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    
Abstract/OtherAbstract:
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.
Authors:
Eileen Hsich; Eiran Z Gorodeski; Randall C Starling; Eugene H Blackstone; Hemant Ishwaran; Michael S Lauer
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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    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Exercise Test / methods*
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Mass Screening / methods*
Middle Aged
Oxygen Consumption
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Factors
Sex Distribution
Systole
Ventricular Dysfunction, Left / diagnosis*,  mortality*
Grant Support
ID/Acronym/Agency:
UL1 RR024989/RR/NCRR NIH HHS; Z99 HL999999/HL/NHLBI NIH HHS
Comments/Corrections
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


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