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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177 Citations (Scopus)
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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.
Original languageEnglish
Article number180101
JournalEuropean Respiratory Review
Issue number154
Early online date18 Dec 2019
Publication statusPublished - 31 Dec 2019


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