Current aspects in ergometry

: Exercise testing remains an important non-invasive diagnostic test modality in patients with coronary artery disease. In recent years considerable advances have been achieved in the test methodology and in interpretation. The following points are important for the test methodology: (1.) The optimal exercise time is 8-12 minutes. (2.) The stepwise increases in work load should be as small as possible (ideally, according to the ramp protocol). (3.) Whenever possible patients should be tested on a symptom-limited basis. Submaximal ergometry is only indicated in the 2-3 weeks after acute myocardial infarction. (4.) The value of the exercise test depends mainly on the double product achieved (maximal systolic blood pressure x maximal heart rate). The interpretation of the exercise test should consider the clinical and hemodynamic responses and ST-segment changes. ST-segment depressions are the most important diagnostic parameter. The ECG localization (most frequently lateral wall) does not necessarily correspond to the anatomic localization. Exercise capacity and blood pressure response are important prognostic variables.