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PubMed1989

[Holter ECG in evaluating myocardial ischemia. Validation using the exercise test].

OBJECTIVES: Validation of ST-T ischemic changes in the Holter system by those recorded in the 12-lead ECG during the exercise test. DESIGN: The changes induced by the exercise test in the ST segment of the two Holter leads--aVF e V5 like--were compared with the changes simultaneously registered in the 12-lead ECG. SETTING: Exercise Test Laboratory and Holter Laboratory of the UTIC-Arsénio Cordeiro. Hospital de Santa Maria de Lisboa. PATIENTS: 31 patients, 23 male and 8 female, with a mean age of 55 +/- 7 years, 84% with ischemic heart disease. METHODS: The patients underwent a treadmill exercise test. 28 with the Bruce protocol and 3 with the Naugton protocol, during which the electrocardiogram was registered simultaneously with a 2-channel Holter recorder and by a conventional 12-lead system. The changes induced in the ST segment in the two systems were compared. RESULTS: The results of the two tests were concordant in 94% of the patients. In 4 patients (13%) there was not a good correlation between the inferior and anterior leads of the two methods, which diverged mainly between the Holter lead aVF and the inferior leads of the conventional ECG. The morphology of the ST depression was similar in both methods, and the severity of ST depression as judged by its amplitude showed an excellent positive linear correlation (r = 0.8542, p less than 0.001). CONCLUSIONS: The sensitivity and the specificity of the Holter system is similar to the conventional 12-lead ECG in detecting ischemic changes during exercise whenever they have electrocardiographic evidence.

Adult↗
PubMed1990

Additional prognostic value of exercise testing and thallium-201 scintigraphy in catheterized patients without previous myocardial infarction.

To determine whether exercise testing and thallium scintigraphy provide additional prognostic information in symptomatic patients undergoing catheterization, we studied 432 consecutive male patients without a previous myocardial infarction by means of an exercise test, thallium scintigraphy and catheterization. The follow-up period was 46 +/- 24 months (from 12 to 96). Events were defined as death (27 patients), nonfatal myocardial infarction (occurring in 27 patients) or late (greater than 60 days after test) surgery or dilatation (needed in 45 patients). The 5 year survival rate was 89% and the event-free rate was 72%. History, noninvasive and invasive variables were submitted to a stepwise Cox regression analysis. By multivariate analysis, the significant variables related to death were the number of diseased vessels and exercise workload; the selected variables for all cardiac events were the number of diseased vessels; the score at thallium exercise testing and exercise workload. Among the subgroups of 337 coronary patients, the predictive variables for death were exercise workload and the number of diseased vessels. For all cardiac events, the selected variables were the number of diseased vessels, the score of defects during thallium exercise and exercise workload. Thus, in patients without a previous myocardial infarction, noninvasive variables do provide prognostic information which is not available either from the history or from catheterization.

Cardiac Catheterization↗
PubMed1990

An empirical evaluation of the ACSM guidelines for exercise testing.

The American College of Sports Medicine (ACSM) has published exercise guidelines identifying individuals who should have an exercise test prior to clearance for exercise participation and whether a physician should supervise the test. These age and health status criteria (apparently healthy, higher risk, and diseased) were developed using clinical judgement and opinion rather than empirical data. Thus, there is a need to validate the recommendations with actual data. We studied the results of 24,332 maximal treadmill tests in men (n = 18,076) and women (n = 5,626) as they associated with age and baseline health status. Commonly accepted criteria for abnormal exercise tests were used (i.e., 1 mm ST segment depression at 0.08 s, systolic blood pressure drop with exercise, complex ventricular ectopy, etc.). There were 895 and 183 abnormal exercise tests in men and women, respectively. Men and women who were apparently healthy had lower abnormality rates per 1,000 tests than those considered to be at higher risk for coronary heart disease and those who had preexisting disease. Further, when those who were at higher risk were considered, those men with only one risk factor had significantly lower abnormality rates than did men with more than one risk factor (95% confidence intervals (CI) per 1,000 tests: 1 risk factor = 36.1-46.4; greater than 1 risk factor = 47.5-62.5). Abnormality rates in women with 1 risk factor were also lower than those in their peers with greater than 1 risk factor, but not statistically so (95% CI per 1,000 tests: 1 risk factor = 24.9-43.0; greater than 1 risk factor = 25.3-54.4).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[The effect of thrombolytic therapy on the outcome of early exercise test in patients with acute myocardial infarction].

