Skip to main content
Erschienen in: The International Journal of Cardiovascular Imaging 1/2012

01.01.2012 | Original Paper

How to evaluate physical fitness without a stress test?

verfasst von: Judith B. Fischer, Bernhard Friedli, Niklas F. Ehl, Michael J. Zellweger

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

To assess cardiorespiratory fitness (CF), usually a stress test is necessary. Our aims were to assess CF in a patient population with suspected or known coronary artery disease (CAD) based on a questionnaire (quest); to compare estimated CF with achieved workloads, and to evaluate its prediction of stress modality (physical/pharmacologic). Consecutive 612 patients undergoing myocardial perfusion SPECT (MPS) completed quest. They first chose one category which best described their daily physical activities. The second part contained patient characteristics (gender, age, BMI, and resting heart rate). An activity score was calculated and metabolic equivalents (METs) were estimated. Estimated and achieved results were compared. Patients with pharmacologic test (n = 208) provided a lower estimate of their performance than physically stressed patients (n = 404): 7.0 ± 2.1 and 8.2 ± 2.3 METs, respectively (P < 0.0001). The latter showed a good correlation between estimated and achieved METs (r = 0.63, P < 0.0001). Regarding prediction of the stress modality, area under the curve (ROC) was 0.65 (P < 0.0001). The quest can easily be applied in daily practice to assess CF in a patient population with CAD and for estimating whether an adequate physical stress test can be carried out.
Literatur
1.
Zurück zum Zitat Laukkanen JA, Lakka TA, Rauramaa R, Kuhanen R, Venalainen JM, Salonen R, Salonen JT (2001) Cardiovascular fitness as a predictor of mortality in men. Arch Intern Med 161:825–831PubMedCrossRef Laukkanen JA, Lakka TA, Rauramaa R, Kuhanen R, Venalainen JM, Salonen R, Salonen JT (2001) Cardiovascular fitness as a predictor of mortality in men. Arch Intern Med 161:825–831PubMedCrossRef
2.
Zurück zum Zitat Lee IM, Paffenbarger RS Jr (2000) Associations of light, moderate, and vigorous intensity physical activity with longevity. The harvard alumni health study. Am J Epidemiol 151:293–299PubMed Lee IM, Paffenbarger RS Jr (2000) Associations of light, moderate, and vigorous intensity physical activity with longevity. The harvard alumni health study. Am J Epidemiol 151:293–299PubMed
3.
Zurück zum Zitat Kokkinos P, Myers J, Kokkinos JP, Pittaras A, Narayan P, Manolis A, Karasik P, Greenberg M, Papademetriou V, Singh S (2008) Exercise capacity and mortality in black and white men. Circulation 117:614–622PubMedCrossRef Kokkinos P, Myers J, Kokkinos JP, Pittaras A, Narayan P, Manolis A, Karasik P, Greenberg M, Papademetriou V, Singh S (2008) Exercise capacity and mortality in black and white men. Circulation 117:614–622PubMedCrossRef
4.
Zurück zum Zitat Laukkanen JA, Rauramaa R, Salonen JT, Kurl S (2007) The predictive value of cardiorespiratory fitness combined with coronary risk evaluation and the risk of cardiovascular and all-cause death. J Intern Med 262:263–272PubMedCrossRef Laukkanen JA, Rauramaa R, Salonen JT, Kurl S (2007) The predictive value of cardiorespiratory fitness combined with coronary risk evaluation and the risk of cardiovascular and all-cause death. J Intern Med 262:263–272PubMedCrossRef
5.
Zurück zum Zitat Nocon M, Hiemann T, Muller-Riemenschneider F, Thalau F, Roll S, Willich SN (2008) Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 15:239–246PubMedCrossRef Nocon M, Hiemann T, Muller-Riemenschneider F, Thalau F, Roll S, Willich SN (2008) Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 15:239–246PubMedCrossRef
6.
