Two-minute exercise testing is sufficient to estimate maximal cardiorespiratory fitness in people with epilepsy

We aimed to examine the agreement between submaximal cardiopulmonary exercise testing (CPET) measures and peak oxygen consumption (VO2peak) in adults with epilepsy. Data from a randomized controlled trial with adults with epilepsy (N = 21) were analyzed. VO2peak was assessed using indirect calorimetry during a treadmill graded maximal CPET. Oxygen uptake efficiency slope (OUES) was calculated from the relationship between oxygen uptake and minute ventilation during the entire test (OUESpeak) and the first 2 (OUES2min), 3 (OUES3(min)), and 4 (OUES4(min)) minutes of the CPET. The strength of the association between measures was tested by Pearson correlation. Linear regression models were used to predict VO2(peak) based on OUES from the different testing durations. Agreement between measured and predicted maximal values was tested using intraclass correlation coefficient (ICC) and Bland-Altman plots. OUES2(min), OUES3(min), and OUES4(min) were highly associated with absolute (r = 0.84, r = 0.76, r = 0.75, respectively) and relative (r = 0.84, r = 0.78, r = 0.78, respectively) VO2(peak). Agreement (ICC = 0.83) between CPET-measured and OUES-predicted VO2(peak) values was stronger with OUES2(min) than the other time-based OUES markers. Bland-Altman plot showed satisfactory agreement between predicted and measured CPET measures with the narrowest limits of agreement observed with the OUES2(min). No potential bias was identified between these two measurements (p = 0.33). Changes in absolute (r = 0.77) and relative (r = 0.88) VO(2)peak were highly associated with the change in OUES2min. OUES2min can be used as a surrogate for maximal cardiorespiratory fitness in adults with epilepsy. Studies with larger samples size are encouraged to confirm our findings in a more heterogeneous population. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to examine the agreement between submaximal cardiopulmonary exercise testing (CPET) measures and peak oxygen consumption (VO2peak) in adults with epilepsy. The results showed that OUES2(min) can serve as a surrogate for maximal cardiorespiratory fitness in adults with epilepsy. Larger sample size studies are encouraged to confirm these findings.