranolol on perceived exertion soon after myocardial revascularization surgery.

Effect of propranolol on perceived exertion soon after myocardial revascularization surgery. Med. Sci. Sports Exercise. Vol. 14, No. 4, pp. 276-280, 1982. This study evaluated the effects of propranolol on ratings of perceived exertion (RPE), heart rate (HR), and systolic blood pressure (SBP) during graded exercise testing of myocardial revascularization surgery patients before hospital discharge. Eighty-six men performed a symptom-limited, graded exercise test on a treadmill an average of 11 d after surgery. Patients were assigned to three groups: those not taking propranolol (no-propranolol group, N = 54), those taking propranolol (propranolol group, N = 22), and those exhibiting exertional hypotension during testing (hypotensive group, N = 10). Test results showed that estimated METs during peak exercise were similar for the three groups. The propranolol group demonstrated a lower HR for submaximal and peak exercise when compared with the no-propranolol group, but RPE was the same for matched exercise intensities. The hypotensive group failed to increase SBP during exercise, but perceived the matched exercise intensities to be the same as the other two groups. The HR response of the hypotensive group was similar to that of the no-propranolol group. Thus, an abnormal SBP response during exercise was not reflected in a changed RPE when compared with patients who increased SBP appropriately. It was concluded that propranolol does not affect RPE during graded exercise testing soon after cardiac surgery.

Adult↗
PubMedDate not supplied

Non-physician supervision of cardiopulmonary exercise testing in chronic heart failure: safety and results of a preliminary investigation.

PURPOSE: In the current era of efficient use of personnel and cost containment, the use of non-physicians in selected roles previously occupied exclusively by physicians has become increasingly prevalent. Traditionally, physicians have directly supervised graded exercise testing of patients with chronic heart failure. The purpose of this prospective pilot investigation was to determine the safety and results of non-physician supervised exercise testing of these high-risk patients. METHODS: Two hundred eighty-nine consecutive outpatients (211 men, 78 women) with left ventricular ejection fractions of < or = 35% were referred for cardiopulmonary exercise testing. Symptom-limited treadmill graded exercise tests were supervised by paramedical personnel with a physician immediately available, but not present in the lab. RESULTS: Nonsustained ventricular tachycardia was present during exercise in approximately 20% of patients. Test-limiting hypotension was documented in 5% of subjects. Only one serious event occurred during the 289 exercise tests, an episode of ventricular fibrillation with a successful resuscitation outcome. Peak exercise respiratory exchange ratio averaged 1.10 +/- 0.14, consistent with a near-maximal patient effort. Peak oxygen uptake was 18 +/- 5 ml/kg/min. CONCLUSIONS: Supervision of cardiopulmonary graded exercise testing in properly screened patients with severe systolic left ventricular dysfunction by experienced non-physicians appears to be reasonably safe and the results are suitable for clinical decision making. Such a practice is an attractive cost-containment strategy and deserves further investigation.

Adult↗