Introduction

This book is intended for clinicians who want to become proficient in the use of formal exercise testing as a tool for diagnostic evaluation of patients with exercise limitation. The material in this book is focused on the measurements acquired during a standard maximal progressive work exercise test utilizing either a cycle ergometer or a treadmill. The respiratory, cardiac, and metabolic measurements acquired during the test provide unique insights into the pathophysiology contributing to a patient's exercise limitation. In addition, the test results can be used to establish risk profiles for patients with known cardiac and respiratory diseases and to provide insight into performance impairments that have developed in athletes. While maximal exercise capacity and maximal oxygen uptake measured during a progressive work test are ordinarily determined by the maximal cardiac output, the role of respiratory impairment or muscle abnormalities may also play a role in different disease conditions.