Cardio exercise OK in high-risk CVD patients

Nov 1 2012

By Lauretta Ihonor, medwireNews reporter

US study results indicate that cardiopulmonary exercise (CPX) is well tolerated, even when performed by individuals with high-risk cardiovascular disease (CVD).

Only 0.16% of such individuals experienced an adverse event during CPX and none died, say Todd Miller (Mayo Clinic, Rochester, Minnesota) and co-authors.

"Interestingly, all eight of the adverse events occurred in males," they observe.

However, the researchers add that this should not be taken as evidence that men are more likely than women to have an adverse event during CPX.

The study, which examined outcomes of 4250 individuals with high-risk CVD, showed that sustained ventricular tachycardia was the most common adverse event associated with CPX.

The arrhythmia accounted for six of the eight adverse events seen among the group, which included patients with congestive heart failure (n=1289), hypertrophic cardiomyopathy (n=598), pulmonary hypertension (n=194), and aortic stenosis (n=212), as well as other less-common forms of CVD.

The patients, 65% of whom were male, had a mean age of 57 years.

CPX was performed as a symptom-limited exercise stress test, in which each participant was asked to run on a treadmill or cycle on a stationary bike while undergoing electrocardiography (ECG).

Most patients (94.5%) completed their stress test, stopping only because of fatigue, chest pain, or shortness of breath.

The remaining 5.5% asked for their test to be terminated early or experienced ECG changes, abnormal blood pressure, or a major adverse event, which led to test termination.

Adverse events were defined as death within 48 hours of stress test, external defibrillation or implantable cardioverter defibrillator discharge, sustained ventricular tachycardia, myocardial infarction, syncope, administration of advanced cardiac life support medications, hospital admission, or referral to the emergency department for testing.

"Stress testing is not widely applied for disability assessment, in part due to concerns about safety of testing in high-risk populations," highlight Miller et al in Circulation.

However, they conclude: "The results of this study will hopefully encourage increased use of CPX for this purpose."

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