Exercise-induced increase in diastolic pressure: Indicator of severe coronary artery disease

Sheps, David S.; Ernst, Jack C.; Briese, Franklin W.; Myerburg, Robert J.

doi:10.1016/0002-9149(79)90067-5

Cited by 37 publications

(10 citation statements)

References 15 publications

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“…A decrease in peak systolic pressure of 10 mm Hg or VOL 65, No 7, JUNE 1982 more or an increase in diastolic pressure of 15 mm Hg or more during exercise that was sustained for two or more consecutive determinations was noted. Both criteria are associated with multivessel coronary disease in symptomatic males.14' 16 The ECG'was monitored continuously and recorded each minute during upright exercise and for 5 minutes after exercise in the sitting position. The most common reason for stopping exercise was chest pain in women with typical angina (18 of 41, 44%) and exhaustion in women with probable angina (11 of 28, 39%) or nonspecific chest pain (31 of 43, 72%).…”

Section: Exercise Protocolmentioning

confidence: 99%

Diagnostic accuracy of exercise ECG lead systems in clinical subsets of women.

Guiteras¹,

Chaitman²,

Waters³

et al. 1982

Circulation

100

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The diagnostic accuracy of 14-lead exercise electrocardiography was evaluated in 112 women who had no history of myocardial infarction and underwent coronary angiography. The sensitivity of ST-segment displacement of 0.1 mV or more in any of 14 ECG leads was 0.79 for coronary artery stenosis of at least 70%; the specificity was 0.66. Results were similar using bipolar ECG leads CC5 and CM5 or 11 standard ECG leads. The ST-segment shifts that occurred only during exercise were associated with a 77% false-positive rate (10 of 13). Downsloping ST-segment depression did not provide more diagnostic information than horizontal ST-segment depression in the three clinical subsets of women. In women with typical angina pectoris, ST-segment depression of at least 0.15 mV for 0.08 second after the J point or a final treadmill time less than 360 seconds was predictive of proximal left or multivessel coronary artery disease. In the women with probable angina or nonspecific chest pain, this finding was not of diagnostic value. ST-segment elevation of 0.1 mV or more in leads V1-2 or a VL predicted proximal stenosis of at lest 80% in the left anterior descending coronary artery in all six women with typical angina pectoris. Maximal exercise testing in women with typical angina provides important diagnostic information when 11 standard ECG leads are recorded. In women with probable angina or nonspecific chest pain, diagnostic exercise testing is less useful and bipolar leads CC5 and CM5 are sufficient for most clinical purposes.

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Section: Exercise Protocolmentioning

confidence: 99%

Diagnostic accuracy of exercise ECG lead systems in clinical subsets of women.

Guiteras¹,

Chaitman²,

Waters³

et al. 1982

Circulation

100

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show abstract

“…The statistically significant increase in diastolic blood pressure with stair climbing was not clinically significant, as only increases of 15 mmHg or more are considered to be abnormal ( Sheps, Ernst, Briese and Myerburg, 1979) .…”

Section: Discussionmentioning

confidence: 81%

Cardiovascular and respiratory responses to early ambulation and stair climbing following coronary artery surgery

Cockram¹,

Jenkins²,

Clugston³

1999

Physiotherapy Theory and Practice

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“…A significant increase in diastolic blood pressure and 94 calculated systemic vascular resistance may be seen and be indicative of significant underlying left ventricular dysfunction. 76,78 Hossack and coworkers 76 have pointed out that systemic vascular resistance is higher at rest in cardiac patients than in normal subjects and with exercise there is a reduction in systemic resistance but the reduction is attenuated compared with normal persons. Lund-Johansen 3 has shown similar data in mild hypertensive.…”

Section: Cardiovascular Response To Acute Exercise In Patients With Cmentioning

confidence: 99%