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Safety analysis and parameters of cardiopulmonary exercise test in patients with ventricular aneurysm after
Jie Gao1,2, Yun-Mei Zhang3, Ying-Yue Zhang1
1Department of Cardiology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Insights
Cardiopulmonary Exercise Testing (CPET) is safe for patients with ventricular aneurysm (VA) after myocardial infarction (MI). CPET did not show increased adverse events in VA patients, suggesting its utility in this population.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Ventricular aneurysm (VA) following myocardial infarction (MI) presents unique challenges for patient assessment.
- Evidence regarding the safety and utility of Cardiopulmonary Exercise Testing (CPET) in post-MI VA patients is limited.
Purpose of the Study:
- To evaluate the safety and characteristics of CPET in patients with post-MI VA.
- To compare CPET parameters between patients with and without VA.
Main Methods:
- Retrospective analysis of 803 CPETs in patients with and without VA (diagnosed via echocardiography).
- Safety endpoints included blood pressure drops, ischemia, and arrhythmias.
- Propensity score matching was used to compare CPET parameters between groups.
Main Results:
- No fatal adverse events occurred; endpoint events (1.87%) were exclusively in the non-VA group.
- VA patients exhibited lower maximum voluntary ventilation and left ventricular ejection fraction, and larger left ventricular end-diastolic diameter.
- VA status was not a risk factor for primary endpoint events during CPET.
Conclusions:
- CPET is a safe procedure for patients with post-MI VA.
- CPET reveals distinct physiological characteristics in VA patients.
- CPET can be safely utilized to assess patients with post-MI VA without increased risk.
Abstract:
Assessing ventricular aneurysm (VA) after myocardial infarction (MI) with Cardiopulmonary Exercise Testing (CPET) are lack of evidence. This study aimed to evaluate the safety and characteristics of CPET in patients with post-MI VA. A total of 803 CPET were completed. The patients were divided into VA and non-VA groups according to echocardiography results (60 vs 743). The primary endpoint events about safety were set as blood pressure (BP) drops, exercise-related myocardial ischemia, and severe arrhythmias, while secondary endpoint events were set as abnormal BP response and frequent ventricular premature beats. The differences about CPET parameters were compared by propensity score matching analysis. No fatal adverse events were observed during or within 2 h post-CPET, while endpoint adverse events were observed in 15 cases (1.87%) which all occurred in the non-VA group. The maximum voluntary ventilation and left ventricular ejection fraction were statistically lower in the VA group, while left ventricular end-diastolic diameter was larger. A logistic regression analysis suggested that development of VA or not was not the risk factor for the occurrence of the primary endpoint events during CPET. No increase in the incidence of adverse events during CPET was observed in the VA versus non-VA group.
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