The ratio of calculated myocardial oxygen consumption to estimated oxygen uptake of the body (MVO<sub>2</sub>/VO<sub>2</sub>) provides insight into relative cardiac efficiency. The authors investigated the relation of ST depression to the calculated MVO<sub>2</sub>/VO<sub>2</sub> ratio during a progressive bicycle exercise test in 23 patients with good chronotropic capacity after acute myocardial infarction. ST depression of 0.2 mV or more was required at the highest exercise level. In each case, the lowest MVO<sub>2</sub>/VO<sub>2</sub> value was, on an average, at 60.5% (SD 12.7) of the maximally tolerated work load. The magnitude (mV) and the velocity (µV/min) of ST depression measured at the exercise level after the lowest MVO<sub>2</sub>/VO<sub>2</sub> value were significantly higher than the same parameters at the exercise level corresponding to the lowest MVO<sub>2</sub>/VO<sub>2</sub> value. The authors believe that the lowest value of the calculated MVO<sub>2</sub>/VO<sub>2 </sub>ratio can be regarded as a critical point which is f
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