What is the clinical evidence from this study?

Study design: Observational. Population: Postmenopausal obesity (n=9). Intervention: Maximal cardiopulmonary exercise testing (CPET). Primary outcome: Cardiorespiratory and metabolic responses (VO2max, RER, HR, O2 pulse) at rest, anaerobic threshold, maximum workload, and recovery.

What question did this study set out to answer?

To characterize cardiorespiratory and metabolic responses to graded exercise testing in sedentary, obese postmenopausal women.

June 16, 2026Central European Journal of Sport Sciences and MedicineOpen Access

Mechanisms of Exercise Limitation during Incremental Testing in Postmenopausal Obesity: A Cardiopulmonary Case Series

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Key result

Obese postmenopausal women exhibit severely impaired functional capacity with a peak VO2 of 16 ml/kg/min.

Why the study?

Obese postmenopausal women are at high risk for cardiometabolic disease, but the specific physiological patterns of their exercise intolerance remain poorly described.

Key Points

To characterize cardiorespiratory and metabolic responses to graded exercise testing in sedentary, obese postmenopausal women.
Conducted a case series in nine sedentary, obese postmenopausal women (mean age 56.78±9.02 years; BMI 33.87±3.8 kg/m²).
Assessed participants with maximal cardiopulmonary exercise testing using graded cycle ergometry, recording VO₂, VCO₂, respiratory exchange ratio, heart rate, and O₂ pulse at rest, anaerobic threshold, maximal workload, and recovery.
Peak oxygen uptake was severely reduced, ranging from (4±1) to (16±3) ml/kg/min with a mean of 16±3 ml/kg/min, and mean peak workload reached 111±24 W (anaerobic threshold at 54% Wmax).
Resting respiratory exchange ratio was ~0.93 and rose to 1.38 during recovery, reflecting metabolic inflexibility and severe acid-base disturbance.
Patients demonstrated blunted peak heart rate (~143 bpm) and delayed heart rate recovery indicating autonomic dysregulation, whereas O₂ pulse remained preserved.

Study Design

Type

Observational (n=9)

Structured PICO

Population

9 sedentary, obese postmenopausal women underwent maximal cardiopulmonary exercise testing to characterize their cardiorespiratory and metabolic responses.

Exposure

Maximal cardiopulmonary exercise testing (CPET) using graded cycle ergometry (workload increased continuously by 20 watts per minute until exhaustion).

Outcome

Cardiorespiratory and metabolic responses to graded exercise (VO2, VCO2, respiratory exchange ratio (RER), heart rate (HR), and O2 pulse) recorded at rest, anaerobic threshold, maximum workload, and 1 and 3 minutes into recovery.surrogate

Obese postmenopausal women exhibit severe exercise intolerance driven by reduced cardiovascular reserve, metabolic inflexibility, and autonomic dysfunction, highlighting the utility of CPET for personalized exercise prescription.

Limitations

Small sample size (n=9) restricts statistical power and generalizability.
No lean control group.
No mechanistic biomarkers (e.g., lactate levels, inflammatory markers) were measured.
Lack of detailed data on comorbidities or medications that could have influenced the results.
small sample (n=9), which restricts statistical power and generalizability
No lean control group or mechanistic biomarkers (e.g. lactate levels, inflammatory markers) were measured
did not collect detailed data on comorbidities or medications that could have influenced the results

Discussion

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Implication

CPET may delineate mechanisms of exercise intolerance in obese postmenopausal women; hypothesis-generating and should not yet change practice.

Cite This Study

Pusceddu et al. (2026) conducted an observational in Postmenopausal obesity (n=9). Maximal cardiopulmonary exercise testing (CPET) was evaluated on Cardiorespiratory and metabolic responses (VO2max, RER, HR, O2 pulse) at rest, anaerobic threshold, maximum workload, and recovery. Obese postmenopausal women exhibited severely impaired functional capacity with a mean peak oxygen uptake of 16 ml/kg/min, alongside profound metabolic inflexibility and autonomic dysfunction.

synapsesocial.com/papers/6a31570faf7cf7f8256b3ced https://doi.org/10.18276/cej.2026.1-02

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Implication

CPET may delineate mechanisms of exercise intolerance in obese postmenopausal women; hypothesis-generating and should not yet change practice.

Mechanisms of Exercise Limitation during Incremental Testing in Postmenopausal Obesity: A Cardiopulmonary Case Series

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Mechanisms of Exercise Limitation during Incremental Testing in Postmenopausal Obesity: A Cardiopulmonary Case Series

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider