ReviewEuropean heart journal. Imaging methods and practice2023
Combining cardiopulmonary exercise testing with echocardiography: a multiparametric approach to the cardiovascular and cardiopulmonary systems.
Review in European heart journal. Imaging methods and practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed.
- Cardiopulmonary Exercise Testing and Exercise Stress Echocardiography in Degenerative Mitral Regurgitation: An Exploratory Analysis of Functional and Left Ventricular Outcomes After Surgery.Journal of cardiovascular development and disease · 2026Article
- Distinct Exercise Response Patterns in Patients With Heart Failure With Preserved Ejection Fraction.Journal of the American Heart Association · 2026Article
- Update in Perioperative Ischemic Workup: Integrating 2024 AHA/ACC Guidelines and Contemporary Evidence.Journal of cardiovascular development and disease · 2026Review
- Integrating Cardiopulmonary Exercise Testing, Stress Echocardiography and Near-Infrared Spectroscopy for Multimodal Assessment of Exercise Intolerance: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Functional Assessment of Hypertrophic Phenotype Cardiomyopathies Using Combined Cardiopulmonary Exercise Testing and Echocardiography: A Pilot Single-Centre Study.Journal of clinical medicine · 2026Article
- The Prognostic Value of Exercise Stress Echocardiography in Asymptomatic Moderate and Severe Aortic Stenosis: A Systematic Review of Stress-Derived Hemodynamic and Functional Markers.Journal of clinical medicine · 2026Review
- A multicomponent cardiac rehabilitation programme as a safe, feasible, and beneficial approach, including patients with left ventricular assist devices: a case report.European heart journal. Case reports · 2026Article
- Integrating Cardiopulmonary Exercise Testing in the Assessment of Aortic Stenosis: A Comprehensive Review.Healthcare (Basel, Switzerland) · 2026Review
- Artificial intelligence-based characterization of multi-organ ultrasound congestion across the heart failure Spectrum.European heart journal. Imaging methods and practice · 2026Review
- Influence of Endurance Training, High-Intensity Interval Training, and Acute Exercise on Left Ventricular Mechanics: A Systematic Review.Journal of clinical medicine · 2025Review
- Advancing Cardiovascular Risk Stratification and Functional Assessment: A Narrative Review of CPET and ESE Applications.Healthcare (Basel, Switzerland) · 2025Review
- Biomarkers of aging: from molecules and surrogates to physiology and function.Physiological reviews · 2025Review
- Cardiopulmonary exercise testing as a prognosis-assessing tool in heart failure with preserved ejection fraction.ESC heart failure · 2025Observational
- Comprehensive exploration of unexplained dyspnoea in subjects with normal ejection fraction and low natriuretic peptides.ESC heart failure · 2025Article
- Circulating mitochondrial DNA signature in cardiometabolic patients.Cardiovascular diabetology · 2025Article
- Cardiopulmonary exercise test with bicycle stress echocardiography for predicting adverse cardiac events in patients with stage A or B heart failure.American journal of preventive cardiology · 2025Article
- Integrative assessment of congestion in heart failure using ultrasound imaging.Internal and emergency medicine · 2025Review
- Long-term cardiovascular consequences of cancer therapy-related cardiac dysfunction: insights from ventricular-arterial coupling and myocardial work.European heart journal. Imaging methods and practice · 2025Article
- Advancing Cardiac Amyloidosis Care Through Insights from Cardiopulmonary Exercise Testing.Journal of clinical medicine · 2024Review
- Biventricular responses to exercise and their relation to cardiorespiratory fitness in pediatric pulmonary hypertension.American journal of physiology. Heart and circulatory physiology · 2024Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Exercise intolerance is a prominent feature of several cardiovascular conditions. However, the physical effort requires the intertwined adaptation of several factors, namely the cardiovascular system, the lungs, and peripheral muscles. Several abnormalities in each domain may be present in a given patient. Cardiopulmonary exercise testing (CPET) has been used to investigate metabolic and ventilatory alterations responsible for exercise intolerance but does not allow for direct evaluation of cardiovascular function. However, this can readily be obtained by concomitant exercise-stress echocardiography (ESE). The combined CPET-ESE approach allows for precise and thorough phenotyping of the pathophysiologic mechanisms underpinning exercise intolerance. Thus, it can be used to refine the diagnostic workup of patients with dyspnoea of unknown origin, as well as improve risk stratification and potentially guide the therapeutic approach in specific conditions, including left and right heart failure or valvular heart disease. However, given its hitherto sporadic use, both the conceptual and technical aspects of CPET-ESE are often poorly known by the clinician. Improving knowledge in this field could significantly aid in anticipating individual disease trajectories and tailoring treatment strategies accordingly. Therefore, we designed this review to revise the pathophysiologic correlates of exercise intolerance, the practical principles of the combined CPET-ESE examination, and its main applications according to current literature.
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