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DOI: 10.1055/s-2000-7350
Ergometrie nach akutem Myokardinfarkt
Publication History
Publication Date:
31 December 2000 (online)

Das Augsburger Myokardinfarkt-Register zeigte, dass 1985-1992 nur bei 45 % der Patienten und 37 % der Patientinnen eine Ergometrie nach akutem Myokardinfarkt während des Krankenhausaufenthaltes erfolgte [21]. Eine 1986 in den USA durchgeführte Analyse von Ergometrien nach akutem Myokardinfarkt ergab, dass sie in 64 % der Zentren regelmäßig vor Entlassung, in 29 % nach Entlassung und in 7 % sowohl vor als auch nach Entlassung erfolgte. In 147 Zentren wurden die Ergometrien ≤ 14 Tage nach Myokardinfarkt (129 728, 85 % der erfassten Ergometrien) und in 46 Zentren 15-28 Tage nach Myokardinfarkt (22 221 Untersuchungen, 15 % der erfassten Ergometrien) durchgeführt. 111 Zentren führten ausschließlich submaximale Belastungen durch, 50 symptomlimitierte Belastungen, und 32 Zentren verwandten beide Belastungsformen [15].
Unter Berücksichtigung der relevanten Daten aus der Literatur möchte ich darstellen, welche Bedeutung eine Ergometrie nach akutem Myokardinfarkt hat und inwieweit eine Patientengefährdung durch die Ergometrie vom Zeitpunkt nach Myokardinfarkt abhängt. Die Richtlinien zur Belastungsdiagnostik nach akutem Herzinfarkt des American College of Cardiology, der American Heart Association, der European Society of Cardiology und der Deutschen Gesellschaft für Kardiologie werden diskutiert.
Literatur
- 1
Abboud L, Hir J, Eisen I, Cohen A, Markiewicz W.
Long-term value of
exercise testing after myocardial infarction. Influence of thrombolytic
therapy.
Chest.
2000;
117
556-561
Reference Ris Wihthout Link
- 2
Antman E M, Kuntz K M.
The length of
the hospital stay after myocardial infarction.
N Engl J
Med.
2000;
342
808-810
Reference Ris Wihthout Link
- 3
Astarita C.
Dipyridamole
echocardiography test performed between third-fifth day in the uncomplicated
acute myocardial infarction for early risk stratification.
Europ
Heart J.
1999;
20
(Suppl)
688
Reference Ris Wihthout Link
- 4
Beller G A, Zaret B L.
Contributions
of nuclear cardiology to diagnosis and prognosis of patients with
coronary artery disease.
Circulation.
2000;
101
1465-1478
Reference Ris Wihthout Link
- 5
Breuer H WM, Eckert K.
Das Görlitzer
Herzinfarktprojekt.
Herz/Kreisl.
1999;
31
443- 447
Reference Ris Wihthout Link
- 6
Breuer H WM.
Streß-Echokardiographie.
Dtsch
med Wschr.
1997;
122
409-412
Reference Ris Wihthout Link
- 7
Chaitmann B R, McMahon R P, Terrin M, Younis L T, Shaw L J, Weiner D A, Frederick M M, Knatterud G L, Sopko G, Braunwald E. (for the TIMI Investigators) .
Impact
of treatment strategy on predischarge exercise test in the thrombolysis
in myocardial infarction (TMI) II Trial.
Amer J Cardiol.
1993;
71
131-138
Reference Ris Wihthout Link
- 8
Dakik H A, Mahmarian J J, Kimball K T, Koutelou M G, Medrano R, Verani M S.
Prognostic
value of exercise 201Tl tomography in patients treated
with thrombolytic therapy during acute myocardial infarction.
Circulation.
1996;
94
2735- 2742
Reference Ris Wihthout Link
- 9
De la Torre M M, San Román J A, Bermejo J, Vega J L, Paniagua J, Sanz O, Pastor G, Garcia E, Fernández-Avilés F.
