title: [Prognostic significance of stress studies in patients with coronary 2-vessel disease--effect of stenosis of the proximal ramus intraventricularis anterior].
abstract: To determine whether exercise testing can provide additional prognostic information in patients with angiographically determined 2-vessel disease and normal or mildly impaired left ventricular function, we followed 316 medically treated patients (pts) for a mean of 4.5 years. The 5-year survival rate (5-YSR) was 89.7%. On the basis of the results of exercise testing (supine bicycle ergometry) pts were divided into 3 equally sized groups. Pts with an exercise tolerance (ET) of more than 110 W had a 5-YSR of 95% compared to 81% for pts with an ET of less than or equal to 90 W (p less than 0.003). The 5-YSR was 86% and 91% for pts with (n = 87) and without (n = 229) a proximal LAD stenosis (p = 0.12). Pts with a proximal LAD stenosis and an ET of more than greater than 80 W (the better half) had a 5-YSR of 97% in contrast to 76% in pts with an ET of less than or equal to 80 W (p less than 0.02). Pts without proximal LAD disease had a 5-YSR of 93% (ET greater than 80 W) and 87% (ET less than or equal to 80 W) (p = n.s.). Thus in pts with 2-vessel disease and good left ventricular function, exercise testing can differentiate patients with a good long-term prognosis from pts with a markedly reduced prognosis. Exercise testing appears particularly useful in patients with proximal LAD disease and can facilitate the decision-making process for aortocoronary bypass surgery.
mesh_terms: D000787:Angina Pectoris / Q000503:physiopathology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D003331:Coronary Vessels / Q000503:physiopathology*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011379:Prognosis
vernacular_title: Prognostische Bedeutung der Belastungsuntersuchung bei Patienten mit koronarer Zweigefässerkrankung - Einfluss einer proximalen RIVA-Stenose.