[Assessment of coronary reserve in patients after myocardial infarction]

Clinical data were compared with results of stress tests (veloergometry and transesophageal cardiac pacing) in 320 patients 1.5-2 months after myocardial infarction. Severity of angina was classified as functional class 0, I, II, III and IV in 78 (24.4%), 162 (50.6%), 64 (20%), 12 (3.75%), and 4 (1.25%) patients, respectively. Characteristics of coronary reserve by exercise test and transesophageal pacing considerably differed mostly in patients with class 0 and I and were practically identical in patients with class III and IV angina. Pearson's coefficient of correlation was the highest between clinical data and results of transesophageal pacing. It was lower between results of pacing and veloergometry and the lowest between clinical data and results of veloergometry. Values of Pearson's coefficient of correlation rose with increase of functional class of angina from 0.38 to 0.88. All methods analyzed in this study were reliable for estimation of degree of lowering of coronary reserve in patients with high functional class of angina. However in patients without angina or with class I angina additional methods were required and transesophageal cardiac pacing appeared to be a preferable technique for assessment of level of coronary reserve in these patients.