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

doi:10.1016/j.chest.2017.01.009

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

Research output: Contribution to journal › Article › peer-review

Abstract

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 language	English
Pages (from-to)	1329-1337
Number of pages	9
Journal	Chest
Volume	151
Issue number	6
DOIs	https://doi.org/10.1016/j.chest.2017.01.009
Publication status	Published - 2017

Keywords

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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@article{30b5c73d7770420d8d98daadbd4a3011,

title = "Reference Values for Peak Exercise Cardiac Output in Healthy Individuals",

abstract = "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. {\textcopyright} 2017 American College of Chest Physicians",

keywords = "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",

author = "P. Agostoni and C. Vignati and P. Gentile and C. Boiti and S. Farina and E. Salvioni and M. Mapelli and D. Magr{\`i} and S. Paolillo and N. Corrieri and G. Sinagra and G. Cattadori",

note = "Cited By :3 Export Date: 6 March 2018 CODEN: CHETB Correspondence Address: Agostoni, P.; Centro Cardiologico Monzino, IRCCS, University of Milan, via Parea 4, Italy; email: piergiuseppe.agostoni@unimi.it Chemicals/CAS: oxygen, 7782-44-7 References: Lipkin, D.P., Poole-Wilson, P.A., Measurement of cardiac output during exercise by the thermodilution and direct Fick techniques in patients with chronic congestive heart failure (1985) Am J Cardiol, 56 (4), pp. 321-324; Francis, G.S., Hemodynamic and neurohumoral responses to dynamic exercise: normal subjects versus patients with heart disease (1987) Circulation, 76 (6), pp. VI11-VI17; Sullivan, M.J., Knight, J.D., Higginbotham, M.B., Cobb, F.R., Relation between central and peripheral hemodynamics during exercise in patients with chronic heart failure: muscle blood flow is reduced with maintenance of arterial perfusion pressure (1989) Circulation, 80 (4), pp. 769-781; Chomsky, D.B., Lang, C.C., Rayos, G.H., Hemodynamic exercise testing: a valuable tool in the selection of cardiac transplantation candidates (1996) Circulation, 94 (12), pp. 3176-3183; Metra, M., Faggiano, P., D'Aloia, A., Use of cardiopulmonary exercise testing with hemodynamic monitoring in the prognostic assessment of ambulatory patients with chronic heart failure (1999) J Am Coll Cardiol, 33 (4), pp. 943-950; Weber, K.T., Janicki, J.S., Cardiopulmonary exercise testing for evaluation of chronic cardiac failure (1985) Am J Cardiol, 55 (2), pp. 22A-31A; Schlosshan, D., Barker, D., Pepper, C., Williams, G., Morley, C., Tan, L.B., CRT improves the exercise capacity and functional reserve of the failing heart through enhancing the cardiac flow- and pressure-generating capacity (2006) Eur J Heart Fail, 8 (5), pp. 515-521; Balady, G.J., Arena, R., Sietsema, K., Clinician's guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association (2010) Circulation, 122 (2), pp. 191-225; Welsman, J., Bywater, K., Farr, C., Welford, D., Armstrong, N., Reliability of peak V˙O2 and maximal cardiac output assessed using thoracic bioimpedance in children (2005) Eur J Appl Physiol, 94 (3), pp. 228-234; Moore, R., Sansores, R., Guimond, V., Abboud, R., Evaluation of cardiac output by thoracic electrical bioimpedance during exercise in normal subjects (1992) Chest, 102 (2), pp. 