Outcomes of patients with reduced exercise capacity at time of exercise echocardiography

Robert B. McCully, Veronique Lee Roger, Steve R. Ommen, Douglas W. Mahoney, Kelli N. Burger, William K. Freeman, Patricia Pellikka

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To characterize prognostic implications of exercise echocardiography in patients who have reduced exercise capacity at the of testing. Patients and Methods: We examined the outcomes of 941 patients at the Mayo Clinic in Rochester, Minn, between January 1, 1990, and December 31, 1995, who had reduced exercise capacity on exercise echocardiography (women, <5 metabolic equivalents; men, <7 metabolic equivalents) and evaluated the potential association between clinical, electrocardiographic, and echocardiographic variables and outcomes for patients with normal vs abnormal exercise echocardiograms. We used variables of independent prognostic value to estimate cardiac risk. Results: For patients with normal exercise echocardiograms (n=282), the rate of cardiac death or nonfatal myocardial infarction was 0.9% per person-year of follow-up, and previous coronary revascularization was the only predictor of the time to cardiac event. For patients with abnormal exercise echocardiograms (n=659), the cardiac event rate was 4.4%. Independent predictors of outcome were exercise left ventricular (LV) ejection fraction (risk ratio, 1.44 per 10% decrement; 95% confidence interval, 1.2-1.7; P<.001) and an increase or no change in LV end-systolic size in response to exercise (risk ratio, 2.22; 95% confidence interval, 1.2.41; P=.01). Conclusion: Exercise echocardiographic findings have important prognostic implications for patients who have reduced exercise capacity on testing. Echocardiographic descriptors of LV systolle function and dysfunction obtained immediately after exercise can he used to stratify cardiac risk of patents who do not achieve a level of exercise ordinarily considered to he of "diagnostic" value.

Original languageEnglish (US)
Pages (from-to)750-757
Number of pages8
JournalMayo Clinic Proceedings
Volume79
Issue number6
StatePublished - 2004

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Echocardiography
Exercise
Metabolic Equivalent
Odds Ratio
Confidence Intervals
Patents
Left Ventricular Dysfunction
Left Ventricular Function
Stroke Volume
Myocardial Infarction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

McCully, R. B., Roger, V. L., Ommen, S. R., Mahoney, D. W., Burger, K. N., Freeman, W. K., & Pellikka, P. (2004). Outcomes of patients with reduced exercise capacity at time of exercise echocardiography. Mayo Clinic Proceedings, 79(6), 750-757.

Outcomes of patients with reduced exercise capacity at time of exercise echocardiography. / McCully, Robert B.; Roger, Veronique Lee; Ommen, Steve R.; Mahoney, Douglas W.; Burger, Kelli N.; Freeman, William K.; Pellikka, Patricia.

In: Mayo Clinic Proceedings, Vol. 79, No. 6, 2004, p. 750-757.

Research output: Contribution to journalArticle

McCully, RB, Roger, VL, Ommen, SR, Mahoney, DW, Burger, KN, Freeman, WK & Pellikka, P 2004, 'Outcomes of patients with reduced exercise capacity at time of exercise echocardiography', Mayo Clinic Proceedings, vol. 79, no. 6, pp. 750-757.
McCully RB, Roger VL, Ommen SR, Mahoney DW, Burger KN, Freeman WK et al. Outcomes of patients with reduced exercise capacity at time of exercise echocardiography. Mayo Clinic Proceedings. 2004;79(6):750-757.
McCully, Robert B. ; Roger, Veronique Lee ; Ommen, Steve R. ; Mahoney, Douglas W. ; Burger, Kelli N. ; Freeman, William K. ; Pellikka, Patricia. / Outcomes of patients with reduced exercise capacity at time of exercise echocardiography. In: Mayo Clinic Proceedings. 2004 ; Vol. 79, No. 6. pp. 750-757.
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