Exercise testing: Intercenter variabilities, prognostic value, work and training prescription

J. J. Kellermann, M. Hayet, E. Fisman

Research output: Contribution to journalArticlepeer-review


There exist many intercenter differences in exercise testing methodology, criteria for selection and end-point parameters. One should be cautious when comparing results from various centers, especially when they are located in different geographical areas. Further, different cultures and ethnic groups may require different end-point parameters. The prevalence of coronary heart disease in a certain population may require different test procedures when compared to other populations where, for example, valvular heart disease or nonobstructive cardiomyopathies are more prevalent. Our study has demonstrated that ATHR represents a useful and clinically important prognostic sign in patients with symptomatic coronary artery disease. However, repeated exercise testing is often needed to establish the severity and the dynamics of the disease. Naturally this does not exclude the use of exercise echocardiography and radionuclide methods in these patients, especially since left ventricular function has a significant influence on prognosis. Spiroergometry can be used safely in patients with cardiac failure. In our opinion, one of the most important objectives of these tests in patients with impaired cardiac function (NYHA, class III (late) or IV) is to improve their quality of survival and to find proper occupational (or any other kind of activity) levels to avoid severe emotional and physical disability. Exercise testing can be used for vocational counseling and exercise prescription. In our experience, a 50% safety margin is recommended when the outcome of the test is translated into caloric requirements of a full day's occupation. Exercise testing remains a valuable diagnostic technique despite the introduction of more sophisticated diagnostic procedures. Nonetheless, it is important to understand that exercise test procedures should be applied to properly selected examinees in whom the test results may eventually contribute to diagnosis, management and establishing prognosis.

Original languageEnglish
Pages (from-to)64-73
Number of pages10
JournalAdvances in Cardiology
VolumeVol. 33
StatePublished - 1986


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