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1

Cardiopulmonary Exercise Testing in Clinical Practice  

Microsoft Academic Search

Cardiopulmonary exercise testing refers to the noninvasive measurement of respiratory gas exchange and air flow, together with heart rate, blood pressure, and the electrocardiogram. These data, obtained during an incremental exercise test, can be used to derive the aerobic capacity or Vo2max, which is an objective measure of the severity of chronic cardiac and circulatory failure, as well as to

Karl T. Weber; Joseph S. Janicki; Patricia A. McElroy; Carol S. Maskin

1987-01-01

2

Software for interpreting cardiopulmonary exercise tests  

Microsoft Academic Search

BACKGROUND: Cardiopulmonary exercise testing (CPET) has become an important modality for the evaluation and management of patients with a diverse array of medical problems. However, interpreting these tests is often difficult and time consuming, requiring significant expertise. METHODS: We created a computer software program (XINT) that assists in CPET interpretation. The program uses an integrative approach as recommended in the

Robert M Ross; David B Corry

2007-01-01

3

Cardiopulmonary Exercise Testing in Chronic Heart Failure  

Microsoft Academic Search

Cardiopulmonary exercise testing (CPX) is being increasingly used in patients with chronic heart failure (CHF) for diagnostic\\u000a and prognostic purposes. It provides major insights regarding the degree of functional impairment, the prognosis, and the\\u000a effect of treatment. Despite the availability of simple and rapid gas analyzers, the general belief is that the procedure\\u000a is complex, which is not the case.

Alain Cohen-Solal; Florence Beauvais; Jean Yves Tabet

4

Exercise-Induced Myocardial Ischemia Detected by Cardiopulmonary Exercise Testing  

Microsoft Academic Search

Cardiopulmonary exercise testing (CPET) is a well-accepted physiologic evaluation tech- nique in patients diagnosed with heart failure and in patients presenting with unexplained dyspnea on exertion. Several variables obtained during CPET, including oxygen consump- tion relative to heart rate and work rate provide consistent, quantitative patterns of abnormal physiologic responses to graded exercise when left ventricular dysfunction is caused by

Sundeep Chaudhry; Ross Arena; Karlman Wasserman; James E. Hansen; Gregory D. Lewis; Jonathan Myers; Nicolas Chronos; William E. Boden

2009-01-01

5

Software for interpreting cardiopulmonary exercise tests  

PubMed Central

Background Cardiopulmonary exercise testing (CPET) has become an important modality for the evaluation and management of patients with a diverse array of medical problems. However, interpreting these tests is often difficult and time consuming, requiring significant expertise. Methods We created a computer software program (XINT) that assists in CPET interpretation. The program uses an integrative approach as recommended in the Official Statement of the American Thoracic Society/American College of Chest Physicians (ATS/ACCP) on Cardiopulmonary Exercise Testing. In this paper we discuss the principles behind the software. We also provide the detailed logic in an accompanying file (Additional File 1). The actual program and the open source code are also available free over the Internet at . For convenience, the required download files can also be accessed from this article. Results To test the clinical usefulness of XINT, we present the computer generated interpretations of the case studies discussed in the ATS/ACCP document in another accompanying file (Additional File 2). We believe the interpretations are consistent with the document's criteria and the interpretations given by the expert panel. Conclusion Computers have become an integral part of modern life. Peer-reviewed scientific journals are now able to present not just medical concepts and experimental studies, but actual functioning medical interpretive software. This has enormous potential to improve medical diagnoses and patient care. We believe XINT is such a program that will give clinically useful interpretations when used by the medical community at large.

Ross, Robert M; Corry, David B

2007-01-01

6

Cardiopulmonary Exercise Testing in Fabry Disease  

Microsoft Academic Search

Background: Fabry disease is a rare X-linked disorder that results from a deficiency in a lysosomal enzyme known as ?-galactosidase A, with accumulation of globotriaosylceramide (Gl3). Early manifestations include angiokeratomas, acroparesthesias, and hypohidrosis and may progress to renal failure, cardiac dysfunction, and stroke. Patients exhibit decreased exercise tolerance and often complain of fatigue. Objective: Our study evaluates the cardiopulmonary characteristics

Gregory Bierer; Nader Kamangar; David Balfe; William R. Wilcox; Zab Mosenifar

2005-01-01

7

Cardiopulmonary exercise testing (CPET) in pulmonary emphysema  

Microsoft Academic Search

In patients affected by chronic obstructive pulmonary disease (COPD), cardiopulmonary response to exercise was never related to the severity of emphysema (E) measured by high resolution computed tomography (HRCT).Sixteen patients (age=65±8yrs; FEV1=54±18%pred; RV=160±28%pred) with moderate to severe E (quantified by lung HRCT as % voxelsexercised on a cycle-ergometer to exhaustion. Oxygen uptake (V?O2), carbon dioxide output (V?CO2),

Patrizia Paoletti; Francesca De Filippis; Francesco Fraioli; Alessandra Cinquanta; Gabriele Valli; Pierantonio Laveneziana; Francesco Vaccaro; Dario Martolini; Paolo Palange

2011-01-01

8

Cardiopulmonary exercise test evidence of isolated right coronary artery disease  

Microsoft Academic Search

Isolated right coronary artery disease is usually difficult to diagnose because of frequent negativity of standard exercise stress test. We report a case of isolated coronary artery stenosis which was not detected by standard ECG stress testing. The cardiopulmonary exercise test showed a peculiar pattern: abrupt flattening in VO2\\/Work relationship, plateau in O2 pulse and 90 s afterwards a plateau

Mauro Contini; Daniele Andreini; Piergiuseppe Agostoni

2006-01-01

9

Cardiopulmonary exercise testing for the evaluation of perioperative risk in non-cardiopulmonary surgery  

Microsoft Academic Search

The use of cardiopulmonary exercise testing (CPET) as a preoperative risk stratification tool for a range of non-cardiopulmonary surgery is increasing. The utility of CPET in this role is dependent on the technology being able to identify accurately and reliably those patients at increased risk of perioperative events when compared with existing risk stratification tools. This article identifies and reviews

Philip J Hennis; Paula M Meale; Michael P W Grocott

2011-01-01

10

Cardiopulmonary exercise testing in obstructive sleep apnea syndrome  

Microsoft Academic Search

To investigate whether cardiac dysfunction or abnormal measurements on cardiopulmonary exercise testing (CPET) are present in patients with obstructive sleep apnea syndrome (OSAS) and what factors are responsible for exercise limitation in these patients. We enrolled 20 patients with moderate or severe OSAS in the OSA group and 20 subjects without OSAS in the control group. All subjects underwent a

Ching-Chi Lin; Wen-Yeh Hsieh; Chon-Shin Chou; Shwu-Fang Liaw

2006-01-01

11

Serial Cardiopulmonary Exercise Testing in Patients with Previous Fontan Surgery  

Microsoft Academic Search

Patients with previous Fontan surgery have reduced peak oxygen consumption (Vo\\u000a 2), and data regarding progression of exercise intolerance is limited. The purpose of this study was to assess the evolution\\u000a of exercise tolerance in patients with previous Fontan surgery. We performed a retrospective cohort study of patients with\\u000a previous Fontan surgery who underwent cardiopulmonary exercise testing between November 2002

Susan M. Fernandes; Doff B. McElhinney; Paul Khairy; Dionne A. Graham; Michael J. Landzberg; Jonathan Rhodes

2010-01-01

12

CARDIOPULMONARY EXERCISE TESTING: UTILITY IN RESEARCH AND PATIENT CARE  

Microsoft Academic Search

Cardiopulmonary exercise testing is a non-invasive physiological test which incorporates the conventional method of exercise stress test with a more advanced breath-to-breath ventilatory analysis. The physiological parameters obtained from the test help to illustrate the cardiovascular, respiratory and metabolic responses to physical exertion. Individual's functional capacity and aerobic fitness is reflected by the value of maximal oxygen consumption (VO 2

Elina RA; Husain R; Lang CC

13

Cardiopulmonary exercise test in patients with subacute pulmonary emboli  

Microsoft Academic Search

ObjectivePatients presenting with suspected pulmonary embolism (PE) may present a challenge, particularly if diagnostic testing is not immediately available or clinically not indicated (iodine allergy, pregnancy, renal dysfunction). These patients have abnormal regional gas exchange that can be recognized by a cardiopulmonary exercise test (CPET), which may become helpful in their evaluation.

