Doc 0000022008

The image is a graphic banner resembling a vault door, with the title "THE BLACK VAULT" in large, stylized white font. Below the title, there is text explaining that the document was obtained from The Black Vault, an online database of declassified government documents, specifically the MKULTRA/Mind Control Collection. The text further indicates that this collection contains over 20,000 pages declassified by the CIA and provides a URL for online access. The left side of the banner features an illustration of a heavy, circular vault door with complex locking mechanisms and a glowing blue light emanating from its interior. There are no photographs, handwritten annotations, signatures, official stamps, forms, diagrams, tables, redactions, or visual evidence of experimental procedures visible on this page. RESEARCH PU..'f AND SUPPORTING DATA I THZ HF.ART D13F..ASf: PROf.R.A:-4 ReseArch Pbn Introduc':.lon Md Speci fie Aims: Increased proficiency.in perfor.nance, decreasec morbidity rr~ illness, tnc~easEd longevity and similar chiii\S tor improved healtu status hnve been proposed as benefits of re~ular physical exercise. In certain populations; rec1.ll1>.r p::,rmna.stic$ are a. part of dail:f life from childhood to adva."\ced agr:. In P.~:shs f:>octorJ vot"kers "brcak11 not for coffee and a eigar-ette • but for calest.he~~ics. Arrican noma~. herders by vocation and necessity or life, vith ~diet eo~­ parn.ble to that round in Western societies but who walk up to forty l:l.iles a. dtq are repo:-ted to have ne~ligible eoronary &rtery ard ischemic heart dise!lSe. A dccrensc in physical e~er:ise has been related to an increASed incidenc~ cf re, coronary lltld ischemic he&.rt disei'I.Se. In this set tin~. the sedentuy ll "5 purt '' acti.vi ty has been bcriJIIinated in acute is chemic episodes. Whether directly related or whether one or several condi tionin.~t or predis'!)osin~,; factors. mo:;t investigators noW' agre~ that sedcntsry livi.na: h not conducive • throw;h severrt.l :>ossible mechanis~U • vtth good eardiovasc:W.ar he!Llth. Phydca.l excrci5e has been purported to be of' theraoeutie benefit. It h3S been pruerlbed in the treatment of' obesity. in lllUSC!ull\l' and skeletal diSO!'d~n, i::: routi.1e in general rehabilitation !rotQ acute ar_d chronic disease. is en eouraoJ;ed post-oocrativel.y to t~re-el~de pu.l:m.onary elllbolism and is recc::I!Qe!ll!~~ foll~win~ acute myocardial inf&rctlon in the hope that inter-coronary nrtery llnS.Stomo11s will increase. Physical medicine is part of the ther&;:.y of aooole:q from it~ onset to reeover,y. Other examples could be cited and ~~~ ~~sicians .. re~ular' ~td.'llonition to p.11tient~ is to exercise rcrtUluly. The phy~iolo~ ot exercise has been the subject or intensive study, especially since th~ Scco::w. 'llorld War. The respiratory and circulntorJ R.daotations to exerci3C stress has been studied: ia acut~ mild to severe exercis~ ~tress; durin~ supine Md upri~ht exercl:.e; in the N.eld and in the laboratory; in "conditionl!d" Md "unconditioned" subJ'!cts; in Vtl.ri.ou:; occupation:1l r.rou::;,s~ in ~~c group~ from childhood to old ~_r; du~in~ and sometime nrt~r acute . ci rc.ulatory d\!l,o11e~ Qlld in vnrious cH!OeJ\.Se !Hntes. inclu<!ing chronic lun~ di:>we. di::~.betr.s mellitus rmd ~i tuntioliS ot" chronic sy:aolle !llld d13!:tolie lert.· vcnt.ricul·'l.r ovcrlo.~Lci. Despite this tremendour.. I'! ffort. ther~ is muctt thn.t rcmn:in:o obscure 11bout the r~3 ponse to phy!i i clll work. ~-1!1 ile ~ h/\npens in v:1rio~ :situations • in ~spon:>e to this !Hntes. inclu<!ing chronic lun~ di:>we. di::~.betr.s mellitus rmd ~i tuntioliS ot" chronic sy:aolle !llld d13!:tolie lert.· vcnt.ricul·'l.r ovcrlo.