胺碘酮结合稳心颗粒治疗儿童室上性心动过速的临床分析

目的 分析胺碘酮结合稳心颗粒治疗儿童室上性心动过速(SVT)的临床效果.方法 选择2018年8月-2020年9月收治的122例SVT患儿,根据随机数字表法分两组,各61例.对照组采用胺碘酮治疗,观察组采用稳心颗粒联合胺碘酮治疗,两组均治疗3周.比较两组治疗前、治疗3周的心电图指标[ST下降时间、ST段压低幅度]和血清超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)水平.结果 治疗3周,观察组ST下降时间短于对照组,ST段压低幅度低于对照组(P＜0.05);治疗3周,观察组hs-CRP水平低于对照组,BNP水平低于对照组(P＜0.05).结论 胺碘酮结合稳心颗粒治疗儿童SVT可促进心率恢复,减轻炎症反应.     

心电图负荷试验对诊断冠心病的临床价值

我们对正常和冠心病(CAD)人进行了心电图潘生丁(DPT)和活动平板(TST)试验对比分析,探讨这二种无创心电图应激试验在诊断CAD人中的规律。并在TST中采用了_△R和最大ST段/心率(HR)斜率二项新指标,将其与TST的ST段参数进行了对比,探讨其在临床中的应用价值。 1 资料和方法 正常人组共102例,男92例,女10例。其中飞行员72例,均无高血压及心血管疾病史,体检、X线、心电图、血脂分析等均属正常。     

飞行员飞行中与地面的动态心电图分析

笔者对30名歼击飞行员用CM_1、CM_3、CM_5双极导联进行24h动态心电图(DCG)监测,结果心率在地面工作日与普通人基本相同,飞行中平均68±7次/min,最高为124±24次/min,最低54±6次/min,飞行后与地面工作日相应时间相同;未见心脏节律的明显变化;未监 测到T波改变。2例在高空特技飞行中ST段水平下移0.075～.0100mV,但活动平板运动试验阴性。笔者认为DCG适用于飞行员飞行中监测,特别对平时有症状的飞行员,可以提高诊断的准确性。     

心肌梗死患者药物溶栓治疗对窦性心率振荡的影响

目的观察心肌梗死(MI)患者在应用尿激酶溶栓后对窦性心率振荡(HRT)的影响。方法选择MI后接受溶栓治疗的40例(治疗组)及未采取溶栓治疗的23例(对照组)患者均接受24 h动态心电图检查,分别计算HRT的振荡初始(TO)和震荡斜率(TS)数据,比较两组之间的差异。结果治疗组TO较对照组明显降低(P<0.05),TS明显升高(P<0.05)。结论溶栓治疗后患者的HRT现象趋于正常。     

持续ST段抬高对直接经皮冠脉介入治疗疗效的影响

目的探讨心电图梗死相关导联持续ST段抬高对判断直接PCI治疗AMI疗效的应用价值。方法根据心电图梗死相关导联ST段抬高回落情况将229例直接PCI后TIMI血流3级的AMI患者分2组:ST段回落>50%组(甲组),147例;与ST段回落<50%组(乙组),82例,比较两组一般临床特征,随访心血管事件的发生率。结果甲乙两组:无复流(blush分级<2级)为14/147(9.5%)和21/82(25.6%);住院期间病死率5/147(3.40%)和9/82(11.0%);MACE 8/147(5.4%)和11/82(13.4%);心功能EF数值56.99±9.78和49.82±8.78比较,P<0.05,均有明显统计学差异。随访期间病死率2/147(1.34%)和3/82(3.7%);MACE 10/147(5.4%)和7/82(8.5%),P>0.05,均无统计学差异。结论心电图梗死相关导联ST段抬高回落情况可作为直接PCI后心肌组织水平再灌注及预后判断的指标。     

急性前壁心梗经皮冠状动脉血运重建术后ST段持续抬高对心梗晚期左室功能的影响

目的　探讨急性前壁心肌梗死行直接经皮冠状动脉血运重建术 (PCI)后心电图ST段持续抬高对心梗后晚期左室功能和临床预后的影响。方法　选择因急性前壁心肌梗死入院接受急诊PCI的患者 72例 ,动态观察PCI术前后心电图ST段的变化 ,以PCI术后 1hST段下降大于 5 0 %为ST段下降组 ,相反为ST段抬高组。应用超声心动图测定心梗后早期 (2～ 3周 )和晚期 (5～ 6个月 )左室功能和室壁活动异常的变化 ,并随访其间心血管事件的发生率。结果　ST段下降组 5 3例 (74 % ) ,ST段抬高组 19例(2 6 % )。心梗后早期两组间左室功能和室壁活动异常无明显差异 ;晚期ST段抬高组LVEF明显低于ST段下降组 (P <0 .0 5 ) ,而LVEDVI、LVESVI和VWMA积分均明显高于ST段下降组 (P <0 .0 5 ,P <0 .0 1)。随访期间ST段抬高组主要心血管事件的发生率略高于ST段下降组 ,但差异无统计学意义。ST段下降组梗死前心绞痛和直接支架术的比例明显高于ST段抬高组 (P <0 .0 5 )。结论　急性前壁心肌梗死成功直接PCI后ST段持续性抬高者心梗后晚期左室功能较差。有梗死前心绞痛和直接支架术者PCI术后ST段持续性抬高的发生率可能较低     

冠状动脉内注射小剂量重组尿激酶原治疗急性ST段抬高型心肌梗死临床效果观察

目的探讨冠状动脉内注射小剂量重组尿激酶原治疗急性ST段抬高型心肌梗死的临床效果。方法选取徐州医科大附属沭阳县人民医院自2018年1月至2019年2月收治的86例急性ST段抬高型心肌梗死患者为研究对象。根据治疗方法不同,将患者分入A组和B组,每组各43例。A组患者接受常规治疗,B组患者在常规治疗基础上联合冠状动脉内注射小剂量重组尿激酶原治疗。比较两组患者的治疗有效率,术后4、8、12、24 h和术后1、3个月6个时间点的心肌酶、心电图QT离散度、血浆B型脑钠肽、左室射血分数,心肌梗死溶栓(TIMI)血流分级,ST段回落和再通情况,以及主要不良心血管事件发生率。结果 B组治疗有效率为95.4%(41/43),高于A组的76.7%(33/43),差异有统计学意义(P<0.05)。治疗后,两组患者心肌酶、心电图QT离散度、血浆B型脑钠肽在术后4、8、12、24 h和术后1、3个月这6个时间点呈逐渐下降趋势,各时间点比较,差异均有统计学意义(P<0.05);且B组低于A组,差异有统计学意义(P<0.05)。治疗后,两组患者左室射血分数在术后4、8、12、24 h和术后1、3个月这6个时间点呈逐渐上升趋势,各时间点比较,差异均有统计学意义(P<0.05);且B组高于A组,差异有统计学意义(P<0.05)。B组TIMI血流分级2～3级所占比例为95.4%(41/43),高于A组的79.1%(34/43),差异有统计学意义(P<0.05)。B组患者ST段回落≥50%者所占比例为81.4%(35/43),高于A组的60.5%(26/43),差异有统计学意义(P<0.05);B组ST段完全回落者所占比例为55.8%(24/43),高于A组的34.9%(15/43),差异有统计学意义(P<0.05);B组再通者所占比例为76.7%(33/43),高于A组的55.8%(24/43),差异有统计学意义(P<0.05)。B组主要不良心血管事件发生率为7.0%(3/43),低于A组的18.6%(8/43),差异有统计学意义(P<0.05)。结论冠状动脉内注射小剂量重组尿激酶原治疗急性ST段抬高型心肌梗死的临床效果显著,可有效改善患者心功能和心肌灌注,减少出血风险,降低主要不良心血管事件发生率。     

远端血管保护装置在急性ST段抬高心梗中的应用

目的 评价远端血管保护装置(DPD)在急性ST段抬高心梗中的应用价值.方法 回顾性分析2004年1月1日-2005年12月31日第四军医大学西京医院心内科收治的267例急性Sr段抬高心梗患者行急诊FCI的相关临床资料.其中常规PCI(对照组)169例,PCI术中使用DPD(实验组)98例.比较两组术中无复流发生率、心肌梗死溶栓治疗(TIMI)3级血流比例、术后ST段回降率、住院死亡率、术后1周左室射血分数(LVEF)等指标.结果 DPD组无复流发生率、TIMI 3级血流比例、术后ST段回降率分别为3.06%(3例)、93.88%(92例)、94.90%(93例),对照组分别为13.61%(23例)、77.51%(131例)、84.02%(142例),两组比较差异显著(P<0.05).两组间住院期间死亡率、术后1周LVEF比较无显著性差异.结论 在急性ST段抬高心梗急诊PCI术中应用DPD能明显减少无复流发生率,改善TIMI血流,而对住院死亡率、PCI术后近期心功能改善的影响有待进一步研究.     

