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Prognosis of someones with Ef of 20%

My husband had an MI in 1997 and bypass surgery (3) last March. He had an Echo in August which showed an EF of 20 %. He is moderately obese, and started smoking again 3 months ago. he had a sleep study 2 weeks ago which showed 14 apnea spells per hour. He had a pacemaker defib. placed in July what is his prognosis ? no edema in feet or legs. some SOB on exertion. Blood pressure is controlled for now
Asked On : Sun, 16 Jan 2011
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Thoracic Surgeon 's  Response
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.
Answered: Sun, 16 Jan 2011
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