Conclusion
CPET is a valid, accessible, non-invasive and easily repeatable method of functional diagnostics, which is applicable in childhood to determine the functional capacity of the organism of the subject and to detect the causes of reduced exercise tolerance. Pectus excavatum is a frequent deformity of the chest (especially in the male population) and the functional obstacles in the tolerance of physical exertion are frequently attributed to persons with this deformity. Understanding the pathophysiological context in patients with PE should lead to the discovery of the real impact of the deformity on the overall health of the patient and should guide the decision on therapeutic interventions. When conducting future studies in patients with PE, it is appropriate to compare their CPET parameters with equally active healthy controls to distinguish changes that are attributable to deformity and those that are due to other physical activity. The appropriateness of using the OUES parameter to assess the relationship of deformity to physical condition and performance should be supported by other independent observations as well as observations in patients with PE with respect to normal weekly physical activity. In order to develop knowledge of the body’s adaptation to stress and the impact of this adaptation on CPET parameters, it is necessary to evaluate in the future not only performance parameters but also regeneration parameters (e.g. pulse regeneration, respiratory regeneration) and also focus on new parameters such as respiratory patterns or the character of flow limitation.