scholarly journals ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

2019 ◽  
Vol 28 (154) ◽  
pp. 180101 ◽  
Author(s):  
Thomas Radtke ◽  
Sarah Crook ◽  
Georgios Kaltsakas ◽  
Zafeiris Louvaris ◽  
Danilo Berton ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Lung Diseases ◽  
Cardiopulmonary Exercise Testing ◽  
Work Rate ◽  
Cochrane Library ◽  
Future Research ◽  
Test Protocol ◽  
Cardiopulmonary Exercise ◽  
Chronic Lung Diseases ◽  
Multicentre Research

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.

scholarly journals Standardisation of cardiopulmonary exercise testing in chronic lung diseases: summary of key findings from the ERS task force

2019 ◽  
Vol 54 (6) ◽  
pp. 1901441 ◽  
Author(s):  
Thomas Radtke ◽  
Ioannis Vogiatzis ◽  
Don S. Urquhart ◽  
Pierantonio Laveneziana ◽  
Richard Casaburi ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Lung Diseases ◽  
Task Force ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise ◽  
Chronic Lung Diseases

scholarly journals Streamlining cardiopulmonary exercise testing for use as a screening and tracking tool in primary care

2018 ◽  
Vol 8 (2) ◽  
pp. 204589401877648
Author(s):  
Chul-Ho Kim ◽  
Erik H. Van Iterson ◽  
James E. Hansen ◽  
Dean J. MacCarter ◽  
Bruce D. Johnson
Keyword(s):  
Lung Disease ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Data Interpretation ◽  
Step Test ◽  
Test Protocol ◽  
Restrictive Lung Disease ◽  
Cardiopulmonary Exercise ◽  
Patient Assessments ◽  
Effective Use

Cardiopulmonary exercise testing (CPET) using a spectrum of different approaches demonstrates usefulness for objectively assessing patient disease severity in clinical and research settings. Still, an absence of trained specialists and/or improper data interpretation techniques can pose major limitations to the effective use of CPET for the clinical classification of patients. This study aimed to test an automated disease likelihood scoring algorithm system based on cardiopulmonary responses during a simplified step-test protocol. For patients with heart failure (HF), pulmonary hypertension (PAH), obstructive lung disease (OLD), or restrictive lung disease (RLD), we compared patient scores stratified into one of four “silos” generated from our novel algorithm system against patient evaluations provided by expert clinicians. Patients with HF (n = 12), PAH (n = 9), OLD (n = 16), or RLD (n = 10) performed baseline pulmonary function testing followed by submaximal step-testing. Breath-by-breath measures of ventilation and gas exchange, in addition to oxygen saturation and heart rate were collected continuously throughout testing. The algorithm demonstrated close alignment with patient assessments provided by clinical specialists: HF (r = 0.89, P < 0.01); PAH (r = 0.88, P < 0.01); OLD (r = 0.70, P < 0.01); and RLD (r = 0.88, P < 0.01). Furthermore, the algorithm was capable of differentiating major disease from other disease pathologies. Thus, in a clinically relevant manner, these data suggest this simplified automated disease algorithm scoring system used during step-testing to identify the likelihood that patients have HF, PAH, OLD, or RLD closely correlates with patient assessments conducted by trained clinicians.

Energy expenditure during cardiopulmonary exercise testing

2021 ◽  
Vol 25 (2) ◽  
pp. 102-114
Author(s):  
Thanh Tuan Do ◽  
Duc Son Nguyen ◽  
Dinh Tung Le
Keyword(s):  
Physical Activity ◽  
Energy Expenditure ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Recovery Phase ◽  
Maximum Energy ◽  
Work Rate ◽  
Exercise Recovery ◽  
Phase 3 ◽  
Cardiopulmonary Exercise

Objectives: To determine energy expenditure during cardiopulmonary exercise testing in healthy adults aged 20-60 years old and to determine the correlation between energy expenditure with the duration and the capacity of physical activity. Methods: Thirty-two healthy volunteers aged 20-60 years old (17 males and 15 females) agreed to participate in our study and performed cardiopulmonary exercise testing: resting phase (4 minutes, work rate 0 w), warming-up phase (4 minutes, work rate 0 w, 50-60 rounds per minute), exercise phase (work rate increment 10 watts per minutes, 50-60 rounds per minute) and recovery phase (3 minutes, work rate 0 w, 10-20 rounds per minute). Results and conclusions: Energy expenditure during CPET was 1,03 ± 0,30 MET, 1,97 ± 0,74 MET, 3,48 ± 1,78 MET, 4,57 ± 2,26 in resting, warming-up, exercise, recovery phase, respectively. Maximum energy expenditure during CPET was 4,75 ± 2,17 MET. Energy expenditure is negatively correlated with the duration of physical activity and positively correlated with the capacity of physical activity at 95% confidence interval.

