Quantification of coronary artery disease using different modalities of cardiopulmonary exercise testing

Background:This study examined the accuracy of cardiopulmonary exercise testing (CPET) on a treadmill (TM)and recumbent ergometry (RE) in the predicting coronary artery disease (CAD) severity and prognosis.Methods:Forty Caucasian subjects, mean age 63.5 ± 7.6, with significant coronary artery lesions (≥50%) were in-cluded. Within two months of coronary angiography, TM and RE CPET were performed on two visits 2–4daysapart and subsequently followed up to 32 ± 10 months.Results:Mean left ventricular ejection fraction was 56.7 ± 9.6%. TM CPET exhibited a higher occurrence of STsegment depression≥1 mm (71.05% vs 28.95%,p= 0.04). Subjects with 1–2 stenotic coronary arteries (SCA)demonstrated a better CPET response compared to those with 3-SCA. ROC analysis revealed a high predictivevalue for the ventilation/carbon dioxide production (VE/VCO2) slope obtained on TM (area 0.84,p=0.003,Sn88.9%, Sp 72%) in distinguishing between 1 and 2-SCA and 3-SCA. Among all CPET parameters, work efficiency(ΔVO2/ΔWR) during RE predicted cumulative cardiac events (pb0.01).Conclusions:CPET parameters hold predictive value for CAD severity and prognosis. CPET on a TM appears to bemore reliable in the quantification of CAD compared to RE.