Dumitrescu D, Rosenkranz S.

Ann Am Thorac Soc. 2017 Jul;14(Supplement_1):S12-S21. doi:
10.1513/AnnalsATS.201612-955FR

Cardiopulmonary exercise testing is a well-known, valuable tool in the clinical
evaluation of patients with different causes of exercise limitation and
unexplained dyspnea. A wealth of data is generated by each individual test. This
may be challenging regarding a comprehensive and reliable interpretation of an
exercise study in a timely manner. An optimized graphical display of exercise
data may substantially help to improve the efficacy and reliability of the
interpretation process. However, there are limited and heterogeneous
recommendations on standardized graphical display in current exercise testing
guidelines. To date, a widely used three-by-three array of specifically arranged
graphical panels known as the “nine-panel plot” is probably the most common
method of plotting exercise gas exchange data in a standardized way. Furthermore,
optimized scaling of the plots, the use of colors and style elements, as well as
suitable averaging methods have to be considered to achieve a high level of
quality and reproducibility of the results. Specific plots of key parameters may
allow a fast and reliable visual determination of important diagnostic and
prognostic markers in cardiac and pulmonary diseases.