Abstract
Educational aims
To provide a comprehensive introduction to the physiological basis of integrative exercise testing.
To identify the indications and the protocols used in clinical settings.
To discuss the clinical applications of exercise testing with special reference to lung and heart diseases.
To understand the utility of exercise testing in the prescription and evaluation of therapeutic interventions and in rehabilitation.
Summary Exercise intolerance is the hallmark of pulmonary and cardiac diseases. However, measurements of lung and cardiac function obtained at rest (e.g. forced expiratory volume in one second (FEV1), pulmonary diffusing capacity of the lung for carbon monoxide (DL,CO), left ventricular ejection fraction (EF)) are poorly predictive of the degree of exercise intolerance. Therefore, it is necessary to directly assess an individual's exercise intolerance and, where possible, establish its cause(s). The “gold standard” approach for this is cardiopulmonary exercise testing (CPET). CPET has also proven to be very useful in the following applications: prognostic evaluation of patients with chronic lung and heart diseases, such as chronic obstructive pulmonary diseases (COPD), interstitial lung diseases (ILD), cystic fibrosis (CF) and chronic heart failure (CHF); and evaluating the effects of interventions such as drug therapy, oxygen and heliox supplementation during exercise, and pulmonary rehabilitation based on exercise training.
- ©ERS 2006
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