CARDIOPULMONARY EXERCISE TESTING IN INTERSTITIAL LUNG-DISEASE

Interstitial lung disease (ILD) can determine severe lung function imp airment both at rest and during exercise. Usually, resting measurement s of lung and cardiac function give enough information on the degree o f the disease. Thus, exercise testing should be reserved only for part icular situations such as presence at the same time of cardiac and res piratory involvement, symptomatic patients with normal spirometry, and to check the response to therapy. A better understanding of the patho physiology and cardiorespiratory consequences of ILD can give an impor tant contribution in improving methods of exercise testing to assess d isability. In this perspective, we analyze the factors limiting exerci se performance: the progressive hypoxemia that appears or is worsened by exertion; the ventilatory abnormalities that lead to a rapid shallo w breathing pattern with a VE that reach the MW; and the cardiovascula r limitation with low maximum heart rate, low cardiac output and high PVR and PAP.