Zurück zum Zitat Sofi F, Capalbo A, Cesari F, Abbate R, Gensini GF (2008) Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil 15:247–257PubMedCrossRef Sofi F, Capalbo A, Cesari F, Abbate R, Gensini GF (2008) Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil 15:247–257PubMedCrossRef
7.
Zurück zum Zitat Laukkanen JA, Kurl S, Salonen R, Rauramaa R, Salonen JT (2004) The predictive value of cardiorespiratory fitness for cardiovascular events in men with various risk profiles: a prospective population-based cohort study. Eur Heart J 25:1428–1437PubMedCrossRef Laukkanen JA, Kurl S, Salonen R, Rauramaa R, Salonen JT (2004) The predictive value of cardiorespiratory fitness for cardiovascular events in men with various risk profiles: a prospective population-based cohort study. Eur Heart J 25:1428–1437PubMedCrossRef
8.
Zurück zum Zitat Lee IM, Sesso HD, Paffenbarger RS Jr (2000) Physical activity and coronary heart disease risk in men: does the duration of exercise episodes predict risk? Circulation 102:981–986PubMed Lee IM, Sesso HD, Paffenbarger RS Jr (2000) Physical activity and coronary heart disease risk in men: does the duration of exercise episodes predict risk? Circulation 102:981–986PubMed
9.
Zurück zum Zitat Zellweger MJ, Hachamovitch R, Kang X, Hayes SW, Friedman JD, Germano G, Pfisterer ME, Berman DS (2004) Prognostic relevance of symptoms versus objective evidence of coronary artery disease in diabetic patients. Eur Heart J 25:543–550PubMedCrossRef Zellweger MJ, Hachamovitch R, Kang X, Hayes SW, Friedman JD, Germano G, Pfisterer ME, Berman DS (2004) Prognostic relevance of symptoms versus objective evidence of coronary artery disease in diabetic patients. Eur Heart J 25:543–550PubMedCrossRef
10.
Zurück zum Zitat Snader CE, Marwick TH, Pashkow FJ, Harvey SA, Thomas JD, Lauer MS (1997) Importance of estimated functional capacity as a predictor of all-cause mortality among patients referred for exercise thallium single-photon emission computed tomography: Report of 3,400 patients from a single center. J Am Coll Cardiol 30:641–648PubMedCrossRef Snader CE, Marwick TH, Pashkow FJ, Harvey SA, Thomas JD, Lauer MS (1997) Importance of estimated functional capacity as a predictor of all-cause mortality among patients referred for exercise thallium single-photon emission computed tomography: Report of 3,400 patients from a single center. J Am Coll Cardiol 30:641–648PubMedCrossRef
11.
Zurück zum Zitat Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Pina IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American heart association. Circulation 104:1694–1740PubMedCrossRef Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Pina IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American heart association. Circulation 104:1694–1740PubMedCrossRef
12.
Zurück zum Zitat Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD, Winters WL Jr, Yanowitz FG, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Lewis RP, O’Rourke RA, Ryan TJ (1997) Acc/aha guidelines for exercise testing: executive summary. A report of the American college of cardiology/American heart association task force on practice guidelines (committee on exercise testing). Circulation 96:345–354PubMed Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD, Winters WL Jr, Yanowitz FG, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Lewis RP, O’Rourke RA, Ryan TJ (1997) Acc/aha guidelines for exercise testing: executive summary. A report of the American college of cardiology/American heart association task force on practice guidelines (committee on exercise testing). Circulation 96:345–354PubMed
13.
Zurück zum Zitat Jurca R, Jackson AS, LaMonte MJ, Morrow JR Jr, Blair SN, Wareham NJ, Haskell WL, van Mechelen W, Church TS, Jakicic JM, Laukkanen R (2005) Assessing cardiorespiratory fitness without performing exercise testing. Am J Prev Med 29:185–193PubMedCrossRef Jurca R, Jackson AS, LaMonte MJ, Morrow JR Jr, Blair SN, Wareham NJ, Haskell WL, van Mechelen W, Church TS, Jakicic JM, Laukkanen R (2005) Assessing cardiorespiratory fitness without performing exercise testing. Am J Prev Med 29:185–193PubMedCrossRef
