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Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults: A Scientific Statement From the American Heart Association
Open accessAbstract
Arteriovenous oxygen difference EOB Exercise oscillatory breathing FECO 2 Fraction of carbon dioxide in expired air FEO 2 Fraction of oxygen in expired air FEV 1 Forced expiratory volume in 1 second MET Metabolic equivalent MVV Maximum voluntary ventilation O 2 Oxygen OUES Oxygen-uptake efficiency slope P ET CO 2 Partial pressure of end-tidal carbon dioxide P ET O 2 Partial pressure of end-tidal oxygen RER Respiratory exchange ratio V ˙CO 2 Carbon dioxide output VD Volume of dead space V ˙E Minute ventilation V ˙E/V ˙CO 2 Ventilatory equivalent of carbon dioxide V ˙E/V ˙O2 Ventilatory equivalent of oxygen V ˙O2 Oxygen uptake VT Ventilatory threshold 192
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“Cardiologists have tended to regard peak V˙o2 as a particularly valuable index for heart function because V˙o2 can be applied as a proxy for cardiac output,8 and this is most commonly used as part of heart failure (HF) management.”
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Minute ventilation/carbon dioxide production in chronic heart failure
Agostoni, P., Sciomer, S., Palermo, P., Contini, M. C., Pezzuto, B., Farina, S., Magini, A., Martino, F. D., Magrì, D., Paolillo, S., et al. (2021) · European Respiratory Review · doi:10.1183/16000617.0141-2020 · Cited by 11
Arena, R. A., MYERS, J. N., Ozemek, C., Hall, G., Severin, R. S., Laddu, D., Kaminsky, L. A., Stoner, L. R., Conners, R. T., & Faghy, M. A. (2021) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2021.100879 · Cited by 17
Self-citationEdmonton Obesity Staging System: an improvement by cardiopulmonary exercise testing
Bettini, S., Quinto, G., Neunhäeuserer, D., Battista, F., Belligoli, A., Milan, G., Gasperetti, A., Vettor, R., Ermolao, A., & Busetto, L. (2021) · International Journal of Obesity · doi:10.1038/s41366-021-00856-9 · Cited by 12
“Moreover, VO2peak/kg can importantly decrease in individuals suffering from obesity, but represents a more reliable parameter than the absolute value of oxygen consumption in evaluating the ability to carry out activities of daily living [15, 21].”
BackgroundIndoor cycling training in rehabilitation of patients after myocardial infarction
Gloc, D., Nowak, Z., Nowak-Lis, A., Gabrys, T. T., Szmatlan-Gabrys, U. B., Valach, P., & Pilis, A. (2021) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-021-00379-w · Cited by 11
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Exercise Stress Testing in Athletes
Parizher, G., & Emery, M. S. (2022) · Clinics in Sports Medicine · doi:10.1016/j.csm.2022.02.006 · Cited by 11
Zhao, Y. F., Li, J., Tao, C., & Ding, R. (2022) · Medicine in Novel Technology and Devices · doi:10.1016/j.medntd.2022.100191 · Cited by 11
Wilde, C. D., Bekhuis, Y., Kuznetsova, T., Claes, J., Claessen, G., Coninx, K., Decorte, E., Smedt, D. D., Hansen, D., Lannoo, M., et al. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1194693 · Cited by 11
Exercise Rehabilitation for People With End-Stage Kidney Disease: Who Will Fill the Gaps?