~Lci. Despite this tremendour.. I'! ffort. ther~ is muctt thn.t rcmn:in:o obscure 11bout the r~3 ponse to phy!i i clll work. ~-1!1 ile ~ h/\npens in v:1rio~ :situations • in ~spon:>e to this stress • i:o kno...-n • ~ 1V1d <i!l.:f it h'\ppcr.s is l~:s ~le:1r. In m:1ny of. these studies. the r~~g1ts 1\l"P. not consistent. the or s~Unnles nr~ sm/\ll, the stress is .~rioble "-fld the result:. are qucst\on'\~l"! st~ti~tic/\l siP.nificnncP. in extrnpolation to copulation~ or p,en~r3l r.rouns. .... =se ~·--------·--~----------.....- -.....- ---------------------------~------~----------------- .. .. ?hys i.c:1l ~xc 1"<' l;je hn.z been O:!:!.!llo:red as a di ·'l~cs tie tool: to cH'lb! ~s:t rer. oi :r:ttory Md ci rculatorJ ade<1uacy; to dete r.r.ine and to 1W!.ntitate ~nysi ::ill ri tne:.:i i to cst.:-.b lian functi onfll or aerobic eapaci ty Md f\&nctiona l rue rr• ., ror p:iY:iic:t.l work :lnct to dia>trlose or detect llltl>r.t ischemic he'lrt dise>t.Se ifi ~e ~rour;s ~t hi!lh risk t"rolll co~rt cor-onary hc:ai~ riisell-~~. The st:tnda.t'd exercise tolor:'lnr.i'!' test (i'>b.sters) has been eh.ri fied 8.3 to cr!.tcrl a (:.fattin~l:..r). tl.nd 1\.J.Mtit:~.tl!d in tcn:u; of dc:r.~e of' pcr.>itlvtt.Y (ilobb :'!nd \{ark~) t'!-Jrou.~~ "'-"i:it.cd:: and clinic:ll ccrrnloltions. 'rlhile this test detect~ advr.~nce'i corona17 he!\rt dls~~1e, it is tn~cnsitivc to Mild or moderate de~rees that c~ be eq~al~ h~z'lr:iou= by loc:1tion or ot!ler rnc>l.tls to overt isc.iemic heart. <U~eue. The studi~s emplo.vinv, r.raded and maxir:~nl exercise stress (Bruce. Hellerstein) hliivc:; nrr~:rc:l a mor1! sensitive m~thod or detecting si~it'icant coronai*J artery • •u ~ea.s~ o.t lltl early sh.ge. s~c'!1 sensitivity isl essential. if ccthods avllihble or rte·.rcloped. 11rc to be applied to p:-eveat the overt cxp.~S:l;ion of' t.~is prec:e:;;; :u; clin1c:U ischemic he~rt disease. Fror:: ':!"."! :.tudies avllil~ble then. it h clear t~at no one par:!.':leter vill cll.'\racte!riz~ :u~ indivic:!u."\l'3 physiolo~ic or car-diov!ISC\llar he3.lt!i !Ot'ltU.S at :s. ~i vc:n point in t ioc. Th(! b lll.:f milieu is d:,rnac.ic and there fo!'l!. dyn3.lllic t~s tin~ vill best. tl~scribf! its resp·lnStt c:har~teristic~ ard health statU3. ThroUJ;h the app1icati~~ or physical exe~cise as a stressor. e£pecial~ it suffi~ient st~~ss is applied. Md through. the meilSurernent of mu.ltip.Je response characteristic~ or or pa:-llii1Cters. a phys.tologi: portrl\YaJ. an ind.i ·iidual c:an be descrioed. >toreover, such & portrayal "1111 remain relat1vly const>'Ult unless improved by physical tnining or deteri·lr&ted by intercurrent illness or d.i:;~!l.Se. Health 3tatus c:M The image depicts a page of a declassified document, likely a research paper or report, with typewritten text. There are no photographs, stamps, forms, diagrams, tables, or visual evidence of experimental procedures. However, there is a handwritten annotation in the bottom right corner, a circled number "235," likely a page number. The text discusses research on the benefits and physiological effects of physical exercise, particularly in relation to heart disease and improved health status. The provided page is a scanned document containing typed text. There are no photographs of people, locations, equipment, or subjects. No handwritten annotations, signatures, or marginalia are visible. There are no official stamps or marks. No forms with filled-in fields, diagrams, schematics, organizational charts, or tables are present. There are no redactions or obscured content. The document appears to be a standard academic or research paper with a page number "-2-" at the bottom. stressor. e£pecial~ it suffi~ient st~~ss is applied. Md through. the meilSurernent of mu.ltip.Je response characteristic~ or or pa:-llii1Cters. a