University of Milan, Cardiology University Department, Heart Failure Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
University of Milan, Cardiology University Department, Heart Failure Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
J Am Coll Cardiol. 2017 Sep 26;70(13):1618-1636. doi: 10.1016/j.jacc.2017.08.012.
Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension. The most impactful advance has recently come from the introduction of CPET combined with echocardiography or CPET imaging, which provides basic information regarding cardiac and valve morphology and function. This review highlights modern CPET use as a single or combined test that allows the pathophysiological bases of exercise limitation to be translated, quite easily, into clinical practice.
与传统运动试验相比，心肺运动试验（CPET）提供了对涉及肺、心血管、肌肉和细胞氧化系统的运动综合生理学的全面评估。由于关键变量的预测能力，CPET 在心脏病学中的应用令人印象深刻地扩展到包括所有形式的运动不耐受，主要侧重于射血分数降低或保留的心衰。由于心输出量和外周氧弥散受损是心脏患者异常功能反应的主要决定因素，因此侵入性 CPET 重新受到欢迎，特别是用于诊断早期射血分数保留的心衰和运动性肺动脉高压。最近，最具影响力的进展来自 CPET 与超声心动图或 CPET 成像的结合使用，它提供了关于心脏和瓣膜形态和功能的基本信息。这篇综述强调了 CPET 的单一或联合使用，它可以将运动受限的病理生理基础非常容易地转化为临床实践。
