Palange P, Ward SA, Carlsen KH, Casaburi R, Gallagher CG, Gosselink R, et al. Recommendations on the use of exercise testing in clinical practice. Eur Respir J. 2007. https://doi.org/10.1183/09031936.00046906.

Article  PubMed  Google Scholar 

Whipp BJ, Davis JA, Torres F, Wasserman K. A test to determine parameters of aerobic function during exercise. J Appl Physiol. 1981;50:217–21.

Article  CAS  PubMed  Google Scholar 

Keir DA, Paterson DH, Kowalchuk JM, Murias JM. Using ramp-incremental V̇O2 responses for constant-intensity exercise selection. Appl Physiol Nutr Metab. 2018;43:882–92. https://doi.org/10.1139/apnm-2017-0826.

Article  PubMed  Google Scholar 

Agostoni P, Dumitrescu D. How to perform and report a cardiopulmonary exercise test in patients with chronic heart failure. Int J Cardiol. 2019;288:107–13. https://doi.org/10.1016/j.ijcard.2019.04.053.

Article  PubMed  Google Scholar 

da Conceicao CR, Krannich A, Zach V, Pinto R, Deichl A, Feuerstein A, et al. Cardiopulmonary exercise testing as a prognosis-assessing tool in heart failure with preserved ejection fraction. ESC Heart Fail. 2025. https://doi.org/10.1002/EHF2.15219.

Article  PubMed  PubMed Central  Google Scholar 

Balady GJ, Arena R, Sietsema K, Myers J, Coke L, Fletcher GF, et al. Clinician’s guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association. Circulation. 2010;122(2):191–225. https://doi.org/10.1161/CIR.0B013E3181E52E69.

Article  PubMed  Google Scholar 

Mezzani A, Hamm LF, Jones AM, McBride PE, Moholdt T, Stone JA, et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation. J Cardiopulm Rehabil Prev. 2012;32:327–50. https://doi.org/10.1097/HCR.0b013e3182757050.

Article  PubMed  Google Scholar 

Guazzi M, Adams V, Conraads V, Halle M, Mezzani A, Vanhees L, et al. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Circulation. 2012;126:2261–74. https://doi.org/10.1161/CIR.0b013e31826fb946.

Article  PubMed  PubMed Central  Google Scholar 

Keir DA, Iannetta D, Mattioni Maturana F, Kowalchuk JM, Murias JM. Identification of non-invasive exercise thresholds: methods, strategies, and an online app. Sports Med. 2022;52:237–55. https://doi.org/10.1007/s40279-021-01581-z.

Article  PubMed  Google Scholar 

Whipp BJ, Ward SA, Wasserman K. Respiratory markers of the anaerobic threshold. Adv Cardiol. 1986;35:47–64.

Article  CAS  PubMed  Google Scholar 

Binder RK, Wonisch M, Corra U, Cohen-Solal A, Vanhees L, Saner H, et al. Methodological approach to the first and second lactate threshold in incremental cardiopulmonary exercise testing. Eur J Cardiovasc Prev Rehabil. 2008;15:726–34. https://doi.org/10.1097/HJR.0b013e328304fed4.

Article  PubMed  Google Scholar 

Iannetta D, Keir DA, Fontana FY, Inglis EC, Mattu AT, Paterson DH, et al. Evaluating the accuracy of using fixed ranges of METs to categorize exertional intensity in a heterogeneous group of healthy individuals: implications for cardiorespiratory fitness and health outcomes. Sports Med. 2021;51:2411–21. https://doi.org/10.1007/s40279-021-01476-z.

Article  PubMed  Google Scholar 

Whipp BJ, Davis JA, Wasserman K. Ventilatory control of the ‘isocapnic buffering’ region in rapidly-incremental exercise. Respir Physiol. 1989;76:357–67.

Article  CAS  PubMed  Google Scholar 

Wasserman K, Whipp BJ, Koyl SN, Beaver WL, Koyal SK, Beaver WL. Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol. 1973;35:236–43.

Article  CAS  PubMed  Google Scholar 

Myers J, Goldsmith RL, Keteyian SJ, Brawner CA, Brazil DA, Aldred H, et al. The ventilatory anaerobic threshold in heart failure: a multicenter evaluation of reliability. J Card Fail. 2010;16:76–83. https://doi.org/10.1016/j.cardfail.2009.08.009.

Article  PubMed  Google Scholar 

Gladden LB, Yates JW, Stremel RW, Stamford BA. Gas exchange and lactate anaerobic thresholds: inter- and intraevaluator agreement. J Appl Physiol. 1985;58:2082–9. https://doi.org/10.1152/jappl.1985.58.6.2082.

