Influence of Ocular Tropicamide on Exercise Testing

Abstract

This study was aimed to evaluate the effects of tropicamide 0.5% eye drops on cardiovascular parameters during exercise testing. The study group included 154 healthy subjects (mean age: 44.7 ± 8 years). The subjects were divided into three groups according to the size of the pupils at the onset of exercise: A: pupils not dilated (n = 27), B: pupils partially dilated (n = 90) and C: pupils widely dilated (n = 37). They were compared to 66 healthy controls (age 43.8 ± 8) who did not receive the drops. Rest and exercise parameters were affected in groups A and B, while the results of group C resembled those of the controls: (a) resting heart rate – 66.7, 66.6, 70.9 and 69.3, respectively (p = 0.03); (b) heart rate at 50 and 100 W- 104, 107, 110 and 111 (p = 0.01) and 131, 131, 137, 139, respectively (p = 0.01); and (c) peak systolic blood pressure – 192, 186, 183, 175; respectively (p = 0.004). Reanalyzing the data by scoring of visual impairment gave identical results. As a whole, the study group achieved higher work loads than the controls (126 vs. 119 W; p = 0.03). We conclude that the instillation of ocular tropicamide has definite effects on cardiovascular parameters, both at rest and during exercise. Mainly, patients showed a lower heart rate at the initial levels of exercise. However, at symptom-limited level, tropicamide does not influence a patient’s ability to achieve the target heart rate, and stress testing results are not altered by the drug.

Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint

“…In a Doppler echocardiography study of women before and whilst taking HRT, the use of oestrogencontaining HRT resulted in an alteration of haemodynamics causing, for example, a fall in impedence [38] and an increase in both stroke volume and flow acceleration [39]. The acute administration of sublingual oestradiol to postmenopausal women with CHD may also diminish cardiac ischaemia [40].…”

Evaluation of the pinhole pupillometer

“…Many methods can also be utilised to assess pupil function, the majority of which are objective. Static pupil evaluation by classi®cation into groups of `not dilated', `moderately dilated' and `widely dilated' (Pines et al, 1992) is generally regarded as too crude for present day investigations. The method of comparing the pupil diameter with circles of known diameters (Kussmaul, 1885) is occasionally used in clinical practice but a more accurate, and objective, method is believed to be direct measurement with a scale.…”