Post‐Myocardial Infarction Exercise Testing: Clinical Significance of a Left Ventricular Function Index and Ventricular Arrhythmias

Publisher Website
Google Scholar
Abstract
A predischarge exercise test was performed in a prospective series of 187 patients, less than 70 years old, with acute myocardial infarction. A survival analysis confirmed previous retrospective findings of a significantly increased long‐term mortality in patients with a low increase in the pressure‐rate‐product (PRP) and/or with major exercise‐induced arrhythmias. ST segment depression was without prognostic significance. By a graduated, quantitative re‐evaluation of the significance of exercise‐induced ventricular arrhythmias, an appropriate, significantly discriminating cutoff point for the frequency of solitary ventricular premature beats (VPBs) was found at two or more VPBs/min. Repetitive VPBs had an equal significance. The probability of 4.5‐year survival in patients with these arrhythmias and a low increase in PRP was 0.49 vs. 0.85 in patients with less frequent arrhythmias and with a high increase in PRP (p < 10‐6).