Dobutamine
stress echocardiography after uncomplicated myocardial infarction
in the elderly.
Europ Heart J.
1999;
20
(Suppl)
662
Reference Ris Wihthout Link
- 10
Erbel R, Engel H J, Kübler W, Meinertz T, Neuhaus K L, Sauer G, Strauer B E, Bonzel T, Ewen K.
Richtlinien der interventionellen
Koronartherapie.
Z Kardiol.
1997;
86
1040-1063
Reference Ris Wihthout Link
- 11
ESC .
Guidelines
for cardiac exercise testing.
Europ Heart J.
1993;
14
969-988
Reference Ris Wihthout Link
- 12
Flechter G F, Balady G, Froelicher V F, Hartley L H, Haskell W L, Pollock M L.
Exercise standards.
Circulation.
1995;
91
580-615
Reference Ris Wihthout Link
- 13
Gibbons R J, Chatterjee K, Daley J. et al .
ACC/AHA/ACP-ASIM Guidelines
for the management of patients with chronic stable angina: Executive
summary and recommendations.
Circulation.
1999;
99
2829-2848
Reference Ris Wihthout Link
- 14
Gibbons R J, Balady G J, Beasley J W. et al .
ACC/AHA Guidelines for exercise
testing: Executive Summary.
Circulation.
1997;
96
345-354
Reference Ris Wihthout Link
- 15
Hamm L F, Crow R S, Stull G A, Hannan P.
Safety and characteristics of
exercise testing early after acute myocardial infarction.
Amer
J Cardiol.
1989;
63
1193-1197
Reference Ris Wihthout Link
- 16
Hecht H S, Debord L, Shaw R, Dunlap R, Ryan C, Stertzer S H, Myler R K.
Digital supine
bicycle stress echocardiography.
J Amer Coll Cardiol.
1993;
21
950- 956
Reference Ris Wihthout Link
- 17
Hollenberg S M.
Preoperative
Cardiac Risk Assessment.
Chest.
1999;
115/5
51S- 57S
Reference Ris Wihthout Link
- 18 Hollmann W, Hettinger T. Sportmedizin - Arbeits-
und Trainingsgrundlagen. 3. Auflage, Studienausgab.
Schattauer, Stuttgart, New York 1990: 434-439
Reference Ris Wihthout Link
- 19
Jain A, Myers H, Sapin P M, O’Rourke R A.
Comparison
of symptom-limited and low level exercise tolerance tests early
after myocardial infarction.
J Amer Coll Cardiol.
1993;
22
1816-1820
Reference Ris Wihthout Link
- 20
Juneau M, Colles P, Théroux P, De Guise P, Pelletier G, Lam J, Waters D.
Symptom
limited versus low level exercise testing before hospital discharge
after myocardial infarction.
J Amer Coll Cardiol.
1992;
20
927-933
Reference Ris Wihthout Link
- 21
Löwel H, Koenig W, Engel S, Hörmann A, Keil U.
The impact of diabetes
mellitus on suvival after myocardial infarction: Can it be modified
by drug treatment.
Diabetologia.
2000;
4✓
218-226
Reference Ris Wihthout Link
- 22
Marwick T H, Nemec J J, Pashkow F J, Stewart W J, Salcedo E E.
Accuracy
and limitations of exercise echocardiography in routine clinical
setting.
J Amer Coll Cardiol.
1992;
19
74- 81
Reference Ris Wihthout Link
- 23
Newby L K, Eisenstein E L, Califf R M, Thompson T D, Nelson C L, Peterson E D, Armstrong P W, Van de Werf F, White H D, Topol E J, Mark D B.
Cost
effectiveness of early discharge after uncomplicated acute myocardial
infarction.
N Engl J Med.
2000;
342
749-756
Reference Ris Wihthout Link
- 24
Picano E, Sicari R, Landi P, Cortigiani L, Bigi R, Coletta C, Galati A, Heyman J, Mattioli R, Previtali M, Mathias W, Dodi C, Minardi G, Lowenstein J, Seveso G, Pingitore A, Salustri A, Raciti M. for the EDIC Study Group .
