Biomedical subjects

V E Friedewald

Publications and source records attributed to V E Friedewald.

21 records · Page 2Linked to original sources

PubMed1990

Sudden cardiac death associated with exercise: the risk-benefit issue.

Although there is an overall increased risk of sudden cardiac death associated with physical exertion, the risk is small. Yet it warrants consideration by physicians and their adult patients who pursue exercise because, in any individual patient, the risk may be high. To advise patients properly on the risks and benefits of exercise, physicians should have an understanding of the risks of exercise, a strategy for patient evaluation that effectively identifies patients at risk, and a knowledge of appropriate exercise procedures that minimize risk. Patients should also know proper exercise procedures, be aware that there is some degree of risk in exercise, know their exercise tolerance, understand self-monitoring procedures, and be sensitive to prodromal symptoms. The essential feature of prudent exercise is a gradual progression during which an individual remains well within the limits of his/her exercise tolerance.

Death, Sudden↗

PubMed1987

Relation of blood pressure during exercise to anaerobic metabolism.

To determine the effects of anaerobic metabolism on blood pressure (BP), 25 subjects were studied for BP response to graded and continuous leg-crank ergometry under both aerobic and anaerobic conditions. Measurements obtained during exercise also included ventilatory equivalents for oxygen and carbon dioxide to determine anaerobic threshold. Systolic and diastolic BP responses to exercise before anaerobic threshold were compared with responses after anaerobic threshold by linear regression analyses. The systolic BP response to graded exercise was significantly accelerated (p less than 0.01) after anaerobic threshold, demonstrating a nonlinear response to proportionately graded exercise demand. Comparison of the slopes or rates of change in diastolic BP before and after anaerobic threshold also indicated a significant difference (p less than 0.01) under these 2 different metabolic conditions. It is concluded that in contrast to the linear response of BP under conditions of aerobic metabolism, BP responds nonlinearly during anaerobic metabolism.

Anaerobiosis↗

PubMedDate not supplied

Maximal-stress, multiple-lead exercise testing: the significance of ST-segment changes in the detection of coronary arterial occlusive disease.

Recognition of the value of objective parameters in the diagnostic evaluation for coronary arterial occlusive disease had led to increased application of maximal-stress multiple-lead electrocardiography. Changes in the ST-segment during and immediately following exercise are the most significant electrocardiographic indicators of myocardial ischemia. When such causes of ischemia as congenital anomalies, embolism, and arteritis have been excluded, exercise testing is a sensitive and specific means of detecting coronary arterial occlusion. The sensitivity and specificity of this parameter are evaluated in terms of long-term morbidity and mortality and, more recently, through correlation of electrocardiographic results with angiographic evidence. In our series of 308 patients undergoing both exercise testing and coronary arteriography, the sensitivity factor for 80 negative stress tests approached 95 per cent, with only four false-negative resting and exercise electrocardiograms. For 129 patients with ST-segment changes indicative of myocardial ischemia, angiography demonstrated significant coronary stenosis in 84 per cent of the cases. Of the twenty patients with false-positive stress electrocardiograms twelve were females, wich correlates with the generally higher rate of false-negative stress-electrocardiographic response among women.

Coronary Angiography↗