Comparison of CPET Results between Normal and Anemic Populations

This research report aims to compare Cardiopulmonary Exercise Testing (CPET) of a normal healthy group with those of an anemia population. It shall outline differences in the responses from the healthy and anemic groups. The report includes research questions, hypothesis, methods, demographic characteristics, statistical analysis, results, and limitations. The study compares respiratory responses of the two groups at rest, at anaerobic threshold, and at peak exercise.

A RESEARCH PROJECT TO COMPARE CPET RESULTS OF A NORMAL HEALTHY
POPULATION AND THOSE OF AN ANEMIC GROUP

Table of Contents
Introduction.................................................................................................................................................3
Research question...................................................................................................................................4
Hypothesis...............................................................................................................................................4
Methods......................................................................................................................................................5
Demographic characteristics...................................................................................................................5
Statistical analysis....................................................................................................................................6
Results.........................................................................................................................................................7
Comparison between means of tests at rest for a healthy and anemic population..............................11
Comparison between means of tests at anaerobic threshold for a healthy and anemic population....13
Comparison between means of tests at peak exercise for a healthy and anemic population...............16
Conclusion.................................................................................................................................................19
Limitations.................................................................................................................................................20
References.................................................................................................................................................21

Introduction
This research report aims to compare Cardiopulmonary Exercise Testing (CPET) of a normal
healthy group with those of an anemia population. It shall outline differences in the responses
from the healthy and anemic groups.
Cardiopulmonary Exercise Testing (CPET) is a method used to assess the performance of the
heart and lungs at rest and during activity without introducing medical instruments into the body
(Weisman, 2002). It has become an essential tool for evaluating heart and lung performance and
predicting outcome in patients with failures in these organs (Steve Benington, 2012).
CPET involves measurement of inspiratory gas, oxygen uptake (Vo2) and expiratory gas, Carbon
(IV) oxide production (Vco2) and heart rate (Weisman, 2002).
It is expected that respiratory activities of a normal healthy person shall be standard normal
while the respiratory activities of any anemic person shall experience variations (Bandera, 2015).
It then follows that patients with anemia experience exercise intolerance leading to exercise
limitation.
Exercise plays a significant role in determining one’s oxygen intake, carbon (IV) oxide emission
and pulse rate. Lung dysfunctions could lead to low inspiratory and expiratory metabolism (Hale,
1977). The exercise one performs plays an important role in determining their respiratory
response and heart rate. The heart does not beat as quickly when at rest, when you exercise at a
moderate rate and at vigorous rate. Exercises such as water aerobics, walking and dancing are
moderately vigorous while exercises such as swimming, jogging and running are among
vigorous exercises.

In this research, we examined respiratory respondents for a healthy and anemic population at
rest, at anaerobic threshold and at peak exercise. Analysis was then carried out and differences in
the respiratory responses of the two groups and comparison made.
Research question
The following research questions guided the study;
i. How do CPET of a normal healthy group compare to that of an anemic population?
ii. How do CPET results compare at rest, at anaerobic threshold and at peak exercise for
normal and anemic populations?
Hypothesis
The null and alternative hypotheses based on the research question are:
i. H0: There is no difference in CPET results of a normal healthy group and that of an
anemic population.
H1: There is difference in CPET results of a normal healthy group and that of an anemic
population.
ii. H0: There is no difference in CPET results of normal and anemic populations at rest, at
anaerobic threshold and at peak exercise.
H1: There is difference in CPET results of normal and healthy populations at rest, at
anaerobic threshold and at peak exercise.

Methods
Demographic characteristics
CPET data was collected from 8 healthy people, of whom 6 were of the male gender and 2 of the
female gender. They were selected from ages from 23 to 42, 42 being an outlier. The mean age
of the participants was 28.75. The 8 participants were from the height of 158cm to 192. Their
mean heights was 172.63 cm. Their weights were from 53 kilograms to 102 kilograms. 74.125
kg. The hemoglobin blood count ranged from 119 to 150.
Sex Age Height Weight BMI Hb
1 F 23 162 53 133
2 M 25 185 79 142
3 M 30 162 60 150
4 M 42 180 80 119
5 M 26 192 102 145
6 M 27 181 86 127
7 F 27 158 76 127
8 M 30 161 57 129
For the anemic population, 8 participants were selected all of whom were male. Their ages
ranged from 61 to 89. Their mean age is 75. Their heights ranged from 166 cm to 176 cm. Their
mean height was 168.375 cm. Their weights ranged from 46.5 kg to 116.7 kg. Their BMI ranged
from 20.39 to 39.45. Their BMI average was 24.84. The hemoglobin blood count ranged from 78
to 90.
Sex Age Height Weight BMI Hb

1 M 77 176 82.4 26.60 88
2 M 65 172 116.7 39.45 82
3 M 61 165 51.2 18.81 80
4 M 79 174 74.1 24.47 78
5 M 70 175 71.7 23.41 90
6 M 78 151 46.5 20.39 90
7 M 78 168 60.4 21.40 88
8 M 89 166 66.7 24.21 80
CPET data was gathered by examining breath-by-breath, which measured oxygen concentration
and carbon (IV) oxide concentration time.
Height and weight were measured for the calculation of the body mass index (BMI). Gas
exchange and ventilator responses were analyzed for oxygen uptake and carbon (IV) oxide
emission.
Testing was done at rest, at anaerobic threshold and at vigorous activity.
Statistical analysis
Standard descriptive analysis was performed and the normality of data distribution was assessed
using parametric tests. Categorical data was analyzed using paired t-tests. Continuous data were
analyzed using independent samples t-tests. All analyses were performed using IBM SPSS
Statistics. The variables of interest were heart rate, oxygen intake and carbon (IV) oxide outtake.

