Effect of blood pressure drop during cardiopulmonary exercise testing on prognosis of patients with coronary heart disease
Objective To investigate the effect of blood pressure drop during cardiopulmonary exercise testing(CPET)on the progno-sis of patients with coronary heart disease.Methods A total of 4 911 coronary heart disease patients who underwent CPET after angi-ography or percutaneous coronary intervention(PCI)from February 2016 to September 2021 in General Hospital of Northern Theater Command were selected as the study objects.Patients were divided into group A(increased blood pressure,n =2 838)and group B(de-creased blood pressure,n =2 073)based on changes in blood pressure during CPET.Clinical data,laboratory and surgical information,cardiopulmonary function,and incidence of major adverse cardiovascular events(MACE)were collected and compared between the two groups.Results The proportion of body mass index,ejection fraction and clopidogrel,β-blocker,calcium channel blocker,ni-trates,proton pump inhibitors,diuretics,angiotensin receptor blockers,bivalirudin and tirofiban in group B were lower than those in group A,and the proportion of PCI history,ticagrelor and angiotensin-converting enzyme inhibitors were higher than those in group A.The differences were statistically significant(P<0.05).There were statistically significant differences in drinking history and coronary heart disease type between the two groups(P<0.05).The proportions of N-terminal pro-B-type natriuretic peptide,triglyceride,low density lipoprotein,total cholesterol,serum creatinine,alanine aminotransferase and left anterior descending branch PCI in group B were lower than those in group A,and the proportions of high density lipoprotein and left rotatory branch lesions were higher than those in group A,with statistical significance(P<0.05).The peak oxygen uptake,peak oxygen uptake in kg,anaerobic threshold oxygen up-take,anaerobic threshold oxygen uptake in kg and peak metabolic equivalent in group B were higher than those in group A,diastolic blood pressure and respiratory reserve during exercise were lower than those in group A,with statistical significance(P<0.05).The proportion of death and re-hospitalization in group B was lower than that in group A,and the differences were statistically significant(P<0.05).Conclusion The cumulative incidence of five-year MACE was not significantly increased in patients with coronary heart disease whose blood pressure decreased during exercise,and it had no significant effect on the prognosis of coronary heart disease patients.
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