Abstract
Most diagnostic tests assess the function of a single organ or organ system at rest. Conversely, exercise requires the integrated function of multiple systems under stress, including the cardiovascular, pulmonary, and musculoskeletal systems. The physical stress of exercise can expose physiological limitations not otherwise apparent at rest. This is particularly relevant for patients with respiratory and/or heart diseases in whom the increased physical demands of exercise quickly exhaust their reduced functional reserves, leading to the disabling symptoms of dyspnea, leg discomfort, and fatigue. The present chapter provides a framework for CPET performance and interpretation aimed at maximizing its clinical relevance. This approach underscores the principle that measurement of exertional symptoms, using validated scales and parameters of ventilatory control and dynamic respiratory mechanics, should be routinely used to optimize clinical CPET interpretation.
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Selected References
American Thoracic Society. American College of Chest Physicians. ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167:211–77.
ERS Task Force, Palange P, Ward SA, Carlsen K-H, Casaburi R, Gallagher CG, Gosselink R, O’Donnell DE, Puente-Maestu L, Schols AM, Singh S, Whipp BJ. Recommendations on the use of exercise testing in clinical practice. Eur Respir J. 2007;29:185–209.
Babb TG, Rodarte JR. Estimation of ventilatory capacity during submaximal exercise. J Appl Physiol. 1993;74:2016–22.
Babb TG. Exercise ventilatory limitation: the role of expiratory flow limitation. Exerc Sport Sci Rev. 2013;41:11–8.
Bernhardt V, Babb TG. Exertional dyspnoea in obesity. Eur Respir Rev. 2016;25(142):487–95.
Neder JA, Ramos RP, Ota-Arakaki JS, Hirai DM, D’Arsigny CL, O’Donnell D. Exercise intolerance in pulmonary arterial hypertension. The role of cardiopulmonary exercise testing. Ann Am Thorac Soc. 2015;12:604–12.
Neder JA, Berton DC, Arbex FF, Alencar MCN, Rocha A, Sperandio PA, Palange P, O’Donnell DE. Physiological and clinical relevance of exercise ventilatory efficiency in COPD. Eur Respir J. 2017;49(3) pii: 1602036.
O’Donnell DE, Elbehairy AF, Faisal A, Webb KA, Neder JA, Mahler DA. Exertional dyspnoea in COPD: the clinical utility of cardiopulmonary exercise testing. Eur Respir Rev. 2016;25:333–47.
O’Donnell DE, Elbehairy AF, Berton DC, Domnik NJ, Neder JA. Advances in the evaluation of respiratory pathophysiology during exercise in chronic lung diseases. Front Physiol. 2017;8:82.
Ramos RP, Alencar MC, Treptow E, Arbex F, Ferreira EM, Neder JA. Clinical usefulness of response profiles to rapidly incremental cardiopulmonary exercise testing. Pulm Med. 2013;2013:359021. https://doi.org/10.1155/2013/359021.
Whipp BJ. The bioenergetic and gas exchange basis of exercise testing. Clin Chest Med. 1994;15:173–92.
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Neder, J.A., Tomlinson, A.R., Babb, T.G., O’Donnell, D.E. (2018). Integrating the Whole: Cardiopulmonary Exercise Testing. In: Kaminsky, D., Irvin, C. (eds) Pulmonary Function Testing. Respiratory Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-94159-2_11
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DOI: https://doi.org/10.1007/978-3-319-94159-2_11
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