Diagnostic value of stress testing in the elderly.

The exercise tests performed by 197 patients aged 65 years or more (mean age 68.8) have been reviewed, including 43 healthy subjects, 20 with high blood pressure, 10 with mitral valve disease and 125 with demonstrated coronary artery disease. All tests were done on an electrical cycloergometer, with load increases of 30 W every 3 min. Eighty-four (42.6%) achieved at least 85% of their maximal predicted heart rate. The reasons for non-achievement of this heart rate were limitation by symptoms (30.2%), betablocker therapy (25.8), exhaustion (20.2%), pain in lower extremities (14%) and non-adaptation to cycloergometer (10%). The maximum load achieved and the duration of exercise were significantly lower in mitral and coronary patients. Functional aerobic capacity was decreased in coronary and mitral patients. The VO2 max was directly determined in 45 patients. Mean values (ml kg-1 min-1) were 33.3 +/- 3.5 in normals, 15.4 +/- 6.2 in coronary and 15.8 +/- 4.1 in mitral patients. The incidence of arrhythmias during exercise was higher in hypertensive (55%) than in mitral (40%), normal (33.3%) and coronary patients (32.8%). In 5 patients the test had to be interrupted because of ventricular tachycardia. The yield of ST depression (greater than 0.1 mV) or elevation (greater than 0.2 mV) in the diagnosis of coronary artery disease was 0.62 sensitivity and 0.93 specificity. We conclude that stress test is a useful tool in cardiovascular diagnosis among older patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Evaluation of the functional aerobic capacity in mitral prostheses. Preliminary report]. / Valoración de la capacidad funcional aeróbica en las prótesis mitrales. Informe preliminar.

Based on the results of an ergometric stress testing performed in 22 patients with mitral replacement, the author concludes that this method is a highly reproductive and safe to evaluate the functional improvement of patients undergoing a mitral replacement. The results are similar for Bjork-Shiley (11 patients) and Starr-Edwards prothesis (11 patients), slurring that the only parameter that can affect functional results can be a controlled rehabilitation program.