Cardiopulmonary exercise testing and its application
Tóm tắt
Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance and for objective determination of functional capacity and impairment. This review focuses on the exercise physiology and physiological basis for functional exercise testing and discusses the methodology, indications, contraindications and interpretation of CPET in normal people and in patients with heart failure.
Từ khóa
Tài liệu tham khảo
ATS/ACCP statement on cardiopulmonary exercise testing, 2003, Am J Respir Care Med, 167, 211, 10.1164/rccm.167.2.211
Dennis, 1992, Heart disease, a textbook of cardiovascular medicine, 4th ed, 1382
Brooks, 1985, Anaerobic threshold: review of the concept and directions for future research, Med Sci Sports Exerc, 17, 22, 10.1249/00005768-198502000-00005
Simonton, 1988, The ventilatory threshold: quantitative analysis of reproducibility and relation to arterial lactate concentrations in normal subjects and in patients in congestive heart failure, Am J Cardiol, 62, 100, 10.1016/0002-9149(88)91372-0
Matsumura, 1983, Determination of anaerobic threshold for assessment of functional state in patients with congestive heart failure, Circulation, 68, 360, 10.1161/01.CIR.68.2.360
Neuberg, 1988, Cardiopulmonary exercise testing. The clinical value of gas exchange data, Arch Intern Med, 148, 2221, 10.1001/archinte.1988.00380100083018
Buchfuhrer, 1983, Optimizing the exercise protocol for cardiopulmonary assessment, J Appl Physiol, 55, 1558, 10.1152/jappl.1983.55.5.1558
Naughton, 1963, Physiological responses of normal and pathologic subjects to a modified work capacity test, J Sports Med, 31, 201
Wright, 2001, Assessment of a low-intensity cardiac rehabilitation programme using the six-minute walk test, Clin Rehabil, 15, 119, 10.1191/026921501671364449
Davis, 1985, Anaerobic threshold: review of the concept and directions for future research, Med Sci Sports Exerc, 17, 6, 10.1249/00005768-198502000-00003
Jennings, 1990, Circulatory regulation at rest and exercise and the functional assessment of patients with congestive heart failure, Circulation, 81, II5
Wasserman, 1987, Principles of exercise testing and interpretation, 10.1097/00008483-198704000-00014
Beaver, 1986, A new method for detecting the anaerobic threshold by gas exchange, J Appl Physiol, 60, 2020, 10.1152/jappl.1986.60.6.2020
Yeh, 1983, Anaerobic threshold: problems of determination and validation, J Appl Physiol, 55, 1178, 10.1152/jappl.1983.55.4.1178
Gibbons, 2002, ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines), Circulation, 106, 1883, 10.1161/01.CIR.0000034670.06526.15
Gibbons, 1997, ACC/AHA guidelines for exercise testing: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing), J Am Coll Cardiol, 30, 260
Rochmis, 1971, Exercise tests: a survey of procedures, safety, and litigation experience in approximately 170,000 tests, JAMA, 217, 1061, 10.1001/jama.1971.03190080023005
Pina, 2003, Exercise and heart failure: a statement from the American Heart Association Committee on exercise, rehabilitation, and prevention, Circulation, 107, 1210, 10.1161/01.CIR.0000055013.92097.40
Reddy, 1988, Hemodynamic, ventilatory and metabolic effects of light isometric exercise in patients with chronic heart failure, J Am Coll Cardiol, 12, 353, 10.1016/0735-1097(88)90405-6
Harrington, 1997, Skeletal muscle function and its relation to exercise tolerance in chronic heart failure, J Am Coll Cardiol, 30, 1758, 10.1016/S0735-1097(97)00381-1
Wright, 1999, The role of exercise testing in the evaluation and management of heart failure, Postgrad Med J, 75, 453, 10.1136/pgmj.75.886.453
Ghali, 1990, Trends in hospitalisation rates for heart failure in the US 197386, Arch Intern Med, 150, 769, 10.1001/archinte.1990.00390160043010
Colucci, 1990, In vivo studies of myocardial beta-adrenergic receptor pharmacology in patients with congestive heart failure, Circulation, 82, I44
