Early flattening of the oxygen pulse during the cardiopulmonary exercise test in asymptomatic adults and its association with cardiovascular risk factors

Author(s)

Almeida, Vitor Rossi de ; Ostolin, Thatiane Lopes Valentim di Paschoale ; Gonze, Barbara de Barros ; Almeida, Flavio Rossi de ; Romiti, Marcello ; Arantes, Rodolfo Leite ; Dourado, Victor Zuniga

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF CARDIOLOGY; v. 367, p. 9-pg., 2022-11-15.

Abstract

Background: Individuals with cardiovascular exercise limitations present oxygen pulse morphology with early flattening (plateau) during the cardiopulmonary exercise test (CPET). Although this oxygen pulse response is well known in cardiac patients, these changes' prevalence and clinical relevance in asymptomatic individuals are not known. We aimed to quantify the proportion of asymptomatic adults with an early flattening of the oxygen pulse and investigate its association with classical cardiovascular risk factors.Methods: We carried out a cross-sectional study with a sample of 824 adults aged between 18 and 80 years. We assessed anthropometry, body composition, and cardiovascular risk. In addition, we obtained cardiorespiratory and metabolic responses during a ramp protocol treadmill CPET.Results: The prevalence of early flattening of the oxygen pulse was 36.8%. These participants were predominantly females, older, less educated, with a higher body mass and percentage of fat and a lower percentage of lean body mass. After a multinominal multiple logistic regression analysis, we identified female sex (odds ratio, 5.46: 95% confidence interval, 3.73-7.99), low education (2.24: 1.47-3.42), dyslipidemia (1.67: 1.14-2.45), smoking (1.64: 1.00-2.69), and physical inactivity (1.39: 1.02-1.96) as the leading independent predictors of the early flattening of oxygen pulse.Conclusion: The early flattening of oxygen pulse is common in asymptomatic adults and is highly determined by modifiable cardiovascular risk factors. These results suggest that identifying the early flattening of oxygen pulse may be helpful in the prevention of cardiovascular diseases. (AU)

• FAPESP's process: 11/07282-6 - Level of physical activity and fitness and its association with pulmonary function decline in adults in the city of Santos, Brazil
• Grantee: Victor Zuniga Dourado
• Support Opportunities: Research Grants - Young Investigators Grants