Thompson, S., Stickland, M. K., Wilund, K., Gyenes, G. T., & Bohm, C. J. (2023) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2023.08.011 · Cited by 11
Physiological Profile and Limitations in Exercise in Idiopathic Pulmonary Fibrosis
Vainshelboim, B., de Oliveira, J. J. F., Fox, B. D., Adir, Y., Ollech, J. E., & Kramer, M. R. (2016) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000177 · Cited by 11
Exercise Training in Cancer Survivors
Chyu, C. K., & Halnon, N. J. (2016) · Current Oncology Reports · doi:10.1007/s11912-016-0520-2 · Cited by 13
Cardiac and Peripheral Autonomic Control in Restrictive Cardiomyopathy
Sayegh, A. L. C., dos Santos, M. R., de Oliveira, A. S., de Souza, F. R., Salemi, V. M. C., Hotta, V. T., Marques, A. C. D. B., Krämer, H. H., Trombetta, I. C., Mady, C., et al. (2017) · ESC Heart Failure · doi:10.1002/ehf2.12142 · Cited by 11
Chao, T. P., Sperandio, E. F., Ostolin, T. L. V. D. P., de Almeida, V. R., Romiti, M., Gagliardi, A. R. T., Arantes, R. L., & Dourado, V. Z. (2018) · Brazilian Journal of Medical and Biological Research · doi:10.1590/1414-431x20186486 · Cited by 11
“The evaluation of cardiorespiratory fitness with cardiopulmonary exercise testing (CPET) is used for the diagnosis of exercise intolerance as well as prognosis of patients with chronic diseases (8).”
MethodBirkett, S. T., Nichols, S., Sawrey, R., Gleadall-Siddall, D. O., McGregor, G., & Ingle, L. (2019) · Sport Sciences for Health · doi:10.1007/s11332-019-00552-2 · Cited by 11
Coll‐Risco, I., Acosta‐Manzano, P., Borges‐Cosic, M., Camiletti‐Moirón, D., Aranda, P., Soriano‐Maldonado, A., & Aparicio, V. A. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8101678 · Cited by 11
“Cardiorespiratory fitness was assessed with the modified Bruce test [27,28], upper-body muscle strength with the handgrip strength test [29,30], and lower body muscle strength with the 30 s chair stand test [29].”
MethodHuang, D., Guo, J., Yang, W., & Liu, J. (2019) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2019.12.011 · Cited by 11
dos Santos, M. R., da Fonseca, G. W. P., Sherveninas, L. P., de Souza, F. R., Filho, A. C. B., Novaes, C. E., Pereira, R. M. R., Negrão, C. E., Barretto, A. C. P., & Alves, M. J. D. N. N. (2020) · ESC Heart Failure · doi:10.1002/ehf2.12657 · Cited by 11
“10.(11) Heart rate was continuously recorded at rest and during the graded exercise testing using a 12-lead digital electrocardiogram (ERGO PC 13, MICROMED Biotech-”
MethodMarmett, B., Carvalho, R. B., Dorneles, G. P., da Silva, I. M., Romão, P. R. T., Nunes, R. B., & Rhoden, C. R. (2020) · Environmental Science and Pollution Research · doi:10.1007/s11356-020-10019-4 · Cited by 11
Peripheral Oxygen Extraction and Exercise Limitation in Asymptomatic Patients with Diabetes Mellitus
Kobayashi, Y., Christle, J. W., Contrepois, K., Nishi, T., Moneghetti, K. J., Cauwenberghs, N., MYERS, J. N., Kuznetsova, T., Palaniappan, L. P., & Haddad, F. (2021) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2021.03.011 · Cited by 11
Self-citationValidity of Estimated Cardiorespiratory Fitness in Patients With Primary Breast Cancer
Michalski, M., Rowed, K., Lavery, J. A., Moskowitz, C. S., Capaci, C., Stene, G. B., Edvardsen, E., Eves, N. D., Jones, L. W., & Scott, J. M. (2022) · JACC CardioOncology · doi:10.1016/j.jaccao.2022.05.003 · Cited by 11
“VO2peak (mL O2$kg (1)$min (1)) was assessed by an incremental walking CPET on an electronic motorized treadmill with 12-lead electrocardiographic monitoring (Mac 5000, GE Healthcare) according to standard procedures.(3,22) Breath-bybreath (averaged every 30 seconds) expired gases were collected using a mouthpiece and…”
MethodPleguezuelos, E., Carmen, A. D., Moreno, E., Ortega, P., Robles, A., Serra-Prat, M., Miravitlles, M., Yébenes, J. C., & Garnacho‐Castaño, M. V. (2022) · Scientific Reports · doi:10.1038/s41598-022-24941-9 · Cited by 11
Ujeyl, A., Stevenson, L. W., West, E., Kato, M., Liszkowski, M., Campbell, P., & Forman, D. E. (2010) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2010.10.007 · Cited by 11
Self-citationVainshelboim, B., Amin, A., Christle, J. W., Hebbal, S., Ashley, E. A., & MYERS, J. N. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.09.028 · Cited by 11
Self-citationBeltrame, T., Catai, A. M., Rebelo, A. C. S., Tamburús, N. Y., Zuttin, R. S., Takahashi, A. C. D. M., & da Silva, E. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00533 · Cited by 12
“The peak VO2−peak was obtained following the American Heart Association guidelines (Balady et al., 2010).”
