Cardiopulmonary exercise testing and efficacy of percutaneous coronary intervention: a substudy of the ORBITA trial

Figures

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  Figure 1. Relationship between the presence of an O2-pulse plateau and severity of ischaemia. Relationship between the presence of an oxygen-pulse plateau and (A) DSE score, (B) FFR, and (C) iFR. Data are presented as mean with error bars indicating standard error values. DSE, Dobutamine stress echocardiography; FFR, fractional flow reserve; iFR, instantaneous wave-free ratio; and O2, oxygen. P values were calculated from the regression model which was adjusted for age, weight, height, and sex.

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  Figure 2. Relationship between pre-randomization peak VO2 and pre-randomization FFR (A), iFR (B) and DSE score (C). Data are presented as mean with error bars indicating standard error values. DSE, dobutamine stress echocardiography; FFR, fractional flow reserve; iFR, instantaneous wave-free ratio; O2, oxygen; OUES, oxygen uptake efficiency slope; VE/VCO2: Minute ventilation to carbon dioxide VO2: oxygen uptake P values were calculated from the regression model which was adjusted for age, weight, height, and sex.

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  Figure 3. Relationship between pre-randomization peak VO2 and pre-randomization patient-reported and physician-assessed anginal symptoms including exercise time (A), EQ-5D-5L VAS (B), SAQ angina frequency score (C), SAQ angina physical limitation score (D), SAQ quality of life score (E) and CCS angina class (F). The shaded area represents the 95% CI for the estimate of this mean effect. Higher scores on the questionnaires indicate a better angina health status and quality of life. CCS indicates Canadian Cardiovascular Society; EQ-5D-5L indicates five level version of EuroQol 5 dimensions; QOL, quality of life; SAQ, Seattle Angina Questionnaire; VAS, visual analogue score; VO2, oxygen uptake. P values were calculated from the regression model which was adjusted for age, weight, height, and sex.

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  Figure 4. Interaction between pre-randomization O2-pulse plateau gradient and the efficacy of placebo-controlled PCI on ORBITA endpoints. The shaded area represents the 95% CI for the estimate of this mean effect. In panels 4A, 4B, 4E, 4F, and 4H, the vertical axis shows the absolute improvement or worsening with PCI over placebo where an unweighted linear regression model was used to calculate the improvement or worsening in dobutamine stress echocardiography (DSE) scores, SAQ physical-limitation score, SAQ quality of life (QOL) score, EQ-5D-5L visual analogue score (VAS) and exercise time. In panels 4C, 4D, and 4G, the vertical axis shows the natural logarithm of the odds ratio for improvement or worsening with PCI over placebo where an ordinal cumulative probability model was used to calculate the improvement or worsening in SAQ angina frequency, becoming free from angina and CCS angina class. CCS, Canadian Cardiovascular Society; EQ-5D-5L indicates 5 level version of EuroQol 5 dimensions; PCI, percutaneous coronary intervention; SAQ; SAQ, Seattle Angina Questionnaire; VAS, Visual Analogue Score; VO2, oxygen uptake.