Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “EXERCISE TEST”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources

Early exercise tests after uncomplicated acute myocardial infarction before early discharge from hospital.

As part of an early mobilization and early discharge scheme, 76 consecutive low-risk patients were selected from a population of 298 acute myocardial infarction (AMI) patients, to undergo an exercise test. The test was done on the 7th day after an AMI. The patients were 57 men and 19 women of mean age 57 and 68 years, respectively. Twelve patients were unable to complete the test, but no serious complications were observed. Average heart rate during the highest exercise load (50 W) was 106 beats/min. The following risk indices (RI) were considered abnormal and were looked for during or after exercise: 1) heart rate greater than 125 (n = 12), 2) major ventricular arrhythmias (n = 3), 3) angina pectoris (n = 9), 4) ST deviation of more than 1 mm (n = 11). Two RIs were found in 9 patients during the exercise test which led to prolonged hospitalization. One RI was found in 26 patients (34%). Eighty-eight per cent (n = 36) of the patients with normal exercise test had an uneventful recovery during the six-month observation period, in contrast to 35% (n = 9) of patients with heart rate greater than 125 recovered normally, a significantly lower number (p less than 0.05) than among patients with a normal exercise test. Reinfarction occurred in one patient with normal exercise test and in six (23%) of those with one RI (p less than 0.01) and two of those with two RIs (N.S.). We conclude that a submaximal bicycle exercise test seven days after an AMI is a safe and useful selection instrument for early discharge from hospital as well as a useful predicting instrument of future complications.

Adult↗

Pilot study examining the motivational effects of maximal exercise testing to modify risk factors and health habits.

A mailed questionnaire was sent to 2,892 men aged 35-65 years who had undergone symptom-limited treadmill exercise testing. The study was designed to assess the possible role of exercise testing as a means of motivating patients to modify appropriate risk factors and health habits. There was a 69% response to the questionnaire and 63% of patients replying indicated they modified one or more risk factors and health habits and this change they attributed to the exercise test. It was found that persons with an abnormal functional aerobic impairment, demonstrated by the exercise test, were more likely to be motivatged to change. This pilot study raises the possibility that exercise testing may play an important role in modification of coronary risk factors and health habits and the design of a better controlled study is suggested.

Adult↗

NEGATIVE TREADMILL EXERCISE TEST RESULT WITH SUBSEQUENT MYOCARDIAL INFARCTION AND CORONARY ARTERY BYPASS: CASE REPORT.

Myocardial infarction is a rare complication of maximal exercise testing.(1) In the case presented here, infarction occurred in a 54-year-old man, 14 minutes after he showed a normal response to maximal multistage treadmill exercise testing. The presence of coronary artery disease had been documented angiographically prior to exercise testing. After infarction, the patient underwent emergency double aortocoronary bypass to the left anterior descending and right coronary arteries with good results. Clinical evidence suggests that the extent of myocardial necrosis was reduced by timely surgical intervention. There is no conclusive explanation for this patient's normal response to maximal exercise testing in the presence of advanced coronary artery occlusive disease followed rapidly by infarction. The value of exercise testing is well established in assessing the existence or severity of coronary artery disease; a normal response, however, cannot be used as an infallible indication that critical coronary artery disease does not exist.

Journal Article↗

The test-retest reliability of gas exchange kinetics in humans using a pseudo random binary sequence exercise test.

