摘要:

During a four-year period, 6,650 persons were enrolled in the exercise testing registry of the Seattle Heart Watch Study. Risk factors and maximal exercise responses were assessed. The purpose of the study was to document the prognostic value of these variables for primary cardiac events in asymptomatic persons and for secondary cardiac events in persons with known heart disease. In asymptomatic persons, age and the combination of risk factors and abnormal exercise responses identified individuals at increased risk. In persons with established coronary heart disease, age and conventional risk factors were of little prognostic value. However, findings that included cardiomegaly, poor blood pressure response during exercise, and limited exercise tolerance, all of which suggested poor left ventricular function, were predictive of poor prognosis. Exertional chest pain and abnormal ST depression were not predictive.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Exercise testing in the late hospital phase of acute myocardial infarction (MI) should be performed for all patients without contraindications. Signs of ischemia (exertional angina and ST-segment depression), ventricular arrhythmias, and duration of exercise are important both for prognosis and clinical management. Blood pressure and heart rate response to exercise, nonischemic symptoms, and physical examination for an exercise-induced third heart sound or murmur of mitral regurgitation are of further value in prescribing post-MI therapy and exercise regimens. Reported series vary widely in selection criteria for exercise testing and in testing technique, which has resulted in different conclusions about the prognostic significance of exercise test variables. Risk for posthospital cardiac death is low in post-Mi patients who are well enough to perform the test. However, even among these low-risk patients, the exercise test identifies high-risk subgroups and suggests specific pathophysiologic mechanisms underlying the stratification of risk.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The value of predischarge quantitative exercise thallium-201 scintigraphy for predicting future coronary events was evaluated in 140 consecutive patients after uncomplicated myocardial infarction (MI). Thallium-201 defects in more than one discrete vascular region, the presence of delayed redistribution, or an increased lung thallium uptake indicated a high-risk subgroup, whereas low-risk patients were best identified by a single-region201Tl defect without redistribution and without increased lung uptake. Predischarge Tl exercise testing was a better predictor of subsequent cardiac events than were ST-segment depression, angina, or even extent of angiographic coronary disease in this series of patients. These results should be helpful in assessing the decision for catheterization after MI and in planning cardiac rehabilitation.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

An educational intervention, consisting of telephone counseling for patient and spouse and a mailed pamphlet, was designed to improve cardiac patient attendance at six exercise programs. Attendance was tested against the pamphlet alone in a randomized, controlled trial with 174 patients and 134 spouses. Unadjusted results showed a nonsignificant increase (2%) in the first three months' attendance of the experimental group over the comparison group. However, adjustment for covariates showed that the intervention significantly increased attendance by 12% (P = .03) and had the strongest effect on subjects with a high school education or less. Evidence regarding the effect of spouse support was contradictory. Nonexperimental variables that significantly affected attendance, when controlling for all other variables, included exercise site, smoking, cardiac diagnosis, and patients' anticipation that their job would make them miss exercise sessions. Three quarters of the patients continued to exercise on their own after dropping out, but only one third of these people exercised at levels sufficient to maintain cardiorespiratory benefits.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID