Hemodynamic and metabolic responses to different forms of incremental exercise were studied in 20 patients following myocardial infarction. Upper body exercise was performed by a modified rowing ergometer (RE) with a fixed seat and compared with bicycle ergometer (BE) exercise in supine position (BE and RE: 25 W, 3-min-stages) and treadmill walking exercise (TE; first stage 2.5 km/h, 3% inclination and 0.5 km/h, 3%, 3-min-stages). All tests were performed in random order. Maximal performance was 8.3 W lower in RE than in BE exercise. Maximal heart rate was higher in RE (128.8 +/- 26.5) and TE (132.5 +/- 17.1) than in BE (114.2 +/- 17.1), whereas systolic blood pressure was higher in BE (194.5 +/- 24.1 mmHg) than in RE (168.3 +/- 29.5 mmHg) and TE (164.0 +/- 30.6 mmHg). These differences may be partly explained by different body position (sitting in RE, standing in TE, supine in BE). Double product was comparable in all three forms of exercise. Lactate concentrations were higher in RE than in TE and BE probably due to different muscle fiber composition.