Estimated peak functional capacity: an accurate method for assessing change in peak oxygen consumption after cardiac rehabilitation?
Autor: | Sean Carroll, John G.F. Cleland, Renjith Antony, Andrew L. Clark, Lee Ingle, Damien Gleadall-Siddall, Simon Nichols |
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Přispěvatelé: | Royal Brompton & Harefield NHS Foundation Trust, National Institute for Health Research |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
Sports medicine Physiology Intraclass correlation Health Status Coronary Disease 030204 cardiovascular system & hematology Metabolic equivalent 0302 clinical medicine Medicine 030212 general & internal medicine Treadmill Lead (electronics) Cardiac Rehabilitation Exercise Tolerance General Medicine Middle Aged metabolic equivalents Exercise Therapy Treatment Outcome Cardiorespiratory Fitness METs Cardiology Female VO 2peak medicine.medical_specialty 03 medical and health sciences Oxygen Consumption Predictive Value of Tests Physiology (medical) Internal medicine cardiopulmonary exercise testing Humans coronary heart disease Aged exercise testing estimated VO2peak business.industry Reproducibility of Results Cardiorespiratory fitness Gold standard (test) Recovery of Function R1 Bicycling 1116 Medical Physiology Physical therapy Exercise Test business Body mass index human activities |
ISSN: | 1475-097X 1475-0961 |
Popis: | Objective: Maximal cardiopulmonary exercise testing (CPET) is the “gold standard” method of determining VO2peak. When CPET is unavailable, VO2peak may be estimated from treadmill or cycle ergometer workloads and expressed as estimated metabolic equivalents (METs). Cardiac rehabilitation (CR) programmes use estimated VO2peak (METs) to report changes in cardiorespiratory fitness (CRF). However, the accuracy of determining changes in VO2peak based on estimated functional capacity is not known.\ud \ud Methods: 27 patients with coronary heart disease (88.9% male; age 59.5 ± 10.0 years, body mass index 29.6 ± 3.8 kg.m-2) performed maximal CPET before and after an exercise based CR intervention. VO2peak was directly determined using ventilatory gas exchange data and was also estimated using the American College of Sports Medicine (ACSM) leg cycling equation for METs. Agreement between changes in directly determined VO2peak and VO2peak estimated from METs was tested using Bland-Altman limits of agreement (LoA), and intraclass correlation coefficients. \ud \ud Results: Directly determined VO2peak did not increase significantly following CR (0.5 ml.kg-1.min-1 (2.7%); p=0.332). In contrast, estimated VO2peak increased significantly (0.4 METs; 1.4 ml.kg-1.min-1; 6.7%; p=0.006). The mean bias for estimated VO2peak versus directly-determined VO2peak was 0.7 ml.kg-1.min-1 (LoA -4.7 to 5.9 ml.kg-1.min-1). Aerobic efficiency, (ΔVO2/ΔWR slope) was significantly associated with estimated VO2peak measurement error.\ud \ud Conclusion: Changes in estimated VO2peak determined using the ACSM equation for leg cycling are not accurate surrogates for directly determined changes in VO2peak. Reporting mean CRF changes using estimated METs may over-estimate the efficacy of CR and lead to a different interpretation of study findings compared to directly determined VO2peak. \ud \ud Key Words: CHD, Coronary Heart Disease, Cardiac Rehab, Cardiovascular Rehab, Exercise Testing, Cardiopulmonary Exercise Testing, Metabolic Equivalents, METs \ud \ud Clinicaltrial.gov identifier: NCT01761448 |
Databáze: | OpenAIRE |
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