Setor K Kunutsor1, Sudhir Kurl2, Hassan Khan3, Francesco Zaccardi4, Jari A Laukkanen5. 1. School of Clinical Sciences, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, UK. Electronic address: skk31@cantab.net. 2. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. Electronic address: sudhir.kurl@uef.fi. 3. Emory University School of Medicine, Atlanta, GA, USA. Electronic address: drhasankhan@gmail.com. 4. Diabetes Research Centre, University of Leicester, Leicester, UK. Electronic address: frazac@fastwebnet.it. 5. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Central Hospital, Internal Medicine, Jyväskylä, Finland. Electronic address: jariantero.laukkanen@uef.fi.
Abstract
BACKGROUND: Oxygen uptake (VO2) at ventilatory threshold (VT), is a cardiopulmonary exercise testing parameter which may be a proxy for peak VO2. We aimed to assess the associations of VO2 at VT with sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD), and all-cause mortality. METHODS AND RESULTS: VO2 at VT was assessed during a submaximal exercise test using respiratory gas analyzers in the Kuopio Ischemic Heart Disease cohort of 1639 middle-aged men. Hazard ratios (HRs) (95% CIs) were assessed. During a median follow-up of 25.6years, 121 SCDs, 202 fatal CHDs, 312 fatal CVDs, and 703 all-cause mortality events occurred. VO2 at VT was correlated with peak VO2 (r=0.90) and linearly associated with each outcome. Comparing extreme quartiles of VO2 at VT, the HRs (95% CIs) for SCD, fatal CHD, fatal CVD, and all-cause mortality on adjustment for established risk factors were 0.37 (0.18-0.78), 0.32 (0.18-0.57), 0.45 (0.30-0.69), and 0.50 (0.38-0.64) respectively. The HRs were 1.02 (0.36-2.91), 1.43 (0.63-3.25), 1.46 (0.79-2.71), and 1.02 (0.69-1.51) respectively on further adjustment for peak VO2. Addition of VO2 at VT to a CVD mortality risk prediction model containing established risk factors significantly improved risk discrimination and reclassification at 25years. CONCLUSIONS: There are linear and inverse associations of VO2 at VT with fatal cardiovascular and all-cause mortality events, which are dependent on peak VO2. Inclusion of VO2 at VT in the standard established risk factors panel significantly improves the prediction and classification of long-term CVD mortality risk.
BACKGROUND:Oxygen uptake (VO2) at ventilatory threshold (VT), is a cardiopulmonary exercise testing parameter which may be a proxy for peak VO2. We aimed to assess the associations of VO2 at VT with sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD), and all-cause mortality. METHODS AND RESULTS: VO2 at VT was assessed during a submaximal exercise test using respiratory gas analyzers in the Kuopio Ischemic Heart Disease cohort of 1639 middle-aged men. Hazard ratios (HRs) (95% CIs) were assessed. During a median follow-up of 25.6years, 121 SCDs, 202 fatal CHDs, 312 fatal CVDs, and 703 all-cause mortality events occurred. VO2 at VT was correlated with peak VO2 (r=0.90) and linearly associated with each outcome. Comparing extreme quartiles of VO2 at VT, the HRs (95% CIs) for SCD, fatal CHD, fatal CVD, and all-cause mortality on adjustment for established risk factors were 0.37 (0.18-0.78), 0.32 (0.18-0.57), 0.45 (0.30-0.69), and 0.50 (0.38-0.64) respectively. The HRs were 1.02 (0.36-2.91), 1.43 (0.63-3.25), 1.46 (0.79-2.71), and 1.02 (0.69-1.51) respectively on further adjustment for peak VO2. Addition of VO2 at VT to a CVD mortality risk prediction model containing established risk factors significantly improved risk discrimination and reclassification at 25years. CONCLUSIONS: There are linear and inverse associations of VO2 at VT with fatal cardiovascular and all-cause mortality events, which are dependent on peak VO2. Inclusion of VO2 at VT in the standard established risk factors panel significantly improves the prediction and classification of long-term CVD mortality risk.
Authors: Michael J Kirton; Mitchel T Burnley; Joyce S Ramos; Ryan Weatherwax; Lance C Dalleck Journal: J Sports Sci Med Date: 2022-09-01 Impact factor: 4.017
Authors: Rianne C Bijl; Jérôme M J Cornette; Kim van der Ham; Merle L de Zwart; Dinis Dos Reis Miranda; Régine P M Steegers-Theunissen; Arie Franx; Jeroen Molinger; M P H Wendy Koster Journal: Physiol Rep Date: 2020-11