Key result
A nonexercise estimate of cardiorespiratory fitness predicted all-cause mortality similarly to measured fitness, with a 26% reduction in mortality risk per 1 MET higher increment.
Why the study?
Cardiorespiratory fitness is a recognized risk factor for mortality but is not routinely measured clinically, prompting the assessment of a nonexercise method to estimate it.
Does a nonexercise estimate of cardiorespiratory fitness (eCRF) predict all-cause mortality similarly to measured CRF in clinically referred subjects?
Cohort (n=1,545)
Does a nonexercise estimate of cardiorespiratory fitness (eCRF) predict all-cause mortality similarly to measured CRF in clinically referred subjects?
Effect estimate: 26% reduction per 1 MET increment
A nonexercise estimate of cardiorespiratory fitness using a symptom questionnaire and clinical variables predicts mortality risk similarly to maximal exercise testing.
PURPOSE: Cardiorespiratory fitness (CRF) has recently been recognized as a risk factor for mortality, but it is not routinely measured in clinical settings. The purpose of this study was to assess a nonexercise method to estimate CRF (eCRF) and its association with mortality in a clinically referred population. METHODS: A symptom tool, termed the Veterans Specific Activity Questionnaire (VSAQ), and nonexercise clinical variables were obtained from 1545 clinically referred subjects (60 ± 13 yr), and followed for a mean of 5.6 ± 4.2 yr. The VSAQ along with nonexercise clinical and historical variables was used to develop a multivariate model to predict achieved CRF from maximal exercise testing. Proportional hazards analysis was used to assess the association between measured and eCRF and all-cause mortality. RESULTS: The eCRF model was significantly associated with achieved CRF (multiple R = 0.67, P < .001). Mean achieved CRF from maximal treadmill testing and eCRF were similar (8.6 ± 5.0 metabolic equivalents [METs] vs 8.7 ± 4.7 METs respectively, P = .27). Achieved CRF and eCRF performed similarly for predicting mortality. After full adjustment, each 1 MET higher increment in achieved CRF and eCRF was associated with 19% and 26% reductions in mortality risk, respectively. Compared with the lowest fit group (<5 METs), the highest CRF groups (>11 METs) had 88% and 87% lower risks for mortality for achieved CRF and eCRF, respectively. CONCLUSIONS: A multivariable nonexercise model featuring a symptom questionnaire combined with clinical variables that are readily available during a typical clinical encounter had a reasonably strong association with achieved CRF and exhibited prognostic characteristics that were similar to achieved CRF.
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Myers et al. (2022) conducted a cohort in Clinically referred subjects (n=1,545). Estimated cardiorespiratory fitness (eCRF) vs. Measured achieved cardiorespiratory fitness was evaluated on All-cause mortality (26% reduction per 1 MET increment). A nonexercise estimate of cardiorespiratory fitness predicted all-cause mortality similarly to measured fitness, with a 26% reduction in mortality risk per 1 MET higher increment.
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