title: Cardiopulmonary exercise testing in the assessment of exertional dyspnea.
abstract: Dyspnea on exertion is a commonly encountered problem in clinical practice. It is usually investigated by resting tests such as pulmonary function tests and echocardiogram, which may at times can be non-diagnostic. Cardiopulmonary exercise testing (CPET) measures physiologic parameters during exercise which can enable accurate identification of the cause of dyspnea. Though CPET has been around for decades and provides valuable and pertinent physiologic information on the integrated cardiopulmonary responses to exercise, it remains underutilized. The objective of this review is to provide a comprehensible overview of the underlying principles of exercise physiology, indications and contraindications of CPET, methodology and interpretative strategies involved and thereby increase the understanding of the insights that can be gained from the use of CPET.
authors.affiliation: Department of Medicine, Division of Pulmonary-Critical Care Medicine, University of CT Health Center, Farmington, CT 06030, USA.
authors.forename: Debapriya
authors.initials: D
authors.lastname: Datta
authors.affiliation: Division of Pulmonary Medicine, St Francis Hospital and Medical Center, Hartford, CT 06105, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Normandin
authors.affiliation: Division of Pulmonary Medicine, St Francis Hospital and Medical Center, Hartford, CT 06105, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: ZuWallack
keywords: Anaerobic threshold; carbon dioxide output; cardiopulmonary exercise test; dyspnea; exercise limitation; oxygen uptake
references.citation: Annu Rev Physiol. 1996;58:21-50
references.pmid: 8815793
references.citation: J Am Coll Cardiol. 1997 Jul;30(1):260-311
references.pmid: 9207652
references.citation: Thorax. 1992 Dec;47(12):1019-24
references.pmid: 1494764
references.citation: J Appl Physiol Respir Environ Exerc Physiol. 1983 Nov;55(5):1558-64
references.pmid: 6643191
references.citation: J Appl Physiol Respir Environ Exerc Physiol. 1981 Dec;51(6):1662-75
references.pmid: 6798003
references.citation: J Appl Physiol. 1973 Jan;34(1):128-32
references.pmid: 4697371
references.citation: Chest. 1998 Mar;113(3):602-11
references.pmid: 9515832
references.citation: Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
references.pmid: 12091180
references.citation: J Appl Physiol (1985). 1989 Aug;67(2):547-55
references.pmid: 2793656
references.citation: Surgery. 1984 Feb;95(2):221-9
references.pmid: 6695339
references.citation: J Appl Physiol. 1957 Jul;11(1):72-8
references.pmid: 13462921
references.citation: Am Rev Respir Dis. 1992 Oct;146(4):935-40
references.pmid: 1416421
references.citation: Med Sci Sports. 1973 Fall;5(3):156-60
references.pmid: 4747636
references.citation: Clin Chest Med. 1994 Jun;15(2):421-45
references.pmid: 8088102
references.citation: Chest. 1991 Apr;99(4):981-92
references.pmid: 2009806
references.citation: Med Sci Sports Exerc. 2000 Aug;32(8):1365-8
references.pmid: 10948999
references.citation: Am J Respir Crit Care Med. 2003 Jan 15;167(2):211-77
references.pmid: 12524257
references.citation: J Appl Physiol (1985). 1986 Jun;60(6):2020-7
references.pmid: 3087938
references.citation: Am J Respir Crit Care Med. 1999 Nov;160(5 Pt 1):1540-3
references.pmid: 10556117
references.citation: J Appl Physiol Respir Environ Exerc Physiol. 1984 Dec;57(6):1773-82
references.pmid: 6511552
references.citation: J Appl Physiol. 1955 Jul;8(1):73-80
references.pmid: 13242493
references.citation: J Gen Physiol. 1985 Jul;86(1):135-65
references.pmid: 4031824
references.citation: Chest. 2012 Mar;141(3):753-62
references.pmid: 21852298
references.citation: J Appl Physiol (1985). 1987 Jul;63(1):238-44
references.pmid: 3114217
references.citation: Chest. 1988 Nov;94(5):931-8
references.pmid: 3180897