Results
Descriptive analysis was carried out and the following are the results. Minimum, maximum,
means and standard deviations of the variables are as shown in the tables below.
Descriptive Statistics for CPET at rest for a normal population
N Minimum Maximum Mean Std. Deviation
Age 8 23.0 42.0 28.750 5.8493
Height 8 158.0 192.0 172.625 13.2443
Weight 8 53.0 102.0 74.125 16.5567
BMI 0
Hb 8 119.0 150.0 134.000 10.6234
PetO2_Rest 8 105.4 110.4 108.163 1.6431
PetCO2_Rest 8 32.3 38.1 35.325 1.9308
SPO2_Rest 8 97.0 99.0 97.875 .6409
VT_Rest 8 .49 .81 .6800 .11796
VE/VO2_Rest 8 20.9 43.7 29.600 7.1901
VCO2_Rest 8 .210 .465 .28962 .084939
HR_Rest 8 50.0 98.0 68.875 14.0757
VE/VCO2_Rest 8 24.9 41.3 32.788 4.7909
VO2/HR_Rest 8 3.0 9.2 5.363 2.1051
RER_Rest 8 .73 .90 .8250 .05657
VO2/Kg_Rest 8 3.6 7.0 4.944 1.3664
VE_Rest 8 8.5 15.8 11.437 2.6624
VO2_Rest 8 .241 .569 .35475 .104159
RR_Rest 8 12.6 22.8 17.487 3.5595
Valid N (listwise) 0

Descriptive Statistics for CPET at anaerobic threshold of a healthy population
N Minimum Maximum Mean Std. Deviation
HR_AT 8 100.0 132.0 115.375 11.6489
WR_AT 6 72.0 228.0 122.333 63.3803
PetCO2_AT 8 38.5 48.1 42.900 3.9864
PetO2_AT 8 92.4 106.5 96.762 4.9526
VO2/HR_AT 8 7.0 22.3 12.925 6.4380
VT_AT 8 .67 2.00 1.3350 .48335
VO2_AT 8 .718 2.613 1.49525 .759013
VE/VCO2_AT 8 21.5 30.4 25.638 3.4628
RER_AT 8 .64 .93 .7912 .08593
VCO2_AT 8 .461 2.259 1.20112 .651579
VE_AT 8 16.2 58.3 32.750 13.9756
VE/VO2_AT 8 16.7 30.4 21.750 4.9353
RR_AT 8 16.0 29.5 24.625 4.5953
VO2/Kg_AT 8 9.0 29.0 19.750 7.6672
Valid N (listwise) 6
Descriptive Statistics for CPET at peak exercise of a normal population
N Minimum Maximum Mean Std. Deviation
HR_VOP 8 158.0 185.0 170.875 8.4589
VO2/HR_VOP 8 8.7 33.3 18.925 9.7155
RR_VOP 8 37.1 51.4 43.638 5.3471
PetCO2_VOP 8 35.4 49.8 40.863 5.0057
VCO2_VOP 8 1.625 6.102 3.69837 1.629433
PetO2_VOP 8 97.6 116.1 110.950 6.4578
WR_VOP 8 120.0 437.0 276.000 114.3378
VE_VOP 8 55.0 150.5 96.600 31.3583
VO2_VOP 8 1.403 5.710 3.21575 1.592437
VT_VOP 8 1.07 3.63 2.2850 .88402
VE/VCO2_VOP 8 19.8 37.8 27.063 5.6710

VE/VO2_VOP 8 21.2 36.5 29.863 5.5693
RER_VOP 8 1.06 1.35 1.1825 .10566
VO2/Kg_VOP 8 18.0 64.0 42.375 15.2497
Valid N (listwise) 8
Descriptive Statistics
N Minimum Maximum Mean Std. Deviation
Age 8 23.0 42.0 28.750 5.8493
Height 8 158.0 192.0 172.625 13.2443
Weight 8 53.0 102.0 74.125 16.5567
Hb 8 119.0 150.0 134.000 10.6234
Valid N (listwise) 8
Descriptive Statistics for anemic population at rest
N Minimum Maximum Mean Std. Deviation
HR_Rest 8 68.0 115.0 85.625 16.1770
SPO2_Rest 8 93.0 97.0 95.500 1.4142
VE/VCO2_Rest 8 26.0 60.5 42.000 10.5013
PetO2_Rest 8 95.0 118.5 112.550 7.3783
VO2/HR_Rest 8 2.7 4.5 3.625 .6089
PetCO2_Rest 8 21.5 43.0 31.063 6.2712
VT_Rest 8 .32 .82 .6300 .14243
VE/VO2_Rest 8 19.5 46.4 34.788 7.8734
RR_Rest 8 15.3 24.4 20.138 3.2342
VO2_Rest 8 .199 .445 .30925 .075760
VE_Rest 8 6.3 17.4 12.525 3.6947
RER_Rest 8 .75213675213
67522
.94676806083650
19
.833970957456
215
.079366676298
994
VO2/Kg_Rest 8 2.9835082458
770614
6.1328125000000
000
4.51212680394
0848
1.09175144234
4802
VCO2_Rest 8 .166 .394 .25875 .072832
Valid N (listwise) 8

Descriptive Statistics for anemic population at anaerobic threshold
N Minimum Maximum Mean Std. Deviation
HR_AT 8 81.0 124.0 102.875 16.6084
PetCO2_AT 8 28.1 44.7 33.713 5.9338
PetO2_AT 8 95.4 118.8 110.638 8.1138
VE/VO2_AT 8 23.6 41.0 32.975 5.8470
VE/VCO2_AT 8 29.5 48.2 37.838 6.5766
RER_AT 8 .76851851851851
84
1.0043196544276
458
.87456708526825
8
.09127958068727
9
VT_AT 8 .65 1.39 .9938 .23464
VCO2_AT 8 .363 .930 .56025 .177498
VO2/Kg_AT 8 6.1893203883495
14
11.347656250000
000
9.1700594923885
46
1.6797526353296
99
VO2/HR_AT 8 4.7 7.6 6.163 .9768
VE_AT 8 12.3 35.5 23.313 7.6262
VO2_AT 8 .454 .926 .63312 .148459
RR_AT 8 17.3 31.8 23.325 5.7033
Valid N (listwise) 8
Descriptive Statistics for anemic population at peak exercise
N Minimum Maximum Mean Std. Deviation
RR_VOP 8 19.5 38.3 28.937 6.8708
HR_VOP 8 85.0 151.0 119.375 21.7711
VT_VOP 8 .76 1.93 1.3075 .38920
PetO2_VOP 8 102.0 125.3 116.675 7.8565
PetCO2_VOP 8 26.2 46.5 32.738 6.8352
WR_VOP 8 27.0 90.0 45.688 21.4791
RER_VOP 8 .97365406643757
16
1.3015873015873
016
1.0715691834140
01
.12299267459988
7
VE/VCO2_VOP 8 26.6 49.1 38.450 7.2746
VE/VO2_VOP 8 26.5 51.4 41.250 9.4437