MethodOvershoot Phenomena of Respiratory Gas Variables During Exercise Recovery in Cardiac Patients
Suzuki, T., Koike, A., Nagayama, O., Sakurada, K., Tsuneoka, H., Kato, J., Yamashita, T., & Yamazaki, J. (2012) · Circulation Journal · doi:10.1253/circj.cj-11-1279 · Cited by 11
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Chase, P. J., Arena, R. A., Guazzi, M., MYERS, J. N., Peberdy, M. A., & Bensimhon, D. (2010) · American Heart Journal · doi:10.1016/j.ahj.2010.08.003 · Cited by 10
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Richter, M. J., Milger, K., Haase, S., Sommer, N., Tello, K., Seeger, W., Mayer, E., Wiedenroth, C. B., Grimminger, F., George, W. M., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0152580 · Cited by 10
Correlation Between Exercise Capacity and Quality of Life in Patients With Cardiac Disease
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Sayegh, A. L. C., Silva, B. M., Ferreira, E. V. M., Ramos, R. P., Fisher, J. P., Nery, L. E., Arakaki, J. S. O., & Oliveira, R. K. F. (2020) · Respirology · doi:10.1111/resp.13959 · Cited by 10
Physical Functioning in Heart Failure With Preserved Ejection Fraction
Cosiano, M. F., Tobin, R. S., Mentz, R. J., & Greene, S. J. (2021) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2021.04.013 · Cited by 10
Christou, G. A., Pagourelias, E. D., Deligiannis, A. P., & Kouidi, E. J. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.693733 · Cited by 10
A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Cardiopulmonary System
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Chaikijurajai, T., Wu, Y., Grodin, J. L., Harb, S. C., Jaber, W. A., & Tang, W. H. W. (2022) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2022.100174 · Cited by 10
“…men, and women, we also aimed to demonstrate the prognostic significance of the HGI in subgroups of patients with and without certain conditions that may affect exercise performance and hemodynamic responses to exercise, such as significantly elevated BMI, HF, CAD, and beta blocker use [1,4,16].”
BackgroundInfluentialDillon, H. T., Foulkes, S., Horne-Okano, Y. A., Kliman, D. S., Dunstan, D. W., Daly, R. M., Fraser, S. F., Avery, S., Kingwell, B. A., Gerche, A. L., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.926064 · Cited by 10
Neurophysiological mechanisms of exertional dyspnea in post-pulmonary embolism syndrome
Milne, K. M., James, M. D., Smyth, R. M., Vincent, S. G., Singh, N., D’Arsigny, C. L., de-Torres, J. P., de Wit, K., Johri, A. M., Neder, J. A., et al. (2023) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00677.2022 · Cited by 10
Scrutinio, D., Guida, P., Rovere, M. T. L., Vecchia, L. A. D., Forni, G., Raimondo, R., Scalvini, S., & Passantino, A. (2024) · Scientific Reports · doi:10.1038/s41598-024-53817-3 · Cited by 10
“However, some aspects of this important technique, such as the “need for additional expensive equipment and personnel who are proficient in the administration and interpretation of the test”, limit its broad clinical application 28 .”
BackgroundFarmani, A., Hemmatinafar, M., Jahromi, M. K., Pirmohammadi, S., Imanian, B., & Jahan, Z. (2024) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2024.2340556 · Cited by 11
“…equivalent method (the point at which VE/VO 2 begins to rise without an increase in VE/VCO 2 ) and end-tidal methods (partial pressure of end-tidal oxygen tension (PetO2) starts to grow without a decrease in partial pressure of end-tidal carbon dioxide (PetCO2)) was used as a complement [37].”
MethodChen, C., Weng, M., Chen, T., & Huang, M. (2013) · The Kaohsiung Journal of Medical Sciences · doi:10.1016/j.kjms.2013.05.004 · Cited by 10
Guazzi, M., Vitelli, A., & Arena, R. A. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.04.091 · Cited by 10
Self-citationTreating exercise oscillatory ventilation in heart failure: the detail that may matter
Guazzi, M. (2012) · European Respiratory Journal · doi:10.1183/09031936.00039012 · Cited by 10
Self-citationWaheed, S., Chaves, P. H. M., Gardin, J. M., & Cao, J. J. (2015) · Journal of the American Heart Association · doi:10.1161/jaha.115.002308 · Cited by 10
Effects of heat acclimation on hand cooling efficacy following exercise in the heat
Adams, E. L., Vandermark, L. W., Pryor, J. L., Pryor, R. R., VanScoy, R. M., Denegar, C. R., Huggins, R. A., & Casa, D. J. (2016) · Journal of Sports Sciences · doi:10.1080/02640414.2016.1192671 · Cited by 10
“…if participants met 3 of the 4 following criteria: (1) Within 10% of age predicted maximum HR (220-age), (2) Rating of perceived exertion greater than 17/20, (3) Plateau in VO2 values during the last two stages of exercise, (4) Respiratory exchange ratio greater than 1.1 (Balady et al., 2010).”
BackgroundInfluentialAslanger, E. K. (2016) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2016.7009 · Cited by 10
Heat Exposure and Hypohydration Exacerbate Physiological Strain During Load Carrying
Adams, E. L., Casa, D. J., Huggins, R. A., DeMartini-Nolan, J. K., Stearns, R. L., Kennedy, R., Bosworth, M. M., DiStefano, L. J., Armstrong, L. E., & Maresh, C. M. (2017) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000001831 · Cited by 10
Grannell, A., & VITO, G. D. (2017) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12437 · Cited by 10
“In a clinical setting, both the VT and RCP have enabled practitioners to quantify the functional state of individuals with various conditions including but not limited to cardiac disease, pulmonary disease and type 2 diabetes (Shimizu et al., 1991; Balady et al., 2010).”
BackgroundMazzuco, A., Medeiros, W. M., de Souza, A. S., Alencar, M. C. N., Neder, J. A., & Borghi‐Silva, A. (2017) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2017.05.002 · Cited by 9
Oyake, K., Yamaguchi, T., Oda, C., Kudo, D., Kondo, K., Otaka, Y., & Momose, K. (2017) · BioMed Research International · doi:10.1155/2017/6862041 · Cited by 10
“The respiratory exchange ratio is defined as the ratio between carbon dioxide output (V̇CO 2 ) and V̇O 2 and is also an indicator of exercise effort [24].”
BackgroundMethodInfluentialA Comparison of the Maximal Fat Oxidation Rates of Three Different Time Periods in The Fatmax Stage.
Özgünen, K., Özdemir, Ç., Eryılmaz, S. K., Kılcı, A., Günaştı, Ö., & Kurdak, S. S. (2019) · Europe PMC (PubMed Central) · Cited by 10
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“Both ICU patients and controls reported a Borg RPE score of 13 defined as “somewhat hard,” indicating that there was no difference in perceived exertion.(16,17)”
BackgroundMethodCardiorespiratory fitness and future risk of venous thromboembolism
Evensen, L. H., Isaksen, T., Brækkan, S. K., & Hansen, J. (2019) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.14619 · Cited by 10
Exercise Testing in Individuals With Diabetes, Practical Considerations for Exercise Physiologists
Kosinski, C., Besson, C., & Amati, F. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.01257 · Cited by 11
“Interpretation of the CPET outcomes should be done as usual, independently of the presence of diabetes or not (Balady et al., 2010; Guazzi et al., 2012, 2016).”
