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. 1982 Jan;47(1):44–50. doi: 10.1136/hrt.47.1.44

Myocardial infarct size and cardiac performance at exercise soon after myocardial infarction.

P Grande, A Pedersen
PMCID: PMC481094  PMID: 7055512

Abstract

Infarct size was estimated from serial serum CK MB measurements in a series of 101 patients admitted less than 15 hours after the first acute myocardial infarction. A maximal symptom limited exercise test comprising impedance measurements for the estimation of stroke volume at rest and at different levels of exercise was performed early after admission by 26 patients. There was a slight, though not significant, negative correlation between infarct size and physical capability as measured by the duration of work. The rise in systolic blood pressure during exercise showed a significantly negative and the increase in heart a significantly positive correlation to infarct size. This suggests that the rise in blood pressure, which is less in patients with the larger infarcts, is compensated by an increase in heart rate, so that the same maximum of cardiac performance and myocardial oxygen consumption is reached. The increase in cardiac stroke volume during exercise was negatively correlated with infarct size. Stroke volume only increased during lower levels of exercise; the increase in cardiac output at higher levels of exercise was achieved entirely by an increase in heart rate. The magnitude of ST segment elevation during exercise showed a significantly positive correlation with infarct size, whereas the occurrence of arrhythmias during exercise was independent of it.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bleifeld W., Mathey D., Hanrath P., Buss H., Effert S. Infarct size estimated from serial serum creatine phosphokinase in relation to left ventricular hemodynamics. Circulation. 1977 Feb;55(2):303–311. doi: 10.1161/01.cir.55.2.303. [DOI] [PubMed] [Google Scholar]
  2. Davidson D. M., DeBusk R. F. Prognostic value of a single exercise test 3 weeks after uncomplicated myocardial infarction. Circulation. 1980 Feb;61(2):236–242. doi: 10.1161/01.cir.61.2.236. [DOI] [PubMed] [Google Scholar]
  3. Denniston J. C., Maher J. T., Reeves J. T., Cruz J. C., Cymerman A., Grover R. F. Measurement of cardiac output by electrical impedance at rest and during exercise. J Appl Physiol. 1976 Jan;40(1):91–95. doi: 10.1152/jappl.1976.40.1.91. [DOI] [PubMed] [Google Scholar]
  4. Dunn R. F., Bailey I. K., Uren R., Kelly D. T. Exercise-induced ST-segment elevation. Correlation of thallium-201 myocardial perfusion scanning and coronary arteriography. Circulation. 1980 May;61(5):989–995. doi: 10.1161/01.cir.61.5.989. [DOI] [PubMed] [Google Scholar]
  5. Epstein S. E., Beiser G. D., Stampfer M., Robinson B. F., Braunwald E. Characterization of the circulatory response to maximal upright exercise in normal subjects and patients with heart disease. Circulation. 1967 Jun;35(6):1049–1062. doi: 10.1161/01.cir.35.6.1049. [DOI] [PubMed] [Google Scholar]
  6. Ericsson M., Granath A., Ohlsén P., Södermark T., Volpe U. Arrhythmias and symptoms during treadmill testing three weeks after myocardial infarction in 100 patients. Br Heart J. 1973 Aug;35(8):787–790. doi: 10.1136/hrt.35.8.787. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Geltman E. M., Ehsani A. A., Campbell M. K., Schechtman K., Roberts R., Sobel B. E. The influence of location and extent of myocardial infarction on long-term ventricular dysrhythmia and mortality. Circulation. 1979 Oct;60(4):805–814. doi: 10.1161/01.cir.60.4.805. [DOI] [PubMed] [Google Scholar]
  8. Grande P., Christiansen C., Naestoft J. Creatine kinase isoenzyme MB assay by electrophoresis. Scand J Clin Lab Invest. 1979 Nov;39(7):607–612. doi: 10.3109/00365517909108864. [DOI] [PubMed] [Google Scholar]
