Cardiopulmonary exercise testing and six minute walk test

What CPET and the six minute walk test measure, how to tell cardiac from ventilatory limitation and deconditioning, peak VO2 thresholds for surgery and heart transplant, 6MWD cut-offs in pulmonary hypertension, and exertional desaturation for ambulatory oxygen.

Tier 2Medical sciences concept

Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made

3 questions 8 flashcards

At a glance

CPET measures oxygen uptake (VO2), CO2 output, ventilation and ECG during a ramped cycle or treadmill test to a symptom-limited maximum. It shows why someone stops exercising.
Peak VO2 is the headline: normal is over 80 to 85% predicted. It decides heart transplant listing and lung resection risk.
The six minute walk test (6MWT) is a simple submaximal test: distance walked in 6 minutes on a 30 m corridor, with SpO2 and Borg dyspnoea. It tracks disease, predicts prognosis and guides ambulatory oxygen.

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Sources

ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003;167:211-277American Thoracic Society and American College of Chest Physicians, 2003
Radtke T, Crook S, Kaltsakas G et al. ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases. Eur Respir Rev 2019;28:180101European Respiratory Society, 2019
Holland AE, Spruit MA, Troosters T et al. An official ERS/ATS technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44:1428-1446European Respiratory Society and American Thoracic Society, 2014
McDonald CF, Whyte K, Jenkins S et al. Clinical practice guideline on adult domiciliary oxygen therapy: executive summary from the Thoracic Society of Australia and New Zealand. Respirology 2016;21:76-78AU/NZThoracic Society of Australia and New Zealand, 2015
McDonald CF et al. Thoracic Society of Australia and New Zealand clinical practice guideline on adult home oxygen therapy. Respirology 2024;29(9):765-84AU/NZThoracic Society of Australia and New Zealand (Respirology), 2024 (replaces the 2015 guideline)
MBS item 11503 (complex respiratory function tests, including functional exercise testing for PBS PAH medicines or portable oxygen)AU/NZAustralian Government Department of Health, Disability and Ageing (MBS Online), accessed November 2026
Humbert M, Kovacs G, Hoeper MM et al. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2022;43:3618-3731European Society of Cardiology and European Respiratory Society, 2022
Peled Y, Ducharme A, Kittleson M et al. International Society for Heart and Lung Transplantation guidelines for the evaluation and care of cardiac transplant candidates, 2024. J Heart Lung Transplant 2024;43:1529-1628.e54International Society for Heart and Lung Transplantation, 2024 (replaces the 2016 listing criteria)
Kovacs G, Zeder K, Humbert M et al. European Respiratory Society clinical practice guidelines update for the treatment of pulmonary arterial hypertension. Eur Respir J 2026European Respiratory Society, 2026
Long-Term Oxygen Treatment Trial Research Group; Albert RK, Au DH, Blackford AL et al. A randomized trial of long-term oxygen for COPD with moderate desaturation (LOTT). N Engl J Med 2016;375:1617-1627New England Journal of Medicine, 2016
Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidence-based clinical practice guidelines. Chest 2013;143(5 Suppl):e166S-e190SAmerican College of Chest Physicians, 2013

Last updated: 14 November 2026

What changed

14 November 2026 Personal emails, About story and Australian-style copy