Anginal Threshold between Stress Tests: Exercise versus Dobutamine Stress Echocardiography
Bibliographic record
Abstract
PURPOSE: Dobutamine echocardiography (DOB) can be substituted to exercise testing when necessary for clinical reasons. Current literature suggests DOB is maximal when 85% of maximal predicted heart rate (%PHR) is achieved (similar to EX), but there is little evidence to determine whether this target has the same clinical significance as during EX. We therefore performed this study to compare the ischemic threshold between EX and DOB. METHODS: Twenty men with stable angina underwent in a random order DOB and EX echocardiograms after being weaned off their cardiac medications. Electrocardiography, heart rate (HR), and systolic blood pressure were recorded every minute. Ischemic threshold was defined as the precise time at which clinical angina occurred. RESULTS: Anginal threshold appeared consistently at a higher level for DOB than EX as evidenced by the higher rate-pressure product (RPP) values (22,492 +/- 4,300 vs 20,371 +/- 5,367 bpm x mm Hg, DOB vs EX, respectively, P = 0.02), HR (126 +/- 23 vs 119 +/- 15 bpm, P = 0.01), and %PHR (79 +/- 15% vs 74 +/- 10%, P < 0.01). Thirty-two percent of the subjects presented an ischemic HR above 85% of PHR and 60% had a higher ischemic HR during DOB versus EX. CONCLUSIONS: This study shows that estimation of anginal threshold during DOB is feasible and is slightly higher (approximately 10%) than during EX. Extrapolation of a cut off target heart rate from an exercise modality to a pharmaceutical one may not be valid.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".