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Novel insights into the pathophysiology of different forms of stress testing

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Novel insights into the pathophysiology of different forms of stress testing. / Hochgruber, Thomas; Reichlin, Tobias; Wasila, Mariusz; Vogler, Eliane; Twerenbold, Raphael; Sou, Seoung Mann; Roost, Kathrin; Lee, Gino; Fischer, Andreas; Freidank, Heike; Osswald, Stefan; Zellweger, Michael J; Mueller, Christian.

in: Clinical Biochemistry, Jahrgang 47, Nr. 6, 04.2014, S. 338-43.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Hochgruber, T, Reichlin, T, Wasila, M, Vogler, E, Twerenbold, R, Sou, SM, Roost, K, Lee, G, Fischer, A, Freidank, H, Osswald, S, Zellweger, MJ & Mueller, C 2014, 'Novel insights into the pathophysiology of different forms of stress testing', Clinical Biochemistry, Jg. 47, Nr. 6, S. 338-43. https://doi.org/10.1016/j.clinbiochem.2014.02.018

APA

Hochgruber, T., Reichlin, T., Wasila, M., Vogler, E., Twerenbold, R., Sou, S. M., Roost, K., Lee, G., Fischer, A., Freidank, H., Osswald, S., Zellweger, M. J., & Mueller, C. (2014). Novel insights into the pathophysiology of different forms of stress testing. Clinical Biochemistry, 47(6), 338-43. https://doi.org/10.1016/j.clinbiochem.2014.02.018

Vancouver

Hochgruber T, Reichlin T, Wasila M, Vogler E, Twerenbold R, Sou SM et al. Novel insights into the pathophysiology of different forms of stress testing. Clinical Biochemistry. 2014 Apr;47(6):338-43. https://doi.org/10.1016/j.clinbiochem.2014.02.018

Bibtex

@article{ce54fec35e804a4a9e1478c545b2cf73,
title = "Novel insights into the pathophysiology of different forms of stress testing",
abstract = "BACKGROUND: The impact of different forms of cardiac stress testing (exercise versus pharmacological stress testing) on cardiac wall stress and myocardial ischemia is incompletely understood.METHODS: In a prospective study, 331 consecutive patients with suspected myocardial ischemia referred for nuclear perfusion imaging were enrolled: 266 underwent exercise (bicycle) stress testing and 65 adenosine stress testing. Levels of B-type natriuretic peptide (BNP) measured before and 1 min after stress testing, ischemic ECG changes, and typical angina symptoms were used to compare the 2 testing modalities.RESULTS: Cardiac wall stress as quantified by changes in BNP levels significantly increased in the exercise stress group, but not in the adenosine group (increase in BNP levels 22 pg/ml (IQR 6-46) versus -3 pg/ml (IQR -3 to 28); p<0.001). In the bicycle exercise stress group, patients with reversible defects on nuclear perfusion imaging more often had angina symptoms (25% vs. 9%, p=0.0001) and ischemic ECG changes (33% vs. 12%, p=0.0001) during the stress test, and a greater increase in BNP levels (28 (IQR 11-58) versus 16 (IQR 3-34) pg/ml, p=0.001) compared to those without reversible defects. Those differences between patients with and without reversible defects were not observed with the adenosine protocol (p-values all >0.05).CONCLUSION: Exercise stress testing but not adenosine stress results in an increase of cardiac wall stress, angina symptoms and ECG changes. The absence of these surrogates of myocardial ischemia suggests that adenosine stress does not induce acute myocardial ischemia, but rather displays relative perfusion differences.",
keywords = "Aged, Angina Pectoris/blood, Electrocardiography, Exercise Test/methods, Female, Humans, Male, Middle Aged, Myocardial Ischemia/blood, Myocardium/pathology, Natriuretic Peptide, Brain/blood, Radionuclide Imaging, Ultrasonography",
author = "Thomas Hochgruber and Tobias Reichlin and Mariusz Wasila and Eliane Vogler and Raphael Twerenbold and Sou, {Seoung Mann} and Kathrin Roost and Gino Lee and Andreas Fischer and Heike Freidank and Stefan Osswald and Zellweger, {Michael J} and Christian Mueller",
note = "Copyright {\textcopyright} 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.",
year = "2014",
month = apr,
doi = "10.1016/j.clinbiochem.2014.02.018",
language = "English",
volume = "47",
pages = "338--43",
journal = "CLIN BIOCHEM",
issn = "0009-9120",
publisher = "Elsevier Inc.",
number = "6",

