Elsevier

American Heart Journal

Volume 114, Issue 6, December 1987, Pages 1305-1316
American Heart Journal

Risk stratification after acute myocardial infarction by means of exercise two-dimensional echocardiography

https://doi.org/10.1016/0002-8703(87)90530-8Get rights and content

Abstract

To determine whether exercise two-dimensional echocardiography contributes to the prognostic information provided by exercise testing in patients recovering from acute myocardial infarction, 40 patients were prospectively studies by means of pre- and postexercise echocardiography 10 to 21 days after myocardial infarction. Patients were followed for 6 to 10 months or until one of the following clinical end points occurred: death, recurrent myocardial infarction, unstable angina, or coronary artery bypass grafting. Results of treadmill exercise tests were negative in 13 of 20 patients with good clinical outcome (65% specificity) and positive in 11 of 20 patients with poor clinical outcome (55% sensitivity). The resting echocardiogram was abnormal in 37 of 40 patients. The exercise echocardiogram was negative in 19 of 20 patients with good clinical outcome (95% specificity) and positive in 16 of 20 patients with poor clinical outcome (80% sensitivity). We conclude that exercise echocardiography is more sensitive and specific than treadmill exercise testing for predicting the occurrence of subsequent cardiac events after acute myocardial infarction.

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    Supported in part by the Herman C. Krannert Fund, Indianapolis, Ind.; grants HL-06308 and HL-07182 and Clinical Investigator Award HL-01041 (Dr. Armstrong) from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.; the American Heart Association, Indiana Affiliate, Indianapolis, Ind.; and the Whitaker Foundation, Camp Hill, Pa.

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