Cardiopulmonary exercise test in cardiovascular risk prognosis in patients undergoing elective surgery for gastric, esophageal, and pancreatic cancer

The aim of the study was to assess cardiopulmonary exercise test value in cardiovascular risk determining in noncardiac elective surgery. The study included 136 patients with cardiac problems in anamnesis who underwent elective surgery for esophageal, gastric, and pancreatic cancer. 86 (63.2%) patients were older than 65 years. Cardiovascular complications, which were recorded during surgery and within 30 days after it, were detected in 12 (8.8%) patients (6 (4.4%) cases of non-fatal myocardial infarction, 2 (1.5%) cases of non-fatal stroke, and 4 (2.9%) cases of cardiovascular death). On the basis of presence or absence of cardiovascular complications patients were divided into two groups. In the group with cardiovascular complications (n = 12) when compared with the group without ones (n = 124) significant differences in exercise time (245.1 (188.0-310.5) vs 330.0 (258.1-411.2) sec) (here and below, median and interquartile range) (P = 0.02); maximum oxygen uptake at peak exercise (14.0 (12.2-18.2) vs 18.8 (of 15.7 and 21.9) ml/kg/min) (P = 0.04); anaerobic threshold (11.1 V (8.2-13.8) vs 14.2 (11.3 per is 16.2) ml/kg/min) (P = 0.01); heart rate increasing (in % to baseline) (35.2 (20.7-48.1) vs 20.1 (10.2-27.1) %) (P < 0,01) were revealed. Heart rate increasing (in % to baseline) m.ore than 25%c was the only independent cardiovascular complications risk factor. The standard exercise test increases the predictive ability of baseline study and should be performed before surgery in the absence of contraindications (AUC increases from 0,780 to 0,850, the sensitivity from 69 to 72%, and specificity from 73 to 76). Cardiopulmonary exercise test does not increase prognostic value of baseline study.

эргоспирометрия, кардиальный риск, некардиологические хирургические вмешательства, рак желудка, пищевода и поджелудочной железы, ardiopulmonary exercise test, cardiac risk, noncardiac surgery, gastric, esophageal, and pancreatic cancer

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