Characteristics and reference values for cardiopulmonary exercise testing in the adult Chinese population – The Xiangya hospital exercise testing project (the X-ET project)

Dun, Yaoshan; Olson, Thomas P.; Cui, Li; Qiu, Ling; Fu, Siqian; Cao, Zeng; Ripley-Gonzalez, Jeffrey W.; You, Baiyang; Li, Qiuxia; Deng, Lei; Li, Qingfang; Liu, Suixin

doi:10.1016/j.ijcard.2021.03.013

Cited by 14 publications

(20 citation statements)

References 36 publications

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“…Anthropometric features such as weight and height of the Caucasian and Asian population are different. For example, height, weight and BMI of subjects in an Asian population 14 16 19 20 21 22 23 were similar to those of the present study, but lower than those of primarily Caucasians. 12 13 18 As above, the predicted VO 2 max using Yaoshan equation using the Asian population had good agreement with our study.…”

Section: Discussionsupporting

confidence: 84%

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Comparison of Predicted Exercise Capacity Equations in Adult Korean Subjects

Jeong

Lee

et al. 2022

J Korean Med Sci

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Background Maximal oxygen uptake (VO 2 max) is a useful index to assess exercise capacity. However, there is no reference value for Koreans. This study aimed to compare actual VO 2 max and predicted VO 2 max using exercise capacity equations in Korean subjects. Methods This retrospective study enrolled 383 patients who underwent cardiopulmonary exercise test (CPET) with incremental maximal cycle ergometer test at Asan Medical Center from January 2020 to May 2021. Stage 1 and 2 lung cancer patients with normal lung function and healthy persons of 50 subjects who had maximal CPET were analyzed. Results The subjects were aged 65 ± 13 years and predominantly male (74%). CPET results were as follows: absolute VO 2 max, 1.2 ± 0.3 L/min; body weight referenced VO 2 max, 20 ± 3.9 mL/kg/min; peak work rate, 94 ± 24 watts; peak heart rate, 142 ± 21 bpm; peak O 2 pulse, 10 ± 3 mL/beat; minute ventilation, 59 ± 14 L/min; peak respiratory rate, 34 ± 6 breaths per minute; and peak breathing reserve, 41 ± 18%. There was significant discordance between the measured and predicted absolute VO 2 max using the Jones, Hansen, and Wasserman prediction equations developed for Caucasian population ( P < 0.001). Agreement using Bland-Altman test between true and predicted absolute VO 2 max was the best in Chinese equation (−0.03, 2SD = 0.55) compared to Jones (0.42, 2SD = 1.07), Hansen (0.44, 2SD = 0.86), and Wasserman (0.42, 2SD = 0.86) equations. Conclusion The reference value and prediction equation from studies including primarily Caucasians may not be appropriate for Koreans. Since the mean difference is the lowest in Chinese equation, the Chinese equation might be used for the Korean adult population.

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Section: Discussionsupporting

confidence: 84%

“…Most reference values and prediction equations are available for the Caucasians only. 10 11 12 13 In contrast, there are few reference values for the Asians 14 15 16 and no reference value of VO 2 max for Koreans. There are no reliable exercise capacity equations for VO 2 max applicable to Koreans.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Predicted Exercise Capacity Equations in Adult Korean Subjects

Jeong

Lee

et al. 2022

J Korean Med Sci

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“…Mean

O 2peak values reported in our study was higher compared with that reported by Dun and colleagues in 2021 among Chinese patients who had no symptoms recorded. For example, for people aged from 20 to 30 years in both genders, mean

O 2peak values were about 30% higher in our study [ 14 ]. We believe this discrepancy should be mainly due to the difference in source of the study samples.…”

Section: Discussionmentioning

confidence: 67%

“…However, the safety concerns for exercise are a real hurdle to the mass physical exercise endeavor. To help Chinese people exercise safely, reference values of CRF based on healthy Chinese individuals from the general population are also urgently needed, though a recent study of

O 2peak reference values was reported using the hospital electronic medical record data of Chinese individuals without specific clinical complaints [ 14 ]. The importance of research on normal references of CRF based on healthy individuals from general population has been emphasized by the American Heart Association (AHA) in 2013 [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Normal References of Peak Oxygen Uptake for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing in Chinese Adults