448-455; Nugent, A.M., McParland, J., McEneaney, D.J., Non-invasive measurement of cardiac output by a carbon dioxide rebreathing method at rest and during exercise (1994) Eur Heart J, 15 (3), pp. 361-368; Stringer, W.W., Hansen, J.E., Wasserman, K., Cardiac output estimated noninvasively from oxygen uptake during exercise (1997) J Appl Physiol (1985), 82 (3), pp. 908-912; Cotter, G., Moshkovitz, Y., Kaluski, E., The role of cardiac power and systemic vascular resistance in the pathophysiology and diagnosis of patients with acute congestive heart failure (2003) Eur J Heart Fail, 5 (4), pp. 443-451; Cohen-Solal, A., Tabet, J.Y., Logeart, D., Bourgoin, P., Tokmakova, M., Dahan, M., A non-invasively determined surrogate of cardiac power (“circulatory power”) at peak exercise is a powerful prognostic factor in chronic heart failure (2002) Eur Heart J, 23 (10), pp. 806-814; Higginbotham, M.B., Morris, K.G., Williams, R.S., McHale, P.A., Coleman, R.E., Cobb, F.R., Regulation of stroke volume during submaximal and maximal upright exercise in normal man (1986) Circ Res, 58 (2), pp. 281-291; Granath, A., Jonsson, B., Strandell, T., Circulation in healthy old men, studied by right heart catheterization at rest and during exercise in supine and sitting position (1964) Acta Med Scand, 176, pp. 425-446; Bevegard, S., Holmgren, A., Jonsson, B., Circulatory studies in well trained athletes at rest and during heavy exercise: with special reference to stroke volume and the influence of body position (1963) Acta Physiol Scand, 57, pp. 26-50; Stringer, W.W., Whipp, B.J., Wasserman, K., Porszasz, J., Christenson, P., French, W.J., Non-linear cardiac output dynamics during ramp-incremental cycle ergometry (2005) Eur J Appl Physiol, 93 (5-6), pp. 634-639; Julius, S., Amery, A., Whitlock, L.S., Conway, J., Influence of age on the hemodynamic response to exercise (1967) Circulation, 36 (2), pp. 222-230; Sullivan, M.J., Cobb, F.R., Higginbotham, M.B., Stroke volume increases by similar mechanisms during upright exercise in normal men and women (1991) Am J Cardiol, 67 (16), pp. 1405-1412; Rodeheffer, R.J., Gerstenblith, G., Becker, L.C., Fleg, J.L., Weisfeldt, M.L., Lakatta, E.G., Exercise cardiac output is maintained with advancing age in healthy human subjects: cardiac dilatation and increased stroke volume compensate for a diminished heart rate (1984) Circulation, 69 (2), pp. 203-213; Vella, C.A., Robergs, R.A., A review of the stroke volume response to upright exercise in healthy subjects (2005) Br J Sports Med, 39 (4), pp. 190-195; Thadani, U., Parker, J.O., Hemodynamics at rest and during supine and sitting bicycle exercise in normal subjects (1978) Am J Cardiol, 41 (1), pp. 52-59; Hossack, K.F., Bruce, R.A., Maximal cardiac function in sedentary normal men and women: comparison of age-related changes (1982) J Appl Physiol Respir Environ Exerc Physiol, 53 (4), pp. 799-804; Gordon, A., Tyni-Lenne, R., Jansson, E., Jensen-Urstad, M., Kaijser, L., Beneficial effects of exercise training in heart failure patients with low cardiac output response to exercise: a comparison of two training models (1999) J Internal Med, 246 (2), pp. 175-182; Mancini, D., Katz, S., Donchez, L., Aaronson, K., Coupling of hemodynamic measurements with oxygen consumption during exercise does not improve risk stratification in patients with heart failure (1996) Circulation, 94 (10), pp. 2492-2496; Wilson, J.R., Groves, J., Rayos, G., Circulatory status and