Use of bicycle ergometry and sustained handgrip exercise in the diagnosis of presence and extent of coronary heart disease.

The present study examines the efficacy of the exercise electrocardiogram using the isotonic bicycle ergometer and isometric handgrip in predicting the extent of coronary obstructive disease, coronary collaterals, and abnormalities of left ventricular contraction (asynergy) in 65 patients. Of 32 patients with a normal isotonic exercise electrocardiogram, 25 had a normal coronary arteriogram (78.i%). Of the 32, 7 (2I 9%) were false negatives (normal exercise electrocardiogram with abnormal coronary arteriogram). Conversely, 5 of 3I patients (i6-i%) were false positives (abnormal exercise electrocardiogram with normal coronary arteriogram). In contrast, only 3 of 53 patients tested with isometric handgrip had abnormal electrocardiograms. This correlated with the finding that the product of systolic pressure and heart rate achieved with bicycle ergometry