The Diagnostic Value Of Cardiopulmonary Exercise Testing Combined With Treadmill Exercise Test In Patients With Coronary Heart Disease

Objective:Coronary angiography?CAG?results were used as a standard for the diagnosis of coronary heart disease?CHD?.The diagnostic value of the cardiopulmonary exercise test?CPET?and the treadmill exercise test?TET?were combined in patient with coronary heart disease,as well as the value of oxygen uptake dynamics in CPET for the diagnosis of coronary heart disease.Methods:150 patients with suspected coronary heart disease were enrolled in the affiliated hospital of Hangzhou Normal University during 2016.09-2018.12.The treadmill exercise test,cardiopulmonary exercise testing and coronary angiography were performed respectively?interval less than two weeks?.The patients were divided into coronary heart disease group and non-coronary heart disease group based on the results of coronary angiography.The coronary heart disease group was further divided into single-vessel disease group,multi-vessel disease group.The sensitivity,specificity and accuracy of CPET and TET for CHD diagnosis were analyzed,the detection rate of single-vessel coronary artery and the detection rate of multi-vessel coronary artery by CPET and TET respectively;CPET and TET were analyzed by series way and parallel way respectively.Sensitivity,specificity,and accuracy of serial and parallel tests for the diagnosis of CHD?In serial way result of diagnosis is viewed as positive only when all results are positive;In parallel way,result of diagnosis is viewed as positive when one result is positive but negative only when the two results are negative?;peak oxygen uptake?V'O₂ peak?and peak oxygen pulse?O₂ pulsepeak?were performed between CHD and non-CHD groups.At last,oxygen pulse as a percentage of predicted value?O₂ pulse peak%pred?,anaerobic threshold?AT?,peak oxygen uptake as a percentage of predicted value?VO₂Peakpred?and other indicators were compared between CHD and non-CHD groups.Results:1.The sensitivity of CPET for diagnosis of CHD is 63.64%,the specificity is88.68%,the accuracy rate is 81.33%,the detection rate of single-vessel disease is25.00%,and the detection rate of multi-vessel disease is 72.22%;while the sensitivity of for diagnoses CHD is 68.18%,the specificity is 83.02%,the accuracy rate is 78.67%,the detection rate of single-vessel disease is 37.50%,and the detection rate of multi-vessel disease is 75.00%.The specificity of CHD diagnosis was 94.34%,the accuracy rate is 81.33%in serial way,and the sensitivity of parallel diagnosis of CHD is 81.82%.2.In the CPET oxygen uptake dynamics indexs,the O2 pulse peak,O2 pulse peak%pred,V'O2/V'O2max,V'O2peak,V'O2Peak%pred in the CHD group were significantly lower than those in the non-CHD group.There were significant differences in the analysis?P<0.05?.The ratios of V'O2/V'O2max,V'O2Peak%pred and O2pulse peak%pred were used as predictors for CHD,among which V'O2/V'O2max?40%as a predictor of CHD with a specificity of 98.11%.Conclusion:1.CPET and TET have high sensitivity and specificity in the diagnosis of CHD.With the increase of the number of coronary lesions,the detection rate of coronary heart disease by two methods is increasing.The specificity and accuracy of CPET and TET in the diagnosis of CHD by serial research were 94.34%and 81.33%,respectively,which could significantly reduce the rate of misdiagnosis.The sensitivity of the parallel study method for diagnosing CHD was 81.82%,which could reduce the rate of missed diagnosis.