14.
Zurück zum Zitat Green CP, Porter CB, Bresnahan DR, Spertus JA (2000) Development and evaluation of the kansas city cardiomyopathy questionnaire: a new health status measure for heart failure. J Am Coll Cardiol 35:1245–1255PubMedCrossRef Green CP, Porter CB, Bresnahan DR, Spertus JA (2000) Development and evaluation of the kansas city cardiomyopathy questionnaire: a new health status measure for heart failure. J Am Coll Cardiol 35:1245–1255PubMedCrossRef
15.
Zurück zum Zitat Lip GY, Cader MZ, Lee F, Munir SM, Beevers DG (1996) Ethnic differences in pre-admission levels of physical activity in patients admitted with myocardial infarction. Int J Cardiol 56:169–175PubMedCrossRef Lip GY, Cader MZ, Lee F, Munir SM, Beevers DG (1996) Ethnic differences in pre-admission levels of physical activity in patients admitted with myocardial infarction. Int J Cardiol 56:169–175PubMedCrossRef
16.
Zurück zum Zitat Aadahl M, Jorgensen T (2003) Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35:1196–1202PubMedCrossRef Aadahl M, Jorgensen T (2003) Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35:1196–1202PubMedCrossRef
17.
Zurück zum Zitat Mader U, Martin BW, Schutz Y, Marti B (2006) Validity of four short physical activity questionnaires in middle-aged persons. Med Sci Sports Exerc 38:1255–1266PubMedCrossRef Mader U, Martin BW, Schutz Y, Marti B (2006) Validity of four short physical activity questionnaires in middle-aged persons. Med Sci Sports Exerc 38:1255–1266PubMedCrossRef
18.
Zurück zum Zitat Elmqvist MA, Jordhoy MS, Bjordal K, Kaasa S, Jannert M (2009) Health-related quality of life during the last three months of life in patients with advanced cancer. Support Care Cancer 17:191–198PubMedCrossRef Elmqvist MA, Jordhoy MS, Bjordal K, Kaasa S, Jannert M (2009) Health-related quality of life during the last three months of life in patients with advanced cancer. Support Care Cancer 17:191–198PubMedCrossRef
19.
Zurück zum Zitat Rustoen T, Stubhaug A, Eidsmo I, Westheim A, Paul SM, Miaskowski C (2008) Pain and quality of life in hospitalized patients with heart failure. J Pain Symptom Manage 36:497–504PubMedCrossRef Rustoen T, Stubhaug A, Eidsmo I, Westheim A, Paul SM, Miaskowski C (2008) Pain and quality of life in hospitalized patients with heart failure. J Pain Symptom Manage 36:497–504PubMedCrossRef
20.
Zurück zum Zitat Schiffer AA, Pedersen SS, Widdershoven JW, Denollet J (2008) Type d personality and depressive symptoms are independent predictors of impaired health status in chronic heart failure. Eur J Heart Fail 10:802–810PubMedCrossRef Schiffer AA, Pedersen SS, Widdershoven JW, Denollet J (2008) Type d personality and depressive symptoms are independent predictors of impaired health status in chronic heart failure. Eur J Heart Fail 10:802–810PubMedCrossRef
21.
Zurück zum Zitat Pitsavos C, Kavouras SA, Panagiotakos DB, Arapi S, Anastasiou CA, Zombolos S, Stravopodis P, Mantas Y, Kogias Y, Antonoulas A, Stefanadis C (2008) Physical activity status and acute coronary syndromes survival the greecs (greek study of acute coronary syndromes) study. J Am Coll Cardiol 51:2034–2039PubMedCrossRef Pitsavos C, Kavouras SA, Panagiotakos DB, Arapi S, Anastasiou CA, Zombolos S, Stravopodis P, Mantas Y, Kogias Y, Antonoulas A, Stefanadis C (2008) Physical activity status and acute coronary syndromes survival the greecs (greek study of acute coronary syndromes) study. J Am Coll Cardiol 51:2034–2039PubMedCrossRef
22.