MethodGonçalves, A. V., Mano, T. B., Agapito, A. F., Rosa, S. A., de Sousa, L., Rio, P., Alberto, J., Monteiro, A., da Silva, T. P., Moreira, R. I., et al. (2019) · Cardiology in the Young · doi:10.1017/s1047951119002361 · Cited by 10
Petersen, A. K., Oestergaard, L. G., van Tulder, M. W., & Laustsen, S. (2019) · Clinical Rehabilitation · doi:10.1177/0269215519883411 · Cited by 9
Establishing Reference Cardiorespiratory Fitness Parameters in Alzheimer’s Disease
Salisbury, D. L., & Yu, F. (2020) · Sports Medicine International Open · doi:10.1055/a-1089-4957 · Cited by 10
“In healthy, middle-aged adults, CPET performed on a cycle ergometer generates VO2peak that is typically 10–20 % lower than when performed on the treadmill [15].”
BackgroundWhitworth, J. W., Hayes, S. M., Andrews, R. J., Fonda, J. R., Beck, B. M., Hanlon, L. B., Fortier, C. B., Milberg, W., & McGlinchey, R. E. (2020) · Military Medicine · doi:10.1093/milmed/usaa005 · Cited by 11
An analysis of 2‐day cardiopulmonary exercise testing to assess unexplained fatigue
Lindheimer, J. B., Alexander, T., Qian, W., Klein‐Adams, J. C., Lange, G., Natelson, B. H., Cook, D. B., Hill, H. Z., & Falvo, M. J. (2020) · Physiological Reports · doi:10.14814/phy2.14564 · Cited by 8
“High test–retest reliability has been reported in healthy and chronic disease populations, as reviewed elsewhere (Balady et al., 2010); however, sensitivity to change has been questioned particularly among individuals with fatiguing illness (Heine, van den Akker, Verschuren, Visser-Meily, & Kwakkel, 2015).”
BackgroundMujović, N. M., Marinković, M. M., Nedeljković, I., Marković, N., Banovic, M. D., Vučićević, V., Stankovic, G. R., & Potpara, T. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.120.017445 · Cited by 10
Serra‐Payá, N., Garnacho‐Castaño, M. V., Sánchez-Nuño, S., Albesa-Albiol, L., Farrés, M. G., Arcone, L. M., Fernández, A. P., García-Fresneda, A., Castizo-Olier, J., Viñals, X., et al. (2021) · Nutrients · doi:10.3390/nu13041094 · Cited by 12
“Bearing in mind that high intensity exercise reduces the efficiency of the pulmonary gas exchange [5,6] resulting in an increased VE-perfusion mismatch [7], we hypothesize that NO via dietary BJ could contribute, at least in part, to delaying fatigue and increasing exercise tolerance by improving the VE•VCO2−1 slope,…”
BackgroundInfluentialTuan, S., Chen, G., Chen, C., Chen, Y., Liou, I., Su, Y.-T., & Lin, K. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.657551 · Cited by 10
Laukkanen, J. A., Kurl, S., Khan, H., Zaccardi, F., & Kunutsor, S. K. (2021) · Cardiology · doi:10.1159/000516123 · Cited by 10
Cai, H., Cao, P., Zhou, W., Sun, W., Zhang, X., Li, R., Shao, W., Wang, L., Zou, L., & Zheng, Y. (2021) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-021-00368-z · Cited by 13
Chin, E. C., Leung, C. K., Yu, D. J., Yu, A. P., Bernal, J. D. K., Lai, C. W. K., Chan, D. K. C., Ngai, H. H. Y., Yung, P. S., Lee, C., et al. (2022) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2022.03.003 · Cited by 10
Yates, B. A., Brown, R., Picard, G., & Taylor, J. A. (2023) · Experimental Physiology · doi:10.1113/ep090785 · Cited by 9
Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol
Nessler, J. M., Nessler, B. J., Gołębiowska-Wiatrak, R., Palka, I., Gackowski, A., Kitliński, M., Melander, O., & Fedorowski, A. (2013) · Cardiology Journal · doi:10.5603/cj.2013.0027 · Cited by 10
Cardiac Rehabilitation in Patients with Heart Failure.
Fu, T., Huang, S., Hsu, C., Wang, C., & Wang, J. (2014) · PubMed Central · Cited by 10
Sex Differences on Peak Oxygen Uptake in Heart Failure
Palau, P., Domínguez, E., & Núñez, J. E. (2019) · ESC Heart Failure · doi:10.1002/ehf2.12483 · Cited by 11
“In a recent position paper, Corrà et al.3 accurately reviewed six observational studies24–29 endorsing the utility of CPET parameters for risk stratification in women with HFrEF.”
BackgroundInfluentialFitness and reduced risk of hypertension—approaching causality
Laukkanen, J. A., & Kunutsor, S. K. (2021) · Journal of Human Hypertension · doi:10.1038/s41371-021-00545-0 · Cited by 11
“Directly measured maximum oxygen uptake (VO2max) during CPX is the gold standard for assessing CRF [2].”
BackgroundWard, S. A. (2013) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2013.07.004 · Cited by 10
Moore, M. N., Picone, D. S., Callisaya, M. L., Srikanth, V., Sharman, J. E., & Schultz, M. G. (2019) · The Journal of Clinical Hypertension · doi:10.1111/jch.13717 · Cited by 9
Feasel, C. D., Sandroff, B. M., & Motl, R. W. (2020) · Cardiopulmonary Physical Therapy Journal · doi:10.1097/cpt.0000000000000141 · Cited by 9
“Maximal exertion or effort during CPET was defined for the study based on a participant reaching 2 of the 4 criteria, and this is consistent with previous research(4) and accepted protocols for CPET.(17,28) The application of those criteria resulted in 17 of the 20 (85%) CPETs providing interpretable data.”
MethodResultGroarke, J. D., Ness, K. K., Dhaduk, R., Plana, J. C., Durand, J., Luepker, R. V., Joshi, V. M., Ehrhardt, M. J., Mulrooney, D. A., Dixon, S. B., et al. (2024) · JACC CardioOncology · doi:10.1016/j.jaccao.2024.08.005 · Cited by 9
Advancing Cardiac Amyloidosis Care Through Insights from Cardiopulmonary Exercise Testing
Pugliatti, P., Trimarchi, G., Barocelli, F., Pizzino, F., Spigno, F. D., Tedeschi, A., Cusmà-Piccione, M., Irrera, P., Aschieri, D., Niccoli, G., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13237285 · Cited by 9
Plantier, L., & Delclaux, C. (2018) · European Clinical Respiratory Journal · doi:10.1080/20018525.2018.1492842 · Cited by 9
“Chest Physicians [1], or the American Heart Association [6].”
BackgroundInfluentialUribe-Heredia, G., Arroyo‐Espliguero, R., Viana-Llamas, M. C., Saponara, L. G. P., Alvaro-Fernandez, H., García-Magallón, B., Torán-Martínez, C. G., Silva, J. A., & Alonso, J. L. I. (2019) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000451 · Cited by 9
Canada, J. M., Park, T. S., Ravindra, K., Chiabrando, J. G., Buono, M. G. D., van Wezenbeek, J., Trankle, C. R., Kadariya, D., Keen, L., Carbone, S., et al. (2021) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000605 · Cited by 9
Self-citationRibeiro, G. D. S., Deresz, L. F., Salvioni, E., Hansen, D., Agostoni, P., & Karsten, M. (2022) · International Journal of Cardiology · doi:10.1016/j.ijcard.2022.05.041 · Cited by 9
“Although the American Heart Association has proposed the Corrà definition to screen for EOV cases [7], there is no consensus on the best EOV definition [4, 8].”
