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At least 829 records · Page 46Linked to original sources
PubMed1995

Safety and efficacy study of delapril versus enalapril in patients with congestive heart failure.

The results after the first 6 months of the 1-year treatment of this multicenter, randomized, open, parallel-group design study of delapril versus enalapril in patients with congestive heart failure (CHF), New York Heart Association (NYHA) classes II and III, are presented. The initial dose of delapril (7.5 mg twice daily) and enalapril (2.5 mg twice daily) could be doubled on a 2-weekly basis (from the beginning of the study) to a maximum of 30 mg twice daily and 10 mg twice daily, respectively. The evaluation of the efficacy was based on the changes of NYHA class, results of exercise testing involving bicycle ergometry (duration of exercise, workload, work performed, double product) performed before and after 3 months' treatment, echocardiography (left ventricular end-diastolic volume and end-systolic volume, ejection fraction, and left ventricular wall stress) at baseline and after 3 and 6 months of treatment and changes in cardiothoracic ratio, electrocardiography, and NYHA class, and patient's opinion of efficacy. Safety was evaluated by monitoring the adverse reactions, laboratory tests, and blood pressure. At 3 months, both treatments had produced a significant improvement compared with baseline in the duration of exercise, workload, and work performed in the bicycle ergometry test as well as in the ejection fraction and in left ventricular wall stress after 6 months of treatment. In addition, after 3 and 6 months of treatment, delapril produced a significant decrease in left ventricular end-systolic volume. Improvement of at least one NYHA class was observed in 20% of delapril patients and 14% of enalapril patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Physiologic estradiol replacement therapy and cardiac structure and function in normal postmenopausal women: a randomized, double-blind, placebo-controlled, crossover trial.

OBJECTIVE: To assess the effect of estradiol (E2) replacement therapy on cardiac structure and function in healthy postmenopausal women. METHODS: We conducted a randomized, double-blind, placebo-controlled, crossover study of 31 healthy postmenopausal female volunteer study subjects (55-65 years) using 12 weeks of micronized E2 replacement therapy (2 mg/day). Echocardiography and Doppler techniques were used to assess the cardiac effects of E2 at rest and during graded bicycle ergometry. RESULTS: Crossover analysis demonstrated no carryover effects of estrogen treatment (which increased serum E2 15-fold to 37.6 pmol/L) on the cardiac characteristics measured. Estradiol treatment did not affect measurements of systolic function, diastolic function, left ventricular mass, or pulmonary artery pressure at rest or during bicycle ergometry. Left ventricular end-diastolic volume at rest was slightly higher with E2 treatment (P = .03). However, this change was not reflected by changes in stroke volume, ejection fraction, or cardiac output. CONCLUSIONS: Estrogen replacement therapy, which results in physiologic serum concentrations, does not affect cardiac structure or function in normal postmenopausal women after 12 weeks of treatment.

Aged↗
PubMed1998

Humoral response in patients with chronic heart failure.

AIM: Correlation of five humoral markers with laboratory, echocardiographic and right heart catheterization parameters in patients with chronic heart failure. STUDY POPULATION: 29 patients, heart failure NYHA II and III, ejection fraction below 40% with coronary artery disease or dilated cardiomyopathy. METHODS: evaluation of thromboxane, prostaglandin F (PGF), tumor necrosis factor (TNF) alpha, endothelin-1 and big endothelin rest levels and their correlation with: (1) laboratory parameters: Sodium, urea, creatinine, fibrinogen, (2) chest X-ray: cardiothoracic index (CTI), pulmonary congestion, (3) right heart catheterization parameters at rest, hand-grip and bicycle ergometry: mean pulmonary artery pressure (AP), wedge pressure (WP), systemic and pulmonary vascular resistance (SVR, PVR) and cardiac index (CI), (4) echocardiographic parameters at rest, hand-grip and bicycle ergometry: end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), mitral flow E/A, filling period of left ventricle and time of duration of mitral regurgitation. RESULTS: No correlation was found between thromboxane, prostaglandin F and tumor necrosis factor alpha with the above mentioned parameters. Endothelin-1 level correlated with E/A, PVR and MPA at rest and at hand-grip. Big endothelin level correlated with EDV and ESV, AP, WP and SVR at rest and at both types of exercise. The highest correlation was between big endothelin and rest AP (r=0.79), rest WP (r=0.78) and CTI (r=0.58), all P<0.01. CONCLUSIONS: Big endothelin and partly endothelin-1 levels showed a close correlation with some parameters used for the evaluation of chronic heart failure severity.