UNLABELLED: Exercise test variables, such as an impaired heart rate response, are known to be related to left ventricular function and patient prognosis following acute myocardial infarction. The present study was performed to compare exercise test variables in acute myocardial infarct patients following either intravenous thrombolysis or placebo. Symptom-limited bicycle ergometer tests, carried out one to two weeks from the infarction, were performed in 85 patients randomized to intravenous streptokinase (n = 41) or placebo (n = 44) given within 12 hours from onset of symptoms. Resting heart rate, systolic blood pressure and rate-pressure product were similar in the two groups. At maximum workload the streptokinase treated patients had a significantly higher median maximal heart rate than controls (136 vs. 126 min-1; p < 0.01) but only a trend towards higher systolic blood pressure was seen (175 vs. 163 mmHg; p = 0.09). Rate-pressure product at maximal exercise was 23.620 vs. 20.100 mmHg x min-1; p < 0.01). A significantly smaller number of patients in the streptokinase group had exercise capacity below 50 W (0% vs. 15.9%; p < 0.01). IN CONCLUSION: patients treated with intravenous streptokinase for acute myocardial infarction reach both higher heart rates and rate-pressure products at maximum workload than their controls thus indicating that the beneficial effects of thrombolysis after acute myocardial infarction are reflected in an improved heart rate response during exercise.

Aspirin↗
PubMedDate not supplied

Standardizing and predicting results from cardiopulmonary exercise testing in patients with heart failure.

PURPOSE: Cardiopulmonary exercise testing is a common prognostic tool in heart failure, yet it is not standardized. The purpose of this study was to evaluate a means of standardizing oxygen consumption (VO(2)) measurement and to evaluate the ability to predict peak VO(2) from submaximal exercise. METHODS: Fifty consecutive exercise tests with a respiratory exchange ratio > or =1.10 were evaluated. VO(2) was graphed against respiratory exchange ratio and the peak VO(2) was determined with logarithmic, linear, power, and exponential regression lines. To predict a peak VO(2), each patient's submaximal exercise data (respiratory exchange ratio < or =0.98) were fitted to each regression line. The mean of the last 30 seconds of un-averaged breath-by-breath data was used as the reference value. Peak VO(2) assessments are also provided from the metabolic cart, a rolling time average, and the graphical method. RESULTS: Logarithmic regression best standardized peak VO(2). Mean absolute bias (mL x kg x min) was 0.60 +/- 0.44 for logarithmic, 0.61 +/- 0.47 for linear, 0.85 +/- 0.67 for power, and 1.44 +/- 2.22 for exponential. The mean absolute bias between the peak logarithmic predicted VO(2) and the reference peak VO(2) was 1.62 +/- 1.20 mL x kg x min (9.5% of the peak VO(2)). CONCLUSION: Among the methods studied, logarithmic regression analysis was the best method to standardize and predict peak VO(2) in this cohort of patients with heart failure.

Exercise Test↗
PubMed1984

Invasive exercise testing.

The normal hemodynamic response to dynamic supine exercise embodies the following features: progressive increase in heart rate relative to the work intensity; an increase in cardiac output of 600 ml or greater for every 100-ml increment in oxygen consumption; minimal increase in stroke volume; a progressive increase in oxygen extraction, attaining near-maximal levels during moderate exercise; and a minimal increase in left ventricular end-diastolic, pulmonary capillary wedge, pulmonary arterial, and right ventricular end-diastolic pressures. In heart disease, the major purpose of invasive exercise testing is to assess cardiac functional reserve capacity. An evaluation of the degree of encroachment on cardiac reserve by disease processes establishes hemodynamic correlates of clinical symptomatology and aids in selecting the proper therapeutic modality for each individual patient. In patients with ischemic heart disease, preliminary evidence indicates that invasive exercise testing in conjunction with angiographic findings may contribute additional substantial prognostic information.

Blood Pressure↗
PubMed1997

Cardiovascular responses to treadmill exercise testing in anemia.

