September 22, 2022
View Full PaperA Nonexercise Prediction of Peak Oxygen Uptake for Patients With Cardiovascular Disease
Key Result
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.
Study Design
Type
Observational (n=15,997)
Multicenter
Yes
Structured PICO
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?
P
Population
Participants 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).
I
Intervention
CVD-specific nonexercise prediction equation for peak oxygen uptake (V˙o2peak)
C
Comparator
A previous nonexercise prediction equation developed on a healthy cohort
O
Outcome
Accuracy of predicted V˙o2peak compared to directly measured V˙o2peaksurrogate
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.
Main Result
Absolute Event Rate: 100% vs 141%
Limitations
- Errors associated with nonexercise prediction equations suggest V˙o2peak should be directly measured whenever feasible
Abstract
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.