Cardiopulmonary exercise testing in patients with pulmonary hypertension: clinical recommendations based on a review of the evidence

Expert Review of Respiratory Medicine
Sherry PinkstaffRoss Arena

Abstract

Pulmonary hypertension (PH) remains an ominous diagnosis despite advances in pharmacological and surgical therapy. Early and effective diagnosis is important for clinicians making treatment determinations and patients wishing to understand the prognostic implications of their illness. Cardiopulmonary exercise testing (CPX) has the power to reveal the underlying pathophysiological consequences of the disease process. Research, especially over the last 10-15 years, has demonstrated the utility of this tool. Several CPX variables have been shown to be consistently altered in patients with PH and more so as severity of disease increases. However, to further enhance clinical application, additional research is needed to better define optimal CPX measures and associated cutoff values. This paper gives class-based recommendations with associated levels of evidence for the use of CPX in the PH patient population.

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Citations

Apr 5, 2017·Annals of the American Thoracic Society·Jason WeatheraldPierantonio Laveneziana
Feb 9, 2018·Journal of Applied Physiology·Simon Green, Christopher Askew
Aug 5, 2020·Expert Review of Cardiovascular Therapy·Ross ArenaAntonio Abbate
May 26, 2018·Expert Review of Respiratory Medicine·Abraham Samuel BabuJonathan Myers
Oct 30, 2020·Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine·Sahachat AueyingsakBurabha Pussadhamma
Feb 25, 2021·European Journal of Preventive Cardiology·Simon Green, Deidre Stuart
Dec 19, 2020·The European Respiratory Journal·Marion DelcroixGérald Simonneau

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