The role of cardiopulmonary exercise testing in the investigation of complex unexplained breathlessness

Jayadev, Anita; Devani, Nikesh; Geddes, Lauren; Kyriacou, Christina; Jeetley, Paramjit; Canal, Verena; Martin, Daniel R.; Mandal, Swapna

doi:10.1183/1393003.congress-2017.pa4538

Cited by 2 publications

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“…In that sense, aerobic, ventilatory, cardiac, gas exchange and muscle response to exercise can be determined and compared to normal predicted responses ( Wasserman, 1997 ). Thus, it is an attractive method by which to identify DB clinically ( Toma et al, 2010 ; Griffiths and Anindo, 2014 ; Costa et al, 2016 ; Jayadev et al, 2017 ; Roberts et al, 2017 ; Brat et al, 2019 ).…”

Section: Diagnosis Methodsmentioning

confidence: 99%

Cardiopulmonary Exercise Testing in the Assessment of Dysfunctional Breathing

et al. 2021

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Dysfunctional breathing (DB) is a disabling condition which affects the biomechanical breathing pattern and is challenging to diagnose. It affects individuals in many circumstances, including those without underlying disease who may even be athletic in nature. DB can also aggravate the symptoms of those with established heart or lung conditions. However, it is treatable and individuals have much to gain if it is recognized appropriately. Here we consider the role of cardiopulmonary exercise testing (CPET) in the identification and management of DB. Specifically, we have described the diagnostic criteria and presenting symptoms. We explored the physiology and pathophysiology of DB and physiological consequences in the context of exercise. We have provided examples of its interplay with co-morbidity in other chronic diseases such as asthma, pulmonary hypertension and left heart disease. We have discussed the problems with the current methods of diagnosis and proposed how CPET could improve this. We have provided guidance on how CPET can be used for diagnosis, including consideration of pattern recognition and use of specific data panels. We have considered categorization, e.g., predominant breathing pattern disorder or acute or chronic hyperventilation. We have explored the distinction from gas exchange or ventilation/perfusion abnormalities and described other potential pitfalls, such as false positives and periodic breathing. We have also illustrated an example of a clinical pathway utilizing CPET in the diagnosis and treatment of individuals with suspected DB.

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Section: Diagnosis Methodsmentioning

confidence: 99%

Cardiopulmonary Exercise Testing in the Assessment of Dysfunctional Breathing

et al. 2021

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“…Cardiopulmonary exercise testing (CPET) is a tool that can be used to diagnose dyspnoea of unknown cause [19][20][21][22][23][24]. CPET begins with a resting phase analysis and the subject being asked to quantify their baseline level of breathlessness and muscle fatigue to assess their usual functional status.…”

Section: Dysfunctional Breathingmentioning

confidence: 99%

Minute ventilation/carbon dioxide production in patients with dysfunctional breathing

et al. 2021

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Dysfunctional breathing refers to a multi-dimensional condition that is characterised by pathological changes in an individual's breathing. These changes lead to a feeling of breathlessness and include alterations in the biomechanical, psychological and physiological aspects of breathing. This makes dysfunctional breathing a hard condition to diagnose, given the diversity of aspects that contribute to the feeling of breathlessness. The disorder can debilitate individuals without any health problems, but may also be present in those with underlying cardiopulmonary co-morbidities. The ventilatory equivalent for CO2 (VeqCO2) is a physiological parameter that can be measured using cardiopulmonary exercise testing. This review will explore how this single measurement can be used to aid the diagnosis of dysfunctional breathing. A background discussion about dysfunctional breathing will allow readers to comprehend its multidimensional aspects. This will then allow readers to understand how VeqCO2 can be used in the wider diagnosis of dysfunctional breathing. Whilst VeqCO2 cannot be used as a singular parameter in the diagnosis of dysfunctional breathing, this review supports its use within a broader algorithm to detect physiological abnormalities in patients with dysfunctional breathing. This will allow for more individuals to be accurately diagnosed and appropriately managed.

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The role of cardiopulmonary exercise testing in the investigation of complex unexplained breathlessness

Cited by 2 publications

References 0 publications

Cardiopulmonary Exercise Testing in the Assessment of Dysfunctional Breathing

Cardiopulmonary Exercise Testing in the Assessment of Dysfunctional Breathing

Minute ventilation/carbon dioxide production in patients with dysfunctional breathing

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