Reduced exercise capacity and clinical outcomes following acute myocardial infarction

• Published in: Heart and vessels 2020-08, Vol.35 (8), p.1044-1050
• Main Authors: Tashiro, Hiroshi, Tanaka, Akihito, Ishii, Hideki, Motomura, Nariko, Arai, Kenji, Adachi, Takeshi, Okajima, Takashi, Iwakawa, Naoki, Kojima, Hiroki, Mitsuda, Takayuki, Hirayama, Kenshi, Hitora, Yusuke, Hayashi, Motoharu, Furusawa, Kenji, Yoshida, Ruka, Imai, Hajime, Ogawa, Yasuhiro, Kawaguchi, Katsuhiro, Murohara, Toyoaki
• Format: Article
• Language: English
• Subjects: Aged; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular diseases; Clinical outcomes; Congestive heart failure; Coronary artery disease; Echocardiography; Exercise Test; Exercise Tolerance; Female; Functional Status; Heart attacks; Heart Disease Risk Factors; Heart failure; Hospitalization; Humans; Hypertension; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial infarction; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Original Article; Oxygen Consumption; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - mortality; Recovery of Function; Renal function; Risk Assessment; Time Factors; Treatment Outcome; Vanadium oxides; Vascular Surgery
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-020-01576-2

Reduced exercise capacity is known to be an important predictor of poor prognosis and disability in patients with cardiovascular diseases and chronic heart failure, and even members of the general population. However, data about exercise capacity assessed by cardiopulmonary exercise testing (CPX) in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention (PCI) is scarce. Among 594 consecutive AMI patients who underwent primary PCI, we examined 136 patients (85.3% men, 64.9 ± 11.9 years) who underwent CPX during hospitalization for AMI. CPX was usually performed 5 days after the onset of AMI. Reduced exercise capacity was defined as peak V O 2 ≤ 12. Clinical outcomes including all-cause death, myocardial infarction, and hospitalization due to heart failure were followed. Among 136 patients, reduced exercise capacity (peak V O 2 ≤ 12) was seen in 38 patients (28%). Patients with reduced exercise capacity were older, more likely to have hypertension, and had lower renal function. In echocardiography, patients with reduced exercise capacity had higher E / e’ and larger left atrial dimension. Multivariate logistic analysis showed that E / e’ (OR 1.19, 95% CI 1.09–1.31, p   12 ( p