Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Postgrad Med. 2010 Nov;122(6):68-86. doi: 10.3810/pgm.2010.11.2225.
Cardiopulmonary exercise testing (CPX) is a relatively old technology, but has sustained relevance for many primary care clinical scenarios in which it is, ironically, rarely considered. Advancing computer technology has made CPX easier to administer and interpret at a time when our aging population is more prone to comorbidities and higher prevalence of nonspecific symptoms of exercise intolerance and dyspnea, for which CPX is particularly useful diagnostically and prognostically. These discrepancies in application are compounded by patterns in which CPX is often administered and interpreted by cardiology, pulmonary, or exercise specialists who limit their assessments to the priorities of their own discipline, thereby missing opportunities to distinguish symptom origins. When used properly, CPX enables the physician to assess fitness and uncover cardiopulmonary issues at earlier phases of work-up, which would therefore be especially useful for primary care physicians. In this article, we provide an overview of CPX principles and testing logistics, as well as some of the clinical contexts in which it can enhance patient care.
心肺运动测试（CPX）是一项相对较老的技术，但在许多初级保健临床情况下仍然具有相关性，而在这些情况下，CPX 却很少被考虑使用，这具有讽刺意味。随着计算机技术的进步，CPX 在管理和解释方面变得更加容易，而此时我们的人口老龄化更容易出现合并症和更高的非特异性运动不耐受和呼吸困难症状的患病率，CPX 在诊断和预后方面特别有用。这种应用上的差异因 CPX 通常由心脏病学、肺病学或运动专家进行管理和解释而加剧，他们将评估仅限于自己学科的优先事项，从而错失了区分症状起源的机会。当正确使用时，CPX 使医生能够在工作的早期阶段评估健康状况并发现心肺问题，因此对初级保健医生尤其有用。在本文中，我们提供了 CPX 原则和测试流程的概述，以及它可以增强患者护理的一些临床背景。
