The clinical significance of ventilatory inefficiency is demonstrated by findings showing that the elevated V˙ E/ V˙CO 2 response to exercise is an independent predictor of mortality in patients with CHF, PH, and COPD. Importantly, this potentiated V˙ E/ V˙CO 2 response contributes to dyspnea and exercise intolerance. A growing body of research has shown that the V˙ E/ V˙CO 2 response to exercise is elevated in conditions such as chronic heart failure (CHF), pulmonary hypertension (PH), interstitial lung disease (ILD), and chronic obstructive pulmonary disease (COPD). The response of V˙ E relative to V˙CO 2 ( V˙ E/ V˙CO 2) is commonly termed ventilatory efficiency and is becoming a common physiological tool, in conjunction with other key variables such as operating lung volumes, to evaluate exercise responses in patients with chronic conditions. During exercise, ventilation ( V˙ E) increases in proportion to metabolic demand to maintain arterial blood gas and acid-base balance. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, CanadaĬardiopulmonary exercise testing (CPET) is a method for evaluating pulmonary and cardiocirculatory abnormalities, dyspnea, and exercise tolerance in healthy individuals and patients with chronic conditions. 3Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
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