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Cardiopulmonary stress testing in clinical practice

Cardiopulmonary stress testing (CPT) is a very useful tool to determine the diagnosis and prognosis in clinical practice. The objective of this study is to demonstrate that data obtained in a laboratory outside the hospital are similar to those described in the literature. METHODOLOGY: Patients were submitted to CPT, treadmill ramp protocol, and 13 lead electrocardiogram to evaluate CPT in the clinical practice. RESULTS: Among 261 CPT, 53.3% were male, mean age 48.2 ± 14.3 years, with active (45.2%) or sedentary (34.5%) lifestyle. Male patients showed higher maximal aerobic capacity (<img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2 max) and a significant decrease of <img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2 for each ten years of increment in age, but it decreased from 30 to 69 years in females. Females showed a significant higher (p = 0.0006) distribution in functional classes described as "in training programs or well trained and high motivation". A <img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2 max was superior in maximal effort tests, but anaerobic threshold (<img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2AT) did not show differences between maximal or submaximal tests. The functionalcapacity evaluated by <img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2AT as a fraction (%) of the <img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2 max predicted in comparison to the fraction of the <img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2 max measured was more rigorous, which implies a higher number of patients with circulatory impairment (p = 0.002) and also with lower physical capacity as opposed to active patients or patients under training programs (p < 0.00001); however, between 50.0% and 59.0% of the patients could be classified equally by one or the other criteria (p = 0.221). The more frequent abnormality in CPT was that it did not achieve 85.0% of the <img border=0 width=32 height=32 src="../../../../../img/revistas/rbme/v6n6/V-com-pontinho-menor.gif">O2 max predicted, more significant for females. CONCLUSION: Despite the limitations, this experience indicates that CPT data are reproducible in a laboratory outside the hospital, suggesting that CPT may be applied in clinical practice.

Spirometry; Cardiopulmonary exercise testing; Spiroer-gometry


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