scholarly journals Cardiopulmonary exercise testing in thoracic surgery

Pneumologia ◽  
2020 ◽  
Vol 69 (1) ◽  
pp. 3-10
Author(s):  
Irina Pele ◽  
Florin-Dumitru Mihălțan
Keyword(s):  
Thoracic Surgery ◽  
Exercise Test ◽  
Objective Assessment ◽  
Preoperative Evaluation ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise Test ◽  
Risk Profile ◽  
Training Level ◽  
Cardiopulmonary Exercise ◽  
Thoracic And Abdominal

AbstractThe assessment of functional capacity is a significant part of the preoperative evaluation of patients proposed for both thoracic and abdominal surgery. The cardiopulmonary exercise test (CPET) is the most comprehensive exercise test currently used. It provides an objective assessment of the patient's training level and an individualised risk profile for complications and guides the perioperative care. This article provides a brief description of the roles of CPET in thoracic surgery. Guidelines recommend it for perioperative assessments because of its prognostic value, its utility in the postoperative period and in pulmonary rehabilitation programmes.

scholarly journals Cardiopulmonary Exercise Test in heart failure: A Sine qua non

2020 ◽  
Vol 9 (2) ◽  
pp. 1-8 ◽  
Author(s):  
Stefanos Sakellaropoulos ◽  
Dimitra Lekaditi ◽  
Stefano Svab
Keyword(s):  
Heart Failure ◽  
Exercise Test ◽  
Exercise Physiology ◽  
Cardiopulmonary Exercise Testing ◽  
Critical Evaluation ◽  
Research Area ◽  
Cardiopulmonary Exercise Test ◽  
Exercise Intolerance ◽  
Reduced Ejection Fraction ◽  
Cardiopulmonary Exercise

A robust literature, over the last years, supports the indication of cardiopulmonary exercise testing (CPET) in patients with cardiovascular diseases. Understanding exercise physiology is a crucial component of the critical evaluation of exercise intolerance. Shortness of breath and exercise limitation is often treated with an improper focus, partly because the pathophysiology is not well understood in the frame of the diagnostic spectrum of each subspecialty. A vital field and research area have been cardiopulmonary exercise test in heart failure with preserved/reduced ejection fraction, evaluation of heart failure patients as candidates for LVAD-Implantation, as well as for LVAD-Explantation and ultimately for heart transplantation. All the CPET variables provide synergistic prognostic discrimination. However, Peak VO2 serves as the most critical parameter for risk stratification and prediction of survival rate.

Preoperative cardiopulmonary exercise testing

2021 ◽  
pp. 133-137
Author(s):  
William J.M. Kinnear ◽  
James H. Hull
Keyword(s):  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Exercise Testing ◽  
Exercise Test ◽  
Surgical Planning ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise Test ◽  
Cardiopulmonary Exercise ◽  
Good Outcome ◽  
Clinical Problems

This chapter discusses how the results of a cardiopulmonary exercise test (CPET) can be used for preoperative surgical planning. A low preoperative maximum oxygen uptake (VO2max) is associated with a poor outcome. The lower the VO2max, the worse the prognosis. Use of the anaerobic threshold is less reliable. The CPET may identify clinical problems which can be optimized prior to surgery. Pre-habilitation can improve the chances of a good outcome from surgery.

Idiopathic subglottic stenosis and the consequences in cardiopulmonary exercise testing

2021 ◽  
Vol 14 (11) ◽  
pp. e242149
Author(s):  
Rick Verjans ◽  
Sietske van Berkel ◽  
Tom Brandon ◽  
Hans Grotjohan
Keyword(s):  
Exercise Test ◽  
Cardiopulmonary Exercise Testing ◽  
Balloon Dilation ◽  
Blood Gas Analysis ◽  
Cardiopulmonary Exercise Test ◽  
Gas Analysis ◽  
Subglottic Stenosis ◽  
Progressive Dyspnoea ◽  
Cardiopulmonary Exercise ◽  
History Of

A 15-year-old male patient with progressive dyspnoea and exercise-related wheezing was analysed with spirometry, ECG and a cardiopulmonary exercise test with blood gas analysis. Earlier analysis by a paediatrician concluded no abnormalities. However, the previously performed spirometry test may have clarified the diagnosis in an earlier stage.Severe hypoventilation was seen during the exercise test with hypercapnia and hypoxaemia while hearing a stridor during exercise. Eventually, a circular subglottic stenosis was seen on a CT scan of the chest. No malignancy or granulomatosis with polyangiitis was seen in biopsy and pathologic examination. There was no history of trauma, intubation or infection. Therefore, the diagnosis idiopathic subglottic stenosis was established. Bronchoscopic balloon dilation followed several times, leading to full recovery.

