Spiroergometry

The module Spiroergometry is used to document spiroergometry examinations. The cardiopulmonary exercise test analyses the reactions and the interplay of the heart, circulation, breathing and metabolism during gradually increasing exercise, both in terms of qualitative and quantitative measures.
The examinations ought to be performed according to DZHK-SOP-K-07 .

Examination details

Was the cardiopulmonary exercise testing performed

  Fieldname: spiro_janein
  Data type: String with following options
    yes
    no
    unknown
    not assessed

Date of examination

  Fieldname: spiro_date
  Data type: Timestamp with date, month and year

Quality level

Level 1: The examination is performed in accordance with the guidelines of the medical associations.

Level 2: The examination is performed in accordance with the specifications of the DZHK SOP. Minimum requirements to ensure the quality of the implementation and the examiners are defined in the SOP.

Level 3: The examination is performed in accordance with the specifications of the DZHK SOP and certification of the examiners: Definition of intr-observer and interobserver-variability (standard of epidemiological studies).

DZHK-SOP-K-07: Spiroergonometry, Version: V1.1, Valid as of: 01.07.2015

  Fieldname: spiro_qualitaet
  Data type: Integer with following options
    1
    2
    3

Examination

Pacemaker

  Fieldname: spiro_schritt
  Data type: String with following options
    yes
    no
    unknown
    not assessed

Herz rate

  Fieldname: spiro_rhytm
  Data type: String with following options
    sinus rhythm
    atrial fibrillation
    pacemaker rhythm
    unknown
    not assessed

Use of beta blockers

  Fieldname: spiro_beta
  Data type: String with following options
    yes
    no
    unknown
    not assessed

Duration of exercise

  Fieldname: spiro_belastung
  Data type: Timestamp with minutes and seconds

Type of exercise

  Fieldname: spiro_laufband
  Note in CRF: Treadmill
  Data type: String following options
    Bruce protocol
    modified Bruce protocol
    modified Naughton protocol
    unknown
    not assessed

  Fieldname: spiro_fahrrad
  Note in CRF: Bicycle
  Data type: String with following options
    modified Jones protocol
    WHO protocol
    unknown
    not assessed

Reason for stopping

Objective stopping criteria:
ST depression (> 0.2 mV) or elevation.

Progressive atrial or ventricular arrhythmia or block images

Newly occurring atrial fibrillation

Drop in heart rate during exercise

Lack of increase or drop in RR across 2 exercise levels

Drop in O2 uptake (or oxygen pulse) in spite of increasing the load.

Subjective stopping criteria:
Maximal fatigue (e.g. of the legs)

Thoracic pain (e.g. symptoms of angina), severe dizziness

Excessive dyspnoea

Subject signals to examiner to end the examination.

DZHK-SOP-K-07: Spiroergonometry, Version: V1.1, Valid as of: 01.07.2015

  Fieldname: spiro_grund
  Data type: String with following options
    maximum exertion reached
    ST segment depression (> 0.2 mV) or elevation
    progressive atrial or ventricular arrhythmias or bundle branch block patterns
    frequency decrease during exercise
    missing BP increase or BP decrease over 2 exercise levels
    maximum exhaustion (e.g. of legs)
    chest pain (e.g. AP symptoms), severe dizziness
    excessive dyspnoea
    subject's expression of the wish to terminate the test
    unknown
    not assessed

HR (at rest)

  Fieldname: spiro_hf_ruhe
  Data type: Integer with maximum 3 digits in /min

Maximum HR (during exercise)

  Fieldname: spiro_hf_belast
  Data type: Integer with maximum 3 digits in /min

HR (1min after exercise)

  Fieldname: spiro_hf_1min
  Data type: Integer with maximum 3 digits in /min

Systolic BP (at rest)

  Fieldname: spiro_rrsys_ruhe
  Data type: Integer with maximum 3 digits in mmHg

Diastolic BP (at rest)

  Fieldname: spiro_rrdia_ruhe
  Data type: Integer with maximum 3 digits in mmHg

Systolic BP (during exercise)

  Fieldname: spiro_rrsys_belast
  Data type: Integer with maximum 3 digits in mmHg

Diastolic BP (during exercise)

  Fieldname: spiro_rrdia_belast
  Data type: Integer with maximum 3 digits in mmHg

Watt (max)

  Fieldname: spiro_watt
  Data type: Integer with maximum 3 digits in Watt

VE/VCO2 (at rest)

  Fieldname: spiro_ve_vco2_ruhe
  Data type: Floating point number with 3 places before and 1 place after comma

VE/VCO2 (during exercise)

  Fieldname: spiro_ve_vco2_belast
  Data type: Floating point number with 3 places before and 1 place after comma

PET CO2 (at rest)

  Fieldname: spiro_pet_vco2_ruhe
  Data type: Integer with maximum 3 digits in mmHg

PET CO2 (during exercise)

  Fieldname: spiro_pet_vco2_belast
  Data type: Integer with maximum 3 digits in mmHg

VE/VCO2-slope

Defined as the slope of the straight line in field 5 (VE to VCO₂) value one minute after starting the exercise until VT2 (RCP).
DZHK-SOP-K-07: Spiroergonometry, Version: V1.1, Valid as of: 01.07.2015

