a School of Clinical Sciences , University of Bristol, Learning & Research Building (Level 1), Southmead Hospital , Bristol , UK.
b Institute of Public Health and Clinical Nutrition , University of Eastern Finland , Kuopio , Finland.
Ann Med. 2017 Dec;49(8):698-709. doi: 10.1080/07853890.2017.1367958. Epub 2017 Aug 22.
We aimed to assess the associations of oxygen uptake at aerobic threshold (VO at AT) with cardiovascular and all-cause mortality.
VO at AT was assessed in 1663 middle-aged men in a cohort study. Hazard ratios (HRs) were calculated for sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD) and all-cause mortality.
During a median follow-up of 25.6 years, 138 SCDs, 209 fatal CHDs, 333 fatal CVDs and 719 all-cause mortality events occurred. On adjustment for established risk factors, the HRs (95% CIs) for SCD, fatal CHD, fatal CVD and all-cause mortality were 0.48 (0.28-0.82), 0.48 (0.31-0.74), 0.57 (0.41-0.79) and 0.66 (0.53-0.82), respectively comparing extreme quartiles of VO at AT. On further adjustment for peak VO, the HRs were 0.87 (0.48-1.56), 0.83 (0.52-1.34), 0.91 (0.63-1.30) and 0.88 (0.69-1.12), respectively. Addition of VO at AT to a standard CVD mortality risk prediction model was associated with a C-index change of 0.0085 (95% CI: -0.0002-0.0172; p = .05) at 25 years.
VO at AT is inversely associated with cardiovascular and all-cause mortality events, but the associations are partly dependent on peak VO. VO at AT may improve the prediction of the long-term risk for CVD mortality. KEY MESSAGES Oxygen uptake at aerobic threshold (VO at AT), a cardiopulmonary exercise testing parameter, may be a useful prognostic tool for adverse clinical outcomes in the general population. In a population-based prospective cohort study of men, VO at AT was inversely associated with cardiovascular and all-cause mortality events and improved the prediction of cardiovascular mortality. In populations who cannot achieve maximal VO, VO at AT may serve as a useful prognostic tool; however, further studies are warranted.
我们旨在评估有氧阈下耗氧量（VO at AT）与心血管疾病和全因死亡率的相关性。
在一项队列研究中，评估了 1663 名中年男性的 VO at AT。计算了心源性猝死（SCD）、致命性冠心病（CHD）、心血管疾病（CVD）和全因死亡率的风险比（HRs）。
在中位随访 25.6 年期间，发生了 138 例 SCD、209 例致命性 CHD、333 例致命性 CVD 和 719 例全因死亡事件。在调整了既定危险因素后，SCD、致命性 CHD、致命性 CVD 和全因死亡率的 HR（95%CI）分别为 0.48（0.28-0.82）、0.48（0.31-0.74）、0.57（0.41-0.79）和 0.66（0.53-0.82），比较 VO at AT 极端四分位数。进一步调整峰值 VO 后，HR 分别为 0.87（0.48-1.56）、0.83（0.52-1.34）、0.91（0.63-1.30）和 0.88（0.69-1.12）。将 VO at AT 添加到标准 CVD 死亡率风险预测模型中，与 25 年时的 C 指数变化 0.0085（95%CI：-0.0002-0.0172；p=0.05）相关。
VO at AT 与心血管疾病和全因死亡率事件呈负相关，但相关性部分取决于峰值 VO。VO at AT 可能提高 CVD 死亡率长期风险的预测能力。
有氧阈下耗氧量（VO at AT）是心肺运动测试的一个参数，可能是一般人群不良临床结局的有用预后工具。在一项基于人群的前瞻性队列研究中，VO at AT 与心血管疾病和全因死亡率事件呈负相关，并且提高了心血管死亡率的预测能力。在无法达到最大 VO 的人群中，VO at AT 可能是一种有用的预后工具；但是，还需要进一步的研究。
