title: Prognosis of patients with good exercise capacity and mildly abnormal exercise echocardiography results: identification of an at-risk subgroup.
abstract: BACKGROUND
  Patients with good exercise capacity and mildly abnormal exercise echocardiography results have a favorable overall prognosis.
  
  
  OBJECTIVE
  We sought to define subgroups that might be at higher risk.
  
  
  METHODS
  We examined outcomes of 868 patients (women, > or = 5 metabolic equivalents; men, > or = 7 metabolic equivalents) with mild rest- or exercise-induced wall-motion abnormalities and evaluated potential predictors of time to cardiac death or nonfatal myocardial infarction (MI).
  
  
  RESULTS
  Mean age was 64 +/- 10 years; 477 patients (55%) were men. Mean follow-up was 3.1 +/- 1.5 years; cardiac event rate was 1.2% per person-year. A history of MI was the only significant predictor (risk ratio, 3.9; 95% confidence interval, 1.9-7.8; P = .0001), with 1-, 3-, and 5-year event-free survival of 98.5% +/- 1.1%, 92.6% +/- 2.6%, and 83.3% +/- 5.1%, respectively (event rate, 3.4%).
  
  
  CONCLUSIONS
  Patients with a history of MI have a higher annual cardiac event rate and may benefit from reevaluation, whereas no history of MI connotes a favorable prognosis.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: McCully
authors.forename: Steve R
authors.initials: SR
authors.lastname: Ommen
authors.forename: Kyle W
authors.initials: KW
authors.lastname: Klarich
authors.forename: Kelli N
authors.initials: KN
authors.lastname: Burger
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Mahoney
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pellikka
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D004452:Echocardiography / Q000706:statistics & numerical data*; D005080:Exercise Test / Q000706:statistics & numerical data*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate