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Research ArticleIMAGING

Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?

Angela Macci Bires, Dori Lawson, Thomas E. Wasser and Donna Raber-Baer
Journal of Nuclear Medicine Technology December 2013, 41 (4) 274-278; DOI: https://doi.org/10.2967/jnmt.113.124727
Angela Macci Bires
1Robert Morris University, Moon Township, Pennsylvania
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Dori Lawson
2Invasive and Non-Invasive Cardiology, Regional Heart Center, The Reading Hospital and Medical Center, West Reading, Pennsylvania
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Thomas E. Wasser
3Consult-Stat: Complete Statistical Services, Macungie, Pennsylvania; and
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Donna Raber-Baer
4Regional Heart Center, The Reading Hospital and Medical Center, West Reading, Pennsylvania
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    TABLE 1

    Means Tests on Protocol Versus Raw Age Variable and BMI

    StandardRamped
    VariablenMeanSDnMeanSDP
    BMI62730.036.1649632.2614.02<0.001
    Age62750.8010.4150063.7811.75<0.001
    • View popup
    TABLE 2

    Medication Differences by Protocol

    StandardRamped
    VariableValueCountPercentageCountPercentageP
    β BlockerNo39785.234769.5<0.001
    Yes6914.815230.5
    ACE/ARBNo37580.540681.40.725
    Yes9119.59318.6
    Calcium channelNo54397.248396.80.705
    Yes132.8163.2
    NitrateNo46599.849699.40.350
    Yes10.230.6
    NoneNo17437.326452.9<0.001
    Yes29262.723547.1
    • View popup
    TABLE 3

    Protocol Test Outcomes All Patients

    StandardRamped
    VariablenMeanSDnMeanSDP
    Heart rate, rest62770.7012.0650070.7212.310.979
    Heart rate, peak627155.1515.45500136.0916.83<0.001
    Heart rate, 5 min62791.9914.1950084.1113.82<0.001
    METs62710.672.595008.082.73<0.001
    Maximum predicted heart rate, percentage62790.976.7750086.1210.21<0.001
    PRP62725.714.7050022.974.92<0.001
    Total treadmill time (s)627541.83139.25500443.39137.58<0.001
    Functional capacity impairment6277.8210.935009.0514.510.103
    • View popup
    TABLE 4

    χ2 Analysis Protocol Versus Demographics Age Group and Gender

    StandardRamped
    VariableValueCountPercentageCountPercentageP
    SexMale38661.622344.6<0.001
    Female24138.427755.4
    Age group18–4010216.3183.6<0.001
    41–6040965.215731.4
    61+11618.532565.0
    • View popup
    TABLE 5

    Protocol Outcomes for Normal-Weight (BMI < 25) Patients

    StandardRamped
    VariablenMeanSDnMeanSDP
    Heart rate, rest11270.0313.718870.7813.710.899
    Heart rate, peak112158.2517.6188130.6119.24<0.001
    Heart rate, 5 min11289.3017.598881.7315.46<0.001
    METs11211.762.82888.043.000.002
    Maximum predicted heart rate, percentage11291.856.048885.3111.82<0.001
    PRP11224.934.548821.195.09<0.001
    Total time (s)112608.67157.4688438.25169.76<0.001
    Functional capacity impairment1123.768.55888.5217.280.019
    • View popup
    TABLE 6

    Protocol Outcomes for Obese (BMI ≥ 30) Patients

    StandardRamped
    VariablenMeanSDnMeanSDP
    Heart rate, rest28472.0811.9924470.4712.300.114
    Heart rate, peak284153.3413.91244138.6515.04<0.001
    Heart rate, 5 min28493.4312.8124485.3813.09<0.001
    METs2849.792.322437.972.89<0.001
    Maximum predicted heart rate, percentage28489.866.8624485.499.68<0.001
    PRP28425.994.4524423.674.82<0.001
    Total time (s)284492.19122.52244435.80123.97<0.001
    Functional capacity impairment28411.6912.2724410.6913.930.383
    • View popup
    TABLE 7

    Protocol Outcomes for Overweight (BMI 25–29.99) Patients

    StandardRamped
    VariablenMeanSDnMeanSDP
    Heart rate, rest23169.3411.1316471.0213.090.170
    Heart rate, peak231155.8815.89164135.5617.17<0.001
    Heart rate, 5 min23191.5413.7916483.4113.80<0.001
    METs23111.222.451648.302.29<0.001
    Maximum predicted heart rate, percentage23191.926.8216487.499.84<0.001
    PRP23125.735.0516422.934.76<0.001
    Total time (s)231570.45127.67164460.99136.28<0.001
    Functional capacity impairment2315.018.361646.7613.430.141

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Journal of Nuclear Medicine Technology: 41 (4)
Journal of Nuclear Medicine Technology
Vol. 41, Issue 4
December 1, 2013
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Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?
Angela Macci Bires, Dori Lawson, Thomas E. Wasser, Donna Raber-Baer
Journal of Nuclear Medicine Technology Dec 2013, 41 (4) 274-278; DOI: 10.2967/jnmt.113.124727
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Keywords

  • cardiac exercise stress testing protocols
  • cardiac assessment
  • Bruce protocol versus ramped Bruce protocol
  • body mass index (BMI)
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Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?
Angela Macci Bires, Dori Lawson, Thomas E. Wasser, Donna Raber-Baer
Journal of Nuclear Medicine Technology Dec 2013, 41 (4) 274-278; DOI: 10.2967/jnmt.113.124727

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