Ergospirometry in the assessment of cardiovascular risk and safe physical activity in obese persons

Background. Obesity is one of the most important health problems in the world and in our country and is the main risk factor for reduced functional capacity and therefore for cardiovascular diseases (CVD), so reducing body weight (TT) is important for a good management of the health system and impact on future adverse cardiovascular events. Therefore, a detailed assessment of the cardiopulmonary system in the obese is very important. he aim of our study was to examine the role of ergospirometry in the assessment of cardiopulmonary capacity in relation to the ordinary ECG exercise test in morbidly obese persons reffered for body weight reduction in our Center for obesity.Methods. The study was conducted in the Laboratory for Ergospirometry, Cardiology Clinic, UCCS. Obese patients with a BMI >31 kg/m2 (mean BMI 45±6), aged >18 years, scheduled for the diet or bariatric surgery treatmentv of obesity participated in the research. The total number of patients was 196 (142 women and 54 men). All patients underwent a clinical examination and cardop-pulmonary exercise test (CPET, Bruce protocol) with simultaneous gas analyses. In accordance with guidelines, we used recommended cut off for the ventilatory anaerobic threshold ≥14 ml/kg/min for increased CV risk.Results. During CPET, there was an adequate increase in heart rate and blood pressure compared to resting values. That optimal VAT was achieved by 152 patients, while 31 obese individuals had an anaerobic threshold below 14 ml/kg/min. Persons with a lower anaerobic threshold on the test were older, and the differences were only in the achieved CPET parameters, while the classical parameters of the physical load test did not differ.Conclusion. Cardiopulmonary capacity, as a significant predictor of mortality and morbidity, is greatly influenced by obesity. Objective assessment includes determination of cardiopulmonary capacity and ventilatory anaerobic threshold by ergospirometry which is superior to standard exercise test parameters and VAT values are also the starting point for prescribing safe physical activity. Based on the parameters of CPET we can identify a high-risk patients independently of the BMI value.