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PubMed1993

Beta blockers in heart failure.

The efficacy of beta-blocking drugs in the treatment of chronic heart failure remains controversial. A major obstacle to their acceptance in this pharmacotherapeutic role has been their reputed negative inotropic effects and the resulting depression of cardiac function when given acutely to patients in heart failure. However, in a number of uncontrolled studies in patients in mild or moderate heart failure due to dilated cardiomyopathy, these drugs, when titrated from a low-dose starting point, have been shown to improve the surrogate endpoints of symptoms and certain haemodynamic parameters. It is presumed that this benefit is related to the improvement in myocardial contractile activity secondary to the gradual up-regulation of the depressed myocardial beta-receptors in patients with chronic heart failure. At present, the data regarding the improvement in exercise tolerance are conflicting and there are no published data on the influence of beta-adrenoceptor-blocking drugs on survival. The potential of beta-blocking drugs to improve the clinical state in some patients with heart failure is, however, being further explored in two prospective randomized trials.

Adrenergic beta-Antagonists↗

PubMed2003

[Indices of the lipid peroxidation--antioxidant defense system as markers of chronic cardiac failure in cardiomyopathies].

Content of circulating products of lipid peroxidation (LPO), alpha-tocopherol (AT) and ceruloplasmin (CP), was studied in patients with hypertrophic and dilated cardiomyopathies (HTCMP and DCMP). The data obtained correlates with severity of chronic cardiac failure (CCF) and exercise tolerance of the patients. It is shown that the rise in LPO products level and simultaneous lowering of AT concentration in HTCMP and DCMP depend on the functional class of chronic cardiac failure by NYHA (1964). Content of lipoperoxides, AT and CP in the serum reflect the HTCMP patients' tolerance to exercise. Laboratory estimation of the levels of LPO products, AT and CP in patients with cardiomyopathies can substantially objectivize and supplement both clinical and functional-diagnostic assessment of CCF severity.

Adult↗

PubMedDate not supplied

Exercise myocardial perfusion imaging in elderly patients.

BACKGROUND: Exercise myocardial perfusion imaging (MPI) has significant value for risk stratification, but most patients studied have been middle-aged. In particular, the value of exercise MPI in elderly patients with interpretable electrocardiographic (ECG) stress test results has not been well defined. MEHODS AND RESULTS: Clinical, ECG stress test, MPI, and follow-up data for 626 outpatients aged 65 years or older with interpretable electrocardiograms undergoing symptom-limited exercise MPI between 1992 and 1996 were analyzed. Follow-up was 97% complete after 4.4 +/- 1.3 years. After exclusion of the 27 patients who underwent revascularization within 90 days of MPI, there were 361 men and 217 women, aged 70.7 +/- 4.4 years. By univariate analysis, male sex, increasing age, an abnormal rest ECG result, lower exercise tolerance and lower peak exercise heart rates, exercise ST-segment depression, left ventricular dilatation, and the number of ischemic regions predicted death or myocardial infarction. By multivariable modeling, only increasing patient age, male sex, limitation of exercise tolerance, and the number of ischemic segments by MPI were predictive of subsequent death or myocardial infarction. CONCLUSIONS: In elderly patients referred for exercise MPI, age, sex, exercise tolerance, and MPI ischemia provide significant prognostic information.

Age Factors↗

PubMed2005

A systems model of training for patients in phase 2 cardiac rehabilitation.

BACKGROUND: The aim of this study was to apply a systems model of training for athletes in patients with coronary artery disease (CAD) undergoing phase 2 cardiac rehabilitation. METHODS: Data from six patients with CAD undergoing 20 conventional training sessions were used to test this model. The method required daily training quantification using heart rate, and regular assessment of real exercise tolerance using a constant-duration test. Convolution of training quantity with real exercise tolerance was provided for every patient model exercise tolerance, by minimizing the residual sum of squares. RESULTS: The results showed that application of the systems model of training to the six patients resulted in a strong fit between real and model exercise tolerances: r(2) = 0.77, 0.79, 0.83, 0.84, 0.85 and 0.92, respectively (P < 0.05). DISCUSSION: Moreover, the systems model admitted for all patients corresponded to one first-order transfer function, which was fitness. This result was in contrast with the systems models reported in athletes and in a patient with CAD undergoing phase 3 cardiac rehabilitation which were found to include two first-order transfer functions: fitness and fatigue, simultaneously. CONCLUSION: The systems model of training of patients with CAD undergoing phase 2 suggested two practical consequences: first, the improvement of exercise tolerance is directly related to training, and consequently second, patients who enter immediately phase 3 training may prevent a decrease in their exercise tolerance.

