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Cardiopulmonary Exercise Test

Cardiopulmonary Exercise Test is a comprehensive evaluation of an individual's cardiovascular and respiratory function during physical exertion.
It provides valuable insights into exercise capacity, oxygen utilization, and the integrated response of the cardiopulmonary system.
This test is commonly used to assess the functional status of patients with known or suspected cardiovascular or pulmonary diseases, as well as to evaluate the effects of therapeutic interventions.
The test typically involves the measurement of various physiological parameters, such as oxygen uptake, carbon dioxide production, heart rate, and ventilation, during a graded exercise protocol on a treadmill or cycle ergometer.
The results of the Cardiopulmonary Exercise Test can help clinicians and researchers better understand an individual's exercise tolerance and identify any underlying cardiovascular or pulmonary abnormalities.

Most cited protocols related to «Cardiopulmonary Exercise Test»

A complete description of the design of HF-ACTION has been published previously.15 (link) Briefly, HF-ACTION was a multicenter, randomized controlled trial of exercise training vs usual care in patients with left ventricular ejection fraction ≤ 35% and New York Heart Association (NYHA) class II to IV symptoms despite optimal heart failure therapy for at least 6 weeks. Patients were randomized from April 2003 through February 2007 within the United States, Canada, and France. Exclusion criteria included major comorbidities or limitations that could interfere with exercise training, recent (within 6 weeks) or planned (within 6 months) major cardiovascular events or procedures, performance of regular exercise training, or use of devices that limited the ability to achieve target heart rates. The protocol was reviewed and approved by the appropriate institutional review board or ethics committee for each participating center and by the coordinating center institutional review board. All patients provided written voluntary informed consent.
All patients were to undergo baseline cardiopulmonary exercise testing. Test results were reviewed by investigators to identify significant arrhythmias or ischemia that would prevent safe exercise training, to determine appropriate levels of exercise training, and to establish training heart rate ranges. Eligible patients were randomized 1:1 using a permuted block randomization scheme, stratified by clinical center and heart failure etiology (ischemic vs nonischemic). At the baseline clinic visit prior to randomization, demographics, socioeconomic status, past medical history, current medications, physical exam, and the most recent laboratory tests were obtained. Participants reported race and ethnicity at the time of study enrollment using categories defined by the National Institutes of Health. In an analysis to examine the effect of exercise training by subgroup, we used the reported race categories “black or African American” and “white” and combined all others as “other.” All cardiopulmonary exercise tests were sent to the HF-ACTION cardiopulmonary exercise core lab for review.
Publication 2009
African American Cardiac Arrhythmia Cardiopulmonary Exercise Test Cardiovascular System Clinic Visits Congestive Heart Failure Ethics Committees Ethics Committees, Research Ethnicity Heart Ischemia Medical Devices Patients Pharmaceutical Preparations Physical Examination Rate, Heart Therapeutics Ventricular Ejection Fraction
All results were presented as mean ± standard deviation (SD) for the quantitative variables. The qualitative variables were expressed in percentages. Statistical analyses were performed using SPSS 17.0 statistical software (SPSS Inc., Chicago, IL, USA). The determination of the dependent variable, the 1-minute STS repetitions at baseline, and other independent variables were made using the univariate linear regression analysis. These included anthropometric parameters, the data of the combined COPD assessment A, B, C, and D categories, the Charlson and body mass index, airflow obstruction, dyspnea and exercise capacity index pulmonary function parameters (from the forced expiratory maneuver, plethysmography, and respiratory muscle strength), cardiopulmonary exercise tests parameters, 6MWT, and QMVC parameters. This was followed by a multivariate analysis, combining the most relevant independent variables from the univariate analysis that showed at least a tendency with the 1-minute STS repetitions, ie, a P-value <0.2. Only independent variables, which increased consistently the explained variance (R2 coefficient of determination) of the 1-minute STS repetitions, were used in the final model.
The variables that significantly changed from baseline to the end of the PR were identified using a paired t-test in case of normality of the distribution or the Wilcoxon test if not.
The analysis of the MID was based on the use of distribution-based methods, using the effect size method (1-minute STS repetitions[end-baseline]/SDbaseline), the standardized response mean method (1-minute STS repetitions[end-baseline]/SD[end-baseline]), the SD method (0.5× SD of 1-minute STS repetitions at baseline) or the standard error of measurement method (SD of 1-minute STS repetitions at baseline × √[1-{test–retest reliability}]). Based on personal data of our team, not yet published, we found the test–retest reliability of the 1-minute STS test to be 0.906. For anchor-based estimation of the MID, we used the change from baseline variables that correlated with the change in 1-minute STS repetitions from baseline to the end with a correlation coefficient of at least 0.3 and a P-value <0.05 as recommended.23 (link) Then, we used the sensitivity- and specificity-based approach with receiver operating characteristic curves to determine the best cutoff for the change in 1-minute STS repetitions with the established MID of 30 m for the 6MWT, according to the recommendations.19 (link),20 (link) A P-value of <0.05 was considered significant.
Publication 2016
Cardiopulmonary Exercise Test Chronic Obstructive Airway Disease Dyspnea Exhaling Index, Body Mass Lung Muscle Strength Plethysmography Respiratory Muscles Respiratory Rate
Patients randomized to the exercise training arm first participated in a structured, group-based, supervised exercise program, with a goal of 3 sessions per week for a total of 36 sessions in 3 months. During the supervised training phase, patients performed walking, treadmill, or stationary cycling as their primary training mode. Exercise was initiated at 15 to 30 minutes per session at a heart rate corresponding to 60% of heart rate reserve (maximal heart rate on cardiopulmonary exercise test minus resting heart rate). After 6 sessions, the duration of the exercise was increased to 30 to 35 minutes, and intensity was increased to 70% of heart rate reserve. Details of the exercise training protocol have been reported previously.15 (link) Patients were to begin home-based exercise after completing 18 supervised sessions and were to fully transition to home exercise after 36 supervised sessions. Patients in the exercise training arm were provided home exercise equipment (cycle or treadmill [ICON; Logan, Utah]) and heart rate monitors (Polar USA, Inc, New York, New York). The target training regimen for home exercise was 5 times per week for 40 minutes at a heart rate of 60% to 70% of heart rate reserve. Adherence was evaluated by measuring attendance at the supervised training sessions and by activity logs, telephone and clinic follow-up, and heart rate monitoring data (model A1 or S1, Polar USA Inc) during the home exercise training phase.
Publication 2009
Cardiopulmonary Exercise Test Home Transition Patients Rate, Heart Treatment Protocols

