Comparison of ST segment depression in upright treadmill and supine bicycle exercise testing
Significant differences in the hemodynamic response to upright and supine exercise have been reported in patients with coronary artery disease. The purpose of the present study was to compare the degree of myocardial ischemia as assessed by ST segment depression during upright treadmill and supine b...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1988-02, Vol.11 (2), p.330-337 |
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| creator | Wetherbee, Jule N. Bamrah, Virinderjit S. Ptacin, Michael J. Kalbfleisch, John H. |
| description | Significant differences in the hemodynamic response to upright and supine exercise have been reported in patients with coronary artery disease. The purpose of the present study was to compare the degree of myocardial ischemia as assessed by ST segment depression during upright treadmill and supine bicycle exercise in 98 patients with coronary artery disease and in 34 patients with normal coronary arteries. The amount of ST segment depression at maximal exercise in patients with coronary artery disease was 0.90 ± 0.80 mm for treadmill and 1.34 ± 1.09 mm for supine bicycle (p < 0.001). The amount of ST segment depression during treadmill and supine bicycle exercise tests was also compared at highest similar heart rates (0.68 ± 0.77 versus 1.17 ± 1.01, p < 0.001), at highest similar rate-pressure products (0.71 ± 0.77 versus 1.08 ± 1.04, p < 0.001), at highest similar metabolic equivalents of oxygen consumption (MET) levels (0.69 ± 0.75 versus 1.20 ± 1.05 mm, p < 0.001) and at the onset of angina (0.84 ± 0.73 versus 1.18 ± 0.88 mm, p < 0.001). The rate-pressure product achieved at maximal exercise was similar in both tests (18.74 ± 5.80 × 103versus 18.81 ± 5.17 × 103, p = NS). The occurrence of angina during treadmill and supine bicycle exercise tests was similar (47 of 98 versus 48 of 98, respectively, p = NS). For the detection of coronary artery disease, the sensitivity was 50.0% for treadmill and 63.3% for supine bicycle (p < 0.05) and the specificity was 73.5 versus 70.6%, respectively (p = NS).
Thus, the degree of ST segment depression in patients with coronary artery disease is significantly greater during supine bicycle exercise than during upright treadmill testing at the onset of angina, at similar rate-pressure products, at similar heart rates, at similar MET levels and at maximal exercise. Supine bicycle exercise electrocardiography is significantly more sensitive, yet equally specific for the dejection of coronary artery disease when compared with upright treadmill exercise electrocardiography. |
| doi_str_mv | 10.1016/0735-1097(88)90098-8 |
| format | Article |
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Thus, the degree of ST segment depression in patients with coronary artery disease is significantly greater during supine bicycle exercise than during upright treadmill testing at the onset of angina, at similar rate-pressure products, at similar heart rates, at similar MET levels and at maximal exercise. Supine bicycle exercise electrocardiography is significantly more sensitive, yet equally specific for the dejection of coronary artery disease when compared with upright treadmill exercise electrocardiography.]]></description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(88)90098-8</identifier><identifier>PMID: 3339171</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angina Pectoris - physiopathology ; Biological and medical sciences ; Blood Pressure ; Cardiology. Vascular system ; Coronary Disease - physiopathology ; Coronary heart disease ; Electrocardiography ; Exercise Test - methods ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Male ; Medical sciences ; Middle Aged</subject><ispartof>Journal of the American College of Cardiology, 1988-02, Vol.11 (2), p.330-337</ispartof><rights>1988</rights><rights>1988 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-463cdd73c2a14a486a71118132761d781ec68565f1e61e9e05ac34a435ffa8513</citedby><cites>FETCH-LOGICAL-c386t-463cdd73c2a14a486a71118132761d781ec68565f1e61e9e05ac34a435ffa8513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0735-1097(88)90098-8$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=7558019$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3339171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wetherbee, Jule N.</creatorcontrib><creatorcontrib>Bamrah, Virinderjit S.</creatorcontrib><creatorcontrib>Ptacin, Michael J.</creatorcontrib><creatorcontrib>Kalbfleisch, John H.</creatorcontrib><title>Comparison of ST segment depression in upright treadmill and supine bicycle exercise testing</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description><![CDATA[Significant differences in the hemodynamic response to upright and supine exercise have been reported in patients with coronary artery disease. The purpose of the present study was to compare the degree of myocardial ischemia as assessed by ST segment depression during upright treadmill and supine bicycle exercise in 98 patients with coronary artery disease and in 34 patients with normal coronary arteries. The amount of ST segment depression at maximal exercise in patients with coronary artery disease was 0.90 ± 0.80 mm for treadmill and 1.34 ± 1.09 mm for supine bicycle (p < 0.001). The amount of ST segment depression during treadmill and supine bicycle exercise tests was also compared at highest similar heart rates (0.68 ± 0.77 versus 1.17 ± 1.01, p < 0.001), at highest similar rate-pressure products (0.71 ± 0.77 versus 1.08 ± 1.04, p < 0.001), at highest similar metabolic equivalents of oxygen consumption (MET) levels (0.69 ± 0.75 versus 1.20 ± 1.05 mm, p < 0.001) and at the onset of angina (0.84 ± 0.73 versus 1.18 ± 0.88 mm, p < 0.001). The rate-pressure product achieved at maximal exercise was similar in both tests (18.74 ± 5.80 × 103versus 18.81 ± 5.17 × 103, p = NS). The occurrence of angina during treadmill and supine bicycle exercise tests was similar (47 of 98 versus 48 of 98, respectively, p = NS). For the detection of coronary artery disease, the sensitivity was 50.0% for treadmill and 63.3% for supine bicycle (p < 0.05) and the specificity was 73.5 versus 70.6%, respectively (p = NS).
