[Examination of the effect of aorto-coronary revascularisation by means of exercise tests (author's transl)].

The purpose of this study was to determine the value of exercise tests in the examination of the effect of aorto-coronary revascularisation. 48 patients (mean age 52 +/- 6 years) were examined 5.0 +/- 1.9 months before and 4.9 +/- 3.0 months after coronary revascularisation by means of coronary and left ventricular angiography. Left ventricular function at rest was unchanged. 122 grafts were constructed, the patency rate was 86%. Preoperatively two exercise tests with a bicycle ergometer were performed, some days before angiography and some days before operation, respectively. A third test was performed postoperatively (again some days before angiography). During exercise at identical work load, heart rate and systolic blood pressure did not change significantly pre- and postoperatively. At the second preoperative examination, pulmonary artery pressure (31.6 +/- 11.3 mm Hg) was significantly lower than at the first examination (36.3 +/- 10.8 mm Hg). Postoperatively there was a further decrease of mean pulmonary artery pressure (27.6 +/- 6.5 mm Hg). At the highest work load, mean pulmonary artery pressure was significantly lower at the second preoperative and at the postoperative examination (34.4 +/- 11.6 and 31.3 +/- 8.1 mm Hg versus 39.6 +/- 9.8 mm Hg). The explanation of the preoperative reduction of pulmonary artery pressure is not clear. The pressure decrease must be considered in the examination of the effect of aorto-coronary revascularisation by means of exercise tests.