response to cardiac rehabilitation in patients with heart failure (1996) Circulation, 94 (7), pp. 1567-1572; Higginbotham, M.B., Morris, K.G., Coleman, R.E., Cobb, F.R., Sex-related differences in the normal cardiac response to upright exercise (1984) Circulation, 70 (3), pp. 357-366; Agostoni, P., Cattadori, G., Apostolo, A., Noninvasive measurement of cardiac output during exercise by inert gas rebreathing technique: a new tool for heart failure evaluation (2005) J Am Coll Cardiol, 46 (9), pp. 1779-1781; Goda, A., Lang, C.C., Williams, P., Jones, M., Farr, M.J., Mancini, D.M., Usefulness of non-invasive measurement of cardiac output during sub-maximal exercise to predict outcome in patients with chronic heart failure (2009) Am J Cardiol, 104 (11), pp. 1556-1560; Elkayam, U., Wilson, A.F., Morrison, J., Non-invasive measurement of cardiac output by a single breath constant expiratory technique (1984) Thorax, 39 (2), pp. 107-113; Farina, S., Teruzzi, G., Cattadori, G., Noninvasive cardiac output measurement by inert gas rebreathing in suspected pulmonary hypertension (2014) Am J Cardiol, 113 (3), pp. 546-551; Wasserman, K., Hansen, J.E., Sue, D.Y., Stringer, W.W., Whipp, B.J., Clinical Exercise Testing: Principles of Exercise Testing and Interpretation Including Pathophysiology and Clinical Applications (2005), pp. 138-139. , Lippincott Williams & Wilkins Philadelphia, PA; Ekblom, B., Astrand, P.O., Saltin, B., Stenberg, J., Wallstr{\"o}m, B., Effect of training on circulatory response to exercise (1968) J Appl Physiol, 24 (4), pp. 518-528; Grimby, G., Nilsson, N.J., Saltin, B., Cardiac output during submaximal and maximal exercise in active middle-aged athletes (1966) J Appl Physiol, 21 (4), pp. 1150-1156; Astrand, P.O., Cuddy, T.E., Saltin, B., Stenberg, J., Cardiac output during submaximal and maximal work (1964) J Appl Physiol, 19, pp. 268-274; Astrand, P.O., Human physical fitness with special reference to sex and age (1956) Physiol Rev, 36 (3), pp. 307-335; Ridout, S.J., Parker, B.A., Smithmyer, S.L., Gonzales, J.U., Beck, K.C., Proctor, D.N., Age and sex influence the balance between maximal cardiac output and peripheral vascular reserve (2010) J Appl Physiol (1985), 108 (3), pp. 483-489; Bogaard, H.J., Woltjer, H.H., Dekker, B.M., van Keimpema, A.R., Postmus, P.E., de Vries, P.M., Haemodynamic response to exercise in healthy young and elderly subjects (1997) Eur J Appl Physiol Occup Physiol, 75 (5), pp. 435-442; Tomai, F., Ciavolella, M., Gaspardone, A., Peak exercise left ventricular performance in normal subjects and in athletes assessed by first-pass radionuclide angiography (1992) Am J Cardiol, 70 (4), pp. 531-535; Guazzi, M., Adams, V., Conraads, V., EACPR/AHA scientific statement: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations (2012) Circulation, 126 (18), pp. 2261-2274; Agostoni, P., Corra, U., Cattadori, G., Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score: a multiparametric approach to heart failure prognosis (2013) Int J Cardiol, 167 (6), pp. 2710-2718; Nielsen, O.W., Hansen, S., Gronlund, J., Precision and accuracy of a noninvasive inert gas washin method for determination of cardiac output in men (1994) J Appl Physiol (1985), 76 (4), pp. 1560-1565; Lang, C.C., Agostoni, P., Mancini, D.M., Prognostic significance and measurement of exercise-derived hemodynamic variables in patients with heart failure (2007) J Cardiac Fail, 13 (8), pp. 672-679",

