Delayed heart rate recovery after adenosine stress testing with supplemental arm exercise predicts mortality.
J Nucl Cardiol
; 16(1): 54-62, 2009.
Article
em En
| MEDLINE
| ID: mdl-19152129
ABSTRACT
BACKGROUND:
Delayed heart rate (HR) recovery after treadmill exercise testing predicts mortality. Patients with suspected ischemic heart disease who cannot perform adequate treadmill exercise are typically evaluated with pharmacological stress myocardial perfusion imaging (MPI) studies, but little prognostic significance has been attributed to the hemodynamic response to vasodilator stress testing with low-level exercise. We hypothesized that a delay in HR recovery after adenosine stress testing with arm exercise is associated with increased mortality. METHODS ANDRESULTS:
Technetium 99m-Sestamibi MPI was performed in 1,455 consecutive patients (70 +/- 12 years, 50.2% men) with adenosine stress and supplemental arm exercise. HRs were recorded at rest, continuously during infusion, and then 5 minutes post-infusion. Delayed HR recovery was defined as a decline of < or = 12 bpm from peak HR at 5 minutes after discontinuation of the infusion. Of 1,356 patients during 5 years of follow up, there were 135 deaths (10%). Delayed HR recovery was strongly predictive of all-cause mortality (16.5% vs 5.3% in those with normal HR recovery, P < .001) with an adjusted hazard ratio of 2.5 (95% CI, 1.7-3.6; P < .001).CONCLUSION:
Delayed HR recovery after adenosine stress testing with arm exercise is a readily available and powerful predictor of all-cause mortality.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Adenosina
/
Tecnécio Tc 99m Sestamibi
/
Isquemia Miocárdica
/
Teste de Esforço
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Frequência Cardíaca
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article