Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: a meta-analysis
Abstract
Exercise-induced ischemic preconditioning (IPC) can be assessed with the second exercise stress test during sequential testing. Exercise-induced IPC is defined as the time to 1 mm ST segment depression (STD), the rate-pressure product (RPP) at 1 mm STD, the maximal ST depression and the rate-pressure product at peak exercise. The purpose of this meta-analysis is to validate the parameters used to assess exercise-induced IPC in the scientific community. A literature search was performed using electronic database. The main key words were limited to human studies, which were (a) ischemic preconditioning, (b) warm-up phenomenon, and (c) exercise. Meta-analyses were performed on the study-specific mean difference between the clinical measures obtained in the two consecutive stress tests (second minus first test score). Random effect models were fitted with inverse variance weighting to provide greater weight to studies with larger sample size and more precise estimates. The search resulted in 309 articles of which 34 were included after revision (1053 patients). Results are: (a) time to 1 mm ST segment depression increased by 91 s (95% confidence interval (CI): 75-108), p < 0.001; (b) peak ST depression decreased by -0.38 mm (95% CI: -0.66 to -0.10), p < 0.01; and (c) rate-pressure product at 1 mm STD increased by 1.80 × 10(3)mmHg (95% CI: 1.0-2.0), p < 0.001. This is the first meta-analysis to set clinical parameters to assess the benefit of exercise-induced ischemic preconditioning in sequential stress testing. The results of this first meta-analysis on the sequential stress test confirm what is presented in the literature by independent studies on exercise-induced ischemic preconditioning. From now on, the results could be used in further research to set standardized parameters to assess the phenomenon.
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There is meta-analytical evidence for an immediate, exercise-induced attenuation of cardiac ischaemia in patients with angina, who showed a remarkable delay in the onset of ST-segment depression and a decrease in the magnitude of this phenomenon on a second exercise test when compared with the first test.
“There is also meta-analytical evidence for an immediate, exercise-induced attenuation of cardiac ischaemia in patients with angina who showed a remarkable delay in the onset of ST-segment depression and a decrease in the magnitude of this phenomenon on a second exercise test when compared with the first test.202”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [202]
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- Authors
- Lalonde, F., Poirier, P., Sylvestre, M.-P., Arvisais, D., & Curnier, D.
- Affiliations
- Centre Hospitalier de l’Université de Montréal (CA)
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Université de Montréal (CA)
- Corresponding author
- Curnier, Daniel
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-08-27
- Volume
- 22
- Issue
- 1
- Pages
- 100-112
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2094638609
- Cited by
- 29
- References
- 47
- Citations by year
- 2024: 5 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 1 · 2014: 2 · 2013: 2
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- warm-up phenomenon, ST-segment depression, rate-pressure product, myocardial ischemia
- MeSH terms
- Blood Pressure, Coronary Disease, Electrocardiography, Exercise Test, Heart Rate, Humans, Mitochondria, Heart, Predictive Value of Tests, Time Factors, Potassium Channels, Signal Transduction, Exercise Tolerance, Ischemic Preconditioning, Myocardial
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