International Journal of Cardiovascular Sciences. 01/Jul/2018;31(4):320-2.

Is Cardiorespiratory Optimal Point Measured During the Maximal Cardiopulmonary Exercise Test a Relevant Indicator of Sports Performance?

Jari A. Laukkanen

DOI: 10.5935/2359-4802.20180041

Cardiorespiratory fitness (CRF) is considered the gold standard for assessing aerobic performance among athletes and normal population and has recently been named as a clinical vital sign, being an essential indicator of cardiovascular and pulmonary function. Cardiorespiratory fitness is associated with lower risk of non-fatal and fatal cardiovascular disease (CVD) events, with studies demonstrating a consistent, inverse association between CRF and mortality even after adjustment for the traditional risk factor burden. Additionally, both maximal oxygen consumption (VO₂max) and VO₂ at ventilatory threshold (VT) have been associated with a reduced risk of adverse health outcomes.^,– A literature-based meta-analysis of 33 observational cohort studies has better delineated the relationship of CRF with CVD and all-cause mortality outcomes. However, VO₂max and VT are often used to evaluate athletes’ performance and to monitor their training responses. During the cardiopulmonary exercise test (CPX), many variables could be used to assess specific training responses to the cardiovascular, respiratory and musculoskeletal systems based on the analysis of submaximal and maximal responses to a progressively incremental exercise.

Modern CPX systems allow for the analysis of gas exchange at rest, during mild, moderate and maximal exercise levels, and during recovery and yield measures of VO₂, carbon dioxide output (VCO₂), and ventilation (VE). These advanced computerized systems provide both simple and complex analyses of these data that are easy to retrieve and store, which makes CPX widely available. Oxygen uptake at VT, often referred to as the anaerobic threshold, is a variable assessed at submaximal level of CPX. For majority of healthy individuals, the anaerobic threshold lies at exercise intensities between 50% and 75% of VO₂max, while in trained endurance athletes, it can reach intensities as high as 80% of VO₂max.

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