The Duke Treadmill Exercise Test can be used to stratify patients undergoing exercise testing into prognostic groups. The score was developed by Mark et al at Duke University Medical Center.
Procedure: Symptom-limited (by angina, dyspnea, and/or fatigue) exercise treadmill testing using the Bruce or modified Bruce protocol.
Parameters for score:
(1) duration of exercise in minutes, as a whole number. Different protocols have different completion times (12 minutes in regular Bruce to 27 in modified Bruce). In Figure 1 page 850 in Mark et al (1991) the maximum was 18 minutes. The people with significant disease apparently had exercise times < 3 minutes (Table 2 page 851, Mark et al, 1991).
(2) maximal ST-segment deviation during or after exercise in millimeters, as a whole number
(3) treadmill angina index, according to the following table:
Angina During Treadmill Procedure
Duke treadmill exercise score =
= (duration of exercise in minutes) – (5 * ABSOLUTE((maximal ST segment deviation))) – (4 * (treadmill angina index))
• minimum score: probably around –28 (assumes 0 minute exercise, 4 mm ST segment deviation and angina-limited; see Figure 1 page 850 in Mark et al, 1991).
• maximum score: determined by exercise protocol (no ST segment deviation and no angina)
• The lower the score, the higher the risk for the patient.
>= – 10 to < 5
In Mark et al (1991), the 4 year survival for low risk group was >= 98%, for the intermediate group 92-95%, and 70-80% in the high risk group (Table 3, page 853). Interventions would affect survival.
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Specialty: Cardiology, Sports Medicine & Rehabilitation