Feasibility of a Novel Augmented 6-Minute Incremental Step Test: A Simplified Cardiorespiratory Fitness Assessment Tool

Jeroen Molinger; Veraprapas Kittipibul; J. Matthew Gray; Vishal N. Rao; Stratton Barth; Ashley Swavely; Brian Coyne; Aubrie Coburn; Jan Bakker; Paul E. Wischmeyer; Cynthia L. Green; David MacLeod; Manesh Patel; Marat Fudim

doi:10.1016/j.jacadv.2024.101079

Feasibility of a Novel Augmented 6-Minute Incremental Step Test: A Simplified Cardiorespiratory Fitness Assessment Tool

Jeroen Molinger, Veraprapas Kittipibul, J. Matthew Gray, Vishal N. Rao, Stratton Barth, Ashley Swavely, Brian Coyne, Aubrie Coburn, Jan Bakker, Paul E. Wischmeyer, Cynthia L. Green, David MacLeod, Manesh Patel, Marat Fudim^*

^*Corresponding author for this work

Intensive Care

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Scopus)

35 Downloads (Pure)

Abstract

Background:

The cardiopulmonary exercise test (CPET) is considered a gold standard in assessing cardiorespiratory fitness (CRF) but has limited accessibility due to competency requirements and cost. Incorporating portable sensor devices into a simple bedside test of CRF could improve diagnostic and prognostic value.

Objectives:

The authors sought to evaluate the association of an augmented 6-minute incremental step test (6MIST) with standard CPET.

Methods:

We enrolled patients undergoing clinically indicated supine cycle ergometry CPET with invasive hemodynamics (iCPET) for the same-day 6MIST. CRF-related variables were simultaneously recorded using a signal morphology-based impedance cardiograph (PhysioFlow Enduro) and a portable metabolic analyzer (VO₂ Master Pro) during incremental pace stationary stepping. The correlation between CPET and hemodynamic parameters from both tests was assessed using the intraclass correlation coefficient (ICC).

Results:

Fifteen patients (mean age 60 ± 14 years, 40% female, 27% Black) were included. All patients who agreed to undergo 6MIST completed the study without any test-related adverse events. We observed good to excellent correlation between iCPET- and 6MIST-measured CPET parameters: peak heart rate (ICC = 0.60; 95% CI: 0.15-0.85), absolute peak O₂ consumption (VO₂) (ICC = 0.77; 95% CI: 0.44-0.92), relative peak VO₂ (ICC = 0.64; 95% CI: 0.20-0.86), maximum ventilation (ICC = 0.59; 95% CI: 0.13-0.84), O₂ pulse (ICC = 0.71; 95% CI: 0.33-0.89), and cardiorespiratory optimal point (ICC = 0.82; 95% CI: 0.52-0.94). No significant correlation was determined between iCPET and 6MIST in measuring cardiac index at rest (ICC = 0.19; 95% CI: −0.34 to 0.63) or at peak exercise (ICC = 0.36; 95% CI: −0.17 to 0.73).

Conclusions:

We demonstrate the feasibility of a novel augmented 6MIST with wearable devices for simultaneous CPET and hemodynamic assessment. 6MIST-measured CPET parameters were strongly correlated with the iCPET-derived measurements. Additional studies are needed to confirm the validity of the 6MIST compared to standard upright CPET.

Original language	English
Article number	101079
Journal	JACC: Advances
Volume	3
Issue number	8
DOIs	https://doi.org/10.1016/j.jacadv.2024.101079
Publication status	Published - Aug 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Access to Document

10.1016/j.jacadv.2024.101079Licence: CC BY-NC-ND

Feasibility of a Novel Augmented 6-Minute Incremental Step TestFinal published version, 1.51 MBLicence: CC BY-NC-ND

Cite this

Molinger, J., Kittipibul, V., Gray, J. M., Rao, V. N., Barth, S., Swavely, A., Coyne, B., Coburn, A., Bakker, J., Wischmeyer, P. E., Green, C. L., MacLeod, D., Patel, M., & Fudim, M. (2024). Feasibility of a Novel Augmented 6-Minute Incremental Step Test: A Simplified Cardiorespiratory Fitness Assessment Tool. JACC: Advances, 3(8), Article 101079. https://doi.org/10.1016/j.jacadv.2024.101079

