Glaab T, Taube C. Practical guide to cardiopulmonary exercise testing in adults. Respir Res. 2022;23(1):9. doi:10.1186/s12931-021-01895-6 Link to article
Cardiopulmonary exercise testing (CPET) is a maximal exercise test with concomitant gas exchange analysis that provides an integrative and comprehensive assessment of physiologic responses to exercise and cardiorespiratory fitness. In contrast to , the direct noninvasive determination of minute ventilation, heart rate and expired gases analysis (oxygen uptake and carbon dioxide output) at rest and during exercise provides accurate and reproducible data on the interaction of ventilation, gas exchange, and cardiovascular and musculoskeletal function, and enables determination of deviations from normal. Use of CPET detects abnormalities in the functional capacity of these organ systems that are amplified or are only present during exercise (e.g., coronary arterial disease [CAD), right-to-left shunt [R-L shunt]) and helps to define the pathophysiology of exercise limitation. It is important to note that patient report of symptoms or stated levels of exercise intolerance correlate only mod- estly with resting functional and imaging tests [1-3). As a result, CPET can be particularly valuable in identifying the source of exercise intolerance, monitoring disease progression, evaluating treatment responsiveness and providing information about prognosis. There are many indications for CPET. The most com- mon of these include (1, 4-12]:
- determining the cause(s) and severity of exertional dyspnoea, exercise intolerance or exercise-induced hypoxaemia;
- assessing exercise capacity and estimating prognosis in various disease states (including chronic heart failure);
- assessing perisurgical and postsurgical complication risk (e.g., for thoracic, heart and visceral surgery; surgical and bronchoscopic lung volume reduction);
- early detection and risk stratification of cardiovascular, pulmonary vascular and lung diseases, and musculoskeletal disorders;
- measuring the response to treatment (e.g., drugs, rehabilitation);
- guiding and monitoring individual physical training in rehabilitation (e.g., cardiac, pulmonary), and in preventive and sports medicine;
- evaluating the limitations/impairments of individual maximum and continuous exercise capacity in occupational medicine.