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Title: | The importance of ventilatory thresholds to define aerobic exercise intensity in cardiac patients and healthy subjects | Authors: | Anselmi, Francesca Cavigli, Luna Pagliaro, Antonio Valente, Serafina Valentini, Francesca Cameli, Matteo Focardi, Marta Mochi, Nicola DENDALE, Paul HANSEN, Dominique Bonifazi, Marco Halle, Martin D’ascenzi, Flavio |
Issue Date: | 2021 | Publisher: | Source: | Scandinavian journal of medicine & science in sports, 31(9), p. 1796-1808 | Abstract: | Background: Although structured exercise training is strongly recommended in cardiac patients, uncertainties exist about the methods for determining exercise intensity (EI) and their correspondence with effective EI obtained by ventilatory thresholds. We aimed to determine the first (VT1) and second ventilatory thresholds (VT2) in cardiac patients, sedentary subjects, and athletes comparing VT1 and VT2 with EI defined by recommendations. Methods: We prospectively enrolled 350 subjects (mean age: 50.7±12.9 years; 167 cardiac patients, 150 healthy sedentary subjects, and 33 competitive endurance athletes). Each subject underwent ECG, echocardiography, and cardiopulmonary exercise testing. The percentages of peak VO2, peak heart rate (HR), and HR reserve were obtained at VT1 and VT2 and compared with the EI definition proposed by the recommendations. Results: VO2 at VT1 corresponded to high rather than moderate EI in 67.1% and 79.6% of cardiac patients, applying the definition of moderate exercise by the previous recommendations and the 2020 guidelines, respectively. Most cardiac patients had VO2 values at VT2 corresponding to very-high rather than high EI (59.9% and 50.3%, by previous recommendations and 2020 guidelines, respectively). A better correspondence between ventilatory thresholds and recommended EI domains was observed in healthy subjects and athletes (90% and 93.9%, respectively). Conclusions: EI definition based on percentages of peak HR and peak VO2 may misclassify the effective EI, and the discrepancy between the individually determined and the recommended EI is particularly relevant in cardiac patients. A ventilatory threshold–based rather than a range-based approach is advisable to define an appropriate level of EI | Keywords: | cardiopulmonary exercise testing;exercise intensity;exercise prescription;lactate;ventilatory threshold | Document URI: | http://hdl.handle.net/1942/34444 | ISSN: | 0905-7188 | e-ISSN: | 1600-0838 | DOI: | 10.1111/sms.14007 | ISI #: | WOS:000669423500001 | Rights: | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2021 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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