Value of arm exercise testing in detecting coronary artery disease

Area of Science:

• Cardiology
• Exercise Physiology

Background:

• Patients with vascular, orthopedic, or neurologic conditions often cannot perform standard leg exercise tests.
• Alternative exercise modalities are crucial for diagnosing conditions like coronary artery disease (CAD) in these individuals.

Purpose of the Study:

• To evaluate the sensitivity of arm ergometry in detecting coronary artery disease (CAD).
• To compare the diagnostic performance of arm exercise versus traditional leg exercise testing in patients with angina pectoris.

Main Methods:

• Thirty patients with confirmed CAD (≥70% coronary artery stenosis) underwent both arm ergometry and treadmill testing prior to coronary angiography.
• Key parameters including ischemic ST depression, angina occurrence, rate-pressure product, and oxygen consumption at ischemia onset were recorded.

Main Results:

• Leg exercise testing detected ischemia or angina in 86% of patients, compared to 40% with arm exercise.
• Peak oxygen consumption was significantly higher during leg exercise (18 ml/kg/min) than arm exercise (13 ml/kg/min).
• Oxygen consumption at the onset of ischemia was significantly lower during arm testing (12 ml/kg/min) versus leg testing (17 ml/kg/min) for concordantly positive tests.

Conclusions:

• Arm exercise testing is a reasonable alternative for CAD detection in patients unable to perform leg exercise.
• However, arm ergometry is not as sensitive as leg exercise testing for diagnosing CAD.