Document Detail

Cardiopulmonary exercise testing in the evaluation of patients with ventilatory vs circulatory causes of reduced exercise tolerance.
MedLine Citation:
PMID:  8162736     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Cardiopulmonary exercise testing (CPX) is considered a useful procedure in the evaluation of circulatory, ventilatory, or mixed origin of reduced exercise tolerance. Our study was designed to compare CPX and a standard clinical-instrumental approach in the evaluation of patients with cardiopulmonary disorders. METHODS: Fifty-seven patients (31 male, 26 female; mean [+/- SE] age, 60 +/- 2 years) were studied. Each patient was evaluated by two different observers: one used standard clinical criteria, the other used gas exchange indexes, monitored during a maximal incremental CPX, performed on a cycle ergometer. Cardiac output (CO), at rest and at submaximal work level, was also obtained. RESULTS: In 46 patients (80.7 percent), a concordant evaluation was reached by the two observers (24 were found to have a predominant ventilatory disorder, 22 to have a circulatory disorder); among these, in subjects considered to have circulatory impairment, the maximal CO/maximal workload ratio was significantly lower than in the ventilatory group; in those with ventilatory impairment, the reduced exercise tolerance correlated with the resting spirometric values. In the remaining 11 patients (19.3 percent), CPX better defined the underlying pathophysiology of exercise limitation: in 10 of them, clinically classified as having a mixed or predominantly ventilatory disorder, a greater importance of the circulatory component was detected; 4 had evidence of pulmonary vascular impairment (high VE/VCO2 at anaerobic threshold). CONCLUSIONS: Our study confirmed the sensitivity of CPX in the evaluation of a reduced exercise tolerance in dyspneic patients with cardiopulmonary conditions; when compared with a clinical-laboratory approach, in some patients it allowed the detection of an underestimated circulatory component causing exercise limitation.
P Palange; S Carlone; S Forte; P Galassetti; P Serra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  105     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-05-23     Completed Date:  1994-05-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1122-6     Citation Subset:  AIM; IM    
II Patologia Medica, University La Sapienza Rome, Italy.
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MeSH Terms
Cardiac Output
Cardiovascular Diseases / complications,  diagnosis*
Dyspnea / etiology*
Exercise Test*
Exercise Tolerance*
Lung Diseases / complications,  diagnosis*
Middle Aged
Respiratory Mechanics
Sensitivity and Specificity

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