OBJECTIVE: To study exercise performance on a treadmill in anemic children. DESIGN: Prospective case control study. SETTING: Department of Pediatrics and Intensive Care Unit, Department of Medicine, King George's Medical College, Lucknow. SUBJECTS: The study population consisted of 41 cases of anemia (10 mild, 21 moderate and 10 severe) and 11 normal age and height matched children aged between 7-12 years. METHODS: These subjects were exercise tested on Quinton Model Q5000 treadmill using Modified Naughton Q5000 protocol. Heart rate, systolic blood pressure, double product, ECG changes, exercise duration and metabolic equivalents achieved during peak exercise were studied. Statistical analysis was performed using analysis of variance (ANOVA) test. RESULTS: No significant difference was observed in values of resting heart rate, heart rate at peak exercise, recovery heart rate, blood pressure response, resting double product, double product at peak exercise, recovery double product and ECG changes in any of the study groups (p > 0.05). However, the gain in heart rate at peak exercise compared to basal value, and double product, total exercise duration and metabolic equivalent (MET) values at peak exercise were significantly low in anemic children on comparison to normal controls (p < 0.001). CONCLUSIONS: Cardiovascular responses are blunted in anemia, mainly because of depleted cardiac reserve.

Analysis of Variance↗
PubMed1988

Identification of patients at low risk of dying after acute myocardial infarction, by simple clinical and submaximal exercise test criteria.

A consecutive series of 559 hospital survivors of acute myocardial infarction aged less than 66 years were studied; 93 were designated prospectively as low-risk because they were suitable for early submaximal exercise testing and had none of the following clinical or exercise test 'risk factors': (1) angina for at least one month prior to infarction; (2) symptomatic ventricular arrhythmias, or (3) recurrent ischaemic pain, both after the first 24 h of infarction; (4) cardiac failure; (5) cardiomegaly; and (6) an abnormal exercise test (angina, ST-depression or poor blood pressure response). Altogether 301 patients were exercised; their mortality over a median follow-up of 2.4 years was 10.2%, versus 24.6% in the 258 patients not exercised (P = 0.0005). Absence of clinical 'risk factors' alone, in the exercised patients, identified 156 with a mortality of 5.4% versus 15.6% in the 145 with at least one clinical 'risk factor' (P = 0.004). The fully defined low-risk group comprised 93 of the former patients who had neither clinical nor exercise test 'risk factors'. None of these patients died compared with 19 of those with at least one 'risk factor' (mortality = 14.7%; P = 0.002). Their respective rates of non-fatal reinfarction were similar and never exceeded 5% per annum. Therefore, simple clinical and exercise test criteria can positively identify low-risk patients after infarction in whom secondary prevention may be inappropriate.

Adrenergic beta-Antagonists↗
PubMed2001

Diagnostic exercise tests on 4000 consecutive men.

OBJECTIVE: Our purpose was to report the prevalence of abnormal treadmill test responses and their association with mortality in a large consecutive series of patients referred for standard diagnostic exercise tests, with testing performed and reported in a standardized fashion. BACKGROUND: Exercise testing is widely performed, but an analysis of responses has not been presented for a large number of consecutive tests performed on patients referred for diagnosis of cardiac disease. METHODS: All patients referred for evaluation at 2 university-affiliated Veterans Affairs Medical Centers who underwent exercise treadmill tests for clinical indications between 1987 and 2000 were determined to be dead or alive according to the Social Security Death Index after a mean 5.9-year follow-up. Patients with established heart disease (ie, prior coronary bypass surgery, myocardial infarction, or congestive heart failure) were excluded from analyses. Clinical and exercise test variables were collected prospectively according to standard definitions; testing and data management were performed in a standardized fashion with a computer-assisted protocol. All-cause mortality was used as the end point for follow-up. Standard survival analysis was performed, including Kaplan-Meier curves and a Cox hazard model. RESULTS: After the exclusions, 3974 men (mean age 57.5 +/- 11 years) had standard diagnostic exercise testing over the study period with a mean of 5.9 (+/-3.7) years of follow-up (64% of all tested). There were no complications of testing in this clinically referred population, 82% of whom were referred for chest pain, risk factors, or signs and symptoms of ischemic heart disease. Five hundred forty-nine (14%) had a history of typical angina. Indications for testing were in accordance with published guidelines. A total of 545 died, yielding an annual mortality rate of 1.8%. The Cox hazard model chose the following variables in rank order as independently associated with time to death: change in rate pressure product, age greater than 65 years, METs less than 5, and electrocardiographic left ventricular hypertrophy. A score based on these variables classified patients into low-, medium-, and high-risk groups. The high-risk group with a score greater than 3 has a hazard ratio of 4 (95% confidence interval 3.82-4.27) and an annual mortality rate of 4%. CONCLUSION: This comprehensive analysis provides rates of various abnormal responses that can be expected in men referred for diagnostic exercise testing at typical Veterans Administration Medical Centers. Four simple variables combined as a score predict all-cause mortality after clinical decisions for therapy are prescribed.

Aged↗
PubMed2004

Determination of both the time constant of vO2 and DeltavO2/DeltaW from a single incremental exercise test: validation and repeatability.

A single incremental cycle exercise test including a steady-state load, combined with respiratory gas exchange, was performed with the objective of determining the time constant (tauVO(2)) and the amount of oxygen required at each load (DeltaVO(2)/DeltaW) by using a novel equation. The protocol was validated using four exercise tests at different constant loads and conventionally fitted mono-exponential functions to determine tauVO(2), and interpolation of VO(2) versus load to determine DeltaVO(2)/DeltaW. No significant differences were seen between the means of either tauVO(2) or DeltaVO(2)/DeltaW determined with the two protocols. The correlation coefficient was 0.62 for tauVO(2) and 0.48 for DeltaVO(2)/DeltaW. The absolute differences (2 SD) were 11.6 s for tauVO(2) and 1.1 ml min(-1) W(-1) for DeltaVO(2)/DeltaW. The equations were compared in the same steady-state test and good agreement of tauVO(2) was obtained (R = 0.99). The 5-6-week repeatability (incremental test) was evaluated. No statistical differences were seen between the mean of the repeated tests. The difference between the tests (2 SD) were 20 s for tauVO(2) and 1.2 ml min(-1) W(-1) for DeltaVO(2)/DeltaW. In conclusion, tauVO(2) and DeltaVO(2)/DeltaW can be determined from a single incremental test. The validation showed an acceptable agreement, although the variations in absolute values were not negligible. This could partly be explained by the natural day-to-day variation and fluctuations in incoming raw data. The test-retest variation in absolute values was considerable, which must be taken into account when using tauVO(2) and DeltaVO(2)/DeltaW for evaluation of aerobic function.

Adult↗
PubMed2000

Chronic heart failure in the elderly: value of cardiopulmonary exercise testing in risk stratification.

OBJECTIVE: To assess the value of cardiopulmonary exercise testing in predicting prognosis in a cohort of elderly patients with chronic heart failure (CHF). DESIGN: A retrospective cohort study of all patients with CHF over the age of 70 years assessed between January 1992 and May 1997. SETTING: Tertiary centre. PATIENTS: 50 patients (mean (SD) age 75.9 (4.5) years, 8 women) with CHF New York Heart Association (NYHA) class I (3 patients), II (25 patients), III (20 patients), and IV (2 patients). Follow up was complete for two years in all patients. RESULTS: The patients underwent cardiopulmonary exercise testing (peak oxygen consumption 15.2 (4.5) ml/kg/min, minute ventilation/carbon dioxide production (VE/VCO(2)) slope 38.7 (11.8)); radionucleide ventriculography (left ventricular ejection fraction 32.8 (14.3)%); serum sodium measurement (139 (2.8) mmol/l); and echocardiography (left ventricular end diastolic dimension 6.1 (1.1) cm, left ventricular end systolic dimension 4.7 (1.5) cm). At the end of follow up in May 1999, 26 patients had died. The median follow up of the survivors was 47.7 months (interquartile range 31. 5-53.5 months). On univariate analysis VE/VCO(2) slope (p < 0.0001), NYHA class (p < 0.001), peak oxygen uptake (VO(2)) (p < 0.01), left ventricular end systolic dimension (p < 0.05), and serum sodium concentration (p < 0.05) had significant predictive power. Stepwise multivariate analysis identified only VE/VCO(2) slope (p < 0.01), NYHA class (p < 0.05), and peak VO(2) (p< 0.05) as conveying significant independent prognostic information. CONCLUSION: Elderly patients with CHF have a high mortality, with the majority dead within two years. Cardiopulmonary exercise testing provides important information for risk stratification within this group and its use should not be neglected.

Aged↗
PubMed1989

Exercise testing soon after myocardial infarction: its relation to course and outcome at one year in patients aged less than 55 years.

