Rozanski Alan, Gransar Heidi, Miller Robert J H, Han Donghee, Hayes Sean, Friedman John, Thomson Louise, Berman Daniel
From the Division of Cardiology, Mount Sinai Morningside Hospital New York, NY, USA.
The Departments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, USA.
J Nucl Cardiol. 2024 Nov;41:102066. doi: 10.1016/j.nuclcard.2024.102066. Epub 2024 Oct 31.
There has been an increasing call for employing ultrashort exercise activity questionnaires as a clinical "vital sign". To-date, this has not been applied to patients undergoing cardiac stress testing.
We evaluated 1136 patients who completed a one-item exercise questionnaire before undergoing stress SPECT myocardial perfusion imaging (MPI). This question asked patients to grade how much they exercise during daily life on a 11-point scale (0 = none, 10 = always). Patients were divided into four exercise activity groups based on their response: no, low, moderate, and high exercise activity. The results of this questionnaire were compared with patients' clinical risk profile, mode of stress testing (exercise vs pharmacologic), and exercise treadmill duration.
We noted a stepwise inverse relationship between exercise activity and patients' frequency of hypertension, diabetes, and obesity (P < .001 for each). Patients with no reported exercise activity were more likely to complain of dyspnea. There was a stepwise increase in the number of patients performing treadmill exercise with increasing reported exercise activity (P < .001). The duration on treadmill exercise increased in stepwise fashion with higher patient reported exercise activity (P < .001).
Our single-item, self-reported questionnaire was correlated with patients' risk profiles, their mode of stress testing, and cardiorespiratory fitness. These correlates, along with the pragmatic nature of this ultrashort questionnaire, and its built-in identification of patients who may warrant exercise counseling, augurs for adopting ultrashort questionnaires regarding exercise activity among patients undergoing stress MPI, and other cardiac imaging tests where functional capacity is not routinely assessed.