The purpose of this study was to compare the test-retest reliability of oxygen uptake (VO2) kinetics with carbon dioxide output (VCO2) kinetics using a pseudo random binary sequence (PRBS) exercise test. A reliable test of gas exchange kinetics would have the potential of being applied as a sports fitness test. Ten healthy male subjects agreed to participate in the study and all subjects completed two identical PRBS exercise tests (test 1 and test 2), separated by a 30 min period of inactivity. Three consecutive 300 s PRBS cycles were completed in each test with 20 s exercise intensity changes between 25 and 85 W using an electrically braked cycle ergometer. Fourier analysis was computed for frequencies 3.3, 6.7 and 10 mHz. Statistical analysis by two-way ANOVA with repeated measures did not reveal significant differences between test 1 and test 2 for either VO2 kinetics or VCO2 kinetics. Static gain of VO2 for test 1 [9.11 (SD 0.59) ml.min-1.W-1] and test 2 [9.23 (SD 0.64) ml.min-1.W-1] did not differ significantly between tests. The 95% limits of agreement for VCO2 kinetics displayed increased variability in comparison to VO2 kinetics at each frequency of amplitude ratio and phase shift. Systematic bias ranged between 0% and 4%, except at frequency 10 mHz of VCO2 kinetics phase shift which showed a 10% bias for slower VO2 kinetics in test 2. It is possible that the increased variability of VCO2 kinetics compared to VO2 kinetics might be attributable to a lower signal to noise ratio in VCO2 kinetics, variations in ventilation or the storage mechanisms of CO2. The lower variability of VO2 kinetics compared with VCO2 kinetics suggests that the PRBS test of VO2 kinetics has the greater potential for further development as an indicator of aerobic fitness.

Adult↗

[Atrial pacing and the exercise test in the evaluation of coronary disease. A comparative study].

OBJECTIVE: to compare the relative value of Atrial Pacing and Exercise Electrocardiography in the diagnosis of Myocardial Ischaemia. DESIGN: prospective study in patients referred for coronary cineangiography. SETTING: Cineangiography and Ergonometry Departments of Cardiology Service. Santa Maria Hospital. PATIENTS: 16 patients (mean age 52.4 +/- 6.3), 13 males and 3 females. All were submitted to Atrial Pacing, Exercise Test and Coronariography. RESULTS: both tests were concordant in all cases but one, with negative Atrial Pacing, positive Exercise Test and negative Coronariography. CONCLUSIONS: Atrial Pacing compares favourably with Exercise Test in the diagnosis of Coronary Ischaemic Disease. It may constitute a valid alternative in patients unable to perform a conclusive Exercise Test.

Cardiac Pacing, Artificial↗

Exercise testing with gas exchange analysis.

The value of ventilatory gas exchange techniques during exercise testing, including improved precision and a greater yield of clinically useful information, is underscored by a growing body of literature. With technological advances available in the current metabolic systems, the test can be performed with minimal inconvenience to the patient and a minimal time commitment on the part of the operator. Gas exchange techniques have many applications among patients with cardiovascular and pulmonary disease, including the assessment of therapeutic interventions, a better understanding of the pathophysiology of exercise intolerance, and evaluation of disability. Recent studies suggest that the added precision provided by this technology has important prognostic utility. A cardiopulmonary exercise test can supplement other clinical and exercise test information when precision is important, when the patient's symptoms are mixed, or when it is unclear why the patient was referred for testing.

Coronary Disease↗

Comparison of hemodynamics during hyperthermal immersion and exercise testing in apparently healthy females aged 50-60 years.

BACKGROUND: Owing to excessive worries regarding adverse cardiac events, hyperthermal balneotherapy for patients with coronary artery disease is underprescribed. However, very few cardiac events occur in similar heat stress during Finnish sauna bathing. Exercise testing has proven to be a safe diagnostic procedure even in survivors of myocardial infarction. METHODS: We compared the effects of hyperthermal immersion and exercise testing on cardiac hemodynamics in 21 apparently healthy women aged 50-60 years. The maximal symptom-limited bicycle exercise test was performed according to the modified protocol of Wasserman. Hyperthermal immersion was carried out in 40 degrees C water and was completed by increasing the core temperature by about 2 degrees C. The left ventricular function was evaluated using continuous measurement of thoracic electric bioimpedance during both tests. The blood pressure, index of contractility and heart rate were measured directly, whereas the cardiac index, left cardiac work index and systemic vascular resistance index were calculated. RESULTS: The hemodynamic response, as assessed at continuous non-invasive monitoring, showed substantial differences between hyperthermal immersion and exercise testing. Overall, we found a significantly lower hemodynamic load during hyperthermal immersion in comparison with exercise testing. Entering the bath, there was a significant decrease in the left cardiac work, contractility and blood pressure. We recorded a slight increase in the heart rate towards peak hyperthermal immersion. However, other modulators such as the mean arterial pressure, index of contractility, cardiac index and left cardiac work index decreased even below resting values. CONCLUSIONS: Excessive hyperthermal immersion induced a lower hemodynamic load in apparently healthy women than standard maximal exercise testing.

