Clinical InvestigationAcute Ischemic Heart DiseaseArm exercise testing predicts clinical outcome
Section snippets
Patient characteristics
A total of 359 consecutive patients, referred for cardiac stress tests for clinical reasons but unable or unwilling to perform treadmill exercise because of lower extremity disabilities, were included in this analysis. These individuals performed arm ergometer stress tests (52% also underwent nuclear imaging) at the St. Louis Veterans Administration Medical Center (STL-VAMC) between November 1997 and November 2002.
No patients who completed the exercise protocol were excluded, but those
Results
The indications for arm ergometer stress testing were investigation of chest pain syndromes in 55% of patients, preoperative evaluations (25%), determination of functional capacity as part of employment capability, insurance or disability claims or development of a nontraditional exercise prescription for nonambulatory patients (9%), investigation of dyspnea (7%), assessment for coronary artery disease in individuals with coronary risk factors (3%), and evaluation of heart failure, syncope,
Discussion
Arm exercise stress testing has been reported in a few small investigations to have similar utility to treadmill or leg cycle ergometer exercise for detection of cardiac ischemia and anatomic evidence of coronary artery disease.11, 12, 13, 14, 15, 16 We are aware of only one other investigation of arm exercise for prognostication of survival. That study was conducted in apparently healthy subjects who underwent muscle power output evaluations rather than stress testing for clinical reasons.27
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Cited by (0)
Doctor Ilias, who is currently affiliated with the Division of Cardiology of the University of Texas Medical Center at Houston, was supported by an American Medical Association Foundation Seed Grant Research Award for 2007 (Chicago, IL) and by a Washington University Mentors in Medicine research award for 2007 (Washington University, St. Louis, MO). Doctor Xian was supported by National Institutes of Health grants RO1 DA020810, RO1 AG022381-03, and RO1 AG022982-01 (Washington, DC). Ms Inman and Dr Martin were supported by a Merit Review grant from the Veterans Administration (Washington, DC).