scholarly journals Non ST ergometric variables in the diabetic patient and their prognostic significance

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Gianaugusto Slavich ◽  
Paola Mapelli ◽  
Rudy Fregolent ◽  
Massimo Slavich ◽  
Duilio Tuniz
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Exercise Testing ◽  
Heart Rate Recovery ◽  
Prognostic Significance ◽  
Cardiac Events ◽  
Chronotropic Response ◽  
St Segment ◽  
Number Of Patients

Background. Recent research based on large number of patients has demonstrated that there are strong exercise predictors of cardiovascular events other than ST-segment behaviour. Studies focused on non-ST segment variables in exercise testing (exercise capacity, chronotropic and pressure response, heart rate recovery) in diabetics are lacking. The aim of our study is to find out differences in the exercise- testing variables between diabetics and non and to evaluate their prognostic role. Methods. We analyzed non ST-variables in 1172 patients undergoing exercise testing with Bruce protocol:diabetics vs non diabetics: n=83 (7%) vs n=1089 (93%); mean age: 64.37±8.44 vs 60.44±11.44; males: n=56 (67.47%) vs n=665 (61.06%). Mean follow-up was 13,5±4 months. Results. Follow-up data were available in 74 diabetics (89%), 14 (18,9%) presented cardiac events (death, infarction, coronaric revascularization, heart failure). Diabetics with events showed significantly worse 1st min Heart Rate (HR) and 3rd min Systolic Blood Pressure (SBP) recovery. Conclusions. Preliminary results highlight that non-ST variables (exercise time, chronotropic response, heart rate and blood pressure recovery) are significantly different in diabetics. Abnormal HR and SBP recovery identify a subgroup of diabetics at higher risk of cardiac events in the follow-up.

scholarly journals Relationship between blood pressure response during hemodialysis and exercise tolerance or heart rate recovery measured using cardio-pulmonary exercise testing in maintenance hemodialysis patients

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Yabe ◽  
Kenichi Kono ◽  
Ryota Shiraki ◽  
Akiho Masuda ◽  
Yoshifumi Moriyama ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Uptake ◽  
Exercise Testing ◽  
Exercise Tolerance ◽  
Blood Pressure Response ◽  
Heart Rate Recovery ◽  
Cardiopulmonary Exercise Testing ◽  
Pressure Response ◽  
Exercise Intolerance

Abstract Background This study investigated the association between the blood pressure response during hemodialysis (HD) and exercise tolerance or heart rate recovery (HRR) measured with cardiopulmonary exercise testing (CPX). Methods The study enrolled 23 patients who had been undergoing 4-h regular maintenance HD. The maximum workload (Loadpeak), peak oxygen uptake (VO2peak), workload and oxygen uptake at the anaerobic threshold (LoadAT and VO2AT, respectively), and HRR were measured with CPX. The average systolic blood pressure during HD (SBPav) was measured, and the number of times the SBP was less than 100 mmHg was determined in the 2-week period after CPX. Results The SBPav showed a significant correlation with LoadAT (r = 0.46) and Loadpeak (r = 0.43, p < 0.05). The number of times the SBP was less than 100 mmHg showed a significant correlation with the HRR (r = − 0.44, p < 0.05). Conclusion Exercise intolerance and HRR in HD patients may be associated with blood pressure instability during HD.

P1576 Exercise echocardiography in asymptomatic or mildly symptomatic patients with moderate or severe aortic stenosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J C Peteiro Vazquez ◽  
A Bouzas-Mosquera ◽  
A Varela-Cancelo ◽  
J Broullon ◽  
J M Vazquez-Rodriguez
Keyword(s):  
Blood Pressure ◽  
Aortic Stenosis ◽  
Exercise Testing ◽  
Severe Aortic Stenosis ◽  
Regional Wall Motion ◽  
Lv Function ◽  
Time Interval ◽  
Imaging Results ◽  
Number Of Patients