Zurück zum Zitat Zellweger MJ, Kaiser C, Brunner-La Rocca HP, Buser PT, Osswald S, Weiss P, Mueller-Brand J, Pfisterer ME (2008) Value and limitations of target-vessel ischemia in predicting late clinical events after drug-eluting stent implantation. J Nucl Med 49:550–556PubMedCrossRef Zellweger MJ, Kaiser C, Brunner-La Rocca HP, Buser PT, Osswald S, Weiss P, Mueller-Brand J, Pfisterer ME (2008) Value and limitations of target-vessel ischemia in predicting late clinical events after drug-eluting stent implantation. J Nucl Med 49:550–556PubMedCrossRef
23.
Zurück zum Zitat Zellweger MJ, Tabacek G, Zutter AW, Weinbacher M, Cron TA, Muller-Brand J, Pfisterer ME (2004) Evidence for left ventricular remodeling after percutaneous coronary intervention: effect of percutaneous coronary intervention on left ventricular ejection fraction and volumes. Int J Cardiol 96:197–201PubMedCrossRef Zellweger MJ, Tabacek G, Zutter AW, Weinbacher M, Cron TA, Muller-Brand J, Pfisterer ME (2004) Evidence for left ventricular remodeling after percutaneous coronary intervention: effect of percutaneous coronary intervention on left ventricular ejection fraction and volumes. Int J Cardiol 96:197–201PubMedCrossRef
24.
Zurück zum Zitat Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O’Reilly MG, Winters WL, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Russell RO, Smith SC (2002) Acc/aha 2002 guideline update for exercise testing: summary article. A report of the American college of cardiology/American heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines). J Am Coll Cardiol 40:1531–1540PubMedCrossRef Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O’Reilly MG, Winters WL, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Russell RO, Smith SC (2002) Acc/aha 2002 guideline update for exercise testing: summary article. A report of the American college of cardiology/American heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines). J Am Coll Cardiol 40:1531–1540PubMedCrossRef
25.
Zurück zum Zitat Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J, Diamond GA (1996) Exercise myocardial perfusion spect in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation 93:905–914PubMed Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J, Diamond GA (1996) Exercise myocardial perfusion spect in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation 93:905–914PubMed
26.
Zurück zum Zitat Berman DS, Kiat H, Friedman JD, Wang FP, van Train K, Matzer L, Maddahi J, Germano G (1993) Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: a clinical validation study. J Am Coll Cardiol 22:1455–1464PubMedCrossRef Berman DS, Kiat H, Friedman JD, Wang FP, van Train K, Matzer L, Maddahi J, Germano G (1993) Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: a clinical validation study. J Am Coll Cardiol 22:1455–1464PubMedCrossRef
27.
Zurück zum Zitat Kaufmann BA, Pfisterer ME, Viswanathan S, Muller-Brand J, Zellweger MJ (2006) Stunning and left ventricular function—how long is the ventricle knocked out? Left ventricular function correlated with ischemic burden and recovery time after stress. Int J Cardiol 112:223–228PubMedCrossRef Kaufmann BA, Pfisterer ME, Viswanathan S, Muller-Brand J, Zellweger MJ (2006) Stunning and left ventricular function—how long is the ventricle knocked out? Left ventricular function correlated with ischemic burden and recovery time after stress. Int J Cardiol 112:223–228PubMedCrossRef
28.
Zurück zum Zitat Blair SN, Kampert JB, Kohl HW 3rd, Barlow CE, Macera CA, Paffenbarger RS Jr, Gibbons LW (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Jama 276:205–210PubMedCrossRef Blair SN, Kampert JB, Kohl HW 3rd, Barlow CE, Macera CA, Paffenbarger RS Jr, Gibbons LW (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Jama 276:205–210PubMedCrossRef
29.
