Document Detail


Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population.
MedLine Citation:
PMID:  19401600     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk. METHODS AND RESULTS: Data from 7746 civil servants participating in the Paris Prospective Study I, followed-up for 23 years, allowed to compare heart rate changes between rest and mild mental stress (preparation prior to an exercise test) between subjects who suffered sudden cardiac death (n = 81), non-sudden (n = 129) coronary death, or death from any cause (n = 1306). The mean heart rate increase during mild mental stress was 8.9 +/- 10.8 b.p.m. Risk of sudden cardiac death increased progressively with heart rate increase during mental stress and the relative risk of the third vs. the first tertile was 2.09 (95% confidence interval, 1.13-3.86) after adjustment for confounders. This relationship was not observed for non-sudden coronary death. CONCLUSION: An important heart rate increase produced by a mild mental stress predicts long-term risk for sudden cardiac death. Heart rate changes before an exercise test may provide a simple tool for risk stratification.
Authors:
Xavier Jouven; Peter J Schwartz; Sylvie Escolano; Céline Straczek; Muriel Tafflet; Michel Desnos; Jean Philippe Empana; Pierre Ducimetière
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-28
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-15     Completed Date:  2009-11-03     Revised Date:  2009-11-16    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1703-10     Citation Subset:  IM    
Affiliation:
INSERM, Unit 909, Cardiovascular Epidemiology and Sudden Death, Hopital Européen Georges Pompidou, 75015 Paris, France. xavier.jouven@egp.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Death, Sudden, Cardiac*
Early Diagnosis
Exercise Test / psychology*
Heart Rate / physiology*
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Factors
Stress, Psychological / physiopathology*,  psychology
Comments/Corrections
Comment In:
Eur Heart J. 2009 Nov;30(22):2815; author reply 2815   [PMID:  19850554 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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