Study On The Correlation Between Cardiopulmonary Exercise Testing And The Degree Of Coronary Artery Lesions And Analysis Of Factors Affecting Exercise Tolerance In Patients With Coronary Artery Disease

Objective:1.To investigate the correlation between CPET and the severity of coronary artery disease by observing the relationship between the indexes of cardiopulmonary exercise test assessment and the degree of coronary artery disease in the coronary artery disease group.2.By exploring the factors influencing exercise tolerance in patients with coronary artery disease,an exercise tolerance correlation analysis was conducted to provide guidance for further cardiac rehabilitation and improvement of near and long-term prognosis in patients with coronary artery disease.Methods:1.A retrospective analysis of 120 patients who attended our cardiology department and underwent coronary angiography from November 2019 to September 2020,including: hospitalization number,age,body mass index,past history,lipids,blood glucose,and left ventricular ejection fraction.Coronary angiography results and CPET assessment index were used as observation indexes.The selected patients were divided into non-coronary group and coronary group according to the coronary angiographic findings and the diagnostic criteria of coronary artery disease,and the coronary group was further divided into non-PCI group and PCI group,and the severity of coronary artery lesions and CPET assessment indexes of patients in the coronary group were retrospectively studied.To observe the correlation between the severity of coronary lesions(Gensini score)and the CPET assessment index in the coronary artery disease group.CPET assessment metrics include:peak oxygen uptake(VO2peak),peak oxygen uptake as a percentage of predicted value(VO2peak%pred),peak oxygen uptake per kilogram of body weight(VO2peak/Kg),peak metabolic equivalent(Peak Mets equivalent(Peak Mets),peak oxygen consumption plus(Peak O2 pulse),AT metabolic equivalent,VE/CO2 slope,andΔVO2/ΔWR were the main observations,which were statistically analyzed and correlations were derived.2.A total of 95 patients with coronary heart disease who underwent CPET in our hospital from November 2019 to September 2020 were selected,including 70 men and25 women with a mean age of(57.2±9.2)years.Dual antiplatelet agents,angiotensin converting enzyme inhibitor(ACEI)/angiotensin II receptor blocker(ARB),beta blockers and statins are routinely used for secondary prevention in patients without contraindications.Patients were divided into the group with reduced exercise tolerance(<5 METs)and the group with normal exercise tolerance(≥5 METs),using Peak Mets as the boundary,and comparing the general conditions such as age,sex,Body Mass Index BMI,resting heart rate,smoking history,previous medical history,cardiac ultrasound results,and medication treatment between the two groups.A binary logistic regression analysis was used to explore the influencing factors affecting exercise tolerance in patients with coronary artery disease.Results:1.There was a significant difference(p < 0.05)in Gensini score in the two groups of coronary artery disease.Gensini score was correlated with CPET assessment indexes VO2peak%pred VO2peak/Kg Peak Mets VE/VCO2 slope between the two groups,with significant negative correlations with VO2peak%pred VO2peak/Kg and Peak Mets were significantly negatively correlated(p < 0.005).2.Univariate correlation analysis showed that age,BMI,resting heart rate,history of smoking,history of hypertension,history of diabetes mellitus,left ventricular ejection fraction,and combined anterior descending branch lesions were significantly associated with exercise tolerance.A binary logistic regression analysis was performed with reduced exercise tolerance as the dependent variable and the above indicators of significance as independent variables.The results of the regression analysis suggested that age ≥65 years,resting heart rate,and history of diabetes mellitus were associated risk factors affecting reduced exercise tolerance in patients with coronary artery disease.Conclusion:1.CPET assessment index can predict the severity of coronary lesions;CPET assessment index is significantly correlated with Gensini score of coronary heart disease in patients with coronary heart disease;CPET assessment index can guide physicians to observe the prognosis of patients.2.Age ≥65 years,faster resting heart rate,and a history of comorbid diabetes are risk factors for reduced exercise tolerance in patients with coronary artery disease.