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- Title
The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study.
- Authors
Nieminen, T; Leino, J; Maanoja, J; Nikus, K; Viik, J; Lehtimäki, T; Kööbi, T; Lehtinen, R; Niemelä, K; Turjanmaa, V; Kähönen, M
- Abstract
We tested the hypothesis that the change from the peak to recovery values of systolic arterial pressure (SAPrecovery) and rate–pressure product (RPPrecovery) 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 SAPrecovery, RPPrecovery 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 β-blockers, previous myocardial infarction and other common coronary risk factors, the hazard ratio of the continuous variable RPPrecovery (in units 1000 mm Hg × 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. SAPrecovery 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, RPPrecovery is a promising candidate for a prognostic marker.Journal of Human Hypertension (2008) 22, 537–543; doi:10.1038/jhh.2008.38; published online 29 May 2008
- Subjects
CARDIOVASCULAR system; EXERCISE tests; PROGNOSTIC tests; MYOCARDIAL infarction-related mortality; ARTERIES
- Publication
Journal of Human Hypertension, 2008, Vol 22, Issue 8, p537
- ISSN
0950-9240
- Publication type
Article
- DOI
10.1038/jhh.2008.38