| Objective:The characteristics of cardiopulmonary exercise test(CPET)in patients with coronary atherosclerotic heart disease(CHD)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS)have been analyzed in order to have a better understanding of the effect of OSAHS on the occurrence and development of CHD and improve clinicians’ understanding of patients with CHD complicated with OSAHS.Methods:Patients who were diagnosed with CHD by coronary angiography(CAG)in the Department of Cardiology,Ninth Clinical Medical College of Shanxi Medical University from November 2021 to October 2022 were selected.Finally,70 patients who also underwent CPET and respiratory sleep monitoring were selected,including 53 men and17 woman with an average age of 56.60 ± 9.86 years.According to the results of respiratory sleep monitoring to determine whether the patients had OSAHS syndrome,the selected CHD patients were divided into OSAHS group and non-OSAHS group,including 37 cases in OSAHS group and 33 cases in non-OSAHS group.Baseline data were collected for all patients during hospitalization,including general information: age,sex,body mass index,smoking history,alcohol history,hypertension history,diabetes history,CHD family history,previous coronary intervention,oral drugs,etc.Clinical laboratory indexes includes: hemoglobin(Hb),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood creatinine(s Cr),blood urea nitrogen(BUN),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),homocysteine(HCY),et.Colour Doppler echocardiography indicators includes: left ventricular end diastolic diameter(LVEDD),left atrial inner diameter(LAID),right ventricular inner diameter(RVID),left ventricular ejection fraction(LVEF)and Coronary Artery Gensini score which is calculated based on the results of CAG.We also collected patients’ CPET indicators,including peak metabolic equivalent(Peak Mets),peak oxygen uptake(Peak VO2),percentage of peak oxygen uptake to expected value(Peak VO2%Pred),peak oxygen uptake per kilogram of body weight(VO2 peak/Kg),peak oxygen pulse(Peak O2 pulse),peak blood pressure,peak heart rate,heart rate reserve,respiratory reserve,metabolic equivalent(AT),VE/VCO2 slope and ΔVO2/ ΔWR.Statistical analysis is used to compare data between two groups.The factors affecting exercise tolerance index Peak VO2%Pred in CHD patients were explored through multiple stepwise regression.Results:Compared with the baseline data between OSAHS and non-OSAHS groups,the results of ALT,AST,and RVID were significantly different in two group(P <0.05);There were no significant differences in other general data,laboratory indicators,Colour Doppler echocardiography indicators,and Gensini scores(P>0.05).The indicators of CPET between the two groups showed that there was a statistically significant difference in Peak VO2%Pred,heart rate reserve,and △VO2/△WR(P<0.05).The heart rate reserve in the OSAHS group was higher than that in the non-OSAHS group,while Peak VO2%Pred,and △ VO2/△ WR were lower.There was no significant difference in other CPET indicators(P<0.05).Univariate linear regression analysis was conducted on the exercise tolerance index Peak VO2%Pred in patients with CHD,and Multiple stepwise regression was used for indicators with statistically significant differences.The results showed that age,OSAHS and smoking history were independently correlated with Peak VO2%Pred levels in CHD patients.OSAHS and smoking history were independently negatively associated with the decreased of exercise tolerance indicators Peak VO2%Pred levels in CHD patients.Conclusion:1.CHD patients with OSAHS had higher heart rate reserve levels,and lower levels of Peak VO2%Pred and △VO2/△WR.2.In patients with CHD,OSAHS was independently and negatively correlated with index Peak VO2%Pred.3.Patients with CHD should be actively screened and treated for OSAHS. |
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