Cardiorespiratory Optimal Point: A New Kid in the Block or an Established Star?

Abstract

The article by Araújo et al. 1 published in this issue of the International Journal of Cardiovascular Sciences studied the association of cardiorespiratory optimal point (COP), a parameter obtained from a cardiopulmonary exercise test (CPET), and cardiovascular mortality in 2201 consecutive male patients, aged 46 to 70 years (mean age 57 ± 6 years), from the CLINIMEX Exercise Open Cohort. The patients underwent a CPET, assessed between January 1994 and February 2023, under an individualized ramp protocol, on a cycle ergometer, and they were followed for 4688 ± 2416 days.A cardiovascular death rate of 5.6% was found in the study population, increasing from 3.2% to 9.6% and 18.7%, according to 3 levels of COP: lower (< 28), high (28 to 30), or very high (> 30). After adjustment for age, history of myocardial infarction or coronary artery disease, and diabetes mellitus, cardiovascular mortality increased from 2.76% in the group with the lowest COP (< 28) to 4.07% in the group with the highest COP (> 30). Importantly, when the COP value was below 28 in a group of individuals aged 66 to 70, they had the same survival as the group of subjects aged 46 to 50 years with COP superior to 30.