RESEACH ON THE EXERCISE TESTING COMPARE TO THE RESULT OF CORONARYGRAPHY IN PATIENTS WITH CHEST PAIN

2012 ◽  
pp. 51-57
Author(s):  
Thanh Chung Mang ◽  
Thi Bich Thuan Le

Objective and Materials: The research was conducted on 60 patients with chest pain (average age: 56.67 ± 9.28, oldest is 79 and youngest is 36). Patients were applied exercise testing for orient diagnose coronary disease, especially for assessment the sensitivity and the specific of ST/R rate in diagnosing cardiac muscle local ischemia and to compare with the result of coronarygraphy. Results: There were 17 patients with possitive exercise testing result (28.3%) and possitive exercise testing result (71.7%). The risk factors of patients with chest pain took 88.3%, in which serum lipid disorder was 76.7%, hypertension was 60.0%, obesity (48.3%), smoking (40.0%) and diabetes (23.3%). There was no statistic significant difference between coronarygraphy(-) and coronarygraphy(+), p>0.05. There was statistic significant difference about heart rate parameters, exercise capacity, double multiply (HRxTA), HR recovery and systolic blood pressure between two groups of specific chest pain and nonspecific chest pain, p<0.05. There was statistic significant difference between the index of exercise testing and coronarygraphy result, p<0.05. Exercise testing by bicycle in diagnosing coronary disease has the sensitivity, the specific, the accuracy, positive forecast value and negative forecast value was 59.09%, 89.47%, 78.33%, 76.47%, 79.07%, respectively. The R wave in diagnosing coronary disease has the sensitivity, the specific, the accuracy, positive forecast value and negative forecast value was 77.27%, 23.68%, 43.33%, 36.96%, 64.29%, respectively. The rate ST/R in diagnosing coronary disease has the sensitivity, the specific, the accuracy, positive forecast value and negative forecast value was 50.00%, 94.74%, 78.33%, 84.62%, 76.60%, respectively.

2019 ◽  
Vol 27 (9) ◽  
pp. 978-987 ◽  
Author(s):  
Kristofer Hedman ◽  
Nicholas Cauwenberghs ◽  
Jeffrey W Christle ◽  
Tatiana Kuznetsova ◽  
Francois Haddad ◽  
...  

Aims The association between peak systolic blood pressure (SBP) during exercise testing and outcome remains controversial, possibly due to the confounding effect of external workload (metabolic equivalents of task (METs)) on peak SBP as well as on survival. Indexing the increase in SBP to the increase in workload (SBP/MET-slope) could provide a more clinically relevant measure of the SBP response to exercise. We aimed to characterize the SBP/MET-slope in a large cohort referred for clinical exercise testing and to determine its relation to all-cause mortality. Methods and results Survival status for male Veterans who underwent a maximal treadmill exercise test between the years 1987 and 2007 were retrieved in 2018. We defined a subgroup of non-smoking 10-year survivors with fewer risk factors as a lower-risk reference group. Survival analyses for all-cause mortality were performed using Kaplan–Meier curves and Cox proportional hazard ratios (HRs (95% confidence interval)) adjusted for baseline age, test year, cardiovascular risk factors, medications and comorbidities. A total of 7542 subjects were followed over 18.4 (interquartile range 16.3) years. In lower-risk subjects ( n = 709), the median (95th percentile) of the SBP/MET-slope was 4.9 (10.0) mmHg/MET. Lower peak SBP (<210 mmHg) and higher SBP/MET-slope (>10 mmHg/MET) were both associated with 20% higher mortality (adjusted HRs 1.20 (1.08–1.32) and 1.20 (1.10–1.31), respectively). In subjects with high fitness, a SBP/MET-slope > 6.2 mmHg/MET was associated with a 27% higher risk of mortality (adjusted HR 1.27 (1.12–1.45)). Conclusion In contrast to peak SBP, having a higher SBP/MET-slope was associated with increased risk of mortality. This simple, novel metric can be considered in clinical exercise testing reports.


2020 ◽  
Vol 9 (8) ◽  
pp. e316985536
Author(s):  
Jaqueline Oliveira Barreto ◽  
Julliana Cariry Palhano Freire ◽  
Arthur Willian de Lima Brasil ◽  
Cristian Statkievicz ◽  
Francisley Ávila Souza ◽  
...  

Objective: To assess dental anxiety in patients undergoing oral surgery, as well as its impact on blood pressure and heart rate. Material and Methods: A total of 233 patients answered a socio-demographic questionnaire and another one based on the Corah dental anxiety scale. Blood pressure and heart rate were assessed at three moments while: patients were in the waiting room, immediately before and after the procedure. Results: This study revealed a prevalence of anxiety of 77.3%. There was a statistically significant difference in mean systolic blood pressure and heart rate at the three moments of the evaluation. Anxiety was prevalent in the sample and was observed from the time in the waiting room until the time when local anesthesia was performed, causing variations in systolic blood pressure and heart rate, anxiety levels decreased after the end of the service. In conclusion, we observed that oral surgery is directly related to increased anxiety, and anxiety is mainly related to the change in heart rate.


2020 ◽  
Vol 9 (12) ◽  
pp. 4062
Author(s):  
Ángela Río-González ◽  
Ester Cerezo-Téllez ◽  
Cristina Gala-Guirao ◽  
Laura González-Fernández ◽  
Raquel Díaz-Meco Conde ◽  
...  

The aim of this study is to describe the short-term effects of manual lymph drainage (MLD) isolated in supraclavicular area in healthy subjects. A 4-week cross-sectional, double-blinded randomized clinical trial was conducted. Participants: 24 healthy participants between 18 and 30 years old were recruited from Universidad Europea de Madrid from December 2018 to September 2019. A total of four groups were studied: control, placebo, Vodder, and Godoy. The order of the interventions was randomized. Resting Heart Rate and Oxygen Saturation, blood pressure, pressure pain threshold of trapezius muscle, respiratory rate, range of active cervical movements were measured before and after every intervention. All the participants fulfilled four different interventions with a one-week-wash-out period. No statistically significant differences were found between groups in descriptive data; neither in saturation of oxygen, diastolic blood pressure and cervical range of motion. Significant differences were found in favor of Vodder (p = 0.026) in heart rate diminution and in cardiac-rate-reduction. A significant difference in respiratory rate diminution is found in favor of the Godoy group in comparison with the control group (p = 0.020). A significant difference is found in favor of the Godoy group in systolic blood pressure decrease (p = 0.015) even in pressure pain threshold (p < 0.05). MLD decreases systolic blood pressure in healthy participants. However, it does not produce any changes in other physiologic outcomes maintaining physiologic values, which may suggest the safety of the technique in patients suffering from other pathologies.


1990 ◽  
Vol 79 (1) ◽  
pp. 73-79 ◽  
Author(s):  
B. P. M. Imholz ◽  
J. H. A. Dambrink ◽  
J. M. Karemaker ◽  
W. Wieling

1. Continuous orthostatic responses of blood pressure and heart rate were measured in 40 healthy and active elderly subjects over 70 years of age in order to assess the time course and rapidity of orthostatic cardiovascular adaptation in old age. 2. During the first 30 s (initial phase) the effects of active standing and passive head-up tilt closely resembled those observed earlier in younger age groups. Standing up was accompanied by a drop (mean ± SD) in systolic and diastolic blood pressures of 26 ± 13 mmHg and 12 ± 18 mmHg, respectively, at around 10 s, and a subsequent rise up to 11 ± 17 mmHg and 8 ± 6 mmHg above supine values at around 20 s. The drop in blood pressure upon standing was accompanied by a transient increase in heart rate with a maximum of 13 beats/min, followed by a gradual decrease to 7 beats/min above supine levels. These characteristic transient changes were absent upon a passive head-up tilt. 3. After 1–2 min of standing (early steady-state phase) diastolic blood pressure and heart rate increased significantly after active and passive postural changes. On average, for all subjects systolic blood pressure tended to increase from control during 5–10 min standing, reaching a significant difference at 10 min. During standing, the largest increases in systolic blood pressure were found in subjects with the lowest supine blood pressures. 4. In conclusion, for the investigation of orthostatic circulatory responses in elderly subjects the following factors have to be taken into account: active versus passive changes in posture, the timing of the blood pressure reading, and the level of supine blood pressure.


Medicina ◽  
2008 ◽  
Vol 44 (1) ◽  
pp. 34 ◽  
Author(s):  
Kamilė Bloznelienė ◽  
Remigijus Žaliūnas ◽  
Julija Braždžionytė ◽  
Regina Grybauskienė ◽  
Mindaugas Bloznelis ◽  
...  

