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CPET Characteristics in HFrEF, HFpEF and COPD
Yuqing Zhou1, Guimei Wang1, Xiaohong Wu1
1Department of Respirology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
Journal of Clinical Medicine
|July 28, 2026
Summary
Cardiopulmonary exercise testing (CPET) helps differentiate chronic obstructive pulmonary disease (COPD) from heart failure (HF) and their combined forms. CPET provides a dynamic assessment crucial for diagnosing and managing these complex cardiopulmonary conditions.
Area of Science:
- Cardiology
- Pulmonology
- Exercise Physiology
Background:
- Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist, presenting overlapping symptoms like dyspnea and reduced exercise tolerance.
- Distinguishing between COPD, HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and their combined syndromes (HFrEF-COPD, HFpEF-COPD) is diagnostically challenging.
- Traditional static diagnostic methods are frequently inadequate for differentiating these conditions.
Purpose of the Study:
- To review the characteristic cardiopulmonary exercise testing (CPET) profiles for isolated HFrEF, HFpEF, COPD, and their overlapping syndromes.
- To highlight CPET's role in the dynamic, integrated assessment of cardiopulmonary systems during exercise.
- To emphasize the utility of integrating CPET with pulmonary function testing for diagnosis and prognosis.
Main Methods:
- Comprehensive review of existing literature on CPET in patients with COPD and HF.
- Analysis of characteristic CPET parameters for isolated and combined cardiopulmonary diseases.
- Discussion on integrating CPET findings with pulmonary function tests.
Main Results:
- CPET offers a unique dynamic assessment of respiratory, cardiovascular, and peripheral muscle function during incremental exercise.
- Distinct CPET profiles can characterize isolated HFrEF, HFpEF, COPD, and their coexisting syndromes.
- Integration of CPET and pulmonary function testing enhances diagnostic accuracy and prognostic stratification.
Conclusions:
- CPET is essential for understanding pathophysiological mechanisms underlying exercise limitation in complex cardiopulmonary diseases.
- Combining CPET with pulmonary function tests provides a comprehensive cardiopulmonary assessment.
- Further standardization of CPET and future research are needed for precision medicine in these patients.
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