To assess the value of exercise stress testing to predict the functional result of revascularization, 90 patients were evaluated by coronary angiography and exercise testing pre and postoperatively. Patients were classified on the basis of the postoperative angiogram in a group with successful surgery and a group with usuccessful surgery. The predictive accuracy positive of ST segmet depression to detect usuccessful surgery was 67% The predictive accuracy negative was 61 %. The best predictor of unsuccessful surgery was residual angina pectoris after revascularization with predictive value positive and negative of 85% and 60%, respectively. Thus exercise stress testing has limited value to accurately predict the degree of revascularization.
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Mundt ED, Austen WG. Surgical measures for coronary heart disease. N Eng J Med 1975; 293: 13–9.
Ross RS. Ischaemic heart disease: An overview. Am J Cardiol 1975; 36: 496–505.
McIntosh HD, Garcia JA. The first decade of aortocoronary bypass grafting 1967–1977: A review. Circulation 1978; 57: 405–31.
Bartel AG, Behar VS, Peter RH, Orgain ES, Kong Y. Exercise stress testing in evaluation of aortocoronary bypass surgery. Circulation 1973; 48: 140–9.
Dodek A, Kassebaum DG, Griswold HE. Stress electrocardiography in the evaluation of aortocoronary bypass surgery. Am Heart J 1973; 86: 292–307.
Lapin ES, Marray JA, Bruce RA, Wintersheid L. Changes in maximal exercise performance in the evaluation of saphenous vein bypass surgery. Circulation 1973; 47: 1164–73.
Merrill AJ, Thomas C, Schechter E, Cline R, Armstrong R, Stanford W. Coronary bypass surgery value of maximal exercise testing in assessment of results. Circulation 1975; 51, 52 (suppl) 1: 173–6.
Siegel W, Lim JS, Proudfit WL, Sheldon WC, Loop FD. The spectrum of exercise test and angiographie correlations in myocardial revascularization surgery. Circulation 1975; 51, 52 (suppl) 1: 156–62.
McConahay DR, Valdes M, McCallister BD, Crocket JE, Conn RD, Reed WA, Killen DA. Accuracy of treadmill testing in assessment of direct myocardial revascularization. Circulation 1977; 56: 548–51.
Fox K, Selwyn A, Jonathan A, Westerby S, Shillingford J. Electrocardiographic mapping after exercise for evaluation of coronary bypass graft surgery. Am J Cardiol 1979; 44: 1251–8.
Nitter-Hauge S. Exercise ECG in evaluation of aortocoronary bypass surgery report on 66 patients. Eur J Cardiol 1979; 9/3: 191–8.
Mitchel BF, Adam M, Lambert CJ. Ascending aorta-to-coronary artery saphenous vein bypass grafts. J Thorac Cardiovasc Surg 1970; 60: 457–68.
Spencer FC, Green GE, Tice DA. Bypass grafting for occlusive disease of the coronary arteries: A report of experience with 195 patients. Ann Surg 1971; 173: 1029–44.
Morris CC, Reul GJ, Howell JF, Crawford ES, Chapman DW, Beazley HL, Winters WL, Peterson PK, Lewis JM. Follow-up results of distal coronary artery bypass for ischemie heart disease. Am J Cardiol 1972; 29: 180–5.
Alderman EL, Matlof HJ, Wexler L. Results of direct coronary-artery surgery for the treatment of angina pectoris. N Engl J Med 1973; 288: 525–9.
Kouchoukos NT, Kirklin JW, Oberman A. An appraisal of coronary bypass grafting. Circulation 1974; 50: 11–6.
Achuff SC, Griffith LSC, Conti CR, Humphries JO, Brawley RK, Gott VL, Ross RS. The ‘angina-producing’ myocardial segment: An approach to the interpretation of results of coronary bypass surgery. Am J Cardiol 1975; 36: 723–33.
Assad-Morrel JL, Frye RL, Connolly DC, Davis GD, Pluth JR, Wallace RB, Barnhorst DA, Elveback LR, Danielson GK. Aorta-coronary artery saphenous vein bypass surgery clinical and angiographie results. Mayo Clinic Proc 1975; 50: 379–86.
Banim SO, Balcon R. Angina following aortocoronary bypass surgery. Eur J Cardiol 1978; 7: 479–86.
Winer H, Glassman E, Spencer FC. Mechanism of relief of angina after coronary bypass surgery. An angiographie study. Am J Cardiol 1979; 44: 202–8.
McNeer JF, Conley MJ, Starmer CF, Behar VS, Kong Y, Peter RH, Bartl AG, Oldham ON, Young WG, Sabiston DC, Rosati RA. Complete and incomplete revascularization at aortocoronary bypass surgery: Experience with 392 consecutive patients. Am Heart J 1974; 88: 176–82.
Block TA, Murray JA, English MT. Improvement in exercise performance after unsuccessful myocardial revascularization. Am J Cardiol 1977; 40: 673–80.
