What is the accuracy and clinical value of exercise stress testing across different patient populations and clinical settings?
Exercise stress testing remains a valuable diagnostic tool, with newer parameters like heart rate recovery and functional capacity providing incremental prognostic and diagnostic value beyond conventional ECG changes.
Exercise stress testing is an important diagnostic tool for evaluating patient’s cardiovascular performance. The present review describes the accuracy and the value of exercise stress testing in different settings: after an acute coronary event, after percutaneous coronary intervention or coronary artery bypass graft; in patients risk assessment before non-cardiac surgery; in diabetic population; in patients with baseline electrocardiographic abnormalities. Moreover, this review provides insights relating to test accuracy in women and geriatric patients. Finally, this review explores new variables/parameters (dyspnea, chronotropic incompentence, heart rate recovery, functional capacity, integrated scores) that in the last few years added an incremental value to conventional analysis of exercise-induced angina or electrocardiographic changes.
Giallauria et al. (2011) studied this question.