title: Prognostic significance of the ST-segment response during exercise test shortly after acute myocardial infarction. Comparison with other exercise variables.
abstract: An exercise test was made in 317 patients in the third week after acute myocardial infarction. The following types of exercise associated ST-segment responses were registered in patients less than 70-years-old. I: no ST-deviation (33.6%), II: ST-depression (42.9%), III: ST-elevation (13.4%) and IV: inconclusive ST-response (10.1%). The 5-year mortality was significantly lower in group III than in groups II and IV. Group IV had a significantly higher 5-year mortality than all the other groups. Patients with ST-depression had an increased late mortality compared to that of the patients without ST-deviation, but the total mortality did not differ between these two groups. A highly increased risk of dying was found in groups I, II and IV in patients with exercise associated major ventricular arrhythmias and/or with a small increase of the pressure-rate-product (PRP) during exercise. Patients without arrhythmias and with a high increase of the PRP had a low mortality rate irrespective of their ST-response. In the older patients (70-years-old or more) the ST-response was of no prognostic value at all. The ST-segment response was thus generally of limited value in the prognostic management of the present patients. Their survival was mainly determined by the other exercise variables-the magnitude of an exercise index of left ventricular function and the occurrence of ventricular arrhythmias.
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D011379:Prognosis