phys.tologi: portrl\YaJ. an ind.i ·iidual c:an be descrioed. >toreover, such & portrayal "1111 remain relat1vly const>'Ult unless improved by physical tnining or deteri·lr&ted by intercurrent illness or d.i:;~!l.Se. Health 3tatus c:M therefore be des-:rlbed s.nd folloved in terms of functiona.l ca~acity and reserve. Thro~h the application of <:.hese methods to normal subJects, in ~;;anti ty and thrcugh lon~itudinRl ns vell as vertical observations in different ~e groups; throu;h identical observations in sUbJects at high risk for ci:culatorJ dis~ orders; and ln p11tholo~ical F(roups sui tabl,y e1atched vi th thP. no~als • tile or natural history both no~al and dise~e-affected circulations c~~ be evolved in f'unct.lon.U ter.n."l •. Thi:'J 11.ppro~c~ to eircul~tory study of f'unction and heBlth al~o pr.:>vic:!c's !ll1 o-p~ portunity to test methods and tecllnlques and to evalu3tc instru~cntation for the optimum 'lPPli~f.l.tion of the stress. In a simill\r va.y, the cffP.ct~ of cxerdse st~s~. beneficial or detrimental, or varied ty~es and ~ode or a?plic:~tion ean b~ ev~tu~ted to d~terrntne which vill provide ~He m~i~um thcr~p~utie efrcct in dise.1Scd st~tes. Il'l SUJ!'L'M.ry. the plan or in•resti.p;ation is bMcd 1ii)On the hYl>Oth!.!SiS thnt dyn~ic tcstin~ yields much more meAningrul infor.n~tion abo~t healt~ status thlll\• :.t."lti-: te;tin~ nnd tb-::.t physical exerci:.e cnn be ~sed as a re:;earch tool to d~:ermin~ and ~~antit~te c~rdiovnscul~r health statu~~ to detect latent i:Jchc11tc h~:u·t di~l'!n.:e Vld AS a thcr>'\pcutie ~nt • be used to reverse the 0 dccrc~cnt~ in circulator,y fUnction produced by ~ise~c. -2- •• r rma ._. .. . Hethods of Procedure: Ceneral Method: tach subjec~ will serve as his own con~ol fer longitudinal s~dy. In addition, each subje:~ will be paired with another normal subj~et in a different aie r,~oup and with a pathological control with a specific abnormality of the circu:lation. This pairing or matching will be by bac:kground. amount of training or pt1ysieal exereise, body surface area, lean body ~~~ass and similar parameters. Subject Selection: No~il subjects will be accepted as volunteers for this program from the comm,.mity available for study. "Nor:Jali ty" will be determined by tl)e screeninr eval~ation described below. the study zroup 1 at high risk froa coronary artery and ise~emic hea~ disease, will also be determined by the screening procedure. Allocatiotlo to this group .. will. be according to such indicators· of coronary artery disease as, sugges_~_~v~-, This document appears to be a declassified page from a research protocol. Visually, the page is dominated by typed text, suggesting a formal document rather than raw experimental notes or visual logs. There are no photographs, diagrams, forms, or stamps visible. However, there are some instances of what appears to be handwritten marginalia on the right side of the page and a handwritten number "-3-" at the bottom, likely indicating a page number. The text itself details "Methods of Procedure," including "General Method," "Subject Selection," and "Study Group Size," outlining the parameters for participant recruitment and stratification for a medical study, possibly related to cardiovascular health given the mention of heart disease and related conditions. There is no visual evidence of experimental procedures or equipment on this page. "Nor:Jali ty" will be determined by tl)e screeninr eval~ation described below. the study zroup 1 at high risk froa coronary artery and ise~emic hea~ disease, will also be determined by the screening procedure. Allocatiotlo to this group .. will. be according to such indicators· of coronary artery disease as, sugges_~_~v~-, __ . hist.ory or physical