Relation of graded exercise test findings after myocardial infarction to extent of coronary artery disease and left ventricular dysfunction
| Autor: | Charles E. Rackley, William J. Rogers, L. Thomas Sheffield, Larry E. Dye, David Roitman, Richard O. Russell, Thomas D. Paine |
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| Rok vydání: | 1978 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Time Factors Statistics as Topic Myocardial Infarction Infarction Coronary Disease Coronary artery disease Electrocardiography Internal medicine medicine Humans Myocardial infarction Graded exercise test Depression (differential diagnoses) Aged Ejection fraction business.industry Angiocardiography Heart Middle Aged medicine.disease Myocardial Contraction Stenosis Three vessels Evaluation Studies as Topic Exercise Test cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 42:716-723 |
| ISSN: | 0002-9149 |
| Popis: | To evaluate the effectiveness of the graded exercise test in predicting the extent of coronary artery disease and the degree of left ventricular dysfunction in patients with prior myocardial infarction, 100 consecutive patients underwent both graded exercise testing and coronary and left ventricular angiography at a median of 4 months after infarction. The studies caused no complications. An equal number of patients had anterior and inferior infarction. Coronary artery disease, defined as 70 percent or greater stenosis of luminal diameter, was present in three vessels in 31 patients, in two vessels in 35 patients, in one vessel in 33 patients and in no vessel in one patient. With “diagnostic” electrocardiographic criteria of 1 mm or greater J point depression plus a flat or downsloping S-T segment, 31 patients had an electrocardiographically positive exercise test; 27 of these (87 percent) had two or three vessel coronary artery disease. Of the 21 patients with a negative exercise test, 62 percent had coronary artery disease in no more than one vessel, 33 percent in two vessels and 5 percent in three vessels. Fourteen patients had S-T segment elevation during exercise; these patients had a lower ejection fraction and larger angiographic scar size than the remaining 86 patients. Patients terminating exercise because of symptoms of left ventricular dysfunction (fatigue or dyspnea) showed correlation between duration of exercise and ejection fraction ( r = 0.65) and between duration of exercise and angiographic scar size ( r = −0.62). Thus, several months after infarction, the graded exercise test can be performed safely and can be utilized to predict the extent of coronary artery disease and left ventricular dysfunction in selected groups of patients. |
| Databáze: | OpenAIRE |
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