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PubMed1987

Heart rate, metabolic and hormonal responses to maximal psycho-emotional and physical stress in motor car racing drivers.

Motor car racing is representative of concentrative sporting activities, as well as instructive for mental-concentrative and psycho-emotional stress, which predominates with lower intensity, but longer duration in occupational work of today. A group of 20 car racing drivers was investigated both during car races (Formula Ford and Renault-5-Cup) and during progressive bicycle ergometry in the laboratory. Heart rate during car racing reached a mean level of 174.3 +/- 14.1 min-1 (mean +/- SD), corresponding to 90% of the maximal heart rate achieved at the end of exhaustive ergometry (n = 12). Catecholamine excretion in urine (adrenaline + noradrenaline) on average was 252.3 +/- 77.9 ng min-1 during car racing and 121.9 +/- 37.3 ng min-1 during exhaustive ergometry (n = 10). Most of the other metabolic parameters determined in blood (lactate, glucose, FFA = free fatty acids, plasma protein, insulin, HGH = human growth hormone) also showed significant differences between car racing and bicycle ergometry (n = 20). Therefore it is possible to distinguish between psychical and physical strain and the quantify their specific level. Especially blood lactate can be considered as a metabolic indicator of physical strain and FFA of psycho-emotional strain. Furthermore, significant negative correlations could be found between heart rate, FFA level, and catecholamine excretion during car racing and some measures of physical fitness determined on the bicycle ergometer (n = 12 or 10). This suggests a reduced cardiocirculatory and metabolic strain reaction in response to psychical stress situations with increased fitness. Moreover, HDL (high density lipoprotein) was found increased and oral glucose tolerance test was improved with elevated physical fitness (n = 20, respectively 16). From the results of this study it can be concluded that physical activity counteracts atherosclerosis and CHD (coronary heart disease), which are promoted by psycho-emotional and psycho-social stress.

Adult↗
PubMed1997

[Standardized aerobic walking on the treadmill by healthy probands and patients with mitochondrial and non-mitochondrial myopathies].

Mitochondrial myopathies are characterized by an abnormal aerobic metabolism. The present study examines the serum lactate concentration during standardized aerobic treadmill ergometry and evaluates its relevance for the diagnosis of mitochondrial myopathies. The present study includes 50 volunteers without neuromuscular disorders (control group), 13 patients with mitochondrial, and 14 patients with non-mitochondrial neuromuscular disorders. All members of the control group were able to walk 15 minutes on the treadmill at a constant velocity of at least 5 km/h without exceeding the aerobic threshold (2 mMol/l lactate, venous blood). Ten patients with mitochondrial myopathies and 4 patients with non-mitochondrial myopathies already exceeded the aerobic threshold at walking velocities of 4 or 5 km/h. Though indicating a reduced aerobic endurance, a pathological test result does not prove the diagnosis of a mitochondrial myopathy. Sensitivity and specificity of treadmill ergometry did not differ significantly from those reported for bicycle ergometry. Thus, using the most common aerobic activity in daily life, treadmill ergometry can be considered as an alternative to bicycle exercise tests in the assessment of mitochondrial abnormalities.

Adult↗
PubMed2000

Peripheral and brachial blood pressure during standardized occupation-related tests in normotensive and mild hypertensive men and women.

We investigated the usefulness of peripheral blood pressure (BP) measurement in the assessment of strain in occupational physiology. Our hypothesis was that the brachial and peripheral BP reflect physiologically different events under various occupation-related demands in normotensive (NT) and hypertensive (HT) people. A group of 20 female and 20 male subjects with unmedicated mild hypertension that had been diagnosed by ambulatory blood pressure monitoring [awake time systolic/diastolic BP (BPs/BPd) 142.9 (SD 11.3)/86.4 (SD 6.2) mmHg] and 40 NT matched by age and sex [BPs/BPd 120.0 (SD 9.8)/75.6 (SD 5.9) mmHg] attended a laboratory session to undertake mental arithmetic tasks, a fingergrip test and submaximal cycle ergometry. Brachial and peripheral BP as well as heart rate were measured using a sphygmomanometer and an continuously automatic blood pressure measuring device on the finger, respectively. The peripheral BPs was higher than brachial BPs, BPd was similar for peripheral and brachial BP except during cycle ergometry. Associations between the levels of brachial and peripheral BP depended on demands and did not explain more than 42% of the common variance. The highest correlations between the two BP methods were observed during habituation, recovery and mental demands, and weak correlations during cycle ergometry. For peripheral BPs and BPd we found significant correlations in all phases of the test (r = 0.58 to 0.86, P < 0.001), also in ergometry (NT r = 0.62, P < 0.001, HT r = 0.53, P < 0.001), in contrast to the brachial BP. Peripheral BP differentiated the two BP groups (57.5%-72.5% correctly classified) which had been grouped by daily measurement of brachial BP, but brachial BP was superior in this respect with 65.0%-87.5% being correctly classified. These results supported the suggestion that the combined measurement of peripheral and brachial BP provides complementary information regarding physiological changes in NT and HT in different situations.

