heart tests

[zk]

Thank you for answering my questions but I have lots of questions.First questions deal with Bruce protocol stress test and the second with thoracic aorta normal size. FIRST STAGE. SPEED(MPH) 1.7, GRADE(%) 10, TIME 02:00, SECOND STAGE. SPEED(MPH) 2.5, GRADE(%) 12, TIME 04:00, THIRD STAGE. SPEED(MPH) 3.4, GRADE(%) 14, TIME 07:00, FOURTH STAGE. SPEED(MPH) 4.2, GRADE(%) 16, TIME 10:00, FIFTH STAGE. SPEED(MPH) 5.0, GRADE(%) 18, TIME 12:30. 1. Does anyone know how many VO2 or METS was achieved on the above Bruce treadmill stress test? 2. If above person lasted for 30 more seconds and had finished stage 5 should his VO2 or METS be calculated/estimated from whatever is for finishing stage 5 (even though in stage 1 he walked for 2 instead 3 minutes and than also in stage 2 he walked for 2 instead of 3 minutes)? 3. Are you saying VO2 or METS should be estimated from last stage,in this case 5th stage, no matter if above person walked 2 or 3 minutes in stages 1 and 2 on protocol? 4. There is VO2 (www.exrx.net/Calculators/Treadmill.html)calculator on the net,but I think it is not as accurate as treadmill METS calculator(taken during test by computer),because it does not take into account weight and height of a person.Physical education trainer told me athletes who finish 5th stage and start 6th stage on Bruce treadmill protocol usually achieve 18 METS on computer print out.Does anyone know anything about this? 5. Will starting Bruce protocol tredmill stress test with 2 minutes instead of 3 minutes in stages 1 and 2 affect the reliability of protocol?

[zk]

Are there any long distance runners who could answer my above questions about thoracic aorta?

[dhflp]

The diameter of a normal aorta is dependent on age,BSA and location.For a 50 year old adult male,the normal ascending aorta measures 2.5-3.8cm,typically and for aortic root slightly greater than that.

[zk]

Don't know about you but I think for a person who is 50 years old and with BSA of 2.06 anything up to 4.2 cm might be normal.By defination above which number does aortic root dilatation starts? Did doctor tell you what's the difference between aneurysm and dilatation?

[Mantels]

The Bruce protocol is performed in 3 minute increments.
Not sure what/how your testing was executed.

[zk]

Dr.Bkj there are 5 questions pertaining to thoracic aorta that were not answered? Would you please answer them?Thank you

[zk]

Dr.Bkj there are 5 questions pertaining to thoracic aorta that were not answered? Would you please answer them?Thank you

[lance1881]

zk,
I don't believe they answer a second time.  I sure wish you would have been able to get an answer as I have an aortic aneurysm measuring 4.2cm at the sinus of valsalva.  I am 38 years old.  The first doctor told me I had an aneurysm in January of this year.  In June I had another CT scan with the same outcome, 4.2cm, however this doctor said it was dilated, not an aneurysm.  I guess it really doesn't matter as long as it stays at 4.2cm when I go in for my 6 month CT scan in December.  Good luck!

[zk]

I did not have enough space above.These questions deal with thoracic aorta normal size. There are many different interpretations of thoracic aorta normal size on internet.Apparently anything in the 3.5cm or greater range at the sinus of valsalva level is considered dilated,anything grater than about 4.0/4.5cm is aneurysmal.At the arch/descending thoracic aorta,anything greater than 3.0/3.5cm is aneurysmal.There are websites which state anything in the 3.7cm or greater range at sinus of valsalva level is considered dilated and there are also websites which state anything in the 3.9cm or greater range at sinus of valslva is considered dilated.1. At CCF at what level is sinus of valslva as well as ascending aorta considered dilatated and at what level it is considered aneurysmal in men of 50 years of age with BSA 2.06? 2. At CCF at what level is arch/descending thoracic aorta considered dilatated and at what level it is considered aneurysmal in men of 50 years of age with BSA of 2.06? 3. Do long distance runners(who run marathons for last 20-25 years) have slightly enlarged thoracic aorta as they do left ventricular diastolic internal diameter in the range of 5.0-5.7cm?If yes is it than this considered normal findings in their case(and what would this slightly enlargement in cm or mm be? 4. When on cardiac or thoracic MRI?MRA report is written the following "IMPRESSION: No evidence of aneurysmal dilatation of thoracic aorta.There is no evidence of thoracic aortic dissection." does above means thoracic aorta is normal?If no what does it mean? 5. Why left ventricular diastolic internal diamter in the range of 5.0-5.7 is slightly enlarged in long distance runners and I guess aortic root and ascending aorta in the range of 3.5-3.9cm?Thank you

[Cleveland Clinic]

zk,

Thanks for the post.

The computer programs on the stress systems today give you an estimate of your overall work based on the exact amount of time you exercised. Treadmills still arent perfect so there is a little fudging as some people walk/run more efficiently then others. In some places exercise is performed on a bicycle which is a more precise quatitation of work load achieved.

The Bruce protocol is a fairly aggressive and rapid titration of work load. While good for processing a lot of test in a day, it is not an optimal routine for cardiovascular exercise on a daily basis.  18 METS in the Bruce protocol indicates a very good fitness level and is overall predictive of a low risk for cardiovascular events.

To achieve the precalculated levels of exercise for each stage of the Bruce, the full amount of each stage should be completed.

good luck