Evaiuation Of The Value Of Treadmill Exercise Test On The Patients Of Percutanenous Coronary Intervention To Chronic Total Occlusion

Objective To evaluate the value of treadmill exercise test(TET) on the patients of percutanenous coronary intervention to chronic total occlusion. Methods 247 cases of CTO patients diagnosed by Coronary angiography were selected in this evaluation. Before intervention, they were examined by using TET and were divided into two groups, namely TET positive and TET negative. Each group was divided into two subgroups according to the patency of the artery with CTO after PCI. Group A:TET positive, patency after PCI. Group B:TET positive, no patency after PCI. Group C:TET negative, patency after PCI. Group D:TET negative, no patency after PCI. The patients were followed for one year after PCI. They were graded in angina pectoris by applying CCs Standard (CCSS) and were graded in cardiac function by applying NYHA Standard (NYHAS) respectively. Their changes in echocardiography were observed (including left ventricular ejection fractions and left ventricular end diastolic diameter). The accumulated major adverse cardiovascular events (MACE) were assessed (including the death of cardiovascular disease, non-fatal myocardial infarction, congestive heart failure,TVR).Results All the patients were followed for one year. The grading of the angina pectoris in Group A was lower than that in Group B [1.8±0.5,3.6±0.8;P< 0.05].The cardiac function by applying NYHA Standard in Group A were better than that in Group B[1.6±0.3,3.3±0.6;P< 0.05].The left ventricular end diastolic diameter in Group A was shorter than that in Group B [(47.6±6.2) mm, (59.9±7.1) mm;P< 0.05]. The left ventricular ejection fractions in Group A were higher than that in Group B [(58.13±11.70) %, (42.73±9.88)%;P< 0.05]; The difference of MACE rate between Group A and Group B [13.4%,17.3%;P< 0.05] was not significant. The difference of the grading in angina pectoris and cardiac function between Group C and Group D was not significant (P> 0.05);The left ventricular end diastolic diameter in Group C was shorter than that in Group D [(46.6±6.1) mm, (55.4±6.9) mm;P < 0.05]. The difference of MACE rate between Group C an Group D [12.2%,12.5%;P> 0.05]was not significant. The grading of the angina pectoris in Group C was lower than that in Group B [1.1±0.4,3.6±0.8;P< 0.05]; The cardiac function by applying NYHA Standard in Group C were better than that in Group B[1.5±0.6,3.3±0.6;P< 0.05]; The left ventricular end diastolic diameter in Group C was shorter than that in Group B [(46.6±6.1) mm, (59.9±7.1) mm;P< 0.05]. The left ventricular ejection fractions in Group C were higher than that in Group B [(59.60±10.65)%, (42.73±9.88)%;P< 0.05]. The difference of MACE rate between Group C and Group B [12.2%,17.3%;P> 0.05] was not significant. Followed for one year we can see that Duke score was increased,[(-12.7±5.6), (-1.6±0.3);P<0.05] exercise tolerance was improved[(5.2±1.3), (12.6±1.2);P<0.05],ST segment was reduced [(3.2±0.5) mm, (1.1±0.2) mm;P<0.05] and the positive rate of TET was dropped [100%,48.6%;P<0.05] in Group A.The differences were significant; while the other groups did not change significantly (P> 0.05).Conclusion TET can effectively evaluate the therapeutic effect of PCI for the patients with CTO.