Butler, 1999, Pulmonary hypertension and exercise intolerance in patients with heart failure, J Am Coll Cardiol, 34, 1802, 10.1016/S0735-1097(99)00408-8
Pina, 2003, Exercise and heart failure: a statement from the American Heart Association Committee on exercise, rehabilitation, and prevention, Circulation, 107, 1210, 10.1161/01.CIR.0000055013.92097.40
McMurray, 2002, New therapeutic options in congestive heart failure: part I, Circulation, 105, 2099, 10.1161/01.CIR.0000014763.63528.9D
McMurray, 2002, New therapeutic options in congestive heart failure: part II, Circulation, 105, 2223, 10.1161/01.CIR.0000014771.38666.22
Abraham, 2002, Cardiac resynchronization in chronic heart failure, N Engl J Med, 346, 1845, 10.1056/NEJMoa013168
Beniaminovitz, 1999, The role of exercise-based prognasticating algorithms in the selection of patients for heart transplantation, Curr Opin Cardiol, 4, 114, 10.1097/00001573-199903000-00007
Corra, 2004, Cardiopulmpnary exercise testing and prognosis in chronic heart failure, Chest, 126, 942, 10.1378/chest.126.3.942
Mancini, 1991, Value of peak oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure, Circulation, 83, 778, 10.1161/01.CIR.83.3.778
Costanzo, 1995, Selection and treatment of candidates for heart transplantation, Circulation, 92, 3595, 10.1161/01.CIR.92.12.3593
Stelken, 1996, Prognostic value of cardiopulmonary exercise testing using percent achieved of predicted peak oxygen uptake for patients with ischemic and dilated cardiomyopathy, J Am Coll Cardiol, 27, 345, 10.1016/0735-1097(95)00464-5
Aaronson, 1995, Is percentage of predicted maximal exercise oxygen consumption a better predictor of survival than peak exercise oxygen consumption for patients with severe heart failure, J Heart Lung Transplant, 14, 981
Osman, 2000, The incremental prognostic importance of body fat adjusted peak oxygen consumption in chronic heart failure, J Am Coll Cardiol, 36, 2126, 10.1016/S0735-1097(00)00985-2
Cohen-Solal, 1991, Multicenter determination of the oxygen uptake and ventilatory threshold, Eur Heart J, 12, 1055, 10.1093/oxfordjournals.eurheartj.a059837
Opasich, 1998, Peak oxygen consumption in chronic heart failure: toward efficient use in the individual patient, J Am Coll Cardiol, 31, 766, 10.1016/S0735-1097(98)00002-3
Chua, 1997, Clinical correlates and prognostic significance of the ventilatory response to exercise in CHF, J Am Coll Cardiol, 29, 1585, 10.1016/S0735-1097(97)00078-8
Kleber, 2000, Impairment of ventilatory efficiency in heart failure: prognostic impact, Circulation, 101, 2803, 10.1161/01.CIR.101.24.2803
MacGowan, 1997, Exercise related ventilatory abnormalities and survival in congestive heart failure, Am J Cardiol, 79, 1264, 10.1016/S0002-9149(97)00097-0
Robbins, 1999, Ventilatory and heart rate response to exercise: better predictors of heart failure mortality than peak oxygen consumption, Circulation, 100, 2411, 10.1161/01.CIR.100.24.2411
Corra, Ventilatory response to exercise improves risk stratification in chronic heart failure patients with intermediate functional capacity, Am Heart J, 143, 418, 10.1067/mhj.2002.120772
Mezzani, 2000, Habitual activities and peak aerobic capacity in patients with asymptomatic and symptomatic left ventricular dysfunction: use of a new physical activity scoring system, Chest, 117, 1291, 10.1378/chest.117.5.1291
Mezzani, 2003, Contribution of peak respiratory exchange ratio to peak VO2 prognostic reliability in patients with chronic heart failure and severely reduced exercise capacity, Am Heart J, 145, 1102, 10.1016/S0002-8703(03)00100-5
Task Force of the Italian Working Group on Cardiac Rehabilitation and Prevention (Gruppo Italiano di Cardiologia Riabilitativa e Prevenzione, GICR); Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology, 2006, Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation Part II: How to perform cardiopulmonary exercise testing in chronic heart failure, Eur J Cardiovasc Prev Rehabil, 13, 300