A symptom-limited exercise test using a calibrated
electromagnetically braked cycle ergometer with an
electrical seat height adjustment (Ergoselect 100, Ergoline,
Germany) was performed according to a modified
Jones protocol (stepwise increase in work load of
16 Watts/min, starting with unloaded cycling plus the
ergometer related permanent load) [16]. Study details
are given elsewhere [17–19]. In the absence of chest
pain and ECG abnormalities, all tests were continued as symptom-limited (volitional exertion, dyspnoea or
fatigue). Prior to the test, patients were encouraged to
reach maximal exhaustion, while during exercise no
further motivational interventions were utilised. In accordance
with current recommendations systolic or diastolic
blood pressure were – in the absence of symptoms – not
considered as reasons for termination [20]. All tests were
performed at room air according to current guidelines
for exercise testing, with continuous monitoring of ECG,
and oxygen saturation [21,22]. Systolic and diastolic blood
pressure were measured once before the start of exercise
testing and then measured manually continuously at
each level of work load. All investigators were regularly
certified and strict quality controls were applied.
A symptom-limited exercise test using a calibrated
electromagnetically braked cycle ergometer with an
electrical seat height adjustment (Ergoselect 100, Ergoline,
Germany) was performed according to a modified
Jones protocol (stepwise increase in work load of
16 Watts/min, starting with unloaded cycling plus the
ergometer related permanent load) [16]. Study details
are given elsewhere [17–19]. In the absence of chest
pain and ECG abnormalities, all tests were continued as symptom-limited (volitional exertion, dyspnoea or
fatigue). Prior to the test, patients were encouraged to
reach maximal exhaustion, while during exercise no
further motivational interventions were utilised. In accordance
with current recommendations systolic or diastolic
blood pressure were – in the absence of symptoms – not
considered as reasons for termination [20]. All tests were
performed at room air according to current guidelines
for exercise testing, with continuous monitoring of ECG,
and oxygen saturation [21,22]. Systolic and diastolic blood
pressure were measured once before the start of exercise
testing and then measured manually continuously at
each level of work load. All investigators were regularly
certified and strict quality controls were applied.
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