[The predictive value of ventricular function during exercise after a myocardial infarct].
To assess the prognostic value of exercise left ventricular function, and if this test improves the prognostic value of clinical data and exercise test, 146 patients (mean age 56 +/- 9 years) underwent rest and exercise radionuclide angiography, 10 days after myocardial infarction. During follow-up (mean 16 +/- 5 months), 32 patients had new coronary events: 5 died, 9 had a new myocardial infarction and the remaining 18 developed unstable angina (Class III-IV of the CCS classification). Patients with new coronary events had more frequently severe left ventricular failure (Killip III-IV) (15% vs 3%; p less than 0.05) and postinfarction angina (32% vs 9%; p less than 0.01) than their counterparts. There were no differences regarding rest ejection fraction between both groups of patients. Exercise ejection fraction increased significantly (50 +/- 14% to 56 +/- 16%, p less than 0.001), while there was no change in patients with new coronary events (46 +/- 16% to 43 +/- 15%, NS). Logistic regression analysis including only clinical data identified postinfarction angina (p less than 0.01) and left ventricular failure (Killip III-IV) (p less than 0.01) as independent predictors of new coronary events. The sensitivity and specificity of the regression equation obtained with clinical data were 43% and 90%, respectively. Analyzing data from clinical variables, as well as exercise test and both, rest and exercise radionuclide angiography, logistic regression analysis identified, exercise ejection fraction (p less than 0.001), postinfarction angina (p less than 0.01) and rest ejection fraction (p less than 0.05) as independent predictors of new coronary events.(ABSTRACT TRUNCATED AT 250 WORDS)
Roig
E
E
Servicio de Cardiología, Hospital Clínic i Provincial, Barcelona.
Magriñà
J
J
Armengol
X
X
García
A
A
Bassa
P
P
Francino
A
A
Sanz
G
G
D016009:Chi-Square Distribution; D005080:Exercise Test / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging / Q000706:statistics & numerical data; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D016698:Technetium Tc 99m Pyrophosphate; D016277:Ventricular Function, Left
D016698:Technetium Tc 99m Pyrophosphate
Valor predictivo de la función ventricular durante el esfuerzo tras un infarto de miocardio.