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Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing

journal contribution
posted on 15.06.2019, 00:00 by Dejana Popovic, Marco Guazzi, Djordje G. Jakovljevic, Ratko Lasica, Marko Banovic, Miodrag Ostojic, Ross Arena
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.

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Citation

Popovic, D., Guazzi, M., Jakovljevic, D. G., Lasica, R., Banovic, M., Ostojic, M., & Arena, R. (2019). Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing. International Journal of Cardiology, 285, 11-13. doi:10.1016/j.ijcard.2019.03.012

Publisher

Elsevier

Language

en_US

issn

0167-5273

Issue date

15/06/2019

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