Adult↗
PubMed1999

Cardiovascular responses to light isometric and aerobic exercise in 21- and 59-year-old males.

The effects of aging on the cardiovascular response to continuous light isometric and aerobic exercise remains to be determined. Thus, the purpose of this study was to compare the cardiovascular response of young and older males during light handgrip and cycle ergometry exercise. Blood pressure, heart rate, rate pressure product, as well as pre-ejection period (derived from impedance cardiography) were obtained for 15 young [mean (SE) age: 21 (0.7) years] and 15 older males [59 (0.8) years] during and after light handgrip exercise and cycle ergometry. The parasympathetic influence on the heart was also assessed through a time-series analysis of heart period variability (HPVts). Both during and when recovering from the handgrip exercise and cycle ergometry, the older subjects exhibited a significantly higher absolute systolic and diastolic blood pressure, and rate pressure product, and a lower HRVts than the young subjects. Relative to baseline, the change in pre-ejection period was lower for the young subjects during the handgrip and cycle ergometry, tasks. These results indicate that although the sympathetic influence on both the myocardium and the vasculature was less pronounced in the older males, the aging cardiovasculature was under greater hemodynamic stress both during rest and during exposure to light isometric and aerobic challenge.

Adult↗
PubMed1990

Validity of arm ergometer blood pressures immediately after exercise.

It is not possible to assess blood pressure (BP) by the standard cuff method during exercise primarily involving the arms. Consequently, such measurements are often taken immediately after (within 15 seconds) exercise. To assess the validity of this practice, 18 healthy men (mean age 32 years) who completed 3 progressive 3-minute workloads were studied during arm-crank ergometry. Ankle systolic BP was measured at the dorsalis pedis artery at seated rest, 15 seconds before completion of each exercise stage and immediately after each workload, using a Doppler stethoscope; simultaneous postexercise brachial systolic BPs were determined by auscultation. Brachial systolic BP during armcrank ergometry was estimated by the formula: (resting brachial systolic BP) + (exercise ankle systolic BP - resting ankle systolic BP). Brachial systolic BPs, obtained immediately after arm-crank ergometry, were significantly lower than those estimated during exercise (p less than 0.001), with corresponding mean values of 141 versus 153, 144 versus 173 and 151 versus 182 mm Hg at 150, 300, and 450 kg.m.min-1, respectively. The difference between measured (postexercise) and estimated pressures increased with progressive workloads. These findings indicate that systolic BPs taken by the standard cuff method immediately after arm-crank ergometry are likely to underestimate "true" physiologic responses.

Adult↗
PubMed1988

Increased blood fibrinolytic activity after physical exercise: comparative study in individuals with different sporting activities and in patients after myocardial infarction taking part in a rehabilitation sports program.

The activation of fibrinolysis during bicycle ergometry was studied in two pairs of age-matched groups. Group A: 18 healthy male competitive athletes (23 +/- 3.5 years of age, mean +/- SD), Group B: 18 healthy male volunteers (25.7 +/- 2.7) not engaged in any sports, Group C: 17 healthy male volunteers (50.6 +/- 7.7) regularly practicing sports, and Group D: 18 male survivors from myocardial infarction (MI-patients, 54.2 +/- 7.9) who took part in a rehabilitation sports program. Before ergometry, healthy participants with regular sporting activities showed significantly lower plasma plasminogen activator inhibitor capacities (PAI cap) than the members of the respective age-matched control groups: Group A 13.9 +/- 2.6 AU/ml, Group B 18.5 +/- 5.5, p less than 0.005; Group C 15.2 +/- 2.9, Group D 20.7 +/- 5.5, p less than 0.05. During ergometry the release of tPA antigen did not differ significantly between the age-matched groups, however, tissue plasminogen activator (tPA) activities after ergometry were higher in groups presenting lower pre-test PAI cap values. Group A 5.5 +/- 6.4 AU/ml, Group B 1.1 +/- 2.9 AU/ml, p less than 0.05; Group C 2.9 +/- 3.3, Group D 0.2 +/- 0.7, p less than 0.05. Levels of the fibrin split product (D-dimer) did not change in any of the groups. This investigation indicates that (1) regular vigorous sporting activities enhance blood fibrinolysis by reducing blood PAI cap in healthy individuals, (2) rehabilitation sport is not capable of reducing blood PAI cap in MI-patients to values measured in age matched healthy individuals regularly practicing sports and (3) the activation of fibrinolysis during physical exercise has no systemic fibrinolytic effect.

