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
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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