How to evaluate physical fitness without a stress test?

Area of Science:

• Cardiology
• Exercise Physiology

Background:

• Cardiorespiratory fitness (CF) assessment typically requires stress testing.
• Patients with coronary artery disease (CAD) often undergo such assessments.

Purpose of the Study:

• To evaluate a questionnaire's ability to estimate CF in patients with suspected or known CAD.
• To compare estimated CF with actual workloads achieved during stress tests.
• To assess the questionnaire's predictive power for determining the appropriate stress modality (physical vs. pharmacologic).

Main Methods:

• A questionnaire assessing daily physical activity and patient characteristics was administered to 612 patients undergoing myocardial perfusion SPECT (MPS).
• An activity score was calculated to estimate metabolic equivalents (METs).
• Estimated METs were compared with achieved workloads and correlated with the stress test modality.

Main Results:

• Patients undergoing pharmacologic stress tests estimated lower performance (7.0 ± 2.1 METs) than those with physical stress tests (8.2 ± 2.3 METs).
• A good correlation (r = 0.63) was observed between estimated and achieved METs in physically stressed patients.
• The questionnaire showed moderate predictive ability (Area Under the Curve = 0.65) for the stress modality.

Conclusions:

• The questionnaire provides a practical method for estimating CF in CAD patients.
• It aids in determining the feasibility of a physical stress test.
• This tool can be readily integrated into routine clinical practice for patient evaluation.