Prognostic indicators on electrocardiography stress testing
| Indicator | Comments |
|---|---|
| Functional capacity | Strongest prognostic indicator, reported as metabolic equivalents.7,14 |
| ST-segment depression or elevation | > 1-mm ST deviation is suggestive of ischemia.13 |
| Exercise-induced hypotension | Defined as systolic blood pressure that is lower during exercise than while standing at rest before exercise, reflecting failure of cardiac output to increase during exercise. Associated with severe coronary artery disease or left ventricular systolic dysfunction.15 |
| Chronotropic incompetence | Failure of heart rate to increase as expected during exercise, defined as achieving < 80% of predicted heart rate (or < 62% for patients taking beta-blockers).16 Associated with increased all-cause and cardiovascular mortality.17 |
| Impaired heart rate recovery | Heart rate fails to decrease normally after cessation of exercise. Predicts all-cause mortality and cardiovascular events, including sudden death.18 |
| Ventricular arrhythmia | Sustained ventricular tachychardia or ventricular fibrillation. Associated with significant coronary artery disease or left ventricular dysfunction.19 |