Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age

CanCOLD Collaborative Research group; Canadian Respiratory Research Network

doi:10.1016/j.chest.2020.11.009

Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age

CanCOLD Collaborative Research group, Canadian Respiratory Research Network

Medicine

Résultat de recherche: Article › examen par les pairs

10 Citations (Scopus)

Résumé

Background: Physiologic and symptom responses at the ventilatory threshold (Tvent) during incremental cardiopulmonary exercise testing (CPET) can provide important prognostic information. Research Question: This study aimed to develop an updated normative reference set for physiologic and symptom responses at Tvent during cycle CPET (primary aim) and to evaluate previously recommended reference equations from a 1985 study for predicting Tvent responses (secondary aim). Study Design and Methods: Participants were adults 40 to 80 years of age who were free of clinically relevant disease from the Canadian Cohort Obstructive Lung Disease. Rate of oxygen consumption (V˙O₂) at Tvent was identified by two independent raters; physiologic and symptom responses corresponding to V˙O₂ at Tvent were identified by linear interpolation. Reference ranges (5th-95th percentiles) for responses at Tvent were calculated according to participant sex and age for 29 and eight variables, respectively. Prediction models were developed for nine variables (oxygen pulse, V˙O₂, rate of CO₂ production, minute ventilation, tidal volume, inspiratory capacity, end-inspiratory lung volume [in liters and as percentage of total lung capacity], and end-expiratory lung volume) using quantile regression, estimating the 5th (lower limit of normal), 50th (normal), and 95th (upper limit of normal) percentiles based on readily available participant characteristics. The two one-sided test of equivalence for paired samples evaluated the measured and 1985-predicted V˙O₂ at Tvent for equivalence. Results: Reference ranges and equations were developed based on 96 participants (49% men) with a mean ± SD age of 63 ± 9 years. Mean V˙O₂ at Tvent was 50% of measured V˙O₂ peak; the normal range was 33% to 66%. The 1985 reference equations overpredicted V˙O₂ at Tvent: mean difference in men, −0.17 L/min (95% CI, −0.25 to −0.09 L/min); mean difference in women, −0.19 L/min (95% CI, −0.27 to −0.12 L/min). Interpretation: A contemporary reference set of CPET responses at Tvent from Canadian adults 40 to 80 years of age is presented that differs from the previously recommended and often used reference set from 1985. Trial Registry: ClinicalTrials.gov; No.: NCT00920348; URL: www.clinicaltrials.gov;

Langue d'origine	English
Pages (de-à)	1922-1933
Nombre de pages	12
Journal	Chest
Volume	159
Numéro de publication	5
DOI	https://doi.org/10.1016/j.chest.2020.11.009
Statut de publication	Published - mai 2021

Note bibliographique

Funding Information:
FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease ( ClinicalTrials.gov Identifier: NCT00920348) study currently is funded by the Canadian Respiratory Research Network, the Canadian Institutes of Health Research [CIHR/Rx&D Collaborative Research Program Operating Grant 93326], and the industry partners AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline (GSK) Canada Ltd., and Novartis . Previous funding partners were the Respiratory Health Network of the Fonds de la Recherche en Santé du Québec, the Foundation of the McGill University Health Centre , and the following industry partners: Almirall, Merck , Nycomed, Pfizer Canada Ltd., and Theratechnologies. The funders had no role in any aspect of the manuscript. H. L. was supported by a Fonds de Recherche du Québec Santé Postdoctoral Training Fellowship. J. B. holds a GlaxoSmithKline (GSK)/Canadian Institutes of Health Research (CIHR) Research Chair on Better Understanding of COPD and Intervention Guides at McGill University. J. A. G. was supported by a Scholar Award from the Michael Smith Foundation for Health Research and a Clinical Rehabilitation New Investigator Award from the CIHR. F. M. holds a GSK Research Chair on COPD at Université Laval. B. M. S. is supported by Québec Health Research Fund, the Canadian Institutes of Health Research, the National Institutes of Health (USA), the Respiratory Health Network of Québec, and Québec Lung Association. D. J. holds a Canada Research Chair, Tier II, in Clinical Exercise & Respiratory Physiology from the CIHR.