Zurück zum Zitat Blair SN, Kohl HW 3rd, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW (1989) Physical fitness and all-cause mortality. A prospective study of healthy men and women. Jama 262:2395–2401PubMedCrossRef Blair SN, Kohl HW 3rd, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW (1989) Physical fitness and all-cause mortality. A prospective study of healthy men and women. Jama 262:2395–2401PubMedCrossRef
30.
Zurück zum Zitat Jackson AS, Beard EF, Wier LT, Ross RM, Stuteville JE, Blair SN (1995) Changes in aerobic power of men, ages 25–70 yr. Med Sci Sports Exerc 27:113–120PubMed Jackson AS, Beard EF, Wier LT, Ross RM, Stuteville JE, Blair SN (1995) Changes in aerobic power of men, ages 25–70 yr. Med Sci Sports Exerc 27:113–120PubMed
31.
Zurück zum Zitat Jackson AS, Wier LT, Ayers GW, Beard EF, Stuteville JE, Blair SN (1996) Changes in aerobic power of women, ages 20–64 yr. Med Sci Sports Exerc 28:884–891PubMedCrossRef Jackson AS, Wier LT, Ayers GW, Beard EF, Stuteville JE, Blair SN (1996) Changes in aerobic power of women, ages 20–64 yr. Med Sci Sports Exerc 28:884–891PubMedCrossRef
32.
Zurück zum Zitat Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, Freeman WK, Froehlich JB, Kasper EK, Kersten JR, Riegel B, Robb JF, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Buller CE, Creager MA, Ettinger SM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Ornato JP, Page RL, Tarkington LG, Yancy CW (2007) Acc/aha 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American college of cardiology/American heart association task force on practice guidelines (writing committee to revise the 2002 guidelines on perioperative cardiovascular evaluation for noncardiac surgery): developed in collaboration with the American society of echocardiography, American society of nuclear cardiology, heart rhythm society, society of cardiovascular anesthesiologists, society for cardiovascular angiography and interventions, society for vascular medicine and biology, and society for vascular surgery. Circulation 116:e418–e499PubMedCrossRef Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, Freeman WK, Froehlich JB, Kasper EK, Kersten JR, Riegel B, Robb JF, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Buller CE, Creager MA, Ettinger SM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Ornato JP, Page RL, Tarkington LG, Yancy CW (2007) Acc/aha 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American college of cardiology/American heart association task force on practice guidelines (writing committee to revise the 2002 guidelines on perioperative cardiovascular evaluation for noncardiac surgery): developed in collaboration with the American society of echocardiography, American society of nuclear cardiology, heart rhythm society, society of cardiovascular anesthesiologists, society for cardiovascular angiography and interventions, society for vascular medicine and biology, and society for vascular surgery. Circulation 116:e418–e499PubMedCrossRef
Metadaten
Titel
How to evaluate physical fitness without a stress test?
verfasst von
Judith B. Fischer
Bernhard Friedli
Niklas F. Ehl
Michael J. Zellweger
Publikationsdatum
01.01.2012
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 1/2012
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-010-9763-4

Weitere Artikel der Ausgabe 1/2012

The International Journal of Cardiovascular Imaging 1/2012 Zur Ausgabe

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Dihydropyridin-Kalziumantagonisten können auf die Nieren gehen

30.04.2024 Hypertonie Nachrichten

Im Vergleich zu anderen Blutdrucksenkern sind Kalziumantagonisten vom Diyhdropyridin-Typ mit einem erhöhten Risiko für eine Mikroalbuminurie und in Abwesenheit eines RAS-Blockers auch für ein terminales Nierenversagen verbunden.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.