Václav Chaloupka

Exercise intensity prescription after myocardial infarction in patients treated with beta-blockers.

PURPOSE The aim of our study was to answer the following questions: (1) Is it possible to estimate the exercise training intensity according to heart rate in patients treated with beta-blockers after myocardial infarction? and (2) Are there any other appropriate alternate possibilities to estimate the training intensity? METHODS This study involved 112 men (60.2 +/- 8.6 years) with a previous myocardial infarction treated with beta-blockers. Patients underwent exercise echocardiography and also completed a symptom-limited cardiopulmonary ramp test to determine peak exercise capacity, maximal heart rate, heart rate (HR) at the anaerobic threshold (AT), peak oxygen uptake (VO2peak) VO2 consumption at AT, and exercise capacity at AT. RESULTS The mean value of HR at AT was 104.7 +/- 13.3 bpm, corresponding to 81.0% +/- 8% of VO2peak and 87.9% +/- 5.6% of HRpeak. The mean HR at 80% HRpeak was 96 +/- 13.7 bpm, at 70% heart rate reserve (HRR) 103.3 +/- 13.1 bpm and at 80% HRR 108 +/- 14.4 bpm. A close correlation was observed between HR at AT and values at 80% HRpeak (r = 0.86, P < .01). A similar correlation was found also for 70% and 80% HRR (r = 0.87 and 0.88, respectively, P < .01). Exercise intensity at AT occurred close to the value of 1 W/kg(bodyweight). CONCLUSIONS As an upper limit in determining training intensities, the assessment of AT is the gold standard. However, findings suggest that %HRpeak, %HRR, and %VO2peak can be used alternatively. The use of workload expressed as in W/kg also appears useful.

Cardiac rehabilitation training program focused on risk factors of coronary artery disease

Aim: The aim of this study is to assess an impact of aerobic-resistance exercise on cardiorespiratory indicators in patients after acute coronary event, and evaluate monitored parameters as a result of a positive influence of a physical activity on the risk factors of coronary artery disease (CAD).

392 Echocardiographic assessment of coronary flow reserve in patients with borderline stenosis of LAD. Comparison with exercise echocardiography

Backgrounds and Objectives: The effects of smoking on coronary blood flow has not been well evaluated. Coronary blood flow velocity (CFV) can be measured directly with transthoracic Doppler echocardiography (TTDE) and conducted immediately after smoking. The purpose of this study was to evaluate the chronic and acute effects of smoking on CFV and coronary blood flow reserve (CFR). Methods: The study population consisted of 20 healthy men (11 smokers and 9 non-smokers). None of this study participants had a history of cardiovascular disease or other risk factors for coronary artery disease except smoking. Smoking was abstained at least 4 hours before study in smokers. CFV was measured at the distal left anterior descending coronary artery by TTDE at baseline and during intravenous adenosine infusion (140ug/kg/min) in all subjects. In smokers, immediately after two consecutive cigarettes smoking, CFV was measured repeatedly at baseline and during adenosine infusion. CFR after smoking was corrected with rate pressure product (RPP) because of marked alteration of heart rate and blood pressure after smoking. Results: Before smoking, CFR and coronary vascular resistance index (CVRI) did not differ between non-smokers and smokers (CFR:3.5 ± 0.8 vs 3.6 ± 0.6, p>0.05, CVRI:0.28 vs 0.28, p>0.05). The acute effect of smoking on coronary blood flow is shown below.