Article

Quadriceps strength is related to exercise capacity in normal
subjects and different patient populations, but the relationship between maximal
quadriceps isometric strength (QIS) and different exercise capacity levels in
coronary artery disease (CAD) patients has not been systematically evaluated yet.
METHOD: We studied 621 patients (60.6 +/- 9.9 years, 538 males) with recent
coronary artery bypass grafting or myocardial infarction, who underwent treadmill
exercise testing, maximal QIS measurement (hand-held dynamometry), and coronary
arteriography. Maximal QIS was expressed as absolute value (kg), %bodyweight, and
%predicted maximum. Logistic regression was used to assess the relationship of
maximal QIS, age, sex, number of diseased coronary vessels, peak systolic blood
pressure, peak heart rate,
brain natriuretic peptide, and left ventricular
ejection fraction with 5, 7, and 10 estimated metabolic equivalents (eMETs)
exercise capacity levels. RESULTS: Maximal QIS %bodyweight was the strongest
predictor of exercise capacity in each eMETs category. Receiver-operating
characteristics curves identified maximal QIS of 46, 51, and 59 % bodyweight as
the best predictive cut offs for 5, 7 and 10 eMETs, respectively, with positive
predictive values of 0.72, 0.66, and 0.67, respectively. CONCLUSIONS: Maximal QIS
is related with eMETs levels reached at exercise testing in CAD patients, and
identified maximal QIS cut-off values for eMETs prediction may be used to set
strength training goals according to patients' needs with regard to habitual
physical activity level. Hand-held dynamometry may meet the need of easiness of
use and low cost required for strength evaluation in large-scale clinical trials.
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Langue : ANGLAIS