VO2/HR_VOP 8 5.4 8.7 7.113 1.2415
VCO2_VOP 8 .503 1.394 .92100 .316482
VO2/Kg_VOP 8 6.1771844660194
17
16.473118279569
892
12.523136640872
716
3.6918331678324
54
VE_VOP 8 18.5 57.3 38.400 15.5758
VO2_VOP 8 .509 1.071 .84425 .209320
Valid N (listwise) 8
Comparison between CPET results for a healthy population at rest and at anaerobic
threshold
Paired Samples Test
Paired Differences
t df
Sig. (2-
tailed)Mean
Std.
Deviation
Std. Error
Mean
95% Confidence
Interval of the
Difference
Lower Upper
Pair 1 HR_Rest - HR_AT-46.500017.2378 6.0945 -60.9112 -32.0888 -7.630 7 .000
Pair 2 VO2/HR_Rest -
VO2/HR_AT -7.5625 5.0608 1.7892 -11.7934 -3.3316 -4.227 7 .004
Pair 3 VE_Rest - VE_AT -21.312512.2119 4.3175 -31.5219 -11.1031 -4.936 7 .002
Pair 4 RR_Rest - RR_AT -7.1375 5.4437 1.9246 -11.6886 -2.5864 -3.708 7 .008
Pair 5 VO2_Rest -
VO2_AT
-
1.14050
0
.682615 .241341 -1.711181 -.569819 -4.726 7 .002
Pair 6 VO2/Kg_Rest -
VO2/Kg_AT -14.80596.9174 2.4457 -20.5890 -9.0228 -6.054 7 .001
Pair 7 VCO2_Rest -
VCO2_AT -.911500.589978 .208589 -1.404734 -.418266 -4.370 7 .003

Pair 8 RER_Rest -
RER_AT .03375 .08348 .02952 -.03604 .10354 1.143 7 .290
Pair 9 VE/VO2_Rest -
VE/VO2_AT 7.8500 4.3061 1.5225 4.2500 11.4500 5.156 7 .001
Pair
10
VE/VCO2_Rest -
VE/VCO2_AT 7.1500 4.4574 1.5759 3.4235 10.8765 4.537 7 .003
Pair
11
VT_Rest - VT_AT -.65500 .38385 .13571 -.97591 -.33409 -4.826 7 .002
Pair
12
PetO2_Rest -
PetO2_AT 11.4000 4.6254 1.6353 7.5331 15.2669 6.971 7 .000
Pair
13
PetCO2_Rest -
PetCO2_AT -7.5750 3.2736 1.1574 -10.3118 -4.8382 -6.545 7 .000
Except for pair 8, all other pairs have p-values less than 0.05 implying that we reject the null
hypotheses for these pairs and conclude that there is significant difference between the results of
these pairs at 5% level of significance.
For pair 8 the p-value is greater than 0.05 indicating that we fail to reject the null hypothesis and
thereby conclude that there is no difference in the results of the parameters at this pair. The
parameter RER shows no different results at rest and at anaerobic threshold for a normal healthy
population.
Comparison between CPET results for a healthy population at rest and at peak exercise.
Paired Samples Test
Paired Differences
t df
Sig. (2-
tailed)Mean
Std.
Deviation
Std. Error
Mean
95% Confidence
Interval of the
Difference
Lower Upper
Pair 1 HR_Rest -
HR_VOP
-
102.000
0
10.1278 3.5807 -110.4670 -93.5330 -28.4867 .000
Pair 2 VO2/HR_Rest -
VO2/HR_VOP
-
13.5625 8.3356 2.9471 -20.5313 -6.5937 -4.602 7 .002
Pair 3 VE_Rest -
VE_VOP
-
85.1625 29.4787 10.4223 -109.8073 -60.5177 -8.171 7 .000
Pair 4 RR_Rest -
RR_VOP
-
26.1500 7.2295 2.5560 -32.1940 -20.1060 -10.2317 .000
Pair 5 VO2_Rest -
VO2_VOP
-
2.86100
0
1.529857 .540886 -4.139992 -1.582008 -5.289 7 .001
Pair 6 VO2/Kg_Rest -
VO2/Kg_VOP
-
37.4309 14.7316 5.2084 -49.7468 -25.1150 -7.187 7 .000

Pair 7 VCO2_Rest -
VCO2_VOP
-
3.40875
0
1.568466 .554537 -4.720021 -2.097479 -6.147 7 .000
Pair 8 RER_Rest -
RER_VOP -.35750 .11511 .04070 -.45373 -.26127 -8.784 7 .000
Pair 9 VE/VO2_Rest -
VE/VO2_VOP -.2625 7.7362 2.7352 -6.7301 6.2051 -.096 7 .926
Pair
10
VE/VCO2_Rest -
VE/VCO2_VOP 5.7250 6.2465 2.2085 .5028 10.9472 2.592 7 .036
Pair
11
VT_Rest -
VT_VOP
-
1.60500 .79766 .28201 -2.27186 -.93814 -5.691 7 .001
Pair
12
PetO2_Rest -
PetO2_VOP -2.7875 5.6766 2.0070 -7.5333 1.9583 -1.389 7 .207
Pair
13
PetCO2_Rest -
PetCO2_VOP -5.5375 4.4593 1.5766 -9.2656 -1.8094 -3.512 7 .010
Except for pairs 9 and 12, all other pairs have p-values less than 0.05 implying that we reject the
null hypotheses for these pairs and conclude that there is significant difference between the
results of these pairs at 5% level of significance.
For pairs 9 and 12 the p-values are greater than 0.05 indicating that we fail to reject the null
hypotheses and thereby conclude that there is no difference in the results of the parameters at
these pairs. The parameters VE/V02 and PetO2 show no different results at rest and at peak
exercise for a normal healthy population.
Comparison between CPET results for a healthy population at anaerobic threshold and at
peak exercise.
Paired Samples Test
Paired Differences
t df
Sig. (2-
tailed)Mean
Std.
Deviation
Std. Error
Mean
95% Confidence
Interval of the
Difference
Lower Upper
Pair 1 HR_AT -
HR_VOP -55.50009.0238 3.1904 -63.0441 -47.9559 -17.396 7 .000
Pair 2 VO2/HR_AT -
VO2/HR_VOP -6.0000 3.5865 1.2680 -8.9984 -3.0016 -4.732 7 .002
Pair 3 VE_AT -
VE_VOP -63.850018.9355 6.6947 -79.6805 -48.0195 -9.537 7 .000
Pair 4 RR_AT -
RR_VOP -19.01258.4641 2.9925 -26.0887 -11.9363 -6.353 7 .000

