Language

English

Publication Date

9-19-2024

Journal

Journal of Clinical Medicine

DOI

10.3390/jcm13185562

PMID

39337046

PMCID

PMC11432587

PubMedCentral® Posted Date

9-19-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Exercise stress testing (EST) is commonly used to evaluate chest pain, with some labs using 85% of age-predicted maximum heart rate (APMHR) as an endpoint for EST. The APMHR is often calculated using the formula 220-age. However, the accuracy of this formula and 85% APMHR as an endpoint may be questioned. Moreover, failing to reach 85% APMHR (known as chronotropic insufficiency) may also indicate poor cardiovascular prognosis, but measurements, such as percentage heart rate reserve (%HRR), maximum rate pressure product (MRPP), and the maximum metabolic equivalent of tasks (METs) reached during EST may provide better prediction of cardiovascular outcomes than not reaching 85% of APMHR. There is a need to incorporate comprehensive measurements to improve the diagnostic and prognostic capabilities of EST.

Keywords

chest pain, exercise stress test, age-predicted maximum heart rate, APMHR, HRmax formula, 220-age, cardiovascular prognosis, heart rate reserve, maximum rate pressure product, metabolic equivalents, cardiovascular disease, functional status, nuclear imaging stress test, stress echocardiogram

Published Open-Access

yes

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