Elsevier

Mayo Clinic Proceedings

Volume 92, Issue 2, February 2017, Pages 228-233
Mayo Clinic Proceedings

Brief report
Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing Using Cycle Ergometry: Data From the Fitness Registry and the Importance of Exercise National Database (FRIEND) Registry

https://doi.org/10.1016/j.mayocp.2016.10.003Get rights and content

Abstract

The importance of cardiorespiratory fitness (CRF) is well established. This report provides newly developed standards for CRF reference values derived from cardiopulmonary exercise testing (CPX) using cycle ergometry in the United States. Ten laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the “Fitness Registry and the Importance of Exercise: A National Database” (FRIEND) Registry from April 2014 through May 2016. Data from 4494 maximal (respiratory exchange ratio, ≥1.1) cycle ergometer tests from men and women (20-79 years) from 27 states, without cardiovascular disease, were used to develop these references values. Percentiles of maximum oxygen consumption (VO2max) for men and women were determined for each decade from age 20 years through age 79 years. Comparisons of VO2max were made to reference data established with CPX data from treadmill data in the FRIEND Registry and previously published reports. As expected, there were significant differences between sex and age groups for VO2max (P<.01). For cycle tests within the FRIEND Registry, the 50th percentile VO2max of men and women aged 20 to 29 years declined from 41.9 and 31.0 mLO2/kg/min to 19.5 and 14.8 mLO2/kg/min for ages 70 to 79 years, respectively. The rate of decline in this cohort was approximately 10% per decade. The FRIEND Registry reference data will be useful in providing more accurate interpretations for the US population of CPX-measured VO2max from exercise tests using cycle ergometry compared with previous approaches based on estimations of standard differences from treadmill testing reference values.

Section snippets

Methods

The procedures used for acquiring and managing the data for the FRIEND Registry have been previously reported.2 Briefly, laboratories determined by the CRF advisory board to use valid and reliable calibration and CPX testing procedures administered by experienced personnel were invited to be considered for inclusion in the FRIEND Registry. Although there were some variations in laboratory equipment, protocols, and procedures defining VO2max (using an average of data during the final 30-60

Results

The FRIEND cohort for this report included 1717 tests on men and 2777 on women, with ages ranging from 20 to 79 years. Descriptive characteristics of the cohort, by sex and in 10-year age groups, are listed in Table 1.

Peak responses from CPX using a cycle ergometer are presented in Table 2A. Relative and absolute VO2max values from 2 previous studies from Lithuania (20-59 years) and Finland (55-74 years) are presented in Table 2B for comparison.2, 11, 12 Because a typical approach for

Discussion

This report provides current normative reference standards for CRF for the United States using measures obtained from CPX using cycle ergometry that can be used for test interpretation. As shown in Table 2, although the comparisons between these new cycle reference standards and a 15% lower estimated value than the FRIEND treadmill standards are close (within 1 metabolic equivalent) for the youngest and oldest age groups, the CPX-measured cycle values are notably lower for the in-between decade

Conclusion

The FRIEND Registry was created in response to a need to develop CRF reference values derived from CPX in the United States. This report provides measured VO2max normative values using cycle ergometry, which will allow for more accurate interpretation compared with previous approaches to estimate on the basis of a standard expected lower amount compared with treadmill test values. Similar to US reference standards for CPX with treadmill data, the US reference standards with cycle data found

Acknowledgments

Cardiorespiratory Fitness Registry Board Members: Cochairs: Leonard Kaminsky, PhD, and Ross Arena, PhD, PT; Paige Briggs, MBA, Peter Brubaker, PhD, Daniel Forman, MD, Carol Garber, PhD, Chip Lavie, MD, Jonathan Myers, PhD, Mahesh Patel, MD. Ex-officio members included Ekta Choudhary, PhD, Marco Guazzi, MD, Johanna Johnson, MS, and Laurie Whitsel, PhD.

FRIEND Consortium Contributors: Ball State University (Leonard Kaminsky, PhD), Brooke Army Medical Center (Kenneth Leclerc, MD), Cone Health (Paul

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Grant Support: Partial support for this project was provided by grant GS04T11BFP0001 (L.A.K.) from grant from TKC Global Solutions, LLC. The work was supported by grant UL1TR000050 (R.A.) from the National Center for Advancing Translational Sciences, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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