Adult↗

PubMed2004

[The influence of HRT on exercise performance in women with coronary artery disease].

OBJECTIVES: The aim of this study was to evaluate the effect of hormone replacement therapy (HRT) on exercise tolerance and ischemia during treadmill exercise test. DESIGN: Prospective, cohort study. MATERIALS AND METHODS: Fifty-six postmenopausal women with proven coronary artery disease (CAD) were enrolled into the study (31 were assigned to HRT and 25 were matched as a control group). Clinically both groups were comparable. All patients underwent treadmill exercise test at the beginning and after 12 months of follow up. RESULTS: After 12-months of follow-up exercise tolerance increased significantly and similarly in both groups: duration time (sec): HRT 347 +/- 142 to 401 +/- 113; control 328 +/- 112 to 368 +/- 120; workload (MET): 6.6 +/- 2.1 to 6.8 +/- 2.0 and 6.1 +/- 1.9 to 6.8 +/- 1.7; time to onset of ischemia (sec): 256 +/- 116 to 293 +/- 120 and 238 +/- 87 to 299 +/- 133. Number of leads with ST changes and total sum (mm) of ST depression in all leads did not change significantly. All above parameters were comparable at baseline and after 12 months follow-up between both groups. CONCLUSIONS: Short term, combined, transdermal HRT does not improve exercise tolerance nor coronary ischemia during exercise test in women with CAD.

Aged↗

PubMed1997

Dyspnoea and exercise intolerance during cardiopulmonary exercise testing in patients with univentricular heart. The effects of chronic hypoxaemia and Fontan procedure.

BACKGROUND: Patients with univentricular hearts have decreased exercise tolerance and may demonstrate exertional dyspnoea. It is not known if chronic hypoxaemia exacerbates exercise intolerance and contributes to symptomatic limitation. The extent to which surgical correction of a right-to-left shunt by a Fontan-type procedure can increase exercise tolerance by reducing arterial deoxygenation is not well documented. The cardiopulmonary exercise responses and the symptomatic status in two groups of univentricular patients, those who are cyanotic and those who are acyanotic with Fontan-type circulation, were compared. METHODS AND FINDINGS: Cardiopulmonary exercise testing was performed in 10 univentricular patients with rest or stress-induced cyanosis (age 30.5 +/- 2.3 [SE] years; 5 men) who had palliative or no surgery and eight patients (age 29.4 +/- 1.5 years; 4 men) with Fontan-type circulation. Peak oxygen consumption was comparable in both groups of univentricular patients (21.7 +/- 2.5 vs 21.0 +/- 1.9 ml.kg-1.min-1, P = 0.85) but was less than an age-matched group of 10 healthy subjects (34.7 +/- 1.9 ml.kg-1.min-1, P < 0.001 for both). Arterial oxygen saturation was 90.6% at rest in the cyanotic patients compared with 95.1% in the Fontan patients (P < 0.001) and at peak exercise, 66.2% compared with 90.5% (P < 0.001). Using a modified Borg scale (0-10), the symptoms of dyspnoea and fatigue were also assessed during exercise in the patient groups. The Borg scores for dyspnoea in the cyanotic and the corrected univentricular patients were, respectively, as follows: Stage 1: 0.5 vs 1.7; P= 0.04; Stage 2: 1.8 vs 2.3, P = 0.5; Stage 3: 3.0 vs 3.5, P = 0.7; Peak Exercise: 4.9 vs 4.8, P = 0.9. In addition, the Borg scores for fatigue were: Stage 1: 0.4 vs 1.6, P = 0.08; Stage 2: 2.0 vs 2.2, P = 0.9; Stage 3: 3.0 vs 4.3, P = 0.5; Peak Exercise: 4.9 vs 5.4, P = 0.5. The major limiting symptom at peak exercise was dyspnoea in four cyanotic patients compared with one in the Fontan group (Chi-square 0.982, P > 0.10). The arterial oxygen desaturation at peak exercise in the cyanotic patients limited by dyspnoea was not different from those limited by fatigue (67.5 +/- 10.1% vs 66.7 +/- 13.7%, P = 0.92). Exercise tolerance was also not related to the arterial oxygen saturation at peak exercise (r = 0.47, P = 0.17) in these patients. CONCLUSIONS: Despite correction with Fontan-type surgery, the exercise tolerance and symptoms of these univentricular patients remained similar to those who were cyanosed. Cyanotic patients have adjusted to chronic hypoxaemia and it does not appear to determine the exercise tolerance or the genesis of dyspnoea in these patients. Further randomized prospective studies are required to investigate the long-term benefits of Fontan-type procedures in these patients on exercise tolerance, symptoms and prognosis.

Adult↗

PubMed1981

The prolonged effect of pentaerythritol tetranitrate on exercise capacity in stable effort angina pectoris.

We studied the effect of a single oral dose of 40 mg of pentaerythritol tetranitrate (PETN) on the exercise capacity of ten patients with angina pectoris. The study design was a randomized double-blind crossover comparing the effects of 40 mg of oral PETN with placebo on exercise tolerance. Patients were exercised to moderate angina pectoris before and 2 1/2 and 4 1/2 hours after receiving the placebo or PETN at seven-day intervals during the double-blind crossover period. Exercise tolerance time was measured using a multistage, progressive treadmill test. Exercise times were greater 2 1/2 hours and 4 1/2 hours following PETN compared with placebo (P less than 0.05). Heart rate, systolic and diastolic blood pressure, and double product at rest (supine and standing) and at point of angina pectoris did not change significantly.

Administration, Oral↗

PubMed1991

Symptom-limited exercise testing causes sustained diastolic dysfunction in patients with coronary disease and low effort tolerance.

Exercise stress testing is routinely used for the noninvasive assessment of coronary artery disease and is considered a safe procedure. However, the provocation of severe ischemia might potentially cause delayed recovery of myocardial function. To investigate the possibility that maximal exercise testing could induce prolonged impairment of left ventricular function, 15 patients with angiographically proved coronary disease and 9 age-matched control subjects with atypical chest pain and normal coronary arteries were studied. Radionuclide ventriculography was performed at rest, at peak exercise, during recovery and 2 and 7 days after exercise. Ejection fraction, peak filling and peak emptying rates and left ventricular wall motion were analyzed. All control subjects had a normal exercise test at maximal work loads and improved left ventricular function on exercise. Patients developed 1 mm ST depression at 217 +/- 161 s at a work load of 70 +/- 30 W and a rate-pressure product of 18,530 +/- 4,465 mm Hg x beats/min. Although exercise was discontinued when angina or equivalent symptoms occurred, in all patients diagnostic ST depression (greater than or equal to 1 mm) developed much earlier than symptoms. Predictably, at peak exercise patients showed a decrease in ejection fraction and peak emptying and filling rates. Ejection fraction and peak emptying rate normalized within the recovery period, whereas peak filling rate remained depressed throughout recovery (p less than 0.002) and was still reduced 2 days after exercise (p less than 0.02). In conclusion, in patients with severe impairement of coronary flow reserve, maximal exercise may cause sustained impairement of diastolic function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1985

Beta-blocker therapy after myocardial infarction: secondary prevention in all patients?

The ability of beta-adrenergic blocking drugs to prevent death in patients after myocardial infarction has been demonstrated by several large trials. However, the need to treat patients at low risk has been challenged. Retrospective analysis of the data from one of these studies plus results from many additional studies have shown that electrical, mechanical and ischemic complications after myocardial infarction imply a high risk of subsequent death or recurrent infarction. On the other hand, absence of complications with a negative exercise tolerance test, good exercise tolerance, absence of arrhythmias and normal increase of ejection fraction with exercise documents a very low risk. These considerations lead to the following practical implications: The physician should watch for any evidence of left ventricular dysfunction or arrhythmia. Any such complication justifies treatment or more intensive study. Patients without complications can be further characterized with exercise testing, exercise radionuclide blood pool ventriculography, and Holter monitoring. If these tests expose risk indicators, treatment or more study should again be recommended. Because the beta-blockers are probably life-saving in a considerable portion of the patients with moderate and high risk, the decision to treat or not to treat should be made with due, affirmative consideration. In those patients with a carefully documented uncomplicated course and who have a normal exercise test and appropriate increase in ventricular ejection fraction with stress, beta-blockade is probably of no benefit. Under these conditions, a physician and patient might logically decide not to use the drug.

Adrenergic beta-Antagonists↗

PubMed1989

Pentoxifylline increases extremity blood flow in diabetic atherosclerotic patients.

