Predictive Value of Cardiopulmonary Exercise Testing Parameters in Patients under PCI with High Pulse Pressure

Abstract Background and objective: The correlation of cardiopulmonary exercise testing (CPET) parameters and the prognosis of coronary artery disease (CAD) patients with high pulse pressure (PP) is uncertain. Present study evaluated the association and prognosis value of CPET parameters in high PP patients. Methods: Patients with CAD who underwent percutaneous coronary intervention (PCI) and CPET were enrolled. Enrolled patients were divided into two groups according to PP after admission: high PP group and normal PP group. The primary endpoint was major adverse cardiovascular events (MACE). Cox regression analysis and univariate receiver operating characteristic (ROC) curves were used to identify optimal predictors of MACE. Results: 111 patients with MACE occurred. Compared with the normal PP group, participants in the high PP group showed higher incidence of MACE (4.86% vs. 2.68%, P =0.005). In high PP group, patients had significantly lower peak heart rate, lower peak oxygen pulse, lower breathing reserve whereas higher ventilatory equivalents for carbon dioxide (VE/VCO₂). Peak VO₂ (HR 0.94, 95% CI 0.88 to 1.00, P = 0.038) and VE/VCO₂ (HR 1.08, 95% CI 1.02 to 1.15, P = 0.007) were identified as significant predictive factors through multifactorial analysis. The area under the curve (AUC) of VE/VCO₂ and peak VO₂ were 0.62 (95% CI 0.557 to 0.673) and 0.58 (95% CI 0.515 to 0.634), respectively. Conclusions: The prognosis of CAD patients with high PP was worse compared to the patients with normal PP. The peak VO₂ and VE/VCO₂ were predictors of prognosis of CAD patients with high PP.