scholarly journals Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts

2021 ◽  
Vol 12 ◽  
Author(s):  
Tjeu Souren ◽  
Edward Rose ◽  
Herman Groepenhoff
Keyword(s):  
Tidal Volume ◽  
Exercise Test ◽  
Primary Outcome ◽  
Respiratory Exchange Ratio ◽  
Cardiopulmonary Exercise Testing ◽  
Carbon Dioxide Production ◽  
Cardiopulmonary Exercise Test ◽  
Breathing Frequency ◽  
Cardiopulmonary Exercise ◽  
Metabolic Cart

IntroductionMetabolic simulators (MS) produce simulated human breaths for the purpose of verification of cardiopulmonary exercise test (CPET) equipment. MS should produce consistent identical breaths with known CO2 and O2 gas concentrations over a range of breath rates and tidal volumes. Reliability of a CPET metabolic cart depends on ongoing quality control and maintenance of the device, including intermittent verification with a MS. We compared two MS devices against two standard CPET systems.MethodsThe Vacumed 17056 (Vacumetrics, Ventura, CA) and Relitech (Relitech Systems BV, Nijkerk, The Netherlands) were used with two standard metabolic carts (Vyntus CPX and Vyntus ONE, both Vyaire Medical, Mettawa, IL, United States). Tidal volume (VT) was set at 2 and 3 L and breathing frequency ranged from 20 to 80 breaths per minute for each MS. At each set point, we measured three sets of 40 breaths. Primary outcome parameters collected were VT, oxygen consumption (v.O2), carbon dioxide production (v.CO2), and respiratory exchange ratio (RER).ResultsVT, RER, v.O2, and v.CO2 results as obtained from both MS were all within the limits of acceptability, at both tidal volume settings, and all ventilatory rates. No significant trends were identified for either MS device. The Relitech MS produced tidal volumes that were closer to the target VT for both CPET carts at both VT and all rates, but the results of both MS were within acceptable ranges.ConclusionVerification of CPET equipment using either the VM or RT metabolic simulator, producing highly accurate and predictable simulated breaths of known composition, enabling CPET laboratory managers to rely on subject test data obtained during cardiopulmonary exercise testing.

scholarly journals The Prospects of the Two-Day Cardiopulmonary Exercise Test (CPET) in ME/CFS Patients: A Meta-Analysis

2020 ◽  
Vol 9 (12) ◽  
pp. 4040
Author(s):  
Eun-Jin Lim ◽  
Eun-Bum Kang ◽  
Eun-Su Jang ◽  
Chang-Gue Son
Keyword(s):  
Functional Impairment ◽  
Exercise Test ◽  
Large Scale ◽  
Ventilatory Threshold ◽  
Meta Analysis ◽  
Objective Assessment ◽  
Chronic Fatigue ◽  
Cardiopulmonary Exercise Test ◽  
Mean Values ◽  
Cardiopulmonary Exercise

Background: The diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is problematic due to the lack of established objective measurements. Postexertional malaise (PEM) is a hallmark of ME/CFS, and the two-day cardiopulmonary exercise test (CPET) has been tested as a tool to assess functional impairment in ME/CFS patients. This study aimed to estimate the potential of the CPET. Methods: We reviewed studies of the two-day CPET and meta-analyzed the differences between ME/CFS patients and controls regarding four parameters: volume of oxygen consumption and level of workload at peak (VO2peak, Workloadpeak) and at ventilatory threshold (VO2@VT, Workload@VT). Results: The overall mean values of all parameters were lower on the 2nd day of the CPET than the 1st in ME/CFS patients, while it increased in the controls. From the meta-analysis, the difference between patients and controls was highly significant at Workload@VT (overall mean: −10.8 at Test 1 vs. −33.0 at Test 2, p < 0.05), which may reflect present the functional impairment associated with PEM. Conclusions: Our results show the potential of the two-day CPET to serve as an objective assessment of PEM in ME/CFS patients. Further clinical trials are required to validate this tool compared to other fatigue-inducing disorders, including depression, using well-designed large-scale studies.

scholarly journals Face scale rating of perceived exertion during cardiopulmonary exercise test

2018 ◽  
Vol 4 (1) ◽  
pp. e000474 ◽  
Author(s):  
Shinichiro Morishita ◽  
Atsuhiro Tsubaki ◽  
Satoshi Nashimoto ◽  
Jack B Fu ◽  
Hideaki Onishi
Keyword(s):  
Exercise Test ◽  
Perceived Exertion ◽  
Significant Positive Correlation ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise Test ◽  
Rating Of Perceived Exertion ◽  
Exercise Load ◽  
Cardiopulmonary Exercise ◽  
Face Scale ◽  
The Face

