Exercise Testing in Chronic Respiratory Diseases: Basics and Clinical Implications
Dennis O'Donnell 1, Nicolle J. Domnik 1, J. Alberto Neder 1
1 Division of Respiratory Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
*Correspondence: Dennis O'Donnell, Email not available
Abstract
Dyspnoea and exercise intolerance are common symptoms experienced by patients with various chronic lung diseases. Cardiopulmonary exercise testing provides a unique opportunity to objectively evaluate the respiratory system’s ability to respond to the metabolic stress of exercise. Although widely underutilized, cardiopulmonary exercise testing can help to unravel the underlying mechanisms of exercise intolerance in a given individual. We propose a simple, ordered approach that measures symptom intensity, metabolic and ventilatory control parameters, and dynamic respiratory mechanics during a standardized incremental test to tolerance. The aim of this concise review is to examine exercise pathophysiology in chronic obstructive pulmonary disease and interstitial lung disease. We demonstrate striking similarities in the physiological responses to exercise across these pathologically distinct conditions and provide evidence to support common underlying mechanisms of exertional dyspnoea and reduced exercise capacity. Finally, we discuss the clinical implications of these new advances in exercise pathophysiology in the context of targeted therapeutic manipulation.
