What question did this study set out to answer?

To evaluate how different exercise workload protocols influence exercise capacity and the triple product at the onset of angina during therapeutic assessments.

May 1, 1971CirculationOpen Access

Importance of the Design of an Exercise Protocol in the Evaluation of Patients with Angina Pectoris

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Why the study?

Does the design of an exercise protocol (high initial workload vs standard progressive workload) affect the evaluation of exercise capacity and physiological parameters in patients with angina pectoris?

Key Points

To evaluate how different exercise workload protocols influence exercise capacity and the triple product at the onset of angina during therapeutic assessments.
Assessed 12 patients with angina during upright bicycle exercise under a standard protocol (20-W increments every 3 minutes) versus an abrupt high-workload protocol (20–60 W above the standard anginal threshold).
Measured exercise capacity and the triple product (heart rate × systolic pressure × ejection time) at the onset of angina with and without nitroglycerin (TNG) and carotid sinus nerve stimulation (CSNS).
Starting exercise 20 to 60 W above the standard anginal threshold reduced exercise duration (average 1'40'' vs 4'40'', P < 0.001) and elevated the triple product at angina (average 4,840 vs 4,150, P < 0.001).
Nitroglycerin and carotid sinus nerve stimulation enhanced exercise duration under the standard progressive protocol without changing the anginal triple product, but had minimal effect during excessive initial workloads.

Structured PICO

Population

12 patients with angina pectoris

Intervention

High initial workload exercise protocol (starting 20 to 60 w above the work load of the standard protocol that produced angina), with or without nitroglycerin (TNG) or carotid sinus nerve stimulation (CSNS)

Comparator

Standard progressive exercise protocol (20-w increments every three minutes)

Outcome

Exercise capacity (duration) and triple product (TP) of heart rate, systolic pressure, and ejection time at anginasurrogate

Exercise protocols that induce angina in less than three minutes can mask the beneficial effects of therapeutic interventions, indicating that progressive workloads causing angina in three to six minutes are required for reliable evaluation.

Discussion

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Implication

Protocols inducing angina in <3 min may mask therapeutic effects; supports standardized 3-6 min progressive workloads for reliable testing.

Cite This Study

Redwood et al. (1971) studied this question.

synapsesocial.com/papers/6a1c91c34defe5c851c3ecc6 https://doi.org/10.1161/01.cir.43.5.618

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Implication

Protocols inducing angina in <3 min may mask therapeutic effects; supports standardized 3-6 min progressive workloads for reliable testing.

Importance of the Design of an Exercise Protocol in the Evaluation of Patients with Angina Pectoris

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Importance of the Design of an Exercise Protocol in the Evaluation of Patients with Angina Pectoris

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider