Author + information
- Received June 25, 1992
- Revision received September 22, 1992
- Accepted September 30, 1992
- Published online April 1, 1993.
- Philippe Colles, MD,
- Martin Juneau, MD, FACC∗,
- Jean Grégoire, MD,
- Lucie Larivée, RN,
- Alessandro Desideri, MD and
- David Waters, MD, FACC
- ↵∗Address for correspondence: Martin Juneau, MD, Montreal Heart Institute, 5000 Belanger Street East, Montreal, Quebec, HIT 1C8, Canada.
Objectives. This study was undertaken to determine the effect of a standardized meal on the ischemie threshold and exercise capacity in a series of 20 patients with stable angina, exerciseinduced ischemia and reversible exercise-induced perfusion defects.
Background. It is generally accepted that exercise tolerance in patients with angina is reduced after a meal. However, studies that have addressed this phenomenon have yielded results that are contradictory and inconclusive.
Methods. Two exercise tests using the Brace protocol with technetium-99m (99mTc)-sestamibi were performed on consecutive days in a randomized order. One test was performed in the fasting state and the other 30 min after a 1,000-calorle meal.
Results. In the postprandial state, exercise time to ischemia was reduced by 20% from 248 ± 93 s to 197 ±87 s (p = 0.0007), time to angina by 15% from 340 ± 82 s to 287 ± 94 s (p = 0.002) and exercise tolerance by 9% from 376 ± 65 s to 344 ± 86 s (p = 0.002). Rate-pressure products at these exercise test end points were not significantly different in the fasting and postprandial tests, and the quantitative 99mTc-sestamibi ischemia score was unchanged.
Conclusions. In patients with stable angina, a 1,000-calorie meal significantly reduced tine to ischemia, time to angina and exercise tolerance because of a more rapid increase in myocardial oxygen demand with exercise. The extent and severity of exerciseinduced ischemia were unchanged.
- Received June 25, 1992.
- Revision received September 22, 1992.
- Accepted September 30, 1992.