1、MITCHELL HOROWITZCardiopulmonary Exercise TestingOutline Description of CPET Who should and who should not get CPET When to terminate CPET Exercise physiology Define terms: respiratory exchange ratio, ventilatory equivalent, heart rate reserve, breathing reserve, oxygen pulse Pattern of CPET results
2、 COPD vs CHFRationale for Exercise TestingCardiopulmonary measurements obtained at rest may not estimate functional capacity reliablyClinical Exercise Tests 6-min walk test Submaximal Shuttle walk test Incremental, maximal, symptom-limited Exercise bronchoprovocation Exertional oximetry Cardiac stre
3、ss test CPETKarlman WassermanCoupling of External Ventilation and Cellular MetabolismAdaptations of Wassermans GearsGeneral Mechanisms of Exercise Limitation Pulmonary Ventilatory Respiratory muscle dysfunction Impaired gas exchange Cardiovascular Reduced stroke volume Abnormal HR response Circulato
4、ry abnormality Blood abnormality Peripheral Inactivity Atrophy Neuromuscular dysfunction Reduced oxidative capacity of skeletal muscle Malnutrition Perceptual Motivational EnvironmentalWhat is CPET? Symptom-limited exercise test Measure airflow, SpO2, and expired oxygen and carbon dioxide Allows calculation of peak oxygen consumption, anaerobic thresholdComponents of Integrated CPET Symptom-limited ECG HR Measure expired gas Oxygen consumption CO2 production Minute ventilation SpO2 or PO2 Perceptual responses Breathlessness Leg discomfort
