[Normal or high maximal oxygen uptake: a target in health]

To achieve the predicted maximal oxygen consumption, many organs need to increase their output in a synchronized fashion. Therefore, maximal oxygen consumption is the single most reliable parameter predicting fitness, morbidity and mortality. Peak O2 uptake can be measured from noninvasive ventilatory parameters during short, incremental, cardiopulmonary exercise test (CPET) on a cycle ergometer or on a treadmill. Commercial systems are available and all enable breath by breath measurement of ventilation, exhaled gas concentration, oxygen saturation and additional cardiorespiratory parameters. Performance of the test requires adherence to strict guidelines and experienced technicians and physicians, although their qualification has not yet been defined by the national health authorities. There are well defined indications and benefits from CPET, among them are, determination of the anaerobic threshold, defining the cause of dyspnea, the timing for heart transplantation, exercise prescription for training and rehabilitation purposes and follow-up on disease progression or response to pharmacological or other modes of therapy. Measuring maximal oxygen consumption should be encouraged in health and disease and normal maximal oxygen consumption should be defined as a health target.