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

Dejana Popovic1, Marco Guazzi2, Djordje G Jakovljevic3

  • 1Division of Cardiology, University Clinical Centre Serbia, Faculty of Pharmacy University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia.

International Journal of Cardiology
|March 19, 2019
PubMed

Insights

Cardiopulmonary exercise testing (CPET) accurately predicts coronary artery disease (CAD) severity and prognosis. Treadmill (TM) CPET is more reliable for CAD quantification than recumbent ergometry (RE).

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Coronary artery disease (CAD) diagnosis and prognosis assessment.
  • Cardiopulmonary exercise testing (CPET) as a diagnostic tool.

Purpose of the Study:

  • To evaluate the accuracy of treadmill (TM) and recumbent ergometry (RE) based CPET in predicting CAD severity and prognosis.
  • To compare the reliability of TM-CPET versus RE-CPET for CAD assessment.

Main Methods:

  • Inclusion of 40 Caucasian subjects with significant coronary artery lesions (≥50%).
  • Performance of TM and RE CPET within two months of coronary angiography.
  • Follow-up of subjects for up to 32 months to assess cardiac events.

Main Results:

  • TM CPET showed a higher incidence of ST segment depression (71.05% vs 28.95%, p=0.04).
  • The ventilation/carbon dioxide production (VE/VCO2) slope from TM CPET effectively distinguished between 1-2 and 3 stenotic coronary arteries (Sn 88.9%, Sp 72%).
  • Work efficiency (∆VO2/∆WR) during RE CPET predicted cumulative cardiac events (p<0.01).

Conclusions:

  • CPET parameters are valuable for predicting CAD severity and patient prognosis.
  • Treadmill CPET demonstrates superior reliability for quantifying CAD compared to recumbent ergometry.
Abstract

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