Circulation, Vol 58, 887-891, Copyright © 1978 by American Heart Association
DA Weiner, C McCabe, MD Klein and TJ Ryan
To ascertain whether exercise testing might predict multivessel coronary
disease and left ventricular aneurysm after a myocardial infarction, 154
patients with a single documented myocardial infarction who had both
exercise testing and coronary angiography were grouped according to whether
they had greater than or equal to 1 mm ST depression, greater than or equal
to 1 mm ST elevation, or neither during exercise testing: 83 patients
developed ST depression alone (group 1); 22 patients had ST elevation with
concomitant ST depression in other leads (group 2); 19 patients had ST
elevation alone (group 3); and 30 patients had no ST changes (group 4).
Multivessel disease, defined as greater than or equal to 70% luminal
narrowing in two or more coronary vessels, was present in 76% (63 of 83) of
group 1, 91% (20 of 22) of group 2, 21% (four of 19) of group 3, and 13%
(four of 30) of group 4. A left ventricular aneurysm was present in 31% (26
of 83) of group 1, 68% (15 of 22) of group 2, 79% (15 of 19) of group 3,
and 40% (12 to 30) of group 1. We conclude that ST changes during exercise
testing in patients after a myocardial infarction can reliably predict the
extent of coronary disease and the presence of a left ventricular aneurysm;
ST depression with or without ST elevation predicts multivessel disease; ST
elevation alone or a negative exercise test suggests single vessel
involvement; and ST elevation with or without ST depression predicts left
ventricular aneurysm.
ARTICLES
ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm
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