findings, asymptomatic positive Double Masters test . __ . _: ... ).,.. ischemic S! segments . . . . l on ScNening Procedure • LAD or RV1 patterns OD ECG~ asymptomatic aquired bundle branch block or other conduction distur~ance. suspect of heart disease. elevated sel"\ll!! cholesterol, serum triglycerides. se~lm uric acid or clinical aout a strong family history of he~ disease or 1 oth1~r circulatory disorders. diastolic hypertension. Diabetes Mellitus (clinie.1l or latent) and obesity. Groups of Fa~hological controls for the above ~o eroups will be accepted by re_ferral ~~~--~he _ou.t:-p~ti~n~ services of · . . .. ·, -_· ~~~ . . .. __ 1 a nd from physicians within the Com:'!Uniey. ·In addition, pathological study groups will be established in the follawi:ng disease categories: · 1. Chronl:'c Lung Disease • 2. Chronic Systolic Load. Left Ventricle 3. Chronic Diastolic Load, Left Ventricle Cardiomyopathy: ~. a. I~dhemic Heart Disease b •.. Primar-J Myocardial Disease Study Croup Si:e; The no~al study rroup ~hould ~ltimately comprise 100 subjects in each decade .from the se~ond through the seventh. tach sub-r,roup sl~~!d consist of thirty subjects, as a minimum numbe~ for statistical sir,nifieance. Procedure: Three ~asic procedures vill be f'ollo~ed in this study, accordin~ to the ~rou~ as tollO"o/:i: Proccd..1re A: This is ~ serconing tcchni~ue. adapted to the study ot a l4rce n~~ber ot te5t subJcc:.s. It ts int.ended tn provide a baseline cardiovascular ev!lluaticn o! both. s:..!lti.c and dynami.c nature; to detect latent or pote!itial circulatory in disorder:J "normal10 volunteers; to provide subjects for the group, at hi~h rls::t from ischemic heart disease and is the basic evaluation for all subjects. a: Procedure This p~ocedure will be: 3 more extensive evaluation of circulator/ functional c~pacity and rcserv~. This procedure is an out-patient evaluation thnt e~~ be :tccOt:lolished 1n ont!-half day. It 1s intended to provi.de more dct.uled inronnation t!l~t can be extrapolated to the group studied only by Proc:ed~:-c A. Information obtained in tnh procedure will be useful in de!.ermining &."'ly lllO·::I.i f'i eat ions to...,a.rd a more meaningful screening techni q_ue. Procedure C: This procedure is The page shows a typed document section detailing "Procedure" and "PROTOCOL: Procedure A" for a study. There are no photographs, handwritten annotations, or official stamps visible within the main content area. Some areas of text appear to be slightly obscured or smudged, particularly in the lower right quadrant of the page. The text describes multiple procedures (A, B, and C) and then elaborates on the steps involved in Procedure A, including obtaining subject consent, interviews, blood work, and electrocardiograms. The visual content is entirely text-based, presenting information in a structured list format. 1n ont!-half day. It 1s intended to provi.de more dct.uled inronnation t!l~t can be extrapolated to the group studied only by Proc:ed~:-c A. Information obtained in tnh procedure will be useful in de!.ermining &."'ly lllO·::I.i f'i eat ions to...,a.rd a more meaningful screening techni q_ue. Procedure C: This procedure is e.n exh.:lU3tive study ot cardio~cular health status. It employs ftll available f3Cilities and teehnl~ues av~lable wit~in the Medic~l center. Convcnti~nal catheterization techni~ues and ancilla.rJ radio5ra~~ic. rndioisotope and other pertinent mP.thods ot ~irculatory stu~ vill be empl~·ed or c:tS thc:t uc pertinent to achicvinp; the goo.ls this study. 'This procedure h ~i in-house, in-pl'l.t icnt evaluation req_ui ring three hospital di'.,YS. Fo..cili ties fol' thh e·l''lluation are av~tilable .through the · PROT0C)L: Proc~dure A l. El\c-il sub.lect will sign an inronnal consent a.lthoM.zation for stud,r. . I ~nell 5ubjcct Vill be intcrvielied by a SOCial "JOMtCl' :\llc\ baseline SOciC• en\·ironmental d11ta obtained. 