Exercise physiology in the catheterization laboratory: Still alive and well!

摘要

The salient observation defining the clinical syndrome of warm-up angina, namely that anginal symptoms may be reduced with repeated episodes of work, was initially made >200 years ago by the London physician William Heberden. Consistent with his original description, contemporary demonstrations of warm-up angina either involves greater time to ischemic signs or symptoms (ie, ST-segment depression or chest pain) or a reduction in ischemic manifestations at equivalent workload in patients with coronary artery disease undergoing repeated bouts of exercise. Multiple theories have been proposed to explain this physiological phenomenon, ranging from changes in myocardial signaling to increased collateral recruitment and ischemic preconditioning.