Diluzio V, Roy PR, Sowton E. Angina in patients with occluded aorto-coronary vein grafts. Br Heart J 1974; 36: 139–47.
Kanel WB, Feinleib M. Natural history of angina pectoris in the Framingham study: Prognosis and survival. Am J Cardiol 1972; 29: 154–63.
Matthews E, Amsterdam EA, Lee G, DeMaria AN, Mason DT. Occurence of angina pectoris in relation to history of myocardial infarction: Lack of abolation of angina by infarction. Circulation 1977 (suppl) 3: 5–8.
Soloff LA. Effects of coronary bypass procedures. N Eng J Med 1972; 288: 1302–3.
Cobb LA, Thomas GI, Dillard DH, Merendino KH, Bruce RAA. An evaluation of internal-mammaryartery ligation by a double-blind technic. N Eng J Med 1959; 260: 1115–8.
Dimond EG, Kittle CF, Crocket JE. Comparison of internal mammary artery ligation and sham operation for angina pectoris. Am J Cardiol 1960; 5: 483–6.
Benson H, McCallie DP. Angina pectoris and the placebo effect. N Eng J Med 1979; 300: 1424–9.
Knoebel SB, McHenry PL, Phillips JF, Lowe DK. The effect of aortocoronary bypass grafts on myocardial blood flow reserve and treadmill exercise tolerance. Circulation 1974; 50: 685–93.
Serruys PW, Rousseau MF, Cosyns J, Ponlot R, Brasseur LA, Detry JR. Haemodynamics during maximal exercise after coronary bypass surgery. Br Heart J 1978; 40: 1205–15.
Cukingnan RA, Carey JS, Brown BG. Postoperative treadmill performance and graft patency after myocardial revascularization. Ann Thorac Surg 1983; 35: 29–34.
Gohlke H, Gohlke-Bärwolf C, Samek L, Stürzenofecker P, Schmuziger M, Roskamm H. Serial exercise testing up to 6 years after coronary bypass surgery: Behaviour of exercise parameters in groups with different degrees of revascularization determined by postoperative angiography. Am J Cardiol 1983; 51: 1301–6.
Hollenberg M, Budge R, Wisneski JA, Gertz EW. Treadmill score quantifies electrocardiographic response to exercise and improves test accuracy and reproducibility. Circulation 1980; 61/2: 276–85.
Hollenberg M, Wisneski JA, Gertz EW, Ellis RJ. Computerderived treadmill exercise score quantifies the degree of revascularization and improves exercise performance after coronary artery bypass surgery. Am Heart J 1983; 106: 1096–1104.
Thomas ES, Most AS, Williams DO. Objective assessment of coronary angioplasty for multivessel disease: Result of exercise stress testing. J Am Coll Cardiol 1988; 11: 217–22.
Dubach P, Froelicher V, Atwood E, Myers J, Sandhy SS, Lehmann K. A comparison of the exercise test responses pre/post revascularization: Does coronary artery bypass surgery produce better results than percutaneous transluminal coronary angioplasty? J Cardiopulmonary Rehabil 1990; 10: 120–5.
Mulcahy D, Keegan J, Phadke K, Wright C, Sparrow J, Purcell H, Fox K. Effects of coronary artery bypass surgery and angioplasty on the total ischemie burden: A study of exercise testing and ambulatory ST segment monitoring. Am Heart J 1992; 123: 597–602.
Vandormael MG, Chaitman BR, Ischinger T, Aker UT, Harper M, Hernandez J et al. Immediate and short-term benefit of multilesion coronary angioplasty: Influence of degree of revascularization. J Am Coll Cardiol 1985; 6: 983–91.
Rosing DR, van Raden MJ, Mincemoyer RM, Bonow RO, Bourassa MG, David PR et al. Exercise, electrocardiographic and functional responses after percutanous transluminal coronary angioplasty. Am J Cardiol 1984; 53: 36C-41C.
Deligonul U, Vandormael MG, Shah Y, Galan K, Kern MJ, Chaitman BR. Prognostic value of early exercise stress testing after successful coronary angioplasty: Importance of the degree of revascularization. Am Heart J 1989; 117: 509–14.
Dubach P, Froelicher V, Klein J, Detrano R. Use of exercise test to predict prognosis after coronary artery bypass grafting. Am J Cardiol 1989; 63: 530–3.
Weiner DA, Ryan TJ, McCabe CH, Chaitman BR, Sheffield T, Ferguson JC et al. The value of preoperative exercise testing in predicting long-term survival in patients undergoing aortocoronary bypass surgery. Circulation 1984; 70 (suppl) I: I-226–I-231.
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Visser, F.C., van Campen, L. & de Feyter, P.J. Value and limitations of exercise stress testing to predict the functional results of coronary artery bypass grafting. Int J Cardiac Imag 9, 41–47 (1993). https://doi.org/10.1007/BF01143145
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