Funding Information:
FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease (ClinicalTrials.gov Identifier: NCT00920348) study currently is funded by the Canadian Respiratory Research Network, the Canadian Institutes of Health Research [CIHR/Rx&D Collaborative Research Program Operating Grant 93326], and the industry partners AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline (GSK) Canada Ltd., and Novartis. Previous funding partners were the Respiratory Health Network of the Fonds de la Recherche en Sant? du Qu?bec, the Foundation of the McGill University Health Centre, and the following industry partners: Almirall, Merck, Nycomed, Pfizer Canada Ltd., and Theratechnologies. The funders had no role in any aspect of the manuscript. H. L. was supported by a Fonds de Recherche du Qu?bec Sant? Postdoctoral Training Fellowship. J. B. holds a GlaxoSmithKline (GSK)/Canadian Institutes of Health Research (CIHR) Research Chair on Better Understanding of COPD and Intervention Guides at McGill University. J. A. G. was supported by a Scholar Award from the Michael Smith Foundation for Health Research and a Clinical Rehabilitation New Investigator Award from the CIHR. F. M. holds a GSK Research Chair on COPD at Universit? Laval. B. M. S. is supported by Qu?bec Health Research Fund, the Canadian Institutes of Health Research, the National Institutes of Health (USA), the Respiratory Health Network of Qu?bec, and Qu?bec Lung Association. D. J. holds a Canada Research Chair, Tier II, in Clinical Exercise & Respiratory Physiology from the CIHR.Author contributions: All of the authors reviewed the manuscript, contributed to the concept and design and to data interpretation. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: H. L. reports personal fees for consulting from Boehringer Ingelheim during the conduct of the study. J. A. G. reports personal fees from Agartee Technology, Inc. during the conduct of the study. D. D. M. reports consulting fees from AstraZeneca, Boehringer-Ingelheim, GSK, and Novartis; consulting fees from the Canadian Foundation for Healthcare Improvement, Health Canada, Mylan, and Yukon Health and Social Services; and personal fees from Lung Association of Saskatchewan; and other from the Canadian Thoracic Society. J. B. reports other from GlaxoSmithKline during the conduct of the study; personal fees from the Canadian Thoracic Society and CHEST; and personal fees from AstraZeneca, Boehringer Ingelheim, Grifols, GlaxoSmithKline, Novartis, and Trudell outside the submitted work. W. C. T. reports industry partners Astra Zeneca Canada, Ltd. Boehringer-Ingelheim Canada, Ltd. GlaxoSmithKline Canada, Ltd. Merck, Novartis Pharma Canada, Inc. Nycomed Canada, Inc. and Pfizer Canada, Ltd. during the conduct of the study. F. M. reports personal fees for serving on speaker bureaus and consultation panels from Boehringer Ingelheim, Grifols, and Novartis outside the submitted work, and is financially involved with Oxynov, a company that is developing an oxygen delivery system. D. J. reports personal fees for consulting from Boehringer Ingelheim during the conduct of the study; personal fees from AstraZeneca; None declared (O. E. F. N. M. K. S. D. E. O. B. M. S.). Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. ?CanCOLD Collaborative Research Group Collaborators: Shawn E. Aaron (The Ottawa Hospital Research Institute, Ottawa, ON, Canada); Kenneth R. Chapman (Asthma & Airway Centre, University Health Network and University of Toronto, Toronto, ON, Canada); Mark J. FitzGerald (University of British Columbia, Vancouver, BC, Canada); Paul Hernandez (Faculty of Medicine, Division of Respirology, Dalhousie University, Halifax, NS, Canada); Donald D. Sin (University of British Columbia Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada); and Brandie Walker (University of Calgary, Calgary, AB, Canada). Additional information: The e-Appendix, e-Figures, and e-Tables can be found in the Supplemental Materials section of the online article.

