Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation.

Autor: de Assumpção CRA; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., do Prado DML; ULTRA Exercise Physiology Laboratory, São Paulo, SP, Brazil., Jordão CP; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Dourado LOC; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Vieira MLC; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Montenegro CGSP; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Negrão CE; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Escola de Educação Fisica e Esporte, Universidade de São Paulo, São Paulo, SP, Brazil., Gowdak LHW; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., De Matos LDNJ; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. Electronic address: luciana.matos@einstein.br.
Jazyk: angličtina
Zdroj: Clinics (Sao Paulo, Brazil) [Clinics (Sao Paulo)] 2022 Feb 05; Vol. 77, pp. 100003. Date of Electronic Publication: 2022 Feb 05 (Print Publication: 2022).
DOI: 10.1016/j.clinsp.2021.100003
Abstrakt: Objectives: Refractory angina (RA) is a chronic condition clinically characterized by low effort tolerance; therefore, physical stress testing is not usually requested for these patients. Cardiopulmonary exercise testing (CPET) is considered a gold standard examination for functional capacity evaluation, even in submaximal tests, and it has gained great prominence in detecting ischemia. The authors aimed to determine cardiorespiratory capacity by using the oxygen consumption efficiency slope (OUES) in patients with refractory angina. The authors also studied the O 2 pulse response by CPET and the association of ischemic changes with contractile modifications by exercise stress echocardiography (ESE).
Methods: Thirty-one patients of both sexes, aged 45 to 75 years, with symptomatic (Canadian Cardiovascular Society class II to IV) angina who underwent CPET on a treadmill and exercise stress echocardiography on a lower limb cycle ergometer were studied. ClinicalTrials.gov: NCT03218891.
Results: The patients had low cardiorespiratory capacity (OUES of 1.74 ± 0.4 L/min; 63.9±14.7% of predicted), and 77% of patients had a flattening or drop in O 2 pulse response. There was a direct association between Heart Rate (HR) at the onset of myocardial ischemia detected by ESE and HR at the onset of flattening or drop in oxygen pulse response detected by CPET (R = 0.48; p = 0.019).
Conclusion: Patients with refractory angina demonstrate low cardiorespiratory capacity. CPET shows good sensitivity for detecting abnormal cardiovascular response in these patients with a significant relationship between flattening O 2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography.
Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest.
(Copyright © 2021. Published by Elsevier España, S.L.U.)
Databáze: MEDLINE
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