Early post-myocardial infarction exercise testing. Exercise response and clinical value.

Based on 7 previously published original papers the present review evaluates the response to an exercise test during early recovery from acute myocardial infarction. Selected exercise variables are related to the long-term survival of the patients. The conclusions can be summarized as the following: The exercise test can be carried out with sufficient safety. The exercise physiological response of the patients is dependent on their age, sex and reason to discontinue exercise. ST-segment depression is not significantly predictive of subsequent mortality. Other categories of the ST-segment response are of limited value as prognostic predictors. An exercise index of left ventricular function and exercise associated ventricular arrhythmias are independent, significant predictors of the long-term survival of the patients, regardless their age. These variables can identify a substantial number of patients with a very low subsequent death rate, irrespective of a clinical risk stratification. Different degrees of increased risk of dying can be determined by combining exercise and clinical variables. The prognostic significance of exercise induced ventricular arrhythmias is related to their frequency and the occurrence of repetitive ventricular premature beats.