Yan Topilsky; Courtney L. Hayes; Amber D. Khanna; Thomas G. Allison

14

Cardiopulmonary exercise testing in the pre-operative assessment  

Microsoft Academic Search

We have investigated the value of cardiopulmonary exercise testing in the pre-operative assessment of patients for abdominal\\u000a aortic aneurysm repair. Thirty-six patients were entered into the study. All had a pre-operative clinical assessment and investigations\\u000a including chest radiograph, electrocardiograph, spirometry and echocardiogram with measurement of left ventricular ejection\\u000a fraction. Each patient performed a symptom limited treadmill exercise test using a

A. M. Nugent; M. Riley; J. Megarry; J. MacMahon; R. Lowry; M. J. G. O’Reilly

1998-01-01

15

Quality Assurance and Cardiopulmonary Exercise Testing in Clinical Trials  

Microsoft Academic Search

BackgroundPeak oxygen uptake (VO2) measured during cardiopulmonary exercise testing (CPX) is often used as an outcome measure in clinical trials. The purposes of this study are (a) to report the outcomes of a quality assurance (QA) procedure instituted in multisite clinical trials by a CPX data core laboratory and (b) to report a normative VO2 reference dataset for future use.

Clinton A. Brawner; Jonathan K. Ehrman; Heather Aldred; John R. Schairer; Steven J. Keteyian

2008-01-01

16

Cardiopulmonary exercise testing following hay exposure challenge in farmer's lung  

Microsoft Academic Search

ABSTRACT: In patients experiencing an acute ,episode of hypersensitivity pneu- monitis (HP), the alveoli and interstitium show a marked inflammation. The effects ofthis infiltration with effector cells on gas ,exchange and the cardiopulmonary system are not well characterized, and there are no data regarding cardiopul- monary,exercise testing during hypersensitivitypneumonitis. The aim of this study was to gain new insights into

M. Schwaiblmair; T. Beinert; C. Vogelmeier; G. Fruhmann

1997-01-01

17

Exercise testing in survivors of intensive care—is there a role for cardiopulmonary exercise testing?  

Microsoft Academic Search

PurposeThe aims of this study were to assess the feasibility of cardiopulmonary exercise testing (CPET) for the early assessment of cardiorespiratory fitness in general adult intensive care unit (ICU) survivors and to characterize the pathophysiology of exercise limitation in this population.

Steve Benington; David McWilliams; Jane Eddleston; Dougal Atkinson

18

Usefulness of the Cardiopulmonary Exercise Test in Congenital Heart Disease  

Microsoft Academic Search

Background and Objectives: This study aimed to evaluate the usefulness of cardiopulmonary exercise test (CPET) in children with various congenital heart diseases (CHDs). Subjects and Methods: Forty-eight children and adolescents (18 girls and 30 boys; mean±SD age, 12.6±0.5 years) with CHD who had undergone correc- tive surgery performed CPET using a programmable treadmill. The participants were divided into 4 groups

Gi Beom Kim; Bo Sang Kwon; Eun Young Choi; Eun Jung Bae; Chung Il Noh; Yong Soo Yun; Woong Han Kim; Jeong Ryul Lee; Yong Jin Kim

2007-01-01

19

Cardiopulmonary Exercise Testing in Lung Transplantation: A Review  

PubMed Central

There has been an increase in lung transplantation in the USA. Lung allocation is guided by the lung allocation score (LAS), which takes into account one measure of exercise capacity, the 6-minute walk test (6MWT). There is a paucity of data regarding the role and value of cardiopulmonary stress test (CPET) in the evaluation of lung transplant recipients while on the transplant waiting list and after lung transplantation. While clearly there is a need for further prospective investigation, the available literature strongly suggests a potential role for CPET in the setting of lung transplant.

Dudley, Katherine A.; El-Chemaly, Souheil

2012-01-01

20

Diagnosis of pulmonary vascular limit to exercise by cardiopulmonary exercise testing  

Microsoft Academic Search

BackgroundGiven the recent development of newer and less-invasive treatments for pulmonary hypertension, and the long wait for lung transplantation, early and correct diagnosis of this condition is increasingly important. The purpose of this study was to determine and improve the accuracy of a non-invasive, cardiopulmonary exercise-testing algorithm for detecting a pulmonary vascular limit to exercise.

Deborah H Markowitz; David M Systrom

2004-01-01

21

Cardiopulmonary exercise testing: arm crank vs cycle ergometry.  

PubMed

This pilot study compared oxygen consumption during arm crank and cycle ergometer tests in 15 women. The mean (SD) peak oxygen consumption was less with arm cranking (25 (5) ml.kg(-1) .min(-1)) than with cycling (40 (7) ml.kg(-1) .min(-1)), p < 0.0001. The mean (SD) anaerobic threshold was less with arm cranking (13 (2) ml.kg(-1) .min(-1)) than with cycling (20 (4) ml.kg(-1) .min(-1)), p < 0.0001. There was moderate correlation, r(2) = 0.60, between the anaerobic thresholds determined by arm and leg exercise, p = 0.0007. This study suggests that arm crank cardiopulmonary exercise testing could be used for pre-operative assessment in those unable to cycle. PMID:23573845

Orr, J L; Williamson, P; Anderson, W; Ross, R; McCafferty, S; Fettes, P

2013-05-01

22

[From interpretation of cardiopulmonary exercise testing to medical decision].  

PubMed

Exercise is a situation that involves cardiovascular, respiratory and metabolic responses simultaneously. Thus, interpretating the results of the cardiopulmonary exercise testing (CPET) requires an integrated understanding of the pathophysiology of exercise intolerance which may result from lung, heart, pulmonary or peripheral circulation, muscles disturbances, or a combination of these functional disorders. In this paper, we offer a systematic method to assist clinicians in developing a pathophysiological reasoning from the functional competency of each component measured during incremental exercise. We propose to go through four steps: descriptive analysis, prioritization of the functional disorders, mechanistic proposals and diagnostic and/or therapeutic suggestions. The descriptive analysis step should answer seven key physiological questions, the prioritization step is based on the magnitude of the functional disorders and their relevance to the primary symptoms causing exercise intolerance, the mechanistic proposals step aims at suggesting different mechanisms and etiologies compatible with the scale of observed functional abnormalities, which will finally be tested by exploring specific diagnostic or therapeutic suggestions. PMID:23835322

Aguilaniu, B; Wallaert, B

2013-06-28

23

Cardiopulmonary Exercise Testing in the Functional and Prognostic Evaluation of Patients with Pulmonary Diseases  

Microsoft Academic Search

Exercise testing is increasingly utilized to evaluate the level of exercise intolerance in patients with lung and heart diseases. Cardiopulmonary exercise testing (CPET) is considered the gold standard to study a patient’s level of exercise limitation and its causes. The 2 CPET protocols most frequently used in the clinical setting are the maximal incremental and the constant work rate tests.

