Exercise Capacity (METs)
Patents with a poor exercise capacity (<4 METs) represent a high-risk subset, especially if ischemic ECG changes are noted at this low workload. Conversely, patients with a good exercise capacity (>10 METs) often have an excellent prognosis independent of the extent of anatomical CAD. It is estimated that for every 1 met increase in exercise capacity the survival improved by 12%. Failure to reach 85% of predicted exercise capacity was significantly associated with increased risk of MI, unstable angina, coronary revascularization as well as mortality. The association with nonfatal cardiac events suggests that poor exercise capacity is not simply a reflection of a greater burden of comorbidities and worse patient health status.
- [1]Zipes, Libby, Bonow, Braunwald.: Braunwald’s Heart Disease – 7th Edition. Elsevier Saunders. 2005 (ISBN 0721605095)
- [2]Armstrong LE, Cerny FJ, Burton.: Exercise physiology for health care professionals. Human Kinetics. 2001 (ISBN 0880117524)
- [3]Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O'Reilly MG, Winters WL Jr.: ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines).Journal of the American College of Cardiology 2002 October 16, 40 (8): 1531-40
- [4]Zipes, Libby, Bonow, Braunwald.: Braunwald’s Heart Disease – 7th Edition. Elsevier Saunders. 2005 (156, 162)
- [5]Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE.: Exercise capacity and mortality among men referred for exercise testing.New England Journal of Medicine 2002 March 14, 346 (11): 793-801
- [6]Peterson PN, Magid DJ, Ross C, Ho PM, Rumsfeld JS, Lauer MS, Lyons EE, Smith SS, Masoudi FA.: Association of exercise capacity on treadmill with future cardiac events in patients referred for exercise testing.Archives of Internal Medicine 2008 January 28, 168 (2): 174-9
- [7]Gulati M, Black HR, Shaw LJ, et al.: The prognostic value of a nomogram for exercise capacity in women.New England Journal of Medicine 2005 August 4, 353 (5): 468-75
- [8]Morris CK, Myers J, Froelicher VF, Kawaguchi T, Ueshima K, Hideg A.: Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men.Journal of the American College of Cardiology 1993, 22 (1): 175-82
Results
Real-time automated computation
Patents with a poor exercise capacity (<4 METs) represent a high-risk subset, especially if ischemic ECG changes are noted at this low workload. Conversely, patients with a good exercise capacity (>10 METs) often have an excellent prognosis independent of the extent of anatomical CAD. It is estimated that for every 1 met increase in exercise capacity the survival improved by 12%. Failure to reach 85% of predicted exercise capacity was significantly associated with increased risk of MI, unstable angina, coronary revascularization as well as mortality. The association with nonfatal cardiac events suggests that poor exercise capacity is not simply a reflection of a greater burden of comorbidities and worse patient health status.
- [1]Zipes, Libby, Bonow, Braunwald.: Braunwald’s Heart Disease – 7th Edition. Elsevier Saunders. 2005 (ISBN 0721605095)
- [2]Armstrong LE, Cerny FJ, Burton.: Exercise physiology for health care professionals. Human Kinetics. 2001 (ISBN 0880117524)
- [3]Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O'Reilly MG, Winters WL Jr.: ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines).Journal of the American College of Cardiology 2002 October 16, 40 (8): 1531-40
- [4]Zipes, Libby, Bonow, Braunwald.: Braunwald’s Heart Disease – 7th Edition. Elsevier Saunders. 2005 (156, 162)
- [5]Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE.: Exercise capacity and mortality among men referred for exercise testing.New England Journal of Medicine 2002 March 14, 346 (11): 793-801
- [6]Peterson PN, Magid DJ, Ross C, Ho PM, Rumsfeld JS, Lauer MS, Lyons EE, Smith SS, Masoudi FA.: Association of exercise capacity on treadmill with future cardiac events in patients referred for exercise testing.Archives of Internal Medicine 2008 January 28, 168 (2): 174-9
- [7]Gulati M, Black HR, Shaw LJ, et al.: The prognostic value of a nomogram for exercise capacity in women.New England Journal of Medicine 2005 August 4, 353 (5): 468-75
- [8]Morris CK, Myers J, Froelicher VF, Kawaguchi T, Ueshima K, Hideg A.: Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men.Journal of the American College of Cardiology 1993, 22 (1): 175-82