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Re: Stages of Stress Test
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Re: Stages of Stress Test

Posted By Felix on December 06, 1998 at 08:20:21:

In Reply to: Re: Stages of Stress Test posted by CCF CARDIO MD - CRC on December 05, 1998 at 15:05:25:






: : : : What are the various stages of stress test, for example, Level 4.  What are the various levels of activity that make up Level 1, Level 2, etc. and how many levels are there. Thank you!
: --------------------------------------------------------------------------------------------------------------------
: : : Dear Marcy,
: Each stage refers to a level of exercise.  There are many different types of exercise protocols and each one has a different speed and treadmill grade for each stage.  I have attached below a chart comparing the various protocols.
: I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
: If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
: Table 5. Common Exercise Protocols
: Functional
: : : Class       O2 Cost
: : :             ml/kg/min METS    Treadmill
: : :                               Protocol
:                                  Bruce         Cornell          Balke         Naughton           Jogger
: : :                       3 Min. Stages                2 Min. Stages
: : :                                MPH/Grade                    
: : :
: : : World Class   70.0    20                                                                              
: : : Athlete       66.5    19      6.0     22                                                              
: : :               63.0    18                                                                      6.0     20.0
: : :               59.5    17      5.5     20                                                      6.0     17.5
: : : Athlete       56.0    16      5.0     18      5.0     18                                      6.0     15.0
: : :               52.5    15                                      4.0     20                      6.0     12.5
: : :               49.0    14                      4.6     17                                      6.0     10.0
: : : Fit           45.5    13      4.2     16      4.2     16      3.5     20                      6.0     7.5
: : :               42.0    12                                                                      6.0     5.0
: : :               38.5    11                      3.8     15      3.0     20.0                    5.5     2.5
: : : Normal        35.0    10      3.4     14      3.4     14      3.0     17.5                    5.0     2.5
: : : and  I        31.5    9                                       3.0     15.0                            
: : :               28.0    8                       3.0     13      3.0     12.5    2.0     21.0            
: : :               24.5    7       2.5     12      2.5     12      3.0     10.0    2.0     17.5            
: : : II            21.0    6                       2.1     11      3.0     7.5     2.0     14.0            
: : :               17.5    5       1.7     10      1.7     10      3.0     5.0     2.0     10.5            
: : :               14.0    4                                       3.0     2.5     2.0     7.0            
: : : III           10.5    3       1.7     5       1.7     5       3.0     0       2.0     3.5            
: : :               7.0     2       1.7     0       1.7     0                       2.0     0              
: : : IV            3.5     1                                                       1.0     0              

: : Hi
I had a stress test on cornell 10% tredmill.After stress test they told me weght, height, time achived, BSA, and that sress test was negative for ishemia at 100% mphr.What does BSA mean? What is normal range? How many stages does cornell 10% treadmill have? Also what do the numbers after FIT  and NORMAL mean?Thank you.Felix
------------------------------------------------------------------------
: Dear Felix,
The chart I attached here reads better in the "comments" box and you can see the various stages of the Cornell(11 stages).  The first column in the chart is the "functional level" - this is a measure in laymans terms of how good someone's physical activity level is.  Normal is normal and fit is a bit better than normal. BSA is body surface area.  The next columns are markers of oxygen uptake in ml/kg/min and in METS.  Then the grade and speed for each stage of the treadmill test follows.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

Well, like I said  the stress test was on cornell 10.0% treadmill.Here are the results:weight 84.8, height 180.3cm,age 44yrs. grade  speed  time                                          10     1.7    2.0                                           11     2.1    4.0                                           12     2.5    6.0                                           13     3.0    8.0                                           14     3.4   10.0                                           15     3.8    ? ?                                           16     4.2   12.0                                           17     4.6   13.30                       The test was terminated due to general fatigue at: grade 17,speed 4.6,time 13 min and 30 seconds and heart rate of 178. Conclusions: normal stress test.The stress test is negative for ischemia at 100% mphr.Why I did not get the time reading at grade 15 and speed 3.8? What would my oxygen uptake in  ml/kg/min and mets be at grade 17 speed 4.6 and time of 13.30? With these results, what are the odds of having coronary  artery disease?Thank you in advance. Felix      







_____
Dear Felix,
As you can see from the chart you scored 15 METS which would place you between Fit and Athletic levels (A good result).  I don't know why they didn't print a time for grade 15.  In general the risk of coronary disease for someone with these results would be low.  For you specifically you should ask your doctor.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
A here is stress test report that I got yesterday by mail.  speed  grade  mets  time  hr                                1.7    10.0   5.0   2.0   105                               2.1    11.0   6.0   4.0   119                               2.5    12.0   7.0   6.0   130                              3.0    13.0   8.5   8.0   145                               3.4    14.0  10.0  10.0   155                               3.8    15.0  11.5   ? ?   ? ?                               4.2    16.0  13.0  12.0   169                               4.6    17.0  13.0  13.26  178                               Functional capacity is estimated at 13.0 mets, stage 7 cornell 10.0% protocol.This represents a normal functional aerobic reserve of 5%.Maximal rate pressure product =32752.                                                            According to this report I achived 13 mets at speed 4.2 and grade 16, which is stage 7.What I do not know is why do I have the (same) 13 mets at speed 4.6 and grade 17, which would be stage 8? Also time reading is unclear after the 10 minute.Should there be 15 minutes and 26 seconds instead of 13.26 at the end of last stage?What is the formula for calculating mets?If I achived 15 mets, does that mean that I also achived 52.5 oxygen uptake? What is maximal rate pressure product normal range?Thank you very much. Felix
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