4

votes

Best measure of cardiac health?

Answered on August 19, 2014
Created October 17, 2011 at 7:40 PM

I asked this on another board and was interested in hearing what some of you might say:

What, in your opinion, is the most useful measure(s) of cardiac health?

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on October 19, 2011
at 02:23 PM

Not in your case berger...you have other stuff going on for sure.

Medium avatar

(10611)

on October 18, 2011
at 09:17 PM

Thanks quilt. I'll take that to mean that you believe that lowering my systolic blood pressure and raising my HDL did not reduce my CV risk.

7b91be6e22d4e2960f40935e306bdee5

(245)

on October 18, 2011
at 04:19 PM

I did a stress test shortly after my MI and was told everything was fine. I also had a heart cath within days after my MI and was told everything was fine. Would these tests possibly miss whatever the cause was (cardiologist just say most likely a blood clot) or did the cause most likely disappear after the event?

Medium avatar

(39831)

on October 18, 2011
at 04:12 PM

Calcium score requires ionizing radiation, right?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:04 PM

HEart rate variability is a great quick way to tell a lot about your heart and the parasympathetic and sympathetic systems of the heart.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:03 PM

I think this is close to worthless.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:03 PM

I think a Calcium score is better. In fact if you read the JUPITER trial they make the point in their that calcium scores were very predictive. I think hyperlipid also blogged on this very issue as well.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:01 PM

Stress testing is notorius for missing pretty significant disease. Its a good screen but not tremendously sensitive or specific.

7b91be6e22d4e2960f40935e306bdee5

(245)

on October 18, 2011
at 12:40 PM

I put my values in from the date I had my NSTEMI and it gave me a Less than 1% chance. Actually it wouldn't take my 115 total chol # or my 16 HDL. Had to change to 120 and 20 respectively.

7b91be6e22d4e2960f40935e306bdee5

(245)

on October 18, 2011
at 12:35 PM

So, if one had the following tests and cardiologist said "everything looked fine" should one assume everything is fine? May 13, 2011 CAT Scan MRI & NMR- see note E23 Diagnostic Radiology X-Ray- see note E23 Cardiovascular Stress Test- see note E23

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on October 18, 2011
at 11:25 AM

Heart CT is a deal at $125.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:23 AM

thhq the question never asked about cost. I agree its nuts but it will come down. I know some cardiologist who are now doing cardiac biopsies for patients to run telomere test at very steep prices overseas. Crazy but people want these services.

Medium avatar

(10611)

on October 18, 2011
at 02:45 AM

@quilt, CV MRI looks like a $2000-5000 test depending on who runs it.

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on October 18, 2011
at 12:52 AM

Dr William Davis' mother died a week after a "good" stress test. Coronary Calcium CT measures actual calcification.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 11:41 PM

lol...I play with this with a lot of interest. At my levels I'm less than 1%. Raise my blood pressure to 160 and I'm 3%. Lower my blood pressure to 120 and mark "Yes" for meds and I'm up to 4%!!! So the story is dont take meds for moderately high blood pressure if your a middle aged male? I actually agree. Course I'd still work on exercise and diet.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 11:35 PM

Oh, if your just worried about the run portion I think you could easily replace that with any high intensity activity obviously.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 11:34 PM

Its a functional rather than chemical or anatomical slant is all....throw in some recovery rates like the PACE book by Sears and seems like a good way to monitor your cardio health.

E5c7f14800c5992831f5c70fa746dc5c

(12857)

on October 17, 2011
at 10:35 PM

If you run everyday its obviously gonna be easier to run faster than people who don't. I don't get how that's a good predictor.

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7 Answers

2
Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 01:54 AM

Well the honest answer is no one test is best......but if it were my heart I would use these two in combination.

Cardiovascular Magnetic Resonance Imaging

And a VO2 max.

You can tell just about everything from those two.

http://www.scmr.org/assets/files/2004pennell_ehjcmr_indications.pdf

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on October 18, 2011
at 11:25 AM

Heart CT is a deal at $125.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:23 AM

thhq the question never asked about cost. I agree its nuts but it will come down. I know some cardiologist who are now doing cardiac biopsies for patients to run telomere test at very steep prices overseas. Crazy but people want these services.

Medium avatar

(10611)

on October 18, 2011
at 02:45 AM

@quilt, CV MRI looks like a $2000-5000 test depending on who runs it.

7b91be6e22d4e2960f40935e306bdee5

(245)

on October 18, 2011
at 12:35 PM

So, if one had the following tests and cardiologist said "everything looked fine" should one assume everything is fine? May 13, 2011 CAT Scan MRI & NMR- see note E23 Diagnostic Radiology X-Ray- see note E23 Cardiovascular Stress Test- see note E23

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on October 19, 2011
at 02:23 PM

Not in your case berger...you have other stuff going on for sure.

