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Guidelines Cardiopulmonary exercise testing (CPET)

Stefania Farina, Michele Correale, Noemi Bruno, Stefania Paolillo, Elisabetta Salvioni, Roberto Badagliacca, Piergiuseppe Agostoni
Despite recent advances in the therapeutic management of patients affected by pulmonary arterial hypertension (PAH), survival remains poor. Prompt identification of the disease, especially in subjects at increased risk of developing PAH, and prognostic stratification of patients are a necessary target of clinical practice but remain challenging. Cardiopulmonary exercise test (CPET) parameters, particularly peak oxygen uptake, end-tidal carbon dioxide tension and the minute ventilation/carbon dioxide production relationship, emerged as new prognostic tools for PAH patients...
June 30, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
T Reeves, S Bates, T Sharp, K Richardson, S Bali, J Plumb, H Anderson, J Prentis, M Swart, D Z H Levett
Background: Cardiopulmonary exercise testing (CPET) is an exercise stress test with concomitant expired gas analysis that provides an objective, non-invasive measure of functional capacity under stress. CPET-derived variables predict postoperative morbidity and mortality after major abdominal and thoracic surgery. Two previous surveys have reported increasing utilisation of CPET preoperatively in England. We aimed to evaluate current CPET practice in the UK, to identify who performs CPET, how it is performed, how the data generated are used and the funding models...
2018: Perioperative Medicine
Karsten Keller, Kathrin Stelzer, Mir Abolfazl Ostad, Felix Post
PURPOSE: Arterial hypertension (aHT) is the leading risk factor for morbidity and mortality worldwide. Blood pressure (BP) deviation at rest is well defined and accompanies risk for cardiovascular events and cardiovascular mortality. A growing body of evidence emphasises that an exaggerated blood pressure response (EBPR) in cardiopulmonary exercise testing (CPET) could help to identify seemingly cardiovascular healthy and normotensive subjects, who have an increased risk of developing aHT and cardiovascular events in the future...
September 2017: Advances in Medical Sciences
Pascal Amedro, Arthur Gavotto, Charlène Bredy, Sophie Guillaumont
Advances in heart surgery over the past 30 years have significantly improved the prognosis of congenital heart diseases (CHD). Therefore, the epidemiology of CHD has changed dramatically with a shift of mortality from pediatrics to adulthood and an increased prevalence of complex CHD. Today, caregivers and patients focus their interests to new perspectives: improving the quality of life, practicing sports, improving psychosocial care. Cardiac rehabilitation is completely integrated in these new therapeutic strategies...
May 2017: La Presse Médicale
Ming-Chun Yang, Chun-An Chen, Hsin-Hui Chiu, Jou-Kou Wang, Ming-Tai Lin, Shuenn-Nan Chiu, Chun-Wei Lu, Shu-Chien Huang, Mei-Hwan Wu
Parameters from cardiopulmonary exercise test (CPET) are useful prognostic factors for patients with repaired tetralogy of fallot (TOF). Its application in exercise prescription remains unclear. This study sought to define its role. We made current exercise recommendations in repaired TOF patients according to European Society of Cardiology (ESC) guideline, which were based on ventricular function, pressure/volume load, pulmonary artery pressure, hypoxemia and arrhythmic burden both at rest and during exercise...
February 2017: Heart and Vessels
Rachel E Klaren, Brian M Sandroff, Bo Fernhall, Robert W Motl
BACKGROUND: The study and application of exercise in multiple sclerosis (MS) often requires cardiopulmonary exercise testing (CPET) to provide a comprehensive assessment of exercise tolerance and responses, including an evaluation of the pulmonary, cardiovascular, and skeletal muscle systems. Research on CPET in persons with MS has considerable limitations, including small sample sizes, often without controls; not reporting outcomes across disability status; and different modalities of exercise testing across studies...
September 2016: Sports Medicine
Janos Porszasz, Susan Blonshine, Robert Cao, Heather A Paden, Richard Casaburi, Harry B Rossiter
BACKGROUND: Precision and accuracy assurance in cardiopulmonary exercise testing (CPET) facilitates multicenter clinical trials by maximizing statistical power and minimizing participant risk. Current guidelines recommend quality control that is largely based on precision at individual testing centers (minimizing test-retest variability). The aim of this study was to establish a multicenter biological quality control (BioQC) method that considers both precision and accuracy in CPET. METHODS: BioQC testing was 6-min treadmill walking at 20 W and 70 W (below the lactate threshold) with healthy non-smoking laboratory staff (15 centers; ~16 months)...
