| Objective:Objective To observe the changes of rate-pressure product(RPP)in patients with coronary atherosclerotic heart disease during treadmill exercise test,and to evaluate the value of RPP in evaluating the severity of coronary atherosclerotic heart disease.Subjects and method:According to the strict inclusion criteria and exclusion criteria,we chose to be hospitalized in the First Affiliated Hospital of China Medical University from 2014 to 2019,and needed coronary angiography because of chest distress,chest pain and other related symptoms and ECG indicating myocardial ischemia.The age,sex,rate-pressure product,blood lipid level,previous disease history,echocardiography and coronary angiography results of 87 patients without coronary atherosclerotic heart disease and 76 patients with coronary atherosclerotic heart disease were collected.The relationship between RPP and the degree of coronary artery disease was analyzed from three aspects:the number of coronary lesions,the degree of coronary lesions and Gensini scores.Spss22.0 was used for data statistical analysis.The mean x ± s standard deviation was used for measurement data.The number and percentage of cases were used for counting data.Independent sample t test was used for comparison between two groups.Variance analysis was used for comparison between multiple groups.LSD-t test was used for comparison between two groups.Rank sum test was used for Gensini score.Chi square test was used for comparison between groups.Pearon correlation was used The ROC curve was used to test the correlation between the parameters,and P < 0.05 was used to show the statistical significance.Results:1.The age,creatinine and Gensini scores of the coronary atherosclerotic heart disease group were higher than those of the control group,and the RPP of the control group was higher than that of the coronary atherosclerotic heart disease group,the difference was statistically significant(P<0.05).There was no significant difference between the control group and the coronary atherosclerotic heart disease group in gender,blood lipid level,FBG,BNU,Cys C,UA,CK,CK-MB,LDH,BNP,cTnI,left ventricular ejection fraction,hypertension history and diabetes history,antihypertensive drugs and heart rate lowering drugs between the control group and coronary atherosclerotic heartdisease group(P>0.05).2.The RPP of single lesion group was lower than that of control group [(21347.45±4804.27)bpm.mmhg vs.(22782.90±3412.73)bpm.mmhg,P<0.05];the RPP of multi lesion group was lower than that of control group [(19960.50±3500.63)bpm.mmhg vs.(22782.90±3412.73)bpm.mmhg,P<0.05].3.RPP in severe stenosis group was lower than that in control group [(19768.81 ±3532.25)bpm.mmhg vs.(22782.90 ± 3412.73)bpm.mmhg,P<0.05];RPP in severe stenosis group was lower than that in mild stenosis group [(19768.81 ± 3532.25)bpm.mmhg vs.(22373.15±5273.89)bpm.mmhg,P<0.05].4.Pearson correlation analysis showed that RPP was negatively correlated with age,gender,Plasma B-type natriuretic peptide,Gensini score,history of hypertension,number of lesions,and degree of lesions in patients with coronary atherosclerotic heart disease(correlation coefficients r were 0.213,0.217,0.181,0.153,0.261,0.235,0.294,respectively,P<0.05);RPP was positively correlated with TG,interventricular septal thickness,left ventricular posterior wall thickness,left ventricular end diastolic diameter,and left ventricular diastolic diameter in patients with coronary atherosclerotic heart disease.There was a positive correlation among the end volume,stroke volume and pulmonary valve velocity(r = 0.242,0.183,0.234,0.175,0.267,0.273 and 0.243,respectively,P<0.05).RPP had no significant correlation with TC,LDL-C,HDL-C,UA,Cr,Cys C,FBG,CK,CK-MB and cTnI(P>0.05).5.According to patients’ RPP level,there was no statistically significant difference in Gensini scores between groups D1,D2,D3 and D4(P>0.05).The difference in the number of lesions and the degree of stenosis in the four subgroups was statistically significant(P<0.05),and the difference in the number of lesions and the degree of stenosis in the D1 group was significantly higher than that in the D4 group(P<0.05).6.Using RPP to predict coronary atherosclerotic heart disease,draw ROC curve,the best critical value is 19242.5 bpm.mmHg,ROC curve shows that the area under the curve is0.612,the sensitivity is 85.1%,and the specificity is 39.5%.Conclusions : 1.RPP can be used as an auxiliary reference index of coronary atherosclerotic heart disease.2.RPP was negatively correlated with the degree and number of coronary artery lesions.3.RPP was negatively correlated with age and gender. |
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