Use of bicycle ergometry and sustained handgrip exercise in the diagnosis of presence and extent of coronary heart disease.

Helfant, Richard H.; Banka, Vidya S.; Devilla, Maria A.; Pine, Rogelio; Kabde, Venkat; Meister, Steven G.

doi:10.1136/hrt.35.12.1321

Cited by 39 publications

(3 citation statements)

References 12 publications

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“…We screened 6,055 records finding 126 potentially relevant records (Figure 1). Upon additional review of full‐text articles, 34 studies with 3,352 participants were included in the systematic review (20–53). Studies excluded at the second stage are listed in the reference list (54–124).…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies

Banerjee

Newman

Bruel

et al. 2012

International Journal of Clinical Practice

117

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The diagnostic accuracy of exercise testing varies, depending upon the age, gender and clinical characteristics of the patient, prevalence of CAD and modality of test used. Exercise testing, whether by echocardiography or ECG, is more useful at excluding CAD than confirming it. Clinicians have concentrated on individualising the treatment of CAD, but there is great scope for individualising the diagnosis of CAD using exercise testing.

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Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies

Banerjee

Newman

Bruel

et al. 2012

International Journal of Clinical Practice

117

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“…Since catecholamines are arrhythmogenic and increase myocardial oxygen requirements [6], the findings that isometric exercise rarely pro duces angina or arrhythmias in patients with ischaemic heart disease [9,10,14] suggests that there is no marked increase in coronary cate cholamines during isometric exercise. This is supported by the findings in our present study where there was no change in catecholamine concentra tions, and a fall in cAMP concentrations in the coronary sinus, in con trast to dynamic exercise where coronary sinus catecholamine concentra tions increased [24], Oxprenolol and atropine had no effect either on catecholamine concentrations even though oxprenolol can block cate cholamine uptake [7] and decrease its release [22], whilst atropine may increase catecholamine output during vagal stimulation [17].…”

Section: Discussionmentioning

confidence: 99%

“…Although vagal inhibition is the immediate response to iso metric exercise [8,23], there is also subsequent sympathetic stimulation [20], Isometric exercise produces angina less frequently than dynamic exercise during submaximal laboratory testing [9,10,14], but when an gina does occur during exercise with an isometric component [28], /?-blockade may be less effective at preventing angina than during dynamic exercise, as it has less effect on the determinants of myocardial oxygen consumption during isometric exercise [8,19,20] compared to dynamic exercise [2,4], To investigate how atropine and /9-blockade affect cate cholamine overflow and /1-receptor stimulation in the coronary circula tion during isometric exercise, we measured arterial and coronary sinus…”

mentioning

confidence: 99%

Effect of Submaximal Isometric Exercise on Catecholamine, cAMP and Lactate Concentrations in the Coronary Circulation of Man, Following Atropine and Oxprenolol

Robson¹,

Fluck²

1978

Cardiology

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The effects of atropine and oxprenolol on changes occurring in total catecholamine, cyclic AMP (cAMP) and lactate concentrations in arterial and coronary sinus blood, during submaximal isometric exercise, were studied in 10 patients. Static one-third-maximal handgrip exercsie, sustained for 5 minutes, did not produce an increase in either arterial or coronary sinus plasma catecholamine concentrations (measured at rest and during the last minute of exercise) and was not influenced by atropine and oxprenolol. Myocardial lactate production did not occur. Coronary sinus cAMP concentrations fell during isometric exercise from 11.53 ± 0.93 to 9.42 ± 0.81 nmol/l ( ± SEM), and following autonomic blockade from 12.46 ± 1.12 to 9.6 ± 0.87 nmol/l but rose on subsequent isometric exercise to 11.27 ± 0.8 nmol/l (p < 0.05). Although this latter increase could still be due to β-adrenergic stimulation, the absence of any change in catecholamine concentrations in the presence of β-blockade suggests that other factors may have been responsible.

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Evaluation of left ventricular performance in coronary heart disease: Use of isometric handgrip stress test

Helfant

Devilla

Banka

1976

Cathet. Cardiovasc. Diagn.

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The usefulness of isometric handgrip exercise in the assessment of left ventricular function was studied in 27 patients, all of whom had angiographically documented coronary artery disease. The effect of extensiveness of coronary disease and presence or absence of collaterals (both delineated by coronary arteriography) on the response to handgrip stress was also evaluated. Of 11 patients with a normal handgrip response, 4 exhibited a normal left ventriculogram and 7 were abnormal. Of these 7, 6 had inferior hypokinesis. Conversely, of 16 patients with an abnormal response to handgrip, 15 had abnormal ventriculograms. Of these, 9 had anterior akinesis. Of patients with a normal handgrip response 82% had two- or three-vessel coronary disease, and 94% with an abnormal response exhibited two- or three-vessel obstruction. There was no observed correlation between the presence or absence of collaterals and the response to handgrip. This study indicates that (1) handgrip stress, when combined with left ventriculography, often yields important additional information regarding the effect of localized contraction abnormalities on overall left ventricular performance; (2) the extent of coronary obstructive disease or the presence of collaterals per se do not appear to be the primary determinants of left ventricular performance; (3) it is possible that the location as well as severity and extent of left ventricular contraction abnormality may play an important role in determining overall left ventricular performance.

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Use of bicycle ergometry and sustained handgrip exercise in the diagnosis of presence and extent of coronary heart disease.

Cited by 39 publications

References 12 publications

Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies

Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies

Effect of Submaximal Isometric Exercise on Catecholamine, cAMP and Lactate Concentrations in the Coronary Circulation of Man, Following Atropine and Oxprenolol

Evaluation of left ventricular performance in coronary heart disease: Use of isometric handgrip stress test

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