PubMed · 6567276
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P Gallay, R Grolleau. [Exercise tests. Technics, normal and pathological results].. https://pubmed.ncbi.nlm.nih.gov/6567276/
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No fatal complications occurred in 37,250 exercise tests (98.7% symptom limited) including 683 predischarge maximal tests in patients soon after myocardial infarction. Acute myocardial infarction was observed in 4 patients, ventricular fibrillation in 1 patient was successfully resolved by defibrillation. Extension of infarct area was recorded in 1 patient soon after myocardial infarction. Complication rates decreased from 1:3,400 in years 1969-1984 to 11,700 in years 1985-1994. Maximal exercise testing soon after myocardial infarction appears to be safe too. It cannot be replaced by submaximal testing. It appears to define high-risk patients suitable for revascularization procedures.
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A total of 127 patients with chronic heart failure referred to our exercise laboratory were studied retrospectively to identify parameters predictive of prognosis. Patients were followed for a mean of 14.6 months. The group as a whole had severe ventricular dysfunction with a median ejection fraction of 17% and a median peak rate of oxygen consumption of 13.7 ml/kg/min. During the follow-up period 23 patients (18%) died and 18 (14%) underwent cardiac transplantation. The effect of the following variables on outcome (death or transplantation) were examined: age, cause of heart failure, cardiothoracic ratio on chest radiography, left ventricular end-systolic dimension on echocardiography, left ventricular ejection fraction on radionuclide ventriculography, mean dose of diuretic, plasma sodium and urea concentrations, and peak oxygen consumption during exercise. Although all variables except cause of heart failure affected outcome on univariate analysis, multivariate analysis identified three variables that were statistically significant and independent predictors of outcome. In order of importance these were plasma sodium level, left ventricular ejection fraction and peak oxygen consumption. Even in this group of patients with severe heart failure, these variables were predictive of outcome.