NGHIÊN CỨU KHẢ NĂNG DUNG NẠP VỚI GẮNG SỨC Ở CÁC BỆNH NHÂN ĐAU THẮT NGỰC ỔN ĐỊNH BẰNG ĐIỆN TÂM ĐỒ GẮNG SỨC THẢM CHẠY

Abstract

Aims: To investigate exercise capacity of stable angina patients with treadmill electrocardiogram (ECG) exercise testing and to study the value of VO₂max as a predictor of multi-vessel disease and/or chronic total occlusion of coronary artery. Methods: In five years, 205 stable angina patients were included from 2014 to 2018 in Vietnam National Heart Institute (VNHI), Bach Mai hospital. Clinical assessment, blood test, 12-lead ECG, echocardiography, treadmill ECG exercise testing and coronary angiography were performed in all patients. Results: Stable angina patients with grade II (62,9%) and grade I (21,9%) of CCS were more prevalent. 18,0% had positive exercise test. Significant stenosis of coronary artery (≥50%) were seen in 53 patients (25,9%). Patients with ≥50% stenosis had shorter the exercise duration, smaller proportion of achievement of 85% theoretical maximum heart rate, had lower exercise functional capacity by MET, lower oxygen consumption (VO₂max), higher prevalence of angina and ST depression, chronotropic incompetence, severe arrhythmias occurring during exercise compared to patients without significant stenosis. There were associations of VO₂max, exercise duration, functional capacity with the presence of multi-vessel disease/chronic total occlusion of coronary artery, OR 4,2 (95%CI:1,3-7,3), OR 1,2 (95% CI: 1,1 - 4,6), OR 3,4 (95% CI 1,5-8,2), respectivel.y. VO₂max was the strongest predictor of multi-vessel disease/chronic total occlusion of coronary artery (cut-off 32,6 ml/kg/min, AUC 0,709, p<0,001) in comparision with exercise duration (cut-off 312,4s, AUC:0,521, p<0,05) and exercise functional capacity (cut-off 6,3 MET, AUC:0,617, p<0,05). Conclusions: In the cohort of 205 stable angina patients in VNHI from 2014 to 2018, grade II and grade I were predominant. There were associations of VO₂max, exercise duration, functional capacity with the presence of multi-vessel disease/chronic total occlusion of coronary artery. VO₂max was the strongest predictor of multi-vessel disease/chronic total occlusion of coronary artery.