  Fieldname: spiro_slope
  Data type: Integer with maximum 3 digits

VO2 (at rest)

  Fieldname: spiro_vo2_ruhe
  Data type: Floating point number with 3 places before and 3 places after comma

  Fieldname: spiro_vo2ruh_einheit
  Data type: String with following options
    ml/min
    l/min

VO2 peak

Highest VO₂value achieved during exercise. A reliable statement about VO₂ peak can only be made if an RER of >1.05 was achieved during exercise.
DZHK-SOP-K-07: Spiroergonometry, Version: V1.1, Valid as of: 01.07.2015

  Fieldname: spiro_vo2_peak
  Data type: Integer with maximum 4 digits in ml/min

VO2 Norm

  Fieldname: spiro_vo2_norm
  Data type: Floating point number with 4 places before and 3 places after comma

  Fieldname: spiro_vo2nor_einheit
  Data type: String with following options
    ml/min
    l/min

VO2 AT

  Fieldname: spiro_vo2_at
  Data type: Floating point number with 4 places before and 3 places after comma

  Fieldname: spiro_vo2at_einheit
  Data type: String with following options
    ml/min
    l/min

VE max

  Fieldname: spiro_ve_max
  Data type: Integer with maximum 3 digits in l/min

RR (respiratory rate) (at rest)

  Fieldname: spiro_af_ruhe
  Data type: Integer with maximum 3 digits in /min

RR (during exercise)

  Fieldname: spiro_af_belast
  Data type: Integer with maximum 3 digits in /min

Maximum RR

  Fieldname: spiro_af_max
  Data type: Integer with maximum 3 digits in /min

VT (at rest)

  Fieldname: spiro_vt_ruhe
  Data type: Floating point number with 2 places before and 1 place after comma in ml

VT (during exercise)

  Fieldname: spiro_vt_belast
  Data type: Floating point number with 2 places before and 1 place after comma in ml

VD/VT (at rest)

  Fieldname: spiro_vdvt_ruhe
  Data type: Floating point number with 2 places before and 1 place after comma in %

VD/VT (during exercise)

  Fieldname: spiro_vdvt_belast
  Data type: Floating point number with 2 places before and 1 place after comma in %

Saturation sO2 (at rest)

  Fieldname: spiro_o2_ruhe
  Data type: Integer with maximum 3 digits in %

Saturation sO2 (during exercise)

  Fieldname: spiro_o2_belast
  Data type: Integer with maximum 3 digits in %

Respiratory quotient (RQ) at rest

  Fieldname: spiro_rq_ruhe
  Data type: Floating point number with 1 place before and 2 places after comma

Respiratory quotient (RQ) during exercise

  Fieldname: spiro_rq_max
  Data type: Floating point number with 1 place before and 2 places after comma

Respiratory quotient after end of exercise (RQ maxpost)

  Fieldname: spiro_rq_nach_belast
  Data type: Floating point number with 2 places before and 1 place after comma

BORG scale

It is recommended to preferably use the 6/20 scale for DZHK studies. The variant of the BORG scale to be used has to be stipulated in the study protocol of the respective studies.
Borg Exertion Scale
6 no exertion at all
7 extremely light
8
9 very light
10
11 light
12
13 somewhat hard
14
15 hard (heavy)
16
17 very hard
18
19 extremely hard
20 maximal exertion

Borg Dyspnoea Scale
0 nothing at all
0,5 very, very slight (just noticeable)
1 very slight
2 slight
3 moderate
4 somewhat severe
5 severe
6 severe to very severe
7 very severe
8 very severe to very, very severe
9 very, very severe (almost maximal)
10 maximal dyspnoea
DZHK-SOP-K-07: Spiroergonometry, Version: V1.1, Valid as of: 01.07.2015

Borg Exertion Scale
6	no exertion at all
7	extremely light
8
9	very light
10
11	light
12
13	somewhat hard
14
15	hard (heavy)
16
17	very hard
18
19	extremely hard
20	maximal exertion

Borg Dyspnoea Scale
0	nothing at all
0,5	very, very slight (just noticeable)
1	very slight
2	slight
3	moderate
4	somewhat severe
5	severe
6	severe to very severe
7	very severe
8	very severe to very, very severe
9	very, very severe (almost maximal)
10	maximal dyspnoea

Used BORG scale

  Fieldname: spiro_borg
  Data type: String with following options
    Borg rating of perceived exertion scale (6/20)
    Borg – dyspnoea scale (0/10)
    unknown
    not assessed

Borg rating of perceived exertion scale

  Fieldname: spiro_borganst
  Data type: String with following options
    6 - no exertion at all
    7 - extremely light
    8
    9 - very light
    10
    11 - light
    12
    13 - somewhat hard
    14
    15 - hard
    16
    17 - very hard
    18
    19 - extremely hard
    20 - maximal exertion
    unknown
    not assessed

Borg-dyspnoea scale

  Fieldname: spiro_borgatem
  Data type: String with following options
    0 - no breathing difficulty at all
    0.5 - very, very slight (just noticeable)
    1 - very slight
    2 - slight
    3 - moderate
    4 - somewhat severe
    5 - severe
    6 - severe to very severe
    7 - very severe
    8 - very severe to very, very severe
    9 - very, very severe (almost maximal)
    10 - maximal breathing difficulty
    unknown
    not assessed