[Hemodynamic data during muscular exercise after myocardial infarction. Correlations with coronaro-ventriculographic...

Forty six patients aged 25 to 67 years (average : 52 years) underwent measurement of pulmonary arterial pressure (PAP), systemic pressure and cardiac output (Fick) at rest and during exercise in the recumbent position 12 +/- 3 weeks after uncomplicated myocardial infarction; the results were then compared with those of coronary angiography and right anterior oblique monoplane left ventriculography. The site of infarction was anterior in 18 cases and postero-diaphragmatic in 28 cases; it was non-transmural in 4 cases. Twenty patients (43%) had multivessel disease; this was equally common in anterior and inferior wall infarction. Regional wall abnormalities of 3 or more segments were observed in 14 cases. Mean PAP increased from 12,3 +/- 4,6 Torr at rest to 27,8 +/- 10,5 Torr on exercise. In 17 patients (Group A) PAP was normal at rest and during exercise (10 +/- 2 Torr and 18 +/- 3 Torr respectively); 25 patients (Group B) had normal resting PAP (12 +/- 3 Torr) but an abnormal rise on exercise (32 +/- 8 Torr); in 4 patients (Group C) PAP was abnormal at rest (24 +/- 4 Torr) and on exercise (44 +/- 7 Torr). The increase in PAP on exercise was inversely correlated to the ejection fraction (p less than 0.001) and related to the extent of left ventricular hypokinesia (p less than 0.001). Patients in Group A had higher ejection fractions (p less than 0.05), dp/dt/p index (p less than 0.01) and left ventricular compliance (p less than 0.01), lower resting (p less than 0.01) and exercise (p less than 0.05) systemic pressures and small regional wall abnormalities (p less than 0.01) than patients in Group B.(ABSTRACT TRUNCATED AT 250 WORDS)