Reference Values for Peak Exercise Cardiac Output in Healthy Individuals

P. Agostoni, C. Vignati, P. Gentile, C. Boiti, S. Farina, E. Salvioni, M. Mapelli, D. Magrì, S. Paolillo, N. Corrieri, G. Sinagra, G. Cattadori

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Background Cardiac output (Q˙) is a key parameter in the assessment of cardiac function, its measurement being crucial for the diagnosis, treatment, and prognostic evaluation of all heart diseases. Until recently, Q˙ determination at peak exercise has been possible through invasive methods, so that normal values were obtained in studies based on small populations. Methods Nowadays, peak Q˙ can be measured noninvasively by means of the inert gas rebreathing (IGR) technique. The present study was undertaken to provide reference values for peak Q˙ in the normal general population and to obtain a formula able to estimate peak exercise Q˙ from measured peak oxygen uptake (V˙O2). Results We studied 500 normal subjects (age, 44.9 ± 1.5 years; range, 18-77 years; 260 men, 240 women) who underwent a maximal cardiopulmonary exercise test with peak Q˙ measurement by IGR. In the overall study sample, peak Q˙ was 13.2 ± 3.5 L/min (men, 15.3 ± 3.3 L/min; women, 11.0 ± 2.0 L/min; P < .001) and peak V˙O2 was 95% ± 18% of the maximum predicted value (men, 95% ± 19%; women, 95% ± 18%). Peak V˙O2 and peak Q˙ progressively decreased with age (R2, 0.082; P < .001; and R2, 0.144; P < .001, respectively). The V˙O2-derived formula to measure Q˙ at peak exercise was (4.4 × peak V˙O2) + 4.3 in the overall study cohort, (4.3 × peak V˙O2) + 4.5 in men, and (4.9 × peak V˙O2) + 3.6 in women. Conclusions The simultaneous measurement of Q˙ and V˙O2 at peak exercise in a large sample of healthy subjects provided an equation to predict peak Q˙ from peak V˙O2 values. © 2017 American College of Chest Physicians
Original languageEnglish
Pages (from-to)1329-1337
Number of pages9
Issue number6
Publication statusPublished - 2017


  • cardiac output
  • exercise
  • oxygen consumption
  • inert gas
  • oxygen
  • adult
  • aged
  • anthropometry
  • Article
  • cardiopulmonary exercise test
  • cohort analysis
  • controlled study
  • female
  • heart disease
  • heart function
  • heart output
  • human
  • major clinical study
  • male
  • priority journal
  • prognosis
  • rebreathing
  • reference value
  • adolescent
  • exercise test
  • middle aged
  • normal human
  • physiology
  • young adult
  • Adolescent
  • Adult
  • Aged
  • Cardiac Output
  • Exercise
  • Exercise Test
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption
  • Reference Values
  • Young Adult


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