健身气功对中度帕金森病患者心境状态和认知的影响

目的:观察健身气功改善帕金森病患者心境状态及认知的效果。方法:36名中度帕金森病患者随机分为气功锻炼组(18人)和对照组(18人),气功锻炼组进行为期8周、每周5天、每天60 min的健身气功锻炼,对照组保持平常的生活方式不变且不参与健身气功练习。实验前后运用简式心境状态量表(POMS)和蒙特利尔认知评估量表(Mo CA)进行测试。结果:心境状态方面,在疲劳、抑郁、精力、总分这4个维度上,相比于前测,气功锻炼组后测得分显著改善(P<0.05),而对照组前后测得分差异不显著(P>0.05);在紧张、愤怒、慌乱、自我的四个维度上两组前后测差异均不显著。认知功能方面,注意、延迟回忆、认知总分维度,相比于前测,气功锻炼组后测得分显著改善(P<0.05),而对照组前后测得分差异不显著(P>0.05);在视空间与执行能力、命名、语言、抽象、定向维度上两组前后测差异均不显著。结论:健身气功可以改善中度帕金森病患者部分心境状态和部分认知功能。     

亚低温治疗急性重型颅脑损伤的临床观察

目的　观察亚低温治疗急性重型颅脑损伤的疗效 ;探讨亚低温治疗的平稳性和安全性。方法将 1 1 2例急性重型颅脑损伤随机分为亚低温组 (5 5例 )和对照组 (5 7例 )。亚低温组入院后或术后立即给予亚低温治疗 ,酌情运用冬眠合剂、肌松剂和呼吸机 ,肛温控制在 32℃～ 34℃ ,持续 2 4小时～ 5天。对照组给予常规治疗。两组均观察颅内压 (ICP)、生命体征、脑干听觉诱发电位 (BAEP)Ⅰ /Ⅴ波幅比值等的变化。结果　亚低温组经亚低温治疗后 ,ICP下降明显 ;1 1例血压下降 ,1 2例心率减慢 ,复温后 ,以上指标均恢复正常 ;亚低温治疗后 2 4小时及复温后 ,双侧BAEPⅠ /Ⅴ比值与对照组同时段相比差异显著。亚低温组死亡 1 3例 ,死亡率 2 3.6 % ;对照组死亡 2 6例 ,死亡率 4 5 .6 % ,两组有显著性差异。结论　亚低温治疗能降低脑外伤后增高的ICP ,从而使死亡率及致残率明显下降。亚低温治疗中合理使用辅助药物 ,可以保障亚低温治疗的平稳性及安全性     

Influence of peak exercise heart rate on normal thallium-201 myocardial clearance

Measurement of myocardial clearance rates between initial and delayed images is a major justification for adding computer quantification to the interpretation of exercise 201TI images. To clarify the range of normal thallium clearance and its relationship to the level of exercise achieved, exercise thallium images in 89 normal subjects were analyzed: 45 asymptomatic subjects with less than 1% probability of coronary artery disease (CAD) (Group I), and 44 patients with chest pain found to have no significant CAD on angiography (Group II). Mean initial regional thallium uptake was similar in the two groups, but myocardial thallium clearance (mean +/- 1 s.d.) was slower in Group II, expressed as a longer half-life in the myocardium (8.2 +/- 7.6 hr compared with 3.4 +/- 0.7 hr p less than 0.001). Analysis of variance using ten clinical and exercise variables as covariates showed that the slower clearance in Group II was related to a lower peak exercise heart rate (HR) (154 +/- 27 compared with 183 +/- 11, respectively, p less than 0.001). By linear regression analysis, a decrease in peak HR of 1 beat/min was associated with a slower thallium clearance (longer half-life) of 0.05 hr. Using this formula, the clearance value in each patient was then corrected for peak exercise heart rate by decreasing measured clearance by 0.05 hr multiplied by the amount peak exercise heart rate which was below 183 (the mean value in Group I). There were no differences in the "corrected" clearance between the two groups. We conclude that thallium myocardial clearance after exercise is related in part to factors other than the presence of CAD, being slower when peak exercise HR is lower. Therefore, thallium clearance rates alone uncorrected for peak exercise heart rate should be used with caution when diagnosing CAD.     

