Cardiopulmonary exercise test interpretation using age-matched controls to evaluate exertional dyspnea

Joshua M. Sill, Michael J. Morris, James E. Johnson, Patrick F. Allan, Vincent X. Grbach

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Cardiopulmonary exercise testing (CPKT) is one method to diagnose unexplained dyspnea in young adults, yet few normal reference values exist in this population. This study evaluated interpretation of maximal CPET in a young adult cohort with known pulmonary disorders using published reference values compared to agematched normal controls. Methods: A control population of 69 healthy military volunteers with normal chest radiographs, pulmonary function testing, and bronchoprovocation testing were compared to 105 patients with exertional dyspnea. Both groups underwent a standardized evaluation including CPET on a graded exercise treadmill to maximal exercise with expired gas analysis. Results: Measurements from CPET in the dyspnea group were interpreted using published reference values compared to control population results (mean± 1.65 × SD). Statistical comparison of predicted normals (reference vs. control) of maximal oxygen consumption (>83% vs. 82%), ventilatory anaerobic threshold (>40% vs. 53%), respiratory rate (<60 vs. 56 breaths/min). tidal volume to inspiratory capacity (<80% vs. 111%), ventilatory equivalent for carbon dioxide production (<40 vs. 38), and maximal voluntary ventilation minus minute ventilation (>11 vs.-1 L/min) was performed. The overall specificity for tidal volume to inspiratory capacity improved using agematched controls but sensitivity was decreased. Other parameters were not significantly different. Conclusions: The use of age-matched controls for CPET results in an increase in specificity and decrease in sensitivity for respiratory limitations to exercise. when compared to reference values. The study findings suggest that CPET may be insensitive in detecting mild disease in young healthy adults.

Original languageEnglish
Pages (from-to)1177-1182
Number of pages6
JournalMilitary Medicine
Issue number11
StatePublished - Nov 2009
Externally publishedYes


Dive into the research topics of 'Cardiopulmonary exercise test interpretation using age-matched controls to evaluate exertional dyspnea'. Together they form a unique fingerprint.

Cite this