Cardiorespiratory fitness and exercise-induced ST segment depression in assessing the risk of sudden cardiac death in men

Hagnäs, Magnus J; Lakka, Timo A.; Kurl, Sudhir; Rauramaa, Rainer; Mäkikallio, Timo H.; Savonen, Kai; Laukkanen, Jari A.

doi:10.1136/heartjnl-2015-309217

Cited by 24 publications

(8 citation statements)

References 31 publications

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“…METs were estimated on the standardised basis of maximum workload and weight of the patient, with 1 MET equivalent to 3.5 mL oxygen uptake/kilogram/ min. We used a cut-off point of < 8 METs as a definition of low EC based on previous studies [5,20,21].…”

Section: Sbp Response Ec and Hrrmentioning

confidence: 99%

Combination of low blood pressure response, low exercise capacity and slow heart rate recovery during an exercise test significantly increases mortality risk

et al. 2019

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Aims: We investigated the combination of low systolic blood pressure (SBP) response, low exercise capacity (EC) and slow heart rate recovery (HRR) during an exercise test in mortality prediction. Patients and methods: Our population consisted of 3456 patients from the Finnish Cardiovascular Study. A failure of SBP to increase >42 mmHg was defined as a low response. Low EC was defined as < 8 metabolic equivalents. 1-minute HRR 18 bpm from maximum was defined as slow HRR. Results: During a median follow up of 10.0 years, 537 participants died. Reduced SBP response, low EC and slow HRR were independent predictors of all-cause and CV mortality (p < .001 for all). Patients with reduced SBP response, low EC and slow HRR had a very high mortality rate of 42.1% during follow up compared to only 4.5% of the patients without any of these risk factors. The hazard ratios for all-cause mortality in patients with one, two or three of the studied risk factors were 3.2, 6.0, and 10.6, respectively (p < .001 for all). Conclusion:The combination of reduced SBP response, low exercise capacity, and reduced HRR in an exercise test is associated with very high mortality and can be used in risk stratification. KEY MESSAGESThe combination of low blood pressure response, low exercise capacity and slow heart rate recovery in an exercise test is able to identify a group of patients in a very high mortality risk. These parameters are easily derived from an exercise test. All parameters are commonly available in clinical practice.

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Section: Sbp Response Ec and Hrrmentioning

confidence: 99%

Combination of low blood pressure response, low exercise capacity and slow heart rate recovery during an exercise test significantly increases mortality risk

et al. 2019

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“…The risk increase was even higher in the presence of other conventional risk factors, such as smoking or hypercholesterolemia [82]. Interestingly, when adding fitness level to the analysis, exercise-induced ST depression did not associate with an increased adjusted risk for SCD when compared to subjects with matching cardiorespiratory fitness but no exerciseinduced ST depression [83], which illustrates the challenge of screening fit individuals.…”

Section: St Depressionmentioning

confidence: 91%

Exercise Testing in Firefighters : Work Capacity and Cardiovascular Risk Assessment in a Low-Risk Population

Carlén

2019

Linköping University Medical Dissertations

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“…The present report is based on data from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), an ongoing epidemiological follow-up study designed to investigate risk predictors for atherosclerotic cardiovascular outcomes in men. [9][10][11] A total of 3433 men aged 42 to 60 years from eastern Finland who were randomly selected from the population registry were invited to participate, and 3235 (94%) men were eligible for the study. Altogether 2682 (83%) men participated in the baseline examinations.…”

Section: Methodsmentioning

confidence: 99%

High Leisure-Time Physical Activity Is Associated With Reduced Risk of Sudden Cardiac Death Among Men With Low Cardiorespiratory Fitness

Hagnäs

Lakka

Mäkikallio

et al. 2018

Canadian Journal of Cardiology

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Cardiorespiratory fitness and exercise-induced ST segment depression in assessing the risk of sudden cardiac death in men

Abstract: The combination of low CRF and exercise-induced ST segment depression was associated with a markedly increased risk of SCD in men.

Cited by 24 publications

References 31 publications

Combination of low blood pressure response, low exercise capacity and slow heart rate recovery during an exercise test significantly increases mortality risk

Combination of low blood pressure response, low exercise capacity and slow heart rate recovery during an exercise test significantly increases mortality risk

Exercise Testing in Firefighters : Work Capacity and Cardiovascular Risk Assessment in a Low-Risk Population

High Leisure-Time Physical Activity Is Associated With Reduced Risk of Sudden Cardiac Death Among Men With Low Cardiorespiratory Fitness

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