Biomarkers↗
PubMed1998

Exercise-induced increase in hydrogen peroxide plasma levels is diminished by endurance training after myocardial infarction.

We have investigated the influence of physical training on exercise-induced changes in free radical activity in patients after myocardial infarction. Seventeen patients admitted to the cardiac rehabilitation center performed a bicycle ergometry before and after a 3-week endurance training program. The oxygen consumption and carbon dioxide production were measured and the ECG and the systemic blood pressure were monitored during the tests. Blood samples for acid-base equilibrium, lactic acid levels and hydrogen peroxide concentrations were collected directly before and after each exercise test. Exercise-induced increases in systolic blood pressure, heart rate and rate-pressure product as well as lactic acid concentrations were significantly less marked during the bicycle ergometry performed after the rehabilitation program. During the initial exercise test hydrogen peroxide levels increased significantly from 7.15+/-0.74 micromol/l before to 9.09+/-1.04 micromol/l 3 min after the test (P=0.0229). In contrast, no significant changes in hydrogen peroxide concentrations were observed during the exercise test performed after the training (6.31+/-1.05 micromol/l before the test, 5.85+/-1.08 micromol/l after the test, P=0.201). These observations suggest that physical training may have a beneficial influence on free radicals' generation in patients after myocardial infarction.

Acid-Base Equilibrium↗
PubMed2002

Attenuated cardiovascular reserve during prolonged submaximal cycle exercise in healthy older subjects.

OBJECTIVE: The goal of this study was to determine the effect of age on the hemodynamic response to prolonged submaximal aerobic exercise in healthy volunteers. BACKGROUND: Reductions in peak work rate, heart rate (HR), and left ventricular (LV) emptying but higher blood pressure (BP) and systemic vascular resistance occur in healthy older versus younger humans during short bursts of graded maximal aerobic exercise. However, the effect of aging on the cardiovascular response to prolonged exercise at submaximal work rates typical of daily aerobic activities remains unknown. METHODS: We evaluated cardiovascular performance throughout prolonged submaximal upright cycle ergometry in 40 carefully screened healthy untrained volunteers, 8 men and 12 women <50 years old, mean = 37 +/- 8 years (younger), and 10 men and 10 women >/=50 years old, mean = 66 +/- 9 years (older), during upright cycle exercise at 70% of peak cycle oxygen consumption (VO(2)) to exhaustion or a maximum of 120 min. Cardiac volumes were acquired by gated blood pool scans with (99m)Tc at rest and every 10 min throughout exercise. RESULTS: Duration of exercise was similar in younger ([81 +/- 28 min] versus older [71+/- 29 min] subjects, p = NS). At 10 min of exercise in the steady state, older subjects demonstrated lower VO(2) (1.1 +/- 0.2 l/min vs. 1.3 +/- 0.3 l/min) and lower HR (118 +/- 17 vs. 135 +/- 11 beats/min, p < 0.001) but larger end-diastolic (80 +/- 11 ml/m(2) vs. 73 +/- 8 ml/m(2), p = 0.03) and end-systolic volume index (ESVI) 20 +/- 6 ml/m(2) vs. 17 +/- 4 ml/m(2), p < 0.05) than younger ones. Between 10 min and exercise termination, with VO(2) held constant in both groups, increases in HR (14.0 +/- 12.4 beats/min vs. 5.9 +/- 11.5 beats/min, p = 0.04), cardiac index (1.6 +/- 1.0 l/min/m(2) vs. 0.8 +/- 1.1 l/min/m(2), p = 0.03), and LV ejection fraction (7.1 +/- 4.0% vs. 2.9 +/- 4.4%, p = 0.003) were greater in younger than older subjects, respectively, as was the reduction in ESVI (-5.1 +/- 3.0 ml/m(2) vs. -1.8 +/- 3.3 ml/m(2), p = 0.002), despite similar declines in systolic BP (-12.3 +/- 6.3 mm Hg vs. -12.1 +/- 15.0 mm Hg, p = NS). CONCLUSIONS: Thus, age-associated deficits in chronotropic and LV systolic reserve performance occur during prolonged submaximal upright cycle ergometry, analogous to those observed during graded maximal exercise.

Adult↗
PubMed1987

Arm exercise-thallium imaging testing for the detection of coronary artery disease.

Patients with lower limb impairment are often unable to undergo a standard bicycle or treadmill test for the evaluation of coronary artery disease. To establish an alternative method of testing, 50 subjects (aged 56 +/- 10 years) performed arm ergometry testing in conjunction with myocardial thallium scintigraphy. All underwent coronary angiography; significant coronary artery disease (greater than or equal to 70% stenosis) in at least one vessel was present in 41 (82%) of the 50 patients. Thallium scintigraphy was found to have an 83% sensitivity and 78% specificity for detecting coronary disease, compared with a sensitivity and specificity of 54% (p less than 0.01) and 67% (p = NS), respectively, for exercise electrocardiography. In the subgroup of 23 patients who had no prior myocardial infarction or left bundle branch block and were not taking digitalis, thallium scintigraphy had a sensitivity of 80% versus 50% for exercise electrocardiography. Scintigraphy yielded a sensitivity of 84, 74 and 90% for one, two and three vessel disease, respectively. Noninvasive arm ergometry exercise-thallium imaging testing appears to be reliable and useful and should be considered in the evaluation of coronary artery disease in patients with lower limb impairment.

Adult↗
PubMed2001

Predictors of low physical fitness in a cohort of active-duty U.S. Air Force members.

BACKGROUND: Each branch of the U.S. armed forces has standards for physical fitness as well as programs for ensuring compliance with these standards. In the U.S. Air Force (USAF), physical fitness is assessed using submaximal cycle ergometry to estimate maximal oxygen uptake (VO2(max)). The purpose of this study was to identify the independent effects of demographic and behavioral factors on risk of failure to meet USAF fitness standards (hereafter called low fitness). METHODS: A retrospective cohort study (N=38,837) was conducted using self-reported health risk assessment data and cycle ergometry data from active-duty Air Force (ADAF) members. Poisson regression techniques were used to estimate the associations between the factors studied and low fitness. RESULTS: The factors studied had different effects depending on whether members passed or failed fitness testing in the previous year. All predictors had weaker effects among those with previous failure. Among those with a previous pass, demographic groups at increased risk were toward the upper end of the ADAF age distribution, senior enlisted men, and blacks. Overweight/obesity was the behavioral factor with the largest effect among men, with aerobic exercise frequency ranked second; among women, the order of these two factors was reversed. Cigarette smoking only had an adverse effect among men. For a hypothetical ADAF man who was sedentary, obese, and smoked, the results suggested that aggressive behavioral risk factor modification would produce a 77% relative decrease in risk of low fitness. CONCLUSIONS: Among ADAF members, both demographic and behavioral factors play important roles in physical fitness. Behavioral risk factors are prevalent and potentially modifiable. These data suggest that, depending on a member's risk factor profile, behavioral risk factor modification may produce impressive reductions in risk of low fitness among ADAF personnel.

