Concepts and applications of treadmill exercise testing and the exercise electrocardiogram

Faris, James V.; McHenry, Paul L.; Morris, Stephen N.

doi:10.1016/0002-8703(78)90403-9

Cited by 32 publications

(7 citation statements)

References 58 publications

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“…After several decades of experience with exercise testing in the evaluation of ischemic heart disease and extensive correlations with coronary arteriograms (6,10,16,17) and subsequent coronary events (8,13,21), it would seem inappropriate to merely interpret test results as "positive" or "negative". Although 1 mm or more of horizontal or downsloping ST segment depression remains the most popular criterion utilized in the interpretation of these tests (9,18,20), various studies have shown that thorough analysis of the morphology of the STsegment (3,12,15), magnitude of the depression (1 1, 14, 25), level of exercise at which the ST abnormalities appeared (1 1, 12) the presence or absence of associated chest pain (5, 24), arrhythmias (1,23), or hypotension (19,22) could significantly improve the predictive value of symptom limited exercise tests and help in the assessment of the severity and prognosis of the underlying disease. The markedly positive exercise test, with STdepression of more than 2 or 3 mm, has generally been found to correlate with more severe coronary disease (1 1, 14, 25).…”

Section: Introductionmentioning

confidence: 99%

The magnitude of exercise‐induced ST segment depression and the predictive value of exercise testing

Nahormek

Chahine

Raizner

et al. 1979

Clinical Cardiology

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Summary: To assess whether the magnitude of exercise induced ST segment depression improves the predictive value of symptom limited exercise tests, and helps in the recognition of patients with more severe coronary heart disease, 90 consecutive patients with positive treadmill tests who also underwent selective coronary arteriography were reviewed. The predictive value. improved progressively with the increasing ST depression and was most reliable in a select group of patients with normal electrocardiographic baseline who were not receiving digitalis (73% with ST depression 3 1 mm to 100% with ST depression 3 4 mm). The incidence of 2 and 3 vessel disease increased from 6 1'70 with ST depression 1 mm in the overall population to 100% with STdepression 3 4 mm in the select group, and the incidence of left main trunk lesions increased, respectively from 6 to 30%. The prediction of 2 and 3 vessel disease was found to be significantly greater when patients were dichotomized into those with ST depression 3 4 mm compared to < 4 mm.It is concluded that the magnitude of ST segment depression definitely improves the predictive value of exercise tests as well as the ability to recognize the patients with more severe disease. However, the markedly positive exercise tests cannot be utilized to accurately predict the presence of attains 4 mm or more in patients with normal electrocardiographic baselines who are not taking digitalis. In this group, the ability to predict left main trunk lesion is approximately 30°/0.

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Section: Introductionmentioning

confidence: 99%

The magnitude of exercise‐induced ST segment depression and the predictive value of exercise testing

Nahormek

Chahine

Raizner

et al. 1979

Clinical Cardiology

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“…Exercise is not only the most common physiological stress, but also poses the greatest physiological load on the cardiovascular system and can provoke cardiac abnormalities that are not present at rest (14)(15)(16). A variety of cardiac rhythm disorders, especially ventricular ectopic rhythms, can be induced or unmasked by exercise testing (17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic usefulness of graded exercise testing in pediatric supraventricular tachycardia

Draper¹,

Giddins²,

McCort³

et al. 2009

Canadian Journal of Cardiology

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“…The stud}, protocol complied with Guideline 75/318 of the European Economic Community for trials with drugs to treat angina pectoris, and was in accord with the recommendations for exercise testing of [6]. The study design was a randomised, double-blind, crossover comparison with placebo.…”

Section: Study Protocolmentioning

confidence: 99%

24-hour anti-ischaemic action with once daily nifedipine

Woodcock

Thürmann

Pfleiderer

et al. 1992

Eur J Clin Pharmacol

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The ability of a fatty-alcohol matrix, slow-release tablet of nifedipine 60 mg to maintain a 24-hour anti-ischaemic action in the fixed dose of 60 mg once daily has been investigated in a randomised, placebo-controlled, double-blind trial. 12 normotensive patients with angiographically proven coronary artery disease (stenosis of at least one major vessel > or = 70%) were studied. The anti-ischaemic response was assessed over a period of 4 days as changes in the exercise-induced ST-segment depression 6 h and 24 h post-dose, and ST-segment changes in 24-h ambulatory ECGs. A measurable anti-ischaemic response was observed in 8 of the 12 patients. Exercise-induced ST-segment depression 6 h after the administration of nifedipine was reduced by 30% compared to placebo, and there was still a measurable anti-ischaemic response 24-h post-dosing. Both responses were independent of changes in exercise blood pressure. In 7 patients with ischaemic episodes in the 24-h ECGs, nifedipine treatment had only a minor effect on the intensity and duration of ischaemia. It is concluded that a significant anti-ischaemic effect lasting 24 h could be demonstrated using effort-induced ST-segment changes in patients with angiographically proven coronary heart disease, who were treated once daily with nifedipine 60 mg as a fatty-alcohol slow release tablet.

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Concepts and applications of treadmill exercise testing and the exercise electrocardiogram

Cited by 32 publications

References 58 publications

The magnitude of exercise‐induced ST segment depression and the predictive value of exercise testing

The magnitude of exercise‐induced ST segment depression and the predictive value of exercise testing

Diagnostic usefulness of graded exercise testing in pediatric supraventricular tachycardia

24-hour anti-ischaemic action with once daily nifedipine

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