Pair 5 VO2_AT -
VO2_VOP
-
1.72050
0
.869061 .307260 -2.447054 -.993946 -5.599 7 .001
Pair 6 VO2/Kg_AT -
VO2/Kg_VOP -22.62508.2278 2.9090 -29.5036 -15.7464 -7.778 7 .000
Pair 7 VCO2_AT -
VCO2_VOP
-
2.49725
0
.998256 .352937 -3.331813 -1.662687 -7.076 7 .000
Pair 8 RER_AT -
RER_VOP -.39125 .13538 .04786 -.50443 -.27807 -8.174 7 .000
Pair 9 VE/VO2_AT -
VE/VO2_VOP -8.1125 6.1068 2.1591 -13.2179 -3.0071 -3.757 7 .007
Pair
10
VE/VCO2_AT -
VE/VCO2_VOP -1.4250 5.2271 1.8480 -5.7949 2.9449 -.771 7 .466
Pair
11
VT_AT -
VT_VOP -.95000 .46009 .16267 -1.33465 -.56535 -5.840 7 .001
Pair
12
PetO2_AT -
PetO2_VOP -14.18756.1096 2.1601 -19.2952 -9.0798 -6.568 7 .000
Pair
13
PetCO2_AT -
PetCO2_VOP 2.0375 3.0317 1.0719 -.4971 4.5721 1.901 7 .099
Except for pair 10, all other pairs have p-values less than 0.05 implying that we reject the null
hypotheses for these pairs and conclude that there is significant difference between the results of
these pairs at 5% level of significance.
For pair 10 the p-value is greater than 0.05 indicating that we fail to reject the null hypothesis
and thereby conclude that there is no difference in the results of the parameters at this pair. The
parameter VE/VC02 shows no different results at peak exercise and at anaerobic threshold for a
normal healthy population.
Comparison between CPET results at rest and at anaerobic threshold for an anemic
population
Paired Samples Test
Paired Differences
t df
Sig. (2-
tailed)Mean
Std.
Deviation
Std. Error
Mean
95% Confidence
Interval of the
Difference
Lower Upper
Pair 1 HR_Rest -
HR_AT -17.2500 4.7734 1.6877 -21.2407 -13.2593 -10.2217 .000

Pair 2 VO2/HR_Rest -
VO2/HR_AT -2.5375 .6391 .2259 -3.0718 -2.0032 -11.2317 .000
Pair 3 VE_Rest -
VE_AT -10.7875 4.3590 1.5412 -14.4318 -7.1432 -7.000 7 .000
Pair 4 RR_Rest -
RR_AT -3.1875 4.4105 1.5594 -6.8748 .4998 -2.044 7 .080
Pair 5 VO2_Rest -
VO2_AT -.323875 .083547 .029538 -.393722 -.254028 -10.9657 .000
Pair 6 VO2/Kg_Rest -
VO2/Kg_AT -
4.6579326
88447700
.80277395
7118999
.28382345
4419402
-
5.3290685
11938655
-
3.9867968
64956744
-16.4117 .000
Pair 7 VCO2_Rest -
VCO2_AT -.301500 .109045 .038553 -.392664 -.210336 -7.820 7 .000
Pair 8 RER_Rest -
RER_AT -.0405961
27812043
.05544516
8613561
.01960282
7355340
-.0869494
48776267
.00575719
3152182 -2.071 7 .077
Pair 9 VE/VO2_Rest -
VE/VO2_AT 1.8125 6.7546 2.3881 -3.8345 7.4595 .759 7 .473
Pair
10
VE/VCO2_Rest -
VE/VCO2_AT 4.1625 7.3508 2.5989 -1.9829 10.3079 1.602 7 .153
Pair
11
VT_Rest -
VT_AT -.36375 .13437 .04751 -.47609 -.25141 -7.657 7 .000
Pair
12
PetO2_Rest -
PetO2_AT 1.9125 5.5553 1.9641 -2.7318 6.5568 .974 7 .363
Pair
13
PetCO2_Rest -
PetCO2_AT -2.6500 3.5104 1.2411 -5.5848 .2848 -2.135 7 .070
Except for pairs 8, 9, 10, 12 and 13, all other pairs of variables have significant values less than
0.05 implying that we reject the null hypotheses for these pairs and conclude that there is a
difference in the results of these variables at rest and at anaerobic threshold.
For pairs 8, 9, 10, 12 and 13, we fail to reject the null hypotheses and conclude that there is no
difference in results of these pairs at rest and at anaerobic threshold.
This indicates that the parameters RER, VE/V02, VE/VC02, Pet02 and PetC02 show no
difference at rest and at anaerobic threshold.
Comparison between CPET results for an anemic population at rest and at peak exercise
Paired Samples Test
Paired Differences
t df
Sig. (2-
tailed)Mean
Std.
Deviation
Std. Error
Mean
95% Confidence
Interval of the
Difference
Lower Upper

