Studies of Electrocardiographic Changes during Exercise (Modified Double Two-Step Test)

Yu, Paul N.; Soffer, Alfred

doi:10.1161/01.cir.6.2.183

Cited by 33 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although interpretation of results depends upon electrocardiographic changes, these have not been monitored routinely during exertion, even though a suitable technique was described 10 years ago. 3 The exercise stress varies with age, sex and body weight, but in terms of energy expenditure per unit of weight the underweight individual is stressed much more than the overweight person.…”

mentioning

confidence: 99%

Exercising Testing in Adult Normal Subjects and Cardiac Patients*

Bruce¹,

Blackmon²,

Jones³

et al. 2004

Noninvasive Electrocardiol

195

219

View full text Add to dashboard Cite

Clinical exercise tests are used primarily for diagnosis of coronary insufficiency or appraisal of working capacity. Occasionally hemodynamic responses are observed during diagnostic catherization of the heart. Since interpretation of findings depends upon quantitative differences from normal values, variations due to age, sex, physical status and circumstances of the test need to be appreciated. To be effective, exercise stresses must involve large muscle masses, and the patient or subject must be ambulatory, cooperative and properly motivated. Some of the approaches to testing will be reviewed, and preliminary observations on a new technique will be presented.The simplest test of exercise tolerance is for a physician to accompany a cardiac patient over one or more flights of stairs and to observe the symptoms. If this is not rewarding, increasing the work load by accelerating the pace or taking two steps at a time is more likely to be informative. But under these conditions the work loads are not well standardized, physiological responses are not usually monitored, and the physician is not necessarily of the same sex and comparable age.Master's two step test is familiar to most internists; its value for diagnosis and prognosis of coronary insufficiency has been established. 1,2 An abnormal resting electro-cardiogram is considered a contraindication for performance of this test. Although interpretation of results depends upon electrocardiographic changes, these have not been monitored routinely during exertion, even though a suitable technique was described 10 years ago. 3 The exercise stress varies with age, sex and body weight, but in terms of energy expenditure per unit of weight the underweight individual is stressed much more than the overweight person.

show abstract

mentioning

confidence: 99%

Exercising Testing in Adult Normal Subjects and Cardiac Patients*

Bruce¹,

Blackmon²,

Jones³

et al. 2004

Noninvasive Electrocardiol

195

219

View full text Add to dashboard Cite

show abstract

“…Similarly, Zack et al [9] presented a case report of normalization of T waves occurring with inflation of the balloon during coro nary angioplasty. Several studies have emphasized a pos sible link between normalization of inverted T waves and myocardial ischemia [1,2,7], Investigators have also used the occurrence of normalization of T waves as an indica tion of ischemia. Nadamanee et al [10] used normaliza tion of T waves as a criteria for ischemia in evaluating patients with silent ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…Soffer [1] and Bellet et al [2] were some of the first to mention that reversion of a previously inverted T wave to upright may be indicative of ischemia. Marin et al [3] used thallium-201 scintigraphy in patients with a high prevalence of coronary artery disease and found that nor malization was specific for the presence of coronary artery disease but not for ischemia.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Electrocardiographic T -Wave Normalization with Exercise

Wagoner¹,

Movahed²,

Reeves³

et al. 1993

Am J Noninvas Cardiol

View full text Add to dashboard Cite

A change from inverted T waves at rest to an upright position with exercise, has been debated to be a sign of myocardial ischemia. Retrospective analysis has been performed on exercise thallium-201 myocardial scintigrams from 82 consecutive patients with T-wave inversion of at least 1 mm or more on their resting electrocardiogram (ECG) and normalization with exercise. Ischemia was indicated by a transient myocardial perfusion defect with exercise, and probable scar was indicated by a fixed myocardial defect. This gave four groups: (I) 30 patients had no defects; (II) 36 patients had fixed defects alone; (III) 2 patients had transient defects alone, and (IV) 15 patients had both fixed and transient myocardial perfusion defects. Sixty-six out of 83 (80%) studies with normalization demonstrated no transient myocardial perfusion defect. T-wave normalization occurred often in the leads corresponding to the area of fixed myocardial perfusion defect (77% in group II and 80% in group IV). In 33 patients with coronary angiography, correlation was similar with T-wave normalization found in the distribution of coronary artery disease in 77%. Compared to 251 consecutive patients undergoing exercise thallium testing for suspected coronary artery disease, the study group had a similar frequency of scans without defects, but relatively more studies with fixed relative to transient defects. We conclude that normalization is a nonspecific finding which may be associated with coronary artery disease and fixed myocardial perfusion defect. T-wave normalization with exercise has poor positive predictive value for the diagnosis of transient myocardial perfusion defect.

show abstract

“…A delay in HR recovery has been observed in patients with chronic heart failure Studies of the electrocardiogram during and after exercise (walking on a treadmill ergometer at standard speed and grade) in normal subjects have been performed for very long time [1,2].…”

Section: Introductionmentioning

confidence: 99%

A fully automatic algorithm for the analysis of heart rate changes and cardiac recovery during exercise

Vaglio¹,

Porta

Pizzinelli

et al. 2007

2007 Computers in Cardiology

View full text Add to dashboard Cite

show abstract

Studies of Electrocardiographic Changes during Exercise (Modified Double Two-Step Test)

Abstract: A method of recording electrocardiograms during the performance of a double two-step exercise test is described. Data

Cited by 33 publications

References 16 publications

Exercising Testing in Adult Normal Subjects and Cardiac Patients*

Exercising Testing in Adult Normal Subjects and Cardiac Patients*

Clinical Significance of Electrocardiographic T -Wave Normalization with Exercise

A fully automatic algorithm for the analysis of heart rate changes and cardiac recovery during exercise

Contact Info

Product

Resources

About