Factors determining exercise capacity evaluated during cardiopulmonary exercise testing in 6 months follow up after ST elevation myocardial infarction.

INTRODUCTION: ST elevation myocardial infarction (STEMI) is one of the main causes of congestive heart failure (CHF). The main symptom of CHF is exercise tolerance impairment. The aim of the study was to evaluate the prevalence and risk factors for impaired exercise tolerance in patients after STEMI.

METHODS AND RESULTS: 84 patients with STEMI were analyzed in the study. Cardiopulmonary exercise test (CPET) was performed 6 months after STEMI. Impaired exercise tolerance defined as peak VO2 < 84% predicted for age and sex was present in 49 (58%) patients and was connected with lack of abciximab administration (91,4 vs 69%, p=0·02) and the presence of mitral regurgitation (47 vs. 23%, p=0·02). In univariate analysis the troponin I level at admission (OR 1·89, p=0·047), the use of abciximab (OR 0·21, p=0·03), the presence of mitral regurgitation (OR 2·98, p=0·03) and NT-proBNP concentration (OR 2·17, p=0·021) were related to impaired exercise tolerance. The best multivariate model for predicting impaired exercise tolerance included mitral regurgitation and lack of abciximab administration.

CONCLUSIONS: Impaired exercise tolerance after STEMI is common. Mitral regurgitation and lack of abciximab administration are the best predicting factors of impaired exercise tolerance after STEMI. This article is protected by copyright. All rights reserved.