With the continued high prevalence of coronary artery disease in our country, the need for diagnostic testing for myocardial ischemia will continue to be a high priority. Many advances have been made in the field of diagnostic testing for myocardial ischemia, but the combination of graded exercise testing (GXT) with 12-lead electrocardiogram (with or without nuclear perfusion imaging or echocardiography) continues to be the initial noninvasive test most accepted in the medical field. However, it is imperative that the patient is able and willing to give a good physical effort to increase the sensitivity in detecting disease. In addition to using GXT for diagnostic purposes, the GXT is also beneficial in respect to determining long-term prognosis, assessing therapeutic interventions, and assessing one's functional capacity for the purpose of determining appropriate and safe exercise training.
Rosamond W., Flegal K., Friday G., et al. Heart disease and stroke statistics-2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-e171.
2.
Ogden CL, Carroll MD, McDowell MA, et al. Obesity among adults in the United States-no change since 2003-2004. NCHS Data Brief, US Department of Health and Human Services, CDC and Prevention National Center for Health Statistics, November 2007, No. 1.
3.
Chapman CBEdward Smith (? 1818-1874), physiologist, human ecologist, reformer. J Hist Med Allied Sci. 1967;22:1-26.
4.
Gibbons RJ, Balady GJ, Bricker J., et al. ACC/AHA 2002 guideline update for exercise testing: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). Circulation . 2002;106: 1883-1892.
5.
Kraus WE, Keteyian SJCardiac Rehabilitation. Totowa, NJ: Humana Press; 2007.
6.
Dewey FE, Kapoor JR, Williams RS, et al. Ventricular arrhythmias during clinical treadmill testing and prognosis. Arch Intern Med. 2008;168:225-234.
7.
National High Blood Pressure Education Program.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7). No. 03-5233. Washington, DC: National Heart Lung and Blood Institute ; 2003.
8.
Whaley MH, Brubaker PH, Otto RMACSM's Guidelines for Exercise Testing and Prescription. 7th ed. Philadelphia, PA: Lippincott Wiliams and Wilkins; 2006.
9.
Bruce RA, Fisher LD, Cooper MN, et al. Separation of effects of cardiovascular disease and age on ventricular function with maximal exercise. Am J Cardiol. 1974;34:757-763.
10.
Nishime EO, Cole CR, Blackstone EH, et al. Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA. 2000;284:1392-1398.
11.
Awad-Elkarim AA, Bagger JP, Albers CJ, et al. A prospective study of long term prognosis in young myocardial infarction survivors: the prognostic value of angiography and exercise testing. Heart. 2003;89:843-847.
12.
Goraya TY, Jacobsen SJ, Pellikka PA, et al. Prognostic value of treadmill exercise testing in elderly persons . Ann Intern Med. 2000;132:862-870.
13.
Wong Y., Rodwell A., Dawkins S., et al. Sex differences in investigation results and treatment in subjects referred for investigation of chest pain. Heart. 2001;85:149-152.
14.
Wong YK, Dawkins S., Grimes R., et al. Improving the positive predictive value of exercise testing in women. Heart. 2003;89:1416-1421.
15.
Babapulle MN , Diodati JG, Blankenship JC, et al. Utility of routine exercise treadmill testing early after percutaneous coronary intervention. BMC Cardiovasc Disord. 2007;7:12
16.
Abboud JH, Eisen I., Cohen A., Markiewicz W.Long-term value of exercise testing after acute myocardial infarction. Chest. 2000;117:556-561.
17.
Mark DB, Shaw L., Harrell FE, et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med. 1991;325:849-853.
18.
Kwok JM, Miller TD, Christian TF, et al. Prognostic value of a treadmill exercise score in symptomatic patients with nonspecific ST-T abnormalities on resting ECG. JAMA. 1999;282:1047-1053.
19.
Blair SN, Kohl HW III, Barlow CE, et al. Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men. JAMA. 1995;273:1093-1098.
20.
Vanhees L., Fagard R., Thijs L., et al. Prognostic significance of peak exercise capacity in patients with coronary artery disease. J Am Coll Cardiol. 1994;23: 358-363.
21.
Dorn J., Naughton J., Imamura D., et al. Results of a multi-center randomized clinical trial of exercise and long-term survival in myocardial infarction patients: the National Exercise and Heart Disease Project (NEHDP). Circulation. 1999;100: 1764-1769.
22.
Williams MAExercise testing in cardiac rehabilitation: exercise prescription and beyond . Cardiol Clin. 2001;19:415-431.
23.
Schoenborn CA, Barnes PMLeisure-time physical activity among adults: United States, 1997-98. Advance data from Viral and Health Statistics, No. 325. Hyattsville, MD: National Center for Health Statistics; 2002.
24.
Zoeller RF Jr.Prescribing physical activity for cardiovascular and metabolic health. Am J Lifestyle Med. 2007 ;1:99-102.
25.
Do D., West JA, Morise A., Atwood E., Frolicher V.A consensus approach to diagnosing coronary artery disease based on clinical and exercise test data. Chest. 1997;111:1742-1749.
