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The Prognostic Value of a Nomogram for Exercise Capacity in Women
Open accessAbstract
BACKGROUND: Recent studies have demonstrated that exercise capacity is an independent predictor of mortality in women. Normative values of exercise capacity for age in women have not been well established. Our objectives were to construct a nomogram to permit determination of predicted exercise capacity for age in women and to assess the predictive value of the nomogram with respect to survival. METHODS: A total of 5721 asymptomatic women underwent a symptom-limited, maximal stress test. Exercise capacity was measured in metabolic equivalents (MET). Linear regression was used to estimate the mean MET achieved for age. A nomogram was established to allow the percentage of predicted exercise capacity to be estimated on the basis of age and the exercise capacity achieved. The nomogram was then used to determine the percentage of predicted exercise capacity for both the original cohort and a referral population of 4471 women with cardiovascular symptoms who underwent a symptom-limited stress test. Survival data were obtained for both cohorts, and Cox survival analysis was used to estimate the rates of death from any cause and from cardiac causes in each group. RESULTS: The linear regression equation for predicted exercise capacity (in MET) on the basis of age in the cohort of asymptomatic women was as follows: predicted MET = 14.7 - (0.13 x age). The risk of death among asymptomatic women whose exercise capacity was less than 85 percent of the predicted value for age was twice that among women whose exercise capacity was at least 85 percent of the age-predicted value (P<0.001). Results were similar in the cohort of symptomatic women. CONCLUSIONS: We have established a nomogram for predicted exercise capacity on the basis of age that is predictive of survival among both asymptomatic and symptomatic women. These findings could be incorporated into the interpretation of exercise stress tests, providing additional prognostic information for risk stratification.
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Cites
Physical Fitness as a Predictor of Cardiovascular Mortality in Asymptomatic North American Men
Ekelund, L.-G., Haskell, W. L., Johnson, J. L., Whaley, F. S., Criqui, M. H., Sheps, D. S., & Study, T. L. R. C. M. F.-U. (1988) · New England Journal of Medicine · doi:10.1056/nejm198811243192104 · Cited by 682
Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men.
Morris, C. K., Myers, J., Froelicher, V. F., Kawaguchi, T., Ueshima, K., & Hideg, A. (1993) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(93)90832-l · Cited by 280
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2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes
Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, C., Cuisset, T., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz425 · Cited by 7,166
Fletcher, G. F., Ades, P. A., Kligfield, P., Arena, R., Balady, G. J., Bittner, V. A., Coke, L. A., Fleg, J. L., Forman, D. E., Gerber, T. C., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31829b5b44 · Cited by 2,235
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., Douglas, P. S., Foody, J. M., Gerber, T. C., Hinderliter, A. L., et al. (2012) · Circulation · doi:10.1161/cir.0b013e318277d6a0 · Cited by 845
Self-citationAssociation between muscular strength and mortality in men: prospective cohort study
Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjostrom, M., & Blair, S. N. (2008) · BMJ · doi:10.1136/bmj.a439 · Cited by 815
Review: Mortality trends in the general population: the importance of cardiorespiratory fitness
Lee, D.-C., Artero, E. G., Sui, X., & Blair, S. N. (2010) · Journal of Psychopharmacology · doi:10.1177/1359786810382057 · Cited by 628
Metadata
- Authors
- Gulati, M., Black, H. R., Shaw, L. J., Arnsdorf, M. F., Merz, C. N. B., Lauer, M. S., Marwick, T. H., Pandey, D. K., Wicklund, R. H., & Thisted, R. A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2005-08-04
- Volume
- 353
- Issue
- 5
- Pages
- 468-475
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2116641889
- Cited by
- 405
- References
- 2
- FWCI
- 51.70
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Gulati, M., Black, H. R., Shaw, L. J., Arnsdorf, M. F., Merz, C. N. B., Lauer, M. S., Marwick, T. H., Pandey, D. K., Wicklund, R. H., & Thisted, R. A. (2005). The Prognostic Value of a Nomogram for Exercise Capacity in Women. New England Journal of Medicine. https://doi.org/10.1056/nejmoa044154
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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