Exercise Testing in Asymptomatic Adults

Abstract

Abstract-Along with coronary artery calcium scanning, ankle-brachial index measurement, and carotid artery ultrasound, exercise electrocardiography has been proposed as a screening tool for asymptomatic subjects thought to be at intermediate risk for developing clinical coronary disease. A wealth of data indicate that exercise testing can be used to assess and refine prognosis, particularly when emphasis is placed on nonelectrocardiographic measures such as exercise capacity, chronotropic response, heart rate recovery, and ventricular ectopy. Nevertheless, randomized trial data on the clinical value of screening exercise testing are absent; that is, it is not known whether a strategy of routine screening exercise testing in selected subjects reduces the risk for premature mortality or major cardiac morbidity. The writing group believes that a large-scale randomized trial of such a strategy should be performed.

Consumo de oxigênio de pico em idosas: comparação entre valores medidos e previstos

“…Se for feita a classificação com base nos valores médios medidos e estimados através das duas equações, de acordo com a proposta da American Heart Association (LAUER et al, 2005), seria observado que tanto os valores medidos como os estimados por meio da equação de Foster et al (1996) Com o aumento da população idosa e advento dos protocolos em rampa na ergometria, fica clara a necessidade de estudos que validem uma estimativa adequada do VO 2pico (HUGGET et al, 2005). Nessa direção, a correlação observada entre os valores medidos com velocidade e inclinação atingida no momento da exaustão, bem como com a idade das voluntárias, indicam que tais variáveis deveriam ser consideradas na predição da capacidade individual, em acordo com as recomendações de Peterson et al (2003).…”

“…Esse declínio tem sido relatado mesmo em idosos que continuam engajados em programas de treinamento de endurance intenso e regular. A identificação do VO 2pico é justificada pelo fato de que valores baixos estão associados à maior incidência de doenças cardiovasculares (BLAIR et al, 1995;LAUER et al, 2005). Adicionalmente, o nível de condicionamento aeróbio é considerado para prescrição de intensidades em programas de exercícios físicos.…”

Diving Medicine: A Review of Current Evidence

“…24 Routine screening would not be advised for young, low-risk divers because of the low positive predictive value of exercise stress testing in these individuals. 25 Fitness to dive is optimal when a diver can reach a maximum capacity of 13 metabolic equivalents (METS) or stage 4 of the Bruce protocol. This peak capacity allows a diver to exercise comfortably at 8 to 9 METS.…”

Are We Getting Nearer to Screening for Atherosclerosis?

“…24 Despite agreeing with the prognostic capability of such screening in asymptomatic adults for risk assessment, especially if non-ECG parameters such as functional capacity, chronotropic response, heart rate recovery, and ventricular ectopy also are evaluated, these statements fall short of recommending it as a screening technique because results fail to demonstrate an improvement in long-term outcomes. The 2005 statement includes the suggestion that given the strong evidence linking exercise test findings to risk in asymptomatic subjects, priority should be given to implementing a large-scale randomized trial and including not only the clinical value but also the cost-effectiveness.…”