a Chronic Diseases Clinical Research Center (CDCRC), Los Angeles Biomedical Institute at Harbor-UCLA Medical Center , David Geffen School of Medicine at UCLA , Torrance , CA , USA.
b Respiratory Research Center, Royal University Hospital , University of Saskatchewan , Saskatoon , Canada.
COPD. 2018 Dec;15(6):621-631. doi: 10.1080/15412555.2018.1550476. Epub 2018 Dec 30.
Chronic obstructive pulmonary disease (COPD) is a common multisystem inflammatory disease with ramifications involving essentially all organ systems. Pulmonary rehabilitation is a comprehensive program designed to prevent and mitigate these disparate systemic effects and improve patient quality of life, functional status, and social functioning. Although initial patient assessment is a prominent component of any pulmonary rehabilitation (PR) program, cardiopulmonary exercise testing (CPET) is not regularly performed as a screening physiologic test prior to PR in COPD patients. Further, CPET is not often used to assess or document the improvement in exercise capacity related to completion of PR. In this review we will describe the classic physiologic abnormalities related to COPD on CPET parameters, the role of CPET in Risk Stratification/Safety prior to PR, the physiologic changes that occur in CPET parameters with PR, and the literature regarding the use of CPET to assess PR results. Finally, we will compare CPET to 6MW in COPD PR, the common minimal clinically important difference (MCID) is associated with CPET, and the potential future roles of CPET in PR and Research.
慢性阻塞性肺疾病（COPD）是一种常见的多系统炎症性疾病，其影响涉及几乎所有的器官系统。肺康复是一个综合性的计划，旨在预防和减轻这些不同的全身影响，提高患者的生活质量、功能状态和社会功能。尽管初始患者评估是任何肺康复（PR）计划的一个突出组成部分，但在 COPD 患者进行 PR 之前，心肺运动试验（CPET）并没有作为常规的筛选生理测试进行。此外，CPET 也不常用于评估或记录与 PR 完成相关的运动能力的改善。在这篇综述中，我们将描述 CPET 参数与 COPD 相关的经典生理学异常，CPET 在 PR 前的风险分层/安全性中的作用，CPET 参数在 PR 中发生的生理学变化，以及关于 CPET 评估 PR 结果的文献。最后，我们将比较 CPET 与 6MW 在 COPD PR 中的应用，CPET 与常见的最小临床重要差异（MCID）的关系，以及 CPET 在 PR 和研究中的未来潜在作用。
