Protocol for exercise hemodynamic assessment: performing an invasive cardiopulmonary exercise test in clinical practice

Berry, Natalia
C.; Manyoo, Agarwal; Oldham, William M.; Stephens, Thomas E.;
Goldstein, Ronald H.; Waxman, Aaron B.; Tracy, Julie A.; Leary, Peter
J.; Leopold, Jane A.; Kinlay, Scott; Opotowsky, Alexander R.; Systrom,
David M.; Maron, Bradley A..

Pulmonary Circulation (JSTOR), December 2015, Vol. 5 Issue: Number 4 p610-618, 9p;

Abstract: Invasive cardiopulmonary exercise testing (iCPET) combines full central
hemodynamic assessment with continuous measurements of pulmonary gas
exchange and ventilation to help in understanding the pathophysiology
underpinning unexplained exertional intolerance. There is increasing
evidence to support the use of iCPET as a key methodology for
diagnosing heart failure with preserved ejection fraction and
exercise-induced pulmonary hypertension as occult causes of exercise
limitation, but there is little information available outlining the
methodology to use this diagnostic test in clinical practice. To bridge
this knowledge gap, the operational protocol for iCPET at our
institution is discussed in detail. In turn, a standardized iCPET
protocol may provide a common framework to describe the evolving
understanding of mechanism(s) that limit exercise capacity and to
facilitate research efforts to define novel treatments in these