{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:17:58Z","timestamp":1791901078448,"version":"4.3.4"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"\n Purpose<\/jats:title>\n \n This study aimed to develop non-invasive prediction models for the first ventilatory threshold (VT\n 1<\/jats:sub>\n ) in patients with chronic heart failure (CHF), to address the inaccuracy of guideline-recommended, percentage-based exercise intensity prescriptions (40%\u201369% peak VO\n 2<\/jats:sub>\n , 55%\u201375% peak HR) and the limited accessibility of gold-standard cardiopulmonary exercise testing (CPET).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We analyzed 225 CHF patients who underwent standardized CPET. Using multivariate linear regression with ten-fold cross-validation, we developed prediction models for VT\n 1<\/jats:sub>\n oxygen consumption (VO\n 2<\/jats:sub>\n ) and heart rate (HR) based on readily available clinical parameters, including resting\/peak exercise data, demographics, comorbidities, and medication. Model performance was evaluated using\n R<\/jats:italic>\n 2<\/jats:sup>\n , root mean squared error (RMSE), mean absolute error (MAE), intraclass correlation coefficient (ICC), and Bland-Altman analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Traditional percentage-based methods were inadequate: 80% of patients achieved VO\n 2<\/jats:sub>\n -VT\n 1<\/jats:sub>\n at 60%\u201390% of peak VO\n 2<\/jats:sub>\n , and 75.6% reached HR-VT\n 1<\/jats:sub>\n at 70%\u201390% of peak HR. The VO\n 2<\/jats:sub>\n -VT\n 1<\/jats:sub>\n prediction model showed strong agreement (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.65, RMSE\u2009=\u20091.42\u2005mL\/kg\/min, ICC\u2009=\u20090.79). The HR-VT\n 1<\/jats:sub>\n model demonstrated moderate-to-strong agreement (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.57, RMSE\u2009=\u20098.4\u2005bpm, ICC\u2009=\u20090.71). Bland-Altman analysis indicated good agreement for both models (Within LoA: 95.1% and 95.6%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n CHF patients exhibit distinct exercise intensity patterns. Our validated models enable accurate, individualized estimation of VT\n 1<\/jats:sub>\n parameters using basic clinical and exercise test data, offering a practical alternative to full CPET for personalized exercise prescription in resource-limited settings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1805304","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:37:24Z","timestamp":1783316244000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Non-invasive prediction of the first ventilatory threshold in Chinese patients with chronic heart failure for personalized exercise prescription"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoling","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Department of Geriatrics\/Geriatric Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Xiu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4042","DOI":"10.1093\/eurheartj\/ehaf559","article-title":"Acute heart failure in non-cardiac surgery","volume":"46","author":"Gualandro","year":"2025","journal-title":"Eur Heart 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