Publisher Copyright:
© 2020 American College of Chest Physicians

ASJC Scopus Subject Areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

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10.1016/j.chest.2020.11.009

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@article{e832b23f72d046c4a143a92f9c68983e,

title = "Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age",

abstract = "Background: Physiologic and symptom responses at the ventilatory threshold (Tvent) during incremental cardiopulmonary exercise testing (CPET) can provide important prognostic information. Research Question: This study aimed to develop an updated normative reference set for physiologic and symptom responses at Tvent during cycle CPET (primary aim) and to evaluate previously recommended reference equations from a 1985 study for predicting Tvent responses (secondary aim). Study Design and Methods: Participants were adults 40 to 80 years of age who were free of clinically relevant disease from the Canadian Cohort Obstructive Lung Disease. Rate of oxygen consumption (V˙O2) at Tvent was identified by two independent raters; physiologic and symptom responses corresponding to V˙O2 at Tvent were identified by linear interpolation. Reference ranges (5th-95th percentiles) for responses at Tvent were calculated according to participant sex and age for 29 and eight variables, respectively. Prediction models were developed for nine variables (oxygen pulse, V˙O2, rate of CO2 production, minute ventilation, tidal volume, inspiratory capacity, end-inspiratory lung volume [in liters and as percentage of total lung capacity], and end-expiratory lung volume) using quantile regression, estimating the 5th (lower limit of normal), 50th (normal), and 95th (upper limit of normal) percentiles based on readily available participant characteristics. The two one-sided test of equivalence for paired samples evaluated the measured and 1985-predicted V˙O2 at Tvent for equivalence. Results: Reference ranges and equations were developed based on 96 participants (49% men) with a mean ± SD age of 63 ± 9 years. Mean V˙O2 at Tvent was 50% of measured V˙O2 peak; the normal range was 33% to 66%. The 1985 reference equations overpredicted V˙O2 at Tvent: mean difference in men, −0.17 L/min (95% CI, −0.25 to −0.09 L/min); mean difference in women, −0.19 L/min (95% CI, −0.27 to −0.12 L/min). Interpretation: A contemporary reference set of CPET responses at Tvent from Canadian adults 40 to 80 years of age is presented that differs from the previously recommended and often used reference set from 1985. Trial Registry: ClinicalTrials.gov; No.: NCT00920348; URL: www.clinicaltrials.gov;",

author = "{CanCOLD Collaborative Research group} and {Canadian Respiratory Research Network} and Hayley Lewthwaite and Omar Elsewify and Frank Niro and Jean Bourbeau and Guenette, {Jordan A.} and Fran{\c c}ois Maltais and Marciniuk, {Darcy D.} and O'Donnell, {Denis E.} and Smith, {Benjamin M.} and Stickland, {Michael K.} and Tan, {Wan C.} and Dennis Jensen and Aaron, {S. D.} and Chapman, {K. R.} and P. Hernandez and Sin, {D. D.} and B. Walker",

