title: Prevalence and characterization of exercise oscillatory ventilation in apparently healthy individuals at variable risk for cardiovascular disease: A subanalysis of the EURO-EX trial.
abstract: BACKGROUND
  There has been a greater appreciation of several variables obtained by cardiopulmonary exercise testing (CPX). Exercise oscillatory ventilation (EOV) is a CPX pattern that has gained recognition as an ominous marker of poor prognosis in cardiac patients. The purpose of the present study is to characterize whether such an abnormal ventilatory pattern may also be detected in apparently healthy subjects and determine its clinical significance.
  
  
  METHODS
  The study involved 510 subjects (mean age 60 ± 14 years; 49% male) with a broad cardiovascular (CV) risk factor profile who underwent CPX.
  
  
  RESULTS
  The population was divided into two groups according to the presence (17%) or absence of EOV. Subjects with EOV were significantly older and a higher percentage was female. Risk factor profile and medication use was significantly different between subgroups, indicating subjects with EOV had a worse CV risk factor profile and were prescribed CV-focused preventive medications at a significantly higher frequency. Subjects with EOV had comparatively poorer CPX performance and gas exchange phenotype. Multivariate binary logistic regression analysis found being female was the strongest predictor of EOV (odds ratio: 2.77, 95% confidence interval (CI): 1.66-4.61, p < 0.001). A diagnosis of diabetes (odds ratio: 2.40, 95% CI: 1.34-4.15.2, p < 0.001) added significant value for predicting EOV and was retained in the regression. The likelihood for EOV for subjects who were female and diagnosed with diabetes was 3.71 (95% CI 1.88-7.30, p < 0.001).
  
  
  CONCLUSIONS
  This is the first study to examine EOV prevalence and characterization in apparently healthy persons with results supporting an in-depth definition of abnormal exercise phenotypes.
authors: Heart Failure Unit, University of Milano, Italy marco.guazzi@unimi.it.
authors: Marco
authors: M
authors: Guazzi
authors: Department of Physical Therapy, University of Illinois at Chicago, USA.
authors: Ross
authors: R
authors: Arena
authors: Heart Failure Unit, University of Milano, Italy.
authors: Marta
authors: M
authors: Pellegrino
authors: Heart Failure Unit, University of Milano, Italy.
authors: Francesco
authors: F
authors: Bandera
authors: Heart Failure Unit, University of Milano, Italy.
authors: Greta
authors: G
authors: Generati
authors: Heart Failure Unit, University of Milano, Italy.
authors: Valentina
authors: V
authors: Labate
authors: Heart Failure Unit, University of Milano, Italy.
authors: Eleonora
authors: E
authors: Alfonzetti
authors: Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Italy.
authors: Simona
authors: S
authors: Villani
authors: Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Italy.
authors: Maddalena M
authors: MM
authors: Gaeta
authors: Policlinic for Preventive and Rehabilitative Sports Medicine, Germany.
authors: Martin
authors: M
authors: Halle
authors: Prevention and Rehabilitation Institute, Technische Universität München, Germany.
authors: Robert
authors: R
authors: Haslbauer
authors: Department of Physical Therapy, University of Illinois at Chicago, USA.
authors: Shane A
authors: SA
authors: Phillips
authors: Department of Physical Therapy, University of Miami, USA.
authors: Lawrence P
authors: LP
authors: Cahalin
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009991:Oscillometry; D010641:Phenotype; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012123:Pulmonary Ventilation; D015656:Respiratory Mechanics; D018570:Risk Assessment; D012307:Risk Factors
keywords: Cardiopulmonary exercise testing; aerobic capacity; clinical assessment; oscillatory ventilation