Protocol for exercise hemodynamic assessment: performing an invasive cardiopulmonary exercise test in clinical practice

Invasive cardiopulmonary exercise testing (iCPET) combines full central hemodynamic assessment with continuous measurements of pulmonary gas exchange and ventilation to help in understanding the pathophysiology underpinning unexplained exertional intolerance. There is increasing evidence to support...

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Bibliographic Details
Published in:Pulmonary Circulation 2015-12, Vol.5 (4), p.610-618
Main Authors: Berry, Natalia C., Manyoo, Agarwal, Oldham, William M., Stephens, Thomas E., Goldstein, Ronald H., Waxman, Aaron B., Tracy, Julie A., Leary, Peter J., Leopold, Jane A., Kinlay, Scott, Opotowsky, Alexander R., Systrom, David M., Maron, Bradley A.
Format: Article
Language:English
Subjects:
Cardiac output determination
cardiopulmonary exercise testing
Central venous catheterization
Clinical medicine
Exercise
Heart
Heart catheterization
Hemodynamics
Lactates
protocol
Pulmonary artery catheterization
pulmonary hypertension
Pulmonary wedge pressure
Radial artery
Review
Review Article
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Summary:Invasive cardiopulmonary exercise testing (iCPET) combines full central hemodynamic assessment with continuous measurements of pulmonary gas exchange and ventilation to help in understanding the pathophysiology underpinning unexplained exertional intolerance. There is increasing evidence to support the use of iCPET as a key methodology for diagnosing heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension as occult causes of exercise limitation, but there is little information available outlining the methodology to use this diagnostic test in clinical practice. To bridge this knowledge gap, the operational protocol for iCPET at our institution is discussed in detail. In turn, a standardized iCPET protocol may provide a common framework to describe the evolving understanding of mechanism(s) that limit exercise capacity and to facilitate research efforts to define novel treatments in these patients.
ISSN:2045-8932
2045-8940
2045-8940
DOI:10.1086/683815