Bicycle ergometry and echocardiography were conducted in 54 patients with primary uncomplicated large-focal myocardial infarction (MI), while their central hemodynamic parameters were examined radiocardiographically on days 10, 20 and 30 of the disease. About 70% of patients were doing exercise until they were fatigued or showed a submaximum pulse rate, whereas 20% developed angina pectoris. In the course of recovery, threshold capacity increased in most of the patients and as the cumulative group result (with a 16% increment from day 10 to day 20). No basic changes in hemodynamic response to exercise could be registered between days 10, 20 and 30 of the disease. Most patients showed reduced stroke index during exercise, and their cardiac index grew at the expense of increased heart rate. Exercise-induced rise in the cardiac index was insignificant in anginal cases. Left-ventricular ejection fraction increased significantly: from 48.6 +/- 1.8 on days 1-3, to 55.4 +/- 2.3 on day 30 (p less than 0.01), the magnitude of the increase showing no correlation with threshold capacity parameters and being basically similar in all groups of patients where exercise had to be discontinued for different reasons.
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