Combined Cardiopulmonary Exercise Testing and 99mTC Sestamibi Myocardial Imaging in Trained vs Untrained Patients with Coronary Artery Disease

[摘要] improving systems. Methods: Cardiopulmonary exercise test (CPET) parameters and simultaneous evaluation of myocardial ischemia were performedin 15 trained and 20 untrained pts with CAD and 9 control subjects without coronary disease. The degree of ischemia was evaluated in all 44 subjects,using a 99m sestamibi myocardial perfusion imaging carried out simultaneously with the CPET. Results: Peak oxygen consumption (peak-V.O2) wassignificantly higher (p < 0.001) and the ischemia score was significantly lower (p < 0.001) in the trained pts (1989 ± 422 ml/min and 0.8 ± 0.65,respectively) than in untrained pts (1608 ± 296 ml/min and 1.79 ± 0.95, respectively). The peak oxygen pulse (peak-O2-P) was significantly higher(139 ± 29 % vs 94 ± 11 % of predicted values; p < 0.001) and the decrease in peak heart rate (peak-HR) was also more marked in the trained group(70 ± 11 % vs 84 ± 9 % of predicted values; p < 0.001). Conclusion: The improvement in ischemia score in the trained pts correlates with increasedstroke volume (related to the O2-P) together with the concomitant reduction in peak-HR, while allowing even higher cardiac output in these pts. Suchan effect is metabolically energy-efficient for the ischemic myocardium and is sufficient to explain the improvement in cardiopulmonary function in CAD.

[学科分类] 心脏病和心血管学

[关键词] Kardiologie;Koronare Herzkrankheit;cardiopulmonary exercise test;coronary artery disease;Training