Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing
journal contributionposted on 15.06.2019 by Dejana Popovic, Marco Guazzi, Djordje G. Jakovljevic, Ratko Lasica, Marko Banovic, Miodrag Ostojic, Ross Arena
Any type of content formally published in an academic journal, usually following a peer-review process.
This study examined the accuracy of cardiopulmonary exercise testing (CPET) on a treadmill (TM) and recumbent ergometry (RE) in the predicting coronary artery disease (CAD) severity and prognosis. Methods Forty Caucasian subjects, mean age 63.5 ± 7.6, with significant coronary artery lesions (≥50%) were included. Within two months of coronary angiography, TM and RE CPET were performed on two visits 2–4 days apart and subsequently followed up to 32 ± 10 months. Results Mean left ventricular ejection fraction was 56.7 ± 9.6%. TM CPET exhibited a higher occurrence of ST segment depression ≥ 1 mm (71.05% vs 28.95%, p = 0.04). Subjects with 1–2 stenotic coronary arteries (SCA) demonstrated a better CPET response compared to those with 3-SCA. ROC analysis revealed a high predictive value for the ventilation/carbon dioxide production (VE/VCO2) slope obtained on TM (area 0.84, p = 0.003, Sn 88.9%, Sp 72%) in distinguishing between 1 and 2-SCA and 3-SCA. Among all CPET parameters, work efficiency (∆VO2/∆WR) during RE predicted cumulative cardiac events (p < 0.01). Conclusions CPET parameters hold predictive value for CAD severity and prognosis. CPET on a TM appears to be more reliable in the quantification of CAD compared to RE.