ObjectiveThis study aimed to investigate the correlation between the face scale and heart rate (HR), exercise load and oxygen uptake (V̇O2) during cardiopulmonary exercise testing.MethodsThis was a prospective, observational study of face scale rating of perceived exertion (RPE) and HR, exercise load and V̇O2during cardiopulmonary exercise testing. A total of 30 healthy college men and 21 healthy college women were included. Subjects performed a cardiopulmonary exercise test with ramps and an increment increase in workload of 20 W/min. We recorded the responses of subjects using a face scale for RPE, HR, exercise load and V̇O2every minute during the cardiopulmonary exercise test.ResultsIn men, there was a significant positive correlation between the face scale RPE and HR (ρ=0.856, p<0.01), exercise load (ρ=0.888, p<0.01) and V̇O2(ρ=0.878, p<0.01) during the cardiopulmonary exercise test. Similarly, in women, there was a significant positive correlation between the face scale RPE and HR (ρ=0.885, p<0.01), exercise load (ρ=0.908, p<0.01) and V̇O2(ρ=0.895, p<0.01) during the cardiopulmonary exercise tests.ConclusionThe face scale proposed in this study was related to physiological parameters, which suggests that it may be used to determine the intensity of exercise in healthy adults.

scholarly journals Importance of Cardiopulmonary Exercise Testing Amongst Subjects Recovering from COVID-19

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 507
Author(s):  
Gianluigi Dorelli ◽  
Michele Braggio ◽  
Daniele Gabbiani ◽  
Fabiana Busti ◽  
Marco Caminati ◽  
...  
Keyword(s):  
Minute Ventilation ◽  
Objective Assessment ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise Test ◽  
Gas Analysis ◽  
Carbon Dioxide Output ◽  
Cardiopulmonary Exercise ◽  
The Relationship ◽  
Male Subjects ◽  
Ventilatory Limitation

The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage’s clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.

Do rebreathing manoeuvres for non-invasive measurement of cardiac output during maximum exercise test alter the main cardiopulmonary parameters?

2019 ◽  
Vol 26 (15) ◽  
pp. 1616-1622 ◽  
Author(s):  
Carlo Vignati ◽  
Marco Morosin ◽  
Laura Fusini ◽  
Beatrice Pezzuto ◽  
Emanuele Spadafora ◽  
...  
Keyword(s):  
New York ◽  
Cardiac Output ◽  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Exercise Testing ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Testing ◽  
Heart Association ◽  
Cardiopulmonary Exercise Test ◽  
Cardiopulmonary Exercise

Background Inert gas rebreathing has been recently described as an emergent reliable non-invasive method for cardiac output determination during exercise, allowing a relevant improvement of cardiopulmonary exercise test clinical relevance. For cardiac output measurements by inert gas rebreathing, specific respiratory manoeuvres are needed which might affect pivotal cardiopulmonary exercise test parameters, such as exercise tolerance, oxygen uptake and ventilation vs carbon dioxide output (VE/VCO2) relationship slope. Method We retrospectively analysed cardiopulmonary exercise testing of 181 heart failure patients who underwent both cardiopulmonary exercise testing and cardiopulmonary exercise test+cardiac output within two months (average 16 ± 15 days). All patients were in stable clinical conditions (New York Heart Association I–III) and on optimal medical therapy. Results The majority of patients were in New York Heart Association Class I and II (78.8%), with a mean left ventricular ejection fraction of 31 ± 10%. No difference was found between the two tests in oxygen uptake at peak exercise (1101 (interquartile range 870–1418) ml/min at cardiopulmonary exercise test vs 1103 (844–1389) at cardiopulmonary exercise test-cardiac output) and at anaerobic threshold. However, anaerobic threshold and peak heart rate, peak workload (75 (58–101) watts and 64 (42–90), p < 0.01) and carbon dioxide output were significantly higher at cardiopulmonary exercise testing than at cardiopulmonary exercise test+cardiac output, whereas VE/VCO2 slope was higher at cardiopulmonary exercise test+cardiac output (30 (27–35) vs 33 (28–37), p < 0.01). Conclusion The similar anaerobic threshold and peak oxygen uptake in the two tests with a lower peak workload and higher VE/VCO2 slope at cardiopulmonary exercise test+cardiac output suggest a higher respiratory work and consequent demand for respiratory muscle blood flow secondary to the ventilatory manoeuvres. Accordingly, VE/VCO2 slope and peak workload must be evaluated with caution during cardiopulmonary exercise test+cardiac output.

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