stop
smoking & control weight.Low
Ejection Fraction (EF) and restrictive physiology are known factors of poor prognosis.The Non restrictive diastolic physiology in patients with
systolic dysfunction provide a better prognosis than those with restrictive physiology, independent of EF, therefore in large trials their subtypes
should be further characterized due to its good prognosise measurement of left ventricular ejection fraction (LVEF) plays a key role in many strategies for managing patients myocardial infarction. the hypothesis that exercise capacity 1 month after myocardial infarction provides additional information in patients with a low LVEF and therefore assists in risk stratification. One hundred fifteen patients, with documented myocardial infarction and LVEF less than 35% by gated
radionuclide scan 1 month after
acute myocardial infarction, were followed up for 2 months to 7 years. Exercise capacity was estimated from a treadmill test 1 month after infarction. Using the Cox proportional hazards model, exercise capacity was a significant predictor of death or reinfarction. The
relative risk of death, based on a comparison between the lowermost quintile (less than 4 METS) and uppermost quintile (greater than 7 METS), was 3.5 (95% confidence interval, 1.1-9.7); the relative risk in the fourth, third, and second quintile was 2.7, 2.1, and 1.6, respectively. In a multivariate analysis, the observed effect of a good exercise capacity was independent of LVEF. These data indicate that in patients with a low LVEF after myocardial infarction, useful prognostic information can be obtained from exercise testing.