KERRY M. SCHWARTZ, M.D.; JON D. TURNER, M.D.; L. THOMAS SHEFFIELD, M.D.; DAVID I. ROITMAN, M.D.; SANTOSH KANSAL, M.D.; SILVIO E. PAPAPIETRO, M.D.; JOHN A. MANTLE, M.D.; CHARLES E. RACKLEY, M.D.; RICHARD O. RUSSELL Jr., M.D.; WILLIAM J. ROGERS, M.D.
Forty-eight patients within 3 weeks of myocardial infarction underwent both limited treadmill graded exercise testing and coronary and left ventricular angiography. Nineteen (90%) of 21 patients with positive exercise tests (≥ 1 mm ST depression, angina, or both) had multivessel coronary artery disease. In the 27 patients with negative exercise test results, 15 (55%) had multivessel disease, 11 (41%) had single-vessel disease, and one (4%) had no coronary stenosis. Exercise-induced ST segment elevation occurred in 24 patients and predicted a significantly lower ejection fraction and higher angiographic abnormally contracting segment size. Patients experiencing angina during or after exercise had a significantly shorter 2-year survival (54% ± 21%) than patients without exercise-induced angina (97% ± 3%) (p < 0.03). Thus limited exercise testing postinfarction is useful in evaluating the presence of multivessel coronary artery disease and left ventricular dysfunction and predicting long-term survival.
SCHWARTZ KM, TURNER JD, SHEFFIELD LT, ROITMAN DI, KANSAL S, PAPAPIETRO SE, et al. Limited Exercise Testing Soon After Myocardial Infarction: Correlation with Early Coronary and Left Ventricular Angiography. Ann Intern Med. ;94:727–734. doi: 10.7326/0003-4819-94-6-727
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Published: Ann Intern Med. 1981;94(6):727-734.
Acute Coronary Syndromes, Cardiac Diagnosis and Imaging, Cardiology, Coronary Heart Disease, Emergency Medicine.
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