Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology · 2025
Validation of an Aerobic Fitness Questionnaire to estimate VO2 peak in a cohort of adult cardiac patients - Is it enough?
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Lima Maria Rita, Amador Rita, Presume João, Cunha Gonçalo, Moreno Luís, Durazzo Anaí, Gil Araújo Claudio, Mendes Miguel
Аннотация
INTRODUCTION AND OBJECTIVES: Cardiopulmonary exercise testing (CPET) is the gold standard for quantifying aerobic functional capacity, yet it is costly and not widely available. The CLINIMEX Aerobic Fitness Questionnaire (C-AFQ) may be a practical alternative as it estimates oxygen consumption at peak exercise (VO2 peak) based on patients' responses to a list of activities with known energy requirements. However, its applicability in cardiac patients is unclear and has not yet been studied. This study aims to assess the C-AFQ performance in predicting VO2 peak, measured via CPET, in adult patients with confirmed heart disease.
METHODS: This was a single-center prospective study enrolling consecutive patients who underwent CPET from April/2022 to January/2023. The main indication for CPET was measuring aerobic functional capacity for cardiovascular risk stratification.
RESULTS: A total of 124 patients (mean age 62±12 years, 75% male, 59% in the early phase post-myocardial infarction, 61% had heart failure, mean left ventricular ejection fraction 47±12%) with maximal CPET were included. Overall, a strong correlation was found between CPET and C-AFQ VO2 peak values (r=0.723, p<0.001). However, when performing a Bland-Altman plot analysis, we found a heightened confidence interval for the agreement between CPET and C-AFQ VO2 peak: 0.62±6.93 (95% CI -12.96-14.21) mL kg-1 min-1. CPET VO2 peak and the VO2 peak estimated by the exercise test protocol were related (r=0.777, p<0.001).
CONCLUSION: Although cardiorespiratory fitness estimation from the C-AFQ performs well in a large population, the utility of this questionnaire to estimate cardiorespiratory fitness in this study's population sample has limited value. However, it may be useful to aid physicians in choosing the adequate exercise test protocol that best fits an individual patient.
METHODS: This was a single-center prospective study enrolling consecutive patients who underwent CPET from April/2022 to January/2023. The main indication for CPET was measuring aerobic functional capacity for cardiovascular risk stratification.
RESULTS: A total of 124 patients (mean age 62±12 years, 75% male, 59% in the early phase post-myocardial infarction, 61% had heart failure, mean left ventricular ejection fraction 47±12%) with maximal CPET were included. Overall, a strong correlation was found between CPET and C-AFQ VO2 peak values (r=0.723, p<0.001). However, when performing a Bland-Altman plot analysis, we found a heightened confidence interval for the agreement between CPET and C-AFQ VO2 peak: 0.62±6.93 (95% CI -12.96-14.21) mL kg-1 min-1. CPET VO2 peak and the VO2 peak estimated by the exercise test protocol were related (r=0.777, p<0.001).
CONCLUSION: Although cardiorespiratory fitness estimation from the C-AFQ performs well in a large population, the utility of this questionnaire to estimate cardiorespiratory fitness in this study's population sample has limited value. However, it may be useful to aid physicians in choosing the adequate exercise test protocol that best fits an individual patient.