year = "2017",

doi = "10.1016/j.chest.2017.01.009",

language = "English",

volume = "151",

pages = "1329--1337",

journal = "Chest",

issn = "0012-3692",

publisher = "Elsevier Inc.",

number = "6",

}

TY - JOUR

T1 - Reference Values for Peak Exercise Cardiac Output in Healthy Individuals

AU - Agostoni, P.

AU - Vignati, C.

AU - Gentile, P.

AU - Boiti, C.

AU - Farina, S.

AU - Salvioni, E.

AU - Mapelli, M.

AU - Magrì, D.

AU - Paolillo, S.

AU - Corrieri, N.

AU - Sinagra, G.

AU - Cattadori, G.

N1 - Cited By :3 Export Date: 6 March 2018 CODEN: CHETB Correspondence Address: Agostoni, P.; Centro Cardiologico Monzino, IRCCS, University of Milan, via Parea 4, Italy; email: piergiuseppe.agostoni@unimi.it Chemicals/CAS: oxygen, 7782-44-7 References: Lipkin, D.P., Poole-Wilson, P.A., Measurement of cardiac output during exercise by the thermodilution and direct Fick techniques in patients with chronic congestive heart failure (1985) Am J Cardiol, 56 (4), pp. 321-324; Francis, G.S., Hemodynamic and neurohumoral responses to dynamic exercise: normal subjects versus patients with heart disease (1987) Circulation, 76 (6), pp. VI11-VI17; Sullivan, M.J., Knight, J.D., Higginbotham, M.B., Cobb, F.R., Relation between central and peripheral hemodynamics during exercise in patients with chronic heart failure: muscle blood flow is reduced with maintenance of arterial perfusion pressure (1989) Circulation, 80 (4), pp. 769-781; Chomsky, D.B., Lang, C.C., Rayos, G.H., Hemodynamic exercise testing: a valuable tool in the selection of cardiac transplantation candidates (1996) Circulation, 94 (12), pp. 3176-3183; Metra, M., Faggiano, P., D'Aloia, A., Use of cardiopulmonary exercise testing with hemodynamic monitoring in the prognostic assessment of ambulatory patients with chronic heart failure (1999) J Am Coll Cardiol, 33 (4), pp. 943-950; Weber, K.T., Janicki, J.S., Cardiopulmonary exercise testing for evaluation of chronic cardiac failure (1985) Am J Cardiol, 55 (2), pp. 22A-31A; Schlosshan, D., Barker, D., Pepper, C., Williams, G., Morley, C., Tan, L.B., CRT improves the exercise capacity and functional reserve of the failing heart through enhancing the cardiac flow- and pressure-generating capacity (2006) Eur J Heart Fail, 8 (5), pp. 515-521; Balady, G.J., Arena, R., Sietsema, K., Clinician's guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association (2010) Circulation, 122 (2), pp. 191-225; Welsman, J., Bywater, K., Farr, C., Welford, D., Armstrong, N., Reliability of peak V˙O2 and maximal cardiac output assessed using thoracic bioimpedance in children (2005) Eur J Appl Physiol, 94 (3), pp. 228-234; Moore, R., Sansores, R., Guimond, V., Abboud, R., Evaluation of cardiac output by thoracic electrical bioimpedance during exercise in normal subjects (1992) Chest, 102 (2), pp. 448-455; Nugent, A.M., McParland, J., McEneaney, D.J., Non-invasive measurement of cardiac output by a carbon dioxide rebreathing method at rest and during exercise (1994) Eur Heart J, 15 (3), pp. 361-368; Stringer, W.W., Hansen, J.E., Wasserman, K., Cardiac output estimated noninvasively from oxygen uptake during exercise (1997) J Appl Physiol (1985), 82 (3), pp. 908-912; Cotter, G., Moshkovitz, Y., Kaluski, E., The role of cardiac power and systemic vascular resistance in the pathophysiology and diagnosis of patients with acute congestive heart failure (2003) Eur J Heart Fail, 5 (4), pp. 443-451; Cohen-Solal, A., Tabet, J.Y., Logeart, D., Bourgoin, P., Tokmakova, M., Dahan, M., A non-invasively determined surrogate of cardiac power (“circulatory power”) at peak exercise