Improvements in Key Cardiopulmonary Exercise Testing Variables Following Cardiac Rehabilitation in Patients With Coronary Artery Disease

Purpose: Improvements in cardiorespiratory fitness ( JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2peak ) post-cardiac rehabilitation (post-CR) are used to gauge therapeutic efficacy. The aim of the present study was to assess the effect of supervised CR on other cardiopulmonary exercise testing (CPX) variables, specifically those that reflect ventilatory efficiency and JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2 changes in relation to changes in work rate (WR). Methods: Patients (n = 142; mean age 63 ± 9 y; 23% female) with coronary artery disease (CAD) participated in supervised CR for 3 to 6 mo completing 60 ± 17 sessions (range: 32-96 sessions), with intensity derived from the baseline CPX. CPX was completed at baseline and post-CR on a cycle ergometer. The minimum heart rate (HR) during cycling was set 5 to 10 beats/min above the HR at ventilatory anaerobic threshold (VAT) while the maximum HR remained below the ischemic threshold observed during CPX, and this intensity was maintained for 25 min. JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2peak , peak O 2 pulse, the minute ventilation/carbon dioxide production ( JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif E / JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif co 2 ) slope, the oxygen uptake efficiency slope (OUES), and the Δ JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2 /ΔWR slope were determined at baseline and post-CR. Results: Following CR, there were significant improvements (all P < .001) in JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2peak (17.7 ± 4.7 mL/kg/min vs 20.9 ± 5.4 mL/kg/min), peak O 2 pulse (11.6 ± 3.2 mL/beat vs 13.4 ± 3.6 mL/beat), JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif E / JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif co 2 slope (28.4 ± 5.3 vs 27.5 ± 4.7), OUES (1.8 ± 0.5 vs 2.0 ± 0.6), and Δ JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2 /ΔWR slope (9.1 ± 1.2 mL/min/W vs 9.6 ± 1.1 mL/min/W). Conclusion: Key markers of ventilatory efficiency and JOURNAL/jcprh/04.03/01273116-201809000-00016/16FSM1/v/2023-09-11T074631Z/r/image-gif o 2 kinetics during CPX significantly improve following CR. Expanding the list of variables assessed via CPX may provide better resolution in validation of CR therapeutic efficacy in patients with CAD.