Article  CAS  PubMed  Google Scholar 

Powers S, Dodd S, Garner R. Precision of ventilatory and gas exchange alterations as a predictor of the anaerobic threshold. Eur J Appl Physiol. 1984;52:173–7.

Article  CAS  Google Scholar 

Topol EJ. High-performance medicine: the convergence of human and artificial intelligence. Nat Med. 2019;25(1):44–56. https://doi.org/10.1038/S41591-018-0300-7.

Article  CAS  PubMed  Google Scholar 

Kleinhendler E, Pinkhasov A, Hayek S, Man A, Freund O, Perluk TM, et al. Interpretation of cardiopulmonary exercise test by GPT - promising tool as a first step to identify normal results. Expert Rev Respir Med. 2025;19:371–8. https://doi.org/10.1080/17476348.2025.2474138.

Article  CAS  PubMed  Google Scholar 

Agostoni P, Cattadori G, Salvioni E, Sciomer S. Artificial intelligence and anaerobic threshold: the winner is human physiology. Eur J Prev Cardiol. 2024;31:445–7. https://doi.org/10.1093/EURJPC/ZWAE015.

Article  PubMed  Google Scholar 

Zignoli A, Fornasiero A, Rota P, Muollo V, Peyré-Tartaruga LA, Low DA, Fontana FY, Besson D, Pühringer M, Ring-Dimitriou S, Mourot L. Oxynet: A collective intelligence that detects ventilatory thresholds in cardiopulmonary exercise tests. Eur J Sport Sci. 2022;22(3):425–35.

Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol. 1986;60:2020–7.

Article  CAS  PubMed  Google Scholar 

Zignoli A, MDPI. Machine learning models for the automatic detection of exercise thresholds in cardiopulmonary exercising tests: from regression to generation to explanation. Sensors. 2023;23:1–15. https://doi.org/10.3390/s23020826.

Article  Google Scholar 

Zignoli A, Fornasiero A, Rota P, Muollo V, Peyré-Tartaruga LA, Low DA, et al. Oxynet: A collective intelligence that detects ventilatory thresholds in cardiopulmonary exercise tests. Eur J Sport Sci. 2021. https://doi.org/10.1080/17461391.2020.1866081.

Article  PubMed  Google Scholar 

Zignoli A, Fruet D. Automatic generation of realistic cardiopulmonary exercise test data with a conditional generative adversarial neural network. 2022 IEEE International Workshop on Sport, Technology and Research, STAR 2022 - Proceedings. Institute of Electrical and Electronics Engineers Inc.; 2022. p. 29–34. https://doi.org/10.1109/STAR53492.2022.9859993

Keir DA, Pogliaghi S, Inglis EC, Murias JM, Iannetta D, Springer Science and Business Media Deutschland GmbH. The respiratory compensation point: mechanisms and relation to the maximal metabolic steady state. Sports Med. 2024. https://doi.org/10.1007/s40279-024-02084-3.

Article  PubMed  Google Scholar 

Zignoli A, Fornasiero A, Stella F, Pellegrini B, Schena F, Biral F, et al. Expert-level classification of ventilatory thresholds from cardiopulmonary exercising test data with recurrent neural networks. Eur J Sport Sci. 2019;19:1221–9. https://doi.org/10.1080/17461391.2019.1587523.

Article  PubMed  Google Scholar 

Lamarra N, Whipp BJ, Ward SA, Wasserman K. Effect of interbreath fluctuations on characterizing exercise gas exchange kinetics. J Appl Physiol. 1987;62:2003–12.

Article  CAS  PubMed  Google Scholar 

Keir DA, Murias JM, Paterson DH, Kowalchuk JM. Breath-by-breath pulmonary O2 uptake kinetics: effect of data processing on confidence in estimating model parameters. Exp Physiol. 2014;99:1511–22. https://doi.org/10.1113/expphysiol.2014.080812.

Article  PubMed  Google Scholar 

Whipp BJ. Physiological mechanisms dissociating pulmonary CO2 and O2 exchange dynamics during exercise in humans. Exp Physiol. 2007;92:347–55. https://doi.org/10.1113/expphysiol.2006.034363.

Article  CAS  PubMed  Google Scholar 

Ozcelik O, Ward SA, Whipp BJ. Effect of altered body CO2 stores on pulmonary gas exchange dynamics during incremental exercise in humans. Exp Physiol. 1999;84:999–1011. https://doi.org/10.1111/j.1469-445X.1999.01868.x.

Article  CAS  PubMed  Google Scholar 

Keltz RR, Hartley T, Huitema AA, McKelvie RS, Suskin NG, Keir DA. Do clinical exercise tests permit exercise threshold identification in patients referred to cardiac rehabilitation? Can J Cardiol. 2023;39:1701–11. https://doi.org/10.1016/j.cjca.2023.07.029.

Article  PubMed