硬支气管镜置入条件评分在气管异物取出术中应用的可行性探讨

目的探讨小儿气管异物取出术中硬质支气管镜置入条件评分的可行性。方法就诊于本院的气管异物患儿70例,美国麻醉医师协会体格情况分级（The American Society of Anesthesiologists Physical Status Classification System,ASA体格情况分级）Ⅰ或Ⅱ级,年龄1～3岁,体重9～16 kg,随机分为两组（n=35）：Ⅰ组（不评分组）和Ⅱ组（评分组）。麻醉诱导：分别静脉注射异丙酚2 mg/kg,芬太尼2μg/kg,并静脉输注异丙酚10～12 mg.kg-1.h^-1。Ⅰ组诱导后9 min,Ⅱ组评分达到5分时置镜,两组术中出现体动或呛咳时均追加异丙酚1～2 mg/kg。记录置镜即刻（T0）,置镜后5 min（T1）、10 min（T2）,退镜即刻（T4）的HR、MAP和SpO2;记录诱导时间,手术时间,苏醒时间和异丙酚的用量;以及术中和苏醒期不良反应的发生情况。结果术中两组间各时点HR、MAP和SpO2比较,差异无统计学意义（P〉0.05）;与基础值比较,T1和T2的HR增加,MAP升高,差异有统计学意义（P〈0.05）;两组手术时间、苏醒时间的比较,差异无统计学意义（P〉0.05）,与Ⅰ组比较,Ⅱ组诱导时间延长,异丙酚用量增加,差异有统计学意义（P〈0.05）;诱导期和苏醒期两组不良反应的比较,差异无统计学意义（P〉0.05）;与Ⅰ组比较,Ⅱ组术中去氧饱和（SpO2〈90%超过5s定义为发生1次去氧饱和）、呛咳和体动的发生均减少,差异有统计学意义。结论硬支气管镜置入条件评分可在小儿气管异物取出术中应用。     

舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响

目的评价舒芬太尼复合艾司洛尔对全麻患者气管拔管时心血管反应的影响。方法选择全麻择期手术成年患者120例,ASAⅠ~Ⅱ级,无明显心血管病史,随机分为两组(n=60),A组:舒芬太尼0.5μg/kg;B组:舒芬太尼0.5μg/kg+艾司洛尔1 mg/kg。观测比较麻醉诱导前、插管后5 m in、拔管后5 m in收缩压(SP)、舒张压(DP)和心率(HR)变化,并采集桡动脉血7m l,测定血浆肾上腺素(Ad)和去甲肾上腺素(NA)的浓度。结果两组年龄、体重、ASA分级、并发症比较差异均无统计学意义(P>0.05)。与A组同一时点比较,B组HR、SP、DP及血浆Ad和NA的浓度降低(P<0.05)。A组插管后HR、SP、DP及血浆Ad和NA的浓度明显高于麻醉诱导前(P<0.05),持续至拔管后5 m in;B组拔管前后变化不明显(P>0.05)。结论舒芬太尼复合艾司洛尔可更好地预防全麻患者气管拔管时的心血管反应。     

Quantitative thallium-201 myocardial exercise scintigraphy in normal subjects and patients with normal coronary arteries

Quantitative thallium-201 myocardial exercise scintigraphy was tested in two patient populations representing alternative standards for cardiac normality: group I comprised 18 male uncatheterized patients with a low likelihood of coronary artery disease (CAD); group II contained 41 patients with normal coronary arteriograms. Group I patients were younger, they achieved a higher rate-pressure product than group II patients; all had normal findings by physical examination and electrocardiography at rest and exercise. Group II patients comprised 21 females, 11 patients showed abnormal electrocardiography at rest, and five patients showed ischemic ST depression during exercise. Twelve patients had signs of minimal CAD. Twelve patients revealed abnormal visual and quantitative thallium findings, three of these patients had minimal CAD. Profiles of uptake and washout of thallium-201 were derived from both patient groups, and compared with normal limits developed by Maddahi et al. Furthermore, low likelihood and angiographically normal patients may differ substantially, and both sets of normal patients should be considered when establishing criteria for abnormality in exercise thallium imaging. When commercial software containing normal limits for quantitative analysis of exercise thallium-201 imaging is used in clinical practice, it is mandatory to compare these with normal limits of uptake and washout of thallium-201, derived from the less heterogeneous group of low-likelihood subjects, which should be used in selecting a normal population to define normality.     

Cross-sectional and longitudinal evaluations of an endurance training program.

A comparison of the cardiorespiratory responses obtained using both a longitudinal and cross-sectional evaluation of an endurance training program was made in two groups of 60 young male military personnel. Both groups were initially tested (T1) and then retested 6 months later (T2). At T1, Group I was a sample of personnel not participating in a training program while Group II had undergone a 5-month endurance program (2-4 mile run/day). At T2, Groups I and II had been participating in the program for 6 and 11 months, respectively. Testing consisted of sub-maximal and maximal determinations of VO2, VE and heart rate (HR) using an interrupted treadmill test. VO2 max was 11% greater in Group II compared to Group I at T1 and increased 10% in Group I at T2. Similar results were also seen for HR submax, HR max and VE max. These results show that similar values indicative of an improved level of cardiorespiratory fitness can be obtained using either a cross-sectional or longitudinal design when relatively homogeneous groups are studied.     

Clinical significance of exercise-induced ST segment depression in patients with lateral myocardial infarction involving the left circumflex artery: evaluation by exercise 99mTc-MIBI myocardial scintigraphy

PURPOSE: The aim of this study is to clarify the causes of exercise-induced ST-segment depression in patients with broad lateral old myocardial infraction involving LCX (LCX-OMI) without ischemia on exercise scintigraphy. METHOD: Twenty one patients (M/F = 11/10, age = 62 +/- 19 years) with myocardial infraction involving LCX (LCX-MI), but without fill-in on exercise and rest MIBI quantitative gated SPECT (QGS), were selected. They were divided into two groups of Group ST(+) (n = 11, with significant ST depression (max -2.8 +/- 0.4 mm), Group ST(-) (n = 10) without ST depression. On 20 SPECT segments of both exercise and rest SPECT, we scored uptake score as DS (0 = normal to 3 = defect) and wall motion as WMS (0 = normal to -5 = dyskinesis) and summed DS (TDS) and WMS (TWMS) in LCX region, furthermore, calculated the difference of TWMS (delta TWMS [exercise-rest]), end diastolic volume (EDV) and ejection fraction (EF) during exercise were compared between the two groups. RESULT: Group ST(+) showed significantly (p < 0.01) lower EF (35.4 +/- 9.2% vs. 60.2 +/- 6.2%), larger EDV (146 +/- 53 ml vs. 93 +/- 15 ml), higher TDS (5 vs. 7 +/- 3), lower TWMS (-25 +/- 9 vs. -6 +/- 5), furthermore lower delta TWMS (-6.9 +/- 4.0 vs. -2.0 +/- 0.8) than Group ST(-). CONCLUSION: Exercise-induced significant ST depression in V2-4 without ischema in LCX-MI was observed in patients with broad LCX-MI, low EF, and was related to impaired wall motion in LCX region. ST depression in V2-4 was considered to appear as miller image of ST elevation at postero-inferior wall due to disturbed wall motion on exercise.     

运动试验中变时性功能检测对诊断冠心病的意义

 目的 探讨运动试验中变时性功能检测对冠心病的诊断价值.方法 对68例冠脉造影者在平板运动试验中变时性功能指标的变化进行测量,将冠脉造影阳性(冠心病组)与冠脉造影正常组、冠心病组中ST段压低者与ST段压低伴变时性功能不良者进行对比分析.结果 冠心病患者运动后最大心率、变时性指数以及运动后心率恢复明显低于冠脉正常组(P＜0.05和P＜0.01), ST段压低伴变时性功能不良诊断冠心病的敏感性、特异性和阳性预测值均比ST段压低明显增高(P＜0.05和P＜0.01).结论 平板运动试验中变时性功能变化的观察与分析,是诊断冠心病的一种新的、有价值的无创性方法.     

The incidence of postoperative nausea and vomiting: a retrospective comparison of alfentanil versus sufentanil.

