Linked Life Data

17920370

Source:http://linkedlifedata.com/resource/pubmed/id/17920370

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2007-10-8
pubmed:abstractText
In many heart diseases, exercise tolerance testing (ETT) has useful functional correlates and/or prognostic value. However, its predictive value in mitral regurgitation (MR) is undefined. To determine whether ETT descriptors predict death or indications for mitral valve surgery in patients with MR, we prospectively followed, for 7 +/- 3 end-point-free years, a cohort of 38 patients with chronic severe nonischemic MR who underwent modified Bruce ETT; all lacked surgical indications at study entry. Their baseline exercise descriptors were also compared with those from 46 patients with severe MR who, at entry, already had reached surgical indications. End points during follow-up in the cohort included sudden death (n = 1), heart failure symptoms (n = 2), atrial fibrillation (n = 4), left ventricular (LV) ejection fraction <60% (n = 2), LV systolic dimensions > or =45 mm (n = 12) and >40 mm (n = 11), LV ejection fraction <60% plus LV systolic dimensions > or =45 mm (n = 3), and heart failure plus LV systolic dimensions > or =45 mm plus LV ejection fraction <60% (n = 1). In univariate analysis, exercise duration (p = 0.004), chronotropic response (p = 0.007), percent predicted peak heart rate (p = 0.01), and heart rate recovery (p <0.02) predicted events; in multivariate analysis, only exercise duration was predictive (p <0.02). Average annual event risk was fivefold lower (4.62%) with an exercise duration > or =15 versus <15 minutes (average annual risk 23.48%, p = 0.004). Relative risks in patients with and without exercise-inducible ST-segment depression were comparable (< or =1.3, p = NS) whether defined at entry and/or during follow-up. Exercise duration, but not prevalence of exercise-inducible ST-segment depression, was lower (p <0.001) in patients with surgical indications at entry versus initially end-point-free patients. In conclusion, in asymptomatic patients with chronic severe nonischemic MR and no objective criteria for operation, progression to surgical indications generally is rapid. However, those with excellent exercise tolerance have a relatively benign course. Exercise-inducible ST-segment depression has no prognostic value in this population.
pubmed:grant
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
100
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1274-81
pubmed:dateRevised
2008-5-15
pubmed:meshHeading
pubmed:year
2007
pubmed:articleTitle
Prognostic value of exercise tolerance testing in asymptomatic chronic nonischemic mitral regurgitation.
pubmed:affiliation
Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Evaluation Studies, Research Support, N.I.H., Extramural