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Hemodynamic gain index and risk of ventricular arrhythmias: a prospective cohort study

Kunutsor, Setor K ; Jae, Sae Young ; Kurl, Sudhir ; Laukkanen, Jari A

Scandinavian cardiovascular journal : SCJ, 2024-12, Vol.58 (1), p.2347289-2347289 [Periódico revisado por pares]

England

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  • Título:
    Hemodynamic gain index and risk of ventricular arrhythmias: a prospective cohort study
  • Autor: Kunutsor, Setor K ; Jae, Sae Young ; Kurl, Sudhir ; Laukkanen, Jari A
  • Assuntos: Adult ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - epidemiology ; Arrhythmias, Cardiac - physiopathology ; Blood Pressure ; Cardiorespiratory Fitness ; Exercise Test ; Heart Rate ; Hemodynamics ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Protective Factors ; Risk Assessment ; Risk Factors ; Time Factors
  • É parte de: Scandinavian cardiovascular journal : SCJ, 2024-12, Vol.58 (1), p.2347289-2347289
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Hemodynamic gain index (HGI), a novel hemodynamic index obtained from cardiopulmonary exercise testing (CPX), is associated with adverse cardiovascular outcomes. However, its specific relationship with ventricular arrhythmias (VAs) is unknown. We aimed to assess the association of HGI with risk of VAs in a prospective study. Hemodynamic gain index was estimated using heart rate and systolic blood pressure (SBP) responses ascertained in 1945 men aged 42-61 years during CPX from rest to maximum exercise, using the formula: [(Heart rate x SBP ) - (Heart rate x SBP )]/(Heart rate x SBP ). Cardiorespiratory fitness (CRF) was measured using respiratory gas exchange analysis. Hazard ratios (HRs) (95% confidence intervals, CIs) were estimated for VAs. Over a median follow-up duration of 28.2 years, 75 cases of VA were recorded. In analysis adjusted for established risk factors, a unit (bpm/mmHg) higher HGI was associated with a decreased risk of VA (HR 0.72, 95% CI: 0.55-0.95). The results remained consistent on adjustment for lifestyle factors and comorbidities (HR 0.72, 95% CI: 0.55-0.93). Comparing the top versus bottom tertiles of HGI, the corresponding adjusted HRs (95% CIs) were 0.51 (0.27-0.96) and 0.52 (0.28-0.94), respectively. The associations were attenuated on addition of CRF to the model. HGI improved risk discrimination beyond established risk factors but not CRF. Higher HGI is associated with a reduced risk of VAs in middle-aged and older Caucasian men, but dependent on CRF levels. Furthermore, HGI improves the prediction of the long-term risk for VAs beyond established risk factors but not CRF.
  • Editor: England
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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