3. Io the po~t-~~5orptive ~t~te, blood vill be obt~inP.d for b~eline he~at~lo~ BflC: blood cho:::niztry (FBS. 2 Hr. post-pr~dia.l su~n.r, choles~erol. uric acid, total lipi~~. pho~p~olipid5 nnd tri~lycerides). h. Co.'l'lptet~ history 11nd physico.l ext'IJ:Iino.tion will be recorded. or 5.' D.'l!le line record.-; t.he rollo.,..in~t W'i 11 be recorded: IJ!IliQ'fZN'f'nimr - ·r.. - • -----S?r-=·z •" • ,• .. l • .- :. '.""I r•\r,.~ _. .. . ~ b. !'h.onocardiOJ;rMI c. '{ectorciU'dio;ram d. B4llistocardio~ram G. Stand~rd exercise tolerance test (Double Mast~rs) 7. Post-stMd;u·d exercise (Double :otastcr:l) vectorcardio~O:-am 8. Total_ bo"" Vater (trltilllll) and calculated. leu bod,y mass "'ill be dete:-:uined. 9. EXercise Sc~enin~: or 1\. Restin~t control detenoinatlons vill be made blood· pt'l!ssun (cui'!) and ilP.art rate {RKC). b. Whera'fl!r possible, blood pressure vill be obtained throu.?out the test procedure from an ind:Jelling arterial needle in a brachiu M!~ry .. The blood pressure, in this instance, vill be directlY obt:Uned. to;;ether with' t~e inte~?;r&l and Fil"St derivati'le ot the pressure pulse. e. Arterial oxy~en content vill be monitored by ear oxi:.etry. d. tfherc direct arterial sampling is ave.ilat-le, arterial blood vill be ohtained for the direct determinBtion of~' PCOz, ~4• Lactate and P.Jruv~~ote. · e. R:ldioeardio~rQ.ID vill be continuously l!Loni tore d. r. Y~ntred air will be collected for three oinutes in & Dou~las b~ for .baselinl! oJCy~en consumption 311d RQ. ~· ~te subJect vlll then perfo~ exercise on the bicycle or~~eter ~ follY~s: (1) 50 Watts (300 ________: _. __________ ;__ L min'i!tc ~4/min.) (?} 100 {600 ___ l!Loni tore d. r. Y~ntred air will be collected for three oinutes in & Dou~las b~ for .baselinl! oJCy~en consumption 311d RQ. ~· ~te subJect vlll then perfo~ exercise on the bicycle or~~eter ~ follY~s: (1) 50 Watts (300 ________: _. __________ ;__ L min'i!tc ~4/min.) (?} 100 {600 ___ ;__ _________________________ ?. W~tts KP,~/min.) minut~3 ( 3) :-!00 wilt t!J ( 1.'?00 Kr,i-t/r;~.in.) --------'-*----------------------------------- 3 minutes ( l1) 3?0 'ol:"J.tU ( lBoO K-1~·1/min.) 3 r.~.in'!tes The r~dl oc:'lrdio,'1T31!1 vill be continuously monitored d\lri:\.~ the e:te rei SP.. RP.cor1s. vU 1 be oht-'lined o.t P.!Lch m1nutc Jurin~ ~d follovinf'; t!H! c:o:~­ or flletion the exercise until the r::lte hM returned to the- control levc_.l. or or f..t ~he compl'!tlon three minute3 of the rrt3Xi!lll.l.., a.-nount CX·!rd:.~ t!v~ subject. cM perr.,~. expired nir wl.ll be collcctc:! i:'l 1\ Oou~l:'\l b~~ for e>rH! :!\tnute. for t~e 1lc tc rminrltion ot oxyr,cm ce>nsu::H"'t! o" Md !q. .. OKJ~~n co~tent ~ill be continuously monitored by e~r oxi=~~r,; ar.~ ~ ~c=~~! m~de o~ the l~val at e~ch increment or worK to mAXi~~. ~~ere ~ircc~ arteri1l samplLn~ is possible, ~ samol~ will b~ tL~en durin~ tne ~id-?~i~~ or the bv; collection for POt~, PC02 pK • Lactate and P.,/r.lvate; 0 ~fucn ~rect arterial p~ssure is obt~ined. records of tn~ integral or or the pressure pulse Md the fi.rst deri va.ti·te. pressure •Jill be obtained at e!lch minute durin,:t ell.ercise and ea.ch l!linute rollovin~ exercUc \L'ltil the pressure hQS returned to control levels. P~OTO~O[,: Procedure D- 1. The 3ubJ~ct vill have eom?leted proce~ure A ~d have been selected ae eordtnq; to t!\e cri teris. outlined above unlier "Selection." z. The t>ub.1ect will be allo•Jed a rest period in thE! laboratot"/ wrtll ~looi !lres.sur" >Uld heart rate are stable. 