[Prognostic significance of early ergometry following acute transmural first-time myocardial infarct]

A submaximal exercise test (70% of the maximal age related heart-rate) was performed in 324 patients (214 m, 60 w, mean age 55.2 +/- 11.35 y, 154 anterior infarction, 117 posterior infarction, 3 BBB) within the third week after their first transmural infarction. 50 patients were unable to be exercised because of medical contraindications. The patients were divided in 3 subgroups according to the events during the follow up of 23.6 +/- 14.6 months: group I - patients with reinfarction (22 pts = 8.1%), 4 of them died, group II - patients who died because of cardiac events (sudden death or cardiac decompensation) (13 pts = 4.7%) and group III - patients who had no further events (239 pts = 87.2%). All patients were comparable concerning age, exercise tolerance, appearing of angina, T-shift, monophasic ST-segment-elevation, systolic blood pressure behaviour, ventricular arrhythmias or AV-block. ST-segment depression was significantly more frequent in the group I patients (p less than 0.02) as much as an obvious reduction of the working capacity. Patients who were not exercised (because of contra-indications) had a significant higher mortality during follow up (32% vs. 6%). We conclude that exercise test in the early phase after myocardial infarction gives no information concerning mortality, but there was found statistically more frequent ST-segment depressions in the group of patients with reinfarction as much as an obvious reduction of the working capacity. Thus, exercise test is of value for the detection of patients at risk for reinfarction.