is a powerful prognostic factor in chronic heart failure (2002) Eur Heart J, 23 (10), pp. 806-814; Higginbotham, M.B., Morris, K.G., Williams, R.S., McHale, P.A., Coleman, R.E., Cobb, F.R., Regulation of stroke volume during submaximal and maximal upright exercise in normal man (1986) Circ Res, 58 (2), pp. 281-291; Granath, A., Jonsson, B., Strandell, T., Circulation in healthy old men, studied by right heart catheterization at rest and during exercise in supine and sitting position (1964) Acta Med Scand, 176, pp. 425-446; Bevegard, S., Holmgren, A., Jonsson, B., Circulatory studies in well trained athletes at rest and during heavy exercise: with special reference to stroke volume and the influence of body position (1963) Acta Physiol Scand, 57, pp. 26-50; Stringer, W.W., Whipp, B.J., Wasserman, K., Porszasz, J., Christenson, P., French, W.J., Non-linear cardiac output dynamics during ramp-incremental cycle ergometry (2005) Eur J Appl Physiol, 93 (5-6), pp. 634-639; Julius, S., Amery, A., Whitlock, L.S., Conway, J., Influence of age on the hemodynamic response to exercise (1967) Circulation, 36 (2), pp. 222-230; Sullivan, M.J., Cobb, F.R., Higginbotham, M.B., Stroke volume increases by similar mechanisms during upright exercise in normal men and women (1991) Am J Cardiol, 67 (16), pp. 1405-1412; Rodeheffer, R.J., Gerstenblith, G., Becker, L.C., Fleg, J.L., Weisfeldt, M.L., Lakatta, E.G., Exercise cardiac output is maintained with advancing age in healthy human subjects: cardiac dilatation and increased stroke volume compensate for a diminished heart rate (1984) Circulation, 69 (2), pp. 203-213; Vella, C.A., Robergs, R.A., A review of the stroke volume response to upright exercise in healthy subjects (2005) Br J Sports Med, 39 (4), pp. 190-195; Thadani, U., Parker, J.O., Hemodynamics at rest and during supine and sitting bicycle exercise in normal subjects (1978) Am J Cardiol, 41 (1), pp. 52-59; Hossack, K.F., Bruce, R.A., Maximal cardiac function in sedentary normal men and women: comparison of age-related changes (1982) J Appl Physiol Respir Environ Exerc Physiol, 53 (4), pp. 799-804; Gordon, A., Tyni-Lenne, R., Jansson, E., Jensen-Urstad, M., Kaijser, L., Beneficial effects of exercise training in heart failure patients with low cardiac output response to exercise: a comparison of two training models (1999) J Internal Med, 246 (2), pp. 175-182; Mancini, D., Katz, S., Donchez, L., Aaronson, K., Coupling of hemodynamic measurements with oxygen consumption during exercise does not improve risk stratification in patients with heart failure (1996) Circulation, 94 (10), pp. 2492-2496; Wilson, J.R., Groves, J., Rayos, G., Circulatory status and response to cardiac rehabilitation in patients with heart failure (1996) Circulation, 94 (7), pp. 1567-1572; Higginbotham, M.B., Morris, K.G., Coleman, R.E., Cobb, F.R., Sex-related differences in the normal cardiac response to upright exercise (1984) Circulation, 70 (3), pp. 357-366; Agostoni, P., Cattadori, G., Apostolo, A., Noninvasive measurement of cardiac output during exercise by inert gas rebreathing technique: a new tool for heart failure evaluation (2005) J Am Coll Cardiol, 46 (9), pp. 1779-1781; Goda, A., Lang, C.C., Williams, P., Jones, M., Farr, M.J., Mancini, D.M., Usefulness of non-invasive measurement of cardiac output during sub-maximal exercise to predict outcome in patients with chronic heart failure (2009) Am J Cardiol, 104 (11), pp. 1556-1560; Elkayam, U., Wilson, A.F., Morrison, J., Non-invasive measurement of cardiac output by a single breath constant expiratory technique (1984) Thorax, 