Pentoxifylline, a new trisubstituted methylxanthine derivative known for its hemorrheologic action, has been shown to improve exercise tolerance in atherosclerotic patients. We examined the responses of diabetic atherosclerotic patients to pentoxifylline administration, measured by Doppler waveform analysis and exercise tolerance. Standard exercise tolerance and Doppler waveform analytic studies of the lower extremity, specifically the right dorsalis pedis artery, were performed before and after three months of pentoxifylline administration (400 mg three times a day). The study group comprised ten subjects (six men and four women) with a mean (+/- SD) age of 60 +/- 3.3 years. Data were analyzed using a paired Student t test. All ten subjects showed a significant increase in exercise tolerance after pentoxifylline treatment. Eight of ten subjects demonstrated a significant increase in right dorsalis pedis arterial flow.

Arteries↗

PubMed2004

Properties of slow- and fast-twitch skeletal muscle from mice with an inherited capacity for hypoxic exercise.

Muscle fiber type, myosin heavy chain (MHC) isoform composition, capillary density (CD) and citrate synthase (CS) activity were investigated in predominantly slow-twitch (soleus or SOL) and fast-twitch (extensor digitorum longus or EDL) skeletal muscle from mice with inherited differences in hypoxic exercise tolerance. Striking differences in hypoxic exercise tolerance previously have been found in two inbred strains of mice, Balb/cByJ (C) and C57BL/6J (B6), and their F1 hybrid following exposure to hypobaric hypoxia. Mice from the three strains were exposed for 8 weeks to either normobaric normoxia or hypobaric hypoxia (1/2 atm). Hypoxia exposure led to a slightly higher 2b fiber composition and a lower fiber area of types 1 and 2a in SOL of all mice. In the EDL, muscle fiber and MHC isoform composition remained unaffected by chronic hypoxia. Chronic hypoxia did not significantly affect CD in either muscle from any of the three strains. There were relatively larger differences in CS activity among strains and treatment, and in SOL the highest CS activity was found in the F1 mice that had been acclimated to hypoxia. In general, however, neither differences among strains nor treatment in these properties of muscle vary in a way that clearly relates to inherited hypoxic exercise tolerance.

Anaerobiosis↗

PubMed2000

Cardiopulmonary exercise parameters in relation to all-cause mortality in patients with chronic heart failure.

In this study we analysed the all-cause mortality over a period of maximal 6 years in 60 male patients (age: 63.4+/-8.3 years, mean+/-S.D.), suffering from chronic heart failure with resting left ventricular ejection fraction and E/O2 slope as independent factors. We assessed functional NYHA class (II: n=36, III: n=24), radionuclide left ventricular ejection fraction (29.2+/-10.4%) and peak values of heart rate, O2, CO2, E, anaerobic threshold and exercise duration with an incremental work load test on the treadmill. O2 relative to E was based on the individual slopes of the regression of O2 on E during the first 6 min of exercise. These slopes with other exercise-related variables and factors such as etiology, medication, and NYHA class were analysed with a Cox's Regression Method. A survival time analysis (Kaplan-Meier survival curve) was done to establish the influence of E/O2 slope and left ventricular ejection fraction (both split into above and below median values), as well as their interaction, on survival. From all investigated exercise-related variables. E/O2 slope is the most powerful variable regarding prediction of all-cause mortality in our group of chronic heart failure patients. Concerning risk stratification, the subgroup (n=18) with a relatively high left ventricular ejection fraction (>28%) and flat E/O2 slope (<27.6) had most survivors (77.8%) after about 3 years, while the subgroup (n=12) with a relatively high left ventricular ejection fraction (>28%), but a steep E/O2 slope (>27.6) had least survivors (33.3%). This difference in percentage is highly significant (P=0.0025). The fact that E/O2 slope and left ventricular ejection fraction show comparable main and interaction effects between measures of exercise tolerance (e.g., anaerobic threshold, peak O2, exercise duration) on the one hand, and all-cause mortality on the other, suggests the existence of common sources of variance. Based on our analysis, it is unlikely that effects on all-cause mortality are mediated through phenomena related to exercise tolerance. Therefore, we hypothesize that the effects on exercise tolerance and all-cause mortality both depend on common factors, which cause both cardiac and peripheral organ (c.q. muscular) dysfunctions. Moreover, this study clearly shows that E/O2 slope during incremental exercise is an important prognostic marker for risk stratification in chronic heart failure patients, NYHA class II and III.

Exercise Test↗

PubMed1997

Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease.

