[Cardiopulmonary exercise testing in the management of systemic sclerosis]

Area of Science:

• Cardiology
• Pulmonology
• Rheumatology
• Exercise Physiology

Background:

• Cardiopulmonary complications are the primary cause of mortality in systemic sclerosis (SSc).
• Dyspnoea in SSc has complex and overlapping causes, necessitating a thorough diagnostic strategy.
• Early identification of these complications is vital for improving patient outcomes.

Purpose of the Study:

• To review the clinical utility of cardiopulmonary exercise testing (CPET) in managing SSc.
• To highlight CPET's role in the personalized diagnostic approach for SSc-related complications.
• To emphasize CPET's value in identifying and differentiating causes of exercise limitation in SSc.

Main Methods:

• This review synthesizes current literature on the application of CPET in SSc.
• It examines CPET's integrative assessment of ventilatory, metabolic, cardiovascular, and musculoskeletal functions.
• Focus is placed on CPET's diagnostic and therapeutic guidance capabilities.

Main Results:

• CPET effectively identifies and distinguishes between various mechanisms limiting exercise capacity in SSc patients with dyspnoea.
• It aids in screening for pulmonary arterial hypertension and interstitial lung disease.
• CPET findings can guide therapeutic strategies, including exercise rehabilitation.

Conclusions:

• CPET is a valuable tool for the comprehensive evaluation of SSc patients experiencing dyspnoea.
• Its integrative approach supports personalized diagnostic decision-making for SSc-related cardiopulmonary issues.
• CPET facilitates targeted management and improves the approach to SSc complications.