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[Hemodynamic differences between maximal treadmill and bicycle ergometer test in coronary disease]
Insights
Treadmill tests reveal higher oxygen uptake (VO2) and lower blood pressure (BP) in coronary heart disease patients experiencing angina pectoris. This finding is significant for exercise testing and training in cardiac patients.
Area of Science:
- Cardiology
- Sports Medicine
- Exercise Physiology
Background:
- Coronary heart disease (CHD) and angina pectoris (AP) are common conditions affecting cardiac function.
- Exercise testing is crucial for managing CHD and AP, but test modalities may influence patient outcomes.
Purpose of the Study:
- To compare physiological responses during symptom-limited treadmill (TM) and bicycle ergometer (bike) tests in patients with CHD and AP.
- To determine if exercise modality affects oxygen uptake (VO2), blood pressure (BP), and heart rate (HR) in this patient group.
Main Methods:
- Nine patients with CHD and typical AP underwent both TM and bike tests in a randomized sequence.
- Measurements included oxygen uptake (VO2) via Douglas-bag, arterial blood pressures, and cardiac output (Q) using the Fick principle.
- Patients were limited by AP in most tests.
Main Results:
- Patients achieved higher mean VO2 (1316 ml/min) on the TM compared to the bike.
- Mean arterial blood pressure (BP) was significantly lower (average 10 mm Hg) during TM tests.
- Heart rate (HR), BP, and pressure-rate product (HR × BP) were lower during the final stages of TM tests, while VO2 remained similar.
Conclusions:
- Exercise testing on a treadmill may allow patients with CHD and AP to achieve higher oxygen uptake with lower cardiovascular stress (BP).
- These findings suggest that TM testing might be more beneficial for exercise assessment and training in patients limited by AP.
Abstract:
9 patients with diagnosis of coronary heart disease (CHD) and typical angina pectoris (AP) were studied by means of a multistage, symptom-limited treadmill test and a similar bicycle ergometer (bike)-test. The sequence of tests was determined by chance. Between the tests, the patients rested one hour. Oxygen uptake (vo2) was determined by the Douglas-bag-method, blood pressures were measured via catheters placed in a pulmonary and a brachial or radial artery, respectively. Cardiac output (Q) was calculated by the direct Fick principle. In all tests, with the exception of one bike-test, all patients were limited by AP. They attained high VO2 (mean 1316 ml/min) on the treadmill (TM) while on the TM their mean arterial blood pressure (BP) was significantly (P greater than 0.05), namely 10 mm Hg as an average, lower. Comparing the final minute -3 of the TM-test with the final minute -1 of the bike-test in 5 patients, we found heart rate (HR), BP and pressure rate product (HR times BP) lower on the TM (P greater than 0.05), whereas VO2 was the same. Patients, whose exercise performance is limited by angina pectoris on bike and TM, achieve higher VO2 on the treadmill, together with lower BP. This may be of clinical importance in exercise-testing and -training of patients with CHD.