Prediction of future physical work capacity based on serial echocardiography in patients with acute myocardial infarction
Ozawa, M.; Ando, H.; Hasegawa, M.; Matsuzaki, A.; Suzuki, K.; Katagiri, T.
Journal of Cardiology 19(4): 1017-1025
1989
ISSN/ISBN: 0914-5087 PMID: 2486622 Document Number: 335582
The future physical work capacity of patients with myocardial infarction was predicted based on echocardiograms recorded during the acute stage. Subjects consisted of 55 patients with initial myocardial infarction who were admitted to the CCU within 24 hours after their attacks (anterior 26, inferior 23, non-transmural 6; age 24-85 years). Subjects were categorized in the good tolerance group (greater than or equal to 5.0 Mets; 35 cases) and poor tolerance group (less than 5.0 Mets, or incapable of performing the test; 20 cases) based on multi-stage exercise tests before discharge. These two groups were compared as to their serial echocardiograms made during the two weeks after onset, their maximum myocardial enzyme values, and hemodynamics (catheterization and coronary angiography) on admission and in the chronic stage. Left ventricular dimension did not change in the good tolerance group, but increased in the poor tolerance group. Left atrial dimension showed the same tendency. In the poor tolerance group, the amplitude of the mitral valve echo was smaller, and the A/R ratio of left ventricular inflow velocity was higher, compared with the good tolerance group, though maximum values of myocardial enzyme and coronary angiographic findings were similar. Pulmonary artery and capillary wedge pressures in the acute stage were higher, and cardiac index and left ventricular ejection fraction were lower in the poor tolerance group.