Document Detail


Recommendations on the use of exercise testing in clinical practice.
MedLine Citation:
PMID:  17197484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest. For symptom-limited incremental exercise, CPET indices, such as peak O(2) uptake (V'O(2)), V'O(2) at lactate threshold, the slope of the ventilation-CO(2) output relationship and the presence of arterial O(2) desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable. In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) "When should an evaluation of exercise intolerance be sought?"; 2) "Which particular form of test should be asked for?"; and 3) "What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?"
Authors:
; P Palange; S A Ward; K-H Carlsen; R Casaburi; C G Gallagher; R Gosselink; D E O'Donnell; L Puente-Maestu; A M Schols; S Singh; B J Whipp
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The European respiratory journal     Volume:  29     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-01     Completed Date:  2007-03-20     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  185-209     Citation Subset:  IM    
Affiliation:
Servizio di Fisiopatologia Respiratoria, Dipartimento di Medicina Clinica, University of Rome "La Sapienza", Rome, Italy. paolo.palange@uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Exercise Test*
Exercise Tolerance / physiology
Heart Diseases / diagnosis*,  physiopathology
Humans
Lung Diseases / diagnosis*,  physiopathology
Outcome Assessment (Health Care)
Practice Guidelines as Topic
Prognosis
Comments/Corrections
Comment In:
Eur Respir J. 2007 Jul;30(1):181-2; author reply 182-3   [PMID:  17601978 ]
Eur Respir J. 2007 May;29(5):1064-6; author reply 1066-7   [PMID:  17470627 ]

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