BackgroundInitiation of Dialysis Is Associated With Impaired Cardiovascular Functional Capacity
Arroyo, E., Umukoro, P. E., Burney, H. N., Li, Y., Li, X., Lane, K. A., Sher, S. J., Lu, T., Moe, S. M., Moorthi, R. N., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.122.025656 · Cited by 9
“…VE/VCO 2 slope has been associated with lower cardiac output, higher pulmonary vascular resistance, and increased ventilation-perfusion mismatching, 27,28 all of which have been reported in CKD. 1 Therefore, the degree to which each of these pathophysiological factors may independently contribute…”
Assessment of Exercise Intensity for Uphill Walking in Healthy Adults Performed Indoors and Outdoors
Eisenberger, L., Mayr, B., Beck, M., Venek, V., Kranzinger, C., Menzl, A., Jahn, I., Sareban, M., Oberhoffer, R., Niebauer, J., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416662 · Cited by 9
“001 *,1 HRmax (bpm) 165 [14] 165 [16] 165 [12] 0.”
BackgroundGryglewska-Wawrzak, K., Sakowicz, A., Banach, M., Maciejewski, M., & Bielecka-Dabrowa, A. M. (2022) · Biomedicines · doi:10.3390/biomedicines10123257 · Cited by 9
“Hence, there is an option to address the functional competence of the organs by coupling external adjustments to cellular respiration by studying external respiration in response to exercise [14].”
BackgroundLv, F., Zhang, J., & Tao, Y. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1054666 · Cited by 9
Reduced cardiovascular reserve capacity in long-term allogeneic stem cell transplant survivors
Dillon, H. T., Foulkes, S., Horne-Okano, Y. A., Kliman, D. S., Dunstan, D. W., Daly, R. M., Fraser, S. F., Avery, S., Kingwell, B. A., Gerche, A. L., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-28320-w · Cited by 9
Chen, J., Wu, S., Wu, Y., Zhuang, P., Zhang, Y., & Jiao, J. (2023) · European Journal of Nutrition · doi:10.1007/s00394-023-03120-0 · Cited by 9
“In some circumstances, lactic acid buffering is conducive to carbon dioxide output, and increases carbon dioxide production at a faster rate than oxygen consumption [34], which we speculated resulted in the abnormal RER level in KO male mice (RER > 1.”
BackgroundClinical Exercise Physiologists in Cardiac Rehabilitation and Clinical Exercise Testing
Brawner, C. A., Berry, R., Harding, A. W., Nustad, J. K., Ozemek, C., Richardson, L. A., & Savage, P. D. (2023) · Journal of Clinical Exercise Physiology · doi:10.31189/2165-6193-12.2.38 · Cited by 9
Chaikijurajai, T., Finet, J. E., Engelman, T., Wu, Y., Martens, P., Iterson, E. H. V., Morales-Oyarvide, V., Grodin, J. L., & Tang, W. H. W. (2023) · JACC Heart Failure · doi:10.1016/j.jchf.2023.05.005 · Cited by 9
Yang, J., Ye, X., Liu, Z., Sun, M., Yu, S., Lv, H., Wu, B., Zhang, C., Gu, W., He, J., et al. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1129144 · Cited by 9
Bras, P. G., Gonçalves, A. V., Reis, J., Moreira, R. I., Pereira‐da‐Silva, T., Rio, P., Timóteo, A. T., Silva, S., Soares, R. M., & Ferreira, F. (2023) · Life · doi:10.3390/life13101985 · Cited by 10
“Consequently, our proposed cut-offs might not be applicable to an HF population with submaximal exercise testing, particularly considering the lower prognostic power of pVO 2 in submaximal exercise capacity [57].”
MethodMoyle, B., Kudiersky, N., Totton, N., Sassani, M., Nichols, S., Jenkins, T. M., Redgrave, J. N. E., Baig, D. S., Nair, K. P. S., Majid, P. A., et al. (2023) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2023.107420 · Cited by 9
Huang, S., Lee, C., Hsu, C., Chang, S.-Y., Chen, Y., Chiu, C., Hsiao, C.-C., & Su, H. (2023) · Frontiers in Physiology · doi:10.3389/fphys.2023.1253598 · Cited by 10
Engster, P. H. D. B., Zimerman, A., Schaan, T., Borges, M. S., Souza, G. H. N., Costa, G. D., Rohde, L. E. P., & da Silveira, A. D. (2023) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20230077 · Cited by 9
Schreuder, T. H. A., van den Munckhof, I., Poelkens, F., Hopman, M. T. E., & Thijssen, D. H. J. (2014) · European Journal of Applied Physiology · doi:10.1007/s00421-014-3016-5 · Cited by 9
Bansal, M., Fiutem, J. J., Hill, J. A., O’Riordan, M. A., & Zahka, K. G. (2012) · Pediatric Cardiology · doi:10.1007/s00246-012-0308-6 · Cited by 9
Benefits of exercise therapy in peripheral arterial disease.
