Current Trends in Cardiology

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (202) 780-3397

Brief Report - Current Trends in Cardiology (2023) Volume 7, Issue 4

A brief note on Cardiopulmonary exercise testing.

Ben Cobby*

Department of Medicine, Duke University Medical Center, Durham, North Carolina

*Corresponding Author:
Ben Cobby
Department of Medicine
Duke University Medical Center
Durham, North Carolina

Received: 24-Feb-2023, Manuscript No. AACC-23-93219; Editor assigned: 27-Feb-2023, PreQC No. AACC-23-93219(PQ); Reviewed: 13-Mar-2023, QC No. AACC-23-93219; Revised: 17-Mar-2023, Manuscript No. AACC-23-93219(R); Published: 24-Mar-2023, DOI:10.35841/aacc-7.3.147

Citation: Cobby B. A brief note on Cardiopulmonary exercise testing. J Cell Biol Metab. 2023;7(3):147

Visit for more related articles at Current Trends in Cardiology


Cardiopulmonary exercise testing (CPET) has emerged as a crucial clinical technique for assessing patients with heart failure and other cardiac disorders about their ability to exercise and predicting their prognosis. The assessment of integrative exercise responses including the pulmonary, cardiovascular, and skeletal muscle systems is provided. These reactions are not sufficiently captured by the examination of the function of separate organ systems. For the objective diagnosis of functional capacity and impairment, as well as for the evaluation of undiagnosed exercise intolerance, CPET is being employed more often in a wide range of therapeutic applications. This review examines the technique, indications, contraindications, and interpretation of CPET in healthy individuals and in patients with heart failure. It also focuses on the exercise physiology and physiological underpinnings of functional exercise testing [1].

Cardiopulmonary exercise testing (CPET) evaluates integrative exercise responses including the pulmonary, circulatory, hematopoietic, neuropsychological, and skeletal muscle systems that are not sufficiently reflected through the evaluation of individual organ system performance. The examination of submaximal and maximum exercise reactions is possible with the help of this non-invasive, dynamic physiological overview, which gives the clinician pertinent data for making clinical decisions. The examination of undiagnosed exercise intolerance and the objective estimation of functional capacity and impairment are two clinical applications where CPET is being utilized more and more often. With the knowledge that resting pulmonary and cardiac function tests cannot accurately predict exercise performance and functional capacity and that overall health status correlates better with exercise tolerance than with these measures, its application in patient care is growing [2].

Physiology of exercise

"The maximal capability of the circulatory system to transport oxygen to exercising skeletal muscle and of the exercising muscle to take oxygen from the blood" is the definition of peak exercise capacity. As a result, three factors pulmonary gas exchange, cardiovascular function, particularly the peripheral vascular tree, and skeletal muscle metabolism determine exercise tolerance [3,4].

Cardiopulmonary exercise testing

Ventilation and respiratory gas parameters during exercise may be measured using a variety of techniques. The best measurements of the metabolic response to exercise are provided by breath-by-breath analysis methods, which are used by the majority of clinical systems. To avoid the mixing of inspired and expired air, a mouthpiece is attached to a non-rebreathing valve. Gas analyzers for oxygen and carbon dioxide are typically included on a "metabolic cart" created especially for functional assessment. By integrating the air flow signals over the inspiration and expiration times, respiratory volumes are calculated. Using the breath-by-breath data multiplied by the respiratory rate, average minute volumes are calculated [5].


The CPET is a comprehensive assessment of the cardiorespiratory system that measures the efficiency of the complete oxygen transport chain, from the lungs to the skeletal muscles. Yet, PVo2, which is obtained from CPET, is a powerful and independent factor in evaluating the prognosis of patients with CHF. Interpreting CPET can be challenging. In recent years, it has been found that a stepwise approach may be more beneficial and that a single arbitrary cut-off point for PVo2 may not accurately capture the underlying risk of occurrences. The value of a stepwise multipara metric interpretation of CPET still requires more study. Lastly, CPET plays a significant role in a comprehensive strategy for the evaluation and treatment of cardiac patients.


  1. Simonton CA, Higginbotham MB, Cobb FR. The ventilatory threshold: quantitative analysis of reproducibility and relation to arterial lactate concentration in normal subjects and in patients with chronic congestive heart failure. Am J Cardiol. 1988;62(1):100-7.
  2. Indexed at, Google Scholar, Cross Ref

  3. Matsumura NA, Nishijima HI, Kojima SH, et al. Determination of anaerobic threshold for assessment of functional state in patients with chronic heart failure. Circulation. 1983;68(2):360-7.
  4. Indexed at, Google Scholar, Cross Ref

  5. Neuberg GW, Friedman SH, Weiss MB, et al. Cardiopulmonary exercise testing: the clinical value of gas exchange data. Arch Intenr Med. 1988;148(10):2221-6.
  6. Indexed at, Google Scholar, Cross Ref

  7. Buchfuhrer MJ, Hansen JE, Robinson TE, et al. optimizing the exercise protocol for cardiopulmonary assessment. J Appl Physiol. 1983;55(5):1558-64.
  8. Indexed at, Google Scholar, Cross Ref

Get the App