Understanding the Basics of Cardiopulmonary Exercise Testing

Slides:

Advertisements

Similar presentations

Copyright © 2007 Lippincott Williams & Wilkins.McArdle, Katch, and Katch: Exercise Physiology: Energy, Nutrition, and Human Performance, Sixth Edition.

Advertisements

Date of download: 6/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Pulmonary function in primary pulmonary hypertension.

Chapter 28 Exercise Physiology.

My Treatment Approach to Hairy Cell Leukemia Rahul R. Naik, MD, Alan Saven, MD Mayo Clinic Proceedings Volume 87, Issue 1, Pages (January 2012) DOI:

Date of download: 9/18/2016 Copyright © The American College of Cardiology. All rights reserved. From: Cardiopulmonary Exercise Testing in Heart Failure.

From: Incidence, Predictive Factors, and Prognostic Value of New-Onset Atrial Fibrillation Following Transcatheter Aortic Valve Implantation J Am Coll.

Celebrating the Sesquicentennial of Mayo Clinic: 150 Years of Advances in Medical Practice, Education, Research, and Professionalism William L. Lanier,

From: Effects of Pulmonary Rehabilitation on Physiologic and Psychosocial Outcomes in Patients with Chronic Obstructive Pulmonary Disease Ann Intern Med.

Training for Anaerobic and Aerobic Power

Respiration During Exercise (1)

The Utility of Exercise Testing in Patients with Lung Cancer

Hyperbaric Oxygenation in Cardiac and Pulmonary Disease

Exercise Conditioning and Cardiopulmonary Fitness in Cystic Fibrosis

Volume 55, Issue 1, Pages (January 1969)

Managing Cancer Pain: Basic Principles and Invasive Treatments

Expression of Gratitude to Scott C

Ductal Carcinoma in Situ of the Breast

J. Eric Ahlskog, PhD, MD Mayo Clinic Proceedings

Atrial Fibrillation in the 21st Century: A Current Understanding of Risk Factors and Primary Prevention Strategies Arthur R. Menezes, MD, Carl J. Lavie,

James H. O’Keefe, MD, Salman K. Bhatti, MD, Ata Bajwa, MD, James J

Richard V. Milani, MD, Carl J. Lavie, MD, Robert M

Evaluation of Proteinuria

Medical Education in the Clouds

William L. Lanier, MD Mayo Clinic Proceedings

Unexplained Dyspnea Mayo Clinic Proceedings

Junxiu Liu, MD, Xuemei Sui, MD, PhD, Carl J. Lavie, MD, James R

Jayant A. Talwalkar, MD, MPH, Patrick S. Kamath, MD

Can Vitamin D Deficiency Break Your Heart?

Peripheral Arterial Disease: Diagnosis and Management

A System-Based Approach to Depression Management in Primary Care Using the Patient Health Questionnaire-9 Ramona S. DeJesus, MD, Kristin S. Vickers,

Obesity and Heart Failure: Focus on the Obesity Paradox

Palliative Care and Hospice Programs

Management of Patients With Aortic Valve Stenosis

Topical Analgesics in the Management of Acute and Chronic Pain

Martin R. Farlow, MD Mayo Clinic Proceedings

Tracheostomy in Critically Ill Patients

Chronic Obstructive Pulmonary Disease: An Evidence-Based Approach to Treatment With a Focus on Anticholinergic Bronchodilation Nicholas J. Gross, MD,

Body Composition and Heart Failure Prevalence and Prognosis: Getting to the Fat of the Matter in the “Obesity Paradox” Carl J. Lavie, MD, Richard V.

Sexual Activity and Chronic Heart Failure

The Utility of Exercise Testing in Patients with Lung Cancer

The Obesity Paradox, Weight Loss, and Coronary Disease

To B or Not to B: Is Non–High-Density Lipoprotein Cholesterol an Adequate Surrogate for Apolipoprotein B? Carl J. Lavie, MD, Richard V. Milani, MD, James.

Risk Stratification and Interventional Cardiology: Robert L

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation: Physiologic and Educational Rationale for Changes Roger D. White, MD Mayo.

Effects of Running on Chronic Diseases and Cardiovascular and All-Cause Mortality Carl J. Lavie, MD, Duck-chul Lee, PhD, Xuemei Sui, MD, PhD, MPH, Ross.

Magali P. Disdier Moulder, PharmD, PhD, Jenna M

Shannon M. Dunlay, MD, MS, Naveen L. Pereira, MD, Sudhir S

Refurbishing Mayo Clinic Proceedings:

Half a Century of Visual Pattern-Sensitive Epilepsy

Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction

74-Year-Old Woman With Dyspnea on Exertion and Anemia

Expanding the Recognition and Assessment of Bleeding Events Associated With Antiplatelet Therapy in Primary Care Marc Cohen, MD Mayo Clinic Proceedings

Osteoporosis Associated With Megestrol Acetate

Medication Adherence: WHO Cares?

Pulmonary Tumor Embolism of Unknown Origin

Celebrating the Sesquicentennial of Mayo Clinic: 150 Years of Advances in Medical Practice, Education, Research, and Professionalism William L. Lanier,

Strategies for Optimizing Glycemic Control and Cardiovascular Prognosis in Patients With Type 2 Diabetes Mellitus James H. O'Keefe, MD, Mohammad Abuannadi,

Medical Treatment of Overactive Bladder: In Response

Marrick L. Kukin, MD Mayo Clinic Proceedings

Ross Arena, PhD, PT, FAHA, Carl J. Lavie, MD Mayo Clinic Proceedings

Management of Immune Thrombocytopenic Purpura in Adults

Preoperative Smoking Cessation: The Role of the Primary Care Provider

Medical Student Distress: Causes, Consequences, and Proposed Solutions

Autonomic Tone and Benefits of Cardiac Rehabilitation Programs

Managing Cancer Pain: Basic Principles and Invasive Treatments

Marco Guazzi et al. JACC 2017;70:

Diagnosis and Management of Headache in Older Adults

Mayo Clinic Proceedings 2012: “A New Era in Journal Stewardship”

Significance of Comorbid Psychological Stress and Depression on Outcomes After Cardiac Rehabilitation Sergey Kachur, MD, Arthur R. Menezes, MD, Alban.

Presentation transcript:

Understanding the Basics of Cardiopulmonary Exercise Testing Richard V. Milani, MD, Carl J. Lavie, MD, Mandeep R. Mehra, MD, Hector O. Ventura, MD Mayo Clinic Proceedings Volume 81, Issue 12, Pages 1603-1611 (December 2006) DOI: 10.4065/81.12.1603 Copyright © 2006 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Gas transport mechanisms coupling cellular (internal) respiration to pulmonary (external) respiration. Circ = circulation; CO2 = carbon dioxide; Consum = consumption; Creat = creatine; Lac = lactate; HR = heart rate; Mito = mitochondria; PO4 = phosphate; O2= oxygen; Periph = peripheral; Prod = production; Pulm = pulmonary; Pyr = pyruvate; Qco2 = carbon dioxide production; Qo2 = oxygen utilization; SV = stroke volume; Va = minute alveolar ventilation; Vd = minute dead space ventilation; Ve = minute ventilation; Vf = breathing frequency; Vt = tidal volume; co2 = carbon dioxide output; o2 = oxygen uptake. From Principles of Exercise Testing and Interpretation, 3rd ed,7 with permission from Lippincott Williams & Wilkins. Mayo Clinic Proceedings 2006 81, 1603-1611DOI: (10.4065/81.12.1603) Copyright © 2006 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 A patient undergoing a cardiopulmonary stress test. The head harness worn by the patient holds the mouthpiece and nonrebreathing valve that is connected to a metabolic cart to the immediate left of the patient. Mayo Clinic Proceedings 2006 81, 1603-1611DOI: (10.4065/81.12.1603) Copyright © 2006 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Flowchart for the differential diagnosis of exertional dyspnea and fatigue. o2 = oxygen consumption per unit time. From Arch Intern Med12 with permission. Copyright 1988 American Medical Association. All rights reserved. Mayo Clinic Proceedings 2006 81, 1603-1611DOI: (10.4065/81.12.1603) Copyright © 2006 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 4 Kaplan-Meier survival curves using both peak oxygen uptake (Pk o2) of 14 mL/kg per minute and Pk o2 adjusted for lean body mass of 19 mL/kg per minute as cutoffs showing a stronger prognostic value to the fat-adjusted Pk o2 by log-rank testing. From J Am Coll Cardiol,33 with permission from The American College of Cardiology Foundation. Mayo Clinic Proceedings 2006 81, 1603-1611DOI: (10.4065/81.12.1603) Copyright © 2006 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 5 Kaplan-Meier survival curves using both peak oxygen pulse of 10 mL/beat and peak oxygen pulse adjusted for lean body mass of 14 mL/beat as cutoffs for predicting event-free survival. O2 = oxygen. From Am J Cardiol,32 with permission from Elsevier. Mayo Clinic Proceedings 2006 81, 1603-1611DOI: (10.4065/81.12.1603) Copyright © 2006 Mayo Foundation for Medical Education and Research Terms and Conditions