Effects of the limiting symptom on the achievement of maximal oxygen consumption in patients with coronary artery disease

Patterns of Oxygen Consumption during Exercise Testing in Peripheral Vascular Disease

“…Because the pro tocol results in changes in work load, every 3 min the influence of time in the final stage and the presence of a plateau was examined and no effect was found [2], In the present study the normal subjects were younger than the patients with peripheral vascular disease and this contributed to the difference in peak oxygen consumption. A prior study of cardiac patients who were of similar age to the patients with peripheral vascular disease indicated that 80% of these older cardiac patients achieved a plateau [2], Age did not effect the presence of a plateau [2], It is of interest to contrast the responses of patients limited by angina [2] to those limited by claudication. Eighty percent of the anginalimited subjects achieved a plateau, and it was concluded that they did in fact reach the limits of their cardiovascular system.…”

“…The traditional methodology has employed an interrupted treadmill pro tocol with speed held constant and incre ments in the grade made to determine when oxygen consumption fails to increase by > 2.1 ml/kg/min with the next work load [8], In clinical practice, most treadmill protocols arc continuous and new criteria for the pres ence of a plateau were described [2], Using these criteria a minority (27%) of subjects with peripheral vascular disease were able to reach a plateau. In contrast, 77% of normal subjects reached a plateau.…”

“…The presence of a plateau was defined as a difference of < 3.0 ml/kg/min for normal men, < 2 .5 ml/kg/min for nor mal women and < 2 .0 ml/kg/min for patients with peripheral vascular disease, between the final oxygen consumption and that collected 90 s prior to the end of exercise [2]. Different criteria for the groups were used because of the previously documented differ ences in the relationship between time and oxygen consumption in normal men and women and subjects with cardiac disease [2][3][4][5].…”

“…The purpose of this study was to document the pattern of oxygen consumption during exercise in subjects who terminated exercise because of claudication. The pattern of oxygen consumption over the final 90 s of exercise was reported for normal subjects and patients with coronary artery disease [2], We wished to objectively con firm that patients with peripheral vascular disease were unable to reach the limits of their cardiovascular system because of se vere claudication and compare the pattern of oxygen consumption to normal subjects.…”

Effects of long-term enalapril therapy on cardiopulmonary exercise performance after myocardial infarction.

“…13 Assessment of cardiac reserve in patients with mild left ventricular dysfunction may be accomplished by evaluating performance during peak exercise.14 '15 Cardiopulmonary exercise testing permits objective determination of peak oxygen consumption (Vo2) 16,17 and the Vo2 at the anaerobic threshold.18 This technique provides a sensitive tool for evaluating the effect of therapeutic intervention. '9 Therapy with inotropes,20 vasodilators,21 and exercise training pro-grams22 have demonstrated improvement in peak and submaximal exercise parameters in patients with symptomatic heart failure.…”