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Rapidly upsloping ST-segment on exercise ECG: a marker of reduced coronary heart disease mortality risk
- Source :
- European journal of preventive cardiology. 20(4)
- Publication Year :
- 2012
-
Abstract
- The prognostic value of an isolated J-point depression, or rapidly upsloping ST-segment, on an exercise ECG has long been assumed to be a benign variant. However, little or no data supporting this assumption may be found in the literature. Our task was to examine if a rapidly upsloping ST-segment on an exercise ECG is associated with changes in risk of dying from CHD in 2014 healthy middle-aged men followed for 35 years.A group of healthy middle-aged men (n = 2014) participated in a cardiovascular survey. They underwent an examination programme including a symptom-limited ECG bicycle exercise test. Exercise induced ST-segments were categorised in three groups: normal ST-segment (n = 1383), rapidly upsloping (n = 401), and ST-depression (n = 230). Survival analyses were adjusted for smoking status, total cholesterol, systolic blood pressure, maximal heart rate, and physical fitness. The mean follow-up time was 35 years.The rapidly upsloping group had a 30% decreased risk of CHD death (hazard ratio, HR, 0.70, 95% CI 0.51-0.95) compared to the normal ST-segment group. The risk of CVD-death was numerically lower in the rapidly upsloping group (HR 0.82, 95% CI 0.65-1.04) compared to the normal ST-segment group. The ST-depression group had a 1.45-fold (HR 1.45, 95% CI 1.09-1.90) increased risk of CHD death compared to the normal ST-segment group.The rapidly upsloping ST-segment was a common finding (20%) on exercise ECG among healthy middle-aged men and was associated with a 30% reduced risk of dying from CHD compared to individuals with normal ST-segment. A rapidly upsloping ST-segment on exercise ECG may represent the true healthy state.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Epidemiology
Health Status
Coronary Disease
Kaplan-Meier Estimate
Chd mortality
Electrocardiography
Predictive Value of Tests
Risk Factors
Internal medicine
Cause of Death
medicine
ST segment
Humans
Exercise ecg
Prospective Studies
Depression (differential diagnoses)
Proportional Hazards Models
Chi-Square Distribution
business.industry
Norway
Middle Aged
Health Surveys
Coronary heart disease
Healthy Volunteers
Autonomic nervous system
Cardiology
Physical therapy
Exercise Test
Linear Models
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 20474881
- Volume :
- 20
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- European journal of preventive cardiology
- Accession number :
- edsair.doi.dedup.....89211bc24ab1358fbbe506c9ec114c27