Adolescent↗
PubMed1990

Routine exercise testing to detect coronary artery disease in patients with atherosclerotic vascular disease.

The ability of patients with peripheral vascular disease to perform exercise studies on a conventional treadmill is often hampered by claudication, amputation, ischemic ulceration or rest pain. This study was undertaken to investigate the use of the arm ergometer in these patients. Eighty-three patients admitted with peripheral vascular or carotid artery disease were subjected to electrocardiographic-monitored exercise testing, using both the arm ergometer and conventional treadmill, where possible. Coronary arteriography was performed consecutively on 32 of these patients to establish a control group from which the sensitivity, specificity and predictive accuracy of both methods of exercise testing could be calculated. Nineteen of the 70 arm ergometry tests and 22 of the 48 treadmill tests were positive. Nineteen of the patients with a positive test using either of the methods were asymptomatic for cardiac disease. All five patients who developed cardiac events during surgery had positive exercise tests, preoperatively. The sensitivity of arm ergometry in detecting coronary artery disease was 45.5% and the specificity 100%, while the figures for treadmill testing were 82.4% and 83.3%, respectively. The combined sensitivity for the two tests was 81.8% and the specificity 87.5%. Using a combination of these two tests thus provided a highly specific and adequately sensitive means of detecting the presence of coronary artery disease in patients presenting for peripheral vascular surgery.

Adult↗
PubMedDate not supplied

First-pass radionuclide angiography during bicycle and treadmill exercise.

BACKGROUND: Treadmill testing is usually preferred over cycle ergometry because of the greater sensitivity in diagnosing coronary artery disease. Treadmill testing has only recently been used with radionuclide angiography (RNA) because patient motion makes RNA imaging difficult. In this study we evaluate the comparability of treadmill and cycle exercise RNA with a dual isotope motion correction technique. METHODS AND RESULTS: Volunteer patients (n = 27) performed first-pass RNA during maximal exercise using both cycle ergometer and treadmill. Exercise capacity was greater during treadmill exercise (8.1 +/- 2.4 vs 7.5 +/- 2.2 METs). Twenty-three of 27 treadmill and all cycle ergometer exercise studies were technically adequate. Maximal heart rate was greater during treadmill exercise (150 +/- 24 vs 143 +/- 25 beats * min-l), however, systolic blood pressure was greater during cycle ergometry (174 +/- 23 vs 188 +/- 25 mmHg), resulting in no difference in heart rate times systolic blood pressure (25.7 +/- 7.2 vs 26.9 +/- 6.0). There were no differences between treadmill and cycle ergometer for peak exercise left ventricular ejection fraction (56% +/- 13% vs 57% +/- 14%) (r = 0.89). Calculated left ventricular end-diastolic volume was not different at rest (183 +/- 42 ml vs 176 +/- 44 ml) but differed significantly at peak exercise (282 +/- 75 ml vs 231 +/- 60 ml). The clinical impression, based on wall motion and left ventricular ejection fraction was very similar between treadmill and cycle ergometer. CONCLUSION: Treadmill exercise RNA is feasible, with about 85% of studies likely to be technically adequate. The overall clinical results are very similar to cycle exercise RNA, although the ordinarily expected advantages of treadmill exercise were largely absent.

Adult↗
PubMed1986

Metabolic responses of women to exercise attributable to long term use of a manual wheelchair.

The purpose of this study was to determine the effects of long term use of a manual wheelchair by wheelchair-confined women (means = 14.6 years) on physiological responses to wheelchair ergometry. Six experimental subjects were compared to six able bodied women during maximal exercise as well as submaximal wheelchair ergometry at 50 and 80% of peak VO2. The wheelchair dependent women achieved higher power outputs, greater efficiency at the higher submaximal workload, less metabolic acidosis during submaximal exercise as well as less ventilatory stress. There was no significant difference in peak VO2 between the two groups of women. Because these were not athletically trained women, it was concluded that the long term use of a manual wheelchair leads to physiological adaptations favourable to the daily requirements of wheelchair locomotion.

Acid-Base Equilibrium↗
PubMed1994

Thermoregulation of paraplegic and able bodied men during prolonged exercise in hot and cool climates.

The purpose of this study was to compare the thermoregulatory responses of trained paraplegics (TP) and able bodied subjects (AB) performing submaximal exercise of the same relative intensity in both hot and cool conditions. Five TP (lesion range T12 to L3) and five AB subjects experienced in wheelchair use performed 60 minutes of constant load (55-60% of VO2 max) arm ergometry exercise in 37 degrees C and 15 degrees C climatic conditions. Heart rate (HR), sweat rate and rectal (Tr) and skin (Tsk) temperatures were recorded. In the hot climate the TP subjects recorded a significantly greater change in Tsk (delta Tsk) from 0 to 60 minutes of exercise than the AB subjects, because of greater thigh and calf temperatures, but no other significant differences were found between these groups. In the cool climate no significant differences were observed between the TP and AB groups. It was concluded that TP have a similar thermoregulatory ability to AB subjects who perform identical prolonged exercise in hot and cool conditions, although their lower limb skin temperatures are greater, probably because of venous pooling in the legs. While these results are a promising indication of the ability of TP to thermoregulate effectively while exercising in the, heat caution regarding their participation in endurance competitions in hot conditions should be expressed until data collected during wheelchair exercise (rather than arm ergometry) in the heat is available.

Adult↗
PubMed1995

Effects of electrically-stimulated exercise and passive motion on echocardiographically-derived wall motion and cardiodynamic function in tetraplegic persons.

The purposes of the study were (1) to characterize left ventricular wall motion, and the cardiodynamic and metabolic responses during electrical stimulation cycle ergometry (ESCE) exercise in tetraplegic people; (2) to test whether these responses linger into the post-exercise recovery period; and (3) to test whether they differ from those imposed by lower extremity continuous passive motion (CPM). Subjects were six tetraplegic males aged 25.8 +/- 3.1 (mean +/- SD) years with spinal cord injuries of 6.7 +/- 3.5 years' duration at the C5 and C6 levels (Frankel classifications A and B). On randomized non-consecutive days, subjects underwent either 30 min of steady-state exercise using transcutaneous electrically-stimulated contractions of bilateral quadriceps, hamstring, and gluteus muscle groups, or 30 min of continuous passive motion at 50 rpm. Data were taken at rest, min 15 and 30 of treatment, and min 5, 15, and 30 post-treatment. Stroke volume (SV) was measured echocardiographically as the product of the left ventricular outflow tract area and the integrated area under the left ventricular outflow tract flow-velocity curve acquired by doppler ultrasound. This value was multiplied by heart rate (HR) to determine the cardiac output (CO). Oxygen consumption (VO2) was monitored spirometrically, with arteriovenous oxygen difference (a-vO2DIFF) computed algebraically. Data were analyzed using repeated measures within-subjects design anaysis of variance, with significance accepted at the 0.05 level. Results showed five subjects had small hyperkinetic ventricles at rest that became more dynamic during ESCE than CPM. Though no systolic dysfunction was noted, all but one subject exhibited some degree of septal hypokinesis at rest and during exercise, possibly indicative of left ventricular noncompliance. Significant effects of condition (ESCE vs CPM), trial (measurement time point), and their interaction, were observed for CO (P < 0.05, 0.01, and 0.0001, respectively), HR (P < 0.0001, 0.05 and 0.005, respectively), and VO2 (P < 0.001, 0.05 and 0.005, respectively). A significant trial and condition by trial interaction was found for a-vO2DIFF (P < 0.05 and 0.0001, respectively). No effects for condition, trial or their interaction were found for SV or BPDIAS. Electrical stimulation cycle ergometry-treated subjects achieved peak VO2 of 712 +/- 300 ml min-1, 2.63 times baseline, with 56% elevation of a-vO2DIFF. Cardiac output increased from 3.5 +/- 1.51 min-1 to 6.0 +/- 2.11 min-1, an elevation solely attributable to a 57% increase in HR. Thus, both CO and a-vO2DIFF accounted for elevated VO2 during ESCE.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1999

The effects of exercise intensity on post exercise hypotension.