1. R~ vill be attached Md continuously monitored. lt. Coumllnd needle; will be inserted into :\ convenient arterf and vein; t.'l~ f'omcr tor: arterll\l blood samplin~ Md oressure monitorin~; the latter (Or the injection Of' indicator SubStanceS Md other test materialS. 5. Con:rol rl'!corf\in~ of hef\rt. rat.e :u\d pr-<:ssure, pressure itate.;:-~ 3.tld deri~tive will be o~tained. 6. A V~ls~va m~euver vill then be e~ecuted and the chan~es in ~ressura ~d and n~~rt r~te_ continuously monitor~d and recorded. 7. Wh~~ the subj~ct' is stable u shovn by heart rate Md pressu~. eX?i~d ur will be collected in & Dou~la.s ba;; for t~ree minu1:eS for tha deter:-..inaHC:l or "Jo/P.en eonsu:nption and The document is a typed page, numbered "-5-" at the bottom. It details parts of an exercise screening protocol within a larger study. The text lists various tests and procedures, including different types of electrocardiograms, exercise tolerance tests, and measurements of blood pressure, oxygen content, and expired air. It also outlines a bicycle ergometer exercise regimen with specific wattage and duration settings. There are no images, stamps, handwritten annotations, or redacted content visible on this page. The document is a typed, multi-page report with a header containing two small dots, suggesting possible redactions or symbols. The text is dense, detailing a medical procedure with numbered steps. There are no photographs, handwritten annotations, signatures, stamps, forms, diagrams, tables, or visual evidence of experimental equipment. The layout suggests a continuation from a previous page and a subsequent page, indicated by the bottom-aligned page number "-6-". m~euver vill then be e~ecuted and the chan~es in ~ressura ~d and n~~rt r~te_ continuously monitor~d and recorded. 7. Wh~~ the subj~ct' is stable u shovn by heart rate Md pressu~. eX?i~d ur will be collected in & Dou~la.s ba;; for t~ree minu1:eS for tha deter:-..inaHC:l or "Jo/P.en eonsu:nption and RQ. 8. Duri.np; the secot1d minute of' the collection of expired air: ail arterial blood s~~?le ~ill be obtained for P02• PC0 2 , pK, Lactate And ~;ruvatc (12 cc.) or Q. Follo-.tin~ ::~.rt~rial Sal!lplin~. duplieate 'deterninations car.Hne output will be m::~.de by the indientor dilution technique • ... Part II: ExP-rcise llt 100 W3tts (600 K6~/min.) l. C~l.J.]~ct vill ~xercise on the Flcisc~ tlicycle o~omet~r for seven lftinutes. ~. A~tori~l orcJsure. prc~~urQ int~~rol and fi~t derivative ~~ he~rt ra!e will b<! cMtinuouzly monitorP.d Md record~ t~cn or thi~ re:onon::;e :tt c:tctl mir,ut" durin~ exP.rci::;e Md ~t encll minutr: follo-.,in~ exercU~ until these r~:~~tr:r~ hnv~ returned to the control level~. - r L.."··:. -·.- ..-:-~ ·-· -=·1' At the end of the lith 111inute• eXpired air will !:·e collected in a Dougla$ bag for one • thr~e minutes. At the :otart of the fifth 11inu:e 1 an arterial blood satnple will be ·. obtain2d for Po • Pco • pH Lactate and PyruYate. 2 2 1 Cardh.: output will then be determined by the indic•tor dilution teehniqu•~· Part III: Exercise at 200 Watts (1200 KgM/ftUn.) 1. Part I! will be repeated at this level of work. Part IV: Exerci~e at 300 Watts (1800 K2M/min.) The criterion·for continued testing at the higher wcrk levels will be a return to ncar control levels of heart rate ar.d·blood p~ssure. The criteria for maximal exercise stress will be an exercise level which the subject cannot sustain for mere than ·-·four minutes, up to seven minutes. Thilt is, the maxioal amount of work which any given subject can carry out to~ a full seven minutes will be considered his maximum, Other criteria which will be used to determine that the test was maximal and that a steady state existed at the time of ~ata aquisiticn are: 1. Heart rate of 170 or more ~t the tvo peak levels of work; that is at the 1 peak level of exercise for seven minutes an4 a similar rate increase at the exercise level of failure. 