Heart 2006;92:1219-1224
CARDIOVASCULAR MEDICINE
Peak oxygen pulse during exercise as a predictor for coronary heart disease and all cause death
J A Laukkanen1,*,
S Kurl2,
J T Salonen2,
,
T A Lakka1,
,
R Rauramaa1,
1 Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
2 Research Institute of Public Health, University of Kuopio, Kuopio, Finland
Correspondence to:
J A Laukkanen
Research Institute of Public Health, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland; jariantero.laukkanen{at}uku.fi
Objective: To investigate the prognostic value of peak oxygen pulse, which is the amount of oxygen consumed per heart beat during exercise, and to compare the prognostic value of peak oxygen pulse and maximum oxygen uptake (
O2max) with respect to coronary heart disease (CHD) and overall death.
Design: Prospective population-based study based on 1596 men without CHD or the use of ß blockers at baseline.
Results: The risk of CHD was 2.45 (95% CI 1.10 to 5.45) times higher in men with low peak oxygen pulse (< 13.5 ml/beat) than in those with high peak oxygen pulse (> 17.8 ml/beat) after adjustment for age, alcohol consumption, smoking, body mass index, blood pressure, serum lipids, diabetes, family history of CHD and ischaemic ST changes during exercise. During an average follow up of 14 years, 267 men died, 67 of them due to CHD. The respective risk for overall death was 1.79 (95% CI 1.21 to 2.65). The continuous variable O2max was a stronger risk predictor than peak oxygen pulse for CHD and overall death.
Conclusions: Assessment of oxygen pulse provides no complementary information to O2max about cardiorespiratory fitness and prognosis for CHD. The analysis of respiratory gas exchange including the assessment of oxygen pulse during exercise does, however, provide an additional means for defining prognosis for patients with CHD.
Abbreviations: BMI, body mass index; CHD, coronary heart disease; CVD, cardiovascular disease; FINMONICA, Finnish Multinational Monitoring of trends and determinants in Cardiovascular disease; HR, heart rate; KIHD, Kuopio Ischaemic Heart Disease Risk Factor Study; LV, left ventricular; SBP, systolic blood pressure; O2max, maximum oxygen uptake
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