New Ideas on Limitations to VO2max: Five Major Determinants for VO2max

C hronic obstructive pulmonary disease (COPD) is an impor- tant and a growing cause of morbidity and mortality worldwide. Cardiovascular, musculoskeletal, metabolic, and mental comorbidities are considered to be part of the frequently prevalent non-pulmonary sequelae of the disease. 1,2 Increasing evidence suggests that extra-pulmonary effects of COPD and airflow limitation are only poorly correlated. Waschki, et al. found that objectively measured physical activity is the strongest predictor of all-cause mortality in patients with COPD.