Prognostic value of abnormal postexercisesystolic blood peessure response: Prehospital discharge test after myocardial infarction in Japan

Kato, Kazushige; Saito, Fumio; Hatano, Kiyoshi; Noda, Shoji; Tsuzuki, Jitsuki; Yokota, Mitsuhiro; Hayashi, Hiroshi; Saito, Hidehiko; Sotobata, Iwao

doi:10.1016/s0002-8703(05)80015-8

Cited by 14 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In one of these previous studies, abnormal post-exercise SAP response stratified the all-cause mortality in patients (n ¼ 217) after an acute myocardial infarction. 9 However, two other studies, with either 12 379 low-risk 7 or 2428 consecutive adult patients, 8 did not support this finding, which is consistent with our results: we did not find an association between SAP recovery and overall, cardiovascular or sudden cardiac mortality. Given the impact of the large studies, SAP recovery does not seem to be applicable in risk stratification.…”

Section: Discussionsupporting

confidence: 81%

“…In that case, SAP recovery could also prove valuable in predicting mortality during follow-up, but earlier studies on this hypothesis have been scarce. [7][8][9] Several computed parameters have been derived with the idea that they would integrate several (patho) physiological markers or phenomena into a single variable. Such markers have not yet, however, broken through into wide-scale clinical use.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study

et al. 2008

View full text Add to dashboard Cite

We tested the hypothesis that the change from the peak to recovery values of systolic arterial pressure (SAP recovery ) and rate-pressure product (RPP recovery ) 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 ¼ 2029; mean age±SD ¼ 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 SAP recovery , RPP recovery 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 b-blockers, previous myocardial infarction and other common coronary risk factors, the hazard ratio of the continuous variable RPP recovery (in units 1000 mm Hg Â 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. SAP recovery 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, RPP recovery is a promising candidate for a prognostic marker.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Kato et al conducted a treadmill exercise test for 217 patients with AMI at an average of 9.3 weeks after AMI, and defined an abnormal post-exercise SBP response as a ratio of SBP at 3 min of recovery to peak exercise of 0.9 or more [18]. An abnormal post-exercise SBP response was significantly associated with cardiac death [18]. This finding was in line with our results, although we focused on longterm outcomes.…”

Section: Discussionsupporting

confidence: 88%

“…Specific literature regarding the 200 m walk ECG test in patients with AMI is sparse, but there are several studies regarding the blood pressure response after stress tests in patients with AMI or coronary artery disease. Kato et al conducted a treadmill exercise test for 217 patients with AMI at an average of 9.3 weeks after AMI, and defined an abnormal post-exercise SBP response as a ratio of SBP at 3 min of recovery to peak exercise of 0.9 or more [18]. An abnormal post-exercise SBP response was significantly associated with cardiac death [18].…”

Section: Discussionmentioning

confidence: 99%

Impact of Excessive Increase in Systolic Blood Pressure after Exercise on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

Yamashita,

Sakakura,

Jinnouchi

et al. 2023

JCM

View full text Add to dashboard Cite

Objective: Although the clinical outcomes for patients with ST-elevation myocardial infarction (STEMI) have improved significantly, some patients still experience poor clinical outcomes. The available risk classifications focus on the short-term outcomes, and it remains important to find high-risk features among patients with STEMI. In Japan, the 200 m walk electrocardiogram (ECG) test is widely performed before discharge. The purpose of this study was to investigate the association between the excessive increase in systolic blood pressure (SBP) following a 200 m walk and the long-term clinical outcomes in patients with STEMI. Methods: We included 680 patients with STEMI and divided those into an excessive increase in SBP group (n = 144) and a non-excessive increase in SBP group (n = 536) according to the SBP increase after a 200 m walk ECG test. We defined an excessive increase in SBP as SBP ≥ 20 mmHg either just after or 3 min after a 200 m walk ECG test. The primary endpoint consisted of major cardiovascular events (MACE), defined as the composite of all-cause death, non-fatal myocardial infarction, readmission for heart failure, and ischemia-driven target vessel revascularization. Results: The median follow-up duration was 831 days. MACE was more frequently observed in the excessive increase in SBP group (24.3%) than in the non-excessive increase in SBP group (15.1%). Multivariate Cox hazard analysis revealed that the excessive increase in SBP was significantly associated with MACE (HR 1.509, 95% CI: 1.005–2.267, p = 0.047) after controlling for multiple confounding factors. Conclusion: An excessive increase in SBP after the 200 m walk ECG test was significantly associated with MACE in patients with STEMI. The 200 m walk ECG test is simple and low-cost, but may help to identify high-risk patients with STEMI.

show abstract

Postexercise systolic blood pressure response: Association with the presence and extent of perfusion abnormalities on thallium-201 scintigraphy

Taylor

Beller

1995

American Heart Journal

View full text Add to dashboard Cite

Prognostic value of abnormal postexercisesystolic blood peessure response: Prehospital discharge test after myocardial infarction in Japan

Cited by 14 publications

References 23 publications

The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study

The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study

Impact of Excessive Increase in Systolic Blood Pressure after Exercise on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

Postexercise systolic blood pressure response: Association with the presence and extent of perfusion abnormalities on thallium-201 scintigraphy

Contact Info

Product

Resources

About