Association of patients' perception of health status and exercise electrocardiogram, myocardial perfusion imaging, and ventricular function measures

Am Heart J. 2000 Sep;140(3):409-18. doi: 10.1067/mhj.2000.108518.


Background: Patients' viewpoint of their health status is increasingly used as an important outcome measure of the success of treatments. Because clinicians rarely formally measure patients' health-related quality of life, the question arises whether noninvasive testing for ischemia can provide similar information regarding physical functioning and general health perception.

Methods: We measured physical functioning and general health status with the Medical Outcomes Study Short Form (SF-36) survey in 195 consecutive patients (68% male, mean age 55.6 +/- 11.1 years) referred for exercise testing with myocardial perfusion imaging. The survey was completed immediately before the exercise test.

Results: In the multivariate analysis, the strongest predictor of physical functioning and general health perception was metabolic equivalents. However, the best model, including demographic, clinical, and test variables, predicted only 14% of the variation in physical functioning and 10% of the variability in general health perception.

Conclusions: The variation in physical functioning and general health perception, as measured by the SF-36, among patients referred for exercise testing is not predicted well by the results of the test. As expected, several test results are significantly associated with physical functioning and general health perception; however, there was substantial overlap among individual patients, suggesting that the parameters are poor surrogates for the actual assessment of the domains. If these domains are deemed important to tracking patient outcomes, then they should supplement the current assessments of these patients.

MeSH terms

  • Adult
  • Aged
  • Coronary Disease / diagnosis
  • Electrocardiography
  • Exercise Test
  • Female
  • Health Status*
  • Heart Function Tests
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Ischemia / diagnosis*
  • Myocardial Ischemia / pathology
  • Predictive Value of Tests
  • Quality of Life
  • Self Concept*
  • Sensitivity and Specificity
  • Ventricular Function, Left*