A. M. Ferrazza; D. Martolini; G. Valli; P. Palange

2009-01-01

24

Cardiopulmonary Exercise Test in Chronic Heart Failure: Beyond Peak Oxygen Consumption  

Microsoft Academic Search

Patients with cardiovascular diseases commonly present with exercise intolerance, clinically manifest as shortness of breath\\u000a and fatigue, and these symptoms have important prognostic implications. Cardiopulmonary exercise testing is a well-established\\u000a method for evaluation of cardiopulmonary diseases. It provides an objective assessment of maximal aerobic capacity (peak VO2), estimates prognosis, and allows the physician to discriminate among many subtle and often

Veronica Franco

2011-01-01

25

The Prognostic Value of Cardiopulmonary Exercise Testing in Idiopathic Pulmonary Fibrosis  

Microsoft Academic Search

Rationale: Idiopathic pulmonary fibrosis (IPF) is characterized by pro- gressive dyspnea, impaired gas exchange, and ultimate mortality. Objectives: To test the hypothesis that maximal oxygen uptake during cardiopulmonary exercise testing at baseline and with short-term longitudinal measures would predict mortality in patients with idiopathic pulmonary fibrosis. Methods: Data from 117 patients with IPF and longitudinal cardio- pulmonary exercise tests were

Charlene D. Fell; Lyrica Xiaohong Liu; Caroline Motika; Ella A. Kazerooni; Barry H. Gross; William D. Travis; Thomas V. Colby; Susan Murray; Galen B. Toews; Fernando J. Martinez; Kevin R. Flaherty

26

Potential clinical use of cardiopulmonary exercise testing in obstructive sleep apnea hypopnea syndrome  

Microsoft Academic Search

There is growing evidence linking obstructive sleep apnea hypopnea syndrome (OSAHS) with multiple cardiovascular and metabolic diseases. Exercise testing is generally available and routinely used to provide valuable information on cardiopulmonary function in healthy and diseased populations. This review summarizes and integrates recent findings on exercise testing in OSAHS and discusses the potential mechanisms that may contribute to the responses

Adrian Aron; Donald Zedalis; John M. Gregg; Francis C. Gwazdauskas; William G. Herbert

2009-01-01

27

The Clinical Utility of Cardiopulmonary Exercise Testing in Suspected or Confirmed Myocardial Ischemia  

Microsoft Academic Search

Heart disease is a major cause of morbidity and mortality in the United States, with coronary artery disease (CAD) representing more than half of all cardiovascular events. Stable patients presenting with symptoms suggestive of CAD are likely to undergo an exercise electrocardiogram (ECG) and\\/ or imaging study as a first-line diagnostic assessment. A cardiopulmonary exercise test (CPX) is an ECG

Sherry Pinkstaff; Mary Ann Peberdy; Alexander Fabiato; Sheryl Finucane; Ross Arena

2010-01-01

28

Oxygen uptake kinetics during cardiopulmonary exercise testing and postoperative complications in patients with lung cancer  

Microsoft Academic Search

It is accepted that cardiopulmonary exercise testing is one of the most valuable parameters, especially peak oxygen uptake (VO2), for the evaluation of risk assessment in lung cancer surgery. It therefore represents an attractive way of identifying a patient at high risk for postoperative complications. However, many patients do not achieve the maximal or predictive level during an incremental exercise

Erdem Kasikcioglu; Alper Toker; Serhan Tanju; Piyer Arzuman; Abidin Kayserilioglu; Sukru Dilege; Goksel Kalayci

2009-01-01

29

Association Between Emphysema Score, Six-Minute Walk and Cardiopulmonary Exercise Tests in COPD  

PubMed Central

Background: High-resolution computed tomography (HRCT) has allowed in detection of airway wall abnormalities and emphysema, whose extent may correlate with the clinical severity of the disease in patients with chronic obstructive pulmonary disease (COPD). Six minute walk test (6MWT) and cardiopulmonary exercise test (CPET) can determine functional status. Methods: A study was undertaken to investigate whether the extent of emphysema in COPD patients quantitatively confirmed by HRCT scoring was associated with distance walked, inspiratory capacity (IC) changes after exercise, anaerobic threshold of cardiopulmonary exercise and the BODE index (body mass index, airflow obstruction, dyspnea, exercise performance). Results: Seventeen patients with COPD underwent HRCT scanning, 6MWT and CPET. The emphysema score was highly correlated to forced vital capacity (FVC) (r=-0.748, p<0.001), forced expiratory volume in 1 second (FEV1) (r=-0.615, p<0.01), IC post exercise (r=-0.663, p<0.01) and dyspnea score post exercise (r=0.609, p<0.01), but was not associated with the BODE index. The distance walked during 6MWT was inversely correlated to emphysema score (r=-0.557, p<0.05). IC before exercise was highly related to the 6MWT. The change in IC after exercise was associated with the percent decline of oxygen saturation after exercise (r=0.633, p<0.01). Severity of lung emphysema in COPD patients was inversely correlated to VO2 max (r=-0.514, p<0.05) and anaerobic threshold (r=-0.595, p<0.01) of cardiopulmonary exercise. Conclusions: These results suggest that COPD associated with emphysema on HRCT is characterized by more severe lung function impairment, greater exercise impairment and cardiopulmonary dysfunction.

Chen, Li-Fei; Wang, Chun-Hua; Chou, Pai-Chien; Ho, Shu-Chuan; Joa, Wen-Ching; Sheng, Te-Fang; Kuo, Han-Pin

2012-01-01

30

Prognostic value and diagnostic potential of cardiopulmonary exercise testing in patients with chronic heart failure  

Microsoft Academic Search

Cardiopulmonary exercise testing (CPET) is a well established technique for stratifying cardiovascular risk in patients with chronic heart failure (CHF). Important prognostic variables include a reduced peak oxygen uptake which has a central use in cardiac transplant selection, and the abnormal relation between minute ventilation (VE) and carbon dioxide production (VCO2), often referred to as the elevated VE\\/VCO2 slope. We

Lee Ingle

2008-01-01

31

Optimizing the clinical application of cardiopulmonary exercise testing in patients with heart failure  

Microsoft Academic Search

Cardiopulmonary exercise testing (CPX) is a well-accepted evaluation technique in patients with heart failure (HF). Even so, interpretation of the wealth of data obtained from CPX remains a challenge. The body of evidence demonstrating the clinical value of CPX in HF point toward several key variables that should be assessed in each patient. These variables include ventilatory efficiency, aerobic capacity,

Marco Guazzi; Jonathan Myers; Ross Arena

2009-01-01

32

Evaluation of Enalapril+Losartan Treatment with Cardiopulmonary Exercise Test in Patients with Left Ventricular Dysfunction  

Microsoft Academic Search

The aim of this study was to evaluate the effects of the combination of enalapril and losartan in patients with left ventricular systolic dysfunction by means of cardiopulmonary exercise test (CPET). Patients with left-ventricular systolic dysfunction and ejection fractions of 40% or less were included to the study. All patients were under the treatment of enalapril 20 mg once daily.

Tamer Akbulut; Haldun Akgöz; Seden Erten Çelik; Ufuk Gürkan

2006-01-01

33

A new cardiopulmonary exercise testing prognosticating algorithm for heart failure patients treated with beta-blockers  

Microsoft Academic Search

In 2004, a cardiopulmonary exercise testing (CPET) prognosticating algorithm for heart failure (HF) patients was proposed. The algorithm employed a stepwise assessment of peak oxygen consumption (VO2), slope of regression relating minute ventilation to carbon dioxide output (VE\\/VCO2) and peak respiratory exchange ratio (RER), and was proposed as an alternative to the traditional strategy of using a single CPET parameter

Ugo Corrà; Alessandro Mezzani; Andrea Giordano; Roberto Caruso; Pantaleo Giannuzzi

2012-01-01

34

Cardiopulmonary exercise testing before and one year after mitral valve repair for severe mitral regurgitation  

Microsoft Academic Search

For the evaluation of efficacy of cardiopulmonary exercise testing, we compared New York Heart Association functional class with peak oxygen consumption rate (VO2peak) in 31 patients with severe mitral regurgitation who underwent mitral valve repair surgery. One year later, the VO2peak values did not show significant improvement; however, the patients who had more than a mild degree of residual mitral

Hyun-Joong Kim; Seok Jin Ahn; Seung Woo Park; Byung Ryul Cho; Jidong Sung; Sun-Hee Hong; Pyo Won Park; Kyung Pyo Hong

2004-01-01

35

Assessment of Functional Results after Percutaneous Transluminal Coronary Angioplasty by Cardiopulmonary Exercise Test  

Microsoft Academic Search

Twenty-nine patients with documented coronary artery disease underwent cardiopulmonary exercise tests before and following a percutaneous transluminal coronary angioplasty (PTCA). The patients medication regimen and exercise protocols remained the same in both cases. Following PTCA, significant improvement (p < 0.001–0.0001) was noted in oxygen consumption (1,526.8 ± 470.0 vs. 1,686.2 ± 390 ml\\/min), oxygen pulse (12.40 ± 2.73 vs. 13.44

Eliezer Klainman; Gershon Fink; Joseph Lebzelter; Nily Zafrir

1998-01-01

36

The utility of cardiopulmonary exercise testing in the assessment of suspected microvascular ischemia  

Microsoft Academic Search

Evidence demonstrating the potential value of cardiopulmonary exercise testing (CPET) to accurately detect myocardial ischemia secondary to macro-vascular disease is beginning to emerge. Despite distinct mechanisms mediating ischemia in micro-vascular and macrovascular coronary artery disease (CAD), the net physiologic effect of exercise-induced left ventricular (LV) dysfunction is common to both. The abnormal physiologic response to CPET may, therefore, be similar

Sundeep Chaudhry; Ross Arena; Karlman Wasserman; James E. Hansen; Gregory D. Lewis; Jonathan Myers; Romualdo Belardinelli; Brian LaBudde; Nicholas Menasco; William E. Boden

2011-01-01

37

Improvement in serial cardiopulmonary exercise testing following enzyme replacement therapy in Fabry disease  

Microsoft Academic Search

Summary  Background. Fabry disease is an X-linked genetic disorder resulting in the accumulation of glycosphingolipids in various organs, leading\\u000a to exercise intolerance and early mortality. Enzyme replacement therapy (ERT) has recently been approved for use in Fabry\\u000a patients. Goals of study. To assess baseline cardiopulmonary exercise characteristics in both invasive and noninvasive tests and to study the impact\\u000a of ERT on

Gregory Bierer; David Balfe; William R. Wilcox; Zab Mosenifar

2006-01-01

38

Prognostic value of neurohormonal activation and cardiopulmonary exercise testing in patients with chronic heart failure  

Microsoft Academic Search

We compared the value of plasma neurohormones and cardiopulmonary exercise testing for predicting long-term prognosis in patients with moderate congestive heart failure (CHF). We studied 264 consecutive patients with CHF due to left ventricular systolic dysfunction. Plasma atrial natriuretic peptide (ANP), norepinephrine, and endothelin-1 were measured at rest in all patients, who also underwent a symptom-limited maximal exercise with oxygen

Richard Isnard; Françoise Pousset; Jean-Noël Trochu; Alain Carayon; Jean-Louis Golmard; Philippe Lechat; Daniel Thomas; Jean-Brieuc Bouhour; Michel Komajda

2000-01-01

39

Cardiopulmonary exercise testing in small abdominal aortic aneurysm: profile, safety, and mortality estimates  

Microsoft Academic Search

Aim: Few data are available regarding exercise testing in patients with abdominal aortic aneurysm (AAA) disease. The purpose of this study was to evaluate safety and to characterize the hemodynamic and cardiopulmonary (CPX) response to exercise in a large group of patients with AAA.Methods: Three hundred and six patients with AAA ?3.0 to ?5.0 cm (mean 72 ± 8 years)

Jonathan Myers; Alyssa Powell; Kimberly Smith; Holly Fonda; Ronald L Dalman

2011-01-01

40

Developing Pulmonary Vasculopathy in Systemic Sclerosis, Detected with Non-Invasive Cardiopulmonary Exercise Testing  

Microsoft Academic Search

BackgroundPatients with systemic sclerosis (SSc) may develop exercise intolerance due to musculoskeletal involvement, restrictive lung disease, left ventricular dysfunction, or pulmonary vasculopathy (PV). The latter is particularly important since it may lead to lethal pulmonary arterial hypertension (PAH). We hypothesized that abnormalities during cardiopulmonary exercise testing (CPET) in patients with SSc can identify PV leading to overt PAH.MethodsThirty SSc patients

Daniel Dumitrescu; Ronald J. Oudiz; George Karpouzas; Arsen Hovanesyan; Amali Jayasinghe; James E. Hansen; Stephan Rosenkranz; Karlman Wasserman; Rory Edward Morty

2010-01-01

41

Comparison of physiological response to cardiopulmonary exercise testing among cancer survivors and healthy controls  

Microsoft Academic Search

Selected physiological responses, including lactate kinetics, to cardiopulmonary exercise testing (CPET) were evaluated among\\u000a a group of cancer survivors (CS, n = 55) and healthy controls (HC, n = 213). It was uncertain if lactate testing in a group of cancer survivors could provide useful information about training\\u000a intensity. It was hypothesized that chemotherapy, radiation, surgery, physical inactivity or some combination thereof would\\u000a alter

Riggs J. KlikaKatharina; Katharina S. Golik; Scott N. Drum; Kathleen E. Callahan; William G. Thorland

2011-01-01

42

Chronic heart failure in the elderly: value of cardiopulmonary exercise testing in risk stratification  

Microsoft Academic Search

OBJECTIVETo assess the value of cardiopulmonary exercise testing in predicting prognosis in a cohort of elderly patients with chronic heart failure (CHF).DESIGNA retrospective cohort study of all patients with CHF over the age of 70 years assessed between January 1992 and May 1997.SETTINGTertiary centre.PATIENTS50 patients (mean (SD) age 75.9 (4.5) years, 8 women) with CHF New York Heart Association (NYHA)

L C Davies; D P Francis; M Piepoli; A C Scott; P Ponikowski; A J S Coats

2000-01-01

43

Exertional Oscillatory Ventilation During Cardiopulmonary Exercise Test in Fontan Patients with Total Cavopulmonary Connection  

Microsoft Academic Search

Exertional oscillatory ventilation (EOV) has been noted during cardiopulmonary exercise testing (CPX) in patients with heart\\u000a failure. EOV is a predictor of poor prognosis in adult patients with heart failure. The objective of this study was to clarify\\u000a the incidence and influence of EOV in Fontan patients. Symptom-limited CPX was performed in 36 Fontan patients at 12.3 ± 4.3\\u000a (6.5–24.4) years of

Jun Muneuchi; Kunitaka Joo; Kenichiro Yamamura; Mamie Watanabe; Eiji Morihana; Yutaka Imoto; Akira Sese

2009-01-01

44

Accuracy of Transcutaneous Carbon Dioxide Tension Measurements during Cardiopulmonary Exercise Testing  

Microsoft Academic Search

Background: Measurements of transcutaneous carbon dioxide tension (PtcCO2) with current devices are proven to provide clinically acceptable agreement with measurements of partial arterial carbon dioxide tension (PaCO2) in several settings but not during cardiopulmonary exercise testing (CPET). Objectives: The primary objective of this study was to investigate the agreement between PaCO2 and PtcCO2 measurements (using a Tosca 500 with a

Gerben Stege; Frank J. J. van den Elshout; Yvonne F. Heijdra; Marjo J. T. van de Ven; P. N. Richard Dekhuijzen; Petra J. E. Vos

2009-01-01

45

[Positional paper of the German working group "cardiopulmonary exercise testing" to ventilatory and metabolic (lactate) thresholds].  

