RELATIONSHIP BETWEEN EXERCISE TOLERANCE, HEMODYNAMICS AT REST AND DURING EXERCISE AND EJECTION FRACTION, AND THEIR PROGNOSTIC RELEVANCE IN ASYMPTOMATIC POSTINFARCTION PATIENTS

In 309 postmyocardial infarction patients (age 40 +/- 7.7 years) without persistent ischemia there is only a weak correlation between ejection fraction (EF) and exercise tolerance (r = 0.45, p < 0.01), and between EF and maximum cardiac output (CO; 0.41, p < 0.01) and maximum pulmonary capillary wedge pressure (PCWP; r = -0.32, p < 0.001). The same was true for exercise tolerance and maximum PCWP (r = -0.53, p < 0.001). A big scattering of individual values could be observed. Although we found a high positive correlation between maximum CO and exercise tolerance (r = 0.80, p < 0.001), in individual cases a low CO could be related to high exercise tolerance and vice versa. In the multivariate analysis, only the heart volume/kg body weight and maximum PCWP could be shown to be of independent prognostic importance for survival and/or mortality in the following years (chi(2) = 5.9, p < 0.015 and chi(2) = 7.2, p < 0.007, respectively).