Wang

et al. 2022

JCM

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Introduction: This study aims to establish normal reference values of peak oxygen uptake (VO2peak) for cardiorespiratory fitness (CRF) in Chinese adults using cardiorespiratory exercise testing (CPET). Methods: A cross-sectional study was done in four communities, two in the North (Beijing) and two in the South (Hezhou, Guangxi) of China from 1 January 2017 to 31 December 2018, with one urban and one rural in each region. Out of 1642 participants screened, 1114 were eligible and completed CPET using a cycle ergometer (Ergosana320F) without abnormal ECG and were included in the analysis. The 2nd and 98th percentiles of V(·)O2peak were used as the lower and upper limits of the normal reference values. Results: Significant difference in mean V(·)O2peak was shown between men (27.0 mL·min−1·kg−1) and women (23.7 mL·min−1·kg−1). The mean V(·)O2peak decreased with age in both sexes, from 35.8 mL·min−1·kg−1 in age 20–29 years to 20.5 mL·min−1·kg−1 in 70–79 years in men and from 29.2 mL·min−1·kg−1 to 17.0 mL·min−1·kg−1 in women. Thus, the age- and sex-specific normal reference values of V(·)O2peak were presented for each 10-year age group by men and women separately. Conclusions: This first community-based study in China provides age- and sex-specific normal references of V(·)O2peak as a measure of CRF in Chinese adults, which differed significantly from those established in Western populations. Future studies with national representative samples should be warranted.

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“…From August to November 2021, all participants performed a cardiopulmonary exercise test (CPET) 1 week before practicing X-CircuiT in Xiangya Hospital, Central South University, to obtain the peak heart rate (HR peak ), peak oxygen uptake (VO 2peak ), and the individual regression equation of HR and VO 2 . The standard of procedure for performing CPET has been described previously ( 23 , 24 ). The HR and VO 2 data collected from the CPET were used to fit the individual regression equation of HR-VO 2 , according to which we calculated the VO 2 during X-CircuiT.…”

Section: Methodsmentioning

confidence: 99%

Exercise intensity and energy expenditure of a multicomponent home-based training program: Xiangya hospital circuit training (X-CircuiT)

Zhang

Ripley-Gonzalez

et al. 2022

Front. Public Health

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IntroductionOur previous studies showed that Xiangya Hospital Circuit Training (X-CircuiT) effectively improved physical fitness and reversed pre-frailty in community-dwelling older adults. This study aimed to explore the generalizability and applicability of X-CircuiT in different aged populations in the context of exercise intensity and energy expenditure.MethodsWe prospectively recruited 72 community-dwelling sedentary adults, twelve adults divided into 6 age groups ranging from 20 to 80 years old and separated by decades. Cardiopulmonary exercise testing was performed to determine peak heart rate (HRpeak). An individual HR-oxygen consumption regression equation was fit for each participant, and then a session of remote heart rate monitored X-CircuiT was performed. Exercise intensity (%HRpeak) and energy expenditure of X-CircuiT among the six age groups were assessed. Further sub-analysis was conducted by dividing the participants by peak metabolic equivalent (MET) values, <5 METs, 5–7 METs, and more than 7METs to explore the relationship between maximum exercise capacity and exercise intensity of X-CircuiT.ResultsThe average %HRpeak of X-CircuiT for subjects in the 20–29, 30–39, 40–49, 50–59, 60–69, and 70–80 age groups were 54 ± 6, 59 ± 8, 60 ± 8, 62 ± 5, 66 ± 10, and 67 ± 13, respectively (p = 0.008); and the average energy expenditure was 121.9 ± 26.5, 123.3 ± 33.8, 129.2 ± 40.9, 130.9 ± 31.8, 146.8 ± 29.0, and 125.0 ± 28.4 kcal, respectively. The average %HRpeak for the warm-up, aerobic, acupoint patting, resistance, and stretching stages in overall subjects was 61 ± 9, 70 ± 10, 70 ± 10, 63 ± 9, and 57 ± 9, respectively. Furthermore, when subjects were divided by peak METs, it was found that the lower the peak METs, the greater the value of the relative exercise intensity indicators. The aerobic and acupoint stages of X-CircuiT could illicit a response of high intensity for those with peak METs <5, moderate intensity in those with peak METs of 5–7, and low-intensity for those with peak METs of more than 7.ConclusionXiangya Hospital Circuit Training followed the principle of low-intensity warm-up and medium-intensity training with multicomponent exercise training. It is classified as a moderate-intensity exercise for sedentary middle-aged and older adults, or those with a maximum exercise capacity of 5–7 METs, and is classified as a low-intensity exercise for young people.

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Characteristics and reference values for cardiopulmonary exercise testing in the adult Chinese population – The Xiangya hospital exercise testing project (the X-ET project)

Cited by 14 publications

References 36 publications

Comparison of Predicted Exercise Capacity Equations in Adult Korean Subjects

Comparison of Predicted Exercise Capacity Equations in Adult Korean Subjects

Normal References of Peak Oxygen Uptake for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing in Chinese Adults

Exercise intensity and energy expenditure of a multicomponent home-based training program: Xiangya hospital circuit training (X-CircuiT)

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