Ingle Lee
Carnegie Faculty of Sport and Education, Leeds Metropolitan University, Beckett's Park, Headingley, Leeds LS6 3QS, UK.
Eur J Heart Fail. 2008 Feb;10(2):112-8. doi: 10.1016/j.ejheart.2007.12.011. Epub 2008 Feb 5.
Cardiopulmonary exercise testing (CPET) is a well established technique for stratifying cardiovascular risk in patients with chronic heart failure (CHF). Important prognostic variables include a reduced peak oxygen uptake which has a central use in cardiac transplant selection, and the abnormal relation between minute ventilation (VE) and carbon dioxide production (VCO(2)), often referred to as the elevated VE/VCO(2) slope. We will discuss the pathophysiology of these abnormal responses to exercise in CHF, and how these are interpreted during CPET. The potential of CPET for diagnosing circulatory, respiratory, metabolic, musculoskeletal or mixed limitations is an emerging field of research. We will speculate on how CHF manifests during CPET, and clarify the pathophysiological basis of these exercise responses. To improve our understanding of the diagnostic value of CPET, further investigation is required by clinicians to develop reference ranges for CHF patients from a co-ordinated multicentre approach. The use of CPET technology is becoming increasingly prevalent in cardiology services, and it is likely that, in the future, CPET will take a more prominent role in guiding patient management provision.
心肺运动试验（CPET）是一种成熟的技术，用于对慢性心力衰竭（CHF）患者的心血管风险进行分层。重要的预后变量包括峰值摄氧量降低（这在心脏移植选择中具有核心用途），以及分钟通气量（VE）与二氧化碳产生量（VCO₂）之间的异常关系，通常称为升高的VE/VCO₂斜率。我们将讨论CHF患者运动时这些异常反应的病理生理学，以及在CPET过程中如何解读这些反应。CPET在诊断循环、呼吸、代谢、肌肉骨骼或混合性运动受限方面的潜力是一个新兴的研究领域。我们将推测CHF在CPET过程中的表现方式，并阐明这些运动反应的病理生理基础。为了提高我们对CPET诊断价值的理解，临床医生需要通过协调的多中心方法进一步研究，以制定CHF患者的参考范围。CPET技术在心脏病学服务中的应用越来越普遍，未来CPET很可能在指导患者管理方面发挥更突出的作用。
