AIMS Accurate interpretation of cardiopulmonary exercise testing (CPET) relies on age, gender, and exercise modality-specific reference values. To date, clinically applicable CPET reference values derived from a source population of endurance athletes (EAs) have been lacking. The purpose of this study was to generate CPET reference values for use in the clinical assessment of EA. METHODS AND RESULTS Prospective data accrued during the clinical care of healthy EA were used to derive CPET reference values and to develop novel equations for V˙O2peak. The performance of these equations was compared to the contemporary standard of care equations and assessed in a discrete EA validation cohort. A total of 272 EA (age = 42 ± 15 years, female = 31%, V˙O2peak = 3.6 ± 0.83 L/min) met inclusion criteria and comprised the derivation cohort. V˙O2peak prediction equations derived from general population cohorts described a modest amount of V˙O2peak variability [R2 = 0.58-0.70, root mean square error (RMSE) = 0.46-0.54 L/min] but were mis-calibrated (calibration-in-the-large = 0.45-1.18 L/min) among EA leading to significant V˙O2peak underestimation. Newly derived, externally validated V˙O2peak prediction equations for EA that included age, sex, and height for both treadmill (R2 = 0.74, RMSE = 0.42 L/min) and cycle ergometer CPET (Cycle: R2 = 0.69, RMSE = 0.42 L/min) demonstrated improved accuracy. CONCLUSION Commonly used V˙O2peak prediction equations derived from general population cohorts perform poorly among competitive EA. Newly derived CPET reference values including novel V˙O2peak prediction equations may improve the clinical utility of CPET in this rapidly growing patient population.

中文翻译：

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耐力运动员的规范心肺运动数据：心肺健康和耐力运动登记处 (CHEER)。

AIMS 对心肺运动测试 (CPET) 的准确解释依赖于年龄、性别和运动方式特定的参考值。迄今为止，缺乏来自耐力运动员 (EA) 源人群的临床适用的 CPET 参考值。本研究的目的是生成用于 EA 临床评估的 CPET 参考值。方法和结果 在健康 EA 的临床护理过程中积累的前瞻性数据用于推导 CPET 参考值并开发 V˙O2peak 的新方程。将这些方程的性能与当代标准的护理方程进行比较，并在离散的 EA 验证队列中进行评估。共有 272 名 EA（年龄 = 42 ± 15 岁，女性 = 31%，V˙O2peak = 3.6 ± 0.83 L/min）符合纳入标准并构成推导队列。源自一般人群队列的 V˙O2peak 预测方程描述了适度的 V˙O2peak 变异性 [R2 = 0.58-0.70，均方根误差 (RMSE) = 0.46-0.54 L/min] 但校准错误（校准-the-large = 0.45-1.18 L/min) 在 EA 中导致显着的 V˙O2peak 低估。新推导出的、经过外部验证的 EA V˙O2peak 预测方程，包括跑步机（R2 = 0.74，RMSE = 0.42 L/min）和自行车测力计 CPET（周期：R2 = 0.69，RMSE = 0.42 L）的年龄、性别和身高/min) 表现出更高的准确性。结论 来自一般人群队列的常用 V˙O2peak 预测方程在竞争性 EA 中表现不佳。