note = "Funding Information: FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease ( ClinicalTrials.gov Identifier: NCT00920348) study currently is funded by the Canadian Respiratory Research Network, the Canadian Institutes of Health Research [CIHR/Rx&D Collaborative Research Program Operating Grant 93326], and the industry partners AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline (GSK) Canada Ltd., and Novartis . Previous funding partners were the Respiratory Health Network of the Fonds de la Recherche en Sant{\'e} du Qu{\'e}bec, the Foundation of the McGill University Health Centre , and the following industry partners: Almirall, Merck , Nycomed, Pfizer Canada Ltd., and Theratechnologies. The funders had no role in any aspect of the manuscript. H. L. was supported by a Fonds de Recherche du Qu{\'e}bec Sant{\'e} Postdoctoral Training Fellowship. J. B. holds a GlaxoSmithKline (GSK)/Canadian Institutes of Health Research (CIHR) Research Chair on Better Understanding of COPD and Intervention Guides at McGill University. J. A. G. was supported by a Scholar Award from the Michael Smith Foundation for Health Research and a Clinical Rehabilitation New Investigator Award from the CIHR. F. M. holds a GSK Research Chair on COPD at Universit{\'e} Laval. B. M. S. is supported by Qu{\'e}bec Health Research Fund, the Canadian Institutes of Health Research, the National Institutes of Health (USA), the Respiratory Health Network of Qu{\'e}bec, and Qu{\'e}bec Lung Association. D. J. holds a Canada Research Chair, Tier II, in Clinical Exercise & Respiratory Physiology from the CIHR. Funding Information: FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease (ClinicalTrials.gov Identifier: NCT00920348) study currently is funded by the Canadian Respiratory Research Network, the Canadian Institutes of Health Research [CIHR/Rx&D Collaborative Research Program Operating Grant 93326], and the industry partners AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline (GSK) Canada Ltd., and Novartis. Previous funding partners were the Respiratory Health Network of the Fonds de la Recherche en Sant? du Qu?bec, the Foundation of the McGill University Health Centre, and the following industry partners: Almirall, Merck, Nycomed, Pfizer Canada Ltd., and Theratechnologies. The funders had no role in any aspect of the manuscript. H. L. was supported by a Fonds de Recherche du Qu?bec Sant? Postdoctoral Training Fellowship. J. B. holds a GlaxoSmithKline (GSK)/Canadian Institutes of Health Research (CIHR) Research Chair on Better Understanding of COPD and Intervention Guides at McGill University. J. A. G. was supported by a Scholar Award from the Michael Smith Foundation for Health Research and a Clinical Rehabilitation New Investigator Award from the CIHR. F. M. holds a GSK Research Chair on COPD at Universit? Laval. B. M. S. is supported by Qu?bec Health Research Fund, the Canadian Institutes of Health Research, the National Institutes of Health (USA), the Respiratory Health Network of Qu?bec, and Qu?bec Lung Association. D. J. holds a Canada Research Chair, Tier II, in Clinical Exercise & Respiratory Physiology from the CIHR.Author contributions: All of the authors reviewed the manuscript, contributed to the concept and design and to data interpretation. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: H. L. reports personal fees for consulting from Boehringer Ingelheim during the conduct of the study. J. A. G. reports personal fees from Agartee Technology, Inc. during the conduct of the study. D. D. M. reports consulting fees from AstraZeneca, Boehringer-Ingelheim, GSK, and Novartis; consulting fees from the Canadian Foundation for Healthcare Improvement, Health Canada, Mylan, and Yukon Health and Social Services; and personal fees from Lung Association of Saskatchewan; and other from the Canadian Thoracic Society. J. B. reports other from GlaxoSmithKline during the conduct of the study; personal fees from the Canadian Thoracic Society and CHEST; and personal fees from AstraZeneca, Boehringer Ingelheim, Grifols, GlaxoSmithKline, Novartis, and Trudell outside the submitted work. W. C. T. reports industry partners Astra Zeneca Canada, Ltd. Boehringer-Ingelheim Canada, Ltd. GlaxoSmithKline Canada, Ltd. Merck, Novartis Pharma Canada, Inc. Nycomed Canada, Inc. and Pfizer Canada, Ltd. during the conduct of the study. F. M. reports personal fees for serving on speaker bureaus and consultation panels from Boehringer Ingelheim, Grifols, and Novartis outside the submitted work, and is financially involved with Oxynov, a company that is developing an oxygen delivery system. D. J. reports personal fees for consulting from Boehringer Ingelheim during the conduct of the study; personal fees from AstraZeneca; None declared (O. E. F. N. M. K. S. D. E. O. B. M. S.). Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. ?CanCOLD Collaborative Research Group Collaborators: Shawn E. Aaron (The Ottawa Hospital Research Institute, Ottawa, ON, Canada); Kenneth R. Chapman (Asthma & Airway Centre, University Health Network and University of Toronto, Toronto, ON, Canada); Mark J. FitzGerald (University of British Columbia, Vancouver, BC, Canada); Paul Hernandez (Faculty of Medicine, Division of Respirology, Dalhousie University, Halifax, NS, Canada); Donald D. Sin (University of British Columbia Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada); and Brandie Walker (University of Calgary, Calgary, AB, Canada). Additional information: The e-Appendix, e-Figures, and e-Tables can be found in the Supplemental Materials section of the online article. Publisher Copyright: {\textcopyright} 2020 American College of Chest Physicians",

