Coronary stenosis is a risk marker for impaired cardiac function on cardiopulmonary exercise test

Area of Science:

• Cardiology
• Exercise Physiology
• Medical Diagnostics

Background:

• Ischemic heart disease (IHD) presents with varied cardiac functional changes.
• Understanding these variations based on coronary stenosis severity is crucial for patient management.

Purpose of the Study:

• To evaluate cardiac function characteristics using cardiopulmonary exercise testing (CPET) in IHD patients with differing degrees of coronary artery stenosis.
• To compare CPET-derived cardiac function metrics across non-obstructive (NOCAD), obstructive (OCAD), and severe obstructive (severe OCAD) coronary artery disease categories.

Main Methods:

• 614 IHD patients were categorized by coronary angiography: NOCAD (<50% stenosis), OCAD (50-90% stenosis), and severe OCAD (>90% stenosis).
• 101 healthy volunteers served as controls.
• All participants underwent CPET to measure oxygen uptake (VO2), cardiac output (CO), and heart rate (HR).

Main Results:

• IHD patients generally exhibited lower VO2, CO, and HR compared to controls.
• Significant reductions in VO2 peak, CO, and HR were observed across all IHD groups (NOCAD, OCAD, severe OCAD) compared to controls (P<0.05).
• NOCAD patients showed significantly lower VO2 at anaerobic threshold and VO2 peak compared to healthy volunteers after adjustment, alongside low stroke volume and inefficient gas exchange in all IHD patients.

Conclusions:

• Increasing atherosclerotic burden in IHD correlates with impaired cardiac output and chronotropic response during CPET.
• Non-obstructive coronary artery disease (NOCAD) demonstrates measurable cardiac dysfunction, necessitating enhanced early prevention strategies and diligent follow-up.