2. Agreement of expiratory volume and • plateau in CKYgen consumption. (Less are: 1. Heart rate of 170 or more ~t the tvo peak levels of work; that is at the 1 peak level of exercise for seven minutes an4 a similar rate increase at the exercise level of failure. 2. Agreement of expiratory volume and • plateau in CKYgen consumption. (Less than 500 cc. difference between two consecutive levels of work in V02)• 3, RQ and 0 uptake/minute/K2• 2 ,. Wherever passible, the following ~ata will be aquired both at rest ~d fturinc each exerctse period: • 1. A-a P02 and PC02 gradient. 2. [xtcrnal recording of apex and base phonocardiogram with apexcardiogram, ' PROTOCOL: Procedure C The pro~cdures used in this portion of the study will combine exercise stress and the determination of hemodynamic response by intra-cardiae techniques. The specific procedure will depend upon the patholog[cal probl~m under considerac tion but will be direc~ed to the measurement of the same parameters determined in the other ~rotoeols. Angiocardiographie, radio-isotope and other indicated ancillary nethods vill be used as indicated to obtain the required data (eg. eornary ~rtcriography) • ....._ r J .. ·. DATA ACOUISIT:ON: The raw data obtained directly in analorue form luring the test procedures will t• obtained using a multi-channel photographic r-ecorder and simultaneously rE= corded on magnetic tape ir. either analo2Ue t>r digital form (after A-D conversic·r,). The raw data obtained by interview (Social and environ~~ntal history, medical . history} and by physical examination will be recorded by the examiner.an suit~ able forms (check sheets), key punched and card filed or placed on ~arnetic ta?~a Free field·data will be provided for. All diagnoses will comply with the Intgra nationa~ nomenclature and the diagnostic," Eun:::tional and therapeutic classifi= cations of tho New York Heart Association .nd vi:l be a~1ered to for cardiov~scv1~r classification. A dictionary of terms has been compiled for the above purposes and for the d&~iv~d physiologic parameters. Programs fo~ the ADP of raY data to obtain the deriv~d data is now in process. Automatic data p:a:·ocessinv. equipment is available for this work on a time avail able basis at the present ti~e and other facilities can be employed, should ~~d~ be available. The followin~ paraJneters will be measured • a.s not'ed below an·:l on the followifit two tables: 1. Cardio-pulmonary Index: Av,e +vital capacity (100 ml.) • breath holdin~ (see.) • Pressure breathing (mm. H~.) Systolic pressure + dtastolic pressure + rata hea~ The no~al This document appears to be a technical report or protocol detailing an exercise stress test procedure. Visually, it's a typed document with some light text degradation and faint markings. There are no images, handwritten notes, stamps, forms, diagrams, tables, or redactions visible. The layout consists of numbered and bullet-pointed sections describing different aspects of the exercise protocol, including measurements taken at specific time points and during exercise. The overall visual impression is of a standard, text-heavy research document. can be employed, should ~~d~ be available. The followin~ paraJneters will be measured • a.s not'ed below an·:l on the followifit two tables: 1. Cardio-pulmonary Index: Av,e +vital capacity (100 ml.) • breath holdin~ (see.) • Pressure breathing (mm. H~.) Systolic pressure + dtastolic pressure + rata hea~ The no~al value ls 1.000; values below 0.752 su~~est impairment of cardiovascular function. · 2. RKG a~alysis; (interpretation according to a~tached £CG code) 3. Doubfe Masters analysis; (positive, negative, equivocal) .. ' ~. An~lysis