Reference values for arm ergometry cardiopulmonary exercise testing (CPET) in healthy volunteers

Area of Science:

• Exercise Physiology
• Cardiopulmonary Diagnostics

Background:

• Cardiopulmonary exercise testing (CPET) assesses maximal exercise capacity.
• Arm ergometry (AE) is an alternative to cycle ergometry (CE) but has limited reference equations.
• Existing AE CPET equations suffer from small sample sizes, gender bias, and limited age ranges.

Purpose of the Study:

• To develop novel predicted equations and reference ranges for AE exercise testing.
• To provide a more robust framework for interpreting AE CPET results.

Main Methods:

• 116 healthy volunteers underwent incremental ramp protocol CPET using AE.
• Breath-by-breath gas analysis was conducted using a metabolic cart.
• Quantile regression analysis generated equations for key AE CPET parameters (V̇O₂, WR, AT, VE, HR, O₂ pulse, VE/VCO₂ slope, V̇O₂/WR slope).

Main Results:

• New reference equations, including upper and/or lower limits, were generated using quantile regression.
• The developed equations were validated using a separate cohort.

Conclusions:

• This study provides the largest and most diverse set of predicted values and reference ranges for AE CPET parameters to date.
• Implementing these equations will facilitate wider adoption and improve the interpretation of AE CPET in diverse populations.