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Nevertheless, we have previously shown that left ventricular systolic function and mass are normal in this population (40); thus, it is very unlikely that these factors could have strong effects on the currently reported findings. The subjects were randomly selected in the cohort. Our results suggest that unfit middle-aged men who have low exercise capacity have an increased risk of SCD, whereas among subjects with very good exercise tolerance, SCD is a highly uncommon event. Low levels of cardiorespiratory fitness may PLX3397 mw provide valuable information when the future risk of SCD is estimated, but may not provide incremental utility over prediction based on traditional risk factors. The authors thank the staff of the Kuopio Research Institute of Exercise Medicine, the Research Institute of Public Health, and University of Eastern Finland, Kuopio, Finland, for data collection in the study. ""In their elegant paper in this issue of the Journal, Laukkanen et al. ( 1) report on a seemingly strong association between maximal ALOX15 oxygen consumption and risk of sudden cardiac death. The corresponding p value was BMN 673 nmr for automated implantable cardioverter-defibrillators. Nonetheless, ejection fraction is limited by low sensitivity, as the majority of people who suffer from sudden cardiac death have a preserved ejection fraction (2). Over the past 10 to 15 years, investigators have studied numerous other noninvasive risk-stratification techniques including QRS duration, QT interval and dispersion, signal-averaged electrocardiography, short- and long-term heart rate variability, ventricular ectopy and nonsustained ventricular tachycardia on Holter monitoring, heart rate turbulence, heart rate recovery after graded exercise, T-wave alternans, and baroreceptor sensitivity. To date, there is no evidence that any of these techniques provide clinical utility to guide selection of therapy (2). We now come to the paper of Laukkanen et al.