Adult↗
PubMed1997

Effects of exercise on circulating vascular adhesion molecules in healthy men.

Based on previous studies showing an increase in circulating soluble intercellular adhesion molecule-1 (sICAM-1) after exercise, we hypothesized that exercise may also increase serum levels of the vascular cell adhesion molecule-1 (sVCAM-1) and sE-selection. In a prospective controlled clinical trial, serum levels of sE-selectin, sICAM-1 and sVAM-1 were measured before and after two different exercise protocols in healthy untrained men. Lactate levels increased up to 12.7 mmol/L (95% confidence interval: 10.1-15.9) and 3.6 mmol/L (CI: 2.4-4.7) after ergometry and after an one hour endurance exercise at 60% of the maximal work intensity, respectively (p = 0.028 vs baseline and controls). The maximal increase in lymphocyte counts of 106% (CI: 63-146), which was only of short duration, was higher immediately after ergometry as compared to that observed after endurance exercise (p = 0.028). However, the maximal increase in neutrophil counts of 178% (CI: 120-298) which was seen at 2 hours after endurance exercise was higher than that seen after ergometry (p = 0.028). In contrast, only small changes of circulating adhesion molecules were seen immediately after ergometry: sICAM-1 increased by 11% (CI: 4-25; p = 0.028), and similar tendencies were also observed for sVCAM-1 and sE-selectin. No other consistent and time-dependent changes of circulating adhesion molecules were observed and all differences and changes were < or = 11%. In sum our study provides evidence that recreational sporting activities in untrained healthy subjects at normal altitude have little influence on serum levels of the circulating vascular adhesion molecules sE-selectin, sVCAM-1 or sICAM-1.

Adult↗
PubMed1989

Cardiovascular and ventilatory responses during formalized T'ai Chi Chuan exercise.

T'ai Chi Chuan (TCC) is a widely practiced Chinese martial art said to physically develop balance and coordination as well as enhance emotional and mental health. TCC consists of a series of postures combined into a sequential movement providing a smooth, continuous, low-intensity activity. The purpose of this study was to examine the ventilatory and cardiovascular responses to the Long Form of Yang's style TCC. In addition, the subjects' TCC responses were compared to their ventilatory and cardiovascular responses during cycle ergometry at an oxygen consumption (VO2) equivalent to the mean TCC VO2. Six experienced (M = 8.3 yrs) male TCC practitioners served as subjects with data collected during the Cloud H and movement of the TCC exercise. Significantly (p less than .05) lower responses for ventilatory frequency (Vf) (11.3 and 15.7 breaths.min-1), ventilatory equivalent (VE/VO2) (23.47 and 27.41), and the ratio of dead space ventilation to tidal volume (VD/VT) (20 and 27%) were found in TCC in comparison to cycle ergometry. The percentage of minute ventilation used for alveolar ventilation was significantly higher during TCC (p less than .03) than cycle ergometry, with mean values of 81.1% and 73.1%, respectively. Cardiac output, stroke volume, and heart rate were not significantly different between TCC exercise and cycle ergometry at the same oxygen consumption. We concluded that, during TCC, expert practitioners show significantly different ventilatory responses leading to more efficient use of the ventilatory volume than would be expected from comparable levels of exertion on a cycle ergometer.

Adult↗
PubMedDate not supplied

Impact of steady-state and exercise modality on estimating oxygen consumption in men with and without coronary artery disease.

