Circulation, Vol 82, 1839-1846, Copyright © 1990 by American Heart Association
J Myers and VF Froelicher
Exercise trials in cardiology are often hindered by inconsistent approaches
to exercise testing. These inconsistencies include the choice of exercise
protocol, exercise end points, points of analysis, and absence or misuse of
gas exchange data. Gas exchange techniques greatly enhance the accuracy
with which cardiopulmonary function is assessed by exercise. Commonly used
protocols are not always appropriate for all patients or all studies. Both
cardiovascular disease and the exercise protocol can have an important
impact on the relation between changes in work rate and oxygen uptake. Ramp
protocols appear to offer the greatest promise for assessing
cardiopulmonary function. Analyzing hemodynamic and gas exchange responses
at several points submaximally, in addition to those at peak exercise, can
add important information concerning the efficacy of a drug. A great deal
of confusion continues to hinder the application of the gas exchange
anaerobic threshold, and many of the commonly used testing end points are
not reliable.
ARTICLES
Optimizing the exercise test for pharmacological investigations
Cardiology Section, Long Beach Veterans Administration Medical Center, California 90822.
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