Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction. Recommendations for performance and interpretation

Writing committee: Massimo F. Piepoli and Ugo Corrà (Chairmen) (Italy), Pier Giuseppe Agostoni (Italy), Romualdo Belardinelli (Italy), Alain Cohen-Solal (France), Rainer Hambrecht (Germany) and Luc Vanhees (Belgium) Document reviewers committee: Hans Björnstad (Norway), Andrew J.S. Coats (Australia), Darrel P. Francis (UK), Pantaleo Giannuzzi (Italy), Marco Guazzi (Italy), Marco Metra (Italy), Alessandro Mezzani (Italy), Piotr Ponikowski (Poland) and Hugo Saner (Switzerland) Cardiopulmonary exercise testing (CPET) provides a global assessment of the integrated response to exercise involving the pulmonary, cardiovascular, haematopoietic, neuropsychological, and skeletal muscle systems. Measurement of expiratory gases during exercise allows the best estimate of functional capacity, grading of the severity of functional impairment, objective evaluation of the response to interventions that may affect exercise capacity, objective tracking of the progression of disease that may limit exercise capacity, and assisting in differentiating cardiac from pulmonary limitations in exercise capacity. In conclusion, CPET is a non-invasive tool that provides the physician with relevant information for clinical decision-making.