{
  "abstract": "Introduction An abdominal aortic aneurysm (AAA) is a dilation of the aorta, which requires surgical intervention when fast growing or ≥5.5 cm in diameter, to avoid complications. Cardiopulmonary exercise testing (CPET) is recommended by NICE as a useful tool in the pre-operative assessment for AAA. However, the risks of spirometry and CPET are not well-documented in research, and these tests are listed as relative contraindications by ARTP. 1 This study aims to evaluate the frequency of maximal test achievement, adverse events, and reasons for test termination during CPET in patients with AAA.Methods A retrospective service evaluation was conducted on patients undergoing pre-operative assessment for AAA at Birmingham Heartlands Hospital between 2021 and 2025. The evaluation was registered with CARMS (CARMS-23993). CPET, with spirometry and continuous ECG, were performed. Where CPET could not be performed, a gas transfer test was performed instead. CPET data was extracted from our lung function software. Adverse events were audited through both the local incident reporting software (RADAR; DATIX) and audit of hand-written CPET proformas from the day of testing. ECGs were retrospectively audited manually. Markers of a maximal test were considered: 1) RER ≥ 1.15; 2) HR reserve ≤16 bpm; or 3) evidence of ventilatory limitation – breathing reserve ≤ 20%.Results Of 703 patients, 567 underwent CPET and 136 completed gas transfer. Among CPETs, 284 (50%) met at least one maximal criterion and 80 (14%) met at least two. Tests were mostly terminated due to bilateral leg fatigue (48.5%), musculoskeletal pain (10.9%), or breathlessness (10.8%). Adverse events were rare: two serious events, 63 moderate events, and 161 mild or non-serious events.Conclusion CPET can be performed safely in AAA patients, with a very low incidence of serious adverse events. Although only half of tests achieved one maximal criterion, most provided valuable physiological information to support pre-operative risk assessment. A large sub-contingent stopped CPET due to musculoskeletal pain – this may suggest a future role for arm ergometry as an alternative modality.Reference Sylvester, et al. ARTP statement on pulmonary function testing 2020. BMJ Open Respiratory Research 2020.",
  "authors": [
    {
      "affiliations": [
        "Heartlands Hospital, Bordesley Green, United Kingdom"
      ],
      "name": "Robyn Gregory"
    }
  ],
  "title": "P56 A service evaluation of the safety and utility of cardiopulmonary exercise testing in patients with abdominal aortic aneurysm",
  "uid": "cb3b0c04-5984-50ae-bfd3-9b79e9282ba5"
}