• Piergiuseppe Agostoni, Carlo Vignati, Piero Gentile, Costanza Boiti, Stefania Farina, Elisabetta Salvioni, Massimo Mapelli, Damiano Magrì, Stefania Paolillo, Nicoletta Corrieri, Gianfranco Sinagra, and Gaia Cattadori.
• Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy; Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: piergiuseppe.agostoni@unimi.it.
• Chest. 2017 Jun 1; 151 (6): 1329-1337.

BackgroundCardiac output (Q˙) is a key parameter in the assessment of cardiac function, its measurement being crucial for the diagnosis, treatment, and prognostic evaluation of all heart diseases. Until recently, Q˙ determination at peak exercise has been possible through invasive methods, so that normal values were obtained in studies based on small populations.MethodsNowadays, peak Q˙ can be measured noninvasively by means of the inert gas rebreathing (IGR) technique. The present study was undertaken to provide reference values for peak Q˙ in the normal general population and to obtain a formula able to estimate peak exercise Q˙ from measured peak oxygen uptake (V˙o2).ResultsWe studied 500 normal subjects (age, 44.9 ± 1.5 years; range, 18-77 years; 260 men, 240 women) who underwent a maximal cardiopulmonary exercise test with peak Q˙ measurement by IGR. In the overall study sample, peak Q˙ was 13.2 ± 3.5 L/min (men, 15.3 ± 3.3 L/min; women, 11.0 ± 2.0 L/min; P < .001) and peak V˙o2 was 95% ± 18% of the maximum predicted value (men, 95% ± 19%; women, 95% ± 18%). Peak V˙o2 and peak Q˙ progressively decreased with age (R2, 0.082; P < .001; and R2, 0.144; P < .001, respectively). The V˙o2-derived formula to measure Q˙ at peak exercise was (4.4 × peak V˙o2) + 4.3 in the overall study cohort, (4.3 × peak V˙o2) + 4.5 in men, and (4.9 × peak V˙o2) + 3.6 in women.ConclusionsThe simultaneous measurement of Q˙ and V˙o2 at peak exercise in a large sample of healthy subjects provided an equation to predict peak Q˙ from peak V˙o2 values.Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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