Levine · The Journal of physiology 2008 · narrative review · n=?

.VO2max: what do we know, and what do we still need to know?

Cited 420 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and physiological mechanism synthesis without primary trial data or systematic review methodology.

PubMed 18006574 · doi:10.1113/jphysiol.2007.147629 · record verified 2026-08-29

What was done

This is a narrative physiological review evaluating classical and contemporary evidence regarding the determinants of maximal oxygen uptake (VO2max), focusing on cardiovascular parameters of the Fick equation, convective oxygen transport to working muscle, and peripheral mechanisms of fatigue.

What was found

The abstract provides no quantitative data or effect sizes. It details physiological mechanisms: VO2max is fundamentally bounded by convective oxygen delivery; elite endurance capacity depends primarily on high maximal cardiac output driven by a large, compliant left ventricle with rapid diastolic filling; and the afferent signaling pathways linking peripheral muscle energetic mismatches to central cardiovascular and neuromotor control remain incompletely characterized.

Why it matters

The paper synthesizes central cardiac output mechanics with peripheral metabolic demand, reinforcing convective oxygen transport as a primary determinant of human aerobic capacity while outlining unresolved questions in neuromuscular signaling and cardiac plasticity.

Limits

The paper is a non-systematic narrative review reflecting theoretical synthesis and expert interpretation rather than original empirical data. No sample sizes, quantitative estimates, or systematic selection criteria are reported in the abstract.

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