Document Detail


Assessing Coronary Artery Disease in Patients With Anginal Chest Pain and Left Bundle Branch Block: An Emerging Role for a New Parameter of Cardiopulmonary Exercise Testing.
MedLine Citation:
PMID:  23149365     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Cardiopulmonary exercise testing (CPET) is used in cardiology to grade the severity of heart failure and to assess its prognosis. However, it is unknown whether CPET may be a useful technique to rule out coronary artery disease (CAD) in patients with anginal chest pain and left bundle branch block (LBBB). The aim of this investigation was to evaluate the diagnostic accuracy of CPET to identify CAD in these patients. A cohort of 90 patients with anginal chest pain, 45 with LBBB (group A) and 45 non-LBBB (group B), were studied with CPET and a single-photon emission computed tomographic myocardial perfusion study during the same period. The following variables of CPET were analyzed: peak oxygen uptake (VO2), VO2 at anaerobic threshold, and time to reach the anaerobic threshold (TAT). Group A values were lower compared with group B in peak VO2 (23 ± 6.2 vs. 28 ± 7.6 mLO2 · kg · min; P = 0.002), VO2 at anaerobic threshold (16.1 ± 3.6 vs. 18.9 ± 4.1 mLO2 · kg · min; P =0.001), and TAT (2.7 ± 0.96 vs. 4.4 ± 2.1 min; P < 0.001). Group A showed higher perfusion abnormalities in myocardial perfusion study than group B [27 (60%) vs. 12 (26.7%); P = 0.003]. Multivariate analysis showed that TAT (odds ratio = 1.59; 95% confidence interval, 1.06-2.39; P = 0.02) was the only independent predictor of CAD, after controlling for other factors. Receiver operator characteristic analysis showed an area under the curve of 0.78 for TAT (95% confidence interval, 0.68-0.86; P < 0.0001). In conclusion, our findings suggest that a new functional parameter such as TAT significantly predicts CAD in patients with anginal chest pain and LBBB.
Authors:
Alberto Dominguez-Rodriguez; Pedro Abreu-Gonzalez; Maria Angeles Gomez; Maria Del Carmen Garcia-Baute; Eduardo Arroyo-Ucar; Pablo Avanzas; Antonio Lara-Padron
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  11     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  214-217     Citation Subset:  -    
Affiliation:
From the *Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain; † Department of Physiology, University of La Laguna, Tenerife, Spain; ‡Department of Nuclear Medicine, Hospital Universitario de Canarias, Tenerife, Spain; and § Department of Cardiology, Hospital Central de Asturias, Oviedo, Spain.
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