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
Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Pulm Circ. 2015 Dec;5(4):610-8. doi: 10.1086/683815.
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.
有创心肺运动试验（iCPET）将全面的中心血流动力学评估与肺气体交换和通气的连续测量相结合，以帮助理解导致不明原因运动不耐受的病理生理学。越来越多的证据支持将iCPET作为诊断射血分数保留的心力衰竭和运动性肺动脉高压这两种导致运动受限的隐匿原因的关键方法，但几乎没有信息概述在临床实践中使用这种诊断测试的方法。为了填补这一知识空白，我们详细讨论了本机构iCPET的操作方案。反过来，标准化的iCPET方案可能会提供一个通用框架，以描述对限制运动能力机制的不断演变的理解，并促进为这些患者确定新治疗方法的研究工作。