Analysis of Variance↗

[Chronic obstructive pulmonary disease: evaluation of exercise tolerance using three different exercise tests].

The clinical usefulness of simple exercise tests in patients with chronic obstructive pulmonary disease (COPD) continues to give rise to debate. Questions remain about whether these tests assess maximum effort or only exercise tolerance (submaximal effort). To determine the levels of stress reached during the six-minute walking (6MW) test and stair climbing (SC) test and their relation to maximum aerobic capacity, 50 patients with COPD (FEV1 49 +/- 19%) were studied. Data collected included spirometric variables and VO2, heart rate (HR), ventilatory response and dyspnea during the progressive effort ergometric cycle (PEEC) test. Two 6MW and SC tests were completed on two separate days, with distance, number of steps, HR and dyspnea recorded. HR was higher during the PEEC test. Among the simple tests, SC caused a faster HR than did the 6MW test. Likewise, a significant linear relation was observed between VO2/kgpeak during the 6MW test (r2 = 0.27; p < 0.05) and the SC test (r2 = 0.33; p < 0.01). We therefore conclude that exercise tolerance in patients with COPD can be evaluated using simple stress tests. The SC test is probably the best simple way to determine maximum functional capacity, whereas the 6MW test can be reserved for measurement of exercise tolerance.

Aged↗

Diagnostic merits of exercise testing in females.

The diagnostic accuracy of conventional exercise electrocardiography was compared with exercise algorithms specifically aimed at application in females, with R wave and heart rate adjusted ST-segment changes, and with discriminant analysis. A symptom-limited bicycle exercise test was performed by 189 females without previous infarction with a normal electrocardiogram (ECG) at rest. Frank lead ECG was computer processed. ST-segment amplitudes in lead X were superior to measurements in lead Y, but their sensitivity amounted only to 50% at a specificity of 90%. Correction for R wave amplitude marginally increased sensitivity. It was confirmed that leads with inferiorly directed vectors such as standard leads II, III, aVF or Frank lead Y should not be used for diagnostic purposes in females. Exercise-induced increases in R-wave amplitude of at least 0.1 mV occurred in only 8% of females with coronary disease. Previously described discriminant function using attained heart rate, ST-segment depression and a sex-dependent ST segment correction factor yielded a sensitivity of 60% at a specificity of 90%. Sensitivities of heart rate adjusted ST-segment changes and of a previously proposed discriminant function were greater than 70% at a specificity of 90%. It is concluded that the diagnostic yield of exercise testing in females can be improved by use of more sophisticated electrocardiographic and exercise variables.

Coronary Disease↗

Comparison of respiratory response of jogging in place and Bruce treadmill exercise test.

A comparison of the respiratory responses of jogging in place, an alternative exercise test we recently proposed, was made with those of the Bruce exercise test. We obtained on-line measurements of heart rate, ventilation, oxygen uptake, and carbon dioxide production from 9 healthy subjects of mean age 25 years. There was a higher heart rate and ventilatory response with jogging than with the Bruce test, but by 10 minutes the responses of the two tests were similar. Oxygen consumption, while higher with jogging, rose in parallel with that of the Bruce test from the second to the seventh min, and the change of the ratio of minute ventilation to oxygen consumption indicated that the anaerobic threshold occurred earlier during jogging. These results show that jogging in place is more vigorous than the graded exercise test and may produce ischemia earlier.

Adult↗

[Value of isometric and dynamic exercise tests with standard drug doses for selecting long-term antihypertensive treatment with vasodilators, adrenergic beta blockaders and diuretics].

