Comparison Of Cardiopulmonary Exercise Testing (CPET) By Ergometer And By Treadmill In Healthy Young Subjects

BackgroundCardiopulmonary exercise testing (CPET) provides a global assessment of the integrative exercise responses involving pulmonary, cardiovascular, blood, neuropsychological, and skeletal muscle systems. CPET is an important element of physique study and healthy physical ability evaluation in various countries. It is a relatively noninvasive method, evaluating reserve function of the lungs and the heart, and exercise intolerance. It synthesizes the application breath gas monitor technology, the computer and the treadmill or the cycle technology, real-time examination under different load condition, organism oxygen consumption quantity and carbon dioxide displacement dynamic change, so that it objectively and quantitatively evaluates the reserve function of the lungs and heart and exercise intolerance, providing the physician with relevant information for clinical decision-making. CPET is one of the universal cardiopulmonary functional check methods in evaluating human respiration and circulation function levels[1].CPET has been developing widely in clinical medicine for over ten years. At present CPET has mainly been applied in evaluating exercise-limiting pathology, cardiovascular and respiration functional diagnosis, evaluating the effect of therapy methods, distinguishing unexplained dyspnea, predicting operation risks and prognosis, assessing organ transplantation survivability (heart and lung transplantation etc), exercise prescription for rehabilitative medicine, sport medicine and evaluation of labor force[2].At present the CPET test is mainly used via treadmill and power bicycle.About these two kind of CPET research, only one compositions from James A et al[3], who have the quite detailed elaboration. They draw the following conclusion: Patients with COPD exhibit different perceptual and physiologic responses during treadmill walking and cycling. Although ratings of breathlessness are initially higher with cycling at equivalent levels of VO2, the changes in breathlessness as a function of physiologic stimuli (VO2 and VE) are greater during treadmill exercise.Leg discomfort is the predominant symptom throughout cycling. The regression slope between breathlessness and VO2 is greater on the treadmill than on the cycle ergometer; and the regression slope between leg discomfort and VO2 is greater on the cycle ergometer than on the treadmill.ObjectiveCompares the similarities and differences of respective variables between the ergometry cycling and the treadmill, providing a method for clinical diagnosis.Subjects1. Select normal people standard:(1) Healthy, 18~27years, coordinated 62 subjects (including 36 males, 26 females).(2) No chronic bronchitis, asthma, tuberculosis, pleurisy, heart disease, hypertension, diabetes, disability, anemia, or other cardiopulmonary disease.(3) No history of respiratory tract infections in the past four weeks.(4) No vocation history of being exposed to harmful air, dust, work or live in contaminated environment.(5) No history of smoking and drinking.(6) No exercise contraindication.2. Eliminated standard:(1) Pregnancy or breast-feeding period women.(2)βacceptor block agent due to different causes(including droping eyes).(3) 60beats/min>rest HR and rest HR >100beats/min.(4) Athletes or long-term specialized system physical trainers. Methods1. Resting pulmonary function check: Before the test, accurately record height, weight, age, sex. The pulmonary function test using ATS/ERS control standard. Spirometry (FVC, FEV1, FEV1/FVC, FEF25~75%, PEF) and MVV were performed.2. CPET check:The exercise instrument uses ergometry cycling or treadmill.3. Exercise testing method: Used biggest physiological load of exercise until they had limit symptom. Connected face guard, blood pressure sleeve belt(cycling), ECG respectively. In cycling, male 25w/min, female 20w/min ramp increase; treadmill, using modified Bruce. Upon achieving the biggest physiological load of exercise, the test would be terminated. Several symptoms may appear during exercise. The leg discomfort and the short of breath are main ones. If the patient has leg discomfort, dizzy, short of breath, asthenia, chest pain, palpitation, weary and others symptoms, it would be recorded.4. Test gap: Choose 62 health persons(36 Males, 26 females). Select number separately (for example 1, 2, 3, 4, 5…) at random, each is carried alternately on treadmill and cycling, two kinds of test gap are between 4 days and 2 months.5. Statistical method: Carried on the data processing using the SPPSS12.0 statistics software. The measurement material( x±S)expressed with the mean value±standard deviation. Between the treadmill and the power bicycle various parameters (VO2max, VO2/kg, MET, AT, RQ, VE, BR, Rf, VD/VT, HR, HRR, VO2/HR, VE/VO2@AT, VE/VCO2@AT)use pair t-test. P≤0.05(two-tailed test) was considered statistically significant. The relations between short of breath and cycling/treadmill, the relations between leg discomfort and cycling/treadmill, they would be used McNemar test.ResultThe mean value±standard deviation of the cycling and the treadmill,the results are: VO2max(ml/min)(cycling: male2311.56±522.53, female1446±373.87; treadmill: male 2597.95±627.63, female 1808.62±394.85); VO2max/kg(ml/min/kg)(cycling: male 37.61±9.29, female 28.02±6.90; treadmill: male 41.82±9.06, female 34.41±7.94); METmax(cycling: male 10.81±2.70, female 7.96±1.96; treadmill: male 11.93±2.60, female 9.78±2.27); AT(ml/min)(cycling: male 1239.16±305.75, female 864±240.65; treadmill: male 1450.14±339.01, female 1128.04±266.76); VEmax(L/min)(cycling: male 74.86±16.36, female 51.08±8.83;平板: male 79.69±18.93, female 63.35±13.33); BRmax(L/min)(cycling: male 54.36±10.31, female 56.81±6.54; treadmill: male 50.75±11.90, female 46.62±10.45); Rfmax(b/min)(cycling:male 36.02±6.74, female 35.95±6.85; treadmill: male 37.39±6.32, female 40.70±6.84); HRmax(bpm)(cycling: male 166.61±8.15, female 163.27±12.22; treadmill: male 176.33±8.75, female 172.46±13.50); HRRmax(cycling: male 15.53±3.64, female 17.50±6.12; treadmill: male 10.94±3.88, female 12.88±6.99); VO2/HRmax(ml/bpm)(cycling: male 14.23±3.03, female 9.06±2.47; treadmill: male 15.38±5.24, female 10.57±2.32); RQ(cycling: male 1.29±0.20, female 1.30±0.19; treadmill: male 1.30±0.27, female 1.24±0.21 ); VE/VO2@AT ( cycling: male 23.05±3.05, female 25.55±3.37; treadmill: male 24.15±2.62, female 26.52±3.20); VE/VCO2@AT( cycling: male 25.18±2.72, female 28.58±3.70; treadmill: male 25.90±2.79, female 29.00±2.86).In Compares respective variables between the ergometry cycling and the treadmill, VO2max, VO2/kg, AT, MET, VE, BR, Rf, HR, HRR, VO2/HR, VE/VO2@AT, was considered statistically significant(P<0.05).The main symptoms for exercise test are leg discomfort and short of breath. The leg discomfort correlation slope between the ergometry cycling and the treadmill, was considered statistically significant(P<0.01), the cycling are greater than the treadmill; the short of breath correlation slope between the ergometry cycling and the treadmill, was considered statistically significant(P<0.01), the treadmill are greater than the cycling. Conclusions1. There are statistically significant in most variables between the ergometry cycling and the treadmill. In the normal person exercise endurance's test, the treadmill surpasses the ergometry cycling; but the treadmill lacks a dynamic blood pressure reading.2. The main symptoms for exercise test are leg discomfort and shortness of breath. Regarding the leg discomfort correlation slope between the ergometry cycling and the treadmill, the cycling data is greater than the treadmill data; regarding the shortness of breath correlation slope between the ergometry cycling and the treadmill, the treadmill is greater than the cycling data.