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Exercise tolerance and quality of life in patients with known or suspected coronary artery disease

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Abstract

Background

Coronary artery disease (CAD) is known to impact on patients’ physical and mental health. The relationship between performance on treadmill exercise tolerance test (ETT) and health-related quality of life (HRQL)has never been specifically investigated in the setting of CAD.

Methods

Consecutive patients undergoing an ETT with the Bruce protocol during a diagnostic workup for CAD (n = 1,631, age 55 ± 12 years) were evaluated. Exercise-related indices were recorded. Detailed information on cardiovascular risk factors and past medical history were obtained. HRQLwas assessed with the use of the validated 36-Item Short Form Survey (SF-36) questionnaire.

Results

Increasing age and the presence of cardiovascular risk factors and comorbidities correlated with lower scores on the physical and mental health component of SF-36(all P < 0.05). Subjects with arrhythmias during exercise and slow recovery of systolic blood pressure had lower scores on the physical health indices or the Social Role Functioning component (P < 0.05). Achieved target heart rate and good exercise tolerance were independently associated with better scores of the physical and mental health domains of SF-36 and overall HRQLscores (β = 0.05 for target HR and PCS-36, β = 1.86 and β = 1.66 per increasing stage of exercise tolerance and PCS-36 and MCS-36, respectively, P < 0.001 for all associations). Ischemic ECG changes were associated with worse scores on Physical Functioning (β = − 3.2, P = 0.02) and Bodily Pain (β = − 4.55, P = 0.026).

Conclusion

ETT parameters are associated with HRQL indices in patients evaluated for possible CAD. Physical conditioning may increase patient well-being and could serve as a complementary target in conjunction with cardiovascular drug therapy.

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Acknowledgements

Dr Georgios Georgiopoulos was supported by THE ONASSIS FOUNDATION UNDER THE SPECIAL GRANT & SUPPORT PROGRAM FOR SCHOLARS’ ASSOCIATION MEMBERS (GRANT No. R ZP 001/2019-2020).

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Author notes

  1. Vasiliki Katsi and Georgios Georgiopoulos have contributed equally for this study.

Authors and Affiliations

  1. First Department of Cardiology, Hippocration Hospital, Athens, Greece

    Vasiliki Katsi, Georgios Georgiopoulos, Konstantinos Toutouzas, Dimitrios Oikonomou & Konstantinos Tsioufis

  2. Cardiovascular Imaging Department, School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    Georgios Georgiopoulos

  3. Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece

    Georgios Georgiopoulos

  4. Department of Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Panagiota Mitropoulou

  5. 1st Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece

    Konstantinos Kontoangelos

  6. Emergency Department, Amalia Fleming’ General Hospital, Athens, Greece

    Zoi Kollia, Chara Tzavara & Dimitrios Soulis

  7. Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy

    Alberto Aimo

  8. Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy

    Alberto Aimo

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  1. Vasiliki Katsi
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  2. Georgios Georgiopoulos
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Correspondence to Georgios Georgiopoulos.

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Katsi, V., Georgiopoulos, G., Mitropoulou, P. et al. Exercise tolerance and quality of life in patients with known or suspected coronary artery disease. Qual Life Res 30, 2541–2550 (2021). https://doi.org/10.1007/s11136-021-02844-y

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