title: Association of physical fitness and transient myocardial ischemia in patients with coronary artery disease.
abstract: OBJECTIVE
  To examine the relationship between physical fitness and transient myocardial ischemia (TMI) in the laboratory and during daily life, in a sample of coronary patients with a recent positive exercise test.
  
  
  METHODS
  47 patients with coronary disease (CAD) participated in laboratory mental and exercise stress testing and 48-hour outpatient Holter monitoring after being withdrawn from ant-ischemic medications. During laboratory testing, left ventricular performance was assessed by radionuclide ventriculography. Physical fitness was assessed by measurement of oxygen consumption during symptom-limited exercise treadmill testing.
  
  
  RESULTS
  Higher physical fitness subjects were less likely to exhibit wall-motion abnormalities in response to mental stress (P < .05), and to exercise stress (P < .05) testing. They also had smaller decreases in left ventricular ejection fraction (LVEF) in response to mental stress than less fit subjects (P .056), and exhibited a mean increase in LVEF during exercise, compared to the less fit subjects who exhibited a decrease in LVEF (P < .02). Moreover, higher fit subjects exhibited fewer episodes of TMI (P < .04), for a shorter duration (P < .04), and less total ischemic burden (P < .04) during Holter monitoring.
  
  
  CONCLUSIONS
  These findings suggest that within a population of CAD patients, higher levels of physical fitness are associated with less TMI assessed in the laboratory and during routine activities of daily living.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 22710, USA.
authors.forename: W
authors.initials: W
authors.lastname: Jiang
authors.forename: M A
authors.initials: MA
authors.lastname: Trauner
authors.forename: R E
authors.initials: RE
authors.lastname: Coleman
authors.forename: R A
authors.initials: RA
authors.lastname: Waugh
authors.forename: M W
authors.initials: MW
authors.lastname: Hanson
authors.forename: D J
authors.initials: DJ
authors.lastname: Frid
authors.forename: B G
authors.initials: BG
authors.lastname: Phillips
authors.forename: J J
authors.initials: JJ
authors.lastname: Morris
authors.forename: C
authors.initials: C
authors.lastname: O'Connor
authors.forename: J A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000517:prevention & control*; D010101:Oxygen Consumption; D010809:Physical Fitness; D012008:Recurrence; D013318:Stroke Volume; D016277:Ventricular Function, Left