Factors Influencing the Availability of Cardiopulmonary Exercise Testing for Patients Undergoing Cardiac...

Area of Science:

• Cardiology
• Exercise Physiology
• Medical Device Technology

Background:

• Cardiac resynchronization therapy (CRT) and CRT-defibrillator (CRT-D) are crucial for heart failure management.
• Cardiopulmonary exercise testing (CPET) is a valuable tool for assessing functional capacity in cardiac patients.
• Real-world data on CPET utilization post-CRT/CRT-D implantation is limited.

Purpose of the Study:

• To determine the implementation rate of CPET in patients receiving CRT or CRT-D.
• To identify factors associated with CPET performance in this patient cohort.
• To understand the current landscape of CPET utilization in real-world clinical practice.

Main Methods:

• Analysis of real-world data from Japan's Diagnostic Procedure Combination System (2014-2018).
• Inclusion of 3859 cardiac patients who underwent CRT or CRT-D implantation.
• Statistical analysis including unpaired t-tests, chi-squared tests, and multivariate analysis to identify associated factors.

Main Results:

• CPET was performed in only 3% (134 patients) of the study cohort.
• Patients who underwent CPET were younger and had higher Barthel Index scores at discharge.
• Higher rates of cardiac rehabilitation were observed in patients who received CPET.

Conclusions:

• The implementation rate of CPET following CRT or CRT-D implantation is notably low.
• Factors such as younger age (<70 years) and higher discharge Barthel Index (≥85) are associated with increased CPET utilization.
• In-hospital cardiac rehabilitation emerged as a significant determinant for CPET performance, suggesting a need for integrated care strategies.