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Prognostic value of peak work rate indexed by left ventricular diameter

Eklund Gustafsson, Charlotte ; Ekström, Magnus LU orcid ; Ugander, Martin ; Brudin, Lars ; Carlén, Anna ; Hedman, Kristofer and Lindow, Thomas LU (2023) In Scientific Reports 13(1).
Abstract

Left ventricular diameter (LVEDD) increases with systematic endurance training but also in various cardiac diseases. High exercise capacity associates with favorable outcomes. We hypothesized that peak work rate (Wpeak) indexed to LVEDD would carry prognostic information and aimed to evaluate the association between Wpeak/LVEDDrest and cardiovascular mortality. Wpeak/LVEDDrest (W/mm) was calculated in patients with an echocardiographic examination within 3 months of a maximal cycle ergometer exercise test. Low Wpeak/LVEDDrest was defined as a value below the sex- and age-specific 5th percentile among lower-risk subjects. The association with cardiovascular... (More)

Left ventricular diameter (LVEDD) increases with systematic endurance training but also in various cardiac diseases. High exercise capacity associates with favorable outcomes. We hypothesized that peak work rate (Wpeak) indexed to LVEDD would carry prognostic information and aimed to evaluate the association between Wpeak/LVEDDrest and cardiovascular mortality. Wpeak/LVEDDrest (W/mm) was calculated in patients with an echocardiographic examination within 3 months of a maximal cycle ergometer exercise test. Low Wpeak/LVEDDrest was defined as a value below the sex- and age-specific 5th percentile among lower-risk subjects. The association with cardiovascular mortality was evaluated using Cox regression. In total, 3083 patients were included (8.0 [5.4–11.1] years of follow-up, 249 (8%) cardiovascular deaths). Wpeak/LVEDDrest (W/mm) was associated with cardiovascular mortality (adjusted hazard ratio (HR) 0.28 [0.22–0.36]), similar to Wpeak in % of predicted, with identical prognostic strength when adjusted for age and sex (C-statistics 0.87 for both). A combination of low Wpeak/LVEDDrest and low Wpeak was associated with a particularly poor prognosis (adjusted HR 6.4 [4.0–10.3]). Wpeak/LVEDDrest was associated with cardiovascular mortality but did not provide incremental prognostic value to Wpeak alone. The combination of a low Wpeak/LVEDDrest and low Wpeak was associated with a particularly poor prognosis.

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type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
13
issue
1
article number
8806
publisher
Nature Publishing Group
external identifiers
  • pmid:37258692
  • scopus:85160819592
ISSN
2045-2322
DOI
10.1038/s41598-023-35976-x
language
English
LU publication?
yes
id
0e4ede5f-cedf-48aa-a398-d3163d28b8eb
date added to LUP
2023-08-17 11:29:47
date last changed
2024-04-20 00:53:55
@article{0e4ede5f-cedf-48aa-a398-d3163d28b8eb,
  abstract     = {{<p>Left ventricular diameter (LVEDD) increases with systematic endurance training but also in various cardiac diseases. High exercise capacity associates with favorable outcomes. We hypothesized that peak work rate (W<sub>peak</sub>) indexed to LVEDD would carry prognostic information and aimed to evaluate the association between W<sub>peak</sub>/LVEDD<sub>rest</sub> and cardiovascular mortality. W<sub>peak</sub>/LVEDD<sub>rest</sub> (W/mm) was calculated in patients with an echocardiographic examination within 3 months of a maximal cycle ergometer exercise test. Low W<sub>peak</sub>/LVEDD<sub>rest</sub> was defined as a value below the sex- and age-specific 5th percentile among lower-risk subjects. The association with cardiovascular mortality was evaluated using Cox regression. In total, 3083 patients were included (8.0 [5.4–11.1] years of follow-up, 249 (8%) cardiovascular deaths). W<sub>peak</sub>/LVEDD<sub>rest</sub> (W/mm) was associated with cardiovascular mortality (adjusted hazard ratio (HR) 0.28 [0.22–0.36]), similar to W<sub>peak</sub> in % of predicted, with identical prognostic strength when adjusted for age and sex (C-statistics 0.87 for both). A combination of low W<sub>peak</sub>/LVEDD<sub>rest</sub> and low W<sub>peak</sub> was associated with a particularly poor prognosis (adjusted HR 6.4 [4.0–10.3]). W<sub>peak</sub>/LVEDD<sub>rest</sub> was associated with cardiovascular mortality but did not provide incremental prognostic value to W<sub>peak</sub> alone. The combination of a low W<sub>peak</sub>/LVEDD<sub>rest</sub> and low W<sub>peak</sub> was associated with a particularly poor prognosis.</p>}},
  author       = {{Eklund Gustafsson, Charlotte and Ekström, Magnus and Ugander, Martin and Brudin, Lars and Carlén, Anna and Hedman, Kristofer and Lindow, Thomas}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Prognostic value of peak work rate indexed by left ventricular diameter}},
  url          = {{http://dx.doi.org/10.1038/s41598-023-35976-x}},
  doi          = {{10.1038/s41598-023-35976-x}},
  volume       = {{13}},
  year         = {{2023}},
}