Evaluation Of The Value Of Cardiopulmonary Exercise Test In The Diagnosis Of Coronary Heart Disease In The Old People

Background: Coronary heart disease is a chronic disease that seriously affects human health and has the characteristics of high morbidity and high mortality.The top ten causes of death in the world published in the Lancet magazine in 2015 show that ischemic heart disease ranks first.Far more than cancer and other diseases.At the beginning of the disease,it is usually in a compensatory state in the resting state and a series of pathophysiological changes in the exercise state.Although coronary angiography is still the gold standard for the diagnosis of coronary heart disease,the invasive and expensive operation restricts it as a routine method for screening coronary heart disease.Although the traditional electrocardiogram exercise test has been widely applied in clinical practice It is used to evaluate myocardial ischemia,but it can not evaluate the changes of cardiopulmonary function caused by myocardial ischemia and heart failure.Especially for the elderly,more complicated with cardiopulmonary disease and less tolerant to invasive operation,a non-invasive examination method is needed to evaluate the overall cardiopulmonary function.Cardiopulmonary exercise test(CPET)assesses cardiopulmonary disease as a whole,and with its advantages of noninvasive,high sensitivity,high reproducibility and relatively low cost,it is widely used in scientific research and clinical practice,and is expected to be used in the diagnosis of coronary heart disease.To guide the formulation of treatment plans,judgment of prognosis,development of rehabilitation programs and other important new methods.Objective: To observe the relevant data of cardiopulmonary exercise test in elderly patients with coronary heart disease(CHD),to understand the value of cardiopulmonary exercise test in the diagnosis and evaluation of coronary artery disease(CHD),and to compare it with the golden standard of coronary angiography(CAG).To provide reference for early diagnosis of myocardial ischemia.Methods: From October 2016 to October 2018,91 elderly patients with chest pain and chest tightness were analyzed retrospectively.Coronary angiography and CPET,were performed according to the results of coronary angiography.They were divided into coronary heart disease group(64 cases)and non-coronary disease group(27 cases).To compare the CPET-related core data between the two groups,and to compare the changes of CPET-related core data before and after PCI in 7 patients with coronary heart disease(CHD).Descriptive analysis,t-test,chi-square test,small sample SW normality test and rank sum test were used for statistical analysis.Results: The results of CPET showed that the VO2 max,HR Max,VO2/HR Max,AT,AT/kg,d02/d W@AT in CHD group was lower than that in non-CHD group,and the Eq O2,Eq CO2,Eq02@AT,Eq C02@AT in CHD group was higher than that in non-CHD group.There was significant difference between the two groups(P < 0.05).There was no significant difference in MV,VC Max,V'O2/V02 max between the two groups(P > 0 05).In patients with coronary heart disease,AT,AT/kg after PCI was improved compared with pre-operation.There was no significant difference between V'O2/V02 max,d02/d W@AT,Eq02@AT,Eq C02@AT and preoperative.Conclusion:The core indexes of CPET can be used to quantitatively assess the cardiopulmonary function of the elderly patients with coronary heart disease,so as to diagnose coronary heart disease early,and to provide help for cardiac rehabilitation after PCI.It has good clinical application value.