Back to overview

Longevity Knowledge BETA

Spiroergometry

Table of Contents

What is spiroergometry?

Spiroergometry, also known as cardiopulmonary exercise testing (CPET), is the most comprehensive method for assessing physical fitness and cardiovascular health. The test measures how your heart, lungs, and muscles work together during controlled exercise by combining a treadmill or cycle ergometer with breath-by-breath gas analysis [1].

The primary output—VO2max—represents the maximum amount of oxygen your body can use during peak exertion. Research consistently shows VO2max is one of the strongest predictors of all-cause mortality, with studies demonstrating that improving from low to moderate fitness provides greater survival benefits than eliminating major risk factors like smoking [2].

How the test works

During a CPET session, you wear a face mask connected to a metabolic analyzer while exercising on a cycle ergometer or treadmill. The workload increases gradually in stages until you reach volitional exhaustion. Sensors continuously record oxygen uptake, carbon dioxide output, ventilation, heart rate, blood pressure, and ECG readings throughout the 8 to 12 minute incremental phase [3].

This approach produces a metabolic profile that resting tests and wearable devices cannot replicate. The data reveals your aerobic capacity, anaerobic threshold, ventilatory efficiency, and substrate utilization—providing a complete picture of your cardiorespiratory fitness.

Key measurements explained

Beyond VO2max, spiroergometry yields several clinically important parameters. The anaerobic threshold marks the exercise intensity where lactate begins to accumulate—a critical marker for sustainable training intensity and Zone 2 heart rate training [4].

The respiratory exchange ratio indicates whether your body burns fat or carbohydrates for fuel at different intensities. Ventilatory efficiency measurements help identify cardiac or pulmonary limitations. These precise metrics enable truly personalized training programs and early detection of cardiovascular dysfunction before symptoms appear.

Who should consider testing?

Athletes use CPET to optimize training zones and monitor performance gains. Medical applications include evaluating unexplained shortness of breath, assessing heart failure severity, and preoperative risk stratification [5].

For longevity-focused individuals, a baseline test establishes objective fitness benchmarks. Retesting every 12 to 24 months tracks changes in your cardiovascular trajectory and validates whether your exercise program produces meaningful physiological adaptations.

References

  1. 1. Cardiopulmonary exercise testing: contemporary review of methodology, applications and future directions
  2. 2. Exercise capacity and mortality among men referred for exercise testing
  3. 3. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations
  4. 4. Ventilatory efficiency in heart failure: a prognostic marker and therapeutic target
  5. 5. Physical exercise as treatment for persisting symptoms post-COVID: randomized controlled training study
1.

Choose the right test protocol

Ask your testing facility whether they use a ramp or step protocol. Cycle ergometry offers precise workload control and is standard in Europe, while treadmill protocols typically yield 5-10% higher VO2max values.
pubmed.ncbi.nlm.nih.gov
2.

Use your anaerobic threshold for training zones

Your anaerobic threshold heart rate from CPET defines the upper limit of Zone 2 training—the intensity that builds aerobic base most efficiently. Training at or just below this threshold maximizes cardiovascular adaptation.
pubmed.ncbi.nlm.nih.gov
3.

Retest every 12-24 months

Cardiorespiratory fitness changes with training. Annual retesting objectively measures fitness gains, allows adjustment of training zones as thresholds shift, and detects early age-related decline.
pubmed.ncbi.nlm.nih.gov
4.

Do not rely on wearable estimates

Wearables estimate VO2max using algorithms based on heart rate and pace, but these estimates can deviate from true VO2max by 10-20%. Only direct gas analysis during CPET provides accurate measurements for training optimization.
5.

Ensure proper protocol selection

Ask your testing facility whether they use a ramp or step protocol on a cycle ergometer or treadmill. Cycle ergometry allows more precise workload control and is standard in Europe, while treadmill protocols typically elicit 5-10% higher VO2max values.
pubmed.ncbi.nlm.nih.gov
6.

Prepare properly for accurate results

Avoid heavy meals 2-3 hours before the test, skip caffeine on the morning of testing, and refrain from intense exercise for 24-48 hours beforehand. Wear comfortable athletic clothing and bring appropriate footwear for the ergometer type.
7.

Focus on the anaerobic threshold for training zones

Your anaerobic threshold (VT1) heart rate from CPET defines the upper limit of Zone 2 training—the intensity that builds aerobic base most efficiently. Training consistently at or just below this threshold maximizes cardiovascular adaptation with minimal injury risk.
pubmed.ncbi.nlm.nih.gov
8.