January 16, 2016: BMC Pulmonary Medicine
Rafael Alves, Marcia M Lima, Cheyenne Fonseca, Rodrigo Dos Reis, Pedro H Figueiredo, Henrique Costa, Lucas Kreuser, Maria C Nunes, Antonio L Ribeiro
BACKGROUND: Chagas heart disease (CHD) patients may have a reduced functional capacity (FC). Field tests, as the Incremental Shuttle Walk Test (ISWT), can estimate peak oxygen uptake (VO2 peak). However, the relationship between the ISWT and the Cardiopulmonary Exercise Testing (CPET), the gold standard in the assessment of FC, is not well established in CHD patients. AIM: This study aimed to evaluate the FC of CHD patients by ISWT with direct measurement of VO2 peak and to compare these findings with data obtained from CPET...
February 2016: European Journal of Physical and Rehabilitation Medicine
E F Sperandio, R L Arantes, A C Matheus, R P Silva, V T Lauria, M Romiti, A R T Gagliardi, V Z Dourado
The 6-minute walk test (6MWT) is a simple field test that is widely used in clinical settings to assess functional exercise capacity. However, studies with healthy subjects are scarce. We hypothesized that the 6MWT might be useful to assess exercise capacity in healthy subjects. The purpose of this study was to evaluate 6MWT intensity in middle-aged and older adults, as well as to develop a simple equation to predict oxygen uptake ( V ˙ O 2 ) from the 6-min walk distance (6MWD). Eighty-six participants, 40 men and 46 women, 40-74 years of age and with a mean body mass index of 28±6 kg/m2, performed the 6MWT according to American Thoracic Society guidelines...
April 2015: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Monika Franczuk, Stefan Wesołowski
Surgery is the treatment of choice in patients with a diagnosis of non-small cell lung cancer (NSCLC). A pivotal of eligibility for resection is the early stage of the disease and histopathological assessment. The performance status and comorbidities in population, predominated by elderly patients, also influence the therapeutic decisions. In some lung cancer patients COPD coexists, characterized by a decrease in lung function. Then the preoperative evaluation is particularly important, for both the risk of postoperative complications, lung function and quality of life postoperatively...
2015: Pneumonologia i Alergologia Polska
Katarzyna Gierat-Haponiuk, Ireneusz Haponiuk, Dominika Szalewska, Maciej Chojnicki, Radosław Jaworski, Piotr Niedoszytko, Katarzyna Leszczyńska, Stanisław Bakuła
BACKGROUND: Comprehensive cardiac rehabilitation (CCR) is an important element of the comprehensive management of grown-up congenital heart disease (GUCH) patients after surgical correction of congenital heart disease (CHD) but access to this treatment is still limited. We still lack Polish guidelines on CCR, including controlled training in young adults several years after surgical correction of CHD. AIM: To assess the effect of a CCR program on physical capacity, exercise tolerance, quality of life, and severity of depressive symptoms in GUCH patients long-term after surgical correction of CHD...
2015: Kardiologia Polska
Franck Levy, Nader Fayad, Antoine Jeu, Dominique Choquet, Catherine Szymanski, Dorothée Malaquin, Marcel Peltier, Christophe Tribouilloy
BACKGROUND: Risk stratification in asymptomatic patients with severe aortic stenosis (AS) is based on exercise test results. However, differentiating between pathological and physiological breathlessness during exercise is sometimes challenging. Cardiopulmonary exercise testing (CPET) may improve quantification of cardiopulmonary exercise capacity in patients with valve diseases. AIMS: To assess the ability of CPET to detect abnormal responses to exercise and a clinical endpoint (occurrence of European Society of Cardiology guidelines surgical class I triggers)...
