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Figure 4. Ventilation slopes and Wasserman panel (VT/V’E). (A) Normal subject. (B) Respiratory limitation dysfunctional breathing – view of pulmonologist
showing a regular, but limited increase of tidal volume with high breathing frequency. (C) Dysfunctional
breathing with an erratic pattern. Plots of tidal volume (VT on the right y-axis) and breathing frequency
(BF on the left y-axis) against minute ventilation (V’E on the x-axis) during incremental exercise testing.
Data are not filtered in the ventilation slopes. Geratherm Respiratory combined filter is used in the
Wasserman panel (VT/V’E). BF, breathing frequency; VT, tidal volume; V’E, minute ventilation.51
ever, these techniques are resource- and ev- respiratory panels of CPET can bring up to
idence-limited and need further clinical and a diagnosis of DB. Furthermore, CPET may
experimental research.48 unravel the mechanisms of breathlessness
by simultaneously evaluating cardiovascu-
Cardiopulmonary Exercise Testing lar adaptation, ventilation, and gas exchange
(CPET) is the most detailed diagnostic tool through exercise. CPET permits recognition
to objectify breathing patterns during exer- of any pathophysiological cause of exertion-
cise and it represents “an ideal candidate” al dyspnoea which would not manifest during
for gold standard among proposed diagnostic tests performed at rest.49–51 Precisely, patients
methods for DB.12 A major benefit of CPET with DB usually present with high frequency
is that, in contrast to the questionnaires and of breathing at rest which rises swiftly at the
observation-based approaches, it offers objec- begging of exercise, while tidal volume may
tive measurements and plots data which can remain stable. This can increase dead space
be directly analysed. Erratic ventilation, hy- ventilation and change the kinetics of multiple
perventilation with frequent sighing present CPET variables. Also, decreasing PaCO2 set
at rest or during exercise and recorded in the
Figure 4. Ventilation slopes and Wasserman panel (VT/V’E). (A) Normal subject. (B) Respiratory limitation dysfunctional breathing – view of pulmonologist
showing a regular, but limited increase of tidal volume with high breathing frequency. (C) Dysfunctional
breathing with an erratic pattern. Plots of tidal volume (VT on the right y-axis) and breathing frequency
(BF on the left y-axis) against minute ventilation (V’E on the x-axis) during incremental exercise testing.
Data are not filtered in the ventilation slopes. Geratherm Respiratory combined filter is used in the
Wasserman panel (VT/V’E). BF, breathing frequency; VT, tidal volume; V’E, minute ventilation.51
ever, these techniques are resource- and ev- respiratory panels of CPET can bring up to
idence-limited and need further clinical and a diagnosis of DB. Furthermore, CPET may
experimental research.48 unravel the mechanisms of breathlessness
by simultaneously evaluating cardiovascu-
Cardiopulmonary Exercise Testing lar adaptation, ventilation, and gas exchange
(CPET) is the most detailed diagnostic tool through exercise. CPET permits recognition
to objectify breathing patterns during exer- of any pathophysiological cause of exertion-
cise and it represents “an ideal candidate” al dyspnoea which would not manifest during
for gold standard among proposed diagnostic tests performed at rest.49–51 Precisely, patients
methods for DB.12 A major benefit of CPET with DB usually present with high frequency
is that, in contrast to the questionnaires and of breathing at rest which rises swiftly at the
observation-based approaches, it offers objec- begging of exercise, while tidal volume may
tive measurements and plots data which can remain stable. This can increase dead space
be directly analysed. Erratic ventilation, hy- ventilation and change the kinetics of multiple
perventilation with frequent sighing present CPET variables. Also, decreasing PaCO2 set
at rest or during exercise and recorded in the