39 (2), pp. 107-113; Farina, S., Teruzzi, G., Cattadori, G., Noninvasive cardiac output measurement by inert gas rebreathing in suspected pulmonary hypertension (2014) Am J Cardiol, 113 (3), pp. 546-551; Wasserman, K., Hansen, J.E., Sue, D.Y., Stringer, W.W., Whipp, B.J., Clinical Exercise Testing: Principles of Exercise Testing and Interpretation Including Pathophysiology and Clinical Applications (2005), pp. 138-139. , Lippincott Williams & Wilkins Philadelphia, PA; Ekblom, B., Astrand, P.O., Saltin, B., Stenberg, J., Wallström, B., Effect of training on circulatory response to exercise (1968) J Appl Physiol, 24 (4), pp. 518-528; Grimby, G., Nilsson, N.J., Saltin, B., Cardiac output during submaximal and maximal exercise in active middle-aged athletes (1966) J Appl Physiol, 21 (4), pp. 1150-1156; Astrand, P.O., Cuddy, T.E., Saltin, B., Stenberg, J., Cardiac output during submaximal and maximal work (1964) J Appl Physiol, 19, pp. 268-274; Astrand, P.O., Human physical fitness with special reference to sex and age (1956) Physiol Rev, 36 (3), pp. 307-335; Ridout, S.J., Parker, B.A., Smithmyer, S.L., Gonzales, J.U., Beck, K.C., Proctor, D.N., Age and sex influence the balance between maximal cardiac output and peripheral vascular reserve (2010) J Appl Physiol (1985), 108 (3), pp. 483-489; Bogaard, H.J., Woltjer, H.H., Dekker, B.M., van Keimpema, A.R., Postmus, P.E., de Vries, P.M., Haemodynamic response to exercise in healthy young and elderly subjects (1997) Eur J Appl Physiol Occup Physiol, 75 (5), pp. 435-442; Tomai, F., Ciavolella, M., Gaspardone, A., Peak exercise left ventricular performance in normal subjects and in athletes assessed by first-pass radionuclide angiography (1992) Am J Cardiol, 70 (4), pp. 531-535; Guazzi, M., Adams, V., Conraads, V., EACPR/AHA scientific statement: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations (2012) Circulation, 126 (18), pp. 2261-2274; Agostoni, P., Corra, U., Cattadori, G., Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score: a multiparametric approach to heart failure prognosis (2013) Int J Cardiol, 167 (6), pp. 2710-2718; Nielsen, O.W., Hansen, S., Gronlund, J., Precision and accuracy of a noninvasive inert gas washin method for determination of cardiac output in men (1994) J Appl Physiol (1985), 76 (4), pp. 1560-1565; Lang, C.C., Agostoni, P., Mancini, D.M., Prognostic significance and measurement of exercise-derived hemodynamic variables in patients with heart failure (2007) J Cardiac Fail, 13 (8), pp. 672-679

PY - 2017

Y1 - 2017

N2 - 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

AB - 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

KW - cardiac output

KW - exercise

KW - oxygen consumption

KW - inert gas

KW - oxygen

KW - adult

KW - aged

KW - anthropometry

KW - Article

KW - cardiopulmonary exercise test

KW - cohort analysis

KW - controlled study

KW - female

KW - heart disease

KW - heart function

KW - heart output

KW - human

KW - major clinical study

KW - male

KW - priority journal

KW - prognosis

KW - rebreathing

KW - reference value

KW - adolescent

KW - exercise test

KW - middle aged

KW - normal human

KW - physiology

KW - young adult

KW - Adolescent

KW - Adult

KW - Aged

KW - Cardiac Output

KW - Exercise

KW - Exercise Test

KW - Female

KW - Healthy Volunteers

KW - Humans

KW - Male

KW - Middle Aged

KW - Oxygen Consumption

KW - Reference Values

KW - Young Adult

U2 - 10.1016/j.chest.2017.01.009

DO - 10.1016/j.chest.2017.01.009

M3 - Article

VL - 151

SP - 1329

EP - 1337

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -