BackgroundPatients with fibromyalgia (FM) exhibit low peak oxygen uptake (\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2peak). We aimed to detect the contribution of cardiac output to (\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙) and arteriovenous oxygen difference\documentclass[12pt]{minimal}
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				\begin{document}$$[\text{C}(\text{a-v})\text{O}_{2}]$$\end{document}[C(a-v)O2]to\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}\text{O}_{2}$$\end{document}V˙O2from rest to peak exercise in patients with FM.MethodsThirty-five women with FM, aged 23 to 65 years, and 23 healthy controls performed a step incremental cycle ergometer test until volitional fatigue. Alveolar gas exchange and pulmonary ventilation were measured breath-by-breath and adjusted for fat-free body mass (FFM) where appropriate.\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙(impedance cardiography) was monitored.\documentclass[12pt]{minimal}
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				\begin{document}$$\text{C}(\text{a-v})\text{O}_{2}$$\end{document}C(a-v)O2was calculated using Fick’s equation. Linear regression slopes for oxygen cost (∆\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2/∆work rate) and\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙to\documentclass[12pt]{minimal}
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				\begin{document}$$\text{V}$$\end{document}VO2(∆\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙/∆\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2) were calculated. Normally distributed data were reported as mean ± SD and non-normal data as median [interquartile range].Results\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2peakwas lower in FM patients than in controls (22.2 ± 5.1 vs. 31.1 ± 7.9 mL∙min−1∙kg−1,P< 0.001; 35.7 ± 7.1 vs. 44.0 ± 8.6 mL∙min−1∙kg FFM−1,P< 0.001).\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙and C(a-v)O2were similar between groups at submaximal work rates, but peak\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙(14.17 [13.34–16.03] vs. 16.06 [15.24–16.99] L∙min−1,P= 0.005) and C(a-v)O2(11.6 ± 2.7 vs. 13.3 ± 3.1 mL O2∙100 mL blood−1,P= 0.031) were lower in the FM group. No significant group differences emerged in ∆\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2/∆work rate (11.1 vs. 10.8 mL∙min−1∙W−1,P= 0.248) or ∆\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙/∆\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2(6.58 vs. 5.75,P= 0.122) slopes.ConclusionsBoth\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{Q}}$$\end{document}Q˙and C(a-v)O2contribute to lower\documentclass[12pt]{minimal}
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				\begin{document}$$\dot{\text{V}}$$\end{document}V˙O2peakin FM. The exercise responses were normal and not suggestive of a muscle metabolism pathology.Trial registrationClinicalTrials.gov, NCT03300635. Registered 3 October 2017—Retrospectively registered.https://clinicaltrials.gov/ct2/show/NCT03300635.