Pair 1 HR_Rest -
HR_VOP -33.7500 13.7607 4.8651 -45.2542 -22.2458 -6.937 7 .000
Pair 2 VO2/HR_Rest -
VO2/HR_VOP -3.4875 .9658 .3414 -4.2949 -2.6801 -10.2147 .000
Pair 3 VE_Rest -
VE_VOP -25.8750 13.3184 4.7088 -37.0094 -14.7406 -5.495 7 .001
Pair 4 RR_Rest -
RR_VOP -8.8000 4.8568 1.7171 -12.8604 -4.7396 -5.125 7 .001
Pair 5 VO2_Rest -
VO2_VOP -.535000 .156662 .055388 -.665972 -.404028 -9.659 7 .000
Pair 6 VO2/Kg_Rest -
VO2/Kg_VOP -
8.0110098
36931867
2.7952948
64189452
.98828597
6942145
-
10.347934
825518330
-
5.6740848
48345405
-8.106 7 .000
Pair 7 VCO2_Rest -
VCO2_VOP -.662250 .277655 .098166 -.894375 -.430125 -6.746 7 .000
Pair 8 RER_Rest -
RER_VOP -.2375982
25957786
.13444694
3934462
.04753417
2882933
-.3499986
83936173
-.1251977
67979399 -4.998 7 .002
Pair 9 VE/VO2_Rest -
VE/VO2_VOP -6.4625 9.2011 3.2531 -14.1548 1.2298 -1.987 7 .087
Pair
10
VE/VCO2_Rest -
VE/VCO2_VOP 3.5500 6.7099 2.3723 -2.0596 9.1596 1.496 7 .178
Pair
11
VT_Rest -
VT_VOP -.67750 .32283 .11414 -.94740 -.40760 -5.936 7 .001
Pair
12
PetO2_Rest -
PetO2_VOP -4.1250 5.9076 2.0886 -9.0638 .8138 -1.975 7 .089
Pair
13
PetCO2_Rest -
PetCO2_VOP -1.6750 4.1254 1.4586 -5.1240 1.7740 -1.148 7 .289
Except for pairs 9, 10, 12 and 13, all other pairs of variables have significant values less than
0.05 implying that we reject the null hypotheses for these pairs and conclude that there is a
difference in the results of these variables at rest and at peak exercise.
For pairs 9, 10, 12 and 13, we fail to reject the null hypotheses and conclude that there is no
difference in results of these pairs at rest and at peak exercise.
This is an implication that the parameters VE/V02, VE/VC02, Pet02 and PetC02 show no
difference at rest and at peak exercise.
Comparison between CPET results for an anemic population at anaerobic threshold and at
peak exercise
Paired Samples Test
Paired Differences t df Sig. (2-
tailed)Mean Std.
Deviation
Std. Error
Mean
95% Confidence
Interval of the
Difference

Lower Upper
Pair 1 HR_AT -
HR_VOP -16.5000 12.7055 4.4921 -27.1220 -5.8780 -3.673 7 .008
Pair 2 VO2/HR_AT -
VO2/HR_VOP -.9500 .6370 .2252 -1.4825 -.4175 -4.219 7 .004
Pair 3 VE_AT -
VE_VOP -15.0875 11.1874 3.9554 -24.4404 -5.7346 -3.814 7 .007
Pair 4 RR_AT -
RR_VOP -5.6125 4.0414 1.4288 -8.9912 -2.2338 -3.928 7 .006
Pair 5 VO2_AT -
VO2_VOP -.211125 .132190 .046736 -.321638 -.100612 -4.517 7 .003
Pair 6 VO2/Kg_AT -
VO2/Kg_VOP -
3.3530771
48484168
2.2878781
77212793
.80888708
6817942
-
5.2657911
70774110
-
1.4403631
26194226
-4.145 7 .004
Pair 7 VCO2_AT -
VCO2_VOP -.360750 .256720 .090764 -.575374 -.146126 -3.975 7 .005
Pair 8 RER_AT -
RER_VOP -.1970020
98145743
.13758039
6290188
.04864201
5587562
-.3120221
87850447
-.0819820
08441039 -4.050 7 .005
Pair 9 VE/VO2_AT -
VE/VO2_VOP -8.2750 6.2340 2.2040 -13.4867 -3.0633 -3.754 7 .007
Pair
10
VE/VCO2_AT -
VE/VCO2_VOP -.6125 2.7305 .9654 -2.8952 1.6702 -.634 7 .546
Pair
11
VT_AT -
VT_VOP -.31375 .31928 .11288 -.58068 -.04682 -2.779 7 .027
Pair
12
PetO2_AT -
PetO2_VOP -6.0375 3.0057 1.0627 -8.5503 -3.5247 -5.681 7 .001
Pair
13
PetCO2_AT -
PetCO2_VOP .9750 1.6782 .5933 -.4280 2.3780 1.643 7 .144
Except for pairs 10 and 13, all other pairs of variables have significant values less than 0.05
implying that we reject the null hypotheses for these pairs and conclude that there is a difference
in the results of these variables at anaerobic threshold and at peak exercise.
For pairs 10 and 13, we fail to reject the null hypotheses and conclude that there is no difference
in results of these pairs at anaerobic threshold and at peak exercise.
We can therefore conclude that the parameters VE/VC02 and PetC02 depict no difference at
anaerobic threshold and at peak exercise.

Group Statistics
Anemia N Mean Std. Deviation Std. Error Mean
VO2_Rest Healthy 8 .35475 .104159 .036826
anemic 8 .30925 .075760 .026785
VT_Rest Healthy 8 .6800 .11796 .04170
anemic 8 .6300 .14243 .05036
SPO2_Rest Healthy 8 97.875 .6409 .2266
anemic 8 95.500 1.4142 .5000
PetCO2_Rest Healthy 8 35.325 1.9308 .6826
anemic 8 31.063 6.2712 2.2172
PetO2_Rest Healthy 8 108.163 1.6431 .5809
anemic 8 112.550 7.3783 2.6086
HR_Rest Healthy 8 68.875 14.0757 4.9765
anemic 8 85.625 16.1770 5.7194
VE/VCO2_Rest Healthy 8 32.787 4.7909 1.6938
anemic 8 42.000 10.5013 3.7128
VE/VO2_Rest Healthy 8 29.600 7.1901 2.5421
anemic 8 34.788 7.8734 2.7837
RER_Rest Healthy 8 .825000000000000 .056568542494924 .020000000000000
anemic 8 .833970957456215 .079366676298994 .028060357505628
VO2/HR_Rest Healthy 8 5.363 2.1051 .7442
anemic 8 3.625 .6089 .2153
VCO2_Rest Healthy 8 .28963 .084939 .030030
anemic 8 .25875 .072832 .025750
VO2/Kg_Rest Healthy 8 4.944078947368421 1.366426937738453 .483104876835414
anemic 8 4.512126803940848 1.091751442344802 .385992424126102
RR_Rest Healthy 8 17.487 3.5595 1.2585
anemic 8 20.138 3.2342 1.1434
VE_Rest Healthy 8 11.438 2.6624 .9413
anemic 8 12.525 3.6947 1.3063
Comparison between means of tests at rest for a healthy and anemic population

