French Society of Cardiology guidelines on exercise tests (part 1): Methods and interpretation.
Fiche publication
Date publication
décembre 2018
Journal
Archives of cardiovascular diseases
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CLAUDOT Frédérique
Tous les auteurs :
Marcadet DM, Pavy B, Bosser G, Claudot F, Corone S, Douard H, Iliou MC, Vergès-Patois B, Amedro P, Le Tourneau T, Cueff C, Avedian T, Solal AC, Carré F
Lien Pubmed
Résumé
The exercise test is still a key examination in cardiology, used for the diagnosis of myocardial ischemia, as well as for the clinical evaluation of other heart diseases. The cardiopulmonary exercise test can further define functional capacity and prognosis for any given cardiac pathology. These new guidelines focus on methods, interpretation and indications for an exercise test or cardiopulmonary exercise test, as summarized below. The safety rules associated with the exercise test must be strictly observed. Interpretation of exercise tests and cardiopulmonary exercise tests must be multivariable. Functional capacity is a strong predictor of all-cause mortality and cardiovascular events. Chest pain, ST-segment changes and an abnormal ST/heart rate index constitute the first findings in favor of myocardial ischemia, mostly related to significant coronary artery disease. Chronotropic incompetence, abnormal heart rate recovery, QRS changes (such as enlargement or axial deviations) and the use of scores (based on the presence of various risk factors) must also be considered in exercise test interpretation for a coronary artery disease diagnosis. Arrhythmias or conduction disorders arising during the exercise test must be considered in the assessment of prognosis, in addition to a decrease or low increase in blood pressure during the exercise phase. When performing a cardiopulmonary exercise test, peak oxygen uptake and the volume of expired gas/carbon dioxide output slope are the two main variables used to evaluate prognosis.
Mots clés
Cardiopulmonary exercise test, Exercise test, French guidelines, Interpretation, Interprétation, Recommandations françaises, Safety, Sécurité, Test cardiopulmonaire, Épreuve d’effort
Référence
Arch Cardiovasc Dis. 2018 Dec;111(12):782-790