The prognostic value of a nomogram for exercise capacity in women

Gulati, M, Black, HR, Shaw, LJ, Arnsdorf, MF, Merz, CNB, Lauer, MS, Marwick, TH, Pandey, DK, Wicklund, RH and Thisted, RA (2005) The prognostic value of a nomogram for exercise capacity in women. New England Journal of Medicine, 353 5: 468-475. doi:10.1056/NEJMoa044154

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Author Gulati, M
Black, HR
Shaw, LJ
Arnsdorf, MF
Merz, CNB
Lauer, MS
Marwick, TH
Pandey, DK
Wicklund, RH
Thisted, RA
Title The prognostic value of a nomogram for exercise capacity in women
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 0028-4793
Publication date 2005-01-01
Sub-type Article (original research)
DOI 10.1056/NEJMoa044154
Open Access Status File (Publisher version)
Volume 353
Issue 5
Start page 468
End page 475
Total pages 8
Editor J. M. Drazen
Place of publication USA
Publisher Massachusetts Medical Society
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
Abstract 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.
Keyword Medicine, General & Internal
Predicting Functional-capacity
Maximal Oxygen Intake
Metabolic Equivalents
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 200 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 232 times in Scopus Article | Citations
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Created: Wed, 15 Aug 2007, 15:40:58 EST