P-458: Static walking in place as an alternative to pharmacological stress testing in obese patients for evaluation of coronary artery disease

• Published in: American journal of hypertension 2001-04, Vol.14 (S1), p.184A-185A
• Main Authors: Brewington, Stacy D., Movahed, Assad
• Format: Article
• Language: English
• Subjects: coronary artery disease; obesity; stress testing
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(01)01638-7

The cause of inability to achieve target heart rate in obese patients with treadmill or bicycle exercise is often multifactorial, including severe deconditioning, physical limitations of the patient, refusal of participation, and fear of exercise equipment. Pharmocalogical stress testing in conjunction with a techniciam-99m perfusion agent is an option but is less desirable because of expense and suboptimal image quality. We investigated the ability to achieve adequate heart rate for the evalutaion of chest pain in the deconditioned obese patient by static walking in place. We stressed 11 (8 female, 3 male) obese (average weight 415 lb [body mass index 65]) patients by walking in place to achieve adequate heart rate. Each walked in place while pulse, blood pressure, and ECG were monitored. The speed of static walking was increased as needed and at maximal exercise, technitium-99 sestimibi was injected and walking in place continued for an additional 1-2 minutes. The target heart rate (85% of the age predicted heart rate) was achieved in 6 of 11 patients (55%), 80% of age predicted in 9 of 11 (82%), and 75% of age predicted in 100% of the patients. The systolic blood pressure increased by an average of 42mmHg and all test were ended due to fatigue after an average of 7 minutes and 18 seconds of walking in place. Static walking in place is an option for achieving adequate heart rate in some obese patients for the evaluation of chest pain. (See Table) sex/ age weight (lbs) body mass index max hr achieved/ % target exercise time rest blood pressure max blood pressure F / 35 490 82 161 / 87% 5m 1s 121/79 192/94 F / 40 449 75 152 / 84% 12m 55s 151/90 223/98 M / 26 549 69 145 / 75% 3m 9s 144/100 165/103 F / 28 466 69 156 / 81% 6m 6s 165/113 244/140 F / 25 488 74 155 / 80% 6m 5s 122/70 168/98 F / 36 416 72 151 / 82% 15m 4s 122/75 140/70 M / 28 482 71 166 / 87% 7m 162/80 184/90 F / 52 288 48 147 / 88% 6m 34s 112/72 123/60 M / 53 392 58 145 / 87% 7m 1s 115/92 148/80 F / 45 278 47 151 / 86% 11m 125/88 172/96 F / 57 270 50 147 / 90% 3m 45s 148/96 200/100