Clinical experience of a new reference material for exercise capacity in exercise stress testing in Sweden

2017 ◽  
Vol 38 (4) ◽  
pp. 699-702 ◽  
Author(s):  
Thomas Lindow ◽  
Henrik Mosén ◽  
Henrik Engblom
Keyword(s):  
Reference Material ◽  
Exercise Capacity ◽  
Clinical Experience ◽  
Stress Testing ◽  
Exercise Stress ◽  
Exercise Stress Testing

4097Validation of seven different exercise treadmill stress testing protocols in a large 25-year stress testing registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Harb ◽  
V M Menon ◽  
W U Wu ◽  
P C Cremer ◽  
L C Cho ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Stress Testing ◽  
Multivariable Analysis ◽  
Exercise Stress ◽  
Exercise Stress Testing ◽  
Metabolic Equivalents ◽  
The Individual ◽  
Stage Renal Disease ◽  
End Stage ◽  
Testing Protocols

Abstract Background While the Bruce protocol has been extensively validated, other modified exercise protocols with less workload burden are commonly used, though their prognostic value is not well established. Purpose We sought to assess whether exercise capacity (or workload achieved in metabolic equivalents of task [METs]) remains predictive of mortality across various exercise stress testing protocols. Methods In a 25-year stress testing registry spanning from 1991 to 2015, we identified 120,705 patients who underwent 7 different standardized symptom-limited exercise stress testing protocols: Bruce, Modified Bruce, Cornell 0%, Cornell 5%, Cornell 10%, Naughton, and modified Naughton. The choice of the protocol was dependent on the supervising exercise physiologist according to purpose of the test and the individual patient. The primary outcome was all-cause mortality. Results Mean age was 53.3±12.5 years and 59% were male. There were 74953 Bruce, 8368 modified Bruce, 2648 Cornell 0%, 9972 Cornell 5%, 20425 Cornell 10% 1226 Naughton, and 3113 modified Naughton individual protocols. A total of 8426 death occurred over 8.7 years of mean follow-up duration. Figure 1 shows that there was an inverse relationship between peak METs achieved and mortality across all 7 protocols. On multivariable analysis, increasing METs remained protective against death [adjusted HR of 0.46; 95% CI (0.44 - 0.48); p<0.001] even after adjusting for the protocol chosen, age, gender, hypertension, diabetes, coronary disease, end-stage renal disease, smoking, and statin use. METS vs. mortality by protocol Conclusion Across 7 different exercise protocols with various workloads, the predicted exercise capacity remained predictive of mortality irrespective of the protocol chosen, patients' demographics and comorbidities. Different testing choices likely represent different estimated functional capacity.

Gender differences in exercise stress testing protocol selection, exercise capacity, and prognostic value of METs

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Harb ◽  
T.W Wang ◽  
Y.W Wu ◽  
M.V Menon ◽  
L.C Cho ◽  
...  
Keyword(s):  
Gender Differences ◽  
Exercise Capacity ◽  
Prognostic Value ◽  
Stress Testing ◽  
Exercise Stress ◽  
Exercise Stress Testing ◽  
Metabolic Equivalents ◽  
Testing Protocols ◽  
Gender Specific

Abstract Background Exercise capacity, as measured by metabolic equivalents of task [METs], varies with gender and is an independent predictor of mortality. We sought to investigate gender differences in the protocol selected, the estimated exercise capacity, and the prognostic value of METs. Purpose Investigate the gender differences in the protocol chosen (adjusting for age and comorbidities), the METs achieved (also adjusting for the protocol selected), and the predictive value of exercise capacity adjusted to METs achieved. Methods In a 25-year stress testing registry spanning from 1991 to 2015, we identified 120,705 patients who underwent exercise stress testing. Protocols were split into Bruce vs. non-Bruce. METs were estimated based on established gender-specific formulas (the St James Take Heart Project formula for women, and the Veterans Affairs cohort formula for men).The primary outcome was all-cause mortality. Results The mean age was 53.3±12.5 years, and 59% were male. Table 1 presents the baseline characteristics and exercise parameters. A total of 8426 death occurred over 8.7 years of mean follow-up duration. Females were more commonly referred for non-Bruce protocols [adjusted OR 2.6; 95% CI (2.5–2.7)] even after adjusting for age and comorbidities. Within the same protocol chosen, females achieved lower estimated METs [Beta −1.4; 95% CI (−1.43 to −1.37)]. Exercise capacity was inversely related to mortality in both genders and across protocols (figure 1), however, after adjusting for age, comorbidities, protocol chosen, and the number of METs achieved, the HR for death was significantly lower for women [adjusted HR=0.44; 95% CI (0.41–0.46)]. Conclusion After adjusting for age and comorbidities, women tend to be more commonly referred for non-Bruce protocols, achieve less estimated METs (after adjusting for the protocol chosen), and have half the mortality for the same METs achieved. Death vs. Exercise capacity by gender Funding Acknowledgement Type of funding source: None

Exercise Capacity in Adult African-Americans Referred for Exercise Stress Testing

CHEST Journal ◽  
2004 ◽  
Vol 126 (6) ◽  
pp. 1962-1968 ◽  
Author(s):  
Carl J. Lavie ◽  
Tulsidas Kuruvanka ◽  
Richard V. Milani ◽  
Ananth Prasad ◽  
Hector O. Ventura
Keyword(s):  
African Americans ◽  
Exercise Capacity ◽  
Stress Testing ◽  
Exercise Stress ◽  
Exercise Stress Testing

Respiratory arrest after treadmill exercise stress testing

1984 ◽  
Vol 75 (5) ◽  
pp. 241-248
Author(s):  
Ibrahim Jawad ◽  
Vithal Kinhal ◽  
Harisios Boudoulas
Keyword(s):  
Stress Testing ◽  
Treadmill Exercise ◽  
Respiratory Arrest ◽  
Exercise Stress ◽  
Exercise Stress Testing
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