What question did this study set out to answer?

The aim is to validate VE45 and Vt30 for early identification of exercise abnormalities and differentiate respiratory from cardiac issues.

March 24, 2026

Can VE45 & VT30 predict abnormality during cardio-pulmonary exercise testing?

Q: What does this research mean for the field?

VE45 identifies exercise limitation with 88.57% sensitivity and 13.33% specificity during cardio-pulmonary exercise testing, but cannot distinguish between respiratory and cardiac abnormalities. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

Key Result

VE45 identified exercise limitation with 88.57% sensitivity and 13.33% specificity, but could not distinguish between respiratory and cardiac abnormalities during exercise testing.

Key Points

The aim is to validate VE45 and Vt30 for early identification of exercise abnormalities and differentiate respiratory from cardiac issues.
Analyzed VE45 and Vt30 data from 105 routine cardiopulmonary exercise tests (CPETs).
Compared predictive diagnoses from VE45 and Vt30 against the diagnosis at VO2 peak using ROC analysis.
Evaluated VE45 and Vt30 data of healthy subjects against published normal ranges.
A significant correlation was found between VE45 and VO2 peak in exercise-limited patients, but not in healthy subjects.
Vt30 showed no correlation with VO2 peak across all subjects.
VE45 demonstrated high sensitivity in predicting abnormality in patients with exercise limitations; however, it failed to predict normality in healthy individuals.

Structured PICO

Can VE45 and Vt30 predict abnormality during cardio-pulmonary exercise testing earlier than VO2 peak?

Population

105 consecutive patients undergoing routine Cardio Pulmonary Exercise Tests (CPETs), including healthy subjects and exercise-limited patients

Intervention

Measurement of VE45 (minute ventilation at 1.0L/min VO2) and Vt30 (tidal volume at a ventilation of 30L/min VO2)

Comparator

Diagnosis at VO2 peak and previously published normal ranges

Outcome

Sensitivity and specificity of VE45 and Vt30 to predict abnormality compared to diagnosis at VO2 peaksurrogate

VE45 can identify exercise limitation but cannot distinguish between respiratory and cardiac causes, and Vt30 does not accurately predict abnormality.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Aims : 1. To validate Cotes' hypothesis that VE45 (minute ventilation at 1.0L/min VO2) & Vt30 (tidal volume at a ventilation of 30L/min VO2) can identify abnormalities in exercise earlier than V02 peak 2. To distinguish between respiratory & cardiac abnormalities using VE45 & Vt30. Methods : VE45 & Vt30 were identified in 105 consecutive, routine Cardio Pulmonary Exercise Tests (CPETs). Predictive diagnoses from VE45 & Vt30 were compared to the diagnosis at VO2 peak . ROC analysis was performed to determine the sensitivity/specificity of VE45 & Vt30. VE45 & Vt30 data from healthy subjects was compared to previously published normal ranges by Cotes (1). Results : A significant correlation was observed between VE45 & VO2 peak in exercise-limited patients, but not in healthy subjects. No correlation was observed between Vt30 & VO2 peak in all subjects. Calculated ranges for VE45 in normal subjects were different from published normal ranges(1). VE45 was highly sensitive and accurately predicted abnormality in the majority of patients with exercise limitation at VO2 peak. Sensitivity Vs Specificity TABLE 1 Sensitivity% Specificity% VO2 vs VE45 88.57 13.33 VO2 vs Vt30 38.10 86.67 However, it did not accurately predict normality in healthy subjects. Conclusions : It was not possible to distinguish between respiratory & cardiac abnormality using VE45, but it was possible to distinguish between those with and without limitation. Vt30 did not accurately predict abnormality. Our results differ significantly from previously published normal ranges(1). 1. Cotes, J.E., (1993). Lung Function: Assessment and Application in Medicine, 5th edition. Oxford: Blackwell scientific publishing p429.

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