Cardiopulmonary exercise testing and impedance cardiography in the assessment of exercise capacity of patients with coronary artery disease early after myocardial revascularization

• Published in: BMC sports science, medicine & rehabilitation medicine & rehabilitation, 2022-07, Vol.14 (1), p.1-134, Article 134
• Main Authors: Kurpaska, Małgorzata, Krzesiński, Paweł, Gielerak, Grzegorz, Gołębiewska, Karina, Piotrowicz, Katarzyna
• Format: Article
• Language: English
• Subjects: Anaerobic threshold; Analysis; Atherosclerosis; Blood pressure; Body mass index; Cardiac rehabilitation; Cardiovascular disease; Chronic obstructive pulmonary disease; Coronary artery disease; Coronary heart disease; Coronary vessels; Diabetes; Dyspnea; Exercise; Exercise capacity; Heart beat; Heart rate; Hemodynamic parameters; Hemodynamics; Hypertension; Medical research; Medicine, Experimental; Mortality; Patients; Rehabilitation; Type 2 diabetes; Vein & artery diseases; Workloads
• ISSN: 2052-1847; 2052-1847
• DOI: 10.1186/s13102-022-00527-w

Background Patients with coronary artery disease (CAD) are characterized by different levels of physical capacity, which depends not only on the anatomical advancement of atherosclerosis, but also on the individual cardiovascular hemodynamic response to exercise. The aim of this study was evaluating the relationship between parameters of exercise capacity assessed via cardiopulmonary exercise testing (CPET) and impedance cardiography (ICG) hemodynamics in patients with CAD. Methods Exercise capacity was assessed in 54 patients with CAD (41 men, aged 59.5 [+ or -] 8.6 years) within 6 weeks after revascularization by means of oxygen uptake (VO.sub.2), assessed via CPET, and hemodynamic parameters [heart rate (HR), stroke volume, cardiac output (CO), left cardiac work index (LCWi)], measured by ICG. Correlations between these parameters at anaerobic threshold (AT) and at the peak of exercise as well as their changes ([DELA]peak-rest, [DELA]peak-AT) were evaluated. Results A large proportion of patients exhibited reduced exercise capacity, with 63% not reaching 80% of predicted peak VO.sub.2. Clinically relevant correlations were noted between the absolute peak values of VO.sub.2 versus HR, VO.sub.2 versus CO, and VO.sub.2 versus LCWi (R = 0.45, p = 0.0005; R = 0.33, p = 0.015; and R = 0.40, p = 0.003, respectively). There was no correlation between AT VO.sub.2 and hemodynamic parameters at the AT time point. Furthermore [DELA]VO.sub.2 (peak-AT) correlated with [DELA]HR (peak-AT), [DELA]CO (peak-AT) and [DELA]LCWi (peak-AT) (R = 0.52, p < 0.0001, R = 0.49, p = 0.0001; and R = 0.49, p = 0.0001, respectively). [DELA]VO.sub.2 (peak-rest) correlated with [DELA]HR (peak-rest), [DELA]CO (peak-rest), and [DELA]LCWi (peak-rest) (R = 0.47, p < 0.0001; R = 0.41, p = 0.002; and R = 0.43, p = 0.001, respectively). Conclusion ICG is a reliable method of assessing the cardiovascular response to exercise in patients with CAD. Some ICG parameters show definite correlations with parameters of cardiovascular capacity of proven clinical utility, such as peak VO.sub.2. Keywords: Hemodynamic parameters, Coronary artery disease, Exercise capacity, Cardiac rehabilitation