Landsteiner I; Cardiology Division and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA.
Ikoma T; Lewis GD;

Heart failure clinics [Heart Fail Clin] 2025 Jan; Vol. 21 (1), pp. 35-49.
Date of Electronic Publication: 2024 Oct 18.

Cardiopulmonary exercise testing (CPET) permits the assessment of gas exchange, electrocardiogram, and hemodynamic patterns throughout exercise, providing a window into multi-organ physiologic reserve during exercise. CPET provides risk stratification and informs management of advanced heart failure (HF). Increasingly, CPET is combined with echocardiography, or invasive right heart catheterization, which enables high-resolution assessment of cardiac and extracardiac limitations to exercise. CPET also represents a cornerstone in the evaluation process for advanced HF interventions. This review underscores the importance and utility of CPET in managing patients with advanced HF.