The spectrum of exercise test and angiographic correlations in myocardial revascularization surgery.

Maximal exercise tests and angiographic evaluations were obtained in a group of patients before and after myocardial revascularization. Patients were classified on the basis of angiography and operative records. Two primary groups of 33 patients with complete revascularization and 95 patients with postoperative residual ischemia were studied. The residual ischemia subgroups included patients with partial revascularization, progressive coronary atherosclerosis, or graft failure. Patients with complete revascularization had statistically significant improvements in work capacity, maximal heart rate, maximal rate-pressure products, abnormal exercise electrocardiograms, exercise-induced angina pectoris, and atrial gallop sounds. A spectrum of lesser improvements in these measurements was observed in the subgroups with residual ischemia. Total graft failure resulted in no significant improvements in exercise-test parameters. Maximal stress tests provide a useful adjunct to routine clinical follow-up of myocardial revascularization patients. Myocardial revascularization is associated with significant patient palliation as determined by serial stress testing.