RT Journal Article
SR Electronic
T1 Identifying limitations to exercise with incremental cardiopulmonary exercise testing: a scoping review
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 240010
DO 10.1183/16000617.0010-2024
VO 33
IS 173
A1 Staes, Michaël
A1 Gyselinck, Iwein
A1 Goetschalckx, Kaatje
A1 Troosters, Thierry
A1 Janssens, Wim
YR 2024
UL https://publications.ersnet.org//content/33/173/240010.abstract
AB Cardiopulmonary exercise testing (CPET) is a comprehensive and invaluable assessment used to identify the mechanisms that limit exercise capacity. However, its interpretation remains poorly standardised. This scoping review aims to investigate which limitations to exercise are differentiated by the use of incremental CPET in literature and which criteria are used to identify them. We performed a systematic, electronic literature search of PubMed, Embase, Cochrane CENTRAL, Web of Science and Scopus. All types of publications that reported identification criteria for at least one limitation to exercise based on clinical parameters and CPET variables were eligible for inclusion. 86 publications were included, of which 57 were primary literature and 29 were secondary literature. In general, at the level of the cardiovascular system, a distinction was often made between a normal physiological limitation and a pathological one. Within the respiratory system, ventilatory limitation, commonly identified by a low breathing reserve, and gas exchange limitation, mostly identified by a high minute ventilation/carbon dioxide production slope and/or oxygen desaturation, were often described. Multiple terms were used to describe a limitation in the peripheral muscle, but all variables used to identify this limitation lacked specificity. Deconditioning was a frequently mentioned exercise limiting factor, but there was no consensus on how to identify it through CPET. There is large heterogeneity in the terminology, the classification and the identification criteria of limitations to exercise that are distinguished using incremental CPET. Standardising the interpretation of CPET is essential to establish an objective and consistent framework.There is large heterogeneity in the interpretive strategies to identify limitations to exercise with CPET. To provide a framework for objective and consistent CPET interpretation, there is a need for standardisation of CPET interpretation. https://bit.ly/3Vs3cHE