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The effect of exercise on resting hemodynamics and the reproducibility of clinical and hemodynamic events during two successive exercise periods 25 minutes apart were evaluated in 20 patients with stable angina pectoris.Comparison of the resting data during the first and second control periods (C1 and C,) separated by a period of exercise showed that the values for heart rate (HR) were higher (76 i 11 vs 79 4 11 beats/min [mean + SD]; p < 0.05), while brachial arterial systolic pressure (BASP) (142 + 13 vs 137 : 13 mm Hg; p < 0.05), brachial arterial mean pressure (BAMP) (103 + 10 vs 99 i 9 mm Hg; p < 0.05), pulmonary arterial mean pressure (PAMP) (22 i 5 vs 18 i 5 mm Hg; p < 0.01), and left ventricular end-diastolic pressure (LVEDP) (18 ± 4 vs 15 ± 4 mm Hg; p < 0.001) were lower during C,.Angina was experienced by all 20 patients during both exercise studies (Ex, and Ex,) and the group mean values for the duration of exercise to angina, ST-segment depression, HR and rate-pressure product at the onset of angina were similar during Ex1 and Ex,. However, in five of the 20 patients, exercise duration to angina varied by 60 seconds or more during the two exercise studies and two of these patients had to be exercised at higher work loads to induce angina during Ex2. Comparison of hemodynamic data at the onset of angina induced by Ex1 and Ex, showed that the group values for LVEDP (29 ± 6 vs 25 : 6 mm Hg), PAMP (33 ± 8 vs 29 i 10 mm Hg), BASP (167 ±15 vs 162 i 16 mm Hg) and BAMP (120 : 10 vs 115 i 10 mm Hg were lower (p < 0.02) during Ex,.Clinical and electrocardiographic events and HR, rate-pressure product and cardiac output during two successive exercise periods were reproducible, but LVEDP and PAMP were consistently lower during the Ex,. These results should be considered when the effects of therapeutic interventions are being studied during invasive exercise testing in angina pectoris.

Are the clinical and hemodynamic events during exercise stress testing in invasive studies in patients with angina pectoris reproducible?