Novel CPET Reference Values in Healthy Adults: Associations with Physical Activity

Abstract

Purpose Cardiopulmonary exercise testing (CPET) is an important measurement in clinical practice, and its primary outcome, maximal oxygen uptake (V˙O2peak), is inversely associated with morbidity and mortality. The purposes of this study are to provide CPET reference values for maximal and submaximal parameters across the adult age spectrum of a healthy European cohort, to compare V˙O2peak values with other reference data sets, and to analyze the associations between physical activity (PA) levels and CPET parameters. Methods In this cross-sectional study, we prospectively recruited 502 participants (47% female) from 20 to 90 yr old. The subjects performed a CPET on a cycle ergometer using a ramp protocol. PA was objectively and continuously measured over 14 d using a triaxial accelerometer. Quantile curves were calculated for CPET parameters. To investigate the associations between CPET parameters and PA levels, linear regression analysis was performed. Results V˙O2peak values observed in the group of 20–29 yr were 46.6 ± 7.9 and 39.3 ± 6.5 mL·kg−1⋅min−1 for males and females, respectively. On average, each age category (10-yr increments) showed a 10% lower V˙O2peak relative to the next younger age category. V˙O2peak values of previous studies were on average 7.5 mL·kg−1⋅min−1 (20%) lower for males and 6.5 mL·kg−1⋅min−1 (21%) lower for females. There was strong evidence supporting a positive association between the V˙O2peak (mL·kg−1⋅min−1) and the level of habitual PA performed at vigorous PA (estimate, 0.26; P < 0.001]. Conclusion Maximal and submaximal CPET reference values over a large age range are novel, and differences to other studies are clinically highly relevant. Objectively measured vigorous-intensity PA showed a strong positive association with higher V˙O2peak and other performance-related CPET parameters, supporting the implementation of higher-intensity aerobic exercise in health promotion.

Comparing individual and population differences in minute ventilation/carbon dioxide production slopes using centile growth curves and log-linear allometry

“…In contrast, 50 th centiles for the male VE/VCO2 slopes reported in the current study (treadmill protocol) ranged from 26.31 to 29.46 for 30 years to 60-year-old males respectively. A similar contrast is observed with female VE/VCO2 slopes, The 50 th centiles for the female VE/VCO2 slope scores reported by Wagner et al [23] ranged from 34.0 to 36.5 (30 years to 60 year old females respectively). The 50 th centiles for the female VE/VCO2 slope scores reported in the current study (treadmill) ranged from 27.76 to 29.97 for 30 years to 60-year-old females respectively.…”

“…Comparing the centile curves reported by W agner et al [ 23 ] using bicycle ergometry with those reported in the current study using a treadmill protocol, we detected large differences. The 50th centiles for the male V ʹ E / V ʹ CO 2 slopes reported by W agner et al .…”

“…We recognise that similar centile curves have been published elsewhere recently by W agner et al . [ 23 ] but using a different CPX protocol (bicycle ergometry) and with a reduced sample size [ 24 ].…”

“…The 50th centiles for the male V ʹ E / V ʹ CO 2 slopes reported by W agner et al . [ 23 ] ranged from 34.2 to 37.2 (for 30- to 60-year-old males, respectively). In contrast, 50th centiles for the male V ʹ E / V ʹ CO 2 slopes reported in the current study (treadmill protocol) ranged from 26.31 to 29.46 for 30- to 60-year-old males, respectively.…”

Composite Measures of Physical Fitness to Discriminate Between Healthy Aging and Heart Failure: The COmPLETE Study

“…Peak oxygen uptake (peakVO 2 ) was defined as the highest 30-s average ofVO 2 at any point during the test.VO 2 off-kinetics were assessed from the active recovery period that directly followed the incremental phase of the CPET. A complete description of the CPET is described by Wagner et al (2020).…”