Exercise electrocardiography and vasoregulatory abnormalities

Friesinger, Gottlieb C.; Biernp, Robert O.; Likar, I.N.; Mason, Robert E.

doi:10.1016/0002-9149(72)90147-6

Cited by 55 publications

(13 citation statements)

References 21 publications

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“…They did not manifest any symptoms even at the height of maximal exercise. Unlike the findings of Friesinger et al (1972), the ST-T changes were also 30Khanna, Balasubramanian, Dham, Rai, and Hoon aggravated by the Valsalva manoeuvre. Therefore, the changes attributed to increased sympathetic tone (Nordenfelt, 1941) may essentially be the result of an unstable autonomic nervous control (Holmgren et al, 1959;Levander-Lindgren, 1964).…”

Section: Basalmentioning

confidence: 57%

“…Similar changes have been reported when the upright posture has been assumed and on hyperventilation (Kemp and Ellestad, 1968;McHenry et al, 1970;Biberman et al, 1971). They were attributed to autonomic influences (Nordenfelt, 1941) and labelled vasoregulatory abnormalities by Friesinger et al (1972). When encountered among asymptomatic healthy individuals, the responsibility of the physician to give a definite diagnosis, especially to air crew, is tremendous.…”

mentioning

confidence: 55%

“…Fifty-eight subjects out of a total 800 cases referred to this laboratory for cardiovascular evaluation were found to have vasoregulatory abnormalities as defined by Friesinger et al (1972).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, the changes attributed to increased sympathetic tone (Nordenfelt, 1941) may essentially be the result of an unstable autonomic nervous control (Holmgren et al, 1959;Levander-Lindgren, 1964). It has not been possible to rule out categorically an ischaemic aetiology in these cases, but the clinical picture, electrocardiographic changes, normalisation of these under beta-blockade, and normal coronary arteriograms in some of them have been used as evidence against ischaemia (Friesinger et al, 1972). Positive acceleration in normal individuals results in progressive flattening of the T wave going on to frank T inversion and distinct peaking of the P waves.…”

Section: Basalmentioning

confidence: 99%

“…When encountered among asymptomatic healthy individuals, the responsibility of the physician to give a definite diagnosis, especially to air crew, is tremendous. No evidence of ischaemic heart disease has been found in such subjects (Friesinger et al, 1972). It was, therefore, decided to study the effect of the stress of positive acceleration forces and the resulting alterations in cardiovascular haemodynamics on the electrocardiogram of such subjects.…”

mentioning

confidence: 99%

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Effect of positive acceleration (+gz) on electrocardiogram of subjects with vasoregulatory abnormality.

Khanna¹,

Balasubramanian²,

Dham³

et al. 1977

Heart

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ST-T wave changes in the electrocardiogram detected during routine examination and aggravated by erect posture, hyperventilation, and exercise in apparently healthy young individuals have been termed vasoregulatory abnormalities. No evidence of ischaemic heart disease has been found in such subjects. Ten young healthy air crew with vasoregulatory abnormalities were subjected to maximal exercise on treadmill and procedure repeated after 120 mg propranolol daily for 3 days. After one week, they were subjected to a stress of positive acceleration (+gz) in a human centrifuge at 2-5 g and 3-5 g for 15 seconds each at a constant rate of rise of 0-1 g/s and the electrocardiogram was monitored during and in the post-acceleration phase. The procedure was repeated after propranolol 120 mg daily for 3 days. The stress of positive acceleration resulted in pronounced prominence of P waves and inversion of T waves (as has been reported in normal subjects) with minimal ST depression in the electrocardiogram. ST segment depression during exercise, at heart rates corresponding to those achieved during peak centrifuge runs, was significantly more pronounced. The ST, P, and T wave changes were returned to normal after propranolol. It is concluded that minimal ST segment depression after stress of positive acceleration as compared with conspicuous ST segment depression during exercise at corresponding heart rates, and their normalisation after propranolol, rules out ischaemia as an aetiological factor in subjects with vasoregulatory abnormalities.

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Section: Basalmentioning

confidence: 57%

mentioning

confidence: 55%

Section: Methodsmentioning

confidence: 99%

Section: Basalmentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of positive acceleration (+gz) on electrocardiogram of subjects with vasoregulatory abnormality.

Khanna¹,

Balasubramanian²,

Dham³

et al. 1977

Heart

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Exercise Stress Testing in Patients with Chest Pain and Normal Coronary Arteriography: With Review of the Literature

Goodin

Graham

Gwinn

et al. 1975

Cathet. Cardiovasc. Diagn.

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Eighty of 654 patients studied because of chest pain were found to have normal coronary arteriography. Fifty of these completed submaximal treadmill exercise studies. The purpose of this study was to determine whether treadmill electrocardiography could obviate the need for coronary arteriography in the evaluation of patients with undiagnosed chest pain. Of patients studied, 22% had typical angina pectoris, while 78% had atypical chest pain. The resting electrocardiogram was normal in 58% of patients, while 42% showed repolarization abnormalities. Submaximal treadmill testing was normal in 64%, incomplete in 12%, and demonstrated classic ischemic S-T depression in 24%. Our findings of 24% positive studies in patients with normal vessels and 12% incomplete tests suggest that stress electrocardiography may be of limited value in predicting the morphologic state of the coronary arteries in patients with undiagnosed chest pain.

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