TY - JOUR T1 - Cardiorespiratory optimal point during exercise testing as a predictor of all-cause mortality JO - Revista Portuguesa de Cardiologia T2 - AU - Ramos,Plínio S. AU - Araújo,Claudio Gil S. SN - 08702551 M3 - 10.1016/j.repc.2016.09.017 DO - 10.1016/j.repc.2016.09.017 UR - https://revportcardiol.org/pt-cardiorespiratory-optimal-point-during-exercise-articulo-S0870255117301397 AB - Introduction and AimThe cardiorespiratory optimal point (COP) is a novel index, calculated as the minimum oxygen ventilatory equivalent (VE/VO2) obtained during cardiopulmonary exercise testing (CPET). In this study we demonstrate the prognostic value of COP both independently and in combination with maximum oxygen consumption (VO2max) in community-dwelling adults. MethodsMaximal cycle ergometer CPET was performed in 3331 adults (66% men) aged 40-85 years, healthy (18%) or with chronic disease (81%). COP cut-off values of <22, 22-30, and >30 were selected based on the log-rank test. Risk discrimination was assessed using COP as an independent predictor and combined with VO2max. ResultsMedian follow-up was 6.4 years (7.1% mortality). Subjects with COP >30 demonstrated increased mortality compared to those with COP <22 (hazard ratio [HR] 6.86, 95% confidence interval [CI] 3.69-12.75, p<0.001). Multivariate analysis including gender, age, body mass index, and the forced expiratory volume in 1 s/vital capacity ratio showed adjusted HR for COP >30 of 3.72 (95% CI 1.98-6.98; p<0.001) and for COP 22-30 of 2.15 (95% CI 1.15-4.03, p<0.001). Combining COP and VO2max data further enhanced risk discrimination. ConclusionsCOP >30, either independently or in combination with low VO2max, is a good predictor of all-cause mortality in community-dwelling adults (healthy or with chronic disease). COP is a submaximal prognostic index that is simple to obtain and adds to CPET assessment, especially for adults unable or unwilling to achieve maximal exercise. ER -