The usefulness of the anaerobic threshold in the assessment and prognostic evaluation of the patient with dyspnea

The anaerobic threshold (AT) is defined as the oxygen consumption level above which energy production becomes determined by anaerobic metabolism, which causes a sustained increase in lactate and metabolic acidosis. The AT, as measured by cardiopulmonary stress testing, is ubiquitously used to determine the prognosis and diagnosis of cardiovascular and respiratory diseases. This measurement can help clinicians in the functional evaluation of patients and as guidance for rehabilitation and therapy. This article reviews the pathophysiological aspects and methods of measurement of the AT during a cardiopulmonary stress test, and its clinical use in assessing cardiac and respiratory diseases.