A clinician's guide to cardiopulmonary exercise testing 2: test interpretation

Abstract

Data obtained from cardiopulmonary exercise testing offer additional interpretive power over conventional exercise tolerance testing. When used correctly, these data allow improved clinical decision making in patients with cardiometabolic and respiratory disease.

Is Cardiorespiratory Fitness Related to Cardiometabolic Health and All-Cause Mortality Risk in Patients with Coronary Heart Disease? A CARE CR Study

“…The VAT was determined using the average of the middle 5 of 7 consecutive breaths (excluding the highest and lowest measures) and reported standardised to patient body mass (ml/kg/min). The oxygen uptake efficiency slope (OUES), VE/VCO 2 slope, and oxygen pulse (VO 2 /HR) were calculated as previously described [ 19 ]. Self-reported weekly physical activity levels were obtained by asking patients if they participated in either 150 min of moderate physical activity, 75 min of vigorous physical activity, or both.…”

Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease – a CARE CR study

“…The cardiopulmonary exercise testing adhered to established guidelines and recommendations (American Thoracic Society/ American College of Chest Physicians 2003; Balady et al, 2010;Nichols et al, 2015;Taylor et al, 2015) and was performed using the modified Bruce treadmill protocol (Bruce et al, 1973) (GE Healthcare). A 12-lead ECG was monitored continuously throughout the test.…”

2016 Focused Update: Clinical Recommendations for Cardiopulmonary Exercise Testing Data Assessment in Specific Patient Populations

“…6,9,10 Because of an abundance of new CPX research in recent years and a reassessment of the current algorithms in light of the body of evidence, a focused update to the 2012 scientific statement is now warranted. The purposes of this update are to confirm algorithms included in the initial scientific statement not requiring revision, to propose revisions to algorithms included in the initial scientific statement, to propose new algorithms based on emerging scientific evidence, to further clarify the application of oxygen consumption (V ⋅ o 2 ) at ventilatory threshold (VT), to describe CPX variables with an emerging scientific evidence base, to describe the synergistic value of combining CPX with other assessments, to discuss personnel considerations for CPX laboratories, and to provide recommendations for future CPX research.…”