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Performance during exercise echocardiography predicts mortality risk
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Exercise echocardiography predicts CV death, cancer-related death and death not related to either CVD or cancer, according to data presented at EuroEcho-Imaging.
“There are much cheaper ways to estimate if you could achieve 10 [metabolic equivalents] on the treadmill test,” Jesús Peteiro, MD, a cardiologist at University Hospital de A Coruña in Spain, said in a press release. “If you can walk very fast up three floors of stairs without stopping or fast up four floors without stopping, you have good functional capacity. If not, it’s a good indication that you need more exercise.”
Researchers analyzed data from 12,615 patients (mean age, 62 years; 63% men) who had known or suspected CAD and underwent treadmill exercise echocardiography. Good functional capacity based on the exercise echocardiography was defined as a maximal workload of 10 metabolic equivalents (METs).
The endpoint of interest was CV-related death, cancer-related death or death not related to CVD or cancer.
During follow-up of 4.7 years, CV death occurred in 1,253 patients, 670 patients had cancer-related death and 650 patients died of causes not related to CVD or cancer.
CV death was predicted by different clinical characteristics, exercise echocardiography variables and maximal achieved workload in METs (HR = 0.91, 95% CI, 0.89-0.93). Predictors of cancer-related death were clinical characteristics and achieved METs (HR = 0.91; 95% CI, 0.88-0.93). Other deaths were predicted by clinical characteristics and achieved metabolic equivalents (HR = 0.96; 95% CI, 0.94-0.98).
The risk for cancer-related, non-CVD-related and non-cancer-related death did not increase with ischemia or abnormal exercise echocardiography, although these findings were associated with CV death.
The annual rate of CV death was higher in patients with poor functional capacity compared with those with good functional capacity (3.2% vs. 1.2%; P < .001). This was also seen for non-CVD-related deaths and non-cancer-related deaths (1.7% vs. 0.6%; P < .001). The rate of cancer-related death was greater in patients with poor functional capacity vs. those with good functional capacity (1.5% vs. 0.8%; P < .001).
“Fitness patients based on the achievement of 10 METs during exercise testing have less chance of death for any cause,” Peteiro and colleagues wrote. – by Darlene Dobkowski
Reference:
Peteiro J, et al. Abstract P927. Presented at: EuroEcho-Imaging; Dec. 5-8, 2018; Milan.
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Milind Y. Desai, MD
Patients need to exercise more to live longer. The fitter they are, the longer they live.
We need prospective studies where patients are separated based on their exercise capacity for longer-term follow-up.
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