Illustration of healthy lungs intertwined with an ECG tracing, symbolizing cardiopulmonary function for pulmonary hypertension management.

Pulmonary Hypertension: Can Exercise Testing Help?

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"A New Study Reveals How Cardiopulmonary Exercise Testing Can Improve Outcomes in Pulmonary Arterial Hypertension"

Pulmonary arterial hypertension (PAH) is a serious condition that affects the arteries in your lungs, making it harder for your heart to pump blood. While there are many treatments available, managing PAH can be challenging. Doctors need ways to accurately assess how well treatments are working and predict who is at risk of getting worse.

Traditionally, doctors have relied on methods like the World Health Organization (WHO) functional class, regular check-ups, and imaging to monitor PAH. However, a recent study published in the Journal of Heart and Lung Transplantation suggests that cardiopulmonary exercise testing (CPET) could provide valuable additional information.

CPET is a non-invasive test that measures how your heart and lungs respond to exercise. It can reveal important details about your cardiovascular health that might not be apparent at rest. This article will break down the study's findings and explain how CPET can help personalize PAH treatment and improve patient outcomes.

What is Cardiopulmonary Exercise Testing (CPET) and Why Does It Matter?

Illustration of healthy lungs intertwined with an ECG tracing, symbolizing cardiopulmonary function for pulmonary hypertension management.

Cardiopulmonary exercise testing (CPET) goes beyond a typical stress test. It provides a comprehensive evaluation of your heart and lungs as you exercise, measuring:

The new study looked at the value of CPET in low risk Pulmonary arterial hypertension patients with cardiac index (CI) ≥ 2.5 l/min/m² and right atrial pressure (RAP) < 8 mmHg.

Oxygen Uptake (VO2): How efficiently your body uses oxygen.
Carbon Dioxide Output (VCO2): How well your body eliminates carbon dioxide.
Minute Ventilation (VE): The amount of air you breathe per minute.
Heart Rate Response: How your heart rate changes with exertion.
Blood Pressure Response: How your blood pressure responds to exercise.

By analyzing these measurements, doctors can gain a deeper understanding of your cardiovascular fitness and identify any limitations that may be affecting your PAH. These variables, VO2 peak and ACI independently improved the power of the prognostic model. This information can then be used to tailor your treatment plan and monitor your progress over time.

The Future of PAH Management: Personalized Care Through CPET

While more research is always needed, this study provides compelling evidence that CPET can play a valuable role in the management of PAH. By incorporating CPET into routine follow-up, doctors can gain a more complete picture of their patients' health, personalize treatment plans, and ultimately improve long-term outcomes. If you have PAH, talk to your doctor about whether CPET is right for you. This simple test could be a powerful tool in helping you live a longer, healthier life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.healun.2018.11.015, Alternate LINK

Title: The Added Value Of Cardiopulmonary Exercise Testing In The Follow-Up Of Pulmonary Arterial Hypertension

Subject: Transplantation

Journal: The Journal of Heart and Lung Transplantation

Publisher: Elsevier BV

Authors: Roberto Badagliacca, Silvia Papa, Roberto Poscia, Gabriele Valli, Beatrice Pezzuto, Giovanna Manzi, Roberto Torre, Daniele Gianfrilli, Susanna Sciomer, Paolo Palange, Robert Naeije, Francesco Fedele, Carmine Dario Vizza

Published: 2019-03-01

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Everything You Need To Know

1

What exactly is Cardiopulmonary Exercise Testing (CPET), and what does it do?

Cardiopulmonary exercise testing (CPET) is a non-invasive test that assesses how your heart and lungs function during exercise. It measures several key parameters, including oxygen uptake (VO2), carbon dioxide output (VCO2), minute ventilation (VE), heart rate response, and blood pressure response. In the context of Pulmonary Arterial Hypertension (PAH), CPET provides a more comprehensive evaluation of cardiovascular health than traditional methods, potentially revealing limitations not apparent at rest. These measurements help doctors understand how PAH impacts the body during physical activity, which is crucial for personalized treatment.

2

Why is Pulmonary Arterial Hypertension (PAH) a serious condition, and how does CPET relate to it?

Pulmonary Arterial Hypertension (PAH) is a serious condition where the arteries in your lungs become narrowed, making it difficult for the heart to pump blood. This increased strain on the heart can lead to various complications. CPET is significant because it offers a detailed assessment of how PAH affects the cardiovascular system during exercise. Unlike traditional methods like the World Health Organization (WHO) functional class, regular check-ups, and imaging, CPET provides objective data on exercise capacity, which can be used to tailor treatment plans and monitor disease progression more accurately.

3

What specific measurements are taken during Cardiopulmonary Exercise Testing (CPET), and what do they indicate regarding Pulmonary Arterial Hypertension (PAH)?

The specific measurements taken during Cardiopulmonary Exercise Testing (CPET) provide valuable insights into PAH. Oxygen uptake (VO2) reflects how efficiently the body uses oxygen. Carbon dioxide output (VCO2) indicates how well the body eliminates carbon dioxide. Minute ventilation (VE) measures the amount of air breathed per minute. Heart rate and blood pressure responses show how the cardiovascular system adapts to exercise. By analyzing these measurements, doctors can identify limitations caused by PAH, such as reduced exercise capacity. These findings can be used to tailor and monitor the effectiveness of treatments.

4

How does Cardiopulmonary Exercise Testing (CPET) help doctors personalize treatment for Pulmonary Arterial Hypertension (PAH)?

Cardiopulmonary Exercise Testing (CPET) helps doctors personalize PAH treatment in several ways. First, it provides a comprehensive assessment of cardiovascular function during exercise, identifying specific limitations. This detailed information allows doctors to tailor treatment plans to address the unique needs of each patient. Second, CPET can be used to monitor the effectiveness of treatments over time. By tracking changes in CPET measurements, doctors can assess whether a treatment is improving exercise capacity and overall cardiovascular health. This personalized approach aims to improve long-term outcomes by making treatment more targeted and responsive to the patient's condition.

5

What are the potential implications of using Cardiopulmonary Exercise Testing (CPET) in the management of Pulmonary Arterial Hypertension (PAH)?

Incorporating Cardiopulmonary Exercise Testing (CPET) into the management of Pulmonary Arterial Hypertension (PAH) has several implications. It allows for a more complete understanding of a patient's health status, potentially leading to earlier detection of disease progression or treatment failure. This means interventions can be adjusted more quickly and effectively. CPET may improve long-term outcomes by allowing doctors to personalize treatment plans, as well as monitor the efficacy of the treatment. While more research is needed, this study provides compelling evidence that CPET can play a valuable role in the management of PAH, helping to improve patient outcomes and overall quality of life.