Value of cardiopulmonary exercise testing in interstitial lung diseases

2018 ◽  
Author(s):  
Gonçalo António Cintrão Samouco ◽  
Rebeca Natal ◽  
João Costa ◽  
Andreia Filipa Carriço ◽  
Ana Filipa Fernandes ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Lung Diseases ◽  
Cardiopulmonary Exercise Testing ◽  
Interstitial Lung Diseases ◽  
Cardiopulmonary Exercise

scholarly journals Toward the Establishment of New Clinical Endpoints for Cystic Fibrosis: The Role of Lung Clearance Index and Cardiopulmonary Exercise Testing

2021 ◽  
Vol 9 ◽  
Author(s):  
Elpis Hatziagorou ◽  
Asterios Kampouras ◽  
Vasiliki Avramidou ◽  
Ilektra Toulia ◽  
Elisavet-Anna Chrysochoou ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Future Research ◽  
Lung Clearance ◽  
Clinical Endpoints ◽  
Cardiopulmonary Exercise ◽  
Lung Clearance Index ◽  
Test Outcomes

As Cystic Fibrosis (CF) treatment advances, research evidence has highlighted the value and applicability of Lung Clearance Index and Cardiopulmonary Exercise Testing as endpoints for clinical trials. In the context of these new endpoints for CF trials, we have explored the use of these two test outcomes for routine CF care. In this review we have presented the use of these methods in assessing disease severity, disease progression, and the efficacy of new interventions with considerations for future research.

scholarly journals Cardiopulmonary exercise testing in interstitial lung diseases and the value of ventilatory efficiency

2021 ◽  
Vol 30 (162) ◽  
pp. 200355
Author(s):  
Thomas Gille ◽  
Pierantonio Laveneziana
Keyword(s):  
Exercise Testing ◽  
Lung Diseases ◽  
Pulmonary Function Tests ◽  
Cardiopulmonary Exercise Testing ◽  
Interstitial Lung Diseases ◽  
Prognostic Information ◽  
Ventilatory Efficiency ◽  
Cardiopulmonary Exercise ◽  
Peripheral Muscle ◽  
Exercise Adaptation

Interstitial lung diseases (ILDs) are diverse parenchymal pulmonary disorders, primarily characterised by alveolar and interstitial inflammation and/or fibrosis, and sharing pathophysiological similarities. Thus, patients generally harbour common respiratory symptoms, lung function abnormalities and modified exercise adaptation. The most usual and disabling complaint is exertional dyspnoea, frequently responsible for premature exercise interruption. Cardiopulmonary exercise testing (CPET) is increasingly used for the clinical assessment of patients with ILD. This is because exercise performance or dyspnoea on exertion cannot reliably be predicted by resting pulmonary function tests. CPET, therefore, provides an accurate evaluation of functional capacity on an individual basis. CPET can unmask anomalies in the integrated functions of the respiratory, cardiovascular, metabolic, peripheral muscle and neurosensory systems in ILDs. CPET uniquely provides an evaluation of all above aspects and can help clinicians shape ILD patient management. Preliminary evidence suggests that CPET may also generate valuable prognostic information in ILDs and can be used to shed light on the presence of associated pulmonary hypertension. This review aims to provide comprehensive and updated evidence concerning the clinical utility of CPET in ILD patients, with particular focus on the physiological and clinical value of ventilatory efficiency (V˙E/V˙CO2).

scholarly journals Cardiopulmonary exercise testing in clinical practice

2021 ◽  
Vol 3 (2) ◽  
pp. 58-70
Author(s):  
Oleg B. Kerbikov ◽  
Alexander V. Averyanov ◽  
Ekaterina N. Borskaya ◽  
Tamara V. Krutova
Keyword(s):  
Clinical Practice ◽  
Exercise Testing ◽  
Mitochondrial Myopathy ◽  
Lung Diseases ◽  
Pulmonary Resection ◽  
Cardiopulmonary Exercise Testing ◽  
Skeletal Muscle Fiber ◽  
Testing Methods ◽  
Cardiopulmonary Exercise ◽  
Physiological Values

The review is dedicated to the use of the cardiopulmonary exercise testing (CPET) in clinical practice. Main modes of CPET, most popular protocols and testing methods are discussed in details. Ample space is dedicated to main parameters measuring during CPET, their physiological values and changes in different pathological states. Main indications for CPET are presented and special attention is given to the use of CPET in chronic heart failure, apnea, lung diseases, skeletal muscle fiber and mitochondrial myopathy, rehabilitation. Emerging applications of CPET like congenital heart disease, pulmonary resection and several other are also discussed.

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