Ho John S, Fitzgerald Shannon J, Barlow Carolyn E, Cannaday John J, Kohl Harold W, Haskell William L, Cooper Kenneth H
Cooper Clinic, 12200 Preston Road, Dallas, TX 75230, USA.
Eur J Cardiovasc Prev Rehabil. 2010 Aug;17(4):462-8. doi: 10.1097/HJR.0b013e328336a10d.
Abnormal non-ST segment treadmill parameters are associated with an increased mortality risk. Such measures include fitness, resting heart rate (HR), chronotropic incompetence, and HR recovery. However, whether there is an additive association among these parameters and the risk of mortality is unknown.
Prospective observational registry study.
We assessed the risk of cardiovascular and all-cause mortality in 25 642 individuals as an additive function of the number of these parameters. Abnormal responses were defined as follows: abnormal resting HR as a HR>or=80 bpm, abnormal fitness as an adjusted fitness level in the lowest 20%, chronotropic incompetence as an inability to achieve at least 80% of the predicted HR reserve, and abnormal HR recovery as an HR decline less than 12 bpm 1 min after exercise.
During 7.2 years of follow-up, 392 participants died, with 94 from cardiovascular causes. Each parameter was significantly associated with all-cause and cardiovascular mortality (P<0.01) after adjustment for cardiovascular risk factors. There was a significant trend between both all-cause or cardiovascular mortality and the number of abnormal parameters (P<0.05).
There is a continuum of risk as the number of abnormal parameters increases, suggesting that it may be important to determine their presence and number during exercise testing.
异常的非ST段运动平板参数与死亡风险增加相关。这些指标包括体能、静息心率（HR）、变时性功能不全以及心率恢复情况。然而，这些参数之间是否存在相加性关联以及与死亡风险的关系尚不清楚。
前瞻性观察性登记研究。
我们评估了25642名个体中心血管疾病和全因死亡的风险，将其作为这些参数数量的相加函数。异常反应定义如下：静息心率异常为心率≥80次/分钟，体能异常为调整后的体能水平处于最低的20%，变时性功能不全为无法达到预测心率储备的至少80%，心率恢复异常为运动后1分钟内心率下降少于12次/分钟。
在7.2年的随访期间，392名参与者死亡，其中94例死于心血管疾病。在调整心血管危险因素后，每个参数均与全因和心血管疾病死亡率显著相关（P<0.01）。全因或心血管疾病死亡率与异常参数数量之间存在显著趋势（P<0.05）。
随着异常参数数量的增加，风险呈连续性变化，这表明在运动测试期间确定它们的存在和数量可能很重要。