PURPOSE: This study examined the effect of steady-state on the ability of 15 men with coronary artery disease (CAD) and 13 men without CAD disease (non-CAD) to reach a rate of oxygen consumption (VO2) relative to population norms during treadmill and cycle ergometry exercise testing. METHODS: Subjects completed a maximal graded exercise test on the treadmill and cycle ergometry involving 3-minute stages and a submaximal exercise test involving 6-minute stages to 80% of maximal effort. Estimates of VO2 were derived from commonly cited clinical estimation equations. RESULTS: Only the Foster equation accurately estimated maximal VO2 during a treadmill graded exercise test in patients with CAD. However, each of cited clinical equations accurately estimated maximal VO2 during a treadmill graded exercise test in the non-CAD group. No equation accurately estimated VO2 at submaximal efforts during treadmill exercise for either group. Cycle ergometry estimation equations accurately estimated VO2 in both groups at maximal effort, but were inconsistent at submaximal efforts. Both the CAD and the non-CAD group reached steady-state VO2 within 3 minutes, at submaximal workloads. CONCLUSIONS: The inability to attain an expected VO2 during exercise did not seem related to steady-state VO2 because both CAD and non-CAD groups readily reached steady-state VO2, though the estimation of VO2 remained inaccurate for most treadmill estimation equations. Because VO2 was accurately estimated for cycle ergometry exercise, estimation accuracy seems to be influenced by exercise modality.

Aged↗
PubMed1996

Cardiovascular and respiratory adjustments in normal volunteers during modified exercise tests in comparison to standard exercise tests.

Sixteen normal, non-smoking first year medical students underwent four standard exercise tests, while cardiovascular (heart rate and blood pressure) and pulmonary (respiratory rate, tidal volume and oxygen consumption) adjustments were being monitored. Maximal exercise level for all tests were defined following the Jones scale. No variation was noted in respiratory rate among the four exercise tests. The cycle ergometry (CE), hand ergometry (HE), and treadmill (TM) exercise tests produced progressive increases of the various parameters as expected, although target maximal heart rates were not reached in most cases secondary to muscle fatigue. The step test (ST) approximated the physiological parameter changes noted in these three tests during the early stages of exercise, but levelled off after 3 minutes, probably due to lack of incremental load. The ST took the longest time to reach maximal level of exercise parameters, and recorded the lowest tidal volume increase. The same subjects underwent a modified step test (MST1) by adding 1 kg sandbags every 3 min to backpacks worn by the subjects, to provide incremental load. This modification provided a slight increase in the parameters measured, but still plateaued after 3 min. Another set of 18 normal, non-smoking medical students underwent bicycle ergometry and two other modified exercise tests. The modified step test two (MST2) was similar to our initial MST1, except that the sandbags added every 3 min were not fixed at 1 kg but were also incremental (1, 2, 3 and 4 kg). The other test (Ramp test or RT) required the subjects to walk up and down a ramp, which entailed not only the addition of incremental weights of sandbags every 3 min, but also increasing the elevation of the ramp at each stage. Data analysis showed that these two tests showed almost similar changes in cardiovascular and respiratory adjustments in the subjects, compared to the standard bicycle ergometry. These pilot studies showed that low-cost modified step tests may be utilized to approximate the expensive standard treadmill and bicycle exercise tests. More studies on larger populations have to be done to validate these results.

Adaptation, Physiological↗
PubMed1990

The six-minute walk--an adequate exercise test for pacemaker patients?

In many pacemaker patients bicycle and treadmill ergometry are not practicable. As an alternative, we performed a 6-minute walk on a 20-m corridor in 97 pacemaker patients, who were asked to walk as far as possible determining their speed by themselves. Results were compared with those of bicycle ergometry in 42 of these patients and with treadmill exercise of a group of 92 other pacemaker patients. In the 6-minute walk, performance and maximal heart rate were slightly lower (49 +/- 18 W; 96 +/- 23 beats/min) than in bicycle (57 +/- 16 W; 110 +/- 26 beats/min) and treadmill ergometry (50 +/- 37 W; 102 +/- 35 beats/min). A good correlation was found between walking and bicycling (r = 0.74) and in subgroups of patients with different pacemaker indications. All patients preferred the walk to bicycle ergometry considering it to be more related to daily physical activity. In conclusion, a 6-minute walk is a simple and physiological exercise test for nearly all pacemaker patients with good correlation to other types of exercise. It seems to be preferable to other tests because of its better acceptance and practicability.

Aged↗
PubMed1993

Oxygen desaturation and breathlessness during corridor walking in chronic obstructive pulmonary disease: effect of oxitropium bromide.

