Table 1.

Clinical applications of EIPH measurements.

Diagnostic Tool/Parameters	Diseases	Clinical Applications—“Strengths”	Limitations—“Weaknesses”
ESE (TRVmax PASP calculation)	PAH	(1)Predictor of PH in pts with systemic sclerosis with normal resting mPAP. (2)Higher risk of hospitalizations in pts with myelodysplastic syndrome. (3)Helpful for decision-making in asymptomatic pts with severe MS. (4)Helpful for diagnosis and risk stratification in asymptomatic pts with severe MR. (5)Helpful for diagnosis and risk stratification in asymptomatic pts with severe AS. (6)Index of worse prognosis in pts with HFrEF. (7)Index of worse prognosis in pts with HCM.	(1)PASP influenced by pulmonary function, exercise capacity and age. (2)Sometimes failure to get sufficient Doppler signal for TRVmax. (3)Inability to perform exercise test in older patients or those with orthopedic problems. (4)Need for cut-off value determination and validation.
	MS
	MR
	AS
	HFrEF
	HCM
CPET (VE/VCO2, peak VO2, PETCO2)	PAH	(1)Good correlation with RHC for PAH diagnosis. (2)Normal values exclude PAH.	(1)Patients’ discomfort. (2)Complex interpretation. (3)Need for cut-off value determination and validation.
RHC during exercise (mPAP, wPAP)	MR	(1)Current gold standard method. (2)Helpful for diagnosis and prognosis of MR. (3)Helpful for diagnosis of HFpEF.	(1)Invasive technique. Potential complications and high facilities demand. (2)Not easily repeatable. (3)Artifacts and catheter whip during exercise.
	HFpEF

AS, aortic stenosis; CPET, cardiopulmonary exercise testing; ESE, exercise–stress echocardiography; HCM, hypertrophic cardiomyopathy; MR, mitral regurgitation; HFpEF, heart failure preserved ejection fraction; HFrEF, heart failure reduced ejection fraction; mPAP, mean pulmonary artery pressure; MS, mitral stenosis; PASP, pulmonary artery systolic pressure; peak VO2, peak oxygen consumption; PETCO₂, extrapolated end-tidal carbon dioxide tension; pts, patients; PAH, pulmonary artery hypertension; RHC; right heart catheterization; TRVmax, tricuspid regurgitation maximum velocity; VE/VCO2, ventilation to carbon dioxide production relationship; wPAP, wedge PAP.