| Cardiopulmonary exercise testing in the evaluation of patients with ventilatory vs circulatory causes of reduced exercise tolerance. | |
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MedLine Citation:
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PMID: 8162736 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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P Palange; S Carlone; S Forte; P Galassetti; P Serra |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chest Volume: 105 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 1994 Apr |
Date Detail:
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Created Date: 1994-05-23 Completed Date: 1994-05-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1122-6 Citation Subset: AIM; IM |
Affiliation:
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II Patologia Medica, University La Sapienza Rome, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Output Cardiovascular Diseases / complications, diagnosis* Dyspnea / etiology* Exercise Test* Exercise Tolerance* Female Humans Lung Diseases / complications, diagnosis* Male Middle Aged Respiratory Mechanics Sensitivity and Specificity |
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