title: Cardiopulmonary Exercise Testing in Pulmonary Hypertension.
abstract: Cardiopulmonary exercise testing allows the assessment of the integrative cardiopulmonary response to exercise and is a useful tool to assess the underlying pathophysiologic mechanisms leading to exercise intolerance. Patients with pulmonary hypertension often face a considerable delay in diagnosis due to the rarity of the disease and nonspecific symptoms of dyspnea, fatigue, and exercise limitation. Cardiopulmonary exercise testing may be suggestive of pulmonary hypertension in patients with evidence of both circulatory impairment and ventilatory inefficiency. Other factors, such as mechanical ventilatory constraints from dynamic hyperinflation and peripheral muscle dysfunction, contribute to the profound dyspnea during exercise experienced by many patients with pulmonary hypertension. In patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension, several exercise variables, such as low peak [Formula: see text]o2, high Vd/Vt, and high [Formula: see text]e/[Formula: see text]co2, have proven to be useful in establishing the severity of functional impairment, predicting prognosis, and assessing the efficacy of interventions.
authors.affiliation: 1 Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.|2 University Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France.|3 Service de Pneumologie, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
authors.forename: Jason
authors.identifier: http://orcid.org/0000-0002-0615-4575
authors.initials: J
authors.lastname: Weatherald
authors.affiliation: 4 Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Farina
authors.affiliation: 4 Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Noemi
authors.initials: N
authors.lastname: Bruno
authors.affiliation: 5 Sorbonne Universités, Université Pierre et Marie Curie Université Paris 06, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S_1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; and.|6 Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, Département Respiration, Réanimation, Réhabilitation, Sommeil, Pôle PRAGUES, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique-Höpitaux de Paris, Paris, France.
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Laveneziana
mesh_terms: D004417:Dyspnea / Q000503:physiopathology; D005080:Exercise Test; D017079:Exercise Tolerance; D005221:Fatigue / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology; D051346:Mobility Limitation; D011659:Pulmonary Gas Exchange
keywords: chronic thromboembolic pulmonary hypertension; dyspnea; exercise gas exchange; exercise testing; pulmonary hypertension