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Peak oxygen pulse during exercise as a predictor for coronary heart disease and all cause death
  1. J A Laukkanen1,*,
  2. S Kurl2,
  3. J T Salonen2,§,
  4. T A Lakka1,,
  5. R Rauramaa1,
  1. 1Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
  2. 2Research Institute of Public Health, University of Kuopio, Kuopio, Finland
  1. Correspondence to:
    J A Laukkanen
    Research Institute of Public Health, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland; jariantero.laukkanen{at}


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 (V̇o2max) 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 β 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 V̇o2max was a stronger risk predictor than peak oxygen pulse for CHD and overall death.

Conclusions: Assessment of oxygen pulse provides no complementary information to V̇o2max 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.

  • 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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  • Published Online First 8 February 2006

  • * Also the Research Institute of Public Health, University of Kuopio, and the Department of Internal Medicine, Kuopio University Hospital, Kuopio, Finland;

  • Also the Department of Physiology, University of Kuopio, Kuopio, Finland;

  • Also the Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland;

  • § Also the Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland

  • This study was supported by the grants from National Heart, Lung, and Blood Institute (grant HL44199), Washington, DC, USA; Academy of Finland and the Finnish Ministry of Education, Helsinki, Finland; City of Kuopio, Kuopio, Finland; Juho Vainio Foundation, Helsinki, Finland; Finnish Cultural Foundation of Northern Savo, Kuopio, Finland; Finnish Medical Foundation, Helsinki, Finland; Maud Kuistila Foundation, Helsinki, Finland; Finnish Foundation for Cardiovascular Research, Helsinki, Finland, and Sigrid Juselius Foundation, Helsinki, Finland

  • Competing interests: None declared.