Exercise cardiography still remains the cornerstone of noninvasive evaluation of functional status of cardiovascular system and is almost uniformly performed after myocardial infarction. The patients after myocardial infarction can be divided into relative high- and low-risk groups for subsequent cardiac events if all information available on the exercise test is used. Objective. The aim of this study was to evaluate the prognostic significance of the shape of heart rate and systolic blood pressure curves (their dynamic characteristics) during the early exercise testing and after it and to design the prognostic system capable to recognize patients with a high risk of coronary death during 2 years after myocardial infarction. Material and methods. The submaximal exercise testing within 3 weeks of acute myocardial infarction was performed on 894 patients. Cases of noncardiac deaths or patients subjected to coronary bypass surgery were excluded from the further analysis. At the end of 2 years after myocardial infarction, there were 426 survivors and 42 cases of cardiac death. At 2-year follow-up after infarction in the nonsurvivor group, there were only 42.2% of patients with exercise-induced ST segment depression. This shows that prognostic importance of ST depression is insufficient and demands research of more consistent signs. Results. The cardiovascular response to exercise was interpreted as transiting process of self-regulation of cardiovascular system, and the new predictive signs were found based on the curves of heart rate and systolic blood pressure during the exercise and after it. The prognostic value of these signs was established. The combined use of both the new predictive signs and usual data of early exercise test shows the high predictive possibility of test – the early cardiac death was predicted in 80% of cases. Conclusion. The combined use of both, the widely accepted data of early exercise test after myocardial infarction and dynamic characteristics of heart rate and systolic blood pressure, increased the predictive power of the test.


Author(s):  
Abhay Choudhary ◽  
Arun Pathak ◽  
Sheela Kumari

Aims: to know the influence of yoga on autonomic functions of the body. Material and Methods: The present prospective case control study was conducted among patients visited the OPD, Darbhanga Medical College and Hospital, Bihar, India. The findings were tabulated and subjected to statistical analysis. Case group (N=30): subjects who were performing regular yoga asanas and relaxation techniques for at least 5 years. Control group (N=30): age and gender matched subject who were not performing yoga asanas and relaxation techniques or were not engaged with any other type of physical exercises. Results: Amongst the sympathetic nervous system parameters, statistically significant difference existed between cases and controls for the Resting Heart Rate, Resting Diastolic Blood Pressure, Hand grip systolic blood pressure and Hand grip systolic blood pressure (p<0.05) respectively. Conclusion: yogic activity significantly alters the sympathetic activity like heart rate and blood pressure. Keywords: Autonomic Nervous system, Yoga, Heart Rate, Blood Pressure


2017 ◽  
Vol 3 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Hamdiah Hamdiah ◽  
Ari Suwondo ◽  
Triana Sri Hardjanti ◽  
Ariawan Soejoenoes ◽  
M Choiroel Anwar

Background: Pregnancy increases the risk of developing anxiety that may affect the fetus. Yoga is considered as an alternative therapy to reduce anxiety, blood pressure, and fetal heart rate.Objective: This study aimed to examine the effect of prenatal yoga on anxiety, blood pressure, and fetal heart rate in primigravida mothers.Methods: There were 39 primigravida mothers selected using purposive sampling, which divided to be an experiment group with four-times prenatal yoga and eight-times prenatal yoga, and a control group. The Hamilton Rating Scale For Anxiety (HRSA) was used. Data were analyzed using One way ANOVA and MANOVA.Results: There was a statistically significant difference of prenatal yoga on anxiety (P=0.005), systolic blood pressure (P=0.045), and fetal heart rate (P=0.010). However, there was no significant difference of prenatal yoga on diastolic blood pressure with p-value 0.586 (>0.05)Conclusion: There were significant effects of prenatal yoga on anxiety level, systolic blood pressure, and the fetal heart rates in primigravida mothers. The findings of this study can be an alternative treatment for midwife to deal with anxiety during pregnancy, and an input on the class program of pregnant women to improve the quality of maternal and fetal health.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Neha Bala ◽  
Aashish Negi ◽  
Yogesh Saxena ◽  
Sarfaraz Alam

