Exercise capacity as a predictor of coronary microvascular dysfunction

Abstract Introduction Exercise capacity (EC) is an important prognostic test in patients with coronary artery disease (CAD). Positron-emission tomography (PET) risk-stratifying tool to tailor management of disease. Purpose We aimed assess EC predicting positron emission myocardial perfusion imaging (MPI) derived flow reserve (CFR). Methods Consecutive who had clinically indicated PET MPI and were included. was defined based on peak metabolic equivalents (METS) achieved during exercise stress test. Myocardial blood (MBF) ml/gm/min obtained from dynamic images at rest hyperemia. The (CFR) calculated as the ratio MBF left ventricle. Results study population consisted 511 underwent testing (mean age 56 (±11), 71% male). Cardiovascular risk factors prevalent (75% hypertensive, 82% dyslipidemic, 43% diabetics, 27% known CAD). Peak METS >6 81% patients, CFR <2 present 27%. In multivariable logistic regression models adjusted for age, sex, cardiovascular (hypertension, diabetes, dyslipidemia) medication use (angiotensin converting enzyme inhibitor/angiotensin receptor blocker, statins, beta-blockers), a statistically significant lower odds microvascular dysfunction (CFR <2: OR 0.43, 95% CI 0.26–0.71, p=0.001). Assessment discrimination showed model incremental improvement Harrell's C statistic over clinical variables (0.65 vs 0.69, p=0.02). Conclusion Our findings good predictor health above variables. Further studies are needed interplay between CFR. Funding Acknowledgement Type funding sources: None.