The Effect Of Cardiopulmonary Exercise Test On The Diagnosis Of Coronary Heart Disease And Evaluation Of Severity Of Coronary Heart Disease

ObjectiveThe objective of this study was to investigate the effect on diagnosis of coronary heart disease and evaluation of severity of coronary heart disease with the kinetics of oxygen uptake(VO₂),anaerobic threshold(AT) and cardiopulmonary functional capacity during the onset of exercise in patients with chest pain.MethodsTreadmill graded exercise tests with gas analysis,ultrasound cardiography,coronary angiography were conducted on sixty-eight patients with chest pain. According to the result of coronary angiography,sixty-eight patients were divided into coronary heart disease group(39) a non coronary heart disease group(29).The thirty-nine coronary heart disease patients were divided into PCI group(14) and non PCI group(25).Evaluate the differences of cardiopulmonary function between groups.ResultsCompared with non coronary heart disease group,coronary heart disease group showed statistical significance in VO₂peak[(20.67±6.01)vs.(26.63±4.51) ml/kg/min,P＜0.001],VCO₂[(1.34±0.52)vs.(1.72±0.49) 1/min,P＜0.01],AT[(1.21±0.36)vs.(1.48±0.32) I/min,P＜0.01],O₂-pulse peak[(10.39±3.04)vs. (12.33±2.53) ml/beat,P＜0.01],VT[(1.37±0.43)vs.(1.56±0.32) L,P＜0.05]and VE/VCO₂@AT[(31.18±4.79)vs.(28.88±4.04),P＜0.05].As a predicted index to diagnosis of coronary heart disease,O₂-pulse peak ratio has sensitivity of 51.28% (20/39) and specificity of 75.86%(22/29).Compared with non coronary heart disease group,non PCI group showed statistical significance in VO₂peak,VCO₂,AT,O₂ pulse peak,PCI group not only shown showed statistical significance in VO₂peak,VCO₂,AT,O₂ pulse peak,but also showed statistical significance in HR peak[(120.50±14.00)vs.(139.03±18.97) beats/min,P＜0.01],VE/VCO₂@AT[(31.23±4.89)vs.(28.88±4.04),P＜0.05]and VD/VT(Est) @Peak[(0.21±0.05)vs.(0.17±0.03),P＜0.01].Compared with non PCI group,PCI group showed statistical significance in VD/VT(Est) @Peak.Conclusions1,VO₂peak,AT and O₂ pulse peak have clinical value in diagnosis of coronary heart disease in patients with chest pain..2,O₂-pulse peak has the most sensitive and special in the indexes of CPET.3,HR peak,VE/VCO₂@AT and VD/VT(Est)@Peak clinical value in evaluating the severity of coronary heart disease.