| T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test. | |
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MedLine Citation:
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PMID: 17652105 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: As a part of the Finnish Cardiovascular Study, we tested the hypothesis that T-wave alternans (TWA) predicts mortality in a general population of patients referred for a clinical exercise test. METHODS AND RESULTS: A total of 1037 consecutive patients (mean age+/-SD of 58+/-13 years, 673 men and 364 women) with a clinically indicated exercise test and with technically successful electrocardiographic (ECG) data during a bicycle ergometer test were included in the study. Digital ECGs were recorded and TWA was analysed continuously with the time-domain modified moving average method. The maximum TWA value at heart rate (HR)<125 b.p.m. was derived and its capacity to stratify risk for all-cause death, cardiovascular death, and sudden cardiac death (SCD) was tested. During a follow-up of 44+/-7 months (mean+/-SD), 59 patients died; 34 were due to cardiovascular causes and 20 were due to SCD. In multivariate analysis after adjustment for age, sex, use of beta-blockers, functional class, maximal HR during exercise, previous myocardial infarction, and other common coronary risk factors, the relative risk of TWA>or=65 microV for SCD was 7.4 (95% CI, 2.8-19.4; P<0.001), for cardiovascular mortality 6.0 (95% CI, 2.8-12.8; P<0.001), and for all-cause mortality 3.3 (95% CI, 1.8-6.3; P=0.001). CONCLUSION: Time-domain TWA analysis powerfully predicts mortality in a general population undergoing a clinical exercise test. |
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Authors:
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Tuomo Nieminen; Terho Lehtimäki; Jari Viik; Rami Lehtinen; Kjell Nikus; Tiit Kööbi; Kari Niemelä; Väinö Turjanmaa; Willi Kaiser; Heini Huhtala; Richard L Verrier; Heikki Huikuri; Mika Kähönen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-07-25 |
Journal Detail:
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Title: European heart journal Volume: 28 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-10-02 Completed Date: 2008-04-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 2332-7 Citation Subset: IM |
Affiliation:
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Department of Pharmacological Sciences, Medical School, University of Tampere, and Laboratory of Atherosclerosis Genetics, Department of Clinical Chemistry, Tampere University Hospital, Finland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arrhythmias, Cardiac / diagnosis, mortality* Cardiovascular Diseases / mortality, prevention & control Cohort Studies Death, Sudden, Cardiac / prevention & control Electrocardiography* Exercise Test / methods Female Follow-Up Studies Humans Male Middle Aged Multivariate Analysis Predictive Value of Tests Prognosis Risk Factors |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2007 Nov;28(21):2691; author reply 2691
[PMID:
17934215
]
Eur Heart J. 2007 Oct;28(19):2303-4 [PMID: 17720992 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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