1 Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
2 University Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
Ann Am Thorac Soc. 2017 Jul;14(Supplement_1):S84-S92. doi: 10.1513/AnnalsATS.201610-788FR.
Cardiopulmonary exercise testing allows the assessment of the integrative cardiopulmonary response to exercise and is a useful tool to assess the underlying pathophysiologic mechanisms leading to exercise intolerance. Patients with pulmonary hypertension often face a considerable delay in diagnosis due to the rarity of the disease and nonspecific symptoms of dyspnea, fatigue, and exercise limitation. Cardiopulmonary exercise testing may be suggestive of pulmonary hypertension in patients with evidence of both circulatory impairment and ventilatory inefficiency. Other factors, such as mechanical ventilatory constraints from dynamic hyperinflation and peripheral muscle dysfunction, contribute to the profound dyspnea during exercise experienced by many patients with pulmonary hypertension. In patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension, several exercise variables, such as low peak [Formula: see text]o, high Vd/Vt, and high [Formula: see text]e/[Formula: see text]co, have proven to be useful in establishing the severity of functional impairment, predicting prognosis, and assessing the efficacy of interventions.
心肺运动试验可评估整体心肺对运动的反应，是评估导致运动不耐受的潜在病理生理机制的有用工具。由于肺动脉高压较为罕见，且呼吸困难、疲劳和运动受限等症状无特异性，患者常面临诊断延误。心肺运动试验可提示循环功能障碍和通气效率低下的患者存在肺动脉高压。其他因素，如动态过度充气引起的机械通气限制和外周肌肉功能障碍，导致许多肺动脉高压患者在运动时出现严重呼吸困难。在肺动脉高压或慢性血栓栓塞性肺动脉高压患者中，一些运动变量，如峰值 [Formula: see text]o 降低、Vd/Vt 升高和 [Formula: see text]e/[Formula: see text]co 升高，已被证明可用于确定功能损害的严重程度、预测预后和评估干预措施的疗效。
