Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: A systematic review and meta-analysis

Abstract

Highlights High cardiorespiratory fitness (CRF) in patients with cardiovascular disease (CVD) is associated with 58% lower all-cause mortality risk and 73% lower cardiovascular mortality risk compared to unfit counterparts. Each 1 metabolic equivalent (1-MET) increase in CRF is associated with a 19% lower CVD mortality risk among patients with CVD. Coronary artery disease patients with high CRF have a 68% lower all-cause mortality risk than their unfit counterparts. Each 1-MET increase in CRF is associated with a 17% lower all-cause mortality risk among patients with coronary artery disease. No significant associations were found between increments of 1-MET and lower mortality risk among heart failure patients.

Exercise Prescription and Progression Practices among US Cardiac Rehabilitation Clinics

“…Baseline and post-rehab functional capacity testing, either maximal or submaximal, is a valuable tool in the determination of patient starting points, evaluation of exercise hemodynamics, as well as monitoring improvements gained from cardiac rehabilitation [ 14 ]. Peak or maximal graded exercise testing (GXTs) is the gold standard for the determination of patient functional capacity and allows for the best determination of direct physiological intensity variables, such as HR values [ 10 ]. Abnormal physiological responses to exercise (i.e., ischemia, hypertensive blood pressure) may also be uncovered and limitations may accordingly be placed on patients’ hemodynamic values during exercise.…”

“…Functional capacity is also an important indicator of prognosis (e.g., 5-year mortality) among CVD patients [ 9 ]. Specifically, each 1 MET increase in functional capacity confers a 19% reduction in CVD mortality among heart disease patients [ 10 ]. The implementation of safe and progressive exercise prescriptions during enrollment in cardiac rehabilitation is critical to the successful improvement of functional capacity.…”

Cardiopulmonary exercise test: A 20-year (2002-2021) bibliometric analysis

“…It is a comprehensive reflection of the body's exercise capacity ( 4 ), assessed by the quantifiable index of maximum oxygen uptake (VO 2 max). Many studies have shown that CRF is a strong independent predictor of chronic diseases, such as cardiovascular disease ( 5 ) and cancer ( 6 ), and a modifiable risk factor which is influenced by lifestyle and physical activity. Relevant studies have shown that, compared with traditional clinical risk factors for cardiovascular disease, CRF can better predict the health status and possible adverse events ( 7 , 8 ).…”

Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease

“…Accumulating evidence has demonstrated that exercise-based cardiac rehabilitation (CR) programs reduce mortality rates in patients with CAD [ 1 ]. In this regard, parasympathetic nervous system (PNS) activity and cardiorespiratory fitness (CRF), assessed by heart rate (HR)-based indices (e.g., resting HR, resting HR variability (HRV), and post-exercise HR recovery (HRR)) and maximum oxygen uptake (VO 2 max), respectively, are considered independent predictors of mortality [ 2 , 3 , 4 , 5 , 6 ]. Moreover, Martinez et al [ 7 ] and Medeiros et al [ 8 ] reported an improvement in PNS activity after an exercise-based CR program.…”