Independent samples test
Levene's Test for
Equality of
Variances t-test for Equality of Means
F Sig. t df
Sig.
(2-
tailed)
Mean
Difference
Std. Error
Difference
95% Confidence Interval of
the Difference
Lower Upper
VO2_Rest Equal variances
assumed .580 .459 .999 14 .335 .045500 .045537 -.052166 .143166
Equal variances
not assumed .999 12.787 .336 .045500 .045537 -.053043 .144043
VT_Rest Equal variances
assumed .003 .956 .765 14 .457 .05000 .06538 -.09023 .19023
Equal variances
not assumed .765 13.530 .458 .05000 .06538 -.09069 .19069
SPO2_Rest Equal variances
assumed 5.072 .041 4.326 14 .001 2.3750 .5489 1.1976 3.5524
Equal variances
not assumed 4.326 9.759 .002 2.3750 .5489 1.1478 3.6022
PetCO2_Re
st
Equal variances
assumed 4.485 .053 1.837 14 .087 4.2625 2.3199 -.7132 9.2382
Equal variances
not assumed 1.837 8.315 .102 4.2625 2.3199 -1.0522 9.5772
PetO2_Rest Equal variances
assumed 2.249 .156 -1.642 14 .123 -4.3875 2.6725 -10.1195 1.3445
Equal variances
not assumed -1.642 7.693 .141 -4.3875 2.6725 -10.5935 1.8185
HR_Rest Equal variances
assumed .624 .443 -2.209 14 .044 -16.7500 7.5814 -33.0105 -.4895
Equal variances
not assumed -2.209 13.737 .045 -16.7500 7.5814 -33.0397 -.4603
VE/
VCO2_Rest
Equal variances
assumed 3.623 .078 -2.257 14 .040 -9.2125 4.0809 -17.9652 -.4598
Equal variances
not assumed -2.257 9.793 .048 -9.2125 4.0809 -18.3314 -.0936
VE/
VO2_Rest
Equal variances
assumed
.002 .967 -1.376 14 .190 -5.1875 3.7697 -13.2728 2.8978

Equal variances
not assumed -1.376 13.886 .191 -5.1875 3.7697 -13.2790 2.9040
RER_Rest Equal variances
assumed 1.888 .191 -.260 14 .798 -.00897095745
6215
.034458433849
258
-.0828769476
62598
.06493503
2750169
Equal variances
not assumed -.260 12.653 .799 -.00897095745
6215
.034458433849
258
-.0836218133
72105
.06567989
8459675
VO2/
HR_Rest
Equal variances
assumed 5.734 .031 2.243 14 .042 1.7375 .7748 .0758 3.3992
Equal variances
not assumed 2.243 8.163 .055 1.7375 .7748 -.0429 3.5179
VCO2_Rest Equal variances
assumed .163 .693 .780 14 .448 .030875 .039559 -.053970 .115720
Equal variances
not assumed .780 13.682 .448 .030875 .039559 -.054155 .115905
VO2/
Kg_Rest
Equal variances
assumed .258 .620 .699 14 .496 .431952143427
573
.618369204848
451
-.8943178953
49693
1.7582221
82204839
Equal variances
not assumed .699 13.350 .497 .431952143427
573
.618369204848
451
-.9004054559
88513
1.7643097
42843658
RR_Rest Equal variances
assumed .195 .665 -1.558 14 .141 -2.6500 1.7004 -6.2969 .9969
Equal variances
not assumed -1.558 13.873 .142 -2.6500 1.7004 -6.3000 1.0000
VE_Rest Equal variances
assumed .694 .419 -.675 14 .510 -1.0875 1.6101 -4.5408 2.3658
Equal variances
not assumed -.675 12.726 .511 -1.0875 1.6101 -4.5735 2.3985
The variables SPO2, HR_Rest, VE/VCO2 and VO2/HR_Rest have p-values less than 0.05
indicating that we should reject our null hypotheses that there is no difference in the anemic and
healthy groups’ means of these variables at rest in favor of the alternative hypotheses. We then
conclude that there is indeed difference in the means of these variables for a healthy group and
anemic population at rest. The other variables have p-values greater than or equal to 0.05
implying that we fail to reject the null hypotheses that there is no difference in the means of these
variables for the healthy and anemic groups at rest for these variables.

Comparison between means of tests at anaerobic threshold for a healthy and
anemic population
Group Statistics
Anemia N Mean Std. Deviation Std. Error Mean
HR_AT healthy 8 115.375 11.6489 4.1185
anemic 8 102.875 16.6084 5.8720
VO2/Kg_AT healthy 8 19.750000000000000 7.667184247539268 2.710758987020847
anemic 8 9.170059492388548 1.679752635329698 .593882239578802
PetCO2_AT healthy 8 42.900 3.9864 1.4094
anemic 8 33.713 5.9338 2.0979
PetO2_AT healthy 8 96.763 4.9526 1.7510
anemic 8 110.637 8.1138 2.8687
VT_AT healthy 8 1.3350 .48335 .17089
anemic 8 .9938 .23464 .08296
VE/VCO2_AT healthy 8 25.638 3.4628 1.2243
anemic 8 37.838 6.5766 2.3252
RER_AT healthy 8 .791250000000000 .085929788615058 .030380768117817
anemic 8 .874567085268258 .091279580687279 .032272205243920
VE/VO2_AT healthy 8 21.750 4.9353 1.7449
anemic 8 32.975 5.8470 2.0672
VO2/HR_AT healthy 8 12.925 6.4380 2.2762
anemic 8 6.163 .9768 .3453
VE_AT healthy 8 32.750 13.9756 4.9411
anemic 8 23.313 7.6262 2.6963
RR_AT healthy 8 24.625 4.5953 1.6247
anemic 8 23.325 5.7033 2.0164
VO2_AT healthy 8 1.49525 .759013 .268351
anemic 8 .63313 .148459 .052488
VCO2_AT healthy 8 1.20113 .651579 .230368
anemic 8 .56025 .177498 .062755

