PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brheartjLink to Publisher's site
 
Br Heart J. 1985 February; 53(2): 180–185.
PMCID: PMC481737

Submaximal exercise testing early after myocardial infarction. Difficulty of predicting coronary anatomy and left ventricular performance.

Abstract

Impaired left ventricular function and extensive coronary artery disease are important determinants of prognosis after acute myocardial infarction. The ability of clinical and predischarge submaximal exercise test variables to predict multivessel coronary artery disease and impaired left ventricular function was assessed in 62 survivors of acute myocardial infarction. Abnormal exercise blood pressure response and short exercise performance were predictors of multivessel disease, but exercise induced ST segment changes and clinical variables were not. Q wave infarction, high grade Killip classification, and exercise induced ST segment elevation predicted statistically significant impairment of resting left ventricular function, whereas other clinical and exercise test variables did not. Exercise induced ST segment changes were therefore of little value in detecting extensive coronary disease, although exercise induced ST elevation was an indicator of poor resting left ventricular function. Although abnormal exercise haemodynamics may detect extensive coronary artery disease, other physiological markers of reversible myocardial ischaemia are probably necessary to plan optimal management in these patients.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Norris RM, Agnew TM, Brandt PW, Graham KJ, Hill DG, Kerr AR, Lowe JB, Roche AH, Whitlock RM, Barratt-Boyes BG. Coronary surgery after recurrent myocardial infarction: progress of a trial comparing surgical with nonsurgical management for asymptomatic patients with advanced coronary disease. Circulation. 1981 Apr;63(4):785–792. [PubMed]
  • Taylor GJ, Humphries JO, Mellits ED, Pitt B, Schulze RA, Griffith LS, Achuff SC. Predictors of clinical course, coronary anatomy and left ventricular function after recovery from acute myocardial infarction. Circulation. 1980 Nov;62(5):960–970. [PubMed]
  • Sanz G, Castañer A, Betriu A, Magriña J, Roig E, Coll S, Paré JC, Navarro-López F. Determinants of prognosis in survivors of myocardial infarction: a prospective clinical angiographic study. N Engl J Med. 1982 May 6;306(18):1065–1070. [PubMed]
  • De Feyter PJ, van Eenige MJ, Dighton DH, Visser FC, de Jong J, Roos JP. Prognostic value of exercise testing, coronary angiography and left ventriculography 6--8 weeks after myocardial infarction. Circulation. 1982 Sep;66(3):527–536. [PubMed]
  • Smith JW, Dennis CA, Gassmann A, Gaines JA, Staman M, Phibbs B, Marcus FI. Exercise testing three weeks after myocardial infarction. Chest. 1979 Jan;75(1):12–16. [PubMed]
  • Théroux P, Waters DD, Halphen C, Debaisieux JC, Mizgala HF. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979 Aug 16;301(7):341–345. [PubMed]
  • Davidson DM, DeBusk RF. Prognostic value of a single exercise test 3 weeks after uncomplicated myocardial infarction. Circulation. 1980 Feb;61(2):236–242. [PubMed]
  • Weld FM, Chu KL, Bigger JT, Jr, Rolnitzky LM. Risk stratification with low-level exercise testing 2 weeks after acute myocardial infarction. Circulation. 1981 Aug;64(2):306–314. [PubMed]
  • Starling MR, Crawford MH, Kennedy GT, O'Rourke RA. Exercise testing early after myocardial infarction: predictive value for subsequent unstable angina and death. Am J Cardiol. 1980 Dec 1;46(6):909–914. [PubMed]
  • Schwartz KM, Turner JD, Sheffield LT, Roitman DI, Kansal S, Papapietro SE, Mantle JA, Rackley CE, Russell RO, Jr, Rogers WJ. Limited exercise testing soon after myocardial infarction. Correlation with early coronary and left ventricular angiography. Ann Intern Med. 1981 Jun;94(6):727–734. [PubMed]
  • Patterson JA, Naughton J, Pietras RJ, Gunnar RM. Treadmill exercise in assessment of the functional capacity of patients with cardiac disease. Am J Cardiol. 1972 Nov;30(7):757–762. [PubMed]
  • Sandler H, Dodge HT. The use of single plane angiocardiograms for the calculation of left ventricular volume in man. Am Heart J. 1968 Mar;75(3):325–334. [PubMed]
  • Killip T, 3rd, Kimball JT. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol. 1967 Oct;20(4):457–464. [PubMed]
  • Dillahunt PH, 2nd, Miller AB. Early treadmill testing after myocardial infarction: Angiographic and hemodynamic correlations. Chest. 1979 Aug;76(2):150–155. [PubMed]
  • Fuller CM, Raizner AE, Verani MS, Nahormek PA, Chahine RA, McEntee CW, Miller RR. Early post-myocardial infarction treadmill stress testing. An accurate predictor of multivessel coronary disease and subsequent cardiac events. Ann Intern Med. 1981 Jun;94(6):734–739. [PubMed]
  • Starling MR, Crawford MH, Richards KL, O'Rourke RA. Predictive value of early postmyocardial infarction modified treadmill exercise testing in multivessel coronary artery disease detection. Am Heart J. 1981 Aug;102(2):169–175. [PubMed]
  • Akhras F, Upward J, Stott R, Jackson G. Early exercise testing and coronary angiography after uncomplicated myocardial infarction. Br Med J (Clin Res Ed) 1982 May 1;284(6325):1293–1294. [PMC free article] [PubMed]
  • Betriu A, Castañer A, Sanz GA, Pare JC, Roig E, Coll S, Magriña J, Navarro-Lopez F. Angiographic findings 1 month after myocardial infarction: a prospective study of 259 survivors. Circulation. 1982 Jun;65(6):1099–1105. [PubMed]
  • Schulze RA, Jr, Pitt B, Griffith LS, Ducci HH, Achuff SC, Baird MG, Humphries JO. Coronary angiography and left ventriculography in survivors of transmural and nontransmural myocardial infarction. Am J Med. 1978 Jan;64(1):108–113. [PubMed]
  • Castellanet MJ, Greenberg PS, Ellestad MH. Comparison of S-T segment changes on exercise testing with angiographic findings in patients with prior myocardial infarction. Am J Cardiol. 1978 Jul;42(1):29–35. [PubMed]
  • Fox KM, Jonathan A, Selwyn A. Significance of exercise induced ST segment elevation in patients with previous myocardial infarction. Br Heart J. 1983 Jan;49(1):15–19. [PMC free article] [PubMed]
  • Proceedings of the british cardiac society. Br Heart J. 1983 Mar;49(3):289–304. [PMC free article] [PubMed]
  • Mitchell JR. "But will it help my patients with myocardial infarction?" The implications of recent trials for everyday country folk. Br Med J (Clin Res Ed) 1982 Oct 23;285(6349):1140–1148. [PMC free article] [PubMed]
  • Turner JD, Schwartz KM, Logic JR, Sheffield LT, Kansal S, Roitman DI, Mantle JA, Russell RO, Jr, Rackley CE, Rogers WJ. Detection of residual jeopardized myocardium 3 weeks after myocardial infarction by exercise testing with thallium-201 myocardial scintigraphy. Circulation. 1980 Apr;61(4):729–737. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group