The paper presents the results of the study into the efficacy of single routine doses of essential antihypertensive agents (nifedipine, propranolol, and hydrochlorothiazide) versus its course treatment at rest and during isometric and dynamic exercise tests. The efficacy was assessed by using the Dixon criterion. The routine drug dose tests performed at rest and during isometric and dynamic exercise were shown to have a varying informative value in the prediction of long-term treatment with the above drugs. The isometric and dynamic exercise tests are of the greatest significance in the evaluation of the antihypertensive routine dose of nifedipine, whereas the dynamic exercise test alone is of value for propranolol and the rest exercise test, the both exercise tests for hydrochlorothiazide. Thus, the results of the corresponding routine drug dose tests are of varying predictive informative value, which is essential both for choosing an effective drug and for making an objective assessment of the outcomes of the course therapy.

Adult↗

[The prognostic value of electrocardiographic exercise test in patients after acute myocardial infarction].

The subject of this trial were 243 patients with uncomplicated acute myocardial infarction, hospitalized in years 1992-1996, who were made an electrocardiographic exercise test in the second or third week of the in-hospital stay and whose further history in the 2-6 period after myocardial infarction (average follow-up time lasted for 4.0 +/- 1.9 years) was known. The aim of this trial was to determine the influence of the positive exercise test on the long-term prognosis after acute myocardial infarction in a group with uncomplicated acute myocardial infarction. The course of infarction and the frequency of cardiac events (cardiac death, reinfarction, revascularisation) occurrence in 78 patients with positive exercise test (group I) were compared with a group of 165 patients with negative exercise test (group II). Both groups were compared in respect to age, gender, history of myocardial infarction, risk factors and the course of the infarction in the in-hospital period. The multivariable logistic regression analyse showed that the positive exercise test did not have a statistically significant influence on the increase of post-hospital morbidity but it correlates with significantly more frequent use of the invasive treatment and reinfarction during the follow-up period in this group. Negative exercise test in patients with uncomplicated acute myocardial was a significant factor of the good long-term prognosis.

Electrocardiography↗

Ischemic-like ST-segment changes during Holter monitoring in patients with angina pectoris and normal coronary arteries but negative exercise testing.

To evaluate whether Holter electrocardiographic monitoring may improve the detection of ST-segment depression in patients with anginal chest pain and normal coronary arteries, we performed symptom-limited exercise testing and 24-hour Holter monitoring in a group of 38 such patients (27 women, age 54 +/- 8 years). Patients were divided into 2 groups:group X1 included 28 patients with and group X2 10 patients without significant ST-segment depression during exercise testing. There were no significant differences between the 2 groups in age, gender, characteristics of chest pain, exercise duration, heart rate (HR), and blood pressure at peak exercise, but anginal pain during exercise testing was reported by 10 patients of group X1 (36%) and 9 of group X2 (90%) (p <0.01). Episodes of ST-segment depression on Holter monitoring were found in 17 patients of group X1 (61%) and in 5 patients of group X2 (50%) (p = NS). There were no differences between the 2 groups in daily number of ST episodes (3.6 +/- 4 vs 2.8 +/- 5 episodes per patient), symptomatic episodes (8% vs 18%), and duration of the episodes. On average, HR increased significantly, in a similar way, from 15 minutes before ST-segment depression to 1-mm ST in both groups, and its value at the onset of ischemia was similar in the 2 groups (102 +/- 22 vs 109 +/- 18 beats/min, p = NS). Finally, HR at 1-mm ST during Holter monitoring was significantly lower than that observed at 1-mm ST during exercise testing (127 +/- 16 beats/min, p < or = 0.01) in group X1, and it was also lower than that observed at peak exercise (136 +/- 22 beats/min, p < or = 0.01) in group X2. In conclusion, Holter monitoring can significantly increase the detection of ST-segment depression in patients with anginal pain and normal coronary arteries, indicating a cardiac, although not necessarily ischemic, origin of the pain. Indeed, 50% of our patients with negative symptom-limited exercise testing showed spontaneous ST changes, compatible with transient myocardial ischemia, during daily activities. Differences in the response of coronary microvascular tone to exercise testing and to stimuli operating during daily life are likely to play a significant role in determining these findings.

Activities of Daily Living↗

Wheelchair exercise testing: comparison of continuous and discontinuous exercise.

We have compared wheelchair exercise performed at submaximal levels in a continuous versus discontinuous format. There was a positive linear relationship between heart rate, systolic blood pressure, and VO2 with increasing workload. This was true for both modes of testing with no significant difference in heart rate, systolic blood pressure, VO2, Ve, or Ve/VO2. We conclude that clinical wheelchair exercise testing can be performed in a continuous format without sacrificing physiological data.

Adult↗

[The integrative cardiorespiratory exercise test].

The cardiorespiratory incremental maximal exercise test is being used increasingly for clinical evaluation. It is based on the fact that during physical effort the output of the cardiovascular and respiratory systems increase to maintain a higher metabolic rate and stroke volume. Cardiac output increases by increase in both heart rate and stroke volume. Ventilation increases by increase in respiratory rate and tidal volume. All changes are synchronous, so that blood composition and gas partial pressures are constant over a wide range of work intensities. The response of a normal sedentary subject to incremental exercise is presented, as well as the improvement in an athlete's physical performance as a result of training. An obese subject, despite normal maximal oxygen uptake, felt compromised due to the high energy cost of moving his heavy torso. The large normal breathing reserve during exercise was demonstrated in 2 subjects who, despite lung disease, responded normally to the test. It is likely that this test will be widely used for evaluation of patients with heart and lung disease.

Exercise Test↗

Reference values for exercise tests with continuous increase in load.

Reference values for exercise tests with continuous increase in load are presented. The exercise tests were performed on an electrically braked bicycle ergometer by 188 randomly selected Swedes of both sexes who were between 20 and 79 years of age. The reference values are related to sex, age (in decades) and weight and classified in decreasing levels of exercise capacity. Reference values for systolic blood pressure at different work loads are also given.

Adult↗

Late recurrent ischemia in infarct patients with a normal predischarge exercise test after thrombolysis.

We investigated the prognostic value of normal predischarge exercise test in 109 patients after myocardial infarction treated with i.v. thrombolysis within 4 h. In 29 of these 109 patients, elective PTCA or bypass surgery was performed for prognostic reasons after coronary angiography; 80 patients were treated conservatively with drug therapy. Recurrent postinfarct angina early after hospital discharge was the reason in 4 of 80 for PTCA or bypass surgery. Twenty-three of the remaining 76 conservatively treated patients developed recurrent ischaemia during long-term follow-up of 12.0 +/- 6.2 months, including one patient with reinfarction. Late recurrent ischaemia during long-term follow-up was observed in one third of the conservatively treated patients with a normal predischarge exercise test, although a high percentage (30%) of patients in this subgroup had been treated with PTCA or bypass surgery mainly for prognostic reasons. Predischarge exercise test is therefore of limited value for detection of still viable myocardium at risk of further ischaemic events after acute myocardial infarction and thrombolysis.

Aged↗

Exercise testing in patients with musculoskeletal handicaps.

To determine safe and effective exercise testing techniques for musculoskeletally handicapped individuals, 20 patients (mean age, 61 years) were studied. Types of handicaps included various degrees of paralysis of arms and legs, and leg amputations. Seventeen of the 20 patients had concurrent cardiovascular problems. All were currently hospitalized, engaged in various physical therapy exercises, and referred for exercise testing to increase rehabilitation therapy or for cardiovascular evaluation. Of 20 tests, arm ergometry was used in 15, leg or combination arm-leg ergometry in four, and treadmill in one. All patients completed testing with mean increases in heart rate (82 to 106 bpm arm, 88 to 125 other) and systolic blood pressure (114 to 127 mmHg arm, 118 to 146 other). Low-grade atrial and ventricular ectopy occurred in eight patients, decrease or plateauing of systolic blood pressure in three, increased diastolic blood pressure in two, and significant (greater than or equal to 1mm) ECG S-T segment displacement in one. With the use of appropriate equipment for each patient, exercise testing can be done safely and effectively in musculoskeletally handicapped individuals.

Adult↗