Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/213278 |
Resumo: | 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 O2 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 O2 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 O2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography. |
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Clinics |
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Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluationCardiopulmonary exercise testingOxygen uptake efficiency slopeExercise capacityMyocardial ischemiaObjectives: 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 O2 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 O2 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 O2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2022-02-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21327810.1016/j.clinsp.2021.100003Clinics; v. 77 (2022); 100003Clinics; Vol. 77 (2022); 100003Clinics; Vol. 77 (2022); 1000031980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/213278/195239Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessAssumpção, Camila R.A. dePrado, Danilo M.L. doJordão, Camila P.Dourado, Luciana O.C.Vieira, Marcelo L.C.Montenegro, Carla G. de S.P.Negrão, Carlos E.Gowdak, Luís H.W.Matos, Luciana D.N.J. De2023-06-17T22:02:50Zoai:revistas.usp.br:article/213278Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-06-17T22:02:50Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
title |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
spellingShingle |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation Assumpção, Camila R.A. de Cardiopulmonary exercise testing Oxygen uptake efficiency slope Exercise capacity Myocardial ischemia |
title_short |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
title_full |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
title_fullStr |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
title_full_unstemmed |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
title_sort |
Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation |
author |
Assumpção, Camila R.A. de |
author_facet |
Assumpção, Camila R.A. de Prado, Danilo M.L. do Jordão, Camila P. Dourado, Luciana O.C. Vieira, Marcelo L.C. Montenegro, Carla G. de S.P. Negrão, Carlos E. Gowdak, Luís H.W. Matos, Luciana D.N.J. De |
author_role |
author |
author2 |
Prado, Danilo M.L. do Jordão, Camila P. Dourado, Luciana O.C. Vieira, Marcelo L.C. Montenegro, Carla G. de S.P. Negrão, Carlos E. Gowdak, Luís H.W. Matos, Luciana D.N.J. De |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Assumpção, Camila R.A. de Prado, Danilo M.L. do Jordão, Camila P. Dourado, Luciana O.C. Vieira, Marcelo L.C. Montenegro, Carla G. de S.P. Negrão, Carlos E. Gowdak, Luís H.W. Matos, Luciana D.N.J. De |
dc.subject.por.fl_str_mv |
Cardiopulmonary exercise testing Oxygen uptake efficiency slope Exercise capacity Myocardial ischemia |
topic |
Cardiopulmonary exercise testing Oxygen uptake efficiency slope Exercise capacity Myocardial ischemia |
description |
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 O2 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 O2 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 O2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-02-05 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213278 10.1016/j.clinsp.2021.100003 |
url |
https://www.revistas.usp.br/clinics/article/view/213278 |
identifier_str_mv |
10.1016/j.clinsp.2021.100003 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213278/195239 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; v. 77 (2022); 100003 Clinics; Vol. 77 (2022); 100003 Clinics; Vol. 77 (2022); 100003 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1787713183377522688 |