Document Detail

The prognostic value of a nomogram for exercise capacity in women.
MedLine Citation:
PMID:  16079370     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent studies have demonstrated that exercise capacity is an independent predictor of mortality in women. Normative values of exercise capacity for age in women have not been well established. Our objectives were to construct a nomogram to permit determination of predicted exercise capacity for age in women and to assess the predictive value of the nomogram with respect to survival. METHODS: A total of 5721 asymptomatic women underwent a symptom-limited, maximal stress test. Exercise capacity was measured in metabolic equivalents (MET). Linear regression was used to estimate the mean MET achieved for age. A nomogram was established to allow the percentage of predicted exercise capacity to be estimated on the basis of age and the exercise capacity achieved. The nomogram was then used to determine the percentage of predicted exercise capacity for both the original cohort and a referral population of 4471 women with cardiovascular symptoms who underwent a symptom-limited stress test. Survival data were obtained for both cohorts, and Cox survival analysis was used to estimate the rates of death from any cause and from cardiac causes in each group. RESULTS: The linear regression equation for predicted exercise capacity (in MET) on the basis of age in the cohort of asymptomatic women was as follows: predicted MET = 14.7 - (0.13 x age). The risk of death among asymptomatic women whose exercise capacity was less than 85 percent of the predicted value for age was twice that among women whose exercise capacity was at least 85 percent of the age-predicted value (P<0.001). Results were similar in the cohort of symptomatic women. CONCLUSIONS: We have established a nomogram for predicted exercise capacity on the basis of age that is predictive of survival among both asymptomatic and symptomatic women. These findings could be incorporated into the interpretation of exercise stress tests, providing additional prognostic information for risk stratification.
Martha Gulati; Henry R Black; Leslee J Shaw; Morton F Arnsdorf; C Noel Bairey Merz; Michael S Lauer; Thomas H Marwick; Dilip K Pandey; Roxanne H Wicklund; Ronald A Thisted
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  353     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-04     Completed Date:  2005-08-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  468-75     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2005 Massachusetts Medical Society.
Department of Preventive Medicine, Rush University Medical Center, Chicago, USA.
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MeSH Terms
Aged, 80 and over
Energy Metabolism
Exercise Test*
Exercise Tolerance* / physiology
Follow-Up Studies
Heart Diseases / mortality
Middle Aged
Physical Fitness*
Proportional Hazards Models
Reference Values
Risk Factors
Survival Analysis
Comment In:
N Engl J Med. 2005 Aug 4;353(5):517-9   [PMID:  16079377 ]
N Engl J Med. 2005 Nov 24;353(21):2301-3; author reply 2301-3   [PMID:  16306532 ]
N Engl J Med. 2005 Nov 24;353(21):2301-3; author reply 2301-3   [PMID:  16312064 ]
N Engl J Med. 2005 Nov 24;353(21):2301-3; author reply 2301-3   [PMID:  16312065 ]
ACP J Club. 2006 Jan-Feb;144(1):25   [PMID:  16388574 ]

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

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