The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study
| Autor: | Mika Kähönen, J Maanoja, Kjell Nikus, Tiit Kööbi, Johanna Leino, Tuomo Nieminen, Jari Viik, Väinö Turjanmaa, Kari Niemelä, Terho Lehtimäki, Rami Lehtinen |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Blood Pressure Physical exercise Sudden cardiac death Risk Factors Cause of Death Internal medicine Heart rate Internal Medicine medicine Humans Myocardial infarction Exercise Finland Proportional Hazards Models Retrospective Studies Cause of death business.industry Hazard ratio Recovery of Function Middle Aged Prognosis medicine.disease Surgery Survival Rate Rate pressure product Blood pressure Cardiovascular Diseases Exercise Test Cardiology Female business |
| Zdroj: | Europe PubMed Central |
| ISSN: | 1476-5527 0950-9240 |
| DOI: | 10.1038/jhh.2008.38 |
| Popis: | We tested the hypothesis that the change from the peak to recovery values of systolic arterial pressure (SAP recovery) and rate-pressure product (RPP recovery) can be used to predict all-cause and cardiovascular mortality, as well as sudden cardiac death (SCD) in patients referred to a clinical exercise stress test. As a part of the Finnish Cardiovascular Study (FINCAVAS), consecutive patients (n=2029; mean age+/-SD=57+/-13 years; 1290 men and 739 women) with a clinically indicated exercise test using a bicycle ergometer were included in the present study. Capacities of attenuated SAP recovery, RPP recovery and heart rate recovery (HRR) to stratify the risk of death were estimated. During a follow-up (mean+/-s.d.) of 47+/-13 months, 122 patients died; 58 of the deaths were cardiovascular and 33 were SCD. In Cox regression analysis after adjustment for the peak level of the variable under assessment, age, sex, use of beta-blockers, previous myocardial infarction and other common coronary risk factors, the hazard ratio of the continuous variable RPP recovery (in units 1000 mm Hg x b.p.m.) was 0.85 (95% CI: 0.73-0.98) for SCD, 0.87 (0.78-0.97) for cardiovascular mortality, and 0.87 (0.81 to 0.94) for all-cause mortality. SAP recovery was not a predictor of mortality. The relative risks of having HRR below 18 b.p.m., a widely used cutoff point, were as follows: for SCD 1.28 (0.59-2.81, ns), for cardiovascular mortality 2.39 (1.34-4.26) and for all-cause mortality 2.40 (1.61-3.58). In conclusion, as a readily available parameter, RPP recovery is a promising candidate for a prognostic marker. |
| Databáze: | OpenAIRE |
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