We determined the effect on exercise tolerance and physiological exercise responses of rigorous rehabilitative exercise training in chronic obstructive pulmonary disease (COPD). Fifteen men and 10 women (mean age, 68 +/- 6 yr; FEV1, 0.93 +/- 0.27 L) participated in a rehabilitation program with an exercise component of three per week 45-min sessions of cycle ergometer training for 6 wk with exercise intensity kept near maximal targets. Before and after rehabilitation, patients performed an incremental test and a constant work rate (CWR) test at 80% of the peak work rate in the preprogram incremental test. Ventilation (V(E)) and gas exchange were measured breath by breath; arterialized venous blood was analyzed for blood gas determinations and lactate. Rehabilitation yielded an average increase in peak work rate in the incremental test of 36% (p < 0.001), and in the duration of the CWR test of 77% (p < 0.001). In the CWR test, the kinetics of O2 uptake, CO2 output, V(E), and heart rate were markedly slower than those of healthy subjects. After training, mean response time decrease averaged 17, 22, 34, and 29%, respectively (p < 0.02), evidence of a physiologic training effect. Further, for identical CWR tasks, V(E) was 10% lower (p < 0.02) after training, attributable to altered breathing pattern: tidal volume increased by 8% and respiratory rate decreased by 19%, yielding lower V(D) /V(T) (0.46 versus 0.53 p < 0.005). Rigorous exercise training for patients with severe COPD yields more efficient exercise breathing pattern and lower V(E); this is associated with improved exercise tolerance.

Aged↗

PubMed1981

Effects of exercise training on left ventricular performance and myocardial perfusion in patients with coronary artery disease.

To determine the effects of exercise training on left ventricular performance and myocardial perfusion in coronary artery disease, rest and exercise radionuclide angiocardiography and thallium-201 scintigraphy were performed before and after 12 weeks of training in 16 coronary patients. After training, 15 of the 16 patients had improved exercise tolerance; total treadmill exercise duration increased from (mean +/- standard error of the mean) 491 +/- 37 to 602 +/- 31 seconds (p less than 0.01), and the estimated rate of oxygen consumption (VO2 max) increased from 29.4 +/- 1.4 to 33.8 +/- 1.2 ml/kg per min (p less than 0.001). Resting left ventricular ejection fraction increased from 52 +/- 4 to 57 +/- 4 percent (p less than 0.02); no change occurred in left ventricular functional reserve assessed by ejection fraction and regional wall motion response to exercise at the same rate-pressure product before and after training. Myocardial perfusion at equivalent pre- and post-training cardiac work loads during exercise and on redistribution was unchanged by training. It is concluded that in patients with coronary heart disease, physical training increases exercise tolerance, and results in minimal improvement in resting left ventricular systolic performance. Functional reserve of both left ventricular systolic performance and the coronary circulation appears to be unchanged by exercise training. These data suggest that the beneficial effects of training for 12 weeks in patients with coronary artery disease predominantly result from factors other than improvement in left ventricular pump performance or perfusion.

Adult↗

PubMed1999

Angiotensin-converting enzyme inhibition facilitates alveolar-capillary gas transfer and improves ventilation-perfusion coupling in patients with left ventricular dysfunction.

OBJECTIVE: The backward effects of left ventricular dysfunction include alterations in alveolar-capillary gas transfer and ventilation-perfusion coupling. Because the angiotensin-converting enzyme (ACE) is highly concentrated in the vascular endothelium of the lungs, we examined whether ACE inhibitors may influence the pulmonary function in patients with congestive heart failure. METHODS: In 20 patients with idiopathic cardiomyopathy, pulmonary function and exercise capacity were evaluated at baseline and 6 and 12 months after treatment with enalapril (10 mg twice a day) was started. The study also included 19 age- and sex-matched control subjects with mild primary hypertension and normal left ventricular function who were given enalapril as a standard treatment of high blood pressure. RESULTS: In congestive heart failure, forced expiratory volume in 1 second, vital capacity, and total lung capacity did not vary significantly with enalapril; alveolar-capillary diffusion of carbon monoxide (DL(CO)) increased toward normal; exercise tolerance time, peak exercise oxygen uptake (peak VO2), minute ventilation and tidal volume (peak VT) also increased; and the ratio of volume of dead space (VD) to VT (peak VD/VT) at peak exercise reduced. Changes in peak VO2 showed a direct correlation with those in DL(CO) and an inverse correlation with those in peak VD/VT. Results at 6 and 12 months were comparable. Enalapril did not affect these variables in the control population. CONCLUSIONS: In patients with idiopathic cardiomyopathy heart failure, but not in control subjects, gas transfer and ventilation-perfusion improved with ACE inhibition. These pulmonary changes may contribute to the associated increase in exercise tolerance.

