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1. D2: Exercise and performance > S1: Cardiopulmonary exercise testing > Flashcards

S1: Cardiopulmonary exercise testing Flashcards

1
Q

What does CPET stand for?

A

Cardiopulmonary Exercise Testing

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2
Q

What physiological parameters are measured during CPET?

A

VO2, VCO2, oxygen saturation, ventilation, and heart rate

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3
Q

What is VO2max?

A

The maximal rate of oxygen consumption during exercise

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4
Q

What formula is used to calculate VO2?

A

VO2 = (SV x HR) x (CaO2 - CvO2)

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5
Q

What is the significance of anaerobic threshold in CPET?

A

It indicates the point where lactate accumulation begins

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6
Q

What does a low anaerobic threshold suggest?

A

Poor oxygen delivery, often due to cardiovascular or pulmonary limitations

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7
Q

What is the respiratory exchange ratio (RER)?

A

The ratio of VCO2 to VO2

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8
Q

What is the ‘nine-panel plot’ in CPET?

A

A graphical representation of key CPET parameters

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9
Q

What does an increased VE/VCO2 slope indicate?

A

Reduced ventilatory efficiency or hyperventilation

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10
Q

How is maximum ventilation predicted during CPET?

A

(FEV1 x 20) + 20

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11
Q

What is oxygen pulse?

A

VO2 divided by heart rate, an indirect measure of stroke volume

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12
Q

What is a normal maximum heart rate during CPET?

A

220 minus age

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13
Q

What does a low heart rate reserve suggest in CPET?

A

Non-cardiovascular limitation to exercise

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14
Q

How can CPET help predict surgical outcomes?

A

By assessing anaerobic threshold and overall fitness

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15
Q

What is the ventilatory compensation point?

A

The point where ventilation increases disproportionately to CO2 production

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16
Q

How does CPET differentiate causes of breathlessness?

A

By analyzing patterns of VO2, VCO2, and ventilation

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17
Q

What is the normal VO2 at rest?

A

Approximately 250 ml/min

18
Q

How does body habitus affect VO2max?

A

Larger body size often increases absolute VO2max

19
Q

Why is VO2max a key indicator of cardiorespiratory fitness?

A

It correlates with endurance and mortality risk

20
Q

What is the significance of the A-a gradient in CPET?

A

It helps identify oxygenation issues during exercise

21
Q

How does hyperventilation appear in a VE/VCO2 slope?

A

As an increased slope, often due to acidosis or anxiety

22
Q

What does a reduced VE/VO2 ratio indicate?

A

Improved ventilatory efficiency

23
Q

What is the relationship between cardiac output and VO2?

A

Cardiac output is a primary determinant of VO2

24
Q

What did Myers et al.’s study conclude about exercise capacity?

A

It is a powerful predictor of mortality

25
Q

What is the predicted VO2max formula?

A

VO2max (ml/kg/min) ≈ 50 - (0.4 x age in years)

26
Q

Why are ventilatory equivalents important in CPET?

A

They measure the efficiency of ventilation in clearing CO2 and taking in O2

27
Q

How is stroke volume estimated during CPET?

A

Using oxygen pulse (VO2/HR)

28
Q

What is a hallmark of ventilatory limitation during CPET?

A

Maximum ventilation approaching predicted levels

29
Q

What is the clinical utility of CPET in heart failure?

A

Assessing functional capacity and prognosis

30
Q

What is the significance of the anaerobic threshold for surgery?

A

Lower thresholds are associated with higher surgical risk

31
Q

What parameters are analyzed to assess ventilatory efficiency?

A

VE/VCO2 and VE/VO2 ratios

32
Q

How is heart rate recovery analyzed in CPET?

A

By assessing the rate of HR decline post-exercise

33
Q

What is the impact of beta blockers on CPET results?

A

They may affect heart rate response and exercise capacity

34
Q

What does CPET reveal about pulmonary vascular disease?

A

Desaturation during exercise indicates potential vascular issues

35
Q

What role does CPET play in managing unexplained breathlessness?

A

Identifies potential cardiorespiratory limitations

36
Q

What is the VO2 plateau, and why is it important?

A

The point where oxygen uptake no longer increases with workload

37
Q

How does exercise training modify surgical risk?

A

By improving anaerobic threshold and cardiorespiratory fitness

38
Q

What is the relevance of VE/VCO2 slope in heart failure prognosis?

A

Higher slopes indicate worse outcomes

39
Q

How does CPET contribute to evaluating fitness for surgery?

A

By identifying cardiorespiratory reserves and limitations

40
Q

What is the link between CPET findings and mortality?

A

Markers of low fitness, like low VO2max, correlate with higher risk

1. D2: Exercise and performance (9 decks)

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