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Hemodynamic gain index in women: A validation study
Baruch Vainshelboim1, Peter Kokkinos2, Jonathan Myers1
1Cardiology Division, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA, USA.
Insights
A higher hemodynamic gain index (HGI) in women is linked to a significantly lower risk of all-cause mortality. This finding validates HGI as a valuable tool for predicting mortality risk.
Area of Science:
- Cardiology
- Preventive Medicine
- Exercise Physiology
Background:
- Previous research established a strong association between hemodynamic gain index (HGI) and all-cause mortality in men.
- The current study aimed to validate this association in a female cohort.
Purpose of the Study:
- To validate the prognostic value of the hemodynamic gain index (HGI) for all-cause mortality in women.
- To assess the association between HGI and mortality risk in a pilot cohort of women.
Main Methods:
- Prospective follow-up of 606 women (mean age 54.1 years) for 8.0 years.
- Hemodynamic gain index (HGI) calculated using [(HRpeak*SBPpeak)-(HRrest*SBPrest)]/(HRrest*SBPrest) from treadmill exercise testing.
- Bivariable and multivariable Cox hazard models analyzed for HGI and all-cause mortality.
Main Results:
- 48 participants (7.9%) died during follow-up.
- Higher HGI was significantly associated with reduced all-cause mortality risk in both bivariable (HR 0.36) and multivariable (HR 0.55) analyses.
- Participants in higher HGI percentile groups showed substantial reductions in mortality risk (up to 90%).
Conclusions:
- This study validates that a higher hemodynamic gain index (HGI) is associated with a lower risk of all-cause mortality in women.
- HGI demonstrates prognostic value for risk stratification in both clinical and research settings.
- The findings support the use of HGI in assessing cardiovascular health and mortality risk in women.
Background:
A previous study showed a strong and independent association between hemodynamic gain index (HGI) and all-cause mortality in a large cohort of men. The current study aimed to validate the association between HGI and all-cause mortality in a pilot cohort of women.
Methods:
The cohort included 606 women aged 54.1 ± 12 years who were prospectively followed for 8.0 ± 5.7 years. HGI was calculated according to a previously developed equation using heart rate (HR) and systolic blood pressure (SBP) responses from treadmill exercise testing [(HRpeak*SBPpeak)-(HRrest*SBPrest)]/(HRrest*SBPrest). Bivariable and multivariable Cox hazard models were analyzed for HGI and all-cause mortality.
Results:
During the follow-up, 48 participants (7.9%) died, and mean HGI was 1.86 ± 0.82 bpm/mmHg. In continuous bivariable and multivariable models, each one unit higher in HGI was associated with 64% and 45% reduced risks of mortality, respectively. The corresponding hazard ratios and 95% confidence intervals were: 0.36, (0.22-0.57), and 0.55 (0.33-0.91) (both p < 0.001). In a bivariable categorical model, compared to participants below the 25th percentile (HGI <1.27), participants who were between the 25th and 50th (HGI 1.27 to 1.77), 50th to 75th (HGI 1.78 to 2.39) and >75th percentile (HGI ≥2.4) exhibited 57%, 90% and 79% reductions in mortality risk (p trend <0.001), respectively.
Conclusions:
This validation study in women confirms that a higher HGI is associated with lower risk of all-cause mortality, supporting its prognostic value for risk stratification in clinical and research settings.
