[Can the training of coronary patients be monitored by readily measurable parameters?]

Abstract

The prognosis of coronary patients in terms of the mortality of coronary heart disease shows a positive relation to the severity of clinical and functional diagnostic parameters. Thus exercise therapy should be monitored by criteria that take ischemia, the myocardial situation and rhythm disorders into account. These criteria should be reliable and should be easy to determine as well as to apply. For pragmatic reasons the non-invasive evaluation of findings and the diagnostic symptom-limited ergometer test are especially significant for dosage and monitoring of exercise therapy. Monitored exercise therapy is here understood to mean individually adjusted exercising by patients, and training thus has to be based on diagnostic findings. First existing complaints have to be analyzed and such findings as size of infarction in the ECG, heart volume in the X-ray, size and function of the left ventricle by echography, etc. checked. Afterwards maximum physical work capacity on a multistage bicycle ergometer test is measured with respect to the following termination criteria: a) subjective reports by the patient during exercise (e.g. onset and severity of angina pectoris, dyspnea and/or fatigue of the leg muscles) and b) objective criteria such as significant ischemic ST-depression, exercise-hypertension, age-related submaximal heart rate and significant rhythm disorders. An inverse correlation is found between measured maximum symptom-limited physical performance and the frequency of cardiac termination criteria; a comparable inverse correlation exists with heart volume: max. O2 pulse.(ABSTRACT TRUNCATED AT 250 WORDS)