Test-Retest Reliability of Maximal and Submaximal Gas Exchange Variables in Patients With Coronary Artery Disease

Coeckelberghs, Ellen; Buys, Roselien; Goetschalckx, Kaatje; Pattyn, Nele; Vanhees, Luc; Cornelissen, Véronique

doi:10.1097/hcr.0000000000000158

Cited by 10 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As expected, the 'gold standard' of assessing exercise capacity (VO2peak) by CPET showed good (bordering on 'excellent') test-retest reliability. Our ICC of .866 compares well with previous testing in clinical groups, including patients with multiple sclerosis (.933) (Heine et al, 2015) and coronary heart disease (.970) (Coeckelberghs et al, 2016).…”

Section: Discussionsupporting

confidence: 81%

Test–retest reliability, validation, and “minimal detectable change” scores for frequently reported tests of objective physical function in patients with non-dialysis chronic kidney disease

Wilkinson

Xenophontos

Gould

et al. 2018

Physiotherapy Theory and Practice

View full text Add to dashboard Cite

Physical function is an important outcome in chronic kidney disease (CKD). We aimed to establish the reliability, validity, and the "minimal detectable change" (MDC) of several common tests used in renal rehabilitation and research. In a repeated measures design, 41 patients with CKD not requiring dialysis (stage 3b to 5) were assessed at an interval of 6 weeks. The tests were the incremental shuttle walk test (ISWT), "sit-to-stand" (STS) test, estimated 1 repetition maximum for quadriceps strength (e1RM), and VO by cardiopulmonary exercise testing (CPET). Reliability was assessed using intraclass correlation coefficient and Bland-Altman analysis, and absolute reliability by standard error of measurement and MDC. The ISWT, STS-60, e1RM, and CPET had "good" to "excellent" reliability (0.973, 0.927, 0.927, and 0.866), respectively. STS-5 reliability was poor (0.676). The MDC is ISWT, 20 m; STS-5, 7.5 s; STS-60, 4 reps; e1RM, 6.4 kg; VO, 2.8 ml/kg/min. There was strong correlation between the ISWT and VO (r = 0.73 and 0.74). While there was poor correlation between the STS-5 and e1RM (r = 0.14 and 0.47), better correlation was seen between STS-5 and ISWT (r = 0.55 and 0.74). In conclusion, the ISWT, STS-60, e1RM, and CPET are reliable tests of function in CKD. The ISWT is a valid means of exercise capacity. The MDC can help researchers and rehabilitation professionals interpret changes following an intervention.

show abstract

Section: Discussionsupporting

confidence: 81%

Test–retest reliability, validation, and “minimal detectable change” scores for frequently reported tests of objective physical function in patients with non-dialysis chronic kidney disease

Wilkinson

Xenophontos

Gould

et al. 2018

Physiotherapy Theory and Practice

View full text Add to dashboard Cite

show abstract

“…In absolute terms, patients with a peak VO 2 less than 16 ml O 2 /kg/min at time of discharge after MI and post-percutaneous coronary intervention (PCI) have been shown to be at increased risk for adverse events over 2 years [ 31 ]. With excellent reproducibility of peak VO 2 measurements in the CAD population [ 32 ], the goal in each individual should be to increase this vital sign from baseline for longevity [ 27 ▪▪ ]. Peak VO 2 is a variable that is responsive to therapy, and serial measures are potentially valuable in close surveillance of cardiovascular health status.…”

Section: Prognostic Utility For Therapeutic Monitoringmentioning

confidence: 99%

A practical clinical approach to utilize cardiopulmonary exercise testing in the evaluation and management of coronary artery disease

Chaudhry

Arena

Bhatt

et al. 2018

Current Opinion in Cardiology

View full text Add to dashboard Cite

Purpose of reviewThere is growing clinical interest for the use of cardiopulmonary exercise testing (CPET) to evaluate patients with or suspected coronary artery disease (CAD). With mounting evidence, this concise review with relevant teaching cases helps to illustrate how to integrate CPET data into real world patient care.Recent findingsCPET provides a novel and purely physiological basis to identify cardiac dysfunction in symptomatic patients with both obstructive-CAD and nonobstructive-CAD (NO-CAD). In many cases, abnormal cardiac response on CPET may be the only objective evidence of potentially undertreated ischemic heart disease. When symptomatic patients have NO-CAD on coronary angiogram, they are still at increased risk for cardiovascular events. This problem appears to be more common in women than men and may warrant more aggressive risk factor modification. As the main intervention is lifestyle (diet, smoking cessation, exercise) and medical therapy (statins, angiotensin-converting enzyme inhibitors, beta-blockers), serial CPET testing enables close surveillance of cardiovascular function and is responsive to clinical status.SummaryCPET can enhance outpatient evaluation and management of CAD. Diagnostically, it can help to identify physiologically significant obstructive-CAD and NO-CAD in patients with normal routine cardiac testing. CPET may be of particular value in symptomatic women with NO-CAD. Prognostically, precise quantification of improvements in exercise capacity may help to improve long-term lifestyle and medication adherence for this chronic condition.

show abstract

“…Cardiopulmonary exercise testing (CPET) provides a non-invasive assessment of integrated exercise physiology through evaluation of ventilatory gas exchange (VGE). In chronic coronary syndrome, CPET permits reproducible quantification of cardio-respiratory fitness, 1 discriminates between exercise-limiting pathophysiological adaptations 2 and provides prognostic stratification. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

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

Ganesananthan

Rajkumar

Foley

et al. 2022

European Heart Journal

View full text Add to dashboard Cite

Aims Oxygen-pulse morphology and gas exchange analysis measured during cardiopulmonary exercise testing (CPET) has been associated with myocardial ischaemia. The aim of this analysis was to examine the relationship between CPET parameters, myocardial ischaemia and anginal symptoms in patients with chronic coronary syndrome and to determine the ability of these parameters to predict the placebo-controlled response to percutaneous coronary intervention (PCI). Methods and results Patients with severe single-vessel coronary artery disease (CAD) were randomized 1:1 to PCI or placebo in the ORBITA trial. Subjects underwent pre-randomization treadmill CPET, dobutamine stress echocardiography (DSE) and symptom assessment. These assessments were repeated at the end of a 6-week blinded follow-up period. A total of 195 patients with CPET data were randomized (102 PCI, 93 placebo). Patients in whom an oxygen-pulse plateau was observed during CPET had higher (more ischaemic) DSE score [+0.82 segments; 95% confidence interval (CI): 0.40 to 1.25, P = 0.0068] and lower fractional flow reserve (−0.07; 95% CI: −0.12 to −0.02, P = 0.011) compared with those without. At lower (more abnormal) oxygen-pulse slopes, there was a larger improvement of the placebo-controlled effect of PCI on DSE score [oxygen-pulse plateau presence (Pinteraction = 0.026) and oxygen-pulse gradient (Pinteraction = 0.023)] and Seattle angina physical-limitation score [oxygen-pulse plateau presence (Pinteraction = 0.037)]. Impaired peak VO2, VE/VCO2 slope, peak oxygen-pulse, and oxygen uptake efficacy slope was significantly associated with higher symptom burden but did not relate to severity of ischaemia or predict response to PCI. Conclusion Although selected CPET parameters relate to severity of angina symptoms and quality of life, only an oxygen-pulse plateau detects the severity of myocardial ischaemia and predicts the placebo-controlled efficacy of PCI in patients with single-vessel CAD.

show abstract

Test-Retest Reliability of Maximal and Submaximal Gas Exchange Variables in Patients With Coronary Artery Disease

Abstract: Both peak (Equation is included in full-text article.)O2 and OUES show excellent test-retest reliability. Accordingly, in the case of no or unreliable peak (Equation is included in full-text article.)O2 data, we suggest using OUES to evaluate cardiorespiratory fitness in patients with CAD.

Cited by 10 publications

References 35 publications

Test–retest reliability, validation, and “minimal detectable change” scores for frequently reported tests of objective physical function in patients with non-dialysis chronic kidney disease

Test–retest reliability, validation, and “minimal detectable change” scores for frequently reported tests of objective physical function in patients with non-dialysis chronic kidney disease

A practical clinical approach to utilize cardiopulmonary exercise testing in the evaluation and management of coronary artery disease

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

Contact Info

Product

Resources

About