PubMed

Thresholds in cardiopulmonary exercise testing are necessary for the evaluation of motivation and cooperation in exercise, for training programs, in transplant medicine, preoperative evaluation and medical assessments. There is a hardly comprehensible number of terminologies concerning these thresholds and their definitions. This hampers the comparison of protocols and studies and leads to incertainties in terminologies and interpretations of cardiopulmonary exercise tests. Based on literature a definition of thresholds was undertaken. Thresholds should be regarded from a conceptional and an operational (methodological) point of view. The conceptional model means, that there are two ventilatory thresholds (VT1 and VT2) and two metabolic thresholds (lactate threshold [LT] 1 and 2 ). These thresholds are pathophysiologically based. Both threshold concepts determinate the beginning and the end of the aerobic-anaerobic transition. The lactate thresholds determine the metabolic changes, whereas the ventilator thresholds 1 and 2 represent the ventilatory response to the metabolic changes. VT1 represents the subsequent increase of ventilation and CO2-output relative to oxygen uptake as a consequence of an increase of lactate and a necessary lactate buffering. VT2 is characterized by an exceeding of lactate-steady-state, resulting in excess lactate, metabolic acidosis and overproportional rise of ventilation. The operational concept describes the method, which is used for determination of the different lactate and ventilatory thresholds. In a further step this can be completed by indicating the exercise protocol which was applied. PMID:23361352

Westhoff, M; Rühle, K H; Greiwing, A; Schomaker, R; Eschenbacher, H; Siepmann, M; Lehnigk, B

2013-01-29

46

Combined Cardiopulmonary Exercise Testing and 99m TC Sestamibi Myocardial Imaging in Trained vs Untrained Patients with Coronary Artery Disease  

Microsoft Academic Search

Background: The benefit of exercise training in patients (pts) with coronary artery disease (CAD) is widely conceptual while mentioning several improving systems. Methods: Cardiopulmonary exercise test (CPET) parameters and simultaneous evaluation of myocardial ischemia were performed in 15 trained and 20 untrained pts with CAD and 9 control subjects without coronary disease. The degree of ischemia was evaluated in all

E. Klainman; H. Klein; I. Rosenberg; A. Yarmulovsky; R. Harduf; G. Fink

2009-01-01

47

Clinical usefulness of response profiles to rapidly incremental cardiopulmonary exercise testing.  

PubMed

The advent of microprocessed "metabolic carts" and rapidly incremental protocols greatly expanded the clinical applications of cardiopulmonary exercise testing (CPET). The response normalcy to CPET is more commonly appreciated at discrete time points, for example, at the estimated lactate threshold and at peak exercise. Analysis of the response profiles of cardiopulmonary responses at submaximal exercise and recovery, however, might show abnormal physiologic functioning which would not be otherwise unraveled. Although this approach has long been advocated as a key element of the investigational strategy, it remains largely neglected in practice. The purpose of this paper, therefore, is to highlight the usefulness of selected submaximal metabolic, ventilatory, and cardiovascular variables in different clinical scenarios and patient populations. Special care is taken to physiologically justify their use to answer pertinent clinical questions and to the technical aspects that should be observed to improve responses' reproducibility and reliability. The most recent evidence in favor of (and against) these variables for diagnosis, impairment evaluation, and prognosis in systemic diseases is also critically discussed. PMID:23766901

Ramos, Roberta P; Alencar, Maria Clara N; Treptow, Erika; Arbex, Flávio; Ferreira, Eloara M V; Neder, J Alberto

2013-05-12

48

Rationale for cardiopulmonary exercise test in the assessment of surgical risk.  

PubMed

Although in the past years a reduced mortality in peri-operative care has been observed, cardiovascular mortality and morbidity still is a major burden in patients undergoing noncardiac surgery and its evaluation is still a difficult task. An accurate risk stratification can improve quality of peri-operative care and may improve survival, while reducing healthcare costs. In clinical practice, we make our assessment of a patient's cardiac status based on history, examination and investigations, together with risks related to the surgical procedure, to generate an 'individualized cardiac risk assessment'. At the present, risk stratification with clinical risk score and cardiac testing have been shown to be suboptimal in identifying high-risk patients. Surgery, like exercise, increases oxygen consumption. Indeed, one of the key elements in determining risk assessment is exercise intolerance, but future research in this field is needed to clarify this statement. Cardiopulmonary exercise testing (CPET) provides a global assessment of functional capacity involving and integrating the physiological measurement during incremental exercise. The pattern of CPET's variables identifies the abnormal exercise capacity, often providing an objective evaluation of cause and, moreover, predicting outcomes in both apparently healthy and chronic disease populations. An anaerobic threshold VO2 above 11?ml/kg per min seems to identify individuals with a very low surgical risk even if undergoing major surgery. This review is focused on tools of risk assessment in patients undergoing noncardiac surgery and on the physiological basis for CPET in detecting patients 'at risk'. PMID:22644406

Iorio, Annamaria; Magrì, Damiano; Paolillo, Stefania; Salvioni, Elisabetta; Di Lenarda, Andrea; Sinagra, Gianfranco; Agostoni, Piergiuseppe; Sciomer, Susanna

2013-04-01

49

Comparison of 6-min walk test distance and cardiopulmonary exercise test performance in children with pulmonary hypertension  

Microsoft Academic Search

ObjectiveTo assess the relationship between 6-min walk test (6MWT) distance and variables of cardiopulmonary exercise testing (CPET) in children with pulmonary arterial hypertension (PAH).DesignRetrospective study.SettingTertiary hospital.PatientsChildren with PAH.InterventionsCPETs and 6MWTs.Main outcome measuresCorrelations between variables of CPET and 6MWT distance.Results41 exercise studies were included: 15 in children with idiopathic PAH (mean age 13.0±3.0 years; 9 female), 18 in children with PAH

Astrid E Lammers; Gerhard-Paul Diller; Dolf Odendaal; Sheila Tailor; Graham Derrick; Sheila G Haworth

2011-01-01

50

Echocardiography with Tissue Doppler Imaging and cardiopulmonary exercise testing in patients with heart failure: A correlative and prognostic analysis  

Microsoft Academic Search

BackgroundPrevious investigations have established the prognostic value of variables obtained from both echocardiography with tissue Doppler Imaging (TDI) and cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). Past prognostic comparisons of variables obtained from these evaluation techniques have been limited to the comparison of left ventricular ejection fraction (LVEF) vs. peak oxygen consumption (VO2). The present investigation undertakes

Marco Guazzi; Jonathan Myers; Mary Ann Peberdy; Daniel Bensimhon; Paul Chase; Sherry Pinkstaff; Ross Arena

2010-01-01

51

Cardiopulmonary exercise testing is equally prognostic in young, middle-aged and older individuals diagnosed with heart failure  

Microsoft Academic Search

BackgroundPrevious research has demonstrated the prognostic value of cardiopulmonary exercise testing (CPX) in elderly patients with heart failure (HF). Investigations that have comprehensively examined the value of CPX across different age groups are lacking. The purpose of the present investigation was to evaluate the prognostic value of CPX in young, middle-aged and older patients with HF.

Ross Arena; Jonathan Myers; Joshua Abella; Sherry Pinkstaff; Peter Brubaker; Dalane W. Kitzman; Mary Ann Peberdy; Daniel Bensimhon; Paul Chase; Marco Guazzi

2011-01-01

52

Prognostic relevance of dynamic hyperinflation during cardiopulmonary exercise testing in adult patients with cystic fibrosis.  

PubMed

BACKGROUND: Dynamic hyperinflation during cardiopulmonary exercise testing (CPET) in cystic fibrosis (CF) has not been well characterized, and little is known regarding its prevalence, risk factors and clinical associations. METHODS: CPET data from 109 adult patients with mild-to-moderate CF was used, in this retrospective study, to characterize and determine the prevalence of dynamic hyperinflation, and evaluate its relationship with lung function and exercise tolerance, clinical symptoms, and prognosis over a two-year period. RESULTS: 58% of patients responded to CPET with dynamic hyperinflation. These patients had significantly lower lung function (FEV1 66±19 versus 79±18%pred., p<0.01) and exercise tolerance (peak oxygen uptake 28.7±8.1 versus 32.9±6.1mL·kg(-1)·min(-1), p=0.02), and experienced greater shortness of breath at peak exercise (7±3 versus 5±2 Modified Borg scale, p=0.04) compared to patients who responded without dynamic hyperinflation. Significant relationships between FEV1, FVC, FEV1/FVC, FEF25-75 and dynamic hyperinflation were shown (p<0.01; p=0.02; p<0.01; p<0.01, respectively). Dynamic hyperinflation was also significantly correlated with oxygen uptake, tidal volume, work-rate and shortness of breath at peak exercise (p=0.03; p<0.01; p<0.01; p=0.04, respectively). Responding to CPET with or without dynamic hyperinflation did not significantly predict FEV1 at 2years beyond the FEV1 at baseline (p=0.06), or increase the likelihood of experiencing a pulmonary exacerbation over a two-year period (p=0.24). CONCLUSION: The prevalence of dynamic hyperinflation during CPET in adult patients with mild-to-moderate CF is high, and is associated with reduced lung function and exercise tolerance, and increased exertional dyspnea. However, identifying dynamic hyperinflation during CPET had limited prognostic value for lung function and pulmonary exacerbation. PMID:23706829

Stevens, D; Stephenson, A; Faughnan, M E; Leek, E; Tullis, E

2013-05-22

53

Cardiopulmonary exercise testing following bilateral thoracoscopic sympathicolysis in patients with essential hyperhidrosis  

Microsoft Academic Search

BACKGROUND--Essential hyperhidrosis is characterised by an overactivity of the sympathetic fibres passing through the upper dorsal sympathetic ganglia D2-D3. Anatomical interruption at the D2-D3 level is a highly effective treatment for essential hyperhidrosis but also causes (partial) cardiac denervation and, after surgical sympathicolysis, important impairment of cardiopulmonary exercise function has been observed. The purpose of this study was to compare

M Noppen; P Herregodts; P Dendale; J DHaens; W Vincken

1995-01-01

54

Reproducibility of maximal cardiopulmonary exercise testing for young cystic fibrosis patients.  

PubMed

BACKGROUND: The reproducibility of cardiopulmonary exercise testing (CPET) has not been established in young cystic fibrosis (CF) patients using a valid protocol. METHODS: Thirteen 7-18year olds completed three CPETs, separated by 48h and 4-6weeks. CPET involved a ramp-incremental cycling test with supramaximal verification. RESULTS: Maximal oxygen uptake was repeatedly determined with no learning effect and typical errors expressed as a coefficient of variation (TECV%) of 9.3% (48h) and 13.3% (4-6weeks). The reproducibility of additional parameters of aerobic function [gas exchange threshold (TECV%: 11.2%, 16.8%); V?O2 mean response time (TECV%: 37.8%, 89.4%); V?O2 gain (TECV%: 17.4%, 24.5%)] and clinical utility [e.g. SaO2% (TECV%: 2.2%, 3.1%); ventilatory drive (V?E/V?CO2-slope) (TECV%: 7.8%, 17.7%)] was also established over the short- and the medium-term, respectively. CONCLUSION: These results establish limits of variability to determine meaningful changes over the short- and the medium-term for CPET outcomes in young CF patients. PMID:23726255

Saynor, Zoe L; Barker, Alan R; Oades, Patrick J; Williams, Craig A

2013-05-28

55

Reliability of the anaerobic threshold in cardiopulmonary exercise testing of patients with abdominal aortic aneurysms.  

PubMed

Anaerobic threshold (AT), determined by cardiopulmonary exercise testing (CPET), is a well-documented measure of pre-operative fitness, although its reliability in patient populations is uncertain. Our aim was to assess the reliability of AT measurement in patients with abdominal aortic aneurysms. Eighteen patients were recruited. CPET was performed four times over a 6-week period. We examined shifts in the mean AT to evaluate systematic bias with random measurement error assessed using typical within-patient error and intraclass correlation coefficient (ICC, 3,1) statistics. There was no significant or clinically substantial change in mean AT across the tests (p = 0.68). The typical within-patient error expressed as a percentage coefficient of variation was 10% (95% CI, 8-13%), with an ICC of 0.74 (95% CI, 0.55-0.89). We consider the reliability of the AT to be acceptable, supporting its clinical validity and utility as an objective marker of pre-operative fitness in this population. PMID:19086999

Kothmann, E; Danjoux, G; Owen, S J; Parry, A; Turley, A J; Batterham, A M

2009-01-01

56

A new cardiopulmonary exercise testing prognosticating algorithm for heart failure patients treated with beta-blockers.  

PubMed

In 2004, a cardiopulmonary exercise testing (CPET) prognosticating algorithm for heart failure (HF) patients was proposed. The algorithm employed a stepwise assessment of peak oxygen consumption (VO2), slope of regression relating minute ventilation to carbon dioxide output (VE/VCO2) and peak respiratory exchange ratio (RER), and was proposed as an alternative to the traditional strategy of using a single CPET parameter to describe prognosis. Since its initial proposal, the prognosticating algorithm has not been reassessed, although a re-evaluation is in order given the fact that new HF therapies, such as beta-blocker therapy, have significantly improved survival in HF. The present review, based on a critical examination of CPET outcome studies in HF patients regularly treated with beta-blockers, suggests a new prognosticating algorithm. The algorithm comprises four CPET parameters: peak RER, exertional oscillatory ventilation (EOV), peak VO2 and peak systolic blood pressure (SBP). Compared to previous proposals, the present preliminary attempt includes EOV instead of VE/VCO2 slope as ventilatory CPET parameter, and peak SBP as hemodynamic-derived index. PMID:21450608

Corrà, Ugo; Mezzani, Alessandro; Giordano, Andrea; Caruso, Roberto; Giannuzzi, Pantaleo

2011-03-04

57

Cardiopulmonary exercise test findings in symptomatic mustard gas exposed cases with normal HRCT.  

PubMed

Many patients with sulfur mustard (SM) exposure present dyspnea in exertion while they have a normal pulmonary function test (PFT) and imaging. The cardiopulmonary exercise test (CPET) has been used for evaluation of dyspnea in exertion among patients with different pulmonary disorders focusing on assessing gas exchange. We evaluated subjects who were exposed to SM with normal imaging compared to the controls with CPET. A case-control study was carried out on two groups in Tehran, Iran during 2010 to compare the CPET findings. The cases with a history of SM exposure and complaint of exertional dyspnea while they had normal physical examination, chest X-ray, PFT, and nonsignificant air trapping in lung high resolution computed tomography (HRCT) were included. A group of sex- and age-matched healthy people were considered as controls. One hundred fifty-nine male patients (aged 37 ± 4.3 years) were enrolled as a case group and ten healthy subjects (aged 35 ± 5.9 years) as the control group. There was no significant difference in the demographic and baseline PFT characters between the two groups (P > 0.05). Only peak VO2/kg, VO2-predicted, and RR peak were statistically different between cases and controls (P < 0.05). Despite the fact that abnormal gas exchange may be present in our cases, it does not explain the low VO2 in CPET. Also, impaired cell O2 consumption could be a hypothesis for low VO2 in these cases. It seems that routine assessment of lung structure cannot be effectively used for discrimination of the etiology of dyspnea in low-dose SM exposed cases. PMID:24015343

Aliannejad, Rasoul; Saburi, Amin; Ghanei, Mostafa

2013-04-01

58

MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study  

Microsoft Academic Search

BACKGROUND: Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease. METHODS: We prospectively recruited IPF patients and examined

Effrosyni D. Manali; Panagiotis Lyberopoulos; Christina Triantafillidou; Likourgos F. Kolilekas; Christina Sotiropoulou; Joseph Milic-Emili; Charis Roussos; Spyros A Papiris

2010-01-01

59

Monitoring of ventilation during the early part of cardiopulmonary exercise testing: The first step to detect central sleep apnoea in chronic heart failure  

Microsoft Academic Search

Background and purposeTo evaluate the prediction of nocturnal central sleep apnoea (CSA) syndrome from the presence of periodic breathing (PB) on diurnal monitoring of pre-exercise (cardiopulmonary exercise test [CPX]) parameters. CSA syndrome is commonly found in congestive heart failure (CHF) patients and has several prognostic and therapeutic implications but is frequently undiagnosed. Awake PB pattern is sometimes observed during the

Frédéric Roche; Delphine Maudoux; Yann Jamon; Jean-Claude Barthelemy

2008-01-01

60

Unique cardiopulmonary exercise test responses in overweight middle-aged adults with obstructive sleep apnea  

