Document Detail


Severe frequent ventricular ectopy after exercise as a predictor of death in patients with heart failure.
MedLine Citation:
PMID:  15312865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The study was done to determine the prognostic importance of frequent ventricular ectopy in recovery after exercise among patients with systolic heart failure (HF). BACKGROUND: Although ventricular ectopy during recovery after exercise predicts death in patients without HF, its prognostic importance in patients with significant ventricular dysfunction is unknown. METHODS: Systematic electrocardiographic data during rest, exercise, and recovery were gathered on 2,123 consecutive patients with left ventricular systolic ejection fraction <or=35% who were referred for symptom-limited metabolic treadmill exercise testing. Severe ventricular ectopy was defined as the presence of ventricular triplets, sustained or nonsustained ventricular tachycardia, ventricular flutter, polymorphic ventricular tachycardia, or ventricular fibrillation. The primary end point was all-cause mortality, with censoring for interval cardiac transplantation. RESULTS: Of 2,123 patients, 140 (7%) had severe ventricular ectopy during recovery. There were 530 deaths (median follow-up among survivors 2.9 years). Severe ventricular ectopy during recovery was associated with an increased risk of death (three-year death rates 37% vs. 22%, hazard ratio [HR] 1.76; 95% confidence interval [CI] 1.32 to 2.34, p < 0.0001). After adjustment for ventricular ectopy at rest and during exercise, peak oxygen uptake, and other potential confounders, severe ventricular ectopy during recovery remained predictive of death (adjusted HR 1.48; 95% CI 1.10 to 1.97; p = 0.0089), whereas ventricular ectopy during exercise was not predictive of death in this cohort. CONCLUSIONS: Severe ventricular ectopy during recovery after exercise is predictive of increased mortality in patients with severe HF and can be used as a prognostic indicator of adverse outcomes in HF cohorts.
Authors:
James O O'Neill; James B Young; Claire E Pothier; Michael S Lauer
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  44     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-17     Completed Date:  2004-09-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  820-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Electrocardiography
Exercise Test*
Female
Heart Failure / mortality*,  physiopathology*
Humans
Male
Medical Records
Middle Aged
Ohio / epidemiology
Predictive Value of Tests
Prognosis
Retrospective Studies
Severity of Illness Index
Survival Analysis
Ventricular Premature Complexes / mortality*,  physiopathology*
Grant Support
ID/Acronym/Agency:
HL-66004/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2004 Aug 18;44(4):827-8   [PMID:  15312866 ]

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


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