Document Detail

Reproducibility of cardiopulmonary exercise measurements in patients with pulmonary arterial hypertension.
MedLine Citation:
PMID:  15364761     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: As part of a recent study, cardiopulmonary exercise tests (CPETs) were used to evaluate and follow up patients with pulmonary arterial hypertension (PAH). These patients were more impaired than those in other published series evaluating CPET reproducibility. We used these patient tests to assess patient performance variability and evaluate reading variability. To achieve this end, six independent evaluators graded key CPET measurements in patients with PAH who underwent duplicate CPETs within 3 days of each other.
SETTING AND PATIENTS: Over a 15-month period at two tertiary-care teaching hospitals, 42 patients with PAH underwent repeated, paired CPETs using cycle ergometry.
INTERVENTIONS AND MEASUREMENTS: Each patient underwent one to six pairs of cycle ergometry tests to maximal tolerance. Each pair of tests was separated by 3 months, with each test in the pair separated by 1 to 3 days. Specific guidelines were given to the independent evaluators for the key measurements assessed from each CPET study: peak O(2) uptake (Vo(2)), peak heart rate, peak O(2) pulse, anaerobic threshold (AT), and end-tidal Po(2), end-tidal Pco(2), and the ventilatory equivalent for CO(2) at the AT (Ve/Vco(2)@AT).
RESULTS: There were no fatalities or complications occurring among the 242 tests performed on 42 patients. The mean peak Vo(2) was 722 mL/min or 41% of predicted; 34 patients were Weber class C or D. Using the specific guidelines to measure the variability of measurements made by the six independent evaluators, the coefficients of variation were < 2.2% for peak Vo(2), peak heart rate, peak O(2) pulse, end-tidal values at the AT, and Ve/Vco(2)@AT, while for the AT, it was 8.5%. There were no significant differences in these measurements between the first and second tests of any pair or between the earlier and later sets of pairs.
CONCLUSIONS: Using specific guidelines, key CPET measurements can be safely, reliably, and reproducibly assessed even in patients with severe exercise intolerance.
James E Hansen; Xing-Guo Sun; Yuji Yasunobu; Robert P Garafano; Gregory Gates; Robyn J Barst; Karlman Wasserman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  126     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-14     Completed Date:  2004-11-02     Revised Date:  2014-07-28    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  816-24     Citation Subset:  AIM; IM    
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MeSH Terms
Anaerobic Threshold / physiology
Carbon Dioxide / blood
Exercise Test / statistics & numerical data*
Heart Rate / physiology
Hypertension, Pulmonary / classification,  diagnosis*,  physiopathology
Middle Aged
Observer Variation
Oxygen / blood
Practice Guidelines as Topic
Reproducibility of Results
Tidal Volume / physiology
Reg. No./Substance:
142M471B3J/Carbon Dioxide; S88TT14065/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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