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Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study.

ABSTRACT: To determine whether the walking speed maintained during a 1 km treadmill test at moderate intensity predicts survival in patients with cardiovascular disease.Population-based prospective study.Outpatient secondary prevention programme in Ferrara, Italy.1255 male stable cardiac patients, aged 25-85 years at baseline.Walking speed maintained during a 1 km treadmill test, measured at baseline and mortality over a median follow-up of 8.2 years.Among 1255 patients, 141 died, for an average annual mortality of 1.4%. Of the variables considered, the strongest predictor of all-cause mortality was walking speed (95% CI 0.45 to 0.75, p<0.0001). Based on the average speed maintained during the test, participants were subdivided into quartiles and mortality risk adjusted for confounders was calculated. Compared to the slowest quartile (average walking speed 3.4 km/h), the relative mortality risk decreased for the second, third and fourth quartiles (average walking speed 5.5 km/h), with HRs of 0.73 (95% CI 0.46 to 1.18); 0.54 (95% CI 0.31 to 0.95) and 0.20 (95% CI 0.07 to 0.56), respectively (p for trend <0.0001). Receiver operating curve analysis showed an area under the curve of 0.71 (p<0.0001) and the highest Youden index (0.35) for a walking speed of 4.0 km/h.The average speed maintained during a 1 km treadmill walking test is inversely related to survival in patients with cardiovascular disease and is a simple and useful tool for stratifying risk in patients undergoing secondary prevention and cardiac rehabilitation programmes.

SUBMITTER: Chiaranda G

PROVIDER: S-EPMC3808890 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study.

Chiaranda Giorgio G Bernardi Eva E Codecà Luciano L Conconi Francesco F Myers Jonathan J Terranova Francesco F Volpato Stefano S Mazzoni Gianni G Grazzi Giovanni G

BMJ open 20131025 10

<h4>Objective</h4>To determine whether the walking speed maintained during a 1 km treadmill test at moderate intensity predicts survival in patients with cardiovascular disease.<h4>Design</h4>Population-based prospective study.<h4>Setting</h4>Outpatient secondary prevention programme in Ferrara, Italy.<h4>Participants</h4>1255 male stable cardiac patients, aged 25-85 years at baseline.<h4>Main outcome measures</h4>Walking speed maintained during a 1 km treadmill test, measured at baseline and mo ...[more]

PMID: 24163203

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Project description:Sotos syndrome is caused by a gene deletion with an autosomal dominant pattern of inheritance. Cerebral gigantism, hypotonia and joint hyperextensibility are characteristic features of this syndrome. A percentage of these patients develop progressive scoliosis early in life. In the literature, few studies on the evolution of scoliosis in Sotos syndrome have been published. We retrospectively evaluated eight patients diagnosed with Sotos syndrome and scoliosis treated at the Garrahan Children Hospital between 1988 and March 2009. Clinical charts and imaging studies were assessed. Eight patients (19%) presented with scoliosis and seven of them (87.5%) required surgical treatment. The mean follow-up was 9.5 years (range 3-18). Mean age at first consultation was 5.2 years (range 1.1-11.2). Mean Cobb angle for scoliosis at first consultation was 34.3° (range 20°-42°) and the mean Cobb angle for kyphosis was 45.6° (range 30°-90°). Mean age at surgery was 11.2 years (range 3.7-18.10). The surgical procedures performed were instrumented posterior arthrodesis, alone or combined with anterior arthrodesis, instrumented anterior arthrodesis, while one patient is currently in treatment with growing rods. Preoperative mean Cobb angle for scoliosis was 72.3° (range 54°-130°) and for kyphosis was 59.8° (range 30°-108°); postoperative mean Cobb angle for scoliosis was 45.5° (range 6°-90°) and for kyphosis was 40.2° (range 30°-80°). There were three early complications (pleural effusion in two cases and death due to sepsis in one) and two late complications (kyphosis above the instrumentation area and dislodgement of the proximal hooks). Incidence of scoliosis in Sotos syndrome is high and thus close monitoring of patients with Sotos syndrome during growth is important for early detection of this entity. Joint hyperextensibility and hypotonia that are characteristic of the syndrome should be considered at the moment of surgery to avoid short fusions.

Dataset Information

Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study.

Publications

Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study.

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