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The importance of ventilatory thresholds to define aerobic exercise intensity in cardiac patients and healthy subjects
Author(s) -
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
Publication year - 2021
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.14007
Subject(s) - ventilatory threshold , medicine , physical therapy , athletes , cardiology , vo2 max , endurance training , sports medicine , heart rate , exercise intensity , blood pressure
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 (VT 1 ) and second ventilatory thresholds (VT 2 ) in cardiac patients, sedentary subjects, and athletes comparing VT 1 and VT 2 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 VO 2 , peak heart rate (HR), and HR reserve were obtained at VT 1 and VT 2 and compared with the EI definition proposed by the recommendations. Results VO 2 at VT 1 corresponded to high rather than moderate EI in 67.1% and 19.8% of cardiac patients, applying the definition of moderate exercise by the previous recommendations and the 2020 guidelines, respectively. Most cardiac patients had VO 2 values at VT 2 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 VO 2 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.