Sports Cardiology Assessment


Cardiopulmonary Exercise Test (CPET) is a non-invasive functional assessment tool performed under the direction of cardiologists to evaluate the cardiopulmonary capacity and exercise endurance.

There are reported cases of sudden death occurred during sports contests every year. Many patients with unexplained chest tightness or shortness of breath usually only have their symptoms shown when exercising and their conditions are often overlooked by resting cardiopulmonary examination. CPET, on the other hand, allows sports players to discover not only their exercise capacity but also some hidden diseases such as myocardial ischemia or other cardiopulmonary insufficiencies. This test is suitable for athletes and also applicable under other conditions, including pre-surgery evaluation, post-surgery rehabilitation, and the screening of other cardiopulmonary diseases.

Assessment Procedure

CPET evaluates the response of the cardiopulmonary system to exercise by monitoring the body’s oxygen uptake (VO2), carbon dioxide emissions (VCO2), heart rate (HR), and minute ventilation (VE) during exercise. Together with the reading of the ECG and blood pressure, a comprehensive functional assessment of the cardiovascular and pulmonary system can be produced. 

Different from the resting cardiopulmonary test, CPET requires participants to ride on an exercise bike with a facemask on and have multiple electrodes pasted on their bodies. The intensity of exercise will increase gradually until it reaches the upper limit of the participant’s cardiopulmonary function. The whole assessment takes around 30 minutes and the duration of exercise is approximately 10 minutes.


What are the risks of the test?

The risk of CPET is similar to that of mild-to-moderate exercise. Cardiologists will closely monitor participants’ ECG, blood pressure and blood oxygen level throughout the whole process. If any abnormality is observed, the test will be terminated.

Common Indicators of CPET

Sport Endurance Index:

Peak Oxygen Uptake, VO2 Max

VO2 max, which refers to the maximum amount of oxygen the body can utilize during intense exercise, is an internationally recognized index of cardiopulmonary function. The benchmark of VO2 max differs with age and gender, but in general, the higher the VO2 max, the greater the exercise endurance capacity. The average VO2 max of an adult range from 35-40mL/min/kg; and for endurance athletes, such as marathon runners, their VO2 max usually stands at 70mL/min/kg or higher.

Ventilatory Anaerobic Threshold, VAT

VAT is one of the indicators of exercising endurance capacity. When the intensity of exercise increases, the oxygen intake may fail to supply sufficient energy to maintain muscle activity. In this case, the body will start to run on the anaerobic energy system and produce a waste product known as lactic acid, which is the source of muscle soreness.  The oxygen uptake (VO2) at this critical point is called VAT. A normal person should have a VAT >40% of VO2 max. The higher the value, the better the cardiopulmonary function and the exercise endurance capacity.

Heart Function

•  Maximal Heart Rate, HR max

•  ECG

Metabolic Function

Metabolic Equivalents, MET

An index to estimate one’s functional capacity. Based on this data, doctors can prescribe a suitable exercise formula for those with cardiovascular disease or other people in need.

Resting metabolic rate

Precaution before testing

  1. Do not drink alcoholic beverages 4 hours before the test
  2. Do not eat too much 2 hours before the test
  3. Do not smoke 1 hour before the test
  4. Do not perform vigorous exercise half an hour before the test
  5. Dress in appropriate sportswear, avoid any tight clothing


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