A consecutive series of 184 patients aged less than 55 years who had an acute myocardial infarction were enrolled in a study to examine outcome at one year. One hundred of these patients underwent a maximal exercise test six weeks after infarction to evaluate its ability to predict cardiac events. The in-hospital mortality for the series was 7.6% (14 deaths) and the one year mortality for the 170 survivors was 3.8% (seven deaths). During the exercise test 31 patients had angina and 21 had ST depression. During the one year follow up period 39 of 100 patients had angina on exertion, 15 patients underwent coronary artery surgery, three patients had a reinfarction, and one patient died. Angina during the exercise test but not ST segment depression during the exercise test predicted angina on exertion and the need for coronary artery surgery. In the year of follow up angina occurred during everyday exertion in 25 (81%) (95% confidence interval 62 to 92%) of the 31 patients who developed angina during the exercise test and in only 14 (20%) (95% confidence interval 12 to 32%) of 69 patients who did not, and coronary artery surgery was performed in 11 (35%) (95% confidence interval 19 to 54%) of the 31 patients with angina during the exercise test and only four (6%) (95% confidence interval 2 to 15%) of 69 patients without angina. The outcome after myocardial infarction in patients aged less than 55 years was good and the occurrence of angina, but not ST segment depression, during a maximal exercise test six weeks after infarction was an indication for further investigation.

Age Factors↗
PubMedDate not supplied

[Exercise tests--evaluation of physical and coronary performance in patients after coronary angioplasty].

Exercise tests to assess both physical and coronary performance were carried out in 82 male patients aged between 31 and 62 years (mean 45.6 years) who underwent PTCA for unstable coronary disease (without a history of myocardial infarction). All patients were divided into two age groups: 31-45 years (group A), and 46-62 years (group B). Exercise test was carried out in all patients after 2-4 days, 6 and 12 months following PTCA. Ischemia was diagnosed in 15.2% of patients of group A during the first test, in 6.5% of patients during the second test, and in 4.3% of patients during the third test, indicating a decrease in ischemia. Signs of ischemia were noted in 5.6% of patients of group B in the first test increasing to 11.1% of patients during the second and third exercise testing. Ischemia was found in 6 out of 82 patients (7.3%) after one year following PTCA. Physical performance increased by 28% in patients of group A (p .01) after 6 months, and by 24.4% in patients of group B (p .01). Further increase in physical performance was noted after 12 months, i.e. by 42.1% (p .01) in group A, and by 53.3% (p .01) in group B. A significantly higher increase was noted in patients of group A (p .01) than that in group B after 6 months following PTCA. Therefore, PTCA proved beneficial in both age groups. However, this effect was first noted in younger patients.

Adult↗
PubMed1998

[Is the exercise test performed after myocardial infarct really useful in improving prognosis? Arguments contra].

Exercise testing is considered to play a major role in risk stratification after myocardial infarction. With the aim of improving prognosis, an exercise test should be able to identify patients at higher risk of coronary events. In this sense, its major limitation is a low positive predictive value, especially in patients who have been treated with thrombolytic agents. This fact limits its clinical value in the decision making process in individual patients. Finally, the decision to revascularize with angioplasty or surgery when only a positive exercise test result is taken into account, has not been proven to prolong life in these patients. All these considerations should make us think about some clinical attitudes that are taken for granted.

Electrocardiography↗
PubMed2002

Abnormal delay in recovery of pulse rate in 9454 patients referred for treadmill exercise test to Cleveland Clinic, 1990-1997--an independent predictor of excess mortality.

OBJECTIVE: The objective of this article is to present results from the latest of 3 recent reports from the Cleveland Clinic on excess mortality associated with abnormal delay in the recovery of an elevated pulse rate produced in a treadmill exercise test. This is done in the context of a long-standing medical interest in this phenomenon and its prognostic significance (see Comment section). BACKGROUND: Delay in return of the pulse rate after exercise has long attracted medical interest as a potentially unfavorable prognostic factor. However, this has not become a factor in the interpretation of the treadmill exercise test. Cardiologist staff members of the Cleveland Clinic have recently studied the mortality predictive effect of delay in pulse recovery in 3 different cohorts of patients given a treadmill exercise test (modified Bruce protocol). The newest, largest and most complete of these studies is the source article for this report. STUDY DESIGN: This was an observational follow-up (FU) study with a median of 5.2 years (range 1.4-8.7 years). The patients were categorized as abnormal pulse recovery at 1 minute after peak exercise with decrease of only 12 beats per minute or less, and normal if >12 beats per minute. These classes were combined with dichotomous classes according to the exercise test result and with other associated risk factors. RESULTS: A good approximation of exposure was achieved for each of the 4 pulse recovery/exercise test groups. From numerical data in the article, it was possible to derive aggregate mean annual mortality rates for these groups and selected combinations of pulse recovery with other risk factors. Mortality was lowest (2.8 per 1000) in the group with pulse recovery and exercise test both normal (66% of the total patients screened), and this was used as the "expected" rate, without adjustment for any differences in age. On this basis the excess death rate (EDR) was about 7 per 1000 per year when either pulse recovery or exercise test was abnormal, and 28 per 1000 when both were abnormal. Similar levels of EDR were found in the combinations of pulse recovery with other risk factors. CONCLUSION: Abnormal pulse recovery after the treadmill exercise test is a powerful and independent predictor of significant excess mortality.

