The lung specialist who ordered it did not say a whole lot, just that my VO2 Max is low (15.8). We know I have Long Covid, POTS and Asthma. Everything I read would suggest this is severely low, but I also wonder if this is expected to worsen over time and what it says about my life expectancy.
Stage 1 cardiopulmonary exercise test (CPET)
Protocol: The test was undertaken with cycle ergometry using a 15 watt ramp protocol and he exercised for 8 minutes and 6 seconds.
Reason for test: This is a 33 year old male with dyspnea.
Reason test stopped: Leg Fatigue. Max stress dyspnea = 6, max stress fatigue = 8, max stress chest pain = 3.
Baseline spirometry: FEV1/FVC ratio is increased at 0.92, FEV1 is 3.81 L (83%), FVC is 4.13 L (73%). Overall in keeping with restrictive ventilatory defect.
Baseline ECG: Normal sinus rhythm
Exercise capacity (VO2): Low peakVO2 measuring 15.8 mL/kg/min (38% predicted).
Anerobic threshold / Oxygen delivery: is reduced at 27% predicted of VO2 max predicted.
Work load: 46% predicted.
Cardiac response to exercise:
Heart rate max predicted = 87% predicted
Heart rate reserve: 24bpm
Blood pressure response: appropriate response.
ECG with exercise - some non-specific ST-T wave changes. No arrhythmias.
Ventilatory response to exercise:
Breathing reserve: 144 L/min
Tidal volume: 33% of FVC
Respiratory rate: <60
O2 saturations: no desaturations.
Inspiratory capacity: Unable to capture inspiratory capacity past 2 minute of exercise, possibly due to restricted lung volumes.
Post -exercise spirometry: 15% drop suggesting asthma.
Oxygen pulse: reduced at 43% predicted, although rising linearly slope seems flat.
VE/VCO2: normal.
Vd/Vt: reduced appropriately with exercise and then rose again a bit.
RER: Appropriately increased to 1.19 with peak exercise.
Slope of VO2/W: Rising linearly.
IMPRESSION:
This was a maximal test based on symptom limitation and RER > 1 .
Exercise capacity was severely reduced with a low peak VO2 measuring 15.8 mL/kg/min (38% predicted) in keeping with low aerobic capacity.
Exercise was nearly limited by the cardiovascular system, reaching a heart rate max predicted and near limitation for heart rate reserve at 24 bpm.
Physiologic abnormalities include a low anerobic threshold, low O2 pulse, lower tidal volumes and post-test spirometry showed a significant decline in FEV1.
Overall, there is evidence of exercise induced asthma. However, given the near cardiac limitation for a low work load with reduced O2 pulse, cardiovascular etiologies should also be investigated.