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Diagnostic value of the cardiopulmonary exercise test in coronary artery disease
Ning Li1,2, Jinwen Liu1,2, Yunxia Ren1,2
1Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Insights
Cardiopulmonary exercise testing (CPET) effectively diagnoses coronary heart disease (CHD) and assesses stenosis severity. CPET indexes are lower in CHD patients and correlate with disease severity, offering high diagnostic accuracy.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Coronary angiography (CAG) is the gold standard for diagnosing coronary heart disease (CHD).
- Non-invasive diagnostic methods for CHD are crucial for early detection and management.
Purpose of the Study:
- To evaluate the diagnostic value of cardiopulmonary exercise testing (CPET) for coronary heart disease (CHD).
- To explore the utility of CPET oxygen uptake kinetics indexes in assessing CHD severity.
Main Methods:
- 131 patients with chest pain underwent CPET and CAG.
- Patients were categorized into CHD (n=80) and non-CHD (n=75) groups.
- CPET indexes including peak oxygen uptake and anaerobic threshold were compared between groups and correlated with coronary artery stenosis (Gensini score).
Main Results:
- All CPET indexes were significantly lower in the CHD group compared to the control group (P<0.01).
- These indexes showed a negative correlation with the Gensini score, indicating higher stenosis severity.
- Combined CPET indexes achieved a high diagnostic accuracy (AUC=0.974, sensitivity=86.40%, specificity=98.50%) for CHD.
Conclusions:
- CPET is an effective non-invasive tool for diagnosing CHD.
- CPET provides valuable insights into the severity of coronary artery stenosis.
Background:
Coronary angiography (CAG) is "gold standard" for the diagnosis of coronary heart disease (CHD). This study aimed to explore the diagnostic value of cardiopulmonary exercise testing (CPET) and the oxygen uptake kinetics indexes of CPET.
Methods:
One hundred thirty-one patients with chest pain who underwent coronary angiography in the Department of Cardiology of our hospital from April to September 2021 were selected. According to the results of angiography, the patients were divided into an observation group (patients with coronary heart disease, n=80) and a control group (patients without coronary heart disease, n=75). Both groups underwent CPET before angiography. The differences of peak oxygen uptake, anaerobic threshold, peak kilogram oxygen uptake, peak oxygen pulse, maximum exercise load, maximum metabolic equivalent, and exercise time between the two groups were compared. Also, the correlation between the above indexes and the degree of coronary artery stenosis was analyzed, and the clinical value of the CPET in the diagnosis of CHD was evaluated.
Results:
The peak oxygen uptake, anaerobic threshold, peak kilogram oxygen uptake, peak oxygen pulse, maximum exercise load, maximum metabolic equivalent, and exercise time in the observation group were lower than those in the control group (P<0.01), and were negatively correlated with the Gensini score (P<0.01). The area under the receiver operating characteristic (ROC) curve of the above seven indexes in the combined diagnosis of CHD was 0.974, the sensitivity was 86.40%, and the specificity was 98.50%, which was better than the clinical value of any of the above indexes alone.
Conclusions:
CPET is an effective non-invasive examination in the diagnosis of CHD, and has a certain clinical value in the evaluation of the severity of coronary artery stenosis.
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