Independent Samples Test
Levene's Test for
Equality of Variances t-test for Equality of Means
F Sig. t df
Sig. (2-
tailed)
Mean
Difference
Std. Error
Difference
95% Confidence
Interval of the
Difference
Lower Upper
HR_AT Equal variances
assumed 2.623 .128 1.743 14 .103 12.5000 7.1723 -2.8831 27.8831
Equal variances
not assumed 1.743 12.54
5 .106 12.5000 7.1723 -3.0521 28.0521
VO2/Kg_AT Equal variances
assumed 31.267 .000 3.813 14 .002
10.57994
05076114
52
2.775051
42298326
0
4.628047
15730963
4
16.53183
38579132
70
Equal variances
not assumed 3.813 7.670 .006
10.57994
05076114
52
2.775051
42298326
0
4.132482
31222322
3
17.02739
87029996
83
PetCO2_AT Equal variances
assumed .955 .345 3.635 14 .003 9.1875 2.5274 3.7668 14.6082
Equal variances
not assumed 3.635 12.24
9 .003 9.1875 2.5274 3.6932 14.6818
PetO2_AT Equal variances
assumed 1.246 .283 -4.128 14 .001 -13.8750 3.3608 -21.0833 -6.6667
Equal variances
not assumed -4.128 11.58
0 .002 -13.8750 3.3608 -21.2272 -6.5228
VT_AT Equal variances
assumed 4.594 .050 1.796 14 .094 .34125 .18996 -.06618 .74868
Equal variances
not assumed 1.796 10.12
6 .102 .34125 .18996 -.08130 .76380
VE/VCO2_AT Equal variances
assumed 5.475 .035 -4.643 14 .000 -12.2000 2.6278 -17.8361 -6.5639
Equal variances
not assumed -4.643 10.60
4 .001 -12.2000 2.6278 -18.0102 -6.3898
RER_AT Equal variances
assumed .507 .488 -1.880 14 .081 -.0833170
85268258
.0443225
25906521
-.1783794
48807456
.0117452
78270941
Equal variances
not assumed -1.880 13.94
9 .081 -.0833170
85268258
.0443225
25906521
-.1784119
12167562
.0117777
41631047
VE/VO2_AT Equal variances
assumed .170 .686 -4.149 14 .001 -11.2250 2.7052 -17.0271 -5.4229

The variables VO2/kg_AT, PetCo2_AT, PetO2_AT, VE/VCO2_AT, VE/VO2_AT,
VO2/HR_AT, VO2_AT and VCO2_AT have p-values less than 0.05 implying that we reject the
null hypotheses that there is no difference in the means of these variables for a healthy and
anemic population at anaerobic threshold in favor of the alternative hypotheses. We therefore
conclude that these variables depict that there is a difference in the means of these variables for
healthy and anemic population groups at anaerobic threshold.
The other variables have p-values greater than or equal to 0.05 implying that there is no
significant difference in their means between the healthy and anemic population groups.
Comparison between means of tests at peak exercise for a healthy and
anemic population
Group Statistics
Anemia N Mean Std. Deviation Std. Error Mean
PetCO2_VOP healthy 8 40.863 5.0057 1.7698
anemic 8 32.738 6.8352 2.4166
HR_VOP healthy 8 170.875 8.4589 2.9907
anemic 8 119.375 21.7711 7.6973
RR_VOP healthy 8 43.637 5.3471 1.8905
anemic 8 28.938 6.8708 2.4292
VE/VCO2_VOP healthy 8 27.063 5.6710 2.0050
anemic 8 38.450 7.2746 2.5720
PetO2_VOP healthy 8 110.950 6.4578 2.2832
anemic 8 116.675 7.8565 2.7777
WR_VOP healthy 8 276.000 114.3378 40.4245
anemic 8 45.688 21.4791 7.5940
VT_VOP healthy 8 2.2850 .88402 .31255
anemic 8 1.3075 .38920 .13760
VO2/HR_VOP healthy 8 18.925 9.7155 3.4349
anemic 8 7.113 1.2415 .4389
VCO2_VOP healthy 8 3.69838 1.629433 .576092
anemic 8 .92100 .316482 .111893
VE/VO2_VOP healthy 8 29.863 5.5693 1.9690
anemic 8 41.250 9.4437 3.3388
VE_VOP healthy 8 96.600 31.3583 11.0868
anemic 8 38.400 15.5758 5.5069
VO2_VOP healthy 8 3.21575 1.592437 .563012
anemic 8 .84425 .209320 .074006

RER_VOP healthy 8 1.182500000000000 .105661183574129 .037356869706732
anemic 8 1.071569183414001 .122992674599887 .043484477122925
VO2/Kg_VOP healthy 8 42.37500000000000
0
15.24970725714338
0 5.391585706317895
anemic 8 12.52313664087271
6 3.691833167832454 1.305260133991871
Independent Samples Test
Levene's Test for
Equality of Variances t-test for Equality of Means
F Sig. t df
Sig. (2-
tailed)
Mean
Differenc
e
Std. Error
Differenc
e
95% Confide
Interval of
Difference
Lower Uppe
PetCO2_VOP Equal variances
assumed .659 .431 2.713 14 .017 8.1250 2.9953 1.7006 14.54
Equal variances
not assumed 2.713 12.83
1 .018 8.1250 2.9953 1.6453 14.60
HR_VOP Equal variances
assumed 4.551 .051 6.236 14 .000 51.5000 8.2578 33.7887 69.21
Equal variances
not assumed 6.236 9.066 .000 51.5000 8.2578 32.8403 70.15
RR_VOP Equal variances
assumed .045 .835 4.776 14 .000 14.7000 3.0781 8.0980 21.30
Equal variances
not assumed 4.776 13.20
4 .000 14.7000 3.0781 8.0605 21.33
VE/VCO2_VOP Equal variances
assumed .411 .532 -3.492 14 .004 -11.3875 3.2611 -18.3819 -4.39
Equal variances
not assumed -3.492 13.21
3 .004 -11.3875 3.2611 -18.4212 -4.35
PetO2_VOP Equal variances
assumed .558 .467 -1.592 14 .134 -5.7250 3.5956 -13.4368 1.986
Equal variances
not assumed -1.592 13.49
4 .134 -5.7250 3.5956 -13.4640 2.014

WR_VOP Equal variances
assumed 18.820 .001 5.599 14 .000 230.3125 41.1316 142.0939 318.5
Equal variances
not assumed 5.599 7.493 .001 230.3125 41.1316 134.3350 326.2
VT_VOP Equal variances
assumed 6.352 .024 2.862 14 .013 .97750 .34150 .24506 1.709
Equal variances
not assumed 2.862 9.615 .018 .97750 .34150 .21245 1.742
VO2/HR_VOP Equal variances
assumed 22.508 .000 3.411 14 .004 11.8125 3.4629 4.3854 19.23
Equal variances
not assumed 3.411 7.229 .011 11.8125 3.4629 3.6763 19.94
VCO2_VOP Equal variances
assumed 21.552 .000 4.733 14 .000 2.777375 .586857 1.518691 4.036
Equal variances
not assumed 4.733 7.527 .002 2.777375 .586857 1.409146 4.145
VE/VO2_VOP Equal variances
assumed 4.832 .045 -2.938 14 .011 -11.3875 3.8762 -19.7011 -3.07
Equal variances
not assumed -2.938 11.34
4 .013 -11.3875 3.8762 -19.8875 -2.88
VE_VOP Equal variances
assumed 3.700 .075 4.701 14 .000 58.2000 12.3792 31.6493 84.75
Equal variances
not assumed 4.701 10.25
6 .001 58.2000 12.3792 30.7105 85.68
VO2_VOP Equal variances
assumed 23.737 .000 4.176 14 .001 2.371500 .567855 1.153573 3.589
Equal variances
not assumed 4.176 7.242 .004 2.371500 .567855 1.037773 3.705
RER_VOP Equal variances
assumed .139 .715 1.935 14 .073 .1109308
16585999
.0573274
40767402
-.0120243
15224319
.2338
4839
8
Equal variances
not assumed 1.935 13.68
9 .074 .1109308
16585999
.0573274
40767402
-.0122869
06575484
.2341
3974
2
VO2/Kg_VOP Equal variances
assumed
9.623 .008 5.381 14 .000 29.85186
33591272
86
5.547332
73258057
8
17.95401
79608378
45
41.74
8757
730

Equal variances
not assumed 5.381 7.818 .001
29.85186
33591272
86
5.547332
73258057
8
17.00758
49624783
33
42.69
1755
240
The variables Pet02_VOP and RER_VOP have p-values greater than 0.05 implying that we fail
to reject the null hypotheses that there is no difference in the mean of the results for these
variables between the healthy and anemic groups at peak exercise.
Except for the variables PetO2_VOP and RER_VOP, all other variables have p-values less than
0.05 implying that we reject the null hypotheses for these variables in favor of the alternative
hypotheses and conclude that there is significant difference in the mean results of these variables
between the healthy and anemic groups at peak exercise.

Conclusion
The research detailed in this report provides comparison between CPET results of a normal
healthy population and that of an anemic group.
At rest, there was no significant difference in the cardiopulmonary exercise test performance
between the normal population and the anemic population except for the variables SPO2,
HR_Rest, VE/VCO2 and VO2/HR_Rest. This is because of reduced hemoglobin count in anemic
patients. Therefore, there is reduced gaseous exchange and respiratory activity for anemic
patients due to reduced percentage of oxygen binding sites on hemoglobin for the anemic

patients leading to the difference in CPET results for the variables SPO2, HR_Rest, VE/VCO2
and VO2/HR_Rest as argued by (Zilov, 1959)
At anaerobic threshold, there was found moderate significant difference in the cardiopulmonary
exercise test performance for the normal population and anemic population groups as displayed
by the variables VO2/kg_AT, PetCo2_AT, PetO2_AT, VE/VCO2_AT, VE/VO2_AT,
VO2/HR_AT, VO2_AT and VCO2_AT. This is because some metabolic activities which require
oxygen uptake are paralyzed at anaerobic threshold.
At peak exercise, a significant difference showed in the CPET performance of the normal and
anemic population groups except for the variables Pet02_VOP and RER_VOP. At peak exercise,
the anemic group show reduced exercise capacity for the anemic patients as a result of
cardiovascular limitations thereby resulting to a difference in these parameters between the
normal and anemic groups except for variables Pet02_VOP and RER_VOP.
Descriptive statistics for the two population groups at peak exercise showed that the normal
healthy population was found to perform better for all variables except for VE/V02_VOP,
RR_VOP and VE_PetO2_VOP and RER_VOP in cardiopulmonary exercise tests compared to
the anemic group.
It can therefore be inferenced that anemia has a negative impact on gas exchange and exercise
tolerance during exercise in patients. Because anemia lowers the oxygen carrying capacity of the
blood, it can mimic or exacerbate a cardiovascular limitation and this lowers exercise
performance for anemic people.
Previous findings have studied the effects of anemia on exercise performance. However, this
research tried to find out the comparison between exercise performance for a normal healthy
population group and that for an anemic population group.

Limitations
The study involved too few respondents. A number of 8 participants from each of the two groups
was not sufficient to represent the population from where they were drawn.
References
Bandera, F. G. G. P. M. S. F. M. L. G. M., 2015. Exercise gas exchange analysis in obstructive hypertrophic
cardiomyopathy before and after myectomy (cardiopulmonary exercise test combined with exercise-
echocardiography in HCM). p. 2.
Hale, T. S. J. H. E. J., 1977. The effects of an exercise regime on patients with lung malfunction. British
Journal of Sports , p. 1.
Hennis, P. J. M. P. M. G. M. P. W., 2011. Cardiopulmonary exercise testing for the evaluation of
perioperative risk in non-cardiopulmonary surgery. Postgraduate Medical , p. 8.
Steve Benington, D. M. J. E. D. A., 2012. Exercise testing in survivors of intensive care—is there a role for
cardiopulmonary exercise testing?. p. 6.
Weisman, I. Z. R., 2002. An Integrative Approach to the Interpretation of Cardiopulmonary Exercise
Testing. Volume Volume 32, p. 23.
Weisman, I. Z. R., 2002. The Role of Cardiopulmonary Exercise Testing for Patients with Suspected
Metabolic Myopathies and Other Neuromuscular Disorders. Volume volume 32, p. 12.

Zilov, G. N., 1959. Gaseous exchange when oxygen is inhaled. s.l.:s.n.