Abstract Exercise testing is recommended in current guidelines for discovering symptoms in patients with aortic stenosis (AS) and equivocal or no symptoms at all. The additive value of imaging is controversial. We sought to assess the value of exercise echocardiographic (ExE) parameters in this setting, particularly increase in blood pressure, increase in LV ejection fraction and increase in gradients with exercise. Methods Retrospective analyses of prospectively collected data on 157 patients (83 males, age 70 ± 12 years) with moderate or severe AS and normal LV function (LVEF ≥ 50%) who were asymptomatic or who have equivocal symptoms. The end point was a combined event composed of overall mortality and aortic valve replacement. Results No complications were reported during the exercise testing. Ischemia was reported in 63 patients (40%) whereas 10 subjects had resting regional wall motion abnormalities (6%). During a median follow-up of 21 months (25th-75th percentil 7-60 months) there were 129 events, including 64 deaths. After multivariate adjustment, treatment with digoxine (hazard ratio [HR] = 4.65, 95% Confidence Interval [CI]= 1.97-10.94, p &lt; 0.001), treatment with nitrates (HR = 1.52, 95%CI = 1.00-2.32, p = 0.049) maximal age-predicted achieved heart rate (HR = 0.16, 95% CI = 0.03-0.70, p = 0.02), and increase in blood pressure with exercise (HR = 0.99, 95% CI = 0.98-1.00, p = 0.002) were predictors of the combined event. Increase in LVEF and increase in gradients conferred protection by univariate analyses but were not predictors after adjustment. In conclusion ExE is safe in patients with AS. A significant number of patients have abnormal imaging results. Most of the patients with AS and a clinically indicated ExE have events in a median follow-up time interval. Although increase in gradients and increase in LVEF were associated to less events, the "exercise part" of the ExE seems to be more powerful for predicting outcome.

Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing

2012 ◽  
Vol 28 (6) ◽  
pp. 750-756 ◽  
Author(s):  
Umuttan Dogan ◽  
Mehmet Akif Duzenli ◽  
Kurtulus Ozdemir ◽  
Hasan Gok
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Exercise Testing ◽  
Blood Pressure Response ◽  
Heart Rate Recovery ◽  
Pressure Response

OS 37-04 EFFECTS OF WHITE COAT HYPERTENSION ON HEART RATE RECOVERY AND BLOOD PRESSURE RESPONSE DURING EXERCISE TESTING

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e406
Author(s):  
Kyoung Im Cho ◽  
Eun A. Cho ◽  
Jung Ho Heo ◽  
Hyun Su Kim ◽  
Sung Il Im ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Exercise Testing ◽  
Blood Pressure Response ◽  
Heart Rate Recovery ◽  
Pressure Response ◽  
White Coat ◽  
White Coat Hypertension

scholarly journals Cardiorespiratory fitness and heart rate recovery predict sudden cardiac death independent of ejection fraction

Heart ◽  
2019 ◽  
Vol 106 (6) ◽  
pp. 434-440 ◽  
Author(s):  
Jussi A Hernesniemi ◽  
Kalle Sipilä ◽  
Antti Tikkakoski ◽  
Juho T Tynkkynen ◽  
Pashupati P Mishra ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sudden Cardiac Death ◽  
Ejection Fraction ◽  
Cardiorespiratory Fitness ◽  
Exercise Testing ◽  
Cardiac Death ◽  
Heart Rate Recovery ◽  
Left Ventricular ◽  
Left Ventricular Ejection

ObjectiveTo evaluate whether cardiorespiratory fitness (CRF) and heart rate recovery (HRR) associate with the risk of sudden cardiac death (SCD) independently of left ventricular ejection fraction (LVEF).MethodsThe Finnish Cardiovascular Study is a prospective clinical study of patients referred to clinical exercise testing in 2001–2008 and follow-up until December 2013. Patients without pacemakers undergoing first maximal or submaximal exercise testing with cycle ergometer were included (n=3776). CRF in metabolic equivalents (METs) was estimated by achieving maximal work level. HRR was defined as the reduction in heart rate 1 min after maximal exertion. Adjudication of SCD was based on death certificates. LVEF was measured for clinical indications in 71.4% of the patients (n=2697).ResultsPopulation mean age was 55.7 years (SD 13.1; 61% men). 98 SCDs were recorded during a median follow-up of 9.1 years (6.9–10.7). Mean CRF and HRR were 7.7 (SD 2.9) METs and 25 (SD 12) beats/min/min. Both CRF and HRR were associated with the risk of SCD in the entire study population (HRCRF0.47 (0.37–0.59), p<0.001 and HRHRR0.57 (0.48–0.67), p<0.001 with HR estimates corresponding to one SD increase in the exposure variables) and with CRF, HRR and LVEF in the same model (HRCRF0.60 (0.45–0.79), p<0.001, HRHRR0.65 (0.51–0.82), p<0.001) or adjusting additionally for all significant risk factors for SCD (LVEF, sex, creatinine level, history of myocardial infarction and atrial fibrillation, corrected QT interval) (HRCRF0.69 (0.52–0.93), p<0.01, HRHRR0.74 (0.58–0.95) p=0.02).ConclusionsCRF and HRR are significantly associated with the risk of SCD regardless of LVEF.

Sign in / Sign up

Export Citation Format

Share Document