Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA.
Division of Cardiology, Veterans Affairs Palo Alto Healthcare System and Stanford University, Palo Alto, CA.
Med Sci Sports Exerc. 2022 Nov 1;54(11):1919-1924. doi: 10.1249/MSS.0000000000002985. Epub 2022 Jun 30.
Normative standards for key cardiopulmonary exercise (CPX) test variables, including peak circulatory power (CircP), are needed to guide the interpretation of clinical exercise responses in individuals with and without disease.
This study aimed to establish age- and sex-specific reference standards for peak CircP derived from a healthy cohort from the Fitness Registry and the Importance of Exercise: A National Database (FRIEND).
CPX test data from apparently healthy males and females from eight FRIEND United States exercise laboratories were considered. Inclusion criteria included ages 20-79 yr and a maximal, symptom-limited exercise test performed on a treadmill or cycle ergometer. CircP was calculated as the product of peak oxygen consumption and peak systolic blood pressure. Reference values were determined on both treadmill and cycle ergometer for males and females per age decade. A stepwise linear regression to predict CircP was derived from two-thirds of the sample while the remaining one-third was used as a validation cohort.
A total of 6736 CPX tests (47% treadmill, 53% female) were included in the analysis. Overall, CircP was higher in males, higher on tests conducted on a treadmill, and decreased with age. Sex, exercise mode, age, and body mass index were the most significant contributors to CircP (multiple R = 0.75, R2 = 0.57, root-mean-square error = 1200 mm Hg·mL O 2 ·kg -1 ·min -1 , P < 0.001). Using the generated prediction equation, the average percent-predicted CircP for the validation cohort was 101.3% ± 28.1%.
These results establish reference standards for CircP, a potentially important prognostic indicator of cardiovascular health. Future research exploring the role of percentiles and percent-predicted values for CircP is necessary as they may provide additional prognostic insight.
需要制定关键心肺运动（CPX）测试变量的规范标准，包括峰值循环功率（CircP），以指导对有和没有疾病的个体的临床运动反应进行解释。
本研究旨在建立来自健身登记处和运动重要性：国家数据库（FRIEND）的健康队列的年龄和性别特异性峰值 CircP 参考标准。
考虑了来自八个 FRIEND 美国运动实验室的明显健康男性和女性的 CPX 测试数据。纳入标准包括年龄 20-79 岁，以及在跑步机或功率自行车上进行的最大、症状限制的运动测试。CircP 计算为峰值耗氧量和峰值收缩压的乘积。根据每个年龄十年，为男性和女性在跑步机和功率自行车上确定参考值。三分之二的样本用于推导预测 CircP 的逐步线性回归，其余三分之一用作验证队列。
共纳入 6736 次 CPX 测试（47%为跑步机，53%为女性）进行分析。总体而言，CircP 在男性中更高，在跑步机上进行的测试中更高，并且随年龄下降。性别、运动模式、年龄和体重指数是 CircP 的最重要贡献者（多元 R = 0.75，R2 = 0.57，均方根误差 = 1200 mmHg·mL O2·kg-1·min-1，P <0.001）。使用生成的预测方程，验证队列的平均预测 CircP 百分比为 101.3%±28.1%。
这些结果建立了 CircP 的参考标准，CircP 是心血管健康的潜在重要预后指标。需要进一步研究探索 CircP 的百分位数和预测百分比值的作用，因为它们可能提供额外的预后见解。
