Reduced exercise capacity and clinical outcomes following acute myocardial infarction

Hiroshi Tashiro, Akihito Tanaka, Hideki Ishii, Nariko Motomura, Kenji Arai, Takeshi Adachi, Takashi Okajima, Naoki Iwakawa, Hiroki Kojima, Takayuki Mitsuda, Kenshi Hirayama, Yusuke Hitora, Motoharu Hayashi, Kenji Furusawa, Ruka Yoshida, Hajime Imai, Yasuhiro Ogawa, Katsuhiro Kawaguchi, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

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 VO2 ≤ 12. Clinical outcomes including all-cause death, myocardial infarction, and hospitalization due to heart failure were followed. Among 136 patients, reduced exercise capacity (peak VO2 ≤ 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 < 0.001) was an independent predictor of reduced exercise capacity (peak VO2 ≤ 12). Median follow-up term was 12 months (IQR 9–22). The occurrence of composite endpoints of all-cause death, myocardial infarction, and hospitalization due to heart failure was significantly higher in patients with peak VO2 ≤ 12 than those with peak VO2 > 12 (p < 0.001). Reduced exercise capacity following primary PCI in AMI patients is associated with diastolic dysfunction and may lead to poorer clinical outcomes.

Original languageEnglish
Pages (from-to)1044-1050
Number of pages7
JournalHeart and Vessels
Volume35
Issue number8
DOIs
Publication statusPublished - 01-08-2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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