Cardiopulmonary exercise test (CPET) has been gaining importance as a method of
functional assessment in Brazil and worldwide. In its most frequent
applications, CPET consists in applying a gradually increasing intensity
exercise until exhaustion or until the appearance of limiting symptoms and/or
signs. The following parameters are measured: ventilation; oxygen consumption
(VO2); carbon dioxide production (VCO2); and the other
variables of conventional exercise testing. In addition, in specific situations,
pulse oximetry and flow-volume loops during and after exertion are measured. The
CPET provides joint data analysis that allows complete assessment of the
cardiovascular, respiratory, muscular and metabolic systems during exertion,
being considered gold standard for cardiorespiratory functional
assessment.1-6The CPET allows defining mechanisms related to low functional capacity that can
cause symptoms, such as dyspnea, and correlate them with changes in the
cardiovascular, pulmonary and skeletal muscle systems. Furthermore, it can be
used to provide the prognostic assessment of patients with heart or lung
diseases, and in the preoperative period, in addition to aiding in a more
careful exercise prescription to healthy subjects, athletes and patients with
heart or lung diseases.Similarly to CPET clinical use, its research also increases, with the publication
of several scientific contributions from Brazilian researchers in high-impact
journals.Therefore, this study aimed at providing a comprehensive review on the
applicability of CPET to different clinical situations, in addition to serving
as a practical guide for the interpretation of that test.
Nota: These guidelines are for information purposes and should not replace the clinical judgment of a physician, who must ultimately determine the appropriate treatment for each patient.
Classe I: evidência ou concordância geral de que o tratamento é benéfico, útil e eficaz.Classe II: evidência conflitante e/ou divergência de opinião quanto à utilidade e à eficácia do tratamento.Classe IIa: forças das evidências/opiniões em favor da utilidade e da eficácia.Classe IIb: forças das evidências/opiniões menos bem estabelecidas quanto à utilidade e à eficácia.Classe III: evidência ou concordância geral de que o tratamento não é útil/eficaz e em alguns casos pode ser prejudicial.
Nível de evidência A: presença de múltiplos estudos clínicos randomizados.Nível de evidência B: presença de um único estudo clínico randomizado ou de estudos não-randomizados.Nível de evidência C: consenso de especialistas.O nível de evidência será apresentado apenas para os tratamentos do infarto do miocárdio, não se aplicando aos procedimentos diagnósticos. Todos os métodos complementares deverão ser realizados por profissionais experientes, segundo as recomendações específicas de cada especialidade.
Among asymptomatic patients undergoing stress testing, delayed HRR was independently associated with early and late stages of PHT. Further studies are needed to determine the usefulness of measuring HRR in the prevention and management of hypertension.
Nota: Estas diretrizes se prestam a informar e não a substituir o julgamento clínico do médico que, em última análise, deve determinar o tratamento apropriado para seus pacientes.
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