Τρίτη 17 Μαΐου 2016

The Relation of Arm Exercise Peak Heart Rate to Stress Test Results and Outcome.

Purpose: Arm exercise is an alternative to pharmacologic stress testing for >50% of patients unable to perform treadmill exercise but no data exist regarding the effect of attained peak arm exercise heart rate on test sensitivity. Thus, the purpose of this investigation was to characterize the relationship of peak arm exercise heart rate responses to abnormal stress test findings, coronary revascularization, and mortality in patients unable to perform leg exercise. Methods: From 1997 until 2002 arm cycle ergometer stress tests were performed in 443 consecutive veterans aged 64.1(11.0) yrs. [mean(SD)], of whom 253 also underwent myocardial perfusion imaging(MPI). Patients were categorized by frequency distributions of quartiles of percentage age-predicted peak heart rate(APPHR), heart rate reserve(HRR), and peak heart rate-systolic blood pressure product(PRPP). Exercise-induced ST-segment depression, abnormal MPI findings, coronary revascularization, and 12.0(1.3) yr. Kaplan-Meier all-cause and cardiovascular mortality plots were then characterized by quartile of APPHR, HRR, and PRPP. Results: A reduced frequency of abnormal arm exercise electrocardiogram(ECG) results was associated only with the lowest quartile of APPHR(

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