Bruce, R. A.; Cooper, M. N.; Gey, G. O.; Fisher, L. D.; Peterson, D. R.
December 1973
Angiology;Dec1973, Vol. 24 Issue 11, p691
Academic Journal
The use of a standardized, multistage protocol for maximal exercise testing of ambulatory persons in four teaching hospitals, ten private offices and clinics and an industrial medical department is described. ECG responses in a bipolar precordial lead are transmitted by dataphone for independent computer analysis, and all data are entered into a computer file. Initial experience in testing 2332 middle-aged men, of whom 1275 were normal and 1057 were ambulatory patients with cardiovascular disease demonstrates the feasibility and safety of stress testing. Functional aerobic impairment, or percentage deviation between observed maximal performance and that predicted for individuals of similar sex, age and physical-activity status is derived by nomograms from duration of exercise with this protocol. Significant differences in FAI, and cardio- vascular components, have been defined in relation to hypertension, angina pectoris, prior myocardial infarction and various combinations of these diagnostic categories. One application of these methods to the evaluation of surreal treatment of angina pectoris by saphenous-vein grafting is cited to illustrate the advantages of maximal exercise testing when functional studies at rest fail to demonstrate significant changes. Assessment of the predictive value in the preclinical phases of cardiovascular disease must await future follow-up studies.


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