Syed Zahed Rasheed, Abdus Samad.
Exercise Stress Test early after acute Myocardial Infarction: significance and predictive value of rate pressure product.
Pak J Cardiol Jan ;10(2-3):63-7.

Exercise stress test (EST) is useful in the evaluation and treatment of patients after acute myocardial infarction (AMI). Besides electrocardiographic abnormalities, exercise capacity, heart rate and systolic blood pressure response to exercise and myocardial oxygen consumption are important findings. It has been established that rate pressure product (RPP) (heart rate X systolic blood pressure) represents indirectly the myocardial oxygen demand. In this study, patients were subjected to EST 3-6 days after uncomplicated AML The data were analyzed to assess the significance of RPP and its ability to predict future cardiac events. A total of 105 patients who completed at least one year of follow-up were included in the final analysis. There were 93 (88.57%) male and 12 (11.43%) female patients. The mean RPP in female patients was 28644 ± 4427 and in male patients was 25763 ± 6057 (p=0.115). There was no significant difference statistically in the RPP with relation to type of AMI (p=0.233); age groups (p=0.716); and smoking (p=0.117). It was significantly lower in patients who developed chest pain during exercise (p=0.0001); ST-segment depression (p=0.017) and positive EST (p=0.001). Similarly the RPP was much lower in patients who developed complications during follow-up, viz post myocardial infarction angina pectoris (p=0.001); congestive cardiac failure (p=0.002); recurrent myocardial infarction (p=0.003); and patients requiring hospitalization (p=0.032). However, it was only slightly lower in patients who died during follow-up (p=0.132). We conclude, RPP is an important nonelectrocardiographic indicator for predicting morbidity during follow-up.

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