title: Comparing Cardiopulmonary Exercise Testing in End-Stage Liver Disease Patients.
abstract: Poor cardiopulmonary fitness has been associated with worse outcomes in liver transplant candidates.
  
  
  OBJECTIVE
  To determine if a modified 3-minute step test (potentially office based) is feasible and equivalent to standard cardiopulmonary exercise testing (CPET) in liver transplant candidates with severe decompensation.
  
  
  METHODS
  Five patients with Childs-Pugh C end-stage liver disease and severe debility awaiting liver transplantation performed both standard CPET and the modified 3-minute step test (Shape medical systems).
  
  
  RESULTS
  All 5 patients were able to complete both tests. Mean age was 59.8 ± 9 years, mean MELD score was 20 (range 13-26), and mean BMI was 27.6 kg/m(2) (range 16.4-37.2). Peak Vo2 was similar with a mean of 901 mL/min (step test) compared to 856 mL/min (cycle test), P = .64. Vo2 at a respiratory exchange ratio (RER) of 1.0 was similar with both tests (681 mL/min (step) vs 646 mL/min (cycle), P = .69. Ve/Vco2 slope (ventilatory efficiency) was similar (40 vs 39, P = .94). The ventilatory compensation point (i.e. anaerobic threshold) was also similar (∼80% of peak Vo2) for both studies.
  
  
  CONCLUSIONS
  The modified 3-minute step test provides a simplified, potentially office-based assessment of cardiopulmonary exercise capacity and gas exchange measures as standard testing in patients with decompensated end-stage liver disease, with similar tolerability.
authors.affiliation: William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: T
authors.initials: T
authors.lastname: Gunneson
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: B
authors.initials: B
authors.lastname: Johnson
authors.affiliation: Department of Anesthesia, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: J
authors.initials: J
authors.lastname: Findlay
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA; Department of Anesthesia, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: M
authors.initials: M
authors.lastname: Joyner
authors.affiliation: William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA; Division of Gastroenterology/Hepatology, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: watt.kymberly@mayo.edu.
authors.forename: K D
authors.initials: KD
authors.lastname: Watt
mesh_terms: D000368:Aged; D058625:End Stage Liver Disease / Q000503:physiopathology*; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012720:Severity of Illness Index