Limitations and advantages of exercise testing and fluid loading in the assessment of pulmonary hypertension
| Exercise testing | Fluid loading | |
| Clinical relevance for symptom assessment | + + + | + |
| Clinical relevance for differential diagnosis | + | + + + |
| Main advantages | Respects the pathophysiology; comprehensive test, allowing for additional insights in pulmonary vascular disease (dynamic pulmonary vascular resistance); complementary with cardiopulmonary exercise testing | Easy to perform, no specific setting; minimal risk of misinterpretation of pressures reading; better established cut-off defining abnormal increase in pulmonary arterial wedge pressure |
| Main limitations | Requires a specific complex setting; expertise in conducting the test; pressure reading during exercise; range of normal response uncertain | Unknown response in disease state; age dependency of response |
| Standardised protocol | +/− | + + |