Impaired cardiorespiratory fitness after aneurysmal subarachnoid haemorrhage

Objective: To assess cardiorespiratory fitness in patients following an aneurysmal subarachnoid haemorrhage and to explore this in fatigued and non-fatigued patients. Design: Cross-sectional case-control study. Subjects/patients: A total of 28 patients, 6 months post aneurysmal subarachnoid haemorrhage, and 28 sex- and agematched controls. Methods: Cardiorespiratory responses to a progressive cardiopulmonary exercise test on a cycle ergometer were obtained using indirect calorimetry. Fatigue was assessed using the Fatigue Severity Scale. Results: Mean peak oxygen uptake (VO_2peak) was significantly lower in patients (22.0 (standard deviation (SD) 6.2) ml/kg/min) than in controls (69% of controls, p < 0.001). All other cardiorespiratory fitness parameters were also lower, with peak levels ranging from 62% to 77% of matched controls. Mean VO_2peak was 19.4 (SD 4.1) ml/kg/min in fatigued patients (63% of matched controls, p < 0.001) and 23.9 (SD 6.9) ml/kg/min in non-fatigued patients (74% of matched controls, p = 0.002). Conclusion: Cardiorespiratory fitness is impaired after aneurysmal subarachnoid haemorrhage, both in fatigued and non-fatigued patients. This finding may have implications for treatment.