Utility of the oxygen pulse in the diagnosis of obstructive coronary artery disease in physically fit patients

Cardiopulmonary exercise testing (CPET) guidelines recommend analysis of the oxygen (O2) pulse for a late exercise plateau in evaluation for obstructive coronary artery disease (OCAD). The diagnostic performance of the O2 pulse for OCAD in physically fit individuals, in whom may be more likely to plateau, has not previously been evaluated. We found that a plateau in O2 pulse was not a useful predictor of OCAD in a physically fit population and may reflect a physiologic limitation of stroke volume and/or O2 extraction during exercise rather than a pathologic fall in stroke volume due to ischemia. AbstractCardiopulmonary exercise testing (CPET) guidelines recommend analysis of the oxygen (O2) pulse for a late exercise plateau in evaluation for obstructive coronary artery disease (OCAD). However, whether this O2 pulse trajectory is within the range of normal has been debated, and the diagnostic performance of the O2 pulse for OCAD in physically fit individuals, in whom may be more likely to plateau, has not been evaluated. Using prospectively collected data from a sports cardiology program, patients were identified who were free of other cardiac disease and underwent clinically-indicated CPET within 90  days of invasive or computed tomography coronary angiography. The diagnostic performance of quantitative O2 pulse metrics (late exercise slope, proportional change in slope during late exercise) and qualitative assessment for O2 pulse plateau to predict OCAD was assessed. Among ...
Source: Physiological Reports - Category: Physiology Authors: Tags: ORIGINAL ARTICLE Source Type: research