year = "2021",

month = may,

doi = "10.1016/j.chest.2020.11.009",

language = "English",

volume = "159",

pages = "1922--1933",

journal = "Chest",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "5",

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TY - JOUR

T1 - Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age

AU - CanCOLD Collaborative Research group

AU - Canadian Respiratory Research Network

AU - Lewthwaite, Hayley

AU - Elsewify, Omar

AU - Niro, Frank

AU - Bourbeau, Jean

AU - Guenette, Jordan A.

AU - Maltais, François

AU - Marciniuk, Darcy D.

AU - O'Donnell, Denis E.

AU - Smith, Benjamin M.

AU - Stickland, Michael K.

AU - Tan, Wan C.

AU - Jensen, Dennis

AU - Aaron, S. D.

AU - Chapman, K. R.

AU - Hernandez, P.

AU - Sin, D. D.

AU - Walker, B.

N1 - Funding Information: FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease ( ClinicalTrials.gov Identifier: NCT00920348) study currently is funded by the Canadian Respiratory Research Network, the Canadian Institutes of Health Research [CIHR/Rx&D Collaborative Research Program Operating Grant 93326], and the industry partners AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline (GSK) Canada Ltd., and Novartis . Previous funding partners were the Respiratory Health Network of the Fonds de la Recherche en Santé du Québec, the Foundation of the McGill University Health Centre , and the following industry partners: Almirall, Merck , Nycomed, Pfizer Canada Ltd., and Theratechnologies. The funders had no role in any aspect of the manuscript. H. L. was supported by a Fonds de Recherche du Québec Santé Postdoctoral Training Fellowship. J. B. holds a GlaxoSmithKline (GSK)/Canadian Institutes of Health Research (CIHR) Research Chair on Better Understanding of COPD and Intervention Guides at McGill University. J. A. G. was supported by a Scholar Award from the Michael Smith Foundation for Health Research and a Clinical Rehabilitation New Investigator Award from the CIHR. F. M. holds a GSK Research Chair on COPD at Université Laval. B. M. S. is supported by Québec Health Research Fund, the Canadian Institutes of Health Research, the National Institutes of Health (USA), the Respiratory Health Network of Québec, and Québec Lung Association. D. J. holds a Canada Research Chair, Tier II, in Clinical Exercise & Respiratory Physiology from the CIHR. Funding Information: FUNDING/SUPPORT: The Canadian Cohort Obstructive Lung Disease (ClinicalTrials.gov Identifier: NCT00920348) study currently is funded by the Canadian Respiratory Research Network, the Canadian Institutes of Health Research [CIHR/Rx&D Collaborative Research Program Operating Grant 93326], and the industry partners AstraZeneca Canada Ltd., Boehringer Ingelheim Canada Ltd., GlaxoSmithKline (GSK) Canada Ltd., and Novartis. Previous funding partners were the Respiratory Health Network of the Fonds de la Recherche en Sant? du Qu?bec, the Foundation of the McGill University Health Centre, and the following industry partners: Almirall, Merck, Nycomed, Pfizer Canada Ltd., and Theratechnologies. The funders had no role in any aspect of the manuscript. H. L. was supported by a Fonds de Recherche du Qu?bec Sant? Postdoctoral Training Fellowship. J. B. holds