Table 1.
General characteristics of the prospective cohort studies included.
| Study | Follow-up (month) | Sample size (women/men) | Mean age (year) | Disease condition | Exposure measurement | Outcome | High vs. low definition | Per increment definition | Number of deaths | Adjustment for covariates |
|---|---|---|---|---|---|---|---|---|---|---|
| Aijaz et al. (2009)26 | 120.0 | 282 (48/234) | 61.0 | Coronary heart disease | Cardiopulmonary treadmill testing (symptom-limited graded exercise testing) | All-cause mortality | Low: VO2peak <19 mL/kg/min (men) and <15 mL/kg/min (women) | 55 | Age and gender | |
| Barons et al. (2015)27 | 136.0 | 2714 (547/2167) | 61.3 | Coronary heart disease | Exercise test using the Bruce protocol or the modified Bruce protocol | All-cause mortality and CVD mortality | VO2peak ≥ 22 mL/kg/min (men), VO2peak ≥ 19 mL/kg/min (women, high) vs. VO2peak <15 mL/kg/min (women, low) |
385 (all-cause) and 192 (CVD) | NR | |
| Coats et al. (2015)38 | 67.2 | 1898 (626/1272) | 46.0 | Hypertrophic cardiomyopathy | Maximal exercise test | All-cause mortality, or CVD mortality, sudden cardiac death, and heart failure death | Per 1 mL/kg/min increase in VO2peak | 156 (all cause) and 117 (CVD) | Age, sex, and all exercise parameters | |
| Dhoble et al. (2014)22 | 61.2 | 155 (16/139) | 69.6 | Aortic stenosis | Maximal exercise test | All-cause mortality | VO2peak ≥ 19 mL/kg/min (men) or ≥ 15 mL/kg/min (women), or ≥ 80% (high) vs. <80% (low) for men and women | 41 | Age, gender, symptom status, Charlson index, and AV area | |
| Goda et al. (2009)40 | 45.6 | 549 (112/437) | 63.4 | Various (ischemic heart disease, valvular heart disease, dilated cardiomyopathy, hypertrophic cardiomyopathy, and other CVD) | Incremental symptom-limited exercise test | CVD mortality | >14.5 mL/min/kg (high) vs. <14.5 mL/min/kg (low) | Per 1-SD mL/kg/min change in VO2 | 29 (all-cause) and 28 (CVD) | NR |
| Goel et al. (2011)28 | 24.0 | 855 (170/685) | 62.4 | CAD | Cardiopulmonary exercise testing | All-cause mortality | High vs. <21.5 mL kg/1/min (men) or <16.8 mL kg/1/min (women) | Per 1 mL/kg/min in VO2peak | 159 | Age, smoking, systolic blood pressure, diastolic blood pressure, myocardial infarction, heart failure, diabetes, COPD, renal disease, and BMI |
| Hai et al. (2010)29 | 78.5 | 386 (89/297) | 64.0 | Myocardial infarction | Cardiopulmonary exercise testing | CVD mortality | For men and women, >4 METs (high) vs. <4 METs (low) | 40 (CVD) | Diabetes, LVEF, acute pulmonary edema, revascularizations, angiotensin-converting enzyme inhibitor, statin, exercise training | |
| Hung et al. (2014)30 | 72.6 | 9852 (3016/6836) | 61.0 | CAD | Cardiopulmonary exercise testing | All-cause mortality | For men and women, >12 METs (high) vs. <6 METs (low) | Per 1-MET increase | 3824 | Age; sex; race; obesity; resting heart rate and systolic and diastolic blood pressures; history of hypertension, dyslipidemia, smoking, diabetes mellitus, atrial fibrillation, or heart failure; indication for stress testing; medications used to treat COPD, hypertension, or hyperlipidemia; aspirin; clopidogrel; and β-adrenergic blocking agents |
| Kato et al. (2018)33 | 48.0 | 1501 (400/1111) | 61.0 | Heart failure | Cardiopulmonary exercise testing | Heart failure events (including death) | Per 1 mL/kg/min increase in VO2peak | 141 | Estimated glomerular filtration rate, peak oxygen consumption, atrial fibrillation, and brain natriuretic peptide | |
| Keteyian et al. (2008)31 | 59.0 | 2812 (794/2018) | 61.0 | Coronary heart disease | Cardiopulmonary exercise testing | All-cause and CVD mortality | For men, VO2peak ≥ 22.8 (high) vs. VO2peak <14.9 (low) For women, VO2peak ≥ 16.6 (high) vs. VO2peak <11.9 (low) |
Per 1-MET increase | 280 (103 CVD) | NR |
| Keteyian et al. (2018)34 | 93.6 | 707 (287/420) | 59.0 | Heart failure | Cardiopulmonary exercise testing | All-cause mortality | Per 1-MET increase | 242 | Age, sex, hypertension, diabetes, history of ischemic heart disease, year of cardiac rehabilitation, Charlson comorbidity index, β-adrenergic blockade, angiotensin-converting enzyme inhibitor or angiotensin receptor blockade, and diuretic use | |
| Kiviniemi et al. (2015)32 | 24.0 | 1531 (477/1054) | 67.0 | Stable CAD | Cardiopulmonary exercise testing | CVD deaths and hospitalization | For men and women, ≥73% exercise capacity (high) vs. <73% (low) | 39 | Age, sex, diabetes, smoking, history of acute myocardial infarction, history of coronary intervention, BMI, Canadian Cardiovascular Society grading of angina pectoris, LVEF, mass index, and resting heart rate | |
| Leeper et al. (2013)39 | 135.6 | 725 (17/708) | 62.0 | Peripheral arterial disease | Cardiopulmonary exercise testing | All-cause and CVD mortality | Per 1-MET increase | 364 | Age, pack-years, and heart failure history | |
| Mandsager et al. (2018)21 | 100.8 | 122,007 (49,834/72,173) | 53.4 | CAD, diabetes, hypertension, hyperlipidemia, ESRD, and current/prior smoker | Cardiopulmonary exercise testing | All-cause mortality | For men and women, >97.7th percentile (high) vs. <25th percentile (low) | 13,637 | Age, sex, BMI, history of CAD, hyperlipidemia, hypertension, diabetes, smoking, ESRD, year of testing, and current use of aspirin, β-blockers, or statins | |
| Martin et al. (2013)23 | 12.0 | 5641 (1359/4282) | 60.0 | CAD | Cardiopulmonary exercise testing | All-cause mortality | For men and women, >8 METs (high) vs. <5 METs (low) | Per 1-MET increase | NR | Age, sex, and comorbid conditions |
| Mikkelsen et al. (2020)41 | 72.0 | 1561 (406/1155) | 63.6 | CAD, chronic heart failure, and heart valve replacement | Cardiopulmonary exercise testing | All-cause mortality | Per 1 mL/kg/min increase in VO2peak at baseline | 52 | Age, sex, working status (employed, unemployed, retired, and being on disability pension), education, index diagnosis, medication, tobacco use, COPD, diabetes, kidney disease, and peripheral artery disease. | |
| Nadruz et al. (2017)35 | 50.4 | 969 (315/654) | 55.0 | Heart failure | Cardiopulmonary exercise testing | All-cause mortality | Per 1 mL/kg/min increase in VO2peak | 164 | Age, sex, LVEF, chronic kidney disease, resting heart rate, resting systolic blood pressure, and CAD | |
| Orimoloye et al. (2019)36 | 116.4 | 167 (91/76) | 63.9 | Heart failure with preserved ejection fraction | Cardiopulmonary exercise testing | All-cause mortality | ≥7 METs (high) vs. 1–4 For men and women, METs (low) | Per 1-MET increase | 103 | Age, sex, race, modifiable risk factors (hypertension, diabetes mellitus, smoking status, weight), medication use including β-blockers, angiotensin receptor blockers, medications for chronic lung disease, and history of CAD |
| Sato et al. (2017)37 | 90.0 | 1190 (221/969) | 61.0 | Heart failure | Cardiopulmonary exercise testing | All-cause mortality and cardiac death | 248 (173 cardiac deaths) | Age, gender, BMI, presence of anemia and COPD | ||
| Straw et al. (2020)42 | 48.0 | 199 (27/172) | 76.0 | Various (before endovascular aneurysm repair) | Cardiopulmonary exercise testing | All-cause mortality | For men and women, >15 mL/kg/min vs. <15 mL/kg/min (low) in VO2peak | 98 | Age and sex | |
| Taylor et al. (2016)24 | 168.0 | 670 (136/534) | 60.0 | Coronary heart disease | Cardiopulmonary exercise testing | All-cause mortality | ≥7 METs for women and ≥8 METs for men (high) vs. <5 METs for women and <6 METs for men (low) | Per 1-MET increase | 206 | CAD diagnosis, CVD and other comorbidities, exercise test abnormalities, secondary prevention medications, and self-report physical activity |
Abbreviations: AV = aortic valve; BMI = body mass index; CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; CVD = cardiovascular disease; ESRD = end-stage renal disease; LVEF = left ventricular ejection fraction; METs = metabolic equivalents; NR = not reported; SD = standard deviation; VO2 = oxygen consumption; VO2peak = peak oxygen consumption.