Teste ergométrico em idosos. Parâmetros clínicos, metabólicos, hemodinâmicos e eletrocardiográficos / Stress test in the elderly. Clinical, hemodynamic, metabolic and electrocardiographic variables

RESUMO

PURPOSE: To identify in the elderly adaptations imposed by exercise in both sexes. METHODS: 1528 stress tests were performed on subjects divided in group I (GI) (90) between 65 to 75 years old, and group II (GII) more than 75 years old. Protocols applied were Bruce (72), and modified Naughton (28). Clinical, hemodynamic and electrocardiographic variables were estimated as recommended by the World Health Organization, and the metabolic variables in the adapted Naughton protocols by the American College of Sports Medicine standards. RESULTS: Analysis of GI and GII, respectively disclosed 1) stress electrocardiogram (ECG) normal, 36 and 35; ST depression, 20 and 22; ST elevation, 6 and 1; ventricular ectopic beats, 11 and 14; supra ventricular ectopic beats, 5 and 6; 2) metabolic and hemodynamic variables the double-product 26636 (+/-1539) and 23133 (+/-3218) mmHg X bpm (p < 0.0001). Maximum oxygen uptake measured in METS GI, men, 7.7 (+/-1.9), women 5.4 (+/-0.8) (p < 0.0001); GII, NS, curve of systolic blood pressure GI, men, 8.4 +/- (0.5), women, 10.6 (+/-1.8) mmHg/Met (p = 0.03); GII- NS. Difference of diastolic blood pressure and heart rate during exercise were similar between the two groups; 3) chest pain was the main clinical variable. CONCLUSION: The more frequent indication for stress testing to evaluate chest pain in GI, did not correspond to a predominance of this symptom in this group, during exercise; in GI, in contrast to what is seen in the young, the curve of systolic blood pressure was greater in women; despite the greater prevalence of coronary artery disease in aged subjects, it was not observed significative differences between the two groups, to ischaemic ST depression.