Comparison Between Treadmill and Bicycle Ergometer Exercises in Terms of Safety of Cardiopulmonary Exercise Testing in Patients With Coronary Heart Disease

Abstract

BackgroundCardiopulmonary exercise testing (CPET) is used widely in the diagnosis, exercise therapy, and prognosis evaluation of patients with coronary heart disease (CHD). The current guideline for CPET does not provide any specific recommendations for cardiovascular (CV) safety on exercise stimulation mode, including bicycle ergometer, treadmill, and total body workout equipment.ObjectiveThe aim of this study was to explore the effects of different exercise stimulation modes on the occurrence of safety events during CPET in patients with CHD.MethodsA total of 10,538 CPETs, including 5,674 performed using treadmill exercise and 4,864 performed using bicycle ergometer exercise at Peking University Third Hospital, were analyzed retrospectively. The incidences of CV events and serious adverse events during CPET were compared between the two exercise groups.ResultsCardiovascular events in enrolled patients occurred during 355 CPETs (3.4%), including 2 cases of adverse events (0.019%), both in the treadmill group. The incidences of overall events [235 (4.1%) vs. 120 (2.5%), P < 0.001], premature ventricular contractions (PVCs) [121 (2.1%) vs. 63 (1.3%), P = 0.001], angina pectoris [45 (0.8%) vs. 5 (0.1%), P < 0.001], and ventricular tachycardia (VT) [32 (0.6%) vs. 14 (0.3%), P = 0.032] were significantly higher in the treadmill group compared with the bicycle ergometer group. No significant difference was observed in the incidence of bradyarrhythmia and atrial arrhythmia between the two groups. Logistic regression analysis showed that the occurrence of overall CV events (P < 0.001), PVCs (P = 0.007), angina pectoris (P < 0.001), and VT (P = 0.008) was independently associated with the stimulation method of treadmill exercise. In male subjects, the occurrence of overall CV events, PVCs, angina pectoris, and VT were independently associated with treadmill exercise, while only the overall CV events and angina pectoris were independently associated with treadmill exercise in female subjects.ConclusionIn comparison with treadmill exercise, bicycle ergometer exercise appears to be a safer exercise stimulation mode for CPET in patients with CHD.

Prognostic value of peak work rate indexed by left ventricular diameter

“…with breathing gas analysis, cardiovascular magnetic resonance imaging/or echocardiography 2 , 6 . Given the strong relation between peak VO 2 and peak work rate (W peak ), cycle ergometer exercise testing could be used as a surrogate for CPET, offering a more widely available method for assessment of this relation 12 . No prior study has addressed the potential prognostic value of an abnormal relationship between W peak and LV size.…”

Treadmill has a more beneficial effect than cycling on fat loss through myokines secretion in obese women

“…Jürimäe et al (2022) also showed an increase in irisin levels after aerobic exercise using an ergocycle. The bicycle ergometer offers the advantages of a minor space requirement, less noise, convenient quantification of workload, less interference with the ECG, and avoidance of physical injury that may be caused by unstable standing (Ren et al, 2022). This results in differences in the frequency of muscle contractions during exercise.…”

Heart Rate Recovery: Up to Date in Heart Failure—A Literature Review

“…The reason for this is that initially, maximal exercise on a treadmill exerts more significant stress on the heart and lungs compared to bicycle ergometers. Research has shown that during exercise tests with a bicycle ergometer, untrained individuals often end the test due to fatigue in the quadriceps femoris muscles, resulting in an average 5-20% lower peak oxygen consumption (peak VO2) compared to treadmill exercise [46]. The study's population distribution is shown for example in the studies of Youn et al or Cozlac et al studies.…”