Cardiopulmonary exercise testing and its application

Cardiopulmonary exercise testing (CPET) has grown in importance as a clinical tool for assessing exercise capacity and predicting outcomes in patients with heart failure and other cardiac conditions. It assesses integrative exercise responses involving the cardiovascular, and skeletal muscle systems, which are not adequately reflected by individual organ system function measurement. CPET system is increasingly being used in a wide range of clinical applications to evaluate undiagnosed exercise and to objectively determine functional capacity.

Cardiopulmonary exercise testing (CPET) is the study of the cardiovascular and respiratory systems’ responses to known exercise stress. This is because gas exchange in the airway is a result of cardiac output, pulmonary blood flow, and peripheral O2 extraction coupled to ventilation. The patient exercises on a Treadmill or a Bicycle Ergometer for a set amount of time and grade. This exercise test can be used to manage patients undergoing lung and heart surgery, COPD, cardio and respiratory disease, and as a training tool in athletes. Cardio Pulmonary Test System is primarily concerned with the analysis of respiratory gases, and the applications are as follows:

1. Respiratory oxygen uptake (Vo2): Oxygen uptake (Vo2) is determined by cellular O2 demand up to a certain level that corresponds to the maximal rate of O2 transport, after which it is determined by that maximal rate of transport. As external work increases, one or more of the determinants of Vo2 approach limitations like heart rate, stroke, or tissue extraction.
2. Carbon dioxide production (Vco2): The ratio of carbon dioxide output (Vco2/Vo2) is known as the gas exchange ratio or respiratory exchange ratio (RER). The term “RQ” is frequently used to describe events at the tissue level that are difficult to measure. The term “RER” is usually measured by the gas exchange at the mouth, and the blood , gas transport systems keep up with tissue metabolism.
3. Ventilatory anaerobic threshold: The ventilatory anaerobic threshold (VAT), formerly known as the anaerobic threshold, is a measure of exercise capacity. Because muscle lactic acid production is minimal, blood lactate levels do not change significantly during this phase.

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