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Cardiopulmonary exercise testing: Is it time to be included in a routine checkup for a relatively healthy population?

Published:November 21, 2022DOI:https://doi.org/10.1016/j.ijcard.2022.11.028
      Cardiopulmonary exercise testing (CPET) is the gold-standard approach in assessing cardiorespiratory fitness (CRF), the functional capacity of an individual, with an objective method based on peak oxygen consumption (peak VO2). CRF reflects the integrated ability of an individual to transport oxygen from the atmospheric air to the mitochondria of the muscle cells in order to perform physical work and is dependent on a linked chain of processes. Indeed, oxygen is transferred from the alveoli of the lungs (pulmonary ventilation and diffusion), and it travels in cardiovascular system via both ventricles in systole and diastole. Human vasculature has the ability to accommodate and to efficiently transport oxygen by the blood to the organs by matching their oxygen needs. Oxygen arrives to the muscle cells which have the ability to receive and to use the delivered oxygen and the supplied nutrients, with a precise communication according to the metabolic demands. The cardiovascular control center coordinates all appropriate alterations. Clearly, CRF is directly related to the integrated function of all these systems [
      • Guazzi M.
      • Arena R.
      • Halle M.
      • Piepoli M.F.
      • Myers J.
      • Lavie C.J.
      2016 focused update: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations.
      ,
      • Ross R.
      • Blair S.N.
      • Arena R.
      • Church T.S.
      • Després J.P.
      • Franklin B.A.
      • Haskell W.L.
      • Kaminsky L.A.
      • Levine B.D.
      • Lavie C.J.
      • Myers J.
      • Niebauer J.
      • Sallis R.
      • Sawada S.S.
      • Sui X.
      • Wisløff U.
      • American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council on Cardiovascular and Stroke Nursing; Council on Functional Genomics and Translational Biology; Stroke Council
      Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association.
      ].
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