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Publication 2021
6-Minute Walk Test Cardiac Arrhythmia Cardiologists Cardiopulmonary Exercise Test Congenital Abnormality Congenital Heart Defects Congestive Heart Failure Diagnosis Diastole Echocardiography Heart Heart Ventricle Hospitalization Medical Devices Patients Right-Sided Heart Failure Therapeutics Valve Disease, Heart
This was a prospective, observational study to determine the correlation between the face scale RPE and HR, exercise load and V̇O2 during cardiopulmonary exercise. A total of 30 healthy college men and 21 healthy college were included. Subjects performed cardiopulmonary exercise tests with ramp exercise protocols to determine the V̇O2.18 (link) Each participant provided written informed consent after receiving information regarding the potential risks, study objectives, measurement techniques and benefits associated with the study. Our protocol consisted of a 4 min rest, 4 min warm-up, cardiopulmonary exercise and 2 min cool-down. A ramp programme with an incremental increase in workload of 20 W/min was employed using stationary bicycles (Aerobike 75XLIII; Konami, Tokyo, Japan) with ECG (DS-7520, Fukuda Denshi, Tokyo, Japan), and an exhaled gas analyzer (AE-310S; Minato Medical Science, Osaka, Japan). All subjects were instructed to maintain a cadence of 50 rotations per minute (rpm) during the cardiopulmonary exercise test. Exhaustion was defined as follows19 (link) (1): a plateau in oxygen consumption (VO2); (2) respiratory exchange ratio >1.1; (3) HR values near the age-predicted maximal heart rate, calculated as 220 – (0.65×age); and (4) a decrease in the cycling cadence to <50 rpm, despite strong verbal encouragement. The highest value obtained for V̇O2 was considered the V̇O2 peak. We evaluated HR using ECG, exercise load (watts) and V̇O2 using an exhaled gas analyzer every minute during cardiopulmonary exercise test and at the end of the exercise test. All subjects were asked ‘how hard you feel you are working’ using the face scale RPE and their responses were recorded (figure 1). Additionally, we determined anaerobic thresholds (ATs) using the V-slope method during the cardiopulmonary exercise tests.20 (link)
The outcomes were reported as a mean and SD or median. Spearman’s rank correlation coefficients (ρ) were calculated to evaluate the correlation between the face scale RPE and HR, watts, and V̇O2 every minute during the cardiopulmonary exercise tests. Statistical analyses were performed using SPSS V.19.0J. P values<0.05 were considered statistically significant.
Publication 2018
Cardiopulmonary Exercise Test Exercise Tests Face Feelings Oxygen Consumption Rate, Heart Respiratory Rate

Most recents protocols related to «Cardiopulmonary Exercise Test»

