Prospect of Stress Testing

A new method for analyzing the data of stress electrocardiography, based on physiologically justified approximations of trends in the heart rate (HR) and ST, is discussed. The method makes it possible to determine how the HR and ST of an individual vary with time during graded exercise and how these parameters and the times of their regulation depend on the workload; to reveal general patterns of their behavior; and to derive new physiological characteristics. Analysis of the general patterns of only the load time dependences of HR and ST and of the workload dependence of HR in patients with ischemic heart disease allows us to detect brief episodes of myocardial ischemia; to assess the anaerobic thresholds of locally injured areas of the myocardium and of the whole body; and to propose unified parameters for assessing the coronary reserve, the physical working capacity, and the severity of ischemic injury to the myocardium. The proposed method of analysis of stress electrocardiographic data and the combined use of stress electrocardiography, positron emission tomography, myocardial scintigraphy, and stress echocardiography offer new opportunities for a better understanding of myocardial ischemia.