@article{55132680b0b5463a8ea6efe6b2ee3107,

title = "Feasibility of a Novel Augmented 6-Minute Incremental Step Test: A Simplified Cardiorespiratory Fitness Assessment Tool",

abstract = "Background: The cardiopulmonary exercise test (CPET) is considered a gold standard in assessing cardiorespiratory fitness (CRF) but has limited accessibility due to competency requirements and cost. Incorporating portable sensor devices into a simple bedside test of CRF could improve diagnostic and prognostic value. Objectives: The authors sought to evaluate the association of an augmented 6-minute incremental step test (6MIST) with standard CPET. Methods: We enrolled patients undergoing clinically indicated supine cycle ergometry CPET with invasive hemodynamics (iCPET) for the same-day 6MIST. CRF-related variables were simultaneously recorded using a signal morphology-based impedance cardiograph (PhysioFlow Enduro) and a portable metabolic analyzer (VO2 Master Pro) during incremental pace stationary stepping. The correlation between CPET and hemodynamic parameters from both tests was assessed using the intraclass correlation coefficient (ICC). Results: Fifteen patients (mean age 60 ± 14 years, 40\% female, 27\% Black) were included. All patients who agreed to undergo 6MIST completed the study without any test-related adverse events. We observed good to excellent correlation between iCPET- and 6MIST-measured CPET parameters: peak heart rate (ICC = 0.60; 95\% CI: 0.15-0.85), absolute peak O2 consumption (VO2) (ICC = 0.77; 95\% CI: 0.44-0.92), relative peak VO2 (ICC = 0.64; 95\% CI: 0.20-0.86), maximum ventilation (ICC = 0.59; 95\% CI: 0.13-0.84), O2 pulse (ICC = 0.71; 95\% CI: 0.33-0.89), and cardiorespiratory optimal point (ICC = 0.82; 95\% CI: 0.52-0.94). No significant correlation was determined between iCPET and 6MIST in measuring cardiac index at rest (ICC = 0.19; 95\% CI: −0.34 to 0.63) or at peak exercise (ICC = 0.36; 95\% CI: −0.17 to 0.73). Conclusions: We demonstrate the feasibility of a novel augmented 6MIST with wearable devices for simultaneous CPET and hemodynamic assessment. 6MIST-measured CPET parameters were strongly correlated with the iCPET-derived measurements. Additional studies are needed to confirm the validity of the 6MIST compared to standard upright CPET.",

author = "Jeroen Molinger and Veraprapas Kittipibul and Gray, \{J. Matthew\} and Rao, \{Vishal N.\} and Stratton Barth and Ashley Swavely and Brian Coyne and Aubrie Coburn and Jan Bakker and Wischmeyer, \{Paul E.\} and Green, \{Cynthia L.\} and David MacLeod and Manesh Patel and Marat Fudim",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = aug,

doi = "10.1016/j.jacadv.2024.101079",

language = "English",

volume = "3",

journal = "JACC: Advances",

issn = "2772-963X",

number = "8",

}

Molinger, J, Kittipibul, V, Gray, JM, Rao, VN, Barth, S, Swavely, A, Coyne, B, Coburn, A, Bakker, J, Wischmeyer, PE, Green, CL, MacLeod, D, Patel, M & Fudim, M 2024, 'Feasibility of a Novel Augmented 6-Minute Incremental Step Test: A Simplified Cardiorespiratory Fitness Assessment Tool', JACC: Advances, vol. 3, no. 8, 101079. https://doi.org/10.1016/j.jacadv.2024.101079

TY - JOUR

T1 - Feasibility of a Novel Augmented 6-Minute Incremental Step Test

T2 - A Simplified Cardiorespiratory Fitness Assessment Tool

AU - Molinger, Jeroen

AU - Kittipibul, Veraprapas

AU - Gray, J. Matthew

AU - Rao, Vishal N.

AU - Barth, Stratton

AU - Swavely, Ashley

AU - Coyne, Brian

AU - Coburn, Aubrie

AU - Bakker, Jan

AU - Wischmeyer, Paul E.

AU - Green, Cynthia L.

AU - MacLeod, David

AU - Patel, Manesh

AU - Fudim, Marat

PY - 2024/8

Y1 - 2024/8

N2 - Background: The cardiopulmonary exercise test (CPET) is considered a gold standard in assessing cardiorespiratory fitness (CRF) but has limited accessibility due to competency requirements and cost. Incorporating portable sensor devices into a simple bedside test of CRF could improve diagnostic and prognostic value. Objectives: The authors sought to evaluate the association of an augmented 6-minute incremental step test (6MIST) with standard CPET. Methods: We enrolled patients undergoing clinically indicated supine cycle ergometry CPET with invasive hemodynamics (iCPET) for the same-day 6MIST. CRF-related variables were simultaneously recorded using a signal morphology-based impedance cardiograph (PhysioFlow Enduro) and a portable metabolic analyzer (VO2 Master Pro) during incremental pace stationary stepping. The correlation between CPET and hemodynamic parameters from both tests was assessed using the intraclass correlation coefficient (ICC). Results: Fifteen patients (mean age 60 ± 14 years, 40% female, 27% Black) were included. All patients who agreed to undergo 6MIST completed the study without any test-related adverse events. We observed good to excellent correlation between iCPET- and 6MIST-measured CPET parameters: peak heart rate (ICC = 0.60; 95% CI: 0.15-0.85), absolute peak O2 consumption (VO2) (ICC = 0.77; 95% CI: 0.44-0.92), relative peak VO2 (ICC = 0.64; 95% CI: 0.20-0.86), maximum ventilation (ICC = 0.59; 95% CI: 0.13-0.84), O2 pulse (ICC = 0.71; 95% CI: 0.33-0.89), and cardiorespiratory optimal point (ICC = 0.82; 95% CI: 0.52-0.94). No significant correlation was determined between iCPET and 6MIST in measuring cardiac index at rest (ICC = 0.19; 95% CI: −0.34 to 0.63) or at peak exercise (ICC = 0.36; 95% CI: −0.17 to 0.73). Conclusions: We demonstrate the feasibility of a novel augmented 6MIST with wearable devices for simultaneous CPET and hemodynamic assessment. 6MIST-measured CPET parameters were strongly correlated with the iCPET-derived measurements. Additional studies are needed to confirm the validity of the 6MIST compared to standard upright CPET.

AB - Background: The cardiopulmonary exercise test (CPET) is considered a gold standard in assessing cardiorespiratory fitness (CRF) but has limited accessibility due to competency requirements and cost. Incorporating portable sensor devices into a simple bedside test of CRF could improve diagnostic and prognostic value. Objectives: The authors sought to evaluate the association of an augmented 6-minute incremental step test (6MIST) with standard CPET. Methods: We enrolled patients undergoing clinically indicated supine cycle ergometry CPET with invasive hemodynamics (iCPET) for the same-day 6MIST. CRF-related variables were simultaneously recorded using a signal morphology-based impedance cardiograph (PhysioFlow Enduro) and a portable metabolic analyzer (VO2 Master Pro) during incremental pace stationary stepping. The correlation between CPET and hemodynamic parameters from both tests was assessed using the intraclass correlation coefficient (ICC). Results: Fifteen patients (mean age 60 ± 14 years, 40% female, 27% Black) were included. All patients who agreed to undergo 6MIST completed the study without any test-related adverse events. We observed good to excellent correlation between iCPET- and 6MIST-measured CPET parameters: peak heart rate (ICC = 0.60; 95% CI: 0.15-0.85), absolute peak O2 consumption (VO2) (ICC = 0.77; 95% CI: 0.44-0.92), relative peak VO2 (ICC = 0.64; 95% CI: 0.20-0.86), maximum ventilation (ICC = 0.59; 95% CI: 0.13-0.84), O2 pulse (ICC = 0.71; 95% CI: 0.33-0.89), and cardiorespiratory optimal point (ICC = 0.82; 95% CI: 0.52-0.94). No significant correlation was determined between iCPET and 6MIST in measuring cardiac index at rest (ICC = 0.19; 95% CI: −0.34 to 0.63) or at peak exercise (ICC = 0.36; 95% CI: −0.17 to 0.73). Conclusions: We demonstrate the feasibility of a novel augmented 6MIST with wearable devices for simultaneous CPET and hemodynamic assessment. 6MIST-measured CPET parameters were strongly correlated with the iCPET-derived measurements. Additional studies are needed to confirm the validity of the 6MIST compared to standard upright CPET.

UR - https://www.scopus.com/pages/publications/85197605253

U2 - 10.1016/j.jacadv.2024.101079

DO - 10.1016/j.jacadv.2024.101079

M3 - Article

C2 - 39099774

AN - SCOPUS:85197605253

SN - 2772-963X

VL - 3

JO - JACC: Advances

JF - JACC: Advances

IS - 8

M1 - 101079

ER -

Feasibility of a Novel Augmented 6-Minute Incremental Step Test: A Simplified Cardiorespiratory Fitness Assessment Tool

Abstract

Bibliographical note

Access to Document

Other files and links

Fingerprint

Cite this