Key result
CVD-specific nonexercise equation yields ~100% of measured VO2peak, reducing error vs healthy cohort models.
Why the study?
Current nonexercise prediction equations for peak oxygen uptake were developed in healthy cohorts and may not apply to individuals with cardiovascular disease.
Does a CVD-specific nonexercise prediction equation improve the accuracy of predicting V˙o2peak compared to a healthy cohort equation in patients with cardiovascular disease?
Observational (n=15,997)
Yes
Does a CVD-specific nonexercise prediction equation improve the accuracy of predicting V˙o2peak compared to a healthy cohort equation in patients with cardiovascular disease?
Absolute Event Rate: 100% vs 141%
A newly developed CVD-specific nonexercise prediction equation for VO2peak is significantly more accurate than equations derived from healthy cohorts, though direct measurement remains preferable.
CVD-specific equation improves VO2peak prediction accuracy in validation; leaves open whether it should replace direct measurement in practice.
PURPOSE: Nonexercise predictions of peak oxygen uptake (V˙ o2peak ) are used clinically, yet current equations were developed from cohorts of apparently healthy individuals and may not be applicable to individuals with cardiovascular disease (CVD). Our purpose was to develop a CVD-specific nonexercise prediction equation for V˙ o2peak . METHODS: Participants were from the Fitness Registry and Importance of Exercise International Database (FRIEND) with a diagnosis of coronary artery bypass surgery (CABG), myocardial infarction (MI), percutaneous coronary intervention (PCI), or heart failure (HF) who met maximal effort criteria during a cardiopulmonary exercise test (n = 15 997; 83% male; age 63.1 ± 10.4 yr). The cohort was split into development (n = 12 798) and validation groups (n = 3199). The prediction equation was developed using regression analysis and compared with a previous equation developed on a healthy cohort. RESULTS: Age, sex, height, weight, exercise mode, and CVD diagnosis were all significant predictors of V˙ o2peak . The regression equation was:V˙ o2peak (mL · kg -1 · min -1 ) = 16.18 - (0.22 × age [yr]) + (3.63 × sex [male = 1; female = 0]) + (0.14 × height [cm]) - (0.12 × weight [kg]) + (3.62 × mode [treadmill = 1; cycle = 0]) - (2.70 × CABG [yes = 1, no = 0]) - (0.31 × MI [yes = 1, no = 0]) + (0.37 × PCI [yes = 1, no = 0]) - (4.47 × HF [yes = 1, no = 0]). Adjusted R 2 = 0.43; SEE = 4.75 mL · kg -1 · min -1 .Compared with measured V˙ o2peak in the validation group, percent predicted V˙ o2peak was 141% for the healthy cohort equation and 100% for the CVD-specific equation. CONCLUSIONS: The new equation for individuals with CVD had lower error between measured and predicted V˙ o2peak than the healthy cohort equation, suggesting population-specific equations are needed for predicting V˙ o2peak ; however, errors associated with nonexercise prediction equations suggest V˙ o2peak should be directly measured whenever feasible.
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Peterman et al. (2022) conducted an observational in Cardiovascular disease (CABG, MI, PCI, or HF) (n=15,997). CVD-specific nonexercise prediction equation vs. Healthy cohort prediction equation was evaluated on Percent predicted V˙o2peak compared with measured V˙o2peak. A CVD-specific nonexercise prediction equation yielded 100% of measured peak oxygen uptake in validation, compared with 141% for a healthy cohort equation, reducing prediction error.
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