A new way of testing for cardiac dysfunction

This study aimed to investigate if cardiopulmonary exercise testing (CPET) could be used as a method to detect cardiac dysfunction in patients with non-obstructive coronary artery disease.

This study concluded that CPET could be used as an effective detection method. 

Coronary artery disease occurs when plaque builds up in the coronary arteries that deliver blood to the heart. Non-obstructive coronary artery disease (NO-CAD) involves plaque lining the arteries but the plaque does not block the blood flow completely. Cardiac dysfunction, where the heart is not functioning properly, can occur in NO-CAD patients.

ECG (electrocardiogram) is one test often used to measure cardiac dysfunction. However, it is not always sensitive enough to detects small obstructions caused by NO-CAD. Accurate testing methods are still needed.

Cardiopulmonary exercise testing (CPET) is a method that assesses the hearts performance during rest and exercise. This information can be used to detect cardiac dysfunction. It was unknown if CPET could replace ECG as a method of testing for cardiac dysfunction in NO-CAD patients. 

This study involved 208 patients with symptoms of NO-CAD (chest pain and shortness of breath during excercise) and 116 healthy patients. The stress ECG method and CPET methods were compared. The heart-rate responses during CPET were observed.

The CPET method had higher sensitivity (ability to detect) for detection of cardiac dysfunction in symptomatic patients when compared to the stress ECG method. 32% of the symptomatic patients were determined to have NO-CAD. 50% were determined to have obstructive CAD.

Levels of detection of NO-CAD in both male and female patients increased with CPET when compared to stress ECG method.  

An abnormal heart-rate response during CPET was an indicator of cardiac dysfunction. 

This study concluded that CPET is more effective than the traditional stress response ECG for detection of cardiac dysfunction in patients with non-obstructive CAD.  

Further studies need to be carried out in larger and more varied groups of patients.  

Talk to your physician about using CPET to test for cardiac dysfunction.