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

Journal of Clinical and Basic Cardiology 2009; 12 (1-4): 2-4

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Keywords: Kardiologie,  Koronare Herzkrankheit,  cardiopulmonary exercise test,  coronary artery disease,  Training

improving systems. Methods: Cardiopulmonary exercise test (CPET) parameters and simultaneous evaluation of myocardial ischemia were performed in 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) was significantly 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 increased stroke volume (related to the O2-P) together with the concomitant reduction in peak-HR, while allowing even higher cardiac output in these pts. Such an effect is metabolically energy-efficient for the ischemic myocardium and is sufficient to explain the improvement in cardiopulmonary function in CAD.