Baseline clinical information, including age, sex, body mass index (BMI), disease duration, comorbidities, medication, and LV ejection fraction (LVEF) obtained from 2D echocardiography [27 (link)], from each subject was recorded. Participants had blood sampling before the baseline CMR-LGE imaging study and then underwent a graded cardiopulmonary exercise test (CPET). The physical component score (PCS) and mental component score (MCS) of the Medical Outcomes Study Short Form-36 health survey (SF-36) for quality of life (QoL) were assessed before initiating each CPET. The follow-up CMR-LGE, CPET, and blood samplings were performed within 1 week after completing 36 sessions of HIIT. Haematocrit and b-type natriuretic peptide (BNP) were also measured before and after HIIT. After completing the above study, the remaining blood sample was centrifuged at 2500 rpm for 5 min at room temperature for serum preparation. A graphic depicting the experimental procedure is shown in Additional file 1.
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Publication 2023
2D Echocardiography BLOOD Cardiopulmonary Exercise Test Index, Body Mass Mental Health Nesiritide Pharmaceutical Preparations Phlebotomy Physical Examination Serum Volumes, Packed Erythrocyte
All subjects underwent a maximal cardiopulmonary exercise test on a motorized treadmill (Trackmaster TMX425, Full Vision, Inc., KS, United States). After a 5-min running at 8 km/h (warm-up), the protocol started, and the treadmill speed was increased by 1 km/h every 2 min, in a stepwise fashion. The treadmill inclination was kept constant at 1°. The protocol was continued until exhaustion. Oxygen uptake (VO2, mL/min/kg) and instantaneous minute ventilation (VE, L/min) were measured breath by breath (Cosmed Quark CPET, Rome, Italy) and averaged every 30s. The highest values of VO2 and VE were taken as VO2max (mL/kg/min) and maximal minute ventilation (VEmax, l/min), respectively.
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Publication 2023
Cardiopulmonary Exercise Test Clostridium perfringens epsilon-toxin Oxygen Vision
A schematic overview of the study design is shown in Fig. 1. All participants performed an incremental cardiopulmonary exercise test (CPET) (Lode Excalibur; Lode, Groningen, the Netherlands) on a bicycle ergometer to determine their maximum cardiovascular fitness level (defined as V˙O2max ) and maximum heart rate [21 (link)]. During CPET, the participant was asked to cycle at a continuous rate of 60 to 80 rotations per minute and the work rate was increased every minute by 15 or 20 W until exhaustion, or an indication to stop according to the American Thoracic Society/American College of Chest Physicians (ATS/ACCP) statement [22 (link)]. Directly before and after cycling, venous blood was collected to measure glucose and lactate concentrations using Biosen C-Line (EKF Diagnostics, Cardiff, UK). After screening, all participants were instructed to inject insulin degludec at 23:00 hours during the trial, and participants not on degludec were transferred to it. A 28 day titration run-in was used to reach stable glycaemic control, defined as a self-measured fasting mean glucose concentration below 7 mmol/l.

Overview of the study. Ex, exercise day; Scr, screening visit

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Publication 2023
Cardiopulmonary Exercise Test Cardiovascular System Chest Diagnosis Glucose Glycemic Control insulin degludec Lactates Physicians Rate, Heart Seizures Titrimetry Veins

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Publication 2023
Adrenergic beta-Antagonists Angiotensin Receptor Cardiopulmonary Exercise Test Cardiovascular System Disease Progression Diuretics inhibitors Neprilysin Nurses Patients Pharmaceutical Preparations Rate, Heart Rehabilitation Supervision Titrimetry
We identified all individuals with heart disease ≤21 years old at the time of the first test, and who underwent a routine cardiopulmonary exercise test (CPET) at Cincinnati Children's Hospital within a year before and after March 21, 2020 (i.e., the date that extensive COVID-19 mitigation strategies including school and sports cancellations were established locally). This group we defined as the “COVID lockdown” study group. Heart disease was defined as either electrocardiographic (i.e., Long QT syndrome, catecholaminergic polymorphic ventricular tachycardia) or CHD (bicuspid aortic valve, Fontan physiology, etc). We included only those for whom exercise testing was performed as routine standard of care and not secondary to cardiac symptoms or concern for deterioration (i.e., testing to assess for adequate beta-blockade if long QT patients, evaluate for serial changes in peak VO2 in CHD patients for prognostic purposes, ST segment/T wave changes in patients with left ventricular outflow tract obstruction). This was evaluated on chart review utilizing the electronic medical record. Additional exclusion criteria included a submaximal test (details below) and missing data. Additionally, to determine if any changes in fitness were secondary to COVID-19 mitigation or rather typical fitness changes in patients with heart disease, an age, sex, and diagnosis-matched historical control group was performed for those with serial CPET performed during the 3 years prior to the COVID-19 pandemic. To help account for other confounders, following initial result reporting a sensitivity analysis was performed to evaluate for differences in serial testing by excluding patients with pre-existing activity restrictions, adult patients, and those with a percent predicted peak VO2 < 80%. Lastly, all patients tested during the COVID-19 pandemic required a negative PCR test on a nasopharyngeal swab prior to their CPET.
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Publication 2023
Adult Cardiopulmonary Exercise Test COVID 19 Diagnosis Electrocardiography Heart Heart Diseases Hypersensitivity Long QT Syndrome Nasopharynx Patients physiology Polymorphic catecholergic ventricular tachycardia Valve, Bicuspid Aortic Ventricular Outflow Obstruction, Left

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