American College of Cardiology/American Heart Association Clinical Competence Statement on Stress Testing

Ayanian, John Z.; Balady, Gary J.; Beasley, John W.; Brown, Kenneth A.; Gervino, Ernest V.; Paridon, Stephen M.; Quiñones, Miguel Á.; Schlant, Robert C.; Winters, William L.; Achord, James L.; Boone, Alan W.; Hirshfeld, John W.; Lorell, Beverly H.; Rodgers, George P.; Tracy, Cynthia M.; Weitz, Howard H.

doi:10.1161/01.cir.102.14.1726

Cited by 83 publications

(42 citation statements)

References 29 publications

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“…5,6 In adults the risk of 1 myocardial infarction or death per 2500 exercise tests has been reported. 7 Because ischaemic heart disease is rare in children with CHD, the risk in children is lower than in adults. 6 Several absolute and relative contraindications can be distinguished for performing CPET (table 1).…”

Section: Contraindications For Exercise Testingmentioning

confidence: 99%

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Takken¹,

Blank²,

Hulzebos³

et al. 2009

NHJL

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Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are rare in children. The main indications for CPET in children are evaluation of exercise capacity and the identification of exercise-induced arrhythmias. In this article we will review the main indications for CPET in children with congenital heart disease, the contraindications for exercise testing and the indications for terminating an exercise test. Moreover, we will address the interpretation of gas exchange data from CPET in children with congenital heart disease. (Neth Heart J 2009;17:385-92.)

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Section: Contraindications For Exercise Testingmentioning

confidence: 99%

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Takken¹,

Blank²,

Hulzebos³

et al. 2009

NHJL

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“…12,13 Some patients experience a rapid heart rate (HR) response following dobutamine administration, while others require maximum dobutamine infusion doses or addition of atropine to reach their target HR. 14 In addition, some patients experience marked hypertension or hypotension during the DSE protocol that limits the ability to complete the test and achieve target HR.…”

Section: Introductionmentioning

confidence: 99%

β-Adrenergic receptor gene polymorphisms and hemodynamic response to dobutamine during dobutamine stress echocardiography

et al. 2008

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Our objective was to determine if b 1 -adrenergic receptor (b 1 -AR) and b 2 -AR gene polymorphisms influence heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) response to dobutamine during dobutamine stress echocardiography (DSE). Patients (n ¼ 163) undergoing clinically indicated DSE were enrolled. Dobutamine doses were titrated from 5 to 40 mg kg À1 min À1 at 3 min intervals and HR, SBP and DBP were measured. Genotypes were determined for b 1 -AR Ser49Gly, b 1 -AR Arg389-Gly, b 2 -AR Arg16Gly and b 2 -AR Gln27Glu polymorphisms by polymerase chain reaction-restriction fragment length polymorphism analysis, pyrosequencing and single primer extension methods. b 2 -AR Glu27 homozygotes had a greater HR response at the highest dobutamine dose than Gln27 carriers (P ¼ 0.002). b 2 -AR Gly16 homozygotes had a lower HR response during 5-30 mg kg À1 min À1 of the dobutamine infusion protocol compared to Arg16 carriers (P ¼ 0.03). Differences in SBP by b 2 -AR codon 16 genotype and DBP by b 1 -AR codon 389 genotype were found at baseline and were maintained throughout DSE (P ¼ 0.06 and 0.02, respectively). However, the magnitude of SBP and DBP response to dobutamine did not differ significantly by b 2 -AR codon 16 or b 1 -AR codon 389 genotypes, respectively. These data suggest that the four selected b 1 -and b 2 -AR polymorphisms do not substantially influence the magnitude of hemodynamic response to dobutamine during DSE.

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“…Recognition and treatment of life threatening arrhythmias is particularly relevant with dobutamine stress echocardiography. This writing group has decided to adopt the recommendations made by Rodgers et al 12 which are summarized in this section.…”

Section: Minimum Knowledge Requirements For Performance and Interpretmentioning

confidence: 99%

“…Modified from Rodgers et al 12 Thus, intensive training in echocardiography with a minimum of Level 2 training or equivalent is a prerequisite for acquiring the skills necessary to perform and interpret stress echocardiography studies. 13 Training Requirements (Table 15) Specific recommendations for training in stress echocardiography have been published recently [12][13][14] and consist of achieving Level 2 training in echocardiography plus a minimum of 100 stress studies performed under the supervision of an echocardiographer with Level 3 training and expertise in stress echocardiography, including the independent interpretation of more than 200 stress echocardiograms, and maintenance of skills as outlined Table 16.…”

Section: Image Interpretationmentioning

confidence: 99%

American College of Cardiology/American Heart Association Clinical Competence Statement on Echocardiography

et al. 2003

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American College of Cardiology/American Heart Association Clinical Competence Statement on Stress Testing

Cited by 83 publications

References 29 publications

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

β-Adrenergic receptor gene polymorphisms and hemodynamic response to dobutamine during dobutamine stress echocardiography

American College of Cardiology/American Heart Association Clinical Competence Statement on Echocardiography

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