Key result
High cardiorespiratory optimal point linked to increased cardiovascular and all-cause mortality risk.
Why the study?
The cardiorespiratory optimal point during CPET has emerged as an accessible submaximal tool, but its behavior, relation to cardiorespiratory variables, and role in cardiovascular risk stratification and mortality in adults with and without cardiovascular disease needed systematic analysis.
Does the cardiorespiratory optimal point (COP) predict cardiovascular risk and mortality in adults with and without cardiovascular disease?
Systematic Review (n=14,537)
Does the cardiorespiratory optimal point (COP) predict cardiovascular risk and mortality in adults with and without cardiovascular disease?
The cardiorespiratory optimal point (COP) is an accessible submaximal prognostic marker during exercise testing that predicts cardiovascular and all-cause mortality.
Cardiovascular risk and mortality are global concerns. Cardiopulmonary exercise testing (CPET) helps identify key diagnostic and prognostic variables for cardiorespiratory fitness. The cardiorespiratory optimal point (COP), defined as the lowest point of ventilation required to extract oxygen, has emerged as an accessible and potentially useful submaximal tool. This aimed to analyze COP´s behavior and its relation to cardiorespiratory variables during CPET and its relation with cardiovascular risk (CVR) stratification and mortality in adults with and without cardiovascular disease. A systematic review was conducted using electronic databases (PubMed, Cochrane Library, and ScienceDirect) following PRISMA guidelines. Ten studies with 14,537 participants were included, and methodological quality was assessed through the Newcastle-Ottawa scale. Results showed that high COP values, typically reported within a risk-associated range of >25–30, were significantly associated with increased cardiovascular and all-cause mortality risk. COP showed moderate correlations with other cardiorespiratory variables and appeared at submaximal intensities, before the first ventilatory threshold. COP is an accessible and prognostic tool for assessing cardiovascular health in clinical populations.
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Lemus-Zúñiga et al. (2026) conducted a systematic review in Cardiovascular risk and mortality (n=14,537). Cardiorespiratory optimal point (COP) was evaluated on Cardiovascular and all-cause mortality risk. High cardiorespiratory optimal point values (>25–30) were significantly associated with increased cardiovascular and all-cause mortality risk.
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