Relationships between exercise ECG and angiocardiographic indices of coronary insufficiency and myocardial fibrosis in coronary heart disease.

Patients with coronary heart disease were examined with exercise ECG and angiocardiography. Maximum work capacity expressed as a percentage of the predicted normal exercise tolerance (Wmax%) was significantly associated with the angiocardiographic score of the myocardial mass subserved by obstructed coronary arteries (MCOS). Variables related to myocardial fibrosis (MF) such as post infarction ECG signs, the left ventricular wall motion score (LVMS) and the ejection fraction of the left ventricle (LVEF) correlated significantly as did variables related to reversible myocardial ischaemia or coronary insufficiency (CI), such as ST depression during exercise (STdepr), ST/W and ST/HR indices, effort angina (EA/W) index, the extent of collaterals (CollS), and 'MCOS-LVMS'. MF variables correlated weakly with CI variables. Wmax% covariated with the variables related to both CI and MF, and most closely with MCOS. Discrepancies between results of exercise ECG and angiocardiography have to some extent been overcome by comparing appropriate parameters.