ArticleHerz2010
Exercise capacity is the most powerful predictor of 2-year mortality in patients with left ventricular systolic dysfunction.
Article in Herz, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Physical functional performance and prognosis in patients with heart failure: a systematic review and meta-analysis.BMC cardiovascular disorders · 2020Pooled it
- Six-minute walk test: prognostic value and effects of nebivolol versus placebo in elderly patients with heart failure from the SENIORS trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Trial
- Exercise training in the treatment of paroxysmal atrial fibrillation: study protocol of the Cologne ExAfib Trial.BMJ open · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are few data about predictors of cardiovascular mortality and rehospitalization rate in patients with left ventricular systolic dysfunction (LVSD) after myocardial revascularization and optimization of pharmacological treatment. PATIENTS AND
methods1,346 consecutive patients with left ventricular ejection fraction (LVEF) < 45% (64 + or - 10 years, 73% male, LVEF 36.3% + or - 8%), who were referred for inpatient cardiac rehabilitation, were followed prospectively for 731 + or - 215 days in a unicentric prospective longitudinal registry. Multivariate logistic regression Cox models were used to analyze demographic, echocardiographic and exercise variables in order to determine independent predictors of cardiovascular mortality and rehospitalization.
resultsLVEF failed to show prognostic power (hazard ratio [HR] 0.99 [95% confidence interval, CI, 0.94-1.03]; p = not significant), whereas moderate to severe mitral regurgitation (HR, 5.71 [95% CI 1.75-18.6]; p = 0.004) and atrial fibrillation (HR 1.67 [95% CI 1.15-2.44]; p = 0.008) were associated with a poorer prognosis. In an optimized multivariate model, 6-min walk test (HR 0.93 [95% CI 0.86-1.00] per 50 m; p = 0.049) and symptom-limited maximum exercise capacity test (HR 0.83 [95% CI 0.76-0.91] per 10 W; p < 0.001) as well as female gender (HR 0.58 [95% CI 0.39-0.84]; p = 0.005) were strong predictors for reduced overall mortality.
conclusionIn patients with LVSD, independently of LVEF, traditional prognostic factors including atrial fibrillation or mitral regurgitation predict poorer survival, whereas symptom-limited exercise capacity and walking distance performed in 6-min walk test were highly predictive for a good prognosis.
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Registered trials
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