In contrast to exercise ECG, 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. ).Ĭardiopulmonary 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. Without it, the evaluation of patients with exercise intolerance may be too narrowly focused by the physician’s particular subspecialty.” (Preface Wasserman & Whipp’s Principles of Exercise Testing and Interpretation, 6th. “It is likely that no test in medicine is as informative and cost-effective as cardiopulmonary exercise testing for distinguishing among the broad spectrum of disorders causing symptoms of exercise intolerance. This article describes the underlying principles of exercise physiology and provides a practical guide to performing CPET and interpreting the results in adults. However, this test requires specific knowledge and there is still a major information gap for those physicians primarily interested in learning how to systematically analyse and interpret CPET findings. Consequently, CPET should be one of the early tests used to assess exercise intolerance. Therefore, it improves diagnostic accuracy and patient health care by directing more targeted diagnostics and facilitating treatment decisions.
CPET can distinguish between a normal and an abnormal exercise response and usually identifies which of multiple pathophysiological conditions alone or in combination is the leading cause of exercise intolerance. Noninvasive cardiopulmonary exercise testing (CPET) offers a unique, but still under-utilised and unrecognised, opportunity to study cardiopulmonary and metabolic changes simultaneously. Unexplained exertional dyspnoea or fatigue can arise from a number of underlying disorders and shows only a weak correlation with resting functional or imaging tests.
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