Postoperative nausea and vomiting have been associated with the use of intravenous narcotics, and nitrous oxide may worsen the emetic effects of narcotics. Alfentanil and sufentanil are two synthetic derivatives of fentanyl; alfentanil has a shorter wake-up time than fentanyl, and sufentanil is equivalent to fentanyl. In order to study comparative emetic properties of these two drugs, patients in two different cities were randomly allocated to two different groups and retrospectively compared. Group I received sufentanil N2O/O2 with 0.25% isoflurane. Group II received alfentanil N2O/O2 with 0.25% isoflurane. With group I, the overall incidence of nausea was 31% and of vomiting was 6.2%. For group II, the overall rate for nausea was 38.2% and 8.8% for vomiting. Statistically, there was no significant difference in nausea or vomiting between groups.     

Hemodynamic and metabolic responses to hypergravity on a human-powered centrifuge

INTRODUCTION: Microgravity causes the deconditioning of many physiological systems, and there is great interest in developing effective countermeasures. We recently developed a short-arm human-powered centrifuge, and the primary objective of this study was to assess the hemodynamic and metabolic responses to exercise under hypergravity conditions. METHODS: Phase I compared the hemodynamic and metabolic responses to 1 Gz (upright cycle ergometry) and 2 Gz conditions (Space Cycle) at the same work rate. Phase II contrasted the hemodynamic and metabolic responses at 2 and 3 Gz and at the same work rate. Phase III examined the BP and heart rate (HR) responses during passive and active centrifugation. Phase IV examined the relationship between work rate and oxygen uptake. RESULTS: In Phase I, the HR and BP responses were very similar between the two Gz conditions, with the exception that 2 Gz produced a lower diastolic BP in female subjects. In Phase II, both systolic and diastolic BPs were similar under the two different Gz conditions. However, there was a significant increase in HR at 3 Gz. In Phase III, the slope of the HR/Gz relationship was greater for passive conditions, suggesting that venous return is facilitated by the skeletal muscle pump. In Phase IV, it was found that there was a highly linear relationship between work rate and oxygen uptake. CONCLUSION: The results of this study demonstrate that exercise under low hypergravity conditions on the Space Cycle is well tolerated from a hemodynamic perspective.     

Walking trials in postmenopausal women: effect of low doses of exercise and exercise fractionization on coronary risk factors

We studied the fractionization of walking training and searched for the minimum dose to affect coronary risk factors in two randomized controlled trials. Altogether 134 (Study I) and 121 (Study II) healthy, sedentary postmenopausal women started the trials, and 130 (Study I) and 116 (Study II) completed them. In Study I the exercise intensity was 65% of the maximal aerobic power (VO2max) and a total of 300 kcal was expended in one (Group W1) or two (Group W2) daily walking bouts. In Study II the exercise was continuous, and the exercise intensity (% of VO2max) and energy expenditure (kcal session(-1)) were 55% and 300 kcal (Group W3), 45% and 300 kcal (Group W4), 55% and 200 kcal (Group W5) and 45% and 200 kcal (Group W6). All the subjects walked 5 days a week. The outcome measures were blood pressure, serum lipoproteins and blood glucose and plasma insulin in fasting state and also during 2-h oral glucose tolerance test in Study I. There was no change in diastolic pressure in the original study groups, but in the combined exercise group (W1+W2) in Study I, the mean diastolic pressure declined by -3.0 mmHg (95% con-fidence interval (CI) -5.5 to -0.4) (P=0.025) in comparison with that of the controls. The mean blood glucose declined by -0.21 mmol L(-1) (CI -0.33 to -0.09) in Group W1 and -0.13 mmol L(-1) (CI -0.25 to -0.01) in Group W2 compared to controls (P=0.03). Also the 2-h glucose concentration decreased in Groups W1 and W2 compared to controls. Systolic blood pressure, serum lipoproteins and insulin levels did not change in Study I or Study II. We conclude that our training program with the greatest exercise dose, exercise intensity 65% of VO2max and weekly expenditure of 1500 kcal had a minimal, positive effect on diastolic pressure and blood glucose, and the effect was similar in one or two daily exercise session groups. This exercise dose is probably close to the minimum to affect coronary risk factors in healthy postmenopausal women. To get a more pronounced and clinically relevant effect, a greater exercise dose is needed.