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European Heart Journal Advance Access originally published online on April 15, 2008
European Heart Journal 2008 29(15):1803-1806; doi:10.1093/eurheartj/ehn165
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Exercise testing in asymptomatic subjects: from diagnostic test to prognostic tool?

Paolo Palatini*

Department of Clinical and Experimental Medicine, University of Padova, 35128 Padova, Italy

* Corresponding author. Tel: +39 049 8212278, Fax: +39 049 8754179, Email: palatini@unipd.it

The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.

The first 150 words of the full text of this article appear below.


   Introduction
 
Exercise testing historically has been considered a useful modality for diagnosing coronary heart disease (CHD). However, false-positive tests are common in asymptomatic adults, especially among women, and there is no evidence at this time to recommend exercise electrocardiography as a routine screening test. Thus, conventional guidelines recommend against the use of exercise testing for risk assessment in asymptomatic subjects with a <10% pre-test likelihood of underlying CHD.1 However, a number of recent studies have extended our knowledge on the prognostic significance of exercise testing and suggest that the prognostic value of this test may have been underestimated. Measures other than those directly related to myocardial ischaemia have proved to be strong predictors of mortality.1 Among these, the chronotropic response to exercise and assessment of heart . . . [Full Text of this Article]


   Chronotropic response to exercise
 

   Treadmill vs bicycle ergometry
 

   Heart rate recovery
 

   Pathogenetic mechanisms
 

   Conclusion
 

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