Characteristics Of Cardiopulmonary Exercise Test Indexes In Patients With Coronary Microvascular Disease

ObjectiveCardiopulmonary exercise testing?CPET?is a method comprehensively assessing cardiopulmonary function,which through dynamically examining metabolic index,ventilation index and changes in ECG under a specific increasing load of power.CPET has been applied more and more widely in cardiovascular diseases,especially in the field of coronary atherosclerotic heart disease?CHD?.However,there are a few domestic and international studies on coronary microvascular disease.The purpose of this study is to investigate the characteristics of cardiopulmonary cardiopulmonary exercise test indexes inpatients with coronary microvascular disease by comparing with the indexes of cardiopulmonary exercise testing.There were 60 patients who were diagnosed and met standards by hospital from October 2013 to October 2017,divided into three groups,including the coronary microvascular disease group?group CMVD?,the coronary atherosclerotic heart disease group?group CHD?and the control group.There were 20 cases in group CMVD,of which 12 were males,8 were females.The age of the patients was between 37 and 78and the average age was 59.85±11.03.There were 20 cases in group CHD,of which 16were males,4 were females.The age of the patients was between 42 and 82 and the average age was 66.8±9.23.At the same time,there were 20 cases in group CHD,of which 10 were males,10 were females.The age of the patients was between 49 and 73and the average age was 56.95±6.77.All subjects had complete general baseline data,clinical data,and finished the electrocardiograph?ECG?,single-photon emission computed tomography?SPECT?,CPET and coronary angiography?CAG?.Group CMVD`s patients had typical symptoms of chest pain after activity,and ECG changes of myocardial ischemia at the chest pain.At the same time,the stenosis of coronary artery was<50%,but SPECT showed that there were varying degree of myocardial ischemia.Group CHD`s patients had typical symptoms of chest pain after activity,and ECG changes of myocardial ischemia at the chest pain.At the same time,CAG was positive,that the stenosis of coronary artery was?50%,and SPECT showed that there were varying degree of myocardial ischemia.In the control group,patients had typical symptoms,and ECG had no changes of myocardial ischemia at the chest pain and rest.In addition,both CAG and SPECT were negative.SPSS 24 software was used for statistical analysis.The parameters between the two groups were compared by independent-samples t test,non-parameters rank sum test,chi-square test,continue correction of chi-square or Fisher exact method.If P<0.05,the difference was statistically significant.Results1.Comparison of basic conditions:?Comparison of basic conditions between group CMVD and the control group:there were no statistical difference except for LAD?P<0.05?.?Comparison of basic conditions between group CHD and the control group:there were no statistical difference except for hypertension,BNP,cTnI,LDL-C,HDL-C,HbA1c and LAD?P<0.05?.?Comparison of basic conditions between group CMVD and CHD:there were no statistical difference except for age,BNP and cTnI?P<0.05?.2.Comparison of indicators of CPET:?Comparison of indexes of CPET between group CMVD and the control group:there were no statistical difference except for time,VO₂max,VO₂/kg,MET and BR?P<0.05?.?Comparison of indexes of CPET between group CHD and the control group:there were no statistical difference except for time,VO₂max,VO₂/kg,AT,VO₂/HR,HRR,RPP,RQ,BR and MET?P<0.05?.?Comparison of indexes of CPET between group CMVD and CHD:there were nostatisticaldifferenceexceptfortime,VO2max,VO2/kg,AT,METand V_E/VCO₂?P<0.05?.3.All patients did not have malignant arrhythmia,syncope,cardiacarrest and other adverse events during the cardiopulmonary exercise test.Conclusion1.The exercise tolerance has declined in patients with coronary microvascular disease when they keep under normal cardiac function.It is reflected in declining of VO₂max,VO₂/kg and MET.2.The cardiopulmonary exercise test provides a reference for the diagnosis of coronary microvascular disease.There are more meaningful in VO2max,VO2/kg and MET.But further research is needed to determine the reference value.