IJCS | Volume 32, Nº4, July/August 2019

DOI: 10.5935/2359-4802.20190057 343 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(4):343-354 Mailing Address: Ricardo Stein Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS) - Largo Eduardo Zaccaro Faraco, Rua Ramiro Barcelos 2350 - Serviço de Fisiatria,Térreo. Postal Code: 90035-903, Porto Alegre, RS - Brazil. E-mail: rstein@cardiol.br Classification System for Cardiorespiratory Fitness Based on a Sample of the Brazilian Population Antonio Eduardo Monteiro de Almeida, 1, 2 I gor Rafael Miranda Ferreira Santander, 3 Maria Izabel Macedo Campos, 2 Jorge René Garcia Arévalo, 1 J oão Agnaldo do Nascimento, 2 L uiz Eduardo Fonteles Ritt, 4, 5 K arlyse Claudino Belli, 6 J orge Pinto Ribeiro, †6 Ricardo Stein 6, 7 Cardio Lógica Métodos Gráficos, 1 João Pessoa, PB - Brazil Universidade Federal da Paraíba (UFPB), 2 João Pessoa, PB - Brazil Faculdade de Ciências Médicas da Paraíba, 3 João Pessoa, PB - Brazil Escola Bahiana de Medicina e Saúde Pública, 4 Salvador, BA - Brazil Hospital Cárdio Pulmonar, 5 Salvador, BA - Brazil Universidade Federal do Rio Grande do Sul (UFRGS), 6 Porto Alegre, RS - Brazil Hospital de Clínicas de Porto Alegre (HCPA), 7 Porto Alegre, RS - Brazil Manuscript received on February 05, 2018; reviewed on March 17, 2019; accepted on April 01, 2019. Abstract Background: Peak oxygen consumption (VO 2peak ) is an important prognostic marker and its classification helps the cardiologist in the therapeutic decision-making process. The most commonly used cardiorespiratory fitness (CRF) classification has not been validated for the Brazilian population. Objective: To elaborate a CRF classification using a Brazilian sample and to compare it with the American Heart Association (AHA), Cooper and UNIFESP classifications. Methods: A total of 6,568 healthy subjects were analyzed through cardiopulmonary exercise testing (CPET). They were distributed by sex and the following age groups (years): 7-12, 13-19, 20-79 (per decades) and > 80 years. After measurement of the VO 2peak , participants were distributed into quintiles of CRF in very poor, poor, moderate, high and very high (AEMA Table). The CRF classifications by AEMA, AHA, Cooper, and UNIFESP were compared using the Wilcoxon, Kappa and concordance percentages. Results: VO 2peak presented an inverse and moderate correlation with age considering both sexes (R = -0.488, p < 0.001). All paired comparisons between CRF classification systems showed differences (p < 0.001) and disagreement percentage - AEMA versus AHA (k = 0.291, 56.7%), AEMA versus Cooper (k = 0.220, 62.4%) and AEMA versus UNIFESP (k = 0.201, 63.9 %). Conclusion: The AEMA table showed important discrepancies in the classification of CRF when compared to other tables widely used in our setting. Because it was obtained from a large sample of the Brazilian population, the AEMA table should be preferred over other classification systems in our population. (Int J Cardiovasc Sci. 2019;32(4):343-354) Keywords: Exercise Tests; Oxygen Consumption; Respiratory Function Tests; Exercise; Cardiorespiratory Fitness; Population Health. Ricardo Stein, PhD Professor Adjunto da Faculdade de Medicina da UFRGS Coordenador do CardioEx-HCPA rstein@cardiol.br † Note: Deceased on August 23, 2012.