Roger V L, Jacobsen S J, Pellikka P A, Miller T D, Bailey K R, Gersh B J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
Circulation. 1998;98(25):2836-41. doi: 10.1161/01.cir.98.25.2836.
The prognostic value of treadmill exercise testing (TMET) has been studied in selected populations. The generalizability of these data to different populations and to women is uncertain.
A retrospective, population-based cohort study of all persons (1452 men and 741 women) who underwent TMET in years 1987 to 1989 in Olmsted County, Minnesota, was undertaken. Individuals were followed up for all-cause mortality and cardiac events (cardiac deaths, nonfatal myocardial infarction, or congestive heart failure). Sex-specific analyses were performed to determine whether the predictors of outcome and the magnitude of the associations were similar in both sexes. In men, 77 deaths and 106 cardiac events occurred during 8956 person-years of observation; in women, 46 deaths and 54 cardiac events occurred during 4801 person-years of follow-up. Exercise-induced angina, ECG changes, and workload achieved on the TMET were strongly associated with all-cause mortality and cardiac events in both sexes, and the strength of the association was similar. After adjustment, workload was the only TMET variable associated with outcome. A higher workload was associated with a reduction in the risk of cardiac events and of all-cause mortality; the protective effect of exercise capacity was strong and was similar in both sexes.
In this population-based cohort, exercise capacity was the TMET variable that exhibited the strongest association with all-cause mortality and cardiac events. This protective effect of exercise capacity was observed in both sexes.
运动平板试验（TMET）的预后价值已在特定人群中进行了研究。这些数据对不同人群及女性的可推广性尚不确定。
对1987年至1989年在明尼苏达州奥尔姆斯特德县接受TMET的所有人（1452名男性和741名女性）进行了一项基于人群的回顾性队列研究。对个体进行全因死亡率和心脏事件（心源性死亡、非致命性心肌梗死或充血性心力衰竭）随访。进行了性别特异性分析，以确定结局的预测因素以及关联强度在两性中是否相似。在男性中，8956人年的观察期内发生了77例死亡和106例心脏事件；在女性中，4801人年的随访期内发生了46例死亡和54例心脏事件。运动诱发的心绞痛、心电图变化以及TMET时达到的工作量与两性的全因死亡率和心脏事件均密切相关，且关联强度相似。调整后，工作量是与结局相关的唯一TMET变量。较高的工作量与心脏事件和全因死亡率风险降低相关；运动能力的保护作用很强，且在两性中相似。
在这个基于人群的队列中，运动能力是与全因死亡率和心脏事件关联最强的TMET变量。在两性中均观察到了运动能力的这种保护作用。
