Ischemic threshold varies in response to different types of exercise in patients with chronic stable angina

American Heart Journal
G PupitaA Maseri

Abstract

The effects of different types of exercise on ischemic threshold were studied in 33 patients with chronic stable angina, documented coronary artery disease, and reproducible positive exercise test results. On average, ST segment depression developed at a significantly higher heart rate and rate-pressure product when the standard modified Bruce protocol was preceded by a warm-up period (113 +/- 13 vs 119 +/- 15 beats/min and 18,813 +/- 3682 vs 20,357 +/- 4227 beats/min X mm Hg, respectively; p less than 0.05 and less than 0.01). No significant changes were observed when the exercise was started abruptly. Analysis of results in individual patients showed that changes in rate-pressure product at 1 mm ST segment depression greater than or equal to 2000 beats/min X mm Hg developed with different types of exercise in 11 patients (group I), whereas in 22 patients little or no change occurred (group II). All patients also underwent exercise testing before and after 0.5 mg of sublingual nitroglycerin; improvement induced by nitroglycerin was significantly greater in group I than in group II (22 +/- 8 vs 8 +/- 9 beats/min and 4896 +/- 1998 vs 1064 +/- 2145 beats/min X mm Hg; p less than 0.01). Furthermore, isometric handgrip exercise car...Continue Reading

Citations

Jul 1, 1994·Journal of the American College of Cardiology·C E GarberR A Carleton
Mar 1, 1991·Journal of the American College of Cardiology·J C KaskiA Maseri

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