Thus, the degree of ST segment depression in patients with coronary artery disease is significantly greater during supine bicycle exercise than during upright treadmill testing at the onset of angina, at similar rate-pressure products, at similar heart rates, at similar MET levels and at maximal exercise. Supine bicycle exercise electrocardiography is significantly more sensitive, yet equally specific for the dejection of coronary artery disease when compared with upright treadmill exercise electrocardiography.]]></description><subject>Aged</subject><subject>Angina Pectoris - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Disease - physiopathology</subject><subject>Coronary heart disease</subject><subject>Electrocardiography</subject><subject>Exercise Test - methods</subject><subject>Heart</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo67j6DxRyENFDa2ozSSoXQQa_YMGD600I2aR6jHSn26Rb3H9vxhnm6CmH96mq1FOMPQXxGgToN8JI1YGw5iXiKyuExQ7vsQ0ohZ1U1txnmzPykD2q9acQQiPYC3YhpbRgYMO-76Zx9iXVKfOp519veKX9SHnhkeZCtaYWpMzXuaT9j4UvhXwc0zBwnyOv65wy8dsU7sJAnP5QCakSX6guKe8fswe9Hyo9Ob2X7NuH9ze7T931l4-fd--uuyBRL91WyxCjkeHKw9ZvUXsDAAjyymiIBoGCRqVVD6SBLAnlg2ygVH3vUYG8ZC-Ofecy_VrbbDemGmgYfKZprc6gsBpQNnB7BEOZai3Uu7bW6MudA-EOUt3BmDsYc4jun1SHrezZqf96O1I8F50stvz5Kfc1-KEvPjcNZ8y0iwiwDXt7xKi5-J2ouBoS5UAxFQqLi1P6_z_-AjUmkwQ</recordid><startdate>19880201</startdate><enddate>19880201</enddate><creator>Wetherbee, Jule N.</creator><creator>Bamrah, Virinderjit S.</creator><creator>Ptacin, Michael J.</creator><creator>Kalbfleisch, John H.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19880201</creationdate><title>Comparison of ST segment depression in upright treadmill and supine bicycle exercise testing</title><author>Wetherbee, Jule N. ; Bamrah, Virinderjit S. ; Ptacin, Michael J. ; Kalbfleisch, John H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-463cdd73c2a14a486a71118132761d781ec68565f1e61e9e05ac34a435ffa8513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1988</creationdate><topic>Aged</topic><topic>Angina Pectoris - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Disease - physiopathology</topic><topic>Coronary heart disease</topic><topic>Electrocardiography</topic><topic>Exercise Test - methods</topic><topic>Heart</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wetherbee, Jule N.</creatorcontrib><creatorcontrib>Bamrah, Virinderjit S.</creatorcontrib><creatorcontrib>Ptacin, Michael J.</creatorcontrib><creatorcontrib>Kalbfleisch, John H.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wetherbee, Jule N.</au><au>Bamrah, Virinderjit S.</au><au>Ptacin, Michael J.</au><au>Kalbfleisch, John H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of ST segment depression in upright treadmill and supine bicycle exercise testing</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1988-02-01</date><risdate>1988</risdate><volume>11</volume><issue>2</issue><spage>330</spage><epage>337</epage><pages>330-337</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract><![CDATA[Significant differences in the hemodynamic response to upright and supine exercise have been reported in patients with coronary artery disease. The purpose of the present study was to compare the degree of myocardial ischemia as assessed by ST segment depression during upright treadmill and supine bicycle exercise in 98 patients with coronary artery disease and in 34 patients with normal coronary arteries. The amount of ST segment depression at maximal exercise in patients with coronary artery disease was 0.90 ± 0.80 mm for treadmill and 1.34 ± 1.09 mm for supine bicycle (p < 0.001). The amount of ST segment depression during treadmill and supine bicycle exercise tests was also compared at highest similar heart rates (0.68 ± 0.77 versus 1.17 ± 1.01, p < 0.001), at highest similar rate-pressure products (0.71 ± 0.77 versus 1.08 ± 1.04, p < 0.001), at highest similar metabolic equivalents of oxygen consumption (MET) levels (0.69 ± 0.75 versus 1.20 ± 1.05 mm, p < 0.001) and at the onset of angina (0.84 ± 0.73 versus 1.18 ± 0.88 mm, p < 0.001). The rate-pressure product achieved at maximal exercise was similar in both tests (18.74 ± 5.80 × 103versus 18.81 ± 5.17 × 103, p = NS). The occurrence of angina during treadmill and supine bicycle exercise tests was similar (47 of 98 versus 48 of 98, respectively, p = NS). For the detection of coronary artery disease, the sensitivity was 50.0% for treadmill and 63.3% for supine bicycle (p < 0.05) and the specificity was 73.5 versus 70.6%, respectively (p = NS).
Thus, the degree of ST segment depression in patients with coronary artery disease is significantly greater during supine bicycle exercise than during upright treadmill testing at the onset of angina, at similar rate-pressure products, at similar heart rates, at similar MET levels and at maximal exercise. Supine bicycle exercise electrocardiography is significantly more sensitive, yet equally specific for the dejection of coronary artery disease when compared with upright treadmill exercise electrocardiography.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>3339171</pmid><doi>10.1016/0735-1097(88)90098-8</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Angina Pectoris - physiopathology Biological and medical sciences Blood Pressure Cardiology. Vascular system Coronary Disease - physiopathology Coronary heart disease Electrocardiography Exercise Test - methods Heart Heart Rate Hemodynamics Humans Male Medical sciences Middle Aged |
| title | Comparison of ST segment depression in upright treadmill and supine bicycle exercise testing |
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