Correlation of early hemodynamics during myocardial infarction and subsequent exercise testing
Cintrón, G.; Hernández, E.; Linares, E.; Aranda, J.M.
Boletin de la Asociacion Medica de Puerto Rico 73(7): 316-320
1981
ISSN/ISBN: 0004-4849 PMID: 6946787 Document Number: 700999
The purpose of this study was to correlate hemodynamic measurements obtained within 24 hours of the first acute transmural myocardial infarction with treadmill testing three months later. Forty-two male veterans patients underwent right heart catheterization within 24 hours of symptoms of myocardial infarction and performed an exercise test three months later. The patients were divided in two groups according to pulmonary artery diastolic or pulmonary wedge pressures. Group I: pulmonary diastolic pressures <12 mmHg (7±.7), 16 patients. Group II: pulmonary diastolic pressures > 12 mmHg (17±.7), 26 patients. Both groups were comparable regarding age, history of prior congestive heart failure and angina pectoris. In Group I, 15 of 16 patients had inferior myocardial infarction and the mean peak creatine kinase was 892±80 international units. In Group II, 23 of 26 patients had anterior infarction and mean peak creatine kinase was 1336±171 international units. The number of positive, negative and inconclusive exercise tests, maximal attained heart rate and maximal blood pressure in both groups was similar. The work load (mets) achieved at peak exercise by Group I patients (7.1±.5) was significantly higher (p<0.05) than the work load achieved by Group II patients (5.9±.3). We conclude that in patients with first acute transmural myocardial infarction there is no correlation between initial pulmonary diastolic pressure and results of treadmill exercise testing three months later except for a higher exercise level attained in patients with low pulmonary diastolic pressure. This may be a result of larger infarct size and more extensive left ventricular dysfunction in patients with acute myocardial infarction and elevated pulmonary artery diastolic pressure.
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