Microsoft Academic Search

BackgroundObstructive sleep apnea (OSA) is characterized by repetitive nighttime obstructions of the upper airway that induce hypoxemia, hypercapnia, sympathetic activation, and arousals. This disorder induces cardiovascular autonomic imbalance and contributes to the development of hypertension. While the diagnostic and prognostic utility of exercise testing is well established in cardiology, the clinical utility of the exercise test in screening for OSA

Anthony S. Kaleth; Thomas W. Chittenden; Brian J. Hawkins; Trent A. Hargens; Steve G. Guill; Donald Zedalis; John M. Gregg; William G. Herbert

2007-01-01

61

Cardiopulmonary exercise testing in evaluation of the functional capacity of survivors of childhood cancer  

Microsoft Academic Search

Progress in the treatment of pediatric cancer has resulted in a growing population of survivors of malignancy treated in childhood. These individuals may have evidence of multiple organ system impairment related to oncologic disease and its therapy. Metabolic exercise testing measures cardiovascular, pulmonary and musculoskeletal components of maximal exercise performance, quantifying functional capacity. This information has been used to describe

Alexa N Hogarty; Jeffrey H Silber; Stephen M Paridon

1998-01-01

62

Noninvasive assessment of normality of VD/VT in clinical cardiopulmonary exercise testing utilizing incremental cycle ergometry.  

PubMed

Dead space to tidal volume ratio (V(D)/V(T)), a measure of pulmonary gas exchange efficiency, cannot be accurately calculated without arterial blood sampling. We sought to determine, in patients presenting for diagnostic cardiopulmonary exercise tests, whether there are ranges of the ratio of exhaled ventilation to carbon dioxide output (V(E)/VCO(2)) measured at the lactate threshold that are highly predictive of normality or abnormality of exercise V(D)/V(T) (below or above 0.3) and whether other demographic or physiologic variables aid in this prediction. We reviewed 691 incremental cycle ergometer cardiopulmonary exercise tests featuring breath-by-breath gas exchange measurement and serial arterial blood sampling that were performed for patients with a range of disorders. When V(E)/VCO(2) at the lactate threshold was ?28, 96 % of subjects had normal V(D)/V(T). For V(E)/VCO(2) 29-32, V(D)/V(T) was normal in 83 % of cases. V(E)/VCO(2) of 33-38 provided no useful information; V(D)/V(T) was normal and abnormal in 50 % of cases each. When V(E)/VCO(2) was ?39, V(D)/V(T) was abnormal in 87 % of cases. For V(E)/VCO(2) ? 39, when FEV(1)/VC was <70 %, V(D)/V(T) was abnormal in 95 % of cases. End-tidal PCO(2) was of no help in distinguishing V(D)/V(T) normality in any V(E)/VCO(2) range. Our results reveal that certain values of V(E)/VCO(2) at LT (V (E)/VCO(2) ? 28 and V(E)/VCO(2) ? 39), but not others (V(E)/VCO(2) 29-32 and especially V(E)/VCO(2) of 33-38), can be helpful in determining normality of V(D)/V(T) during exercise in patients presenting for cardiopulmonary exercise testing. PMID:22562602

Roman, Michael A; Casaburi, James D; Porszasz, Janos; Casaburi, Richard

2012-05-06

63

Preoperative evaluation of cardiopulmonary reserve with the use of expired gas analysis during exercise testing in patients with squamous cell carcinoma of the thoracic esophagus  

Microsoft Academic Search

Objective: We evaluated the usefulness of analyzing expired gas during exercise testing for the prediction of postoperative cardiopulmonary complications in patients with esophageal carcinoma. Background data: Radical esophagectomy with 3-field lymphadenectomy is performed in patients with thoracic esophageal carcinoma but has a high risk of postoperative complications. To reduce the surgical risk, we performed preoperative risk analysis using 8 factors.

Yoshinori Nagamatsu; Ichirou Shima; Hideaki Yamana; Hiromasa Fujita; Kazuo Shirouzu; Tatsuya Ishitake

2001-01-01

64

The value of cardiopulmonary exercise testing and brain natriuretic peptide plasma levels in predicting the prognosis of patients with chronic heart failure  

Microsoft Academic Search

BackgroundA peak VO2 above 14 ml\\/min\\/kg at cardiopulmonary exercise testing and brain natriuretic peptide (BNP) levels is used to estimate survival in patients with chronic heart failure (CHF). Limited data, however, exist comparing the prognostic value of both markers simultaneously in patients with mild to moderate CHF.

Stefan Krüger; Jürgen Graf; Marc W. Merx; Tina Stickel; Dagmar Kunz; Karl Christian Koch; Peter Hanrath; Uwe Janssens

2006-01-01

65

Dyspnoea and exercise intolerance during cardiopulmonary exercise testing in patients with univentricular heart The effects of chronic hypoxaemia and Fontan procedure  

Microsoft Academic Search

Background Patients with univentricular hearts have de- creased exercise tolerance and may demonstrate exertional dyspnoea. It is not known if chronic hypoxaemia exacer- bates exercise intolerance and contributes to symptomatic limitation. The extent to which surgical correction of a right-to-left shunt by a Fontan-type procedure can increase exercise tolerance by reducing arterial deoxygenation is not well documented. The cardiopulmonary exercise

L. Iserin; T. P. Chua; J. Chambers; A. J. S. Coats; J. Somerville

66

The BNP concentrations and exercise capacity assessment with cardiopulmonary stress test in cyanotic adult patients with congenital heart diseases.  

PubMed

Cyanosis is observed in patients with complex congenital heart disease (CHD) and pulmonary hypertension, heart failure represents an important clinical problem in such patients. The aim of this study was to evaluate the exercise capacity in patients with cyanotic CHDs using cardiopulmonary exercise test, measuring serum BNP levels as well as to seek correlation between BNP levels and cardiopulmonary exercise test parameters and identify the effects of blood oxygen desaturation and pulmonary hypertension on these indices. The study group consisted of 53 patients (21 males) at the mean age of 39.4 ± 14.3 years, of whom 19 were operated on at the mean age of 9.6 ± 8.6 years. Mean blood oxygen saturation (SO(2)) in patients was 81.2 ± 6.2%. Twenty four patients presented with Eisenmenger syndrome, 16--univentricular hearts, 4--transposition of the great arteries, 6--Fallot's tetralogy, and 3--Ebstein anomaly. The control group comprised 32 healthy individuals (16 males) at the mean age of 40.7 ± 9.9 years. Cardiopulmonary stress test showed significantly lower exercise capacity in patients with cyanosis than in controls: maximal oxygen uptake (VO(2max)) 15.5 ± 4.9 vs. 31.6 ± 7.1 ml/kg/min (p=0.00001), maximum heart rate at peak exercise (HR max): 139.5 ± 22.5 bpm vs. 176.6 ± 12.1 (p=0.0001), VE/VCO(2) slope: 46.4 ± 10.1 vs. 27.3 ± 2.9 (p=0.00001), forced vital capacity FVC: 3.1 ± 1.1 l vs. 4.4 ± 0.8 l (p=0.00001). Subjects with the evidence of pulmonary hypertension (PH+) had lower exercise capacity than those without (PH-): VO(2max): 17.2 ± 4.2 vs. 12.8 ± 4.8 ml/kg/min (p=0.002), VE/VCO(2): 43.7 ± 11.1 vs. 50.9 ± 6.4 (p=0.01), FVC: 3.46 ± 1.05 l vs. 2.37 ± 0.91 l (p=0.0002). Plasma BNP levels in the study group were higher than in controls: 122.4 ± 106.7 vs. 21.1 ± 20.2 pg/ml p=0.00001 and did not differ between PH+ and PH- groups (115.7 ± 99.0 vs. 127.9 ± 114.1 pg/ml p=0.78). Negative correlations between BNP levels and VO(2max) (r=-0.389, p=0.006), FVC (r=-0.395 p=0.005), FEV1 (r=-0.386 p=0.006), SO(2) (r=-0.445 p=0.00001), and positive correlation between BNP level and VE/VCO(2) (r=0.369 p=0.009) were found. PMID:19042041

Trojnarska, O; Gwizdala, A; Katarzynski, S; Katarzynska, A; Oko-Sarnowska, Z; Grajek, S; Kramer, L

2008-11-29

67

Distinguishing Pulmonary Hypertension in Interstitial Lung Disease by Ventilation and Perfusion Defects Measured by Cardiopulmonary Exercise Testing.  

