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At least 19 recordsLinked to original sources
PubMed1995

[The effects of the treatment with oxitropium bromide after one month or more in patients with pulmonary emphysema--evaluation of pulmonary function tests, exercise tests, and a questionnaire].

Chronic effects of oxitropium bromide were studied in patients with pulmonary emphysema. Pulmonary function tests, an exercise test, and a questionnaire were used. Seven subjects underwent two successive studies, including a questionnaire on QOL, pulmonary function tests, and an exercise test before and after one month or more of regular inhalation of ocitropium bromide (600 micrograms/day). The complaint of breathlessness was significantly reduced and the ability to perform activities of daily living had improved slightly after the treatment. There were no significant differences in the values of arterial oxygen pressure at rest. The VC, RV/TLC, and peak expiratory flow rate improved. A significant decrease in oxygen uptake at rest, a slight decrease in minute ventilation at rest, and a significant prolongation of exercise time were observed after the treatment. No other changes were noted. We conclude that oxitropium bromide may improve lung mechanics and reduce the work of respiratory muscles.

Administration, Inhalation↗
PubMed1988

Early post-myocardial infarction exercise testing. Exercise response and clinical value.

Based on 7 previously published original papers the present review evaluates the response to an exercise test during early recovery from acute myocardial infarction. Selected exercise variables are related to the long-term survival of the patients. The conclusions can be summarized as the following: The exercise test can be carried out with sufficient safety. The exercise physiological response of the patients is dependent on their age, sex and reason to discontinue exercise. ST-segment depression is not significantly predictive of subsequent mortality. Other categories of the ST-segment response are of limited value as prognostic predictors. An exercise index of left ventricular function and exercise associated ventricular arrhythmias are independent, significant predictors of the long-term survival of the patients, regardless their age. These variables can identify a substantial number of patients with a very low subsequent death rate, irrespective of a clinical risk stratification. Different degrees of increased risk of dying can be determined by combining exercise and clinical variables. The prognostic significance of exercise induced ventricular arrhythmias is related to their frequency and the occurrence of repetitive ventricular premature beats.

Adult↗
PubMed1991

Development of an exercise program for older adults: pre-exercise testing, exercise prescription and program maintenance.

Health care practitioners have the technical skills, frequency of contact and credibility with older adults to use exercise as a health-promoting and disease-preventing intervention. This article acquaints the clinician with how to develop an exercise program specifically for older adults. The health-promotion and disease-prevention outcomes of exercise in older adults, including an explanation of the three stages of exercise programming for older adults, are also reviewed. Stage one is labeled pre-exercise testing and discusses assessment protocols for aerobic capacity, body composition, flexibility and strength. Guidelines for who should and should not exercise are also explored. The second stage of exercise programming is exercise prescription. An explanation of how to develop a beginning level of training and guidelines for how to set goals based on the initial pre-exercise testing are presented. Program maintenance is the third stage; this includes suggestions for designing an exercise program that increases program compliance, reduces attrition and prevents relapses to non-exercise behaviors.

Aged↗
PubMed1990

Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity.

One metabolic equivalent (MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2 per kg body weight x min. The MET concept represents a simple, practical, and easily understood procedure for expressing the energy cost of physical activities as a multiple of the resting metabolic rate. The energy cost of an activity can be determined by dividing the relative oxygen cost of the activity (ml O2/kg/min) x by 3.5. This article summarizes and presents energy expenditure values for numerous household and recreational activities in both METS and watts units. Also, the intensity levels (in METS) for selected exercise protocols are compared stage by stage. In spite of its limitations, the MET concept provides a convenient method to describe the functional capacity or exercise tolerance of an individual as determined from progressive exercise testing and to define a repertoire of physical activities in which a person may participate safely, without exceeding a prescribed intensity level.

Activities of Daily Living↗
PubMed1997

Office procedures. Exercise testing.

Exercise testing is an effective method for evaluating patients with chest pain, for diagnosing and managing coronary artery disease, for determining prognosis in patients with known coronary disease, for determining exercise capacity, for evaluating exercise-induced arrhythmias, for verifying the safety of exercise, and for customizing an exercise prescription. With proper clinician training and careful selection of patients, exercise testing is a safe procedure (less than 1 complication per 10,000 cases). Performing office-based exercise testing improves clinician's basic electrocardiograph reading capabilities, communication, and his or her referral patterns with subspecialists. With an understanding of the basic principles of exercise testing, with proper supervision or consultation, and with proper selection of patients, most clinicians can enjoy exercise testing safely.

Adult↗
PubMed1990

Evaluation of cardiac arrhythmias by exercise testing.

