Posture matters: how body position shapes cardiopulmonary response to maximal exercise testing
Body position during exercise testing profoundly affects cardiopulmonary responses, even in healthy individuals. Results obtained in different postures are not directly comparable. Upright, semirecumbent, and supine exercise produce systematic changes in oxygen uptake, ventilation, workload, and dyspnea, with lower performance in reclined positions. Despite this, cardiac output is preserved through adjustments in heart rate and stroke volume, indicating that posture-rather than cardiac dysfunction-drives differences. Without posture-specific reference values, disease severity may be misinterpreted.
Authors
- Mattia Canevari (ORCID: https://orcid.org/0009-0005-5881-1441)
- S. Costantino
- Rebecca Caputo
- Robin Willixhofer (ORCID: https://orcid.org/0000-0003-3405-5715)
- Massimo Mapelli (ORCID: https://orcid.org/0000-0001-9985-7407)
- Andrea Teglia
- Arianna Galotta (ORCID: https://orcid.org/0000-0001-9561-9436)
- Matteo Biroli (ORCID: https://orcid.org/0000-0002-3373-7741)
- D. Grandi (ORCID: https://orcid.org/0000-0003-1942-8587)
- Piergiuseppe Agostoni (ORCID: https://orcid.org/0000-0002-8345-6382)
- M. Valenti
- Irene Mattavelli (ORCID: https://orcid.org/0000-0002-7781-1691)
- Camilla Lustri
- Giovanni Ferrarini
- Fiorella Puttini
- Elisabetta Salvioni
Institutions
- University of Trieste (IT)
- University of Milan (IT)
- Centro Cardiologico Monzino (IT)
- Azienda Unità Sanitaria Locale di Ferrara (IT)
- University of Milano-Bicocca (IT)
- University of Bologna (IT)
Publication Details
- Journal
- American Journal of Physiology-Heart and Circulatory Physiology
- Published
- 2026-04-17
- DOI
- https://doi.org/10.1152/ajpheart.00068.2026
- Primary Topic
- Cardiovascular and exercise physiology
- Type
- article
- Field-Weighted Citation Impact
- 0.00