Computer-derived treadmill exercise score quantifies the degree of revascularization and improved exercise...

A computer-derived treadmill exercise score (TES) that quantifies the severity of the ischemic ST response to exercise was used to detect noninvasively graft occlusion or the progression of new lesions after coronary artery bypass surgery. Three months after surgery TES completely normalized in 68% of patients and improved by more than 70% in another 18% of patients, thus reflecting excellent improvement in exercise-induced ischemia in 87% of patients. Surgical results correlated well with completeness of revascularization as shown by repeat coronary angiography. When TES, done serially up to 4 years after surgery, remained unchanged, grafts were patent and no new critical lesions had occurred. Deterioration in TES always predicted either late graft occlusion or appearance of new, high-grade lesions in the native vessels. Thus TES provides a new, accurate method that quantifies the ischemic response to exercise and detects graft occlusion or new obstructive lesions in the native coronary arteries.