Exercise Test↗
PubMed1979

Diagnostic value of routine exercise testing in hospital patients with angina pectoris.

A group of patients with angina pectoris were investigated prospectively using a simple and well-recognised exercise test protocol, and S-T segment displacements during exercise were correlated with the results of coronary arteriography. Definitive exercise results in 100 patients correlated well with findings on coronary angiograms: 69 out of 70 patients with positive exercise test results had significant coronary disease on angiography, while 23 out of 30 with negative exercise test results had no significant coronary disease. In six patients a period of physical training changed indeterminate initial tests to definitive ones after the training. These results show that the use of a widely available exercise test and a light physical training programme, with rigid adherence to the protocol, can reduce the overall demand on coronary arteriography.

Adult↗
PubMed1983

Ischemia-associated intraventricular conduction disturbances during exercise testing as a predictor of proximal left anterior descending coronary artery disease.

To determine the incidence and significance of transient intraventricular conduction abnormalities occurring in association with myocardial ischemia during exercise testing, the recordings of 2,200 consecutive exercise tests were reviewed. Ten patients (0.45%) were identified as having both ischemia and intraventricular conduction abnormalities that developed transiently during the exercise test. In all 10 patients both typical angina and electrocardiographic evidence of ischemia developed during exercise. Among the 10 patients, left anterior hemiblock developed in 4, left posterior hemiblock in 2, right bundle branch block (RBBB) in 2, RBBB with left axis deviation in 1, and left anterior hemiblock progressing to complete left bundle branch block (LBBB) in 1. All 10 patients had cardiac catheterization showing significant obstruction of the left anterior descending (LAD) coronary artery at or before the origin of the first septal branch. Eight patients were treated surgically and 2 medically, all with relief of ischemic symptoms. Nine of the 10 had repeat exercise stress testing without angina or electrocardiographic evidence of ischemia and without recurrence of the transient intraventricular conduction disturbance. It is concluded that the development of transient intraventricular conduction abnormalities associated with myocardial ischemia during exercise testing is an uncommon occurrence (0.45%). When such conduction disturbances do develop, the existence of significant disease in the proximal portion of the LAD coronary artery is strongly suggested. With control of myocardial ischemia, the transient conduction disturbances during exercise are ameliorated.

Adult↗
PubMedDate not supplied

[Relationship between results of electrocardiographic exercise tests and intraesophageal pH in men with atypical chest pain].

Changes in intraesophageal pH can influence myocardium perfusion via neural reflexes. The aim of this study was to estimate the relationships between intraesophageal pH and the course of electrocardiographic exercise test. 38 male patients with atypical chest pain in mean age 41.1 +/- 7.8 years were studied. In all among other 24-hours oesophageal pH monitoring and exercise test on running track with simultaneous oesophageal pH monitoring were made. Pathological acid reflux in 24-hours monitoring had 11 (29%) patients, exertional acid gastroesophageal reflux in 8 (21%) patients was found and significant ST interval depression in ecg in 11 (29%) patients was observed. The differences in patients quantity in respective subgroups were not significant. Patients with significant ST interval depression during exercise test, in comparison with patients without significant ecg changes, had lower HDL cholesterol level and higher values of daily and exertional gastroesophageal acid reflux parameters. Multiple-regression analysis showed that indicators of functional (pH-metry) and morphological (endoscopy and histology) oesophageal status were the independent factors determining variance of: exercise test duration, percentage of maximal heart rate during exercise test, double product value and maximal ST interval depression. In conclusion, changes in intraesophageal pH can influence exercise test course.

Adult↗