Document Detail


The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study.
MedLine Citation:
PMID:  18509348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We tested the hypothesis that the change from the peak to recovery values of systolic arterial pressure (SAP recovery) and rate-pressure product (RPP recovery) can be used to predict all-cause and cardiovascular mortality, as well as sudden cardiac death (SCD) in patients referred to a clinical exercise stress test. As a part of the Finnish Cardiovascular Study (FINCAVAS), consecutive patients (n=2029; mean age+/-SD=57+/-13 years; 1290 men and 739 women) with a clinically indicated exercise test using a bicycle ergometer were included in the present study. Capacities of attenuated SAP recovery, RPP recovery and heart rate recovery (HRR) to stratify the risk of death were estimated. During a follow-up (mean+/-s.d.) of 47+/-13 months, 122 patients died; 58 of the deaths were cardiovascular and 33 were SCD. In Cox regression analysis after adjustment for the peak level of the variable under assessment, age, sex, use of beta-blockers, previous myocardial infarction and other common coronary risk factors, the hazard ratio of the continuous variable RPP recovery (in units 1000 mm Hg x b.p.m.) was 0.85 (95% CI: 0.73-0.98) for SCD, 0.87 (0.78-0.97) for cardiovascular mortality, and 0.87 (0.81 to 0.94) for all-cause mortality. SAP recovery was not a predictor of mortality. The relative risks of having HRR below 18 b.p.m., a widely used cutoff point, were as follows: for SCD 1.28 (0.59-2.81, ns), for cardiovascular mortality 2.39 (1.34-4.26) and for all-cause mortality 2.40 (1.61-3.58). In conclusion, as a readily available parameter, RPP recovery is a promising candidate for a prognostic marker.
Authors:
T Nieminen; J Leino; J Maanoja; K Nikus; J Viik; T Lehtimäki; T Kööbi; R Lehtinen; K Niemelä; V Turjanmaa; M Kähönen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-29
Journal Detail:
Title:  Journal of human hypertension     Volume:  22     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-17     Completed Date:  2008-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  537-43     Citation Subset:  IM    
Affiliation:
Department of Pharmacological Sciences, Medical School, University of Tampere, Tampere, Finland. tuomo.nieminen@iki.fi
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / physiology*
Cardiovascular Diseases / mortality,  physiopathology*
Cause of Death / trends
Exercise / physiology*
Exercise Test / methods*
Female
Finland / epidemiology
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Recovery of Function / physiology*
Retrospective Studies
Risk Factors
Survival Rate / trends

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


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