Glaab T, Schmidt O, Fritsch J
Medizinische Klinik III, Abteilung Pneumologie, Universitätsmedizin Mainz, Mainz.
Pneumologische Gemeinschaftspraxis, Koblenz.
Pneumologie. 2020 Feb;74(2):88-102. doi: 10.1055/a-1069-0611. Epub 2020 Feb 12.
Cardiorespiratory fitness has been established as an independent overall predictor of morbidity and mortality. However, patients' symptoms or stated levels of exercise intolerance correlate only poorly with resting functional and imaging tests. Cardiopulmonary exercise testing (CPET) is the gold standard for the integrative assessment of the cardiocirculatory, pulmonary and metabolic response to exercise and can help identify the source of exercise limitation, monitor disease progression, evaluate treatment responsiveness and inform about prognosis. Though CPET offers more valuable and pertinent information with slightly more expenditure of time compared to other methods even at submaximal exercise levels, it remains underutilized for various reasons such as costs, reimbursement and expertise. CPET can be seen as a complex, but not necessarily difficult tool. The objective of this review was to provide a description of the underlying principles of physiology, and an easy-to-follow guidance to indications, methodology, and interpretative strategies of CPET.
心肺适能已被确立为发病率和死亡率的独立总体预测指标。然而,患者的症状或所述的运动不耐受程度与静息功能和影像学检查的相关性较差。心肺运动试验(CPET)是综合评估心脏循环、肺部和运动代谢反应的金标准,有助于确定运动受限的原因、监测疾病进展、评估治疗反应性并提供预后信息。尽管与其他方法相比,即使在次最大运动水平下,CPET只需稍微多花费一些时间就能提供更有价值和相关性更强的信息,但由于成本、报销和专业知识等各种原因,它的使用仍然不足。CPET可被视为一种复杂但不一定困难的工具。本综述的目的是描述其生理学基本原理,并提供一份易于遵循的关于CPET的适应症、方法和解读策略的指南。