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
Published Open-Access
no
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
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.