Prognostic value of
myocardial viability in medically treated patients with global left
ventricular dysfunction early afer an acute uncomplicated myocardial
infarction.
Circulation.
1998;
98
1078-1084
Reference Ris Wihthout Link
- 25
PiccalÒ G, Pirelli S, Massa D, Cipriani M, Sarullo F M, De Vita C.
Value of negative predischarge
exercise testing in identifying patients at low risk after acute
myocardial infarction treated by systemic thrombolysis.
Amer
J Cardiol.
1992;
70
31-33
Reference Ris Wihthout Link
- 26
Rustige J, Schiele R, Burczyk U, Koch A, Gottwik M, Neuhaus K L, Tebbe U, Uebis R, Senges J.
The
60 minutes myocardial infarction project.
Europ Heart J.
1997;
18
1438-1446
Reference Ris Wihthout Link
- 27
Ryan T J, Anderson J L, Antman E M, Braniff B A, Brooks N H, Califf R M, Hillis L D, Hiratzka L F, Rapaport E, Riegel B J, Russell R O, Smith E E, Weaver W D.
ACC/AHA
Guidelines for the management of patients with acute myocardial
infarction.
J Amer Coll Cardiol.
1996;
28
1328-1428
Reference Ris Wihthout Link
- 28
Scanlon P I, Faxon D P, Audet A M, Carabello B, Dehmer G J, Eagle K A, Legako R D, Leon D F, Murray J A, Nissen S E, Pepine C J, Watson R M.
ACC/AHA
Guidelines for coronary angiography: executive summary and recommendations.
Circulation.
1999;
99
2354-2357
Reference Ris Wihthout Link
- 29
Sgura F A, Wright R S, Grill J P, Reeder G S, Kopecky S L.
Reduction
in length of stay for acute myocardial infarction: Lesson learned
over 10 years in a defined geographic population.
Europ
Heart J.
1999;
20
(Suppl)
546
Reference Ris Wihthout Link
- 30
The Task Force on the Management
of Acute Myocardial Infarction of the European Society of Cardiology .
Acute
myocardial infarction: Pre-hospital and in-hospital management.
Europ
Heart J.
1996;
17
43 -63
Reference Ris Wihthout Link
- 31
Travin M I, Dessouki A, Cameron T, Heller G V.
Use of exercise
technetium-99m sestamibi SPECT imaging to detect residual ischemia and
for risk stratification after acute myocardial infarction.
Amer
J Cardiol.
1995;
75
665- 669
Reference Ris Wihthout Link
- 32
Villella A, Maggioni A P, Villella M, Giordano A, Turazza F M, Santoro E, Franzosi M G.
Prognostic
significance of maximal exercise testing after myocardial infarction
treated with thrombolytic agents: the GISSI-2-data-base.
Lancet.
1995;
346
523-529
Reference Ris Wihthout Link
- 33
Wagner S, Schneider S, Schiele R, Fischer F, Dehn H, Grube R, Becker G, Baumgärtel B, Altmann E, Senges J.
Akuter
Myokardinfarkt in Deutschland im Zeitraum zwischen 1996 und 1998:
Therapie und hospitaler Verlauf.
Z Kardiol.
1999;
88
857- 867
Reference Ris Wihthout Link
- 34
Worth H, Breuer H -WM.
Empfehlungen
zur Durchführung und Bewertung von Belastungsuntersuchungen
in der Pneumologie. Deutsche Gesellschaft für Pneumologie.
Pneumologie.
1998;
52
225-231
Reference Ris Wihthout Link
Prof. Dr. med. habil. H.-W. M. Breuer
St. Carolus-Krankenhaus Görlitz Chefarzt
der Abteilung Innere Medizin Ärztlicher Leiter
des St. Carolus-Krankenhauses
Carolusstr. 212
02827 Görlitz
Phone: 03581/721002
Fax: 03581/721003
Email: breuer.carolus@gmx.de