[Cardiopulmonary exercise test in cardiology]

In the cardiopneumologic exercise test, a concomitant analysis of respiratory gas exchange is conducted in addition to the usual cardiologic exercise test: After excluding patients with the habitual contraindications, the test must be conducted with a rigorous methodology, with particular care being given to standardizing the equipment settings before each test and in choosing an individualized protocol allowing a maximal test for a duration of no longer than 10 to 12 minutes. This cardiopneumologic exercise test allows a good assessment of the pneumological pathophysiological factors participating in limited exercise capacity of cardiac origin. It can also help the clinician distinguish cardiac from pulmonary dyspnea, particularly by measuring ventilatory reserves at maximum effort. Most importantly, in clinical practice the test provides an objective and reproducible assessment of the patient's exercise capacity. This allows a functional classification useful for therapeutic decision making, as for example when determining the best moment to propose heart transplantation or when prescribing adapted exercise retraining for a heart failure patient. Finally, the exercise test provides objective evidence of symptom improvement, for example after rehabilitation, an improvement which is one of the mainstay objectives of treatment in patients with cardiac-related exercise intolerance.