Posture matters: how body position shapes cardiopulmonary response to maximal exercise testing

American Journal of Physiology-Heart and Circulatory Physiology 2026 Open access

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Authors: Massimo Mapelli, Fiorella Puttini, Irene Mattavelli, Elisabetta Salvioni, Arianna Galotta, Giovanni Ferrarini, Mattia Canevari, Robin Willixhofer, Rebecca Caputo, Simona Costantino, Matteo Biroli, Camilla Lustri
+4 more Davide Grandi, Andrea Teglia, Massimo Valenti, Piergiuseppe Agostoni
DOI: 10.1152/ajpheart.00068.2026
Cited by: 1
References: 30

Abstract

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.

Fields of Study & Subjects

Cardiovascular and exercise physiology Non-Invasive Vital Sign Monitoring Heart Rate Variability and Autonomic Control

Publication details

Journal / source
American Journal of Physiology-Heart and Circulatory Physiology
Publisher
American Physiological Society
Volume
330
Issue
6
Pages
H1715–H1722
Publication date
17 April 2026
Language
EN