October 2014: Archives of Cardiovascular Diseases
Ugo Corrà, Massimo F Piepoli, Stamatis Adamopoulos, Piergiuseppe Agostoni, Andrew J S Coats, Viviane Conraads, Ekaterini Lambrinou, Burkert Pieske, Ewa Piotrowicz, Jean-Paul Schmid, Petar M Seferović, Stefan D Anker, Gerasimos Filippatos, Piotr P Ponikowski
The relationship between exercise capacity, as assessed by peak oxygen consumption, and outcome is well established in heart failure (HF), but the predictive value of cardiopulmonary exercise testing (CPET) has been recently questioned, for two main reasons. First, the decisional power of CPET in the selection of heart transplantation candidates has diminished, since newer therapeutic options and the shortage of donor hearts have restricted this curative option to extremely advanced HF patients, frequently not able to perform a symptom-limited CPET...
September 2014: European Journal of Heart Failure
Naveen Ashish, Marcas M Bamman, Frank J Cerny, Dan M Cooper, Pierre D'Hemecourt, Joey C Eisenmann, Dawn Ericson, John Fahey, Bareket Falk, Davera Gabriel, Michael G Kahn, Han C G Kemper, Szu-Yun Leu, Robert I Liem, Robert McMurray, Patricia A Nixon, J Tod Olin, Paolo T Pianosi, Mary Purucker, Shlomit Radom-Aizik, Amy Taylor
In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children...
February 2015: Clinical and Translational Science
Wilhelm Ammenwerth, Henrik Wurps, Mark A Klemens, Catharina Crolow, Jeanette Schulz-Menger, Nicolas Schönfeld, Roland C Bittner, Torsten T Bauer
BACKGROUND: The non-invasive diagnosis of cardiac sarcoidosis (CS) is difficult. Cardiovascular magnetic resonance (CMR) has become a very valuable diagnostic tool in patients with suspected CS, but usually a combination of different tests is used. Oxygen uptake efficiency slope (OUES) is a parameter of cardiopulmonary exercise testing (CPET), which is used as an indicator for cardiovascular impairment. We investigated the predictive value of OUES for the diagnosis of myocardial involvement in sarcoid patients...
2014: PloS One
Tatsuo Nakagawa, Naohisa Chiba, Masao Saito, Yasuto Sakaguchi, Shinya Ishikawa
OBJECTIVE: The Japanese Association for Chest Surgery (JACS) has released guidelines on preoperative physiologic assessment for lung cancer surgery. However, cardiopulmonary exercise testing (CPET), which is recommended for patients with poor pulmonary function, is available only in limited institutions. We investigated the possibility of 6-min walk test (6MWT) as a substitute of maximum oxygen consumption test (VO(2)max) on preoperative physiologic assessment for lung cancer surgery...
October 2014: General Thoracic and Cardiovascular Surgery
Fabiana Stanzani, Denise de Moraes Paisani, Anderson de Oliveira, Rodrigo Caetano de Souza, João Aléssio Juliano Perfeito, Sonia Maria Faresin
OBJECTIVE: To determine morbidity and mortality rates by risk category in accordance with the American College of Chest Physicians guidelines, to determine what role pulmonary function tests play in this categorization process, and to identify risk factors for perioperative complications (PCs). METHODS: This was a historical cohort study based on preoperative and postoperative data collected for cases of lung cancer diagnosed or suspected between 2001 and 2010. RESULTS: Of the 239 patients evaluated, only 13 (5...
January 2014: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Paweł Balsam, Renata Główczyńska, Rajmund Zaczek, Sebastian Szmit, Grzegorz Opolski, Krzysztof J Filipiak
BACKGROUND: Cardiac rehabilitation in patients after myocardial infarction (MI) is a component of secondary prevention that has an established role in the current guidelines. AIM: To determine the effect of physical training on exercise capacity parameters determined on the basis of cardiopulmonary exercise test (CPET) in patients after MI. We also evaluated the relationship between the number of training sessions and exercise capacity. METHODS: We prospectively evaluated 52 patients after MI who underwent percutaneous coronary intervention of the infarct-related artery...
2013: Kardiologia Polska
Issahar Ben-Dov, Michael Segel
To achieve the predicted maximal oxygen consumption, many organs need to increase their output in a synchronized fashion. Therefore, maximal oxygen consumption is the single most reliable parameter predicting fitness, morbidity and mortality. Peak O2 uptake can be measured from noninvasive ventilatory parameters during short, incremental, cardiopulmonary exercise test (CPET) on a cycle ergometer or on a treadmill. Commercial systems are available and all enable breath by breath measurement of ventilation, exhaled gas concentration, oxygen saturation and additional cardiorespiratory parameters...
February 2012: Harefuah
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