of phonocardio~am, with other para~eters to determine q•l ti~e, mechanical systole, ADC, VDG• etc. • .. ' S. Ballistocardiogram (see attached code)· • 6. Ma)lmal exercise and exercise screening (see Tables 1, 2). _.,,.._.... .!.,... .. ._ _. ........L ..,,__, ____. ,__ _______ '~I-f-~' ,-... --.. . --------------------------~----- . .. TABU: 1 PARAHtTtRS MEASURED Fararneter Dimension 1. Height feet, lnchesi meters 2. tleight pounds; kilograms 3. Body Surface Area square ll\li:ters ~. rat free body rnass kilograms s; Total body watel' liters 6. P·Jlse rate beats pe·C' minute 7. s,stolic press~re 111111 Hg. 8. Diastolic pressure He. 111111 9. Mean Pressure - IDifi Hg. 10. Integral of p~ssure 11. first derivative of press~re mm Hg./sec. (delta :/delt~ Y) 12. First derivatill'e duration, A·B lllillise~onds 13. BA duration, onset to peak millisec-:>nds . 14. S1stolic ejection period tDi llis econ·ds 15. Hemoglobin gral'l'.s 16. Arterial P02 mm Hg. 17. Arterial PC02 111111 Hg. 18. Arterial pH 19. Arterial lactate (Lg, Ln1 mg. \ ,210.. Arterial· pyruvate (Po P; .) mg. \ 1 1 F.espiratory rate br-eaths I minute 22. Minute volu~~ (V£) cc. I minute 23. End tidal C02 percex:;t C02 24. Duration of Z>ag collecti•Jn mlnubs 25. Tidal volume · minutes 26. Anatomic dead space ce. 27.- Physiologic'dead spaca :c. 29. Vc (BTPS) cc. I minute 29. \ oxyr,en in VE ' 30. \ carbon dioxide in V£ ' 31. \ nitroeen in Vt ' 32. Ca.rd".iac output liters I minute • ' -9- ... ·· . ... . TABU: 2 DE:Rivt:D VARIABLES Variable Din:ensicn 1. Oxygen eapaeity cc. 2. O~jgen saturation ' 3. Oxygen content ce./100 cc. Ito Yz (8PTS) ce./lllinute 5. Oxygen consumption ec:. &. Oxyeen consumption index cc:,/H2 F.r.s. 1. Oxygen consumption I cc./Kf/ 8c C02 p•odueed cc. 9. R~~~iratory quotient . 10. Functional capacity' functional reserve; reserve capacity (V02 Hax.) cc. 11. Functional reserve index ce./M2 r.F.B. 12. functional reserve I cc./Kg. 13. Cardiae This page contains no photographs, stamps, filled-in forms, diagrams, or redations. It is composed solely of typed text, which is organized into sections under headings such as "DATA ACQUISITION." There is a list of numbered items that detail various medical analyses and measurements, including "Cardio-pulmonary Index," "RKG analysis," and "Ballistocardiogram." The numerical page indicator "-8-" is present at the bottom right. The image is a page from a declassified document featuring a table titled "TABLE 1 PARAMETERS MEASURED" with two columns: "Parameter" and "Dimension." The table lists 32 numbered parameters related to physiological measurements, such as height, weight, pulse rate, and various arterial blood gas levels, along with their corresponding units of measurement. There are no photographs, stamps, handwritten annotations, forms, diagrams, or redactions visible on this page. The content is solely composed of a printed table and a page number "-9-" at the bottom right. Ito Yz (8PTS) ce./lllinute 5. Oxygen consumption ec:. &. Oxyeen consumption index cc:,/H2 F.r.s. 1. Oxygen consumption I cc./Kf/ 8c C02 p•odueed cc. 9. R~~~iratory quotient . 10. Functional capacity' functional reserve; reserve capacity (V02 Hax.) cc. 11. Functional reserve index ce./M2 r.F.B. 12. functional reserve I cc./Kg. 13. Cardiae output Liters I minute 1~. Cardiac index Liters 1 ltinute I M2 lSc Cardiac output I F.F.B. Liters I minute I r.r.Bc 16. Stroke volume ee. I 'beat 17. Strok-e volume ind F e . x r .s. ce. I beat I ~2 18. Strok~ volume I cc. I beat I K&. 19. Hixed venous P02 cc. I 100 cc. 20. (a-v) ?02 difference c:c. 21, Effective left ventricular work Kg.M I minute 22. Effective stroke work LV Cm.H I t:linute 23. Minute work index Kg.M I ~nute I ~2 2~. Strok~