Abstract

Cardiovascular risk and mortality are global concerns. Cardiopulmonary exercise testing (CPET) helps identify key diagnostic and prognostic variables for cardiorespiratory fitness. The cardiorespiratory optimal point (COP), defined as the lowest point of ventilation required to extract oxygen, has emerged as an accessible and potentially useful submaximal tool. This aimed to analyze COPs behavior and its relation to cardiorespiratory variables during CPET and its relation with cardiovascular risk (CVR) stratification and mortality in adults with and without cardiovascular disease. A systematic review was conducted using electronic databases (PubMed, Cochrane Library, and ScienceDirect) following PRISMA guidelines. Ten studies with 14,537 participants were included, and methodological quality was assessed through the Newcastle-Ottawa scale. Results showed that high COP values, typically reported within a risk-associated range of >25-30, were significantly associated with increased cardiovascular and all-cause mortality risk. COP showed moderate correlations with other cardiorespiratory variables and appeared at submaximal intensities, before the first ventilatory threshold. COP is an accessible and prognostic tool for assessing cardiovascular health in clinical populations.