}

RIS

TY - JOUR

T1 - Novel insights into the pathophysiology of different forms of stress testing

AU - Hochgruber, Thomas

AU - Reichlin, Tobias

AU - Wasila, Mariusz

AU - Vogler, Eliane

AU - Twerenbold, Raphael

AU - Sou, Seoung Mann

AU - Roost, Kathrin

AU - Lee, Gino

AU - Fischer, Andreas

AU - Freidank, Heike

AU - Osswald, Stefan

AU - Zellweger, Michael J

AU - Mueller, Christian

N1 - Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

PY - 2014/4

Y1 - 2014/4

N2 - BACKGROUND: The impact of different forms of cardiac stress testing (exercise versus pharmacological stress testing) on cardiac wall stress and myocardial ischemia is incompletely understood.METHODS: In a prospective study, 331 consecutive patients with suspected myocardial ischemia referred for nuclear perfusion imaging were enrolled: 266 underwent exercise (bicycle) stress testing and 65 adenosine stress testing. Levels of B-type natriuretic peptide (BNP) measured before and 1 min after stress testing, ischemic ECG changes, and typical angina symptoms were used to compare the 2 testing modalities.RESULTS: Cardiac wall stress as quantified by changes in BNP levels significantly increased in the exercise stress group, but not in the adenosine group (increase in BNP levels 22 pg/ml (IQR 6-46) versus -3 pg/ml (IQR -3 to 28); p<0.001). In the bicycle exercise stress group, patients with reversible defects on nuclear perfusion imaging more often had angina symptoms (25% vs. 9%, p=0.0001) and ischemic ECG changes (33% vs. 12%, p=0.0001) during the stress test, and a greater increase in BNP levels (28 (IQR 11-58) versus 16 (IQR 3-34) pg/ml, p=0.001) compared to those without reversible defects. Those differences between patients with and without reversible defects were not observed with the adenosine protocol (p-values all >0.05).CONCLUSION: Exercise stress testing but not adenosine stress results in an increase of cardiac wall stress, angina symptoms and ECG changes. The absence of these surrogates of myocardial ischemia suggests that adenosine stress does not induce acute myocardial ischemia, but rather displays relative perfusion differences.

AB - BACKGROUND: The impact of different forms of cardiac stress testing (exercise versus pharmacological stress testing) on cardiac wall stress and myocardial ischemia is incompletely understood.METHODS: In a prospective study, 331 consecutive patients with suspected myocardial ischemia referred for nuclear perfusion imaging were enrolled: 266 underwent exercise (bicycle) stress testing and 65 adenosine stress testing. Levels of B-type natriuretic peptide (BNP) measured before and 1 min after stress testing, ischemic ECG changes, and typical angina symptoms were used to compare the 2 testing modalities.RESULTS: Cardiac wall stress as quantified by changes in BNP levels significantly increased in the exercise stress group, but not in the adenosine group (increase in BNP levels 22 pg/ml (IQR 6-46) versus -3 pg/ml (IQR -3 to 28); p<0.001). In the bicycle exercise stress group, patients with reversible defects on nuclear perfusion imaging more often had angina symptoms (25% vs. 9%, p=0.0001) and ischemic ECG changes (33% vs. 12%, p=0.0001) during the stress test, and a greater increase in BNP levels (28 (IQR 11-58) versus 16 (IQR 3-34) pg/ml, p=0.001) compared to those without reversible defects. Those differences between patients with and without reversible defects were not observed with the adenosine protocol (p-values all >0.05).CONCLUSION: Exercise stress testing but not adenosine stress results in an increase of cardiac wall stress, angina symptoms and ECG changes. The absence of these surrogates of myocardial ischemia suggests that adenosine stress does not induce acute myocardial ischemia, but rather displays relative perfusion differences.

KW - Aged

KW - Angina Pectoris/blood

KW - Electrocardiography

KW - Exercise Test/methods

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Ischemia/blood

KW - Myocardium/pathology

KW - Natriuretic Peptide, Brain/blood

KW - Radionuclide Imaging

KW - Ultrasonography

U2 - 10.1016/j.clinbiochem.2014.02.018

DO - 10.1016/j.clinbiochem.2014.02.018

M3 - SCORING: Journal article

C2 - 24582696

VL - 47

SP - 338

EP - 343

JO - CLIN BIOCHEM

JF - CLIN BIOCHEM

SN - 0009-9120

IS - 6

ER -