Ten normotensive, recreationally active participants aged 35.0 +/- 16.3 years, volunteered to participate in the study. Average baseline blood pressure (BP) was 132/75 mm Hg for systolic (SBP) and diastolic (DBP) pressure respectively. On two separate days, participants underwent testing in a randomised, repeated measures fashion such that they performed 30-min bouts of cycle ergometry at a power output which elicited 50 or 75% of VO2 Peak. Blood pressure was monitored continuously throughout the session by the Finapres method with 2-min windows recorded at rest, 5, 10, 15, 30, 45 and 60 min post exercise. SBP was similar between the two trials and became hypotensive at 5 through 15 min post exercise. The largest decrement (8 mm Hg) in SBP occurred 5 min post exercise. DBP was also unaffected by the intensity of exercise and was lower than before exercise at 5 and 15 through 45 min post exercise. Similarly, mean arterial pressure (MAP) showed significant decrements at 5 and 15 through 45 min post exercise irrespective of exercise intensity. Heart rate was greater during the 75% intensity than during the 50% intensity trial. Pre-exercise values were re-established by 45 min post exercise. VO2 remained significantly elevated above pre-exercise values in both trials until 15 min post exercise. Haematocrit increased significantly during both exercise bouts but returned to pre-exercise values by 10 min post exercise. This study indicates that cycle ergometry at 50 and 75% of VO2 Peak elicit similar reductions in post exercise BP. Therefore bouts of mild to moderate intensity exercise may be beneficial in the control of hypertension.

Adult↗
PubMed2000

The effects of exercise duration on post-exercise hypotension.

STUDY 1: Thirteen normotensive participants with average baseline blood pressure of 126/71 mm Hg participated in the study. Participants performed bouts of cycle ergometry for 15, 30 and 45 min at 70% VO2 Peak. Blood pressure was monitored by the Finapres method with 2 min windows recorded at rest, 5, 10, 15, 30, 45 and 60 min post-exercise. Following exercise, systolic blood pressure (SBP) was similar between the three trials and was reduced from pre-exercise values at 5 through 60 min of measurement. Diastolic blood pressure (DBP) was also unaffected by the duration of exercise and was lower than before exercise at 30 through 45 min post-exercise. STUDY 2: Eight borderline hypertensive participants with average baseline blood pressure of 133/79 mm Hg participated in the study. Subjects performed bouts of cycle ergometry for 10 and 30 min at 70% VO2 Peak. Following exercise, blood pressure was monitored as in study 1. SBP was similar between both trials and was reduced from baseline at 5 through 60 min post-exercise. The largest decrement of SBP was 14 mm Hg and occurred 15 min post-exercise. DBP was also unaffected by the duration of exercise and was lower than pre-exercise levels at 5 min and again at 15 through 45 min post-exercise. Mean arterial pressure (MAP) also showed significant decrements throughout the entire 1 h post-exercise period by a maximum of 9 mm Hg at 15 min post-exercise, irrespective of exercise duration. We conclude that moderately intense exercise may be as brief as 10 min in duration in order to elicit a decrease in resting blood pressure and may have potential benefits as a non-pharmacological aid to hypertension.

Adult↗
PubMed2000

The effects of exercising muscle mass on post exercise hypotension.

