title: Exercise-induced myocardial ischemia detected by cardiopulmonary exercise testing.
abstract: Cardiopulmonary exercise testing (CPET) is a well-accepted physiologic evaluation technique in patients diagnosed with heart failure and in patients presenting with unexplained dyspnea on exertion. Several variables obtained during CPET, including oxygen consumption relative to heart rate and work rate provide consistent, quantitative patterns of abnormal physiologic responses to graded exercise when left ventricular dysfunction is caused by myocardial ischemia. This concept report describes both the methodology and clinical application of CPET associated with myocardial ischemia. Initial evidence indicates left ventricular dysfunction induced by myocardial ischemia may be accurately detected by an abnormal CPET response. CPET testing may complement current noninvasive testing modalities that elicit inducible ischemia. It provides a physiologic quantification of the work rate, heart rate, and O(2) uptake at which myocardial ischemia develops. In conclusion, adding CPET with gas exchange measurements is likely to be of value in diagnosing and quantifying both overt and occult myocardial ischemia and its reversibility with treatment.
authors.affiliation: Research and Development Department, Met-test, Inc, Atlanta, Georgia, USA. schaudhry@mettest.net
authors.forename: Sundeep
authors.initials: S
authors.lastname: Chaudhry
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.forename: Karlman
authors.initials: K
authors.lastname: Wasserman
authors.forename: James E
authors.initials: JE
authors.lastname: Hansen
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Lewis
authors.forename: Jonathan
authors.initials: J
authors.lastname: Myers
authors.forename: Nicolas
authors.initials: N
authors.lastname: Chronos
authors.forename: William E
authors.initials: WE
authors.lastname: Boden
mesh_terms: D000368:Aged; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis*; D010101:Oxygen Consumption; D011659:Pulmonary Gas Exchange; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis