Yep. But it’s cheap (cost me $150 all-in), quick, and as an initial step, it’s accuracy is pretty good. (And better than not getting a test!).
“We conclude that coronary calcium scoring provided useful information in the management of patients. In CACS less than 100, it has a NPV of 87% in excluding significant stenosis in patients with the risk of CAD but it does not have enough diagnostic accuracy for surely excluding coronary stenosis, so we should perform a combination of CACS and coronary CT angiography for patients.”
The more accurate CT angiogram makes sense if you need/want the higher confidence. But it’s a more involved + costly procedure, which may be enough of a hurdle for some in preventing them from getting one.
I’m giving TR a shot bc one thing I’m hoping to do is map improvement; that is, can I either push more watts or go farther/faster at a steady bpm. I’m sureTR files can show that (and yes, I could most likely do that with Garmin Connect but I’m a little lazy…and I like shiny interfaces)
Speaking of intervals, one part of my cardiac rehab (done on exercise bike with HR monitor linked to therapist’s computer) was intervals with relatively big jumps, but starting from very low power, for example, 3 minutes at 80 watts at 65 rpm, to 1 minute at 130 watts at 65 rpm. For a recent heart patient, it was not comfortable at first. My therapist said I was within the HR limits at 130 watts, so there’s a place for intervals at a low intensity, I think.
Interestingly, my brother went for a heart scan after I told him of my issues last year – he’s in the US so had the calcium scan, whereas I (as a resident of France) went right to a more expensive test. There are some interesting differences in protocols when you have single-payer health care.
There’s a place for high intensity intervals, too. The evidence, protocols, research, and results are out there.
The big hurdle is both the medical industry and the patient fearing death, which is understandable.
I’d probably just hang loose for now. But, as your tech mentioned, you could probably do 5-8sec higher powered jumps throughout a Z2 interval which wouldn’t send your HR skyrocketing.
I can easily do that in WKO but to be honest am scratching my head about doing that in TR. TrainerRoad is really setup around power and the ramp test. The personal records might help if you setup new seasons. But TR at the moment doesn’t track anything HR or HR-power.
For polish and some HR features I’d suggest looking at Intervals.icu
I’d never heard of intervals.icu – looks interesting, although tbh the “.icu” suffix is a bit…foreboding? I’ve got a trial period in TR so if it doesn’t work or offer anything special I’ll try some other apps (which I’m kind of planning on anyway).
My ultimate goal is to get back to training with power but not without getting clearance from docs/therapists to do a ramp test.
TR is great for trainer control, virtual power, etc, but is solely focused on power metrics. Any metrics beyond the power basics and you need another analytics platform. WKO is best in class but there is a learning curve. TrainingPeaks is from the same company as WKO. Then you have Training Day, Cycling Analytics, Garmin Connect, GoldenCheetah, Strava, and newcomer Intervals. Probably missing a couple but that’s a quick list of analytics.
Looking back at what I did, it looks like I found it easier to just go outside for easy rides, and just enjoy riding my bike for about 3 months. Sitting on the turbo staring at your heart rate and the worry that stems if it starts to change a bit can be quite taxing mentally. One thing you can do outside is ride with a heart rate cap that you set yourself (I think you mentioned 130bpm?). It’s quite easy to do this unless you’re on a prolonged or steep hill. You should notice over a few weeks that your average speed (and power if you have a PM) will improve for the same perceived heart rate. What I noticed initially was my heart rate was way high to start with - my first ride I only averaged 14mph, because I was so nervous that my heart rate was at the top of Zone 2 before I even turned a pedal! Those first few rides are very daunting but once you get through a few you should hopefully settle into it.
Take this time to reconnect with why you started cycling in the first place (breathe the fresh air, listen to the birds, admire the scenery!). Being previously very fit I would bet your heart will start to recover quite quickly - within 3 months I had the confidence to start a Low Volume Plan but I did bail on a lot of the harder workouts, and I worked off a much lower FTP (looking at the numbers I lowered it by 20%). But I put in a few months of steady Z2 riding (mostly!) outside before coming back to some structured training.
Initially my heart rate struggled to keep up with my legs but before the first year was out my heart was writing cheques my legs couldn’t cash!
We all know that cardiac drift on steady efforts is a good indicator of aerobic fitness (or not) - this is another area you could focus on while doing your Z2 efforts - at first your heart rate drift will be quite disturbing, which is why I found ti easier riding outside at first - I just got slower and slower during the ride - but it felt GREAT just to be outside doing what I love! That is hard to do on the turbo! It shouldn’t take you more than a few weeks/months for your heart rate to level off at easier efforts, which will be your first sign that it is recovering.
Thanks again for the encouraging words. I live in dark, rainy Paris so we’ve got a couple of months before riding season, and my home office has my workspace and trainer setup so grabbing an hour session is much easier than an outside ride during the week. So I think I need at least 2-3 indoor sessions a week (and it’s a good break from work) to get some kind of base before heading out – it takes a good 30-40 minutes to ride out of the metro area from where I live so any ride less than 2 hours isn’t worth the effort.
Drift…I did a Pettit this week…the cardiac drift, as you note, was distressing. I had to dial effort down to 75% to keep a decent cadence. Whew!
It is to start with quite off putting! As others have said, TR is not set up to train by HR so you’ll just need to keep an eye on it for now. There are plenty of options you can try to make the workouts more interesting - e.g. there’s nothing to stop you lowering the FTP setting way, way down and doing ‘intervals’ with some easy valleys - you also have easier versions of workouts, for example Pettit -1 instead of Pettit. I guarantee that the drift will calm down as your heart starts to recover, but once you get back to something more challenging, your heart rate will be higher than you’re used to simply because it is de-trained!
3 years on, mine is stronger than it was, I am stronger power-wise than I was (I do still lack the endurance i used to have), my heart recovers quicker after intervals etc. I have zero issues, and I can finally say I don’t think too much about what my heart rate is doing now - that has taken the longest.
Be patient, you will get there in time! But for this first year you will feel almost like a beginner cyclist at times - don’t set any unrealistic goals, just enjoy your riding and progress it as and when you feel ready.
I also just remembered - that first year back cycling, I sold my power meter and treated my self to some flashy wheels - there was no point paying any attention to my power while riding outside - it was all about my heart rate and my fatigue etc - I just rode from feel. After that first year, I started to feel more confident and put a PM back on. However, I still do all my easy rides outside to heart rate, but that’s just habit. I set my heart rate zones to my estimated LTHR, as that gives me lower zones than if I set them in Strava to my known max heart rate (safer zones with lower thresholds, that also track quite well to my power zones).
My first Ramp Test this winter, I was unfit after some down time and my heart rate got to maximum before my legs and lungs gave out.
Once I got some training into my legs, for each ramp test it barely gets into Z5 before I have to stop!
I don’t recommend doing any kind of FTP test for the next 6 months to a year - it puts unnecessary stress on your heart - you can make some educated guesses at FTP and tweak it for now.