Osinbowale, O. O., & Milani, R. (2011) · Progress in cardiovascular diseases · doi:10.1016/j.pcad.2011.03.005 · Cited by 9
Self-citationExercise capacity in left ventricular assist device patients with full and partial support
Fresiello, L., Buys, R., Jacobs, S., Puyvelde, J. V., Droogné, W., Rega, F., & Meyns, B. P. (2016) · European Journal of Preventive Cardiology · doi:10.1177/2047487316656088 · Cited by 9
Roncada, G. (2016) · BMC Complementary and Alternative Medicine · doi:10.1186/s12906-016-1468-3 · Cited by 9
“The criteria for defining a maximal cardiopulmonary exercise test are an achieved heart rate > 85% of the maximal predicted heart rate, and/or a Respiratory gas Exchange Ratio (RER) > 1,09 [51].”
BackgroundCosta, H. S., Lima, M. M. O., Nunes, M. C. P., Sousa, G. R., de Almeida, F. R., Figueiredo, P. H. S., & Rocha, M. O. D. C. (2016) · IJC Metabolic & Endocrine · doi:10.1016/j.ijcme.2016.11.007 · Cited by 9
Reliability and Validity of a Self-paced Cardiopulmonary Exercise Test in Post-MI Patients
Jenkins, L. A., Mauger, A. R., Fisher, J., & Hopker, J. (2017) · International Journal of Sports Medicine · doi:10.1055/s-0042-122818 · Cited by 10
Cardiac Dysfunction and Heart Failure in Hematopoietic Cell Transplantation Survivors
Armenian, S. H., Ryan, T. D., & Khouri, M. G. (2017) · Heart Failure Clinics · doi:10.1016/j.hfc.2016.12.008 · Cited by 9
Nichols, S., Nation, F., Goodman, T., Clark, A. L., Carroll, S., & Ingle, L. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019216 · Cited by 9
Metadata
- Authors
- Balady, G. J., Arena, R., Sietsema, K., Myers, J., Coke, L., Fletcher, G. F., Forman, D., Franklin, B., Guazzi, M., Gulati, M., Keteyian, S. J., Lavie, C. J., Macko, R., Mancini, D., Milani, R. V., Council on Epidemiology and Prevention, Council on Peripheral Vascular Disease, & Interdisciplinary Council on Quality of Care and Outcomes Research
- Affiliations
- IRCCS Policlinico San Donato (IT)
- ORCID
- Venue
- Circulation
- Published
- 2010-07-13
- Volume
- 122
- Issue
- 2
- Pages
- 191-225
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2074602210
- Cited by
- 1,964
- References
- 255
- Citations by year
- 2026: 148 · 2025: 128 · 2024: 177 · 2023: 138 · 2022: 156 · 2021: 150 · 2020: 138 · 2019: 139 · 2018: 125 · 2017: 140 · 2016: 122 · 2015: 90 · 2014: 100 · 2013: 78 · 2012: 70
- FWCI
- 177.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (IK6 RX002477)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- cardiopulmonary exercise testing, oxygen consumption, ventilatory threshold, oxygen uptake efficiency slope, respiratory exchange ratio, ventilatory equivalents, end-tidal carbon dioxide, end-tidal oxygen, arteriovenous oxygen difference, carbon dioxide output, dead space, forced expiratory volume, metabolic equivalents, maximal voluntary ventilation, adults
- MeSH terms
- Adult, American Heart Association, Cardiovascular Diseases, Exercise Test, Female, Humans, Lung Diseases, Male, United States
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