| Arm Exercise Stress Perfusion Imaging Predicts Clinical Outcome. | |
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MedLine Citation:
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PMID: 21852405 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Treadmill exercise capacity in resting metabolic equivalents (METs) and stress hemodynamic, electrocardiographic (ECG) and myocardial perfusion imaging (MPI) responses are independently predictive of adverse clinical events. However, limited data exist for arm ergometer stress testing (AXT) in patients who cannot perform leg exercise because of lower extremity disabilities. We sought to determine the extent to which AXT METs, hemodynamic, ECG and MPI responses to arm exercise add independent incremental value to demographic and clinical variables for prediction of all-cause mortality, myocardial infarction (MI), or late coronary revascularization, individually or as a composite. A prospective cohort of 186 patients aged 64±10 (SD) years, unable to perform lower extremity exercise, underwent AXT MPI for clinical reasons between 1997 and 2002, and were followed for 62±23 months, to an endpoint of death or 12/31/2006. Average annual rates were 5.4% for mortality, 2.2% for MI, 2.5% for late coronary revascularization and 8.0% for combined events. After adjustment for age and clinical variables, AXT METs (p<0.05;HR=0.59;CI=0.35-0.84) and abnormal MPI (p<0.01;HR=2.48;CI=2.15-2.81) were independently predictive of mortality. A positive AXT ECG (p<0.05;HR=2.61;CI=2.13-3.10) was predictive of MI. Death and MI combined were prognosticated by METs (p<0.05;HR=0.63;CI=0.41-0.85), MPI (p<0.05;HR=1.77;CI=1.49-2.05), and a positive AXT ECG (p<0.05;HR=1.86;CI=1.55-2.17). In conclusion, for high risk older patients who cannot perform leg exercise because of lower extremity disabilities, AXT METs is as important as MPI for prediction of mortality alone and death and MI combined, and a positive AXT ECG prognosticates MI alone and death and MI combined. |
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Authors:
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Albert K Chan; Nasreen A Ilias-Khan; Hong Xian; Cindi Inman; Wade H Martin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-18 |
Journal Detail:
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Title: Journal of applied physiology (Bethesda, Md. : 1985) Volume: - ISSN: 1522-1601 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8502536 Medline TA: J Appl Physiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1University of Utah School of Medicine. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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