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      Relationships between Anaerobic Threshold and Exercise Hemodynamic Pattern in Patients with Previous Myocardial Infarction

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          Abstract

          In 78 male class I and II NYHA patients with previous myocardial infarction, the relationships between ventilatory anaerobic threshold levels and hemodynamic patterns during a maximal symptom-limited stress test in the supine position were studied. Among the 36 patients with abnormal exercise wedge values, 11 showed an anaerobic threshold (AT) < 35% of the maximal predicted VO<sub>2</sub>(mpVO<sub>2</sub>) (group A) and 23 showed an AT of 36–50% mpVO<sub>2</sub> (group B). In 2 patients, the AT was > 50% mpVO<sub>2</sub>- Among the 42 patients with normal exercise wedge pressure, 13 showed an AT of 36–50% mpVO<sub>2</sub> (group C), whereas in 29 patients, the AT was > 50% mpVO<sub>2</sub> (group D). The mean value of AT in group A was significantly lower than in group B (8.6 ± 0.7 vs. 11.7 ± 0.5 ml/kg·min; p < 0.05). No difference was found in the mean of the AT between groups B and C, while the mean value of AT in group D was significantly higher than in group C (16.9 ± 0.4 vs. 12.9 ± 0.6 ml/kg·min; p < 0.005). No significant differences between groups C and D were found in the invasive and noninvasive parameters considered. Groups C and D were statistically different from groups A and B for pulmonary capillary pressures, total pulmonary resistances, stroke indexes, heart rates, arteriovenous O<sub>2</sub> differences, total systemic resistances and lactate concentrations. Total pulmonary resistances and heart rates were statistically higher and stroke indexes were statistically lower in group A than in group B. In conclusion: (1) patients with normal exercise wedge values show a higher AT than patients with abnormal exercise wedge values. (2) Patients with normal exercise hemodynamic patterns classified according to their AT show no difference in hemodynamics; in these patients the level of AT seems to be related to peripheral determinants. (3) Patients with abnormal exercise hemodynamic patterns classified according to their AT level show different hemodynamics and different responses in ventricular function; in these patients the level of AT seems to be related to the cardiac impairment.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1988
          1988
          11 November 2008
          : 75
          : 1
          : 32-44
          Affiliations
          aFondazione Clinica del Lavoro di Pavia, Istituto di Ricovero e Cura a Carattere Scientifico, Centro Medico di Montescano, Divisione di Cardiologia, Pavia, e bCattedra di Semeiotica Cardiovascolare, Università di Pavia, Italia
          Article
          174347 Cardiology 1988;75:32–44
          10.1159/000174347
          3342423
          © 1988 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 13
          Categories
          Original Paper

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