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September 8, 2026Journal of Clinical MedicineOpen Access

A 10-point ANSI increase is linked to ~39% greater odds of higher cardiorespiratory fitness.

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Why the study?

Does the Autonomic Nervous System Index (ANSI) correlate with cardiorespiratory fitness in adults without overt cardiometabolic disease?

Population

200 adults undergoing preventive health evaluation without overt cardiometabolic disease

Design

Cross-sectional

Key result

A 10-point increase in the Autonomic Nervous System Index (ANSI) was associated with higher cardiorespiratory fitness (OR 1.39, p<0.001).

Authors

GOGianluigi OggionniGBGiuseppina BernardelliMMMara Malacarne

Discussion

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Overview

ANSI was associated with higher CRF in healthy adults; leaves open its added value for risk stratification in prospective cohorts.

Key Points

  • To evaluate the relationship between cardiorespiratory fitness and resting cardiac autonomic regulation using a composite metric, the Autonomic Nervous System Index (ANSI).
  • Conducted a cross-sectional study of 200 adults without overt cardiometabolic disease undergoing preventive health evaluations.
  • Measured cardiorespiratory fitness via cardiopulmonary exercise testing (VO2peak and FRIEND registry percentiles) and assessed resting cardiac autonomic regulation using heart rate variability.
  • Analyzed relationships using correlation, multiple regression adjusted for age, sex, smoking, and anthropometrics, and ordinal regression.
  • ANSI showed the strongest correlation with VO2peak among all heart rate variability metrics (r = 0.457, p < 0.001) and accounted for significant variance in VO2peak (R2 = 0.175, p < 0.001) and VO2peak percentile (R2 = 0.209, p < 0.001).
  • ANSI was the only autonomic variable retained in multiple regression models for VO2peak percentile after adjusting for age, sex, smoking, and anthropometric measures.
  • Ordinal regression demonstrated that each 10-point increase in ANSI was associated with an odds ratio of 1.39 (p < 0.001) for belonging to a higher cardiorespiratory fitness percentile category.

Study Design

Type

Cross-Sectional (n=200)

Structured PICO

Does the Autonomic Nervous System Index (ANSI) correlate with cardiorespiratory fitness in adults without overt cardiometabolic disease?

P
Population
200 adults without overt cardiometabolic disease undergoing preventive health evaluation.
O
Outcome
Relationship between cardiorespiratory fitness (VO2peak and VO2peak percentile) and heart rate variability variables, specifically the Autonomic Nervous System Index (ANSI)surrogate

Main Result

Odds Ratio: 1.39

p-value: p=<0.001

The composite Autonomic Nervous System Index (ANSI) is strongly associated with cardiorespiratory fitness and may serve as a simple, integrated measure of cardiac autonomic regulation.

Cite This Study

Oggionni et al. (2026) conducted a cross-sectional in preventive health evaluation without overt cardiometabolic disease (n=200). Autonomic Nervous System Index (ANSI) was evaluated on belonging to a higher cardiorespiratory fitness (CRF) percentile category (OR 1.39, p=<0.001). A 10-point increase in the Autonomic Nervous System Index (ANSI) was associated with higher cardiorespiratory fitness (OR 1.39, p<0.001).

synapsesocial.com/papers/6a9fd7e758e84d0ff5b470bchttps://doi.org/10.3390/jcm15176929
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Exercise Training on Left Ventricular Hypertrophy and Cardiac Regulation in Elite Athletes: Insight from a Composite Index Proxy of Autonomic Control2026
  2. 2Cardiorespiratory Fitness and Population Attributable Risk: The ETHOS Study2026
  3. 3Cardiorespiratory Fitness as a Determinant of Arterial Elasticity in Response to Exercise: Evidence from a Study of Young Athletes and Healthy Controls.2025
  4. 4Cardiac autonomic function in elderly patients with and without atrial fibrillation2026
  5. 5Cardiac autonomic function in elderly patients with and without atrial fibrillation.2026