Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing

The advent of microprocessed “metabolic carts” and rapidly incremental protocols greatly expanded the clinical applications of cardiopulmonary exercise testing (CPET). The response normalcy to CPET is more commonly appreciated at discrete time points, for example, at the estimated lactate threshold...

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Main Authors: Roberta P. Ramos, Maria Clara N. Alencar, Erika Treptow, Flávio Arbex, Eloara M. V. Ferreira, J. Alberto Neder
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Pulmonary Medicine
Online Access:http://dx.doi.org/10.1155/2013/359021
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author Roberta P. Ramos
Maria Clara N. Alencar
Erika Treptow
Flávio Arbex
Eloara M. V. Ferreira
J. Alberto Neder
author_facet Roberta P. Ramos
Maria Clara N. Alencar
Erika Treptow
Flávio Arbex
Eloara M. V. Ferreira
J. Alberto Neder
author_sort Roberta P. Ramos
collection DOAJ
description The advent of microprocessed “metabolic carts” and rapidly incremental protocols greatly expanded the clinical applications of cardiopulmonary exercise testing (CPET). The response normalcy to CPET is more commonly appreciated at discrete time points, for example, at the estimated lactate threshold and at peak exercise. Analysis of the response profiles of cardiopulmonary responses at submaximal exercise and recovery, however, might show abnormal physiologic functioning which would not be otherwise unraveled. Although this approach has long been advocated as a key element of the investigational strategy, it remains largely neglected in practice. The purpose of this paper, therefore, is to highlight the usefulness of selected submaximal metabolic, ventilatory, and cardiovascular variables in different clinical scenarios and patient populations. Special care is taken to physiologically justify their use to answer pertinent clinical questions and to the technical aspects that should be observed to improve responses’ reproducibility and reliability. The most recent evidence in favor of (and against) these variables for diagnosis, impairment evaluation, and prognosis in systemic diseases is also critically discussed.
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institution Kabale University
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publishDate 2013-01-01
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series Pulmonary Medicine
spelling doaj-art-a965e3b5e670435dbb300b34f5b02c3d2025-08-20T03:39:10ZengWileyPulmonary Medicine2090-18362090-18442013-01-01201310.1155/2013/359021359021Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise TestingRoberta P. Ramos0Maria Clara N. Alencar1Erika Treptow2Flávio Arbex3Eloara M. V. Ferreira4J. Alberto Neder5Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Francisco de Castro 54, Vila Mariana, 04020-050 São Paulo, SP, BrazilPulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Francisco de Castro 54, Vila Mariana, 04020-050 São Paulo, SP, BrazilPulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Francisco de Castro 54, Vila Mariana, 04020-050 São Paulo, SP, BrazilPulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Francisco de Castro 54, Vila Mariana, 04020-050 São Paulo, SP, BrazilPulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Francisco de Castro 54, Vila Mariana, 04020-050 São Paulo, SP, BrazilPulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Department of Medicine, Federal University of Sao Paulo (UNIFESP), Rua Francisco de Castro 54, Vila Mariana, 04020-050 São Paulo, SP, BrazilThe advent of microprocessed “metabolic carts” and rapidly incremental protocols greatly expanded the clinical applications of cardiopulmonary exercise testing (CPET). The response normalcy to CPET is more commonly appreciated at discrete time points, for example, at the estimated lactate threshold and at peak exercise. Analysis of the response profiles of cardiopulmonary responses at submaximal exercise and recovery, however, might show abnormal physiologic functioning which would not be otherwise unraveled. Although this approach has long been advocated as a key element of the investigational strategy, it remains largely neglected in practice. The purpose of this paper, therefore, is to highlight the usefulness of selected submaximal metabolic, ventilatory, and cardiovascular variables in different clinical scenarios and patient populations. Special care is taken to physiologically justify their use to answer pertinent clinical questions and to the technical aspects that should be observed to improve responses’ reproducibility and reliability. The most recent evidence in favor of (and against) these variables for diagnosis, impairment evaluation, and prognosis in systemic diseases is also critically discussed.http://dx.doi.org/10.1155/2013/359021
spellingShingle Roberta P. Ramos
Maria Clara N. Alencar
Erika Treptow
Flávio Arbex
Eloara M. V. Ferreira
J. Alberto Neder
Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing
Pulmonary Medicine
title Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing
title_full Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing
title_fullStr Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing
title_full_unstemmed Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing
title_short Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing
title_sort clinical usefulness of response profiles to rapidly incremental cardiopulmonary exercise testing
url http://dx.doi.org/10.1155/2013/359021
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