Challenges with percent predicted maximal VO2 in patients with heart failure
Brawner CA, Ehrman JK, Shafiq A, et al. Challenges with percent predicted maximal VO2 in patients with heart failure. Med Sci Sports Exerc. 2018;50(2):204-210.
PURPOSE: This study aimed to describe the influence of different equations to predict maximal oxygen uptake (MV˙O2) on the percent predicted MV˙O2 (ppMV˙O2) and the resultant categorization of patients with heart failure with reduced ejection fraction into high or low risk.
METHODS: In this retrospective cohort study, ppMV˙O2 was calculated using six different equations to predict MV˙O2 among 1168 patients with heart failure with reduced ejection fraction (33% women). Repeated-measures ANOVA was used to compare within-subject differences in mean ppMV˙O2 between the prediction equations. Cochrane's Q test was used to compare the within-subject difference in the proportion of patients with ppMV˙O2 of
RESULTS: The ppMV˙O2 varied significantly (P < 0.001) between the MV˙O2 prediction equations, with mean (10th, 90th percentile) ppMV˙O2 ranging from 39% (25%, 54%) to 60% (39%, 83%) in men and 37% (24%, 49%) to 70% (47%, 94%) in women. Significant variation (P < 0.001) was also observed between prediction equations for the proportion of patients with ppMV˙O2 of
CONCLUSIONS: Statistically significant and clinically meaningful variations in the ppMV˙O2 are observed on the basis of the reference equation used to predict MV˙O2. Future writing committees should specify the preferred reference equation when identifying a ppMV˙O2 criterion in guideline statements.