BACKGROUND: Although exercise induced desaturation can occur in patients with chronic obstructive pulmonary disease (COPD), little is known about its frequency during everyday exercise, or how it relates to dyspnoea or prior drug treatment. METHODS: The effects of 200 micrograms inhaled oxitropium bromide, an anticholinergic bronchodilator drug, on spirometric values, dyspnoea score, and oxygen saturation during corridor walking and cycle ergometry were studied in a double blind, randomised, placebo controlled study. RESULTS: Oxitropium produced a small increase in forced expired volume in one second (FEV1) from 0.76 (0.28) 1 to 0.93 (0.69) 1 and in six minute walking distance from 311 (93) m to 332 (86) m, but did not change progressive cycle exercise duration. Resting and end exercise breathlessness levels were reduced in both forms of exercise after oxitropium. Resting oxygen saturation fell significantly after active bronchodilator from 92.9% (3.7%) to 92.0% (4.1%) but the nadir saturation during exercise was unchanged. The patients desaturated more during corridor walking than cycle ergometry [walking 7.8% (4.4%), cycle ergometry 2.1% (2.1%)]. Baseline walking distance was related to FVC, resting breathlessness and resting oxygen saturation (multiple r2 = 0.46) but only resting saturation correlated with end exercise breathlessness (r2 = -0.25). Improvements in symptoms or exercise performance after oxitropium could not be predicted by changes in spirometric indices or oxygen saturation. CONCLUSIONS: In patients with COPD arterial oxygen desaturation during self-paced walking is common, of greater severity than that during cycle ergometry, but is unaffected by inhaled oxitropium bromide. The factors that predict initial performance are not appropriate markers of functional improvement after an active bronchodilator drug.

Double-Blind Method↗
PubMed2006

Does obstructive sleep apnea affect aerobic fitness?

OBJECTIVES: We sought to determine whether patients with obstructive sleep apnea (OSA) had an objective change in aerobic fitness during cycle ergometry compared to a normal population. The most accurate test of aerobic fitness is measurement of maximum oxygen consumption (VO2max) with cycle ergometry. METHODS: We performed a retrospective cohort analysis (247 patients with OSA) of VO2max from annual cycle ergometry tests compared to a large control group (normative data from 1.4 million US Air Force tests) in a tertiary care setting. RESULTS: Overall, individuals with OSA had increased VO2max when compared to the normalized US Air Force data (p < .001). Patients with an apnea-hypopnea index of greater than 20 demonstrated a decreased VO2max as compared to normalized values (p < .001). No differences in VO2max were observed after either medical or surgical therapy for OSA. CONCLUSIONS: Overall, in a US Air Force population, OSA does not predict a decrease in aerobic fitness as measured by cycle ergometry. However, patients with an apnea-hypopnea index of greater than 20 have a statistically significant decrease in aerobic fitness compared to the normal population. This study demonstrates the effects of OSA on aerobic fitness. Further correlation of fitness testing results with OSA severity and treatment is needed.

Adolescent↗
PubMed1990

A comparison of single-versus multi-modal exercise programs: effects on aerobic power.

The purpose of this study was to compare the effects of a 10-week single mode (SM) training program (walk/jog) versus a multimode (MM) training program (walk/jog, cycle, arm crank) on peak aerobic power (VO2 peak) during three ergometry modes. Twenty Ss were stratified initially according to gender and then randomly assigned to either of the treatment groups. Seven additional Ss served as controls. Peak VO2 was determined during treadmill running, cycle ergometry and arm crank ergometry prior to and after ten weeks of training. Training for the SM group (N = 9) consisted of walk/jog three days per week for five weeks at approximately 50-60% peak VO2 and an energy cost of approximately 2400 kJ per week, then increased to approximately 3200 kJ for the duration of the study. Training for the MM group (N = 8) was isoenergetic to the SM group. However, the training differed in that subjects exercised one day walk/jog, one day cycling, and one day arm cranking. Controls were tested twice with no treatment between. Post-training VO2 peaks for the three ergometry modes were analyzed with an analysis of covariance, utilizing pre-training scores as a statistical covariate. The post-training SM VO2 was found to be significantly greater than either the MM or C when testing on the treadmill. No other comparison was statistically significant. These data support the concept that a conditioning program can become sufficiently variable so that expected increases in aerobic power are not produced, despite the fact that isoenergetic training is undertaken.(ABSTRACT TRUNCATED AT 250 WORDS)

Arm↗
PubMed1990

[Silent stress ischemia in patients after aortocoronary bypass].

In a group of 37 patients with chronic stable angina the authors compared results of bicycle ergometry after a load before and after coronary artery bypass grafting. The group included only patients who had to terminate initial ergometry performed during the last two months before operation on account of stenocardia and signs of myocardial ischaemia on the ECG tracing. On average 20 months after coronary artery bypass grafting ergometry was repeated. Nineteen patients (51%) lacked electrocardiographic signs of myocardial ischaemia, 18 patients (49%) suffered from ischaemia after a load (depression S-T greater than or equal to 2 mm). Of these in 18 patients 8 (44%) no stenocardial attacks were present in another 5 (28%) stenocardia developed only when the depressions were S-T greater than 2 mm. Six patients (33%) had depressions S-T greater than or equal to 3.5 mm at a time when during ergometry they had no complaints and were engaged in similar work loads occasionally also at home. The authors conclude that in the investigated group silent ischaemia after a load was frequent in patients after a coronary artery bypass grafting and frequently it was severe. Patients after coronary artery bypass grafting developed stencardia only after greater S-T depressions than before operation. All patients after coronary artery bypass grafting should be checked by means of loading tests.

Adult↗
PubMed1989

Cardiovascular responses and anaerobic threshold for bicycle and arm ergometer exercise.

Cardiovascular responses occurring at the anaerobic threshold (AT) were compared during intermittent bicycle and arm ergometry in eight healthy college students. Arm and bicycle tests used time-matched, discontinuous protocols (three-minute work stages alternated with three-minute rest intervals). Anaerobic threshold was determined by plotting expired minute volume (Ve) on oxygen consumption (VO2) and expressed as the percentage of the respective peak VO2 at which the deflection occurred. Analysis of variance revealed AT was similar for arm and bicycle tests. Absolute VO2 at AT was higher for bicycle than for arm ergometer exercise (p less than .05). Heart rate (HR) and rate pressure product (RPP) were higher for bicycle than for arm ergometry at AT (p less than .05). Moreover, a similarity in percent maximum RPP and percent maximum VO2 was observed at AT for arm ergometry, whereas percent maximum RPP was higher than percent maximum VO2 at AT for bicycle ergometry. Because AT has been suggested as an appropriate intensity of exercise for conditioning, it was concluded that a sufficient level of exercise intensity can be elicited at a lower percentage of the cardiovascular reserve for arm than for bicycle ergometer exercise.

Adult↗
PubMed1984

[Value of the measurement of the repolarization rate in the diagnosis of ischemic heart disease during the veloergometric test].

To assess the bicycle ergometry test, use was made of the indicator of the repolarization rate suggested by the authors. This indicator was calculated according to the first derivative end part of the ventricular complex as a quotient obtained by division of the amplitude of its second phase by the magnitude of the first phase amplitude. In normal subjects at rest, the rate indicator was equal to 1.6 on the average, whereas in patients with angina pectoris, to 1.2-1.5. During the bicycle ergometry test, the indicator decreased to 1.0 (under an average load of 125 W in normal subjects and 25-75 W in angina pectoris patients). The change of the rate indicator to 1.0 outstripped by 40.6 W the moment of recording the conventional criteria of bicycle ergometry test discontinuation. The assessment of the repolarization rate during the bicycle ergometry tests enables one to apply small loads, thereby making the test practically safe and expanding the possibilities of its use.

Adolescent↗
PubMed1995

The VEX-test for myocardial scintigraphy with thallium-201 and sestamibi: effect on abdominal background activity.

UNLABELLED: High abdominal background activity of 99mTc-sestamibi may interfere with the diagnosis in studies in which a coronary vasodilator is used; supplemental dynamic exercise might reduce this problem. METHODS: Clinical and angiographic determinants of subdiaphragmatic-to-myocardial activity ratios were measured on immediate poststress left anterior oblique images and on corresponding tomographic studies 1 hr after injection in 600 sestamibi studies. Similar measurements were made in 550 historic controls with planar 201Tl imaging. Patients performed symptom-limited ergometry when there were no limiting factors, dipyridamole-handgrip in which ergometry was not possible and VEX (vasodilator followed by symptom-limited ergometry) in which exercise capacity was reduced. RESULTS: Abdominal activity was higher with sestamibi than with 201Tl, in women versus men, and with dipyridamole-based tests compared to exercise alone. Compared to the dipyridamole-handgrip, 3 min of ergometry as part of VEX decreased abdominal background (p < or = 0.02) by 18% on immediate 201Tl images, by 13% on immediate sestamibi images and by 12% on 1-hr delayed sestamibi tomoacquisitions. CONCLUSIONS: Poststress abdominal background activity is influenced by similar factors with both agents. Supplemental exercise following dipyridamole reduces potentially interfering abdominal activity but perhaps not as efficiently with sestamibi as with 201Tl.

Abdomen↗