a GlaxoSmithKline (GSK)/Canadian Institutes of Health Research (CIHR) Research Chair on Better Understanding of COPD and Intervention Guides at McGill University. J. A. G. was supported by a Scholar Award from the Michael Smith Foundation for Health Research and a Clinical Rehabilitation New Investigator Award from the CIHR. F. M. holds a GSK Research Chair on COPD at Universit? Laval. B. M. S. is supported by Qu?bec Health Research Fund, the Canadian Institutes of Health Research, the National Institutes of Health (USA), the Respiratory Health Network of Qu?bec, and Qu?bec Lung Association. D. J. holds a Canada Research Chair, Tier II, in Clinical Exercise & Respiratory Physiology from the CIHR.Author contributions: All of the authors reviewed the manuscript, contributed to the concept and design and to data interpretation. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: H. L. reports personal fees for consulting from Boehringer Ingelheim during the conduct of the study. J. A. G. reports personal fees from Agartee Technology, Inc. during the conduct of the study. D. D. M. reports consulting fees from AstraZeneca, Boehringer-Ingelheim, GSK, and Novartis; consulting fees from the Canadian Foundation for Healthcare Improvement, Health Canada, Mylan, and Yukon Health and Social Services; and personal fees from Lung Association of Saskatchewan; and other from the Canadian Thoracic Society. J. B. reports other from GlaxoSmithKline during the conduct of the study; personal fees from the Canadian Thoracic Society and CHEST; and personal fees from AstraZeneca, Boehringer Ingelheim, Grifols, GlaxoSmithKline, Novartis, and Trudell outside the submitted work. W. C. T. reports industry partners Astra Zeneca Canada, Ltd. Boehringer-Ingelheim Canada, Ltd. GlaxoSmithKline Canada, Ltd. Merck, Novartis Pharma Canada, Inc. Nycomed Canada, Inc. and Pfizer Canada, Ltd. during the conduct of the study. F. M. reports personal fees for serving on speaker bureaus and consultation panels from Boehringer Ingelheim, Grifols, and Novartis outside the submitted work, and is financially involved with Oxynov, a company that is developing an oxygen delivery system. D. J. reports personal fees for consulting from Boehringer Ingelheim during the conduct of the study; personal fees from AstraZeneca; None declared (O. E. F. N. M. K. S. D. E. O. B. M. S.). Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. ?CanCOLD Collaborative Research Group Collaborators: Shawn E. Aaron (The Ottawa Hospital Research Institute, Ottawa, ON, Canada); Kenneth R. Chapman (Asthma & Airway Centre, University Health Network and University of Toronto, Toronto, ON, Canada); Mark J. FitzGerald (University of British Columbia, Vancouver, BC, Canada); Paul Hernandez (Faculty of Medicine, Division of Respirology, Dalhousie University, Halifax, NS, Canada); Donald D. Sin (University of British Columbia Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada); and Brandie Walker (University of Calgary, Calgary, AB, Canada). Additional information: The e-Appendix, e-Figures, and e-Tables can be found in the Supplemental Materials section of the online article. Publisher Copyright: © 2020 American College of Chest Physicians

