In honor of ME/CFS week, we are happy to highlight the newest tool in the fight to not only treat but also recognize chronic fatigue and related conditions: The Invasive Cardiopulmonary Exercise Test, also known as iCPET.
As those familiar with ME/CFS and other related conditions may be aware, “traditional” CPET is the gold standard for objectively measuring the limitations caused by chronic fatigue and the impact those limitations have on an individual’s ability to work. Dr. Christopher Snell and the incredible people at the Workwell Foundation have been administering (and improving) this test for years. Despite the plethora of peer-reviewed data confirming CPET’s objective effectiveness in measuring such limitations, insurers still do their best to disregard and minimize CPET.
In contrast to the CPET, which only requires being hooked up to “external” sensors, the iCPET involves the additional insertion of pulmonary artery and radial artery catheters before administering the test. This allows for “complete cardiopulmonary hemodynamic and peripheral tissue O2 extraction analyses, without which only the degree of impairment (maximum Vo2) and the identification of a pulmonary mechanical limitation to exercise are possible.
In this way, iCPET expands broadly over conventional CPET the range of data acquired during exercise to include key physiological measures that are required to diagnose 3 under-recognized causes of exertional dyspnea: exercise-induced PAH,9 exercise-induced heart failure with preserved left ventricular ejection fraction (HFpEF),15 and preload-dependent limitations to cardiac output (preload failure),16,17 as well as quantifying functional limitations to exercise, and thus prognosis, in patients with established PAH at rest.” You can read more about this in Circulation, a publication of the American Heart Association.
In other words, one of the primary areas of improvement of the iCPET over traditional CPET is the iCPET’s ability to better diagnose the cause of a particular limitation. In doing so the iCPET not only helps your doctor treat your symptoms; it can help confirm the physical source of a condition which a disability insurer may be under classifying as psychosomatic. The iCPET is yet another potential tool to help with the fight for identification and recognition of ME/CFS and other fatigue-related illnesses.
If you suffer from ME/CFS and have had your disability benefits denied, please call Kantor & Kantor for a free consultation. We can be reached at (818) 886-2525 or use our online contact form.