[Exercise-induced ST segment depression following acute myocardial infarction. Occurrence and prognostic significance].
On the basis of a review of 20 investigations (3,587 patients), the prevalence of significant ST-segment-depression (ST-depr) in patients performing an exercise test 9-30 days after acute myocardial infarction (AMI) was found to be 33% (3-70%). The reason for the considerable variation is due to a combination of several factors: 1) different and frequently incomplete definition of significant ST-depr; 2) heterogenically composed patient groups (first vs subsequent AMI, different prevalence of infarct types and localization, consecutive vs selected patients, +/- cardioactive drugs during the exercise test); 3) different procedures for the exercise tests (submaximal vs maximal; few vs several ECG leads). The great variation in the prevalence of ST-depr, is also reflected in the prognostic significance. In about half of the investigations ST-depr has been prognostic for future death and/or cardiac events while ECG changes as an isolated variable did not prove to be of prognostic significance in the remainder. In general, it may be stated that a maximal exercise test with several ECG leads is more sensitive while ST-depr at a submaximal work capacity appears to be more specific for subsequent cardiac events.
Mickley
H
H
Pless
P
P
May
O
O
Nielsen
J R
JR
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D005080:Exercise Test; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D011379:Prognosis
Anstrengelsesinduceret ST-segmentdepression efter akut myokardieinfarkt. Forekomst og prognostisk betydning.