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Clinical correlates and prognostic significance of exercise-induced ventricular premature beats in the community: the Framingham Heart Study.
Circulation. 2004 May 25; 109(20):2417-22.Circ

Abstract

BACKGROUND

Recent investigations suggest that ventricular premature beats during exercise (EVPBs) are associated with increased cardiovascular mortality in asymptomatic individuals, but mechanisms underlying the association are unclear.

METHOD AND RESULTS

We evaluated 2885 Framingham Offspring Study participants (1397 men; mean age, 43 years) who were free of cardiovascular disease and who underwent a routine exercise stress test; 792 participants (27%) had development of EVPBs (median, 0.22/min of exercise). Logistic regression was used to evaluate predictors of EVPBs. Cox models were used to examine the relations of infrequent (less than or equal to median) and frequent (greater than median) versus no EVPBs to incidence of hard coronary heart disease (CHD) event (recognized myocardial infarction, coronary insufficiency, or CHD death) and all-cause mortality, adjusting for vascular risk factors and exercise variables. Age and male sex were key correlates of EVPBs. During follow-up (mean, 15 years), 142 (113 men) had a first hard CHD event and 171 participants (109 men) died. EVPBs were not associated with hard CHD events but were associated with increased all-cause mortality rates (multivariable-adjusted hazards ratio, 1.86, 95% CI, 1.24 to 2.79 for infrequent, and 1.71, 95% CI, 1.18 to 2.49 for frequent EVPBs versus none). The relations of EVPBs to mortality risk were not influenced by VPB grade, presence of recovery VPBs, left ventricular dysfunction, or an ischemic ST-segment response.

CONCLUSIONS

In our large, community-based sample of asymptomatic individuals, EVPBs were associated with increased risk of death at a much lower threshold than previously reported. Additional studies are needed to confirm these findings and to clarify the underlying mechanisms.

Authors+Show Affiliations

National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass 01702-5827, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15148273

Citation

Morshedi-Meibodi, Ali, et al. "Clinical Correlates and Prognostic Significance of Exercise-induced Ventricular Premature Beats in the Community: the Framingham Heart Study." Circulation, vol. 109, no. 20, 2004, pp. 2417-22.
Morshedi-Meibodi A, Evans JC, Levy D, et al. Clinical correlates and prognostic significance of exercise-induced ventricular premature beats in the community: the Framingham Heart Study. Circulation. 2004;109(20):2417-22.
Morshedi-Meibodi, A., Evans, J. C., Levy, D., Larson, M. G., & Vasan, R. S. (2004). Clinical correlates and prognostic significance of exercise-induced ventricular premature beats in the community: the Framingham Heart Study. Circulation, 109(20), 2417-22.
Morshedi-Meibodi A, et al. Clinical Correlates and Prognostic Significance of Exercise-induced Ventricular Premature Beats in the Community: the Framingham Heart Study. Circulation. 2004 May 25;109(20):2417-22. PubMed PMID: 15148273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical correlates and prognostic significance of exercise-induced ventricular premature beats in the community: the Framingham Heart Study. AU - Morshedi-Meibodi,Ali, AU - Evans,Jane C, AU - Levy,Daniel, AU - Larson,Martin G, AU - Vasan,Ramachandran S, Y1 - 2004/05/17/ PY - 2004/5/19/pubmed PY - 2004/10/14/medline PY - 2004/5/19/entrez SP - 2417 EP - 22 JF - Circulation JO - Circulation VL - 109 IS - 20 N2 - BACKGROUND: Recent investigations suggest that ventricular premature beats during exercise (EVPBs) are associated with increased cardiovascular mortality in asymptomatic individuals, but mechanisms underlying the association are unclear. METHOD AND RESULTS: We evaluated 2885 Framingham Offspring Study participants (1397 men; mean age, 43 years) who were free of cardiovascular disease and who underwent a routine exercise stress test; 792 participants (27%) had development of EVPBs (median, 0.22/min of exercise). Logistic regression was used to evaluate predictors of EVPBs. Cox models were used to examine the relations of infrequent (less than or equal to median) and frequent (greater than median) versus no EVPBs to incidence of hard coronary heart disease (CHD) event (recognized myocardial infarction, coronary insufficiency, or CHD death) and all-cause mortality, adjusting for vascular risk factors and exercise variables. Age and male sex were key correlates of EVPBs. During follow-up (mean, 15 years), 142 (113 men) had a first hard CHD event and 171 participants (109 men) died. EVPBs were not associated with hard CHD events but were associated with increased all-cause mortality rates (multivariable-adjusted hazards ratio, 1.86, 95% CI, 1.24 to 2.79 for infrequent, and 1.71, 95% CI, 1.18 to 2.49 for frequent EVPBs versus none). The relations of EVPBs to mortality risk were not influenced by VPB grade, presence of recovery VPBs, left ventricular dysfunction, or an ischemic ST-segment response. CONCLUSIONS: In our large, community-based sample of asymptomatic individuals, EVPBs were associated with increased risk of death at a much lower threshold than previously reported. Additional studies are needed to confirm these findings and to clarify the underlying mechanisms. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15148273/Clinical_correlates_and_prognostic_significance_of_exercise_induced_ventricular_premature_beats_in_the_community:_the_Framingham_Heart_Study_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000129762.41889.41?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -