Physiological Principles of Cardiopulmonary Exercise Testing

Of all currently available exercise tests, cardiopulmonary exercise testing (CPET) represents the gold standard that provides the most accurate and objective measure of cardiorespiratory fitness. This is achieved through a comprehensive evaluation of the pulmonary, cardiovascular, hematopoetic, neuropsychological, skeletal muscular and cellular oxidative systems involved in the (patho)physiological response to exercise. Therefore, CPET is ideally suited to quantify exercise tolerance and evaluate the underlying mechanism(s) of exertional dyspnea and exercise limitation in many clinical conditions. CPET can be seen a complex test that requires specific knowledge of exercise physiology and gas exchange. The physiological principles required for understanding CPET are typically complex to teach, and comprehensive presentations may be initially considered too impractical. In this mini review we briefly describe the basics of exercise physiology and the key parameters that are vital for the understanding and interpretation of CPET.