Clinical Predictors of Ventilatory Threshold Achievement in Patients with Claudication

FARAH, BRENO Q.1; RITTI-DIAS, RAPHAEL M.1; CUCATO, GABRIEL G.2; MENÊSES, ANNELISE L.1; GARDNER, ANDREW W.3

Medicine & Science in Sports & Exercise: March 2015 - Volume 47 - Issue 3 - p 493–497
doi: 10.1249/MSS.0000000000000434
Clinical Sciences

Purpose: Ventilatory threshold (VT) is considered a clinically important marker of cardiovascular function in several populations, including patients with claudication, because it is related to walking capacity and hemodynamics. The purpose of this study was to identify clinical predictors for VT achievement in patients with intermittent claudication.

Methods: One hundred and seventy-seven (n = 177) patients with intermittent claudication performed a progressive graded cardiopulmonary treadmill test until maximal claudication pain. Oxygen uptake (V˙O2) was continuously measured during the test, and afterwards, VT was visually detected. Clinical characteristics, demographic data, comorbid conditions, and cardiovascular risk factors were obtained. Patients who achieved and did not achieve VT were compared, as well as the workload that VT occurred in the former group.

Results: VT was achieved in 134 patients (76%), and the mean V˙O2 at VT for these patients was 10.8 ± 2.4 mL·kg−1·min−1. Patients who did not achieve VT presented lower ankle brachial index (ABI), claudication onset time, peak walking time, and V˙O2peak, and the proportion of women was higher compared with patients who achieved VT (P < 0.05). Multiple linear regression analysis identified that sex (b = 0.25, P = 0.002), body mass index (b = −0.18, P = 0.025), peak walking time (b = 0.17, P = 0.044), and ABI (b = 0.23, P = 0.006) were predictors of V˙O2 at VT.

Conclusions: Forty-three patients (24%) with intermittent claudication did not achieve VT, and these patients were mostly women and those with greater severity of disease. Moreover, in those who reached VT, the predictors of poor VT were female sex, high body mass index, low peak walking time, and low ABI.

1Graduate Program in Physical Education, Pernambuco University, Pernambuco, BRAZIL; 2Albert Einstein Hospital, São Paulo, BRAZIL; and 3Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK

Address for correspondence: Andrew W. Gardner, Ph.D., General Clinical Research Center, Oklahoma University Health Sciences Center, O’Donoghue Research Building, 1122 NE 13th Street, Suite 150, Oklahoma City, OK 73117; E-mail: andrew-gardner@ouhsc.edu.

Submitted for publication May 2014.

Accepted for publication June 2014.

© 2015 American College of Sports Medicine