Exercise may cause myocardial ischemia at the anaerobic threshold in cardiac rehabilitation programs

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dc.contributor.authorFuchs, Angela Rúbia Cavalcanti Neves [UNIFESP]
dc.contributor.authorMeneghelo, Romeu Sergio
dc.contributor.authorStefanini, Edson [UNIFESP]
dc.contributor.authorDe Paola, Angelo Amato Vincenzo [UNIFESP]
dc.contributor.authorSmanio, Paola Emanuela Poggio
dc.contributor.authorMastrocolla, Luiz Eduardo
dc.contributor.authorFerraz, Almir Sergio
dc.contributor.authorBuglia, Susimeire
dc.contributor.authorPiegas, Leopoldo Soares
dc.contributor.authorCarvalho, Antonio Carlos [UNIFESP]
dc.contributor.institutionInstituto Dante Pazzanese de Cardiologia Serviço de Reabilitação Cardiovascular
dc.contributor.institutionInstituto Dante Pazzanese de Cardiologia Seção Médica de Medicina Nuclear
dc.contributor.institutionInstituto Dante Pazzanese de Cardiologia Departamento de Saúde
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2015-06-14T13:39:06Z
dc.date.available2015-06-14T13:39:06Z
dc.date.issued2009-03-01
dc.description.abstractMyocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference ≥2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.en
dc.description.affiliationInstituto Dante Pazzanese de Cardiologia Serviço de Reabilitação Cardiovascular
dc.description.affiliationInstituto Dante Pazzanese de Cardiologia Seção Médica de Medicina Nuclear
dc.description.affiliationInstituto Dante Pazzanese de Cardiologia Departamento de Saúde
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Cardiologia
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina
dc.description.affiliationUnifespUNIFESP, EPM, Depto. de Cardiologia
dc.description.affiliationUnifespUNIFESP, EPM, Depto. de Medicina
dc.description.sourceSciELO
dc.format.extent272-278
dc.identifierhttp://dx.doi.org/10.1590/S0100-879X2009000300008
dc.identifier.citationBrazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 42, n. 3, p. 272-278, 2009.
dc.identifier.doi10.1590/S0100-879X2009000300008
dc.identifier.fileS0100-879X2009000300008.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2009000300008
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/4918
dc.identifier.wosWOS:000264200100008
dc.language.isoeng
dc.publisherAssociação Brasileira de Divulgação Científica
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectExercise testen
dc.subjectAnaerobic thresholden
dc.subjectMyocardial ischemiaen
dc.subjectCoronary artery diseaseen
dc.subjectTechnetiumen
dc.subject99mTc-sestamibien
dc.titleExercise may cause myocardial ischemia at the anaerobic threshold in cardiac rehabilitation programsen
dc.typeinfo:eu-repo/semantics/article
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