Retest every 12-24 months to track progress

Cardiorespiratory fitness is highly modifiable through training. Repeating CPET annually allows you to objectively measure fitness gains, adjust training zones as thresholds shift, and detect early age-related decline before it becomes clinically significant.
pubmed.ncbi.nlm.nih.gov
9.

Understand the difference between VO2max and VO2peak

True VO2max shows a plateau in oxygen uptake despite increasing workload, while VO2peak is simply the highest value achieved. Many tests measure VO2peak rather than true VO2max. Both are clinically meaningful, but knowing which value your report shows aids accurate interpretation.
pubmed.ncbi.nlm.nih.gov
1.

What is the difference between CPET and a standard stress test?

A standard cardiac stress test monitors heart rate, blood pressure, and ECG during exercise but does not measure respiratory gases. Cardiopulmonary exercise testing adds breath-by-breath gas exchange analysis, measuring oxygen uptake and carbon dioxide output. This provides a detailed picture of metabolic function and precise aerobic capacity that standard stress tests cannot deliver.
2.

How long does a spiroergometry test take?

The entire appointment typically takes 45 to 60 minutes, including preparation and explanation. The actual exercise phase lasts 8 to 12 minutes of incrementally increasing intensity, followed by a 3 to 5 minute recovery period. The protocol is designed so you reach maximal exertion within this window for optimal data quality.
3.

What are normal VO2max values?

In healthy adults aged 20-39, average VO2max values are approximately 35-45 mL/kg/min for women and 40-50 mL/kg/min for men. After age 30, VO2max declines by roughly 10% per decade without training intervention. Values above the 75th percentile for age and sex are associated with significantly lower mortality risk.
4.

What is the difference between a cardiopulmonary exercise test and a regular stress test?

A standard cardiac stress test monitors heart rate, blood pressure, and ECG during exercise but does not measure respiratory gases. Cardiopulmonary exercise testing (CPET) adds breath-by-breath gas exchange analysis, measuring oxygen uptake (VO2) and carbon dioxide output (VCO2). This provides a far more detailed picture of metabolic function, ventilatory efficiency, and precise aerobic capacity (VO2max) that a standard stress test cannot deliver.
5.

How long does a cardiopulmonary exercise test take?

The entire appointment typically takes 45 to 60 minutes, including preparation, calibration, and explanation. The actual exercise phase lasts 8 to 12 minutes of incrementally increasing intensity, followed by a 3 to 5 minute recovery period. The incremental phase is designed so that you reach maximal exertion within this window for optimal data quality.
6.

What are normal VO2max values by age and sex?

In healthy adults aged 20-39, average VO2max values are approximately 35-45 mL/kg/min for women and 40-50 mL/kg/min for men. After age 30, VO2max declines by roughly 10% per decade without training intervention. Values above the 75th percentile for age and sex are associated with significantly lower all-cause mortality risk, while values below the 25th percentile indicate elevated cardiovascular risk.
7.

How much does cardiopulmonary exercise testing cost?

In Germany, a spiroergometry test typically costs between 100 and 250 EUR when paid out of pocket at a sports medicine clinic. Health insurance may cover the cost when there is a medical indication such as heart failure evaluation or preoperative risk assessment. In the United States, CPET costs range from 200 to 500 USD depending on the facility. Many longevity-focused clinics now offer CPET as part of comprehensive health assessments.
8.

Can wearable devices like WHOOP or Garmin replace a spiroergometry test?

No. Wearables estimate VO2max using algorithms based on heart rate, pace, and demographic data, but these estimates can deviate from true VO2max by 10-20% or more. They cannot measure anaerobic threshold, ventilatory efficiency, or substrate utilization. Spiroergometry remains irreplaceable for precise training zone determination, clinical diagnosis, and accurate baseline assessment. Wearables are useful for daily tracking between formal CPET sessions.
Log in to ask

No discussions yet

Be the first to start a discussion about Spiroergometry.

This content was created and reviewed by the New Zapiens Editorial Team in accordance with our editorial guidelines.
Last updated: February 26, 2026

Community Discussions

How accurate is VO₂max tracking from wearables like WHOOP, Oura, and Garmin compared to lab tests (lactate threshold or spiroergometry)?

Karol Domagalski · 10
Next → Stem Cell Therapy

Discover trusted longevity brands
and expert health stacks

Stop wasting money on ineffective products
Save up to 5 hours of research per week
Delivered to your inbox every Thursday