PY - 2021/5

Y1 - 2021/5

N2 - Background: Physiologic and symptom responses at the ventilatory threshold (Tvent) during incremental cardiopulmonary exercise testing (CPET) can provide important prognostic information. Research Question: This study aimed to develop an updated normative reference set for physiologic and symptom responses at Tvent during cycle CPET (primary aim) and to evaluate previously recommended reference equations from a 1985 study for predicting Tvent responses (secondary aim). Study Design and Methods: Participants were adults 40 to 80 years of age who were free of clinically relevant disease from the Canadian Cohort Obstructive Lung Disease. Rate of oxygen consumption (V˙O2) at Tvent was identified by two independent raters; physiologic and symptom responses corresponding to V˙O2 at Tvent were identified by linear interpolation. Reference ranges (5th-95th percentiles) for responses at Tvent were calculated according to participant sex and age for 29 and eight variables, respectively. Prediction models were developed for nine variables (oxygen pulse, V˙O2, rate of CO2 production, minute ventilation, tidal volume, inspiratory capacity, end-inspiratory lung volume [in liters and as percentage of total lung capacity], and end-expiratory lung volume) using quantile regression, estimating the 5th (lower limit of normal), 50th (normal), and 95th (upper limit of normal) percentiles based on readily available participant characteristics. The two one-sided test of equivalence for paired samples evaluated the measured and 1985-predicted V˙O2 at Tvent for equivalence. Results: Reference ranges and equations were developed based on 96 participants (49% men) with a mean ± SD age of 63 ± 9 years. Mean V˙O2 at Tvent was 50% of measured V˙O2 peak; the normal range was 33% to 66%. The 1985 reference equations overpredicted V˙O2 at Tvent: mean difference in men, −0.17 L/min (95% CI, −0.25 to −0.09 L/min); mean difference in women, −0.19 L/min (95% CI, −0.27 to −0.12 L/min). Interpretation: A contemporary reference set of CPET responses at Tvent from Canadian adults 40 to 80 years of age is presented that differs from the previously recommended and often used reference set from 1985. Trial Registry: ClinicalTrials.gov; No.: NCT00920348; URL: www.clinicaltrials.gov;

AB - Background: Physiologic and symptom responses at the ventilatory threshold (Tvent) during incremental cardiopulmonary exercise testing (CPET) can provide important prognostic information. Research Question: This study aimed to develop an updated normative reference set for physiologic and symptom responses at Tvent during cycle CPET (primary aim) and to evaluate previously recommended reference equations from a 1985 study for predicting Tvent responses (secondary aim). Study Design and Methods: Participants were adults 40 to 80 years of age who were free of clinically relevant disease from the Canadian Cohort Obstructive Lung Disease. Rate of oxygen consumption (V˙O2) at Tvent was identified by two independent raters; physiologic and symptom responses corresponding to V˙O2 at Tvent were identified by linear interpolation. Reference ranges (5th-95th percentiles) for responses at Tvent were calculated according to participant sex and age for 29 and eight variables, respectively. Prediction models were developed for nine variables (oxygen pulse, V˙O2, rate of CO2 production, minute ventilation, tidal volume, inspiratory capacity, end-inspiratory lung volume [in liters and as percentage of total lung capacity], and end-expiratory lung volume) using quantile regression, estimating the 5th (lower limit of normal), 50th (normal), and 95th (upper limit of normal) percentiles based on readily available participant characteristics. The two one-sided test of equivalence for paired samples evaluated the measured and 1985-predicted V˙O2 at Tvent for equivalence. Results: Reference ranges and equations were developed based on 96 participants (49% men) with a mean ± SD age of 63 ± 9 years. Mean V˙O2 at Tvent was 50% of measured V˙O2 peak; the normal range was 33% to 66%. The 1985 reference equations overpredicted V˙O2 at Tvent: mean difference in men, −0.17 L/min (95% CI, −0.25 to −0.09 L/min); mean difference in women, −0.19 L/min (95% CI, −0.27 to −0.12 L/min). Interpretation: A contemporary reference set of CPET responses at Tvent from Canadian adults 40 to 80 years of age is presented that differs from the previously recommended and often used reference set from 1985. Trial Registry: ClinicalTrials.gov; No.: NCT00920348; URL: www.clinicaltrials.gov;

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JF - Chest

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Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age

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PubMed: MeSH publication types

Accès au document

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Empreinte numérique

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