Cardiac patients exhibited a significantly lower ∆VT1-VT2 compared to healthy individuals (28 vs. 37 bpm, p<0.001), with age, beta-blocker use, and ejection fraction acting as key predictors.
Observational (n=865)
What are the clinical and echocardiographic determinants of ventilatory thresholds (VT1, VT2, and ∆VT1-VT2) in individuals undergoing cardiopulmonary exercise testing?
The delta between ventilatory thresholds (∆VT1-VT2) is a valuable marker of metabolic flexibility and endurance potential, influenced by age, beta-blocker use, ejection fraction, and maximal power.
Absolute Event Rate: 28% vs 37%
p-value: p=<0.001
Abstract Background Ventilatory thresholds (VTs: VT1 and VT2), derived from cardiopulmonary exercise testing (CPET), are crucial metabolic markers, but the factors influencing them—particularly the delta between VT1 and VT2 (∆VT1-VT2)—remain underexplored. This study aimed to identify and quantify the determinants of VT1, VT2, and ∆VT1-VT2. Methods We analysed data from 865 individuals (mean age 44±17 years; 83% male) undergoing standardised CPET, incorporating clinical and echocardiographic evaluations. The cohort included healthy subjects and cardiac patients. VT1, VT2, and ∆VT1-VT2 were evaluated across subgroups and age strata. A multivariate regression and decision tree analysis were conducted to identify independent predictors of VTs. Results Cardiac patients exhibited significantly reduced VO2peak (1901.9±631.8 vs. 2409.9±717.8 mL/min) and ventilatory efficiency compared to healthy individuals (all p0.001). VT1 and VT2 values declined with age, and ∆VT1-VT2 was lower in patients (28±15 vs. 37±14 bpm, p0.001) and declined with age (43±12 bpm in ≤35 years vs. 24.4 ± 12.0 bpm in ≥55 years). Betablocker use and age significantly influenced VT1 and VT2 and ∆VT1-VT2 (p0.001); weight significantly affected VT1 (p0.001); powerMAX, and BMI significantly influenced VT2. The ∆VT1-VT2 was significantly predicted by Ejection Fraction (EF) and powerMAX (p0.001). Conclusion This study identifies distinct predictors of ventilatory thresholds and introduces ∆VT1-VT2 as a valuable marker of metabolic flexibility and endurance potential. These findings have important implications for personalised exercise prescription, risk stratification, and monitoring in both clinical and athletic settings.For image description, please refer to the figure legend and surrounding text.
Cavigli et al. (Mon,) conducted a observational in Healthy subjects and cardiac patients (n=865). Cardiac disease vs. Healthy individuals was evaluated on ∆VT1-VT2 (p=<0.001). Cardiac patients exhibited a significantly lower ∆VT1-VT2 compared to healthy individuals (28 vs. 37 bpm, p<0.001), with age, beta-blocker use, and ejection fraction acting as key predictors.