  9. Grande P., Christiansen C., Pedersen A., Christensen M. S. Optimal diagnosis in acute myocardial infarction. A cost-effectiveness study. Circulation. 1980 Apr;61(4):723–728. doi: 10.1161/01.cir.61.4.723. [DOI] [PubMed] [Google Scholar]
  10. Grande P., Hansen B. F., Christiansen C., Naestoft J. Acute myocardial infarct size estimated by serum CK-MB determinations: clinical accuracy and prognostic relevance utilizing a practical modification of the isoenzyme approach. Am Heart J. 1981 May;101(5):582–586. doi: 10.1016/0002-8703(81)90224-6. [DOI] [PubMed] [Google Scholar]
  11. Hori M., Inoue M., Fukui S., Shimazu T., Mishima M., Ohgitani N., Minamino T., Abe H. Correlation of ejection fraction and infarct size estimated from the total CK released in patients with acute myocardial infarction. Br Heart J. 1979 Apr;41(4):433–440. doi: 10.1136/hrt.41.4.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hossack K. F., Bruce R. A., Green B., Kusumi F., DeRouen T. A., Trimble S. Maximal cardiac output during upright exercise: approximate normal standards and variations with coronary heart disease. Am J Cardiol. 1980 Aug;46(2):204–212. doi: 10.1016/0002-9149(80)90059-4. [DOI] [PubMed] [Google Scholar]
  13. Ibsen H., Kjoller E., Styperek J., Pedersen A. Routine exercise ECG three weeks after acute myocardial infarction. Acta Med Scand. 1975 Dec;198(6):463–469. doi: 10.1111/j.0954-6820.1975.tb19576.x. [DOI] [PubMed] [Google Scholar]
  14. Kubicek W. G., Karnegis J. N., Patterson R. P., Witsoe D. A., Mattson R. H. Development and evaluation of an impedance cardiac output system. Aerosp Med. 1966 Dec;37(12):1208–1212. [PubMed] [Google Scholar]
  15. Norris R. M., Caughey D. E., Deeming L. W., Mercer C. J., Scott P. J. Coronary prognostic index for predicting survival after recovery from acute myocardial infarction. Lancet. 1970 Sep 5;2(7671):485–487. doi: 10.1016/s0140-6736(70)90110-8. [DOI] [PubMed] [Google Scholar]
  16. Opie L. H. Myocardial infarct size. Part I. Basic considerations. Am Heart J. 1980 Sep;100(3):355–372. doi: 10.1016/0002-8703(80)90151-9. [DOI] [PubMed] [Google Scholar]
  17. Paine T. D., Dye L. E., Roitman D. I., Sheffield L. T., Rackley C. E., Russell R. O., Jr, Rogers W. J. Relation of graded exercise test findings after myocardial infarction to extent of coronary artery disease and left ventricular dysfunction. Am J Cardiol. 1978 Nov;42(5):716–723. doi: 10.1016/0002-9149(78)90089-9. [DOI] [PubMed] [Google Scholar]
  18. Roberts R., Husain A., Ambos H. D., Oliver G. C., Cox J. R., Jr, Sobel B. E. Relation between infarct size and ventricular arrhythmia. Br Heart J. 1975 Nov;37(11):1169–1175. doi: 10.1136/hrt.37.11.1169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rogers W. J., McDaniel H. G., Smith L. R., Mantle J. A., Russel R. O., Jr, Rackley C. E. Correlation of angiographic estimates of myocardial infarct size and accumulated release of creatine kinase MB isoenzyme in man. Circulation. 1977 Aug;56(2):199–205. doi: 10.1161/01.cir.56.2.199. [DOI] [PubMed] [Google Scholar]
  20. Sami M., Kraemer H., DeBusk R. F. The prognostic significance of serial exercise testing after myocardial infarction. Circulation. 1979 Dec;60(6):1238–1246. doi: 10.1161/01.cir.60.6.1238. [DOI] [PubMed] [Google Scholar]
  21. Shell W. E., Sobel B. E. Biochemical markers of ischemic injury. Circulation. 1976 Mar;53(3 Suppl):I98–106. [PubMed] [Google Scholar]
  22. Théroux P., Waters D. D., Halphen C., Debaisieux J. C., Mizgala H. F. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979 Aug 16;301(7):341–345. doi: 10.1056/NEJM197908163010701. [DOI] [PubMed] [Google Scholar]

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