Quantifying Exertion Level During Exercise Stress Testing Using Percentage of Age-Predicted Maximal Heart Rate, Rate Pressure Product, and Perceived Exertion
| Autor: | Sherry Pinkstaff, Mary Ann Peberdy, Michael C. Kontos, Sheryl Finucane, Ross Arena |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Physical Exertion Myocardial Ischemia Blood Pressure Peak Expiratory Flow Rate Heart Rate Internal medicine Heart rate medicine Humans Aerobic exercise Exertion Respiratory exchange ratio Maximal Expiratory Flow Rate Rating of perceived exertion business.industry General Medicine Middle Aged Blood pressure Rate pressure product Exercise Test Cardiology Physical therapy Female Original Article business |
| Zdroj: | Mayo Clinic Proceedings. 85:1095-1100 |
| ISSN: | 0025-6196 |
| Popis: | OBJECTIVE: To determine if the attainment of at least 85% of age-predicted maximal heart rate (APMHR), using the equation 220 – age, and/or at least 25,000 as the product of maximal heart rate and systolic blood pressure (rate pressure product, RPP) is an accurate indicator of exertion level during exercise stress testing. PATIENTS AND METHODS: From May 1, 2009, to February 15, 2010, 238 patients (mean ± SD age, 49.3±11.9 years; 50% male) with symptoms suggestive of myocardial ischemia underwent an exercise stress test with the addition of ventilatory expired gas analysis and a myocardial perfusion study. Ventilatory expired gas analysis determined the peak respiratory exchange ratio (RER), which is considered a valid and reliable variable for quantifying a patient's exertion during exercise. RESULTS: Of the patients, 207 (87%) attained a peak RER of 1.00 or more, and 123 (52%) attained a peak RER of 1.10 or more. An APMHR of 85% or more and peak RPP of 25,000 or more were both ineffective in identifying patients who put forth a maximal exercise effort (ie, peak RER, ≥1.10). Perceived exertion was a significant indicator (P=.04) of patient exertion, with a threshold of 15 (6-20 scale) being an optimal cut point. The percentage of equivocal myocardial perfusion study results was significantly higher in patients who demonstrated a submaximal exercise effort by peak RER (P≤.007). CONCLUSION: Aerobic exercise testing is an integral component in the assessment of patients with suspected myocardial ischemia. Our findings indicate that the currently used percentage of APMHR and peak RPP thresholds are ineffective in quantifying a patient's level of exertion during exercise stress testing. |
| Databáze: | OpenAIRE |
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