Exercise testing is an important noninvasive method for the exposure of arrhythmias. It provides complementary information to that obtained from ambulatory monitoring or electrophysiologic testing. By producing a number of important physiologic changes, especially activation of the sympathetic nervous system and an increase in circulating catecholamines, exercise testing provides a more complete assessment. On continuous monitoring, exercise-induced ventricular premature beats may be found in up to 34% of healthy subjects, in 60 to 70% of those with heart disease and in all patients who have experienced sustained ventricular tachycardia. Couplets or nonsustained ventricular tachycardia can be found during exercise in 0 to 6% of healthy subjects, in 15 to 31% of patients with heart disease and in 75% of those with sustained ventricular tachycardia. Even in patients with heart disease, there is only a small risk of inducing sustained ventricular tachycardia or ventricular fibrillation during exercise. The prognostic relevance of exercise-induced ventricular arrhythmias in patients with coronary artery disease or cardiomyopathy has not been clearly established. There appears to be an increased risk, however, in patients with ventricular premature beats as well as ST-segment depression or in patients with repetitive forms of ventricular arrhythmias during exercise which cannot be medically controlled. In healthy subjects, exercise-induced ventricular premature beats are of no prognostic relevance. In particular, for patients in whom arrhythmias are induced by exercise, exercise testing should be used to assess the effectiveness of antiarrhythmic drug treatment. Importantly, serious cardiac toxicity, often not observed at rest or during routine activities, may become apparent during exercise testing. It should be a standard part of arrhythmia assessment and management.

Cardiac Complexes, Premature↗
PubMed1994

The physiology behind exercise testing.

Exercise testing is a valuable tool to assess cardiopulmonary function. It can define the limits of performance in an athlete or the functional capabilities of the patient with heart disease. Exercise capacity is determined most accurately by ventilatory oxygen uptake, which is defined by maximal cardiac output and the ability to extract and utilize oxygen in the working muscle. A given increase in cardiac output must be matched by a concomitant increase in ventilation, such that efficient pulmonary gas exchange can occur. The increase in cardiac output required by an exercise test places major demands on the heart muscle; the increase in myocardial oxygen demand can bring out abnormalities not apparent at rest. Thus, the exercise test is useful clinically to assess cardiac perfusion and function under controlled conditions. The physiologic response to exercise is influenced by the state of health and fitness, age, gender, the type of exercise, exercise position, and the environment. A good understanding of the basic physiologic responses to acute exercise can assist the clinician in applying the information gained from the exercise test to patients with cardiovascular disease. In addition to diagnostic and prognostic information, these applications include the assessment of therapy, exercise prescription, and hemodynamic responses.

Exercise Test↗
PubMed1983

The diagnostic value of R-wave amplitude changes during exercise testing.

Exercise ECG, coronary arteriography and left ventriculography were performed in 200 patients with suspected or confirmed coronary artery disease (CAD). The authors compared the diagnostic value of R wave amplitude changes and ST segment depressions in V5. Evaluation of the results showed a near uniform sensitivity of the two methods. R wave amplitude changes in V5 did not correlate with the presence and degree of CAD nor with the number of affected coronary arteries. In contrast to the absence of a definite correlation with topical left ventricular dysfunction there was a correlation with the ejection fraction. The study showed that in some instances R wave amplitude changes may complement the evaluation of exercise testing based on ST segment depressions. Yet, R wave amplitude changes alone during exercise testing lack a sufficient predictive accuracy for being adopted as a routine criterion of coronary insufficiency.

Adult↗
PubMed1993

A multivariate analysis of the diagnostic values of clinical examination, exercise testing and exercise radionuclide angiography in coronary artery disease.

Data of clinical examination, exercise testing and exercise radionuclide angiography in 102 patients referred for assessment of chest pain was included in a logistic regression to optimize the diagnosis of coronary artery disease with coronary arteriography as the reference investigation. None of the patients had other cardiac problems or previous myocardial infarction. In the absence of symptoms, exercise testing was continued until at least 80% of the theoretical maximal heart rate was attained. Each patient was characterized by the value of the logistic function or probability of coronary artery disease. A threshold value corresponding to 80% sensitivity of ROC graphs was determined. The significant variables were: a clinical variable--the type of chest pain as assessed by the clinical history; two radionuclide angiographic variables--the ejection fraction at peak effort and the corrected variation of ejection fraction between rest and stress, that is not taking into account possible decreases at the last increment of exercise. Coronary patients can be identified with an 80% sensitivity and 77% specificity on these criteria. This specificity is greater than that obtained by clinical examination and exercise testing alone (65%). Exercise radionuclide angiography may therefore reduce the number of unnecessary coronary arteriographies.

Adult↗
PubMed2001

Performing the exercise test.

Exercise testing is useful in assessing physical fitness, determining functional capacity, diagnosing ischemic heart disease, defining the prognosis of ischemic heart disease, developing an exercise prescription, and guiding cardiac rehabilitation. This article outlines the current indications, contraindications, and special considerations for exercise testing. Specific protocols are discussed along with physician responsibilities for performing this procedure. A summary of current testing equipment is included.

Cardiovascular Diseases↗
PubMed1994

The bioenergetic and gas exchange basis of exercise testing.

Exercise intolerance results when a subject is unable to sustain a required work rate sufficiently long for the successful completion of the task. The ability to sustain muscular exercise depends in large part on the ability to transport oxygen to its site of utilization as the terminal oxidant of the mitochondrial electron transport chain. This requires a coordinated interaction of skeletal muscle energetics and cardiovascular and pulmonary responses to the task. This article considers the fundamentals of the normal operation of these systems and their patterns of response to particular stress profiles to provide a frame of reference for the normalcy of responses to exercise testing.

Carbon Dioxide↗
PubMed1997

Comparison of dobutamine electrocardiographic stress test and exercise test in two different groups of patients with unstable angina.

Exercise testing is a well known means of evaluating patients with unstable angina, but in recent years, alternative methods have been proposed. We prospectively compared standard exercise testing with dobutamine electrocardiographic stress testing for patients who were admitted with a diagnosis of unstable angina. A total of 43 patients were studied, divided into two different groups, according to the presence (group A n = 26) or absence (group B n = 17) of a previous history of coronary artery disease and/or electrocardiographic changes compatible with ischemia on admission. Dobutamine electrocardiographic stress testing was performed in a standard manner at 3 +/- 1 days after admission in group A and at 16 +/- 8 hours after admission in group B. Exercise testing was performed, on average 5 +/- 1 days following the event in group A and 2 days after admission in group B. Agreement between both tests was observed in 39 (91%) cases, Kappa value: 0.81. The dobutamine test predicted the result of the exercise test with a sensitivity of 79% (95% CI 54-90), and a specificity of 100% (95% CI 86-100), with a positive predictive value of 100% and a negative predictive value of 86%. It can be concluded that dobutamine electrocardiographic stress testing is an objective and reliable procedure that accurately predicts the results of standard exercise testing in patients with a diagnosis of unstable angina. If this result were confirmed with a greater number of patients, it would be a good option for definitive diagnosis and risk stratification, in addition to being inexpensive and easy to perform. It can also be particularly useful for patients who cannot perform exercise.

Adult↗
PubMed1979

Continuous monitoring for ventricular arrhythmias during exercise tests.

Exercise stress testing is being increasingly used to verify exercise-induced arrhythmia and to aid in assessing antiarrhythmic drug efficacy. The true prevalence of ventricular arrhythmia during exercise testing is underestimated by means other than continuous monitoring. We compared the yield of ventricular premature beats (VPBs) between a continuous recording system ("trendscription") and intermittent monitoring among 39 patients undergoing a total of 50 consecutive exercise studies. By intermittent monitoring, 22 (44%) of 50 of the exercise tests demonstrated VPBs; with trendscription, 31 (62%) exhibited such arrhythmia. Most striking, however, was a sixfold increase in the disclosure of complex and repetitive forms of VPBs (56 vs nine episodes). Thus, this form of monitoring presents a cost-efficient, on-line method that allows concentration on the patient during exercise as well as clear recording of all arrhythmic events.

Anti-Arrhythmia Agents↗
PubMed1990

Detecting asymptomatic coronary artery disease using routine exercise testing and exercise thallium scintigraphy in patients with atherosclerotic vascular disease.

ECG-monitored exercise testing has been proposed as a relatively inexpensive and effective means of screening for asymptomatic coronary artery disease in patients presenting for peripheral vascular surgery. Despite the fact that exercise thallium scintigraphy is also dependent on the patient's ability to exercise, using this test in conjunction with ECG-monitored exercise testing may enhance sensitivity and specificity of non-invasive evaluation. Thirty-two patients were subjected to ECG-monitored exercise testing, exercise thallium scintigraphy and coronary angiography. The sensitivity of ECG-monitored exercise testing for detecting coronary artery disease was calculated at 81.8% and the specificity at 87.5%, while the figures for exercise thallium scintigraphy were 73.1% and 33.3% respectively. Using these two methods in combination yielded a predictive accuracy of 90.6%. The only advantage of exercise thallium scintigraphy over exercise ECG appears to be in patients in whom the latter test could not be interpreted or was non-diagnostic.

Adult↗
PubMed1985

Cardiovascular drugs: effects on exercise testing and exercise training of the coronary patient.

The exercise test response and exercise capacity of patients with atherosclerotic coronary heart disease may be significantly altered by a number of commonly used cardiovascular drugs, alone or in combination, via complex interactions of hemodynamic and electrophysiologic changes. The clinician must assess the effects of pharmacotherapy when evaluating the results of exercise testing as well as when prescribing a rehabilitative exercise training regimen.

Adrenergic beta-Antagonists↗
PubMed1985

Exercise test as a physiological form of antepartum stress test.

Exercise test (ET) was repeated in 5-7 day intervals between 35 and 43 weeks of gestation in normal and high-risk pregnancies. The obtained FHR patterns were categorized according to their incidence in different clinical situations and correlated with appearance of amniotic fluid at amniocentesis and incidence of fetal distress in subsequent labor. Prospective meaning of ET is drawn for evaluation of utero-placental reserve and degree of umbilical cord pathology. Consistency and dynamics of FHR pattern is stressed out. Advantage of ET to OCT is discussed.

Exercise Test↗