Document Detail

Importance of treadmill exercise time as an initial prognostic screening tool in patients with systolic left ventricular dysfunction.
MedLine Citation:
PMID:  19528334     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We sought to determine whether treadmill exercise time may be of value as an initial prognostic screening tool in ambulatory patients with impaired systolic function who are referred for cardiopulmonary exercise testing.
METHODS AND RESULTS: We studied 2231 adult systolic heart failure patients (27% of whom were women) who underwent cardiopulmonary stress testing using a modified Naughton protocol. We assessed the value of treadmill exercise time for prediction of all-cause death and a composite of death or United Network for Organ Sharing status 1 heart transplantation. During a mean follow-up of 5 years, 742 patients (33%) died. There were 249 United Network for Organ Sharing status 1 heart transplants (11%). Treadmill exercise time was predictive of death and the composite outcome in both women and men, even after accounting for peak oxygen consumption and other clinical covariates (adjusted hazard ratio of lowest versus high sex-specific quartile for prediction of death 1.70, 95% confidence interval 1.05 to 2.75, P=0.03; for prediction of the composite outcome, 1.75, 95% confidence interval 1.15 to 2.66, P=0.009). For a 1-minute change in exercise time, there was a 7% increased hazard of death (eg, comparing 480 to 540 seconds, hazard ratio =1.07, 95% confidence interval 1.02 to 1.12, P=0.004).
CONCLUSIONS: Because cardiopulmonary stress testing is not available in every hospital, treadmill exercise time with a modified Naughton protocol may be of value as an initial prognostic screening tool.
Eileen Hsich; Eiran Z Gorodeski; Randall C Starling; Eugene H Blackstone; Hemant Ishwaran; Michael S Lauer
Related Documents :
9054754 - Attenuated cardiac sympathetic responsiveness during dynamic exercise in patients with ...
6705284 - A dose response study with oral prenalterol in patients with chronic congestive cardiac...
9468084 - Effect of endothelin-1 on exercise-induced vasodilation in normal subjects and in patie...
6625784 - Evaluating the conditions of patients with congestive heart failure by exercise testing.
23034644 - Exercise-induced igf-i system concentrations after training in women.
6208864 - Effects of electrical stimulation in vivo of m. pectoralis on carbohydrate metabolism w...
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-06-15
Journal Detail:
Title:  Circulation     Volume:  119     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-30     Completed Date:  2009-07-22     Revised Date:  2014-10-22    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3189-97     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Exercise Test / methods*
Follow-Up Studies
Kaplan-Meier Estimate
Mass Screening / methods*
Middle Aged
Oxygen Consumption
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Risk Factors
Sex Distribution
Ventricular Dysfunction, Left / diagnosis*,  mortality*
Grant Support
Comment In:
Circulation. 2009 Jun 30;119(25):3165-7   [PMID:  19528333 ]

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

Previous Document:  Peak expiratory flow analysis in workers exposed to detergent enzymes.
Next Document:  Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science ad...