Prognostic applications of exercise testing

Article Abstract:

Exercise testing has proved to be valuable in the work-up of patients suspected of having coronary heart disease. A common form of exercise testing is the treadmill test; the patient walks on a treadmill while physiological signs are monitored. The heart rate, presence of chest pain, exercise tolerance, and electrocardiograph recordings all contribute to the evaluation of the patient's condition. It is often possible to discern signs of heart disease that are silent when the patient is at rest. Many research studies have used complex statistical methods to determine which signs appearing during exercise testing contribute to the ultimate prognosis. However, these sophisticated statistical methods developed for research are often not practical for use in the day-to-day practice of physicians. In the September 19, 1991 issue of The New England Journal of Medicine, researchers present the results of a new scoring method for the evaluation of outpatients using the treadmill test. A quick plot of several key factors is used to determine the prognosis for the patient and, by implication, the appropriate care and treatment. However, several remaining problems complicate the evaluation of patients. One is that in the current study only three of the women tested were found to be at high risk for heart attack by the scoring method. Therefore, it would be prudent to be cautious in interpreting test results for women until more data become available. In addition, it is not clear how well the test will perform when applied to patient populations with a relatively low incidence of coronary heart disease. Some patients are destined to die suddenly of heart attacks without prior symptoms. Such people may be likely to have low-risk scores on the treadmill test and will therefore not be identified. However, questions about the applicability of the test to a wide range of patients should not detract from its usefulness in the evaluation of patients in whom coronary heart disease is suspected. Among these patients, the scoring method and the assignment of risk may prove to be valuable in determining the best course of treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Reports, Prognosis, Coronary heart disease, Treadmill exercise tests, Cardiology, Predictive value of tests, Predictive value of tests (Medical), editorial, Nuclear medicine, Radioisotopes in cardiology

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Lipoprotein lipase: a multifunctional enzyme relevant to common metabolic diseases

Article Abstract:

Lipoprotein lipase is an enzyme produced by many tissues in the human body, and is an important regulator of fat (lipid) and fat protein (lipoprotein) metabolism. The enzyme plays an important role in a number of metabolic disorders, including obesity. Lipoprotein lipase is located in the capillary walls of most tissues, where it is activated in the break-up of chylomicrons, small particles of fat in the blood after digestion and absorption of fat in food, as well as other types of lipoproteins. Researchers are interested in improving the quality and length of life in patients with metabolic diseases (e.g., obesity) who may suffer from defective lipoprotein lipase activity.

Analysis, Causes of, Physiological aspects, Obesity, Lipid metabolism, Lipid metabolism disorders, Lipidosis, Lipoprotein lipase, column, Hyperlipoproteinemia

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Diet, obesity, and cardiovascular risk

Article Abstract:

Doctors should encourage all their patients to follow a balanced, low-fat diet and get plenty of exercise to prevent obesity and obesity-related diseases. A balanced, low-fat diet can cause as much weight loss as the low-carbohydrate Atkins diet and may have fewer adverse effects. The Atkins diet is high in saturated fat and may be difficult to follow over long periods of time.

Health aspects, Low-fat diet, Low fat diet, Low-carbohydrate diet, Low carbohydrate diet, Atkins diet

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