HIGHLAND MOUNTAIN HIKING AND CORONARY-ARTERY DISEASE - EXERCISE TOLERANCE AND EFFECTS ON LEFT-VENTRICULAR FUNCTION

Physical exercise has become a well-established concept in the seconda ry prevention of coronary artery disease. We investigated the exercise requirements of extensive highland mountain hiking (8.7 lan, 470 m to 1220 m over sea level, average incline 8.5%, mean walking velocity < 3 km.h(-1)) in II regularly exercising male patients with history of M I and stable coronary artery disease (CAD: mean age +/- SD:61.0 +/- 3. 9 yr) and 9 age-matched male healthy controls (GO; mean age I SD:61.2 +/- 5.0 yr), All subjects underwent continuous ECG monitoring; arteria l blood pressure and blood lactate concentrations were measured severa l times during mountain hiking, Before and after exercise, cardiac dim ensions and functions were assessed by two-dimensional echocardiograph y and Doppler echocardiography. The mean exercise levels for heart rat e and blood lactate were compared with the corresponding data of a mul tistage upright cycle ergometry. Clinical manifestations of coronary i nsufficiency, left ventricular myocardial dysfunction, or cardiac arrh ythmias > Lown mb were not observed In any case. No significant differ ences in left atrial and left ventricular dimensions and no changes in systolic left ventricular function compared with the preexercise valu es were found after the mountain hike tour. Doppler echocardiography d emonstrated significant changes in diastolic left ventricular function in CAD, but not in CO. The peak, exercise intensity during mountain h iking was equivalent to a workload of 100-125 W (1.25-1.5 W x kg(-1) b ody weight) in a multistage upright cycle ergometry. Extensive highlan d mountain hiking may be a low risk alternative within the outpatient rehabilitation program for secondary prevention of CAD for MI patients with a cycle ergometric exercise tolerance > 1.5 W x kg(-1) body weig ht.