Method validation of cardiopulmonary exercise testing: intra- and inter-device comparisons across four metabolic...

Area of Science:

• Cardiopulmonary physiology
• Exercise testing technology
• Biomedical engineering

Background:

• Cardiopulmonary exercise testing (CPET) is crucial for evaluating exertional dyspnea and key physiological parameters like peak oxygen uptake (VO2) and the VE/VCO2 slope.
• Variability between different metabolic carts can compromise the accuracy of longitudinal assessments and multicenter clinical trials.
• This study addresses the need to evaluate the consistency and comparability of CPET devices.

Purpose of the Study:

• To assess the intra-device reliability of CPET parameters.
• To compare the inter-device comparability of measurements obtained from different metabolic carts.
• To determine if standardized conditions can minimize variability in CPET data.

Main Methods:

• A prospective, within-subject study involving 34 healthy adults.
• Eight CPETs were conducted on four different metabolic cart systems (MGC Ultima™ CPX, COSMED Quark CPET™, Schiller PowerCube® Ergo, Vyaire Vyntus™ CPX).
• Standardized protocols, calibration, masks, and timing were employed, with data analyzed for reliability and comparability, including iso-workload evaluations.

Main Results:

• High intra-device reliability was observed for most CPET parameters, including VO2, heart rate, and workload at key physiological points (AT, RCP, peak).
• Minor variances were noted in resting VO2 and peak ventilation between devices.
• While peak VO2 and VE/VCO2 slope up to RCP were comparable, the full VE/VCO2 slope showed significant inter-device differences (p=0.0048).

Conclusions:

• Under standardized conditions, the tested metabolic carts demonstrate high intra-device reliability.
• Inter-device comparability for key CPET parameters like peak VO2 is generally good.
• Standardization is effective in yielding comparable results across different CPET systems, supporting their use in multicenter studies.