RT Journal Article
SR Electronic
T1 Recommendations on the use of exercise testing in clinical practice
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 185
OP 209
DO 10.1183/09031936.00046906
VO 29
IS 1
A1 P. Palange
A1 S. A. Ward
A1 K-H. Carlsen
A1 R. Casaburi
A1 C. G. Gallagher
A1 R. Gosselink
A1 D. E. O'Donnell
A1 L. Puente-Maestu
A1 A. M. Schols
A1 S. Singh
A1 B. J. Whipp
YR 2007
UL http://erj.ersjournals.com/content/29/1/185.abstract
AB Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest. For symptom-limited incremental exercise, CPET indices, such as peak O2 uptake (V′O2), V′O2 at lactate threshold, the slope of the ventilation–CO2 output relationship and the presence of arterial O2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable. In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) “When should an evaluation of exercise intolerance be sought?”; 2) “Which particular form of test should be asked for?”; and 3) “What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?”