Cardiopulmonary Exercise Testing: What Is its Value?

Marco Guazzi, Francesco Bandera, Cemal Ozemek, David Systrom, Ross Arena

Research output: Contribution to journalReview article

Abstract

Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension. The most impactful advance has recently come from the introduction of CPET combined with echocardiography or CPET imaging, which provides basic information regarding cardiac and valve morphology and function. This review highlights modern CPET use as a single or combined test that allows the pathophysiological bases of exercise limitation to be translated, quite easily, into clinical practice.

Original languageEnglish
Pages (from-to)1618-1636
Number of pages19
JournalJournal of the American College of Cardiology
Volume70
Issue number13
DOIs
Publication statusPublished - Sep 26 2017

Keywords

  • exercise
  • gas exchange analysis
  • heart failure
  • oxygen consumption

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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