Nine recreationally active, borderline hypertensive subjects completed 30 min of arm ergometry (ARM) at 65% VO2 peak and 30 min of leg ergometry (LEG) at 70% VO2 Peak (randomised order). Blood pressure was monitored before and for 1 h after exercise using the Finapres method. Systolic, diastolic and mean blood pressures were significantly reduced for the entire 1 h post exercise. This reduction was independent of exercise modality, but there was an indication for the duration of the effect to be prolonged following the leg exercise. We conclude that the mass of the working muscle does not directly effect the magnitude of post-exercise hypotension (PEH) but may influence the duration of the response. These results suggest that a central mechanism or decreased vascular responsiveness is responsible for PEH.

Adult↗
PubMed2002

Efficacy of an additional MAZE procedure using cooled-tip radiofrequency ablation in patients with chronic atrial fibrillation and mitral valve disease. A randomized, prospective trial.

AIMS: This study is the first prospective randomized trial evaluating the efficacy of an antiarrhythmic surgical procedure in patients with chronic atrial fibrillation undergoing mitral valve replacement. METHODS AND RESULTS: Thirty consecutive patients with chronic atrial fibrillation undergoing mitral valve replacement were randomized for an additional modified MAZE-operation using intra-operatively cooled-tip radiofrequency ablation (group A) or mitral valve replacement alone (group B). Biatrial contraction was studied and functional capacity was evaluated in spiro-ergometry 6 months after surgery. Thirty-day mortality was 0% in both groups. After 12 months, sinus rhythm was reinstituted significantly more often in patients of group A (cumulative rate of sinus rhythm 0.800) compared to patients in group B (0.267) (P<0.01). 66.7% of patients in sinus rhythm of group A had documented biatrial contraction. Electrocardioversion showed long-term success in only 17% of patients in group A and 0% in group B. Maximal aerobic uptake at the 6-month spiro-ergometry revealed no significant difference (9.3 vs 8.5 ml x min(-1) kg(-1), P=0.530). CONCLUSIONS: A modified MAZE operation using cooled-tip radiofrequency ablation can be safely combined with mitral valve surgery and is highly effective in restoring sinus rhythm. Biatrial contraction is found in 66.7% of patients with sinus rhythm undergoing mitral valve replacement plus the MAZE operation.

Aged↗
PubMed1979

[Diagnosis of peripheral arterial occlusive disease: clinical, haemodynamic and metabolic investigation (author's transl)].

The value of quantitative (venous-occlusion plethysmography), semiquantitative (ultrasound-Doppler method; walking distance; duration of bicycle ergometry) and metabolic (lactate, pyruvate) tests was assessed in 41 patients with arterial occlusive disease of the upper leg type. It was demonstrated that blood pressure measurement using the Doppler method is of great importance. Significant differentiation between normal and impaired blood flow was obtained with venous-occulsion plethysmography for both "first flow" and "peak flow". The diagnostic value as to the degree of peripheral arterial disease was similar for plethysmography and Doppler methods. Duration of bicycle ergometry provided an important pointer to the degree of functional impairment of the affected extremity. The level of lactate and pyruvate in femoral venous blood is suitable more for serial controls and assessment of treatment in patients in whom haemodynamic studies have already clarified the diagnosis of impaired blood flow.

Adult↗
PubMed1979

[Frequency of life-threatening complications associated with exercise testing (author's transl)].

Most of the statistics on complications of ergometric exercise tests come from the United States and are largely related to treadmill ergometry. A questionnaire was sent in the summer of 1978 to 198 investigative units in the German-speaking regions. The results of 1065 923 person-tests were made available. Exercise testing of 353 638 sports-persons revealed no serious complications. On the other hand, testing of 712 285 patients, predominantly with coronary heart disease, lead to 17 deaths and a total of 96 life-threatening complications. The result of this survey indicates that one must expect one such complication for every 7500 ergometry tests. The danger of pulmonary oedema on exercise in recumbency is about five times higher than that on sitting or standing. The most frequent complication was ventricular fibrillation. A defibrillator should therefore always be immediately available during exercise tests.

Coronary Disease↗