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Oxygen pulse variation in symptomatic patients with suspected coronary artery disease: a diagnostic analysis

Shangwei Huang1, Lijie Wang1, Jimin Li1

  • 1Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

Annals of Translational Medicine
|December 22, 2022
PubMed

Insights

Cardiopulmonary exercise testing (CPET) can help diagnose coronary artery disease (CAD). The oxygen pulse variation after the anaerobic threshold (ΔVO₂/HR Peak-AT) effectively identifies significant coronary artery blockages in CAD patients.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Cardiopulmonary exercise testing (CPET) shows high sensitivity and specificity for cardiac ischemia.
  • The diagnostic role of CPET in coronary artery disease (CAD) requires further clarification.

Purpose of the Study:

  • To explore the diagnostic value of CPET indicators in identifying CAD.
  • To assess the effectiveness of specific CPET-derived metrics in evaluating coronary artery stenosis.

Main Methods:

  • A cross-sectional study included 138 symptomatic patients with suspected CAD undergoing CPET.
  • Key CPET indicators, including ΔVO₂/HR (Peak-AT), were collected and analyzed.
  • The Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was used to categorize CAD complexity.

Main Results:

  • No significant differences in most CPET indicators were found between patients with and without CAD.
  • A significant reduction in ΔVO₂/HR (Peak-AT) was observed in patients with high SYNTAX scores (≥22) compared to those with low scores (<22) (P=0.004).
  • ΔVO₂/HR (Peak-AT) demonstrated an Area Under the Curve (AUC) of 0.804 (P=0.005), with 95.7% sensitivity and 62.5% specificity for detecting intermediate to severe stenosis.

Conclusions:

  • The ΔVO₂/HR (Peak-AT) is a valuable quantitative indicator for assessing oxygen pulse response variations during incremental exercise.
  • This CPET-derived variable shows superiority in detecting intermediate to severe coronary artery stenosis in CAD patients.
  • Results should be interpreted with caution due to sample size limitations.
Abstract

Keywords:
Cardiopulmonary exercise testing (CPET)coronary artery disease (CAD)diagnosismyocardial ischemiaoxygen pulse

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