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Serial exercise testing in patients with effort angina: variable tolerance, fixed threshold.

D D Waters, J L McCans, P A Crean

    Journal of the American College of Cardiology
    |November 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

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    This study reveals that the time to 1 mm ST depression in stable effort angina patients varies significantly throughout the day and across multiple testing days. However, the rate-pressure product at this ST depression threshold remained consistent, indicating a stable physiological response despite temporal variations.

    Area of Science:

    • Cardiology
    • Exercise Physiology

    Background:

    • Stable effort angina is characterized by exercise-induced ST segment depression.
    • Understanding the variability in angina threshold is crucial for accurate diagnosis and management.

    Purpose of the Study:

    • To investigate the frequency and underlying mechanisms of variable threshold angina.
    • To assess the day-to-day and intra-day variability of exercise-induced angina.

    Main Methods:

    • Twenty-eight patients with stable effort angina underwent seven treadmill exercise tests each.
    • Tests were conducted over four days within two weeks, with additional intra-day tests at specific times (8 AM, 9 AM, 11 AM, 4 PM).
    • Time to 1 mm ST depression and rate-pressure product at this threshold were recorded.

    Related Experiment Videos

    Main Results:

    • Time to 1 mm ST depression showed a significant increase across testing days (p < 0.05) and varied significantly throughout the day (p < 0.01).
    • Rate-pressure product at 1 mm ST depression remained constant across all tests, indicating a stable ischemic threshold.
    • The standard deviation for time to ST depression was 22%, while for rate-pressure product it was significantly lower at 8.4% (p < 0.001).

    Conclusions:

    • Variable threshold angina exhibits significant temporal variability in exercise response.
    • The rate-pressure product appears to be a more stable indicator of ischemic threshold than the time to ST depression.
    • These findings highlight the importance of considering diurnal variations in angina assessment.