Knowledge Gaps and Controversies on Cardiopulmonary Exercise Testing in the Assessment of Pulmonary Vascular Disease: An Official Statement of the Pulmonary Vascular Research Institute Exercise and Right Ventricular Function Task Force
Aaron B. Waxman, Abraham Babu, Roberto Badagliacca, Eloara Ferreira, Patty George, Marco Guazzi, Luke Howard, Darlene Kim, Gabor Kovacs, Saad Kubba, David Langleben, Colm McCabe, Thais Menezes, Rudolf Oliveira, Stylianos Orfanos, Inderjit Singh, David Systrom, Ryan Tedford, Rebecca Vanderpool, Carmine Dario Vizza, Franz P. Rischard
https://doi.org/10.1002/pul2.70240
Abstract
Exercise testing has long been essential for evaluating diagnosis, prognosis, and functional status in pulmonary hypertension (PH). Recent advances have clarified its role in defining reference values and prognostic markers. Nonetheless, substantial knowledge gaps persist regarding the implementation of invasive cardiopulmonary exercise testing (iCPET) and its potential to inform pathophysiology and therapeutic decision-making. This statement addresses the knowledge gaps that hinder the application of iCPET and exercise right heart catheterization (RHC) in the assessment of PH. We present research priorities and scenarios in which these tests may clarify drug mechanisms and support PH subphenotyping. An international, multidisciplinary task force of cardiology and pulmonology experts reviewed the literature and formulated consensus recommendations through iterative discussions.
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