Exercise Intolerance Assessment

Exercise intolerance is one of the most challenging and expensive problems facing the healthcare systems of many countries around the world. The CPET solution provided by MET-TEST takes a multi-organ, systematic approach to tackling this difficult problem.  MET-TEST effectively reproduces the data collection and interpretation processes developed by Dr. Karlman Wasserman and colleagues at Harbor-UCLA1, one of the most respected exercise physiology laboratories in the world. The primary purpose of exercise stress testing should not be to simply look for inducible myocardial ischemia.  MET-TEST extracts a much higher diagnostic yield per test and aims to determine the reason the patient stops exercising at peak workload during a stress test.

The etiology of exercise impairment may be ischemic or non-ischemic in origin.  The reason for stopping exercise is the source of exercise intolerance and hence symptoms.  This information can then be used to pinpoint more precise therapies.  If the therapy is effective, then the patients exercise capacity must increase and can be objectively verified with serial testing.

If there are multiple reasons for exercise intolerance as is common in clinical practice, a step-wise approach can be used to identify the predominating cause of exercise intolerance and prioritize the appropriate therapies in proper sequence to ensure that the desired goal of alleviating symptoms and restoring exercise capacity is attained.  Deterioration in functional capacity is strongly linked to increased morbidity and mortality.  Long term healthcare costs relating to heart and lung disease can best be contained by identifying and treating disease processes at an earlier stage.

After 8 years of extensive testing in community based clinics, MET-TEST has developed a systematic approach in the evaluation and treatment of patients with exercise intolerance.  This approach is field tested and proven to be clinically effective in the real world where the rubber meets the road.  It heralds an era of customized therapy based upon individual physiological responses of patients during exercise.

1. Wasserman K, Hansen JE, Sue DY, Stringer WW, Whipp BJ. Principles of Exercise Testing and Interpretation, 4th edition, Lippincott Williams and Wilkins, Philadelphia, 2005.

2. Arena R, Myers J et al. Assessement of functional capacity in clinical and research settings. A scientific statement from the AHA committee on exercise, rehabilitation and prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing. Circulation. 2007; 116.

3. Myers J. Applications of Cardiopulmonary exercise testing in the management of cardiovascular and pulmonary disease. Int J Sports Med 2005; 26; S49-55.

4. AHA Science Advisory. Assessment of functional capacity in clinical and research settings.Circulation 2000; 102:1591-1597.

5. Singh VN: The role of gas analysis with exercise testing. Prim Care. 2001 Mar; 28(1):159-79, vii-viii.

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