AI Article Synopsis
- Predischarge exercise testing after a heart attack helps assess patient risk and can guide treatment, but its effectiveness in detecting severe heart issues is limited.
- This study involved 60 patients and compared their exercise test results with other assessments like echocardiograms and Holter monitoring.
- The results showed that exercise testing had low sensitivity for identifying multivessel coronary artery disease, but ischemia found during testing was linked to other heart complications, signaling higher coronary risk.
Article Abstract
Background: Predischarge exercise testing early after myocardial infarction is useful for risk stratification, exercise prescription, and assessment of prognosis and treatment.
Objective: The objective of this study was to compare the findings of exercise testing early after myocardial infarction with those of echocardiography, electrocardiographic monitoring (24-hour Holter monitoring) and coronary angiography.
Methods: We evaluated 60 cases (mean age of 51.42 +/- 9.34 years), of which 46 were males (77%). The symptom-limited maximal exercise test according to the Naughton protocol12 was performed between the sixth day of hospitalization and hospital discharge, with the patients on medication. During hospitalization, the patients underwent echocardiography, electrocardiographic monitoring and coronary angiography. The significance level was set at 0.05 (alpha = 5%).
Results: Exercise testing had a poor performance in the detection of multivessel coronary artery disease (sensitivity, 42%; specificity, 69%). No significant differences were found when the presence of ischemia on exercise test was compared with multivessel coronary disease, complex ventricular arrhythmias on electrocardiographic monitoring, and the finding of an ejection fraction lower than 60% on echocardiography (p = 0.56), as well as with the presence of multivessel lesions, complex ventricular arrhythmias on electrocardiographic monitoring and abnormal ejection fraction on echocardiography (p = 0.36).
Conclusion: The presence of ischemia during exercise testing was associated with the occurrence of ventricular arrhythmias on electrocardiographic monitoring, with reduced ejection fraction on echocardiography, as well as with the presence of multivessel coronary lesions, which constitutes an indicator of a high coronary risk.
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| http://dx.doi.org/10.1590/s0066-782x2008000300007 | DOI Listing |
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