Abstract Background Coronary artery disease (CAD) is increasing day by day in young Indian population with increase in risk factors such as obesity, hypertension etc. Although in early age, these risk factors are clinically asymptomatic but physiologically they are symptomatic. These symptoms can be best assessed by assessing the response of autonomic nervous system Therefore the purpose of this study was to compare the autonomic response of gradient exercise testing protocol in normotensive, overweight, and pre-hypertensive subjects in the form of chronotropic response to exercise, inotropic reponse, heart rate recovery, blood pressure recovery, BRPE, and heart rate variability so that the physiological abnormalities can be corrected. Results There were significant differences (p < 0.05) found in gradient exercise testing protocol in diastolic blood pressure in normotensive, in heart rate variability in overweight and in both systolic as well as diastolic blood pressure in pre-hypertensive subjects. Conclusion Gradient exercise testing protocol can be best utilized as a clinical tool in normotensive, overweight, and pre-hypertensive subjects for the assessment of autonomic nervous system which provides diagnostic and prognostic information regarding cardiovascular disease or abnormalities.


2021 ◽  
Vol 8 (3) ◽  
pp. 460-464
Author(s):  
Devyani Desai ◽  
Bhoomika Kalarthi

: Currently phenylephrine is a preferred 1 line vasopressor for maintenance of blood pressure during spinal anaesthesia, may be associated with reflex bradycardia and decreased cardiac output, posing risk to mother or foetus. Norepinephrine may be an useful alternative as being potent alpha with weak beta adrenergic agonist activity. : This study compared the effectiveness of prophylactic and treatment boluses of norepinephrine and phenylephrine to maintain systolic blood pressure at or above 80% of baseline value during spinal anesthesia for cesarean delivery with the primary aim to compare cardiac output. Secondary aims were total doses of study drug required, neonatal outcome and perioperative complications.: Total 100, term pregnant women with ASA status II undergoing caesarean delivery under spinal anaesthesia were enrolled in this prospective, double blind controlled study. Patients were randomized to receive prophylactic bolus dose of norepinephrine (6 µg) or phenylephrine (100 µg) immediately after spinal anaesthesia. Systolic blood pressure, cardiac output and heart rate were monitored. Intermittent bolus doses were repeated whenever required. Student ‘t’ test and chi square test were used for analysing the data. : Both the drugs were able to maintain the systolic blood pressure ≥ 80% of baseline (p=0.356). Significant difference observed in cardiac output while comparing both the groups from 3 to 15 minutes after spinal anesthesia (p=0.014). The incidence of bradycardia was lower in norepinephrine group as compared to phenylephrine group (P=0.018). : Norepinephrine is as effective as phenylephrine for maintenance of blood pressure after spinal anaesthesia for caesarean delivery with stable heart rate and cardiac output.


2020 ◽  
Author(s):  
atefeh ghanbari ◽  
Ezzat Paryad ◽  
Arefe safati ◽  
Ehsan Kazemnezhad Leyli ◽  
Elaheh Parsasalkisari

Abstract BackgroundTraumatic brain-injured (TBI) patients suffer severe pain. The assessment of behavioral responses and vital signs seems to be necessary for pain detection in these patients, a matter that this study aims to evaluate.MethodsThis cross sectional study uses repeated measures and included ninety-seven TBI patients from Poorsina hospital, Rasht, Iran. Patients’ relevant parameters were recorded using demographic checklist, specifications related to the disease, RASS, CPOT, and FPT tools. The data subsequently were entered into SPSS software V. 21 and were analyze using several tests including Bonferroni’s inferential test and Greenhouse-Geisser test, multiple analysis regression coefficient and general linear model by GEE method.ResultsThe average age of patients was 42.3 ± 18.2. The average consciousness level was 9.30 ± 2.96. There was significant difference between the painful and non-painful stimulations in heart rate, systolic blood pressure and diastolic blood pressure (p <0.001). Heart rate (p < 0.001, r = 0.253), number of respiration (p < 0.001, r = 0.173), systolic (p = 0.002, r = 0.128) and diastolic (p<0.001, r=0.223) blood pressures had a positive correlation with behavioral responses. However, the arterial oxygen saturation showed a negative correlation with behavioral responses (p < 0.001, r = -0.361). Statistical models demonstrated a significant direct relationship between CPOT with heart rate (β = 2.39, p < 0.001) and both systolic blood pressure (β= 1.31, p=0.002) and the fluctuations of diastolic blood pressure (β = 0.690, p = 0.009). ConclusionIt seems that behavioral responses are appropriate indices for pain detection. However, vital signs are not capable of being considered as proper indexes for pain assessment since they changed during several procedures while remained unchanged in other tests.


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