Cardiopulmonary exercise testing. Procedure and recommendations
Silvia Cid-Juárez, José Luis Miguel-Reyes, Arturo Cortés-Télles, Laura Gochicoa-Rangel, Uri de Jesús Mora-Romero, Mónica Silva-Cerón, Luis Torre-Bouscoulet
2015, Number 3
2015; 74 (3)
ABSTRACT
Cardiopulmonary exercise testing (CPET) makes it possible to evaluate, simultaneously, the physiological integration of the cardiovascular, respiratory, metabolic, musculoskeletal and neurosensory systems during exercise. CPET provides a physiological response profile that is useful for diagnosis and follow-up of patients in diverse clinical scenarios. Technological advances have facilitated the performance and interpretation of this test; however, in Mexico it is still little-utilized, in part because it is not widely-known. The objectives of this document are, first, to present a general view of the practical aspects of CPET to pneumologists and the medical community as a whole, and, second, to describe the standard procedure for successful test performance. Finally, the text elucidates basic aspects of the interpretation of test results.
Wasserman K, Hansen JE, Sue DY, Whipp BJ, Casaburi R. Principles of exercise testing and interpretation: including pathophysiology and clinical applications. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 1999.p.xv.
Forman DE, Myers J, Lavie CJ, Guazzi M, Celli B, Arena R Cardiopulmonary exercise testing: relevant but underused. Postgrad Med 2010;122(6):68-86. doi: 10.3810/pgm.2010.11.2225.
American Thoracic Society; American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003;167(2):211-277.
Gibbons RJ, Balady GJ, Beasley JW, et al. ACC/AHA Guidelines for Exercise Testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). J Am Coll Cardiol 1997;30(1):260-311.
Stelken AM, Younis LT, Jennison SH, et al. Prognostic value of cardiopulmonary exercise testing using percent achieved of predicted peak oxygen uptake for patients with ischemic and dilated cardiomyopathy. J Am Coll Cardiol 1996;27(2):345-352.
Hamilton AL, Killian KJ, Summers E, Jones NL. Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. Am J Respir Crit Care Med 1995;152(6 Pt 1):2021-2031.
Gallagher CG. Exercise limitation and clinical exercise testing in chronic obstructive pulmonary disease. Clin Chest Med 1994;15(2):305-326.
Carlin BW, Clausen JL, Ries AL. The effects of exercise testing on the prescription of oxygen therapy. Chest 1994;106(2):361-365.
Garfinkel SK, Kesten S, Chapman KR, Rebuck AS. Physiologic and nonphysiologic determinants of aerobic fitness in mild to moderate asthma. Am Rev Respir Dis 1992;145(4 Pt 1):741-745.
Sun XG, Hansen JE, Oudiz RJ, Wasserman K. Exercise pathophysiology in patients with primary pulmonary typertension. Circulation 2001;104(4):429-435.
Bolliger CT, Jordan P, Solèr M, et al. Exercise capacity as a predictor of postoperative complications in lung resection candidates. Am J Respir Crit Care Med 1995;151(5):1472-1480.
Bolliger CT, Perruchoud AP. Functional evaluation of the lung resection candidate. Eur Respir J 1998;11(1):198-212.
Morice RC, Peters EJ, Ryan MB, Putnam JB, Ali MK, Roth JA. Redefining the lowest exercise peak oxygen consumption acceptable for lung resection of high risk patients. Chest 1996;110(4 Suppl):161S.
Cooper BCh, Storer WT. Exercise testing and interpretation: a practical approach. UK: Cambridge University Press; 2001.p.149-180.
Mezzani A, Agostoni P, Cohen-Solal A, et al. Standards for the use of cardiopulmonary exercise testing for the functional evaluation of cardiac patients: a report from the Exercise Physiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 2009;16(3):249-267. doi: 10.1097/HJR.0b013e32832914c8.