Adult↗

PubMed2005

Impact of exercise training on muscle function and ergoreflex in Fontan patients: a pilot study.

BACKGROUND: Several studies have demonstrated persistent reduced exercise capacity in Fontan patients even after surgical intervention. The purpose of this study was to evaluate if the skeletal muscle function of these patients is abnormal, if it correlates with exercise tolerance and if it can be improved by exercise training. METHODS: We evaluated the functional capacity of seven patients who underwent Fontan procedure (age:16+/-5 years, mean+/-SD) and seven healthy children (19+/-7 years) paired for age, sex, height and weight. Evaluation included pulmonary evaluation, neuromuscular function and exercise tolerance. Secondly, an 8-week exercise training program was performed by five of these patients. RESULTS: The ergoreflex contribution to absolute diastolic blood pressure was higher (12.5+/-4.8 vs. 5.6+/-4.2 mmHg; p=0.04) in Fontan patients vs. healthy subjects whereas a trend was encountered regarding the ergoreflex contribution to absolute systolic blood pressure (9.0+/-7.0 vs. 0.4+/-9.0 mmHg; p=0.09). Furthermore, time to fatigue of the non-dominant forearm muscles was shorter in Fontan patients vs. healthy subjects (431+/-290 vs. 847+/-347 s; p=0.03). Following exercise training, there was a significant reduction of the ergoreflex contribution to absolute values of systolic blood pressure (9.8+/-0.9 vs. 0.3+/-2.7 mmHg; p<0.05). There was an association between muscle strength and VO2 peak in Fontan patients (upper limb: r=0.895; p<0.01; lower limb: r=0.838; p<0.05, respectively). CONCLUSIONS: Skeletal muscle function in Fontan patients is abnormal which may have an impact in the reduced exercise tolerance encountered in these patients. Exercise training may have beneficial impacts on the skeletal muscle function in this population.

Adolescent↗

PubMed2002

[Clinical course of disease and prognosis in patients with ischemic heart disease with stable angina pectoris, caused by stenosing coronary atherosclerosis (data from a a 20-year study].

AIM: To study a course and prognosis of ischemic heart disease (IHD) with stable angina pectoris (SAP) caused by stenotic coronary atherosclerosis (SCA) by 20-year follow-up data. MATERIAL AND DATA: Prognosis of survival was made in 318 patients with SAP due to SCA. RESULTS: The results of a 20-year study show that prognosis in IHD patients depends on SAP severity (by the functional class), exercise tolerance (by the exercise test), severity of coronary bed affection and of left ventricular contractility affection as assessed by coronary- and ventriculography. If lethality of the test subjects was not higher than in the population, the patient had good prognosis associated with one-vessel lesion, normal myocardial contractile function, high exercise tolerance, absence of the leading risk factors. CONCLUSION: The multivariance analysis with stepwise selection enabled the design of the model of the integral prognostic index (IPI) for the studied patients. The IPI index under 1.86 suggests a favourable prognosis, 1.87-2.33--an intermediate prognosis and in IPI higher than 2.34--unfavourable prognosis. Early surgery is recommended for patients with high IPI.

Adaptation, Physiological↗

PubMed1980

[Treadmill exercise testing in patients with idiopathic cardiomyopathy (author's transl)].

Multistage treadmill stress testing was performed in 24 patients with idiopathic cardiomyopathy using Bruce protocol. 5 patients were considered to have hypertrophic obstructive cardiomyopathy (HOCM), 12 hypertrophic nonobstructive cardiomyopathy (HCM) and 7 congestive cardiomyopathy (CCM). Heart rate, systemic blood pressure, electrocardiographic changes and exercise tolerance were observed. The effect of propranolol on exercise tolerance was investigated in HOCM and HCM. 1) Exercise duration was less in patients with HCM and HOCM than in normal subjects (50 subjects) and greater than in 50 anginal patients. In CCM, exercise duration was the least. 2) Electrocardiographic changes observed in HCM and HOCM were increase of T waves and lessening of ST depression. In CCM, appearance of ventricular arrhythmia was noted in 4 of 7 patients. 3) Maximam exercise tolerance was reached at Bruce state III-IV in HOCM, stage III in HCM and stage II in CCM. 4) Propranolol administration resulted in improvement of exercise tolerance in 3 of 7 patients with HOCM and HCM.

Adult↗