Treadmill testing improves survival prediction models in pulmonary arterial hypertension - 30/11/11

Doi : 10.1016/j.ahj.2011.09.015

Chih-Hsin Hsu, MD ^a,^b, Cherylanne Glassner, BS ^c, Aimee J. Foreman, MA ^d, Richa Agarwal, MD ^c, Raymond J. Benza, MD ^e, Robert P. Frantz, MD ^f, Mardi Gomberg-Maitland, MD, MSc ^c,^g,^{^⁎}
^a Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
^b Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
^c Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL
^d ICON Clinical Research, San Francisco, CA
^e Division of Cardiology, Department of Medicine, Allegheny General Hospital, Pittsburgh, PA
^f Section of Cardiology Department of Medicine, Mayo Clinic, Rochester, MN
^g Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago Medical Center, Chicago, IL

^⁎Reprint requests: Mardi Gomberg-Maitland, MD, MSc, University of Chicago Hospitals, 5841 S Maryland Ave., MC 5403, Room L08, Chicago, IL 60637.

Résumé

Background

Six-minute walk distance (6MWD) is used in the REVEAL equation to predict 1-year survival for patients with pulmonary arterial hypertension. We sought to determine whether exercise treadmill testing (ETT) could be used in its place.

Methods

This was a single-center study in which 449 patients were enrolled. The variables predictive of survival in the REVEAL equation were evaluated and compared with survival predicted by the REVEAL equation without an exercise measure and a revised equation using ETT.

Results

The addition of ETT to the equation improved the predictive ability of the REVEAL equation in the high- and low-risk patient groups.

Conclusion

The study findings suggest that the addition of ETT parameters to the REVEAL prognostic equation improves the predictive value of the equation when 6-minute walk distance is unavailable.

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Plan

Characteristics at enrollment

Electrocardiography, echocardiography, hemodynamics, and laboratory testing

Survival

Revised REVEAL equation covariates

The REVEAL risk model predictability without 6MWD in low-, moderate-, and high-risk groups as determined by ETT

The REVEAL prognostic equation with ETT

Sensitivity analysis

Discussion

Disclosures

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Vol 162 - N° 6

P. 1011-1017 - décembre 2011 Retour au numéro

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Treadmill testing improves survival prediction models in pulmonary arterial hypertension - 30/11/11

Résumé

Background

Methods

Results

Conclusion

Plan

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