Ergometry in physical training research.
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In 38 patients after myocardial infarction changes of the main parameters of the central haemodynamics have been found with the aid of tetrapolar transthoracic rheography and phonotachooscillography as compared with a control group (20 practically healthy individuals). A direct interrelationship has been found between the value of the stroke volume of the heart and individual tolerance to exercise as determined by bicycle ergometer. A regression equation was derived with which rough individual tolerance to exercise can be calculated by the value of the stroke volume. By the mathematical method of paired and multiple correlations the direct relationship of the value of the cardiac stroke volume with the degree of coronary and cardiac insufficiency has been found. The sequence of functional methods of examination and control at the sanatorium stage of rehabilitation of patients after myocardial infarction is discussed.
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The usefulness of exercise testing and long term-ECG recording in old age was evaluated in a retrospective study. During a period of 24 months 317 long-term-ECGs in 195 patients greater than 70 years and 208 exercise tests in patients greater than 70 years were performed. The mean age of the patients was 73 +/- 3 years. Long-term ECG revealed a high incidence of supraventricular arrhythmias, while PVCs were found in only 28.7% of patients and PVCs greater than 30/h in only 7.3% of patients. Complex ventricular arrhythmias occurred in 25% of patients. Long-term ECG recording appeared to be of particular value in detecting abnormal regulation of heart rate and bradycardia, although symptom correlation with arrhythmias recorded was rare. Exercise testing revealed a higher incidence of PVCs with PVCs recorded in 67% of patients and PVCs greater than 2/min in 42% of patients. The incidence of complex ventricular arrhythmias was slightly greater compared to long-term recording with 29% of all patients. Exercise testing was particularly useful in detecting complex arrhythmias in patients with additional signs of myocardial ischemia (ST-segment depression and/or angina pectoris during increasing levels of exercise). Thus comparing both exercise testing and long-term ECG both appeared to be useful methods to uncover arrhythmias in symptomic patients older than 70 years and have to be considered as complementary tools. Exercise testing is particularly useful in recovering complex ventricular arrhythmias in patients with signs of myocardial ischemia during exercise. Long-term ECG on the other hand allows better recognition of bradycardias and conduction defects that may also be present and may contribute to the patients symptoms.
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The bicycle ergometric test and selective coronary angiography were performed in 105 women with 39 of them presenting stenosis of the coronary arteries. Judging by the electrocardiographic criteria, the test sensitivity was 68%, its specificity being 90%. Normalization of the ECG at the height of the submaximal exercise in the presence of the baseline changes in the ST-T interval may serve as an additional criterion of the absence of coronary artery stenosis. When the test was evaluated by clinical and electrocardiographic criteria, its specificity decreased.
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