Dejana Popovic1, Marco Guazzi2, Djordje G Jakovljevic3, Ratko Lasica4, Marko Banovic4, Miodrag Ostojic4, Ross Arena5. 1. Division of Cardiology, University Clinical Centre Serbia, Faculty of Pharmacy University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia. Electronic address: dejanapopovic@yahoo.co.uk. 2. Heart Failure Unit and Cardiopulmonary Laboratory, Cardiology, I.R.C.C.S, Policlinico San Donato, University Hospital Milan, Italy. 3. Cardiovascular Research Centre, Institute of Cellular Medicine, Medical School, Newcastle University & Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE24HH, United Kingdom. 4. Division of Cardiology, University Clinical Centre Serbia, Faculty of Pharmacy University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia. 5. Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, 1200W Harrison St, Chicago, IL 60607, USA.
Abstract
BACKGROUND: 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.
BACKGROUND: 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.
Authors: Subodh K Arora; Tyler A Powell; Shannon N Foster; Shana L Hansen; Michael J Morris Journal: Sleep Breath Date: 2022-02-25 Impact factor: 2.816
Authors: Sashiananthan Ganesananthan; Christopher A Rajkumar; Michael Foley; David Thompson; Alexandra N Nowbar; Henry Seligman; Ricardo Petraco; Sayan Sen; Sukhjinder Nijjer; Simon A Thom; Roland Wensel; John Davies; Darrel Francis; Matthew Shun-Shin; James Howard; Rasha Al-Lamee Journal: Eur Heart J Date: 2022-09-01 Impact factor: 35.855