Computerized Cardiopulmonary Exercise Testing

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The measurement of cardio-circulatory and gas-exchange parameters during physical exercise—known as ergo spirometry or cardiopulmonary exercise testing (CPX)—has a rich history in Cologne. Pioneering research by Knipping and his team, particularly Hollmann, focused on healthy subjects. In sports medicine, bicycle and treadmill testing, alongside lactate measurements, have become essential for evaluating cardiac function. However, the significance of ergospirometry has diminished in other medical fields. K. Wasserman in Los Angeles advanced the technique to its current form, utilizing computerized, on-line measuring systems. This evolution was facilitated by innovations like continuous gas analyzers and personal computers, which greatly enhanced understanding of cardiocirculatory and respiratory regulation during exercise. The collaborative efforts of W. Hollmann and K. Wasserman established normal values for gas-exchange parameters across large populations. Wasserman's team also developed a differential diagnostic framework for patients with various cardiovascular and pulmonary conditions. Many cardiologists, especially those dealing with myocardial failure or rate-adaptive pacemakers, advocate for modern computerized ergo spirometry, although it remains a topic of debate among sports medicine and pulmonary function specialists.