IJCS | Volume 32, Nº4, July/August 2019

333 Araújo et al. CLINIMEX aerobic fitness questionnaire Int J Cardiovasc Sci. 2019;32(4):331-342 Original Article bypass grafting. A total of 34.7% were being treated for arterial hypertension, 40.2% were classified as having dyslipidemia, and diabetes mellitus was diagnosed in 13.4% of the subjects studied. Regular use of ß-blockers was reported by 25.6% of the subjects. Maximal cardiopulmonary exercise test (CPET) Only four experienced and specialized physicians directly supervised all maximal CPETs performed in a proper temperature-humidity controlled room equipped for providing medical emergency support if needed. Digital electrocardiogram was continuously monitored and recorded before, during and for at least five minutes after the end of the CPET (Micromed Elite ErgoPC, Brazil). 27,28 The ergometer was chosen according to the subject’s testing objective, whether for clinical diagnosis, exercise prescription or sport training advice. Maximal CPET was most often performed in leg cycling ergometer (85.2%) (Inbramed CG-04, Brazil) than in treadmill (14.8%) (Inbramed ATL Master, Brazil) using individual ramp protocols. For treadmill tests, a constant 0% slope was set and after one-minute walk at 5.5 km/h, the speed was quickly increased to 8.0 km/h and thereafter progressively increased until volitional exhaustion under strong verbal encouragement. For all CPETs, individualized rates of exercise intensity — speed or watts — increment was used. A combination of several physiological and perceptual criteria was utilized for characterizing CPET as maximal in both ergometers. 27,28 No major relevant clinical abnormalities occurred during all 1,000 CPETs performed. During the CPET, subjects used a nose clip and breathed through a Prevent mouthpiece in order to collect expired gas. Calculation of air flow and O 2 and CO 2 expired fraction analysis were carried out in a VO2000 metabolic analyzer (Medical Graphics, United States) regularly calibrated using known syringe volumes and two different gas concentrations. For comparison purposes, VO 2 max related to body weight in cycling CPET was predicted according to age and sex by using the following equations proposed by Jones et al. 29 : men = 60 – 0.55 x age (years) and for women = 48–0.37 x age (years). For treadmill CPET, 11% was added to this predicted value. All data related to VO 2 max - predicted, measured and estimated by C-AFQ - were reported as METs, where 1 MET = 3.5 mL O 2 .kg -1 .min -1 . CLINIMEX aerobic fitness questionnaire (C-AFQ) C-AFQ data were obtained during consultation with the supervising physician either by objective questioning or by showing the list of activities and corresponding METs. C-AFQ was applied in a two-step sequence following standard instructions (please see footnote of Table 1 for more details). (see Portuguese C-AFQ version in supplemental materials). Almost all the corresponding MET values for each of the listed activities were obtained from the literature, 30 with few of them estimated from other sources or by the authors’ scientific knowledge and clinical experience. This two-step approach allowed refining the estimate of maximal exercise capacity and, consequently, maximal aerobic power in METs. By applying C-AFQ, it was possible to estimate aerobic fitness in one or twominutes, from< 1 to > 20METs, with 0.5 intervals from2 to 5METs and thereafter, from one in one MET increments up to 20 or more METs. Other study measurements Our evaluation protocol was quite comprehensive and involved several other variables tests. In order to identify potential influential variables for this particular study, age, sex, height, weight, waist girth, 31 sitting-rising test 32,33 andmaximal muscle power related to body weight in the upper rowmovement 34 were also tabulated and analyzed. Statistical analysis Descriptive statistics for continuous variables were presented as mean and standard deviations or as median and interquartile range, as well as several other potentially useful percentiles for data distribution and frequency distribution for nominal variables. Inferential statistics analyses were carried out by t-tests or ANOVA and Tukey’s post-hoc comparisons, depending on the number of groups compared. Pearson product-moment correlation coefficients were calculated for assessing association and best-fit linear regression was used for data modeling. Statistical significance was set at 5% of probability and the Prism version 8.1.1 software package (GraphPad, United States) was used for statistical calculations and preparation of figures. Results Sex- and age-predicted VO 2 max and measured (CPET) VO 2 max were similar, being, respectively,