ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

Thomas Radtke; Sarah Crook; Georgios Kaltsakas; Zafeiris Louvaris; Danilo Berton; Don S. Urquhart; Asterios Kampouras; Roberto A. Rabinovich; Samuel Verges; Dimitris Kontopidis; Jeanette Boyd; Thomy Tonia; Daniel Langer; Jana De Brandt; Yvonne M.J. Goërtz; Chris Burtin; Martijn A. Spruit; Dionne C.W. Braeken; Sauwaluk Dacha; Frits M.E. Franssen; Pierantonio Laveneziana; Ernst Eber; Thierry Troosters; J. Alberto Neder; Milo A. Puhan; Richard Casaburi; Ioannis Vogiatzis; Helge Hebestreit

doi:10.1183/16000617.0101-2018

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

Thomas Radtke, Sarah Crook, Georgios Kaltsakas, Zafeiris Louvaris, Danilo Berton, Don S. Urquhart, Asterios Kampouras, Roberto A. Rabinovich, Samuel Verges, Dimitris Kontopidis, Jeanette Boyd, Thomy Tonia, Daniel Langer, Jana De Brandt, Yvonne M.J. Goërtz, Chris Burtin, Martijn A. Spruit, Dionne C.W. Braeken, Sauwaluk Dacha, Frits M.E. FranssenPierantonio Laveneziana, Ernst Eber, Thierry Troosters, J. Alberto Neder, Milo A. Puhan, Richard Casaburi, Ioannis Vogiatzis, Helge Hebestreit

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Abstract

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2textendash3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB5

Original language	English
Article number	180101
Journal	European Respiratory Review
Volume	28
Issue number	154
Early online date	18 Dec 2019
DOIs	https://doi.org/10.1183/16000617.0101-2018
Publication status	Published - 31 Dec 2019

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Radtke, T., Crook, S., Kaltsakas, G., Louvaris, Z., Berton, D., Urquhart, D. S., Kampouras, A., Rabinovich, R. A., Verges, S., Kontopidis, D., Boyd, J., Tonia, T., Langer, D., De Brandt, J., Goërtz, Y. M. J., Burtin, C., Spruit, M. A., Braeken, D. C. W., Dacha, S., ... Hebestreit, H. (2019). ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases. European Respiratory Review, 28(154), Article 180101. https://doi.org/10.1183/16000617.0101-2018

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title = "ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases",

abstract = "The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2textendash3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB5",

author = "Thomas Radtke and Sarah Crook and Georgios Kaltsakas and Zafeiris Louvaris and Danilo Berton and Urquhart, {Don S.} and Asterios Kampouras and Rabinovich, {Roberto A.} and Samuel Verges and Dimitris Kontopidis and Jeanette Boyd and Thomy Tonia and Daniel Langer and {De Brandt}, Jana and Go{\"e}rtz, {Yvonne M.J.} and Chris Burtin and Spruit, {Martijn A.} and Braeken, {Dionne C.W.} and Sauwaluk Dacha and Franssen, {Frits M.E.} and Pierantonio Laveneziana and Ernst Eber and Thierry Troosters and Neder, {J. Alberto} and Puhan, {Milo A.} and Richard Casaburi and Ioannis Vogiatzis and Helge Hebestreit",

year = "2019",

month = dec,

day = "31",

doi = "10.1183/16000617.0101-2018",

language = "English",

volume = "28",

journal = "European Respiratory Review",

issn = "0905-9180",

publisher = "European Respiratory Society",

number = "154",

}

Radtke, T, Crook, S, Kaltsakas, G, Louvaris, Z, Berton, D, Urquhart, DS, Kampouras, A, Rabinovich, RA, Verges, S, Kontopidis, D, Boyd, J, Tonia, T, Langer, D, De Brandt, J, Goërtz, YMJ, Burtin, C, Spruit, MA, Braeken, DCW, Dacha, S, Franssen, FME, Laveneziana, P, Eber, E, Troosters, T, Neder, JA, Puhan, MA, Casaburi, R, Vogiatzis, I & Hebestreit, H 2019, 'ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases', European Respiratory Review, vol. 28, no. 154, 180101. https://doi.org/10.1183/16000617.0101-2018

TY - JOUR

T1 - ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

AU - Radtke, Thomas

AU - Crook, Sarah

AU - Kaltsakas, Georgios

AU - Louvaris, Zafeiris

AU - Berton, Danilo

AU - Urquhart, Don S.

AU - Kampouras, Asterios

AU - Rabinovich, Roberto A.

AU - Verges, Samuel

AU - Kontopidis, Dimitris

AU - Boyd, Jeanette

AU - Tonia, Thomy

AU - Langer, Daniel

AU - De Brandt, Jana

AU - Goërtz, Yvonne M.J.

AU - Burtin, Chris

AU - Spruit, Martijn A.

AU - Braeken, Dionne C.W.

AU - Dacha, Sauwaluk

AU - Franssen, Frits M.E.

AU - Laveneziana, Pierantonio

AU - Eber, Ernst

AU - Troosters, Thierry

AU - Neder, J. Alberto

AU - Puhan, Milo A.

AU - Casaburi, Richard

AU - Vogiatzis, Ioannis

AU - Hebestreit, Helge

PY - 2019/12/31

Y1 - 2019/12/31

N2 - The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2textendash3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB5

AB - The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2textendash3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB5

U2 - 10.1183/16000617.0101-2018

DO - 10.1183/16000617.0101-2018

M3 - Article

SN - 0905-9180

VL - 28

JO - European Respiratory Review

JF - European Respiratory Review

IS - 154

M1 - 180101

ER -

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

Abstract

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