Clinical value of cardiopulmonary exercise testing in quantitative evaluation of cardiopulmonary function before and after percutaneous coronary intervention

Abstract:

Objective：To investigate the clinical value of symptom-limited cardiopulmonary exercise testing（CPET） in the quantitative evaluation of cardiopulmonary function before and after percutaneous coronary intervention（PCI）. Methods：A total of 12 healthy in－dividuals and 12 patients who were diagnosed with coronary heart disease by coronary angiography and planned to undergo PCI were enrolled，and CPET was performed for the quantitative evaluation of cardiopulmonary function before and after PCI. The CPET param－eters were interpreted by standardized analysis. Left ventricular ejection fraction（LVEF） was measured at the same time. The changes in CPET parameters after PCI and their correlation with LVEF were analyzed. Results：There was a significant change in LVEF after PCI（42.83%±5.92% vs. 45.08%±4.76%，P<0.05）. As for the core CPET parameters，compared with the normal control group，the pre-PCI group had significantly lower peak oxygen uptake（1.41±0.46 L/min vs. 1.99±0.19 L/min，P<0.05），anaerobic threshold（0.87±0.23 L/min vs. 1.22±0.19 L/min，P<0.05），peak oxygen pulse （11.43±3.29 mL/time vs. 14.18±2.59 mL/time，P<0.05），oxygen uptake efficiency plateau（40.13±5.18 vs. 47.10±4.44，P<0.05），peak load power（112.00±51.10 W vs. 162.00±17.60 W，P <0.05），and increasing power movement time（5.28±1.81 min vs. 6.47±0.80 min，P<0.05） and significantly higher slope of ventilatory equivalent for carbon dioxide（27.85±4.81 vs. 23.01±2.63，P<0.05） and mini－mum ventilatory equivalent for carbon dioxide（29.55±3.90 vs. 25.06±2.43，P<0.05）；in the post-PCI group，these parameters were 1.59±0.33 L/min，1.02±0.20 L/min，12.37±2.72 mL/time，39.20±5.60，26.93±2.88，29.30±2.82，132.00±31.70 W，and 6.21±1.05 min，respectively，and compared with the pre-PCI group，the post-PCI group had significant increases in peak oxygen uptake，anaerobic threshold，peak oxygen pulse，peak load power，and increasing power movement time（P<0.05），while there were no significant differences in oxygen uptake efficiency plateau，slope of ventilatory equivalent for carbon dioxide，and minimum ventilatory equivalent for carbon dioxide between the pre-PCI group and the post-PCI group（P>0.05）. The core CPET parameters were highly correlated with LVEF（absolute r value=0.579-0.908，all P<0.05）. Conclusion：The core CPET parameters can be used for noninvasive quanti－tative monitoring of changes in cardiopulmonary function after PCI and has a good clinical value.