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.
Cardiopulmonary exercise testing (CPET) is a methodology that has profoundly affected the approach to patients' functional evaluation, linking performance and physiological parameters to the underlying metabolic substratum and providing highly reproducible exercise capacity descriptors. This study provides professionals with an up-to-date review of the rationale sustaining the use of CPET for functional evaluation of cardiac patients in both the clinical and research settings, describing parameters obtainable either from ramp incremental or step constant-power CPET and illustrating the wealth of information obtainable through an experienced use of this powerful tool. The choice of parameters to be measured will depend on the specific goals of functional evaluation in the individual patient, namely, exercise tolerance assessment, training prescription, treatment efficacy evaluation, and/or investigation of exercise-induced adaptations of the oxygen transport/utilization system. The full potentialities of CPET in the clinical and research setting still remain largely underused and strong efforts are recommended to promote a more widespread use of CPET in the functional evaluation of cardiac patients.
S Maugeri Foundation, Veruno Scientific Institute, Cardiology Division, Veruno (NO), Italy. amezzani@fsm.it
Alessandro
A
Mezzani
Piergiuseppe
P
Agostoni
Alain
A
Cohen-Solal
Ugo
U
Corrà
Anna
A
Jegier
Evangelia
E
Kouidi
Sanja
S
Mazic
Philippe
P
Meurin
Massimo
M
Piepoli
Attila
A
Simon
Christophe Van
CV
Laethem
Luc
L
Vanhees
D000222:Adaptation, Physiological; D015308:Anaerobic Threshold; D002319:Cardiovascular System / Q000503:physiopathology*; D005080:Exercise Test / Q000592:standards*; D017079:Exercise Tolerance; D006331:Heart Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007700:Kinetics; D008168:Lung / Q000503:physiopathology*; D010101:Oxygen Consumption; D018579:Patient Selection; D011237:Predictive Value of Tests; D011659:Pulmonary Gas Exchange; D020127:Recovery of Function; D015203:Reproducibility of Results; D016896:Treatment Outcome