Document Detail

Are cardiac events during exercise therapy for heart failure predictable from the baseline variables?
MedLine Citation:
PMID:  17587707     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise training (ET) is an emerging therapy for chronic heart failure, but the baseline patient characteristics for predicting cardiac events (CEs) during the course of ET remain unknown. METHODS AND RESULTS: Of the 111 stable heart failure patients who participated in a 3-month ET program, 6 withdrew from the program for cardiac reasons and 9 had transient interruptions in the program because of CEs. The baseline clinical characteristics of these 15 patients (CE group) and the remaining 96 patients (No-CE group) were compared. Compared with the No-CE group, the CE group had a significantly higher prevalence of pacemaker/implantable cardioverter-defibrillators, larger left ventricular end-diastolic diameter (LVEDDs), lower peak oxygen uptake, greater ventilation drive, and higher plasma brain natriuretic peptide concentration at baseline. Multivariate logistic regression analysis showed that a larger LVEDD was a significant predictor of the occurrence of a transient interruption to or permanent withdrawal from the ET program because of CEs. Receiver operating characteristic curve analysis demonstrated that an LVEDD > or = 65 mm had a sensitivity of 93% and specificity of 48% in predicting CEs. CONCLUSIONS: Patients with a large LVEDD (> or = 65 mm) at baseline should be monitored carefully during the course of an ET program.
Isao Nishi; Teruo Noguchi; Shinichi Furuichi; Yoshitaka Iwanaga; Jiyoong Kim; Hideo Ohya; Naohiko Aihara; Hiroshi Takaki; Yoichi Goto
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  71     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1035-9     Citation Subset:  IM    
Division of Cardiology, National Cardiovascular Center, Suita, Japan.
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MeSH Terms
Cardiac Output, Low / pathology,  physiopathology*,  therapy*
Case-Control Studies
Defibrillators, Implantable
Exercise Therapy / adverse effects*,  methods
Exercise Tolerance / physiology
Heart Diseases / etiology*,  pathology,  physiopathology*
Heart Ventricles / pathology
Logistic Models
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood
Predictive Value of Tests
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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