1
2f54dbe892ec89b12d1db686568e885a

(919)

on October 18, 2011
at 08:44 AM

Take your pulse rate

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:04 PM

HEart rate variability is a great quick way to tell a lot about your heart and the parasympathetic and sympathetic systems of the heart.

0
Medium avatar

(10611)

on October 17, 2011
at 11:09 PM

Framingham risk score.

http://hp2010.nhlbihin.net/atpiii/calculator.asp

Though there are now better metrics, this accounts for systolic BP, lipids, age, sex and smoking. It's also based on a large population tracked over several decades. I score 6% risk.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 11:41 PM

lol...I play with this with a lot of interest. At my levels I'm less than 1%. Raise my blood pressure to 160 and I'm 3%. Lower my blood pressure to 120 and mark "Yes" for meds and I'm up to 4%!!! So the story is dont take meds for moderately high blood pressure if your a middle aged male? I actually agree. Course I'd still work on exercise and diet.

7b91be6e22d4e2960f40935e306bdee5

(245)

on October 18, 2011
at 12:40 PM

I put my values in from the date I had my NSTEMI and it gave me a Less than 1% chance. Actually it wouldn't take my 115 total chol # or my 16 HDL. Had to change to 120 and 20 respectively.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:03 PM

I think this is close to worthless.

Medium avatar

(10611)

on October 18, 2011
at 09:17 PM

Thanks quilt. I'll take that to mean that you believe that lowering my systolic blood pressure and raising my HDL did not reduce my CV risk.

0
Da3d4a6835c0f5256b2ef829b3ba3393

on October 17, 2011
at 10:32 PM

How fast you can run a mile?

Blood pressure?

Agatston Score?

“The principal finding of these studies is that your fitness level when you’re young is highly predictive of heart disease risk 30 to 40 years later,” he said. “If we’re trying to boil this down into practical implications, it’s the speed at which you can run. Heart disease risk increases markedly for every minute longer it takes you to run a mile.”

  • Dr. Jarett D. Berry, assistant professor of internal medicine and cardiology at Southwestern Medical School

“Maximal oxygen uptake (VO2max) is widely accepted as the single best measure of cardiovascular fitness and maximal aerobic power."

  • Thomas E. Hyde and Marianne S. Gengenbach, Conservative Management of Sports Injuries (2nd ed; Sudbury, Mass.: Jones & Bartlett, 2007

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 11:35 PM

Oh, if your just worried about the run portion I think you could easily replace that with any high intensity activity obviously.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 11:34 PM

Its a functional rather than chemical or anatomical slant is all....throw in some recovery rates like the PACE book by Sears and seems like a good way to monitor your cardio health.

E5c7f14800c5992831f5c70fa746dc5c

(12857)

on October 17, 2011
at 10:35 PM

If you run everyday its obviously gonna be easier to run faster than people who don't. I don't get how that's a good predictor.

0
F261881ab8346e796718522de51ddef9

on October 17, 2011
at 09:20 PM

Probably a cardiac stress test; or angiogram. Then I would say CRP and VAP test. There is a cat scan that one can do to see plaque level (Dr. William Davis' site: "track your plaque"). There is a doctor in Great Britain, Sidney Bush who does cardioretinometry; This is where they look into the eye to observe blood vessels for plaque buildup.

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on October 18, 2011
at 12:52 AM

Dr William Davis' mother died a week after a "good" stress test. Coronary Calcium CT measures actual calcification.

0
Medium avatar

on October 17, 2011
at 08:24 PM

If you mean a single test, then probably a cardiac stress test.

Medium avatar

(39831)

on October 18, 2011
at 04:12 PM

Calcium score requires ionizing radiation, right?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:03 PM

I think a Calcium score is better. In fact if you read the JUPITER trial they make the point in their that calcium scores were very predictive. I think hyperlipid also blogged on this very issue as well.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on October 18, 2011
at 03:01 PM

Stress testing is notorius for missing pretty significant disease. Its a good screen but not tremendously sensitive or specific.

7b91be6e22d4e2960f40935e306bdee5

(245)

on October 18, 2011
at 04:19 PM

I did a stress test shortly after my MI and was told everything was fine. I also had a heart cath within days after my MI and was told everything was fine. Would these tests possibly miss whatever the cause was (cardiologist just say most likely a blood clot) or did the cause most likely disappear after the event?

0
3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 17, 2011
at 08:16 PM

I'm sure some will give you a grouping of various tests, but I'm going to go with comprehensive lifestyle and physical examination.

If you knew in depth what a persons lifestyle factors had been up to the day of examination and take that into account you have a pretty darn good idea of what their cardiac health is. That is what leads to the other tests.

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