[Chronic myocardial infarct with left ventricular dysfunction: the clinical aspects and exertion tolerance].
The objective of the study is the assessment of the exercise functional capacity of the patients with chronic myocardial infarction and left ventricular disfunction and the relevance of some clinical peculiarities of them in contrast with patients without left ventricular performance.


METHODS
There have been studied 105 patients with chronic myocardial infarction, in a period of time between 1992-1995. There has been taken, as an objective criterium of the assessment of LV disfunction, the ejection fraction (EF) measured by echo 2D at 52 patients. There were created the groups with EF 50%(32p), EF = 35-50% (12p) and EF = 35% (8p). The clinical parameters were: the number of coronary risk factors (CRF), the NYHA class, the exercise test and the assessment of VO2max. The statistical comparison has been made by using an IBM computer 486, programme FoxPro and EPI/INFO.


CONCLUSIONS
50% of the patients with EF > 50% (16/32) had a good exercise tolerance (MET > 5); 13 patients (65%) from the patients with EF < 50% had MET < 5. Similarly, there is no correlation between the low EF (50%) and VO2max. The analysis of the exercise tolerance correlated with the functional class NYHA shows its diminution at patients with cardiac failure (classes I and II) compared with those without dyspnea (67% vs 42%, p < 0.01 and respectively 80% vs 42%, p < 0.05). There are similar differences in the assessment of VO2max at patient from classes III (p < 0.01) and II (p < 0.03) compared with class 0. Dyspnea, as a clinical parameter, does not correlate with low EF, but has significant association with VO2max. The study of the degree of charge in CRF at patients with EF < 50% reveals the following: older age (p < 0.02), the presence of arterial hypertension (p < 0.01) and the greater prevalence of DM (p < 0.05).


CONCLUSIONS
1. There is no correlation between the degree of the left ventricular disfunction and the exercise capacity. 2. VO2max is significantly lower at patients with dyspnea, especially from classes II and III. 3. Patients with myocardial infarction and LV disfunction have statistically more CRF, like older age, HTA, DM.
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Clinica a VI-a Medicală-Spitalul Clinic de Recuperare, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.
Mitu
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D016009:Chi-Square Distribution; D002908:Chronic Disease; D004417:Dyspnea / Q000503:physiopathology; D005080:Exercise Test / Q000706:statistics & numerical data; D017079:Exercise Tolerance / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*