Related Experiment Video

Updated: May 6, 2026

Conducting Maximal and Submaximal Endurance Exercise Testing to Measure Physiological and Biological Responses to Acute Exercise in Humans
07:26

Conducting Maximal and Submaximal Endurance Exercise Testing to Measure Physiological and Biological Responses to Acute Exercise in Humans

Published on: October 17, 2018

20.4K

T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test

Tuomo Nieminen1, Terho Lehtimäki, Jari Viik

  • 1Department of Pharmacological Sciences, Medical School, University of Tampere, and Laboratory of Atherosclerosis Genetics, Department of Clinical Chemistry, Tampere University Hospital, Finland.

European Heart Journal
|July 27, 2007
PubMed

Insights

T-wave alternans (TWA) measured during exercise tests effectively predicts mortality risk in the general population. This electrocardiographic marker identifies individuals at higher risk for sudden cardiac death and overall mortality.

Area of Science:

  • Cardiology
  • Clinical Electrophysiology
  • Preventive Medicine

Background:

  • T-wave alternans (TWA) is a marker of cardiac electrical instability.
  • Predictive value of TWA in a general population undergoing exercise testing is not well established.

Purpose of the Study:

  • To test the hypothesis that T-wave alternans (TWA) predicts mortality in a general population referred for a clinical exercise test.

Main Methods:

  • 1037 patients undergoing exercise tests were included.
  • Digital ECGs were analyzed for TWA using the modified moving average method.
  • Risk stratification for all-cause, cardiovascular, and sudden cardiac death (SCD) was assessed.

Main Results:

  • During follow-up, 59 deaths occurred, including 20 SCDs.
  • Multivariate analysis revealed TWA > or = 65 microV significantly predicted SCD (RR 7.4), cardiovascular mortality (RR 6.0), and all-cause mortality (RR 3.3).
  • These associations remained significant after adjusting for common risk factors.

Conclusions:

  • Time-domain TWA analysis is a powerful predictor of mortality.
  • TWA can effectively stratify risk in a general population undergoing clinical exercise testing.
Abstract

More Related Videos

Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training07:40

Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training

Published on: October 10, 2019

6.8K
Real-Time Electrocardiogram Monitoring During Treadmill Training in Mice04:45

Real-Time Electrocardiogram Monitoring During Treadmill Training in Mice

Published on: May 5, 2022

2.5K

Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
10.0K
Exercise and Cardiovascular Response01:20

Exercise and Cardiovascular Response

Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
6.9K
Exercise Stress Test01:26

Exercise Stress Test

Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
2.3K
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
1.2K
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
428