Sex Differences and Correlates of the Utility of the Cardiopulmonary Exercise Test for Prescribing Exercise at Entry to Cardiac Rehabilitation
Bibliographic record
Abstract
Background Despite the importance of objective measures for prescribing aerobic exercise for mitigating cardiovascular risk in people with coronary artery disease (CAD), no study has examined sex differences in the utility of the cardiopulmonary exercise test (CPET) for developing the exercise prescription. Methods CPET results from 1352 females and 5875 males with CAD were analysed to determine if there was a sex difference in achieving maximal oxygen uptake ( V ˙ O 2max ) or an identifiable first ventilatory threshold (VT 1 ). Secondary outcomes were to determine correlates of not achieving V ˙ O 2max or VT 1 in all patients and in males and females separately. Results A greater proportion of males than females achieved V ˙ O 2max or VT 1 (89.7% vs 71.3%; P < 0.001) as well as specifically achieving V ˙ O 2max (40.2% vs 26.7%; P < 0.001) and VT 1 (88.0% vs 69.2%; P < 0.001). The most influential correlates of not achieving V ˙ O 2max or VT 1 were female sex (odds ratio 3.1, 95% confidence interval 2.6-3.7), age > 60 years, tested on treadmill vs cycle, depressive symptoms, and a secondary heart failure diagnosis. At entry to cardiac rehabilitation, these correlates were more prevalent in females than in males. Correlates differed by sex. The threshold for when age affected achieving V ˙ O 2max or VT 1 on the cycle CPET was earlier for females (> 50 years of age) than for males (> 70 years of age) with no difference on treadmill (> 80 years of age for both). Conclusions Although most patients achieved V ˙ O 2max or VT 1 on the CPET, females were 3 times less likely than males to achieve V ˙ O 2max or VT 1 . Strategies to improve utility of CPETs for females, such as alternative exercise test protocols and investigation into underlying mechanisms for effects of depressive symptoms, should be conducted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".