Exercise Echocardiography After Myocardial Infarction

Abstract

Recent studies have suggested that two-dimensional echocardiographic imaging before and immediately following low level treadmill exercise testing in early post-myocardial infarction patients contributes important prognostic information concerning left ventricular function. Studies in our laboratory indicate that it is comparable to upright bicycle exercise imaging for detecting exercise induced wall motion abnormalities. Also, our data and that of others show that new or worsening wall motion abnormalities after exercise are highly predictive of future cardiac events and that new areas of asynergy remote from the infarct location are indicative of multiple vessel disease. The success rate for obtaining adequate two-dimensional echocardiographic images for the evaluation of wall motion at rest and immediately after exercise is now approximately 90%. Future directions include the possible addition of Doppler flow velocity measurements to assess left ventricular performance during treadmill exercise. Thus, the addition of echocardiographic studies before and after standard post-myocardial infarction treadmill exercise testing is highly feasible and is of considerable value for detecting resting and exercise abnormalities in left ventricular function of prognostic value.