PubMed

Background: Pulmonary hypertension (PH) is common in interstitial lung disease (ILD). Since cardiopulmonary exercise testing (CPET) is useful in understanding the pathophysiology of respiratory disorders and can distinguish between ventilation and perfusion (V/Q) defects, it may have a role in the detection of PH in ILD. We evaluated whether CPET can detect PH through analysis of V/Q defects in ILD. Objectives: We aimed to use CPET to determine if there are changes in the ventilation and the activity pattern of mixed-expired carbon dioxide pressure (PECO2) and end-tidal carbon dioxide pressure (PetCO2) in ILD patients with and without PH. Methods: A retrospective chart review was done of all patients who received lung transplants at the Columbia University Medical Center between 2000 and 2011 with the diagnosis of ILD. CPETs were performed during the 2 years prior to transplantation; right heart catheterizations and pulmonary function tests were performed within 4 months of CPET. Results: The ILD patients with PH demonstrated significantly lower PetCO2 and PECO2 during certain levels of exercise with a distinctive activity pattern for PECO2/PetCO2. Conclusions: Evaluation of V/Q defects through the PECO2 and PetCO2 patterns on CPET in ILD patients can distinguish between patients with and without PH. PMID:23735701

Armstrong, Hilary F; Thirapatarapong, Wilawan; Dussault, Nicole E; Bartels, Matthew N

2013-05-28

68

Comparison of Predicted Exercise Capacity Equations and the Effect of Actual versus Ideal Body Weight among Subjects Undergoing Cardiopulmonary Exercise Testing  

PubMed Central

Background. Oxygen uptake at maximal exercise (VO2 max) is considered the best available index for assessment of exercise capacity. The purpose of this study is to determine if the use of actual versus ideal body weight in standard regression equations for predicted VO2 max results in differences in predicted VO2 max. Methods. This is a retrospective chart review of patients who were predominantly in active military duty with complaints of dyspnea or exercise tolerance and who underwent cardiopulmonary exercise testing (CPET) from 2007 to 2009. Results. A total of 230 subjects completed CPET on a bicycle ergometer with a male predominance (62%) and an average age of 37?±?15 years. There was significant discordance between the measured VO2 max and predicted VO2 max when measured by the Hansen and Wasserman reference equations (P < 0.001). Specifically, there was less overestimation when predicted VO2 max was based on ideal body weight as opposed to actual body weight. Conclusion. Our retrospective analysis confirmed the wide variations in predicted versus measured VO2 max based on varying prediction equations and showed the potential advantage of using ideal body weight as opposed to actual body weight in order to further standardize reference norms.

Ahmadian, H. Reza; Sclafani, Joseph J.; Emmons, Ethan E.; Morris, Michael J.; Leclerc, Kenneth M.; Slim, Ahmad M.

2013-01-01

69

Comparison of Predicted Exercise Capacity Equations and the Effect of Actual versus Ideal Body Weight among Subjects Undergoing Cardiopulmonary Exercise Testing.  

PubMed

Background. Oxygen uptake at maximal exercise (VO2 max) is considered the best available index for assessment of exercise capacity. The purpose of this study is to determine if the use of actual versus ideal body weight in standard regression equations for predicted VO2 max results in differences in predicted VO2 max. Methods. This is a retrospective chart review of patients who were predominantly in active military duty with complaints of dyspnea or exercise tolerance and who underwent cardiopulmonary exercise testing (CPET) from 2007 to 2009. Results. A total of 230 subjects completed CPET on a bicycle ergometer with a male predominance (62%) and an average age of 37?±?15 years. There was significant discordance between the measured VO2 max and predicted VO2 max when measured by the Hansen and Wasserman reference equations (P < 0.001). Specifically, there was less overestimation when predicted VO2 max was based on ideal body weight as opposed to actual body weight. Conclusion. Our retrospective analysis confirmed the wide variations in predicted versus measured VO2 max based on varying prediction equations and showed the potential advantage of using ideal body weight as opposed to actual body weight in order to further standardize reference norms. PMID:23653881

Ahmadian, H Reza; Sclafani, Joseph J; Emmons, Ethan E; Morris, Michael J; Leclerc, Kenneth M; Slim, Ahmad M

2013-04-03

70

The prognostic value of cardiopulmonary exercise testing with a peak respiratory exchange ratio of < 1.0 in patients with chronic heart failure  

Microsoft Academic Search

BackgroundPeak oxygen consumption derived from a maximal cardiopulmonary exercise test (CPET) is a standard prognostic indicator in patients with chronic heart failure (CHF). Tests with a peak respiratory exchange ratio (pRER)<1.0 are often taken to be submaximal, and data from such tests are treated as less helpful. The aim of the current study was to compare the prognostic value of

Lee Ingle; Klaus K. Witte; John G. J. F. Cleland; Andrew L. Clark

2008-01-01

71

The clinical importance of cardiopulmonary exercise testing and aerobic training in patients with heart failure A importância clínica de testes de exercícios cardiopulmonares e treinamento aeróbico em pacientes com insufi ciência cardíaca  

Microsoft Academic Search

Introduction: The appropriate physiological response to an acute bout of progressive aerobic exercise requires proper functioning of the pulmonary, cardiovascular and skeletal muscle systems. Unfortunately, these systems are all negatively impacted in patients with heart failure (HF), resulting in signifi cantly diminished aerobic capacity compared with apparently healthy individuals. Cardiopulmonary exercise testing (CPX) is a noninvasive assessment technique that provides

Arena R; Myers J; Guazzi M

72

Predicting the highest workload in cardiopulmonary test  

Microsoft Academic Search

Cardiopulmonary exercise testing is an objective method to evaluate both the cardiac and pulmonary functions. It is used in different application domains, ranging from the clinical domain to sport sciences, to assess possible cardiac failures as well as athete performance. The highest workload reached in the test is a key information to evaluate the individual’s physiological characteristics, to plan rehabilitation

Elena Baralis; Tania Cerquitelli; Silvia Chiusano; Vincenzo D'Elia; Riccardo Molinari; Davide Susta

2010-01-01

73

A meta-analysis of the prognostic significance of cardiopulmonary exercise testing in patients with heart failure.  

PubMed

The objective of the study is to assess the role of cardiopulmonary exercise testing (CPX) variables, including peak oxygen consumption (VO(2)), which is the most recognized CPX variable, the minute ventilation/carbon dioxide production (VE/VCO(2)) slope, the oxygen uptake efficiency slope (OUES), and exercise oscillatory ventilation (EOV) in a current meta-analysis investigating the prognostic value of a broader list of CPX-derived variables for major adverse cardiovascular events in patients with HF. A search for relevant CPX articles was performed using standard meta-analysis methods. Of the initial 890 articles found, 30 met our inclusion criteria and were included in the final analysis. The total subject populations included were as follows: peak VO(2) (7,319), VE/VCO(2) slope (5,044), EOV (1,617), and OUES (584). Peak VO(2), the VE/VCO(2) slope and EOV were all highly significant prognostic markers (diagnostic odds ratios ? 4.10). The OUES also demonstrated promise as a prognostic marker (diagnostic odds ratio = 8.08) but only in a limited number of studies (n = 2). No other independent variables (including age, ejection fraction, and beta-blockade) had a significant effect on the meta-analysis results for peak VO(2) and the VE/VCO(2) slope. CPX is an important component in the prognostic assessment of patients with HF. The results of this meta-analysis strongly confirm this and support a multivariate approach to the application of CPX in this patient population. PMID:22733204

Cahalin, Lawrence P; Chase, Paul; Arena, Ross; Myers, