A detailed analysis of body composition in relation to cardiopulmonary exercise test indices

A cardiopulmonary exercise test (CPET) is a test assessing an individual's physiological response during exercise. Results may be affected by body composition, which is best evaluated through imaging techniques like magnetic resonance imaging (MRI). The aim of this study was to assess relationships between body composition and indices obtained from CPET. A total of 234 participants (112 female), all aged 50 years, underwent CPETs and whole-body MRI scans (> 1 million voxels). Voxel-wise statistical analysis of tissue volume and fat content was carried out with a method called Imiomics and related to the CPET indices peak oxygen consumption (V̇O_2peak), V̇O_2peak scaled by body weight (V̇O_2kg) and by total lean mass (V̇O_2lean), ventilatory efficiency (V̇E/V̇CO₂-slope), work efficiency (ΔV̇O₂/ΔWR) and peak exercise respiratory exchange ratio (RERpeak). V̇O_2peak showed the highest positive correlation with volume of skeletal muscle. V̇O_2kg negatively correlated with tissue volume in subcutaneous fat, particularly gluteal fat. RERpeak negatively correlated with tissue volume in skeletal muscle, subcutaneous fat, visceral fat and liver. Some associations differed between sexes: in females ΔV̇O₂/ΔWR correlated positively with tissue volume of subcutaneous fat and V̇E/V̇CO₂-slope with tissue volume of visceral fat, and, in males, V̇O_2peak correlated positively to lung volume. In conclusion, voxel-based Imiomics provided detailed insights into how CPET indices were related to the tissue volume and fat content of different body structures.