[Measuring stress hemodynamics in pulmonary circulation during the inpatient phase after myocardial infarct: a rightfully "forgotten" evaluation?].
In 123 consecutive patients pulmonary hemodynamics at rest and during exercise were measured 7-10 days after acute myocardial infarction and systemic thrombolysis. Right- and left-heart catheterizations were performed at the same session and repeated after 6 months. We investigated if right-heart catheterization could predict the number of stenotic or occluded coronaries, the angiographic ventricular function and/or, most important, if the patient would profit from revascularization by PTCA or coronary surgery.


RESULTS
1) Pulmonary hemodynamics at rest and during exercise did not correlate to the number of stenotic or occluded coronaries, but exercise tolerance did. 2) Correlation between ventricular function and pulmonary hemodynamics was weak. 3) Only patients with pathologically elevated pulmonary pressures at exercise showed profit from revascularization (increase of ejection fraction > 5% at control). This profit was closely correlated to the angiographic extent of ventricular damage. Consequences from our results: Individual exercise tolerance can easily be measured non-invasively. Ventricular function can be measured non-invasively as well by echocardiography. Measurement of pulmonary hemodynamics at rest and during exercise does not contribute to planning the future management of the postinfarction patient and does not replace coronarography when indicated by clinical or non-invasive parameters.
Spielberg
C
C
Kardiologische Gemeinschaftspraxis, Potsdam.
Langheim
E
E
Schröder
K
K
Völler
H
H
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006760:Hospitalization; D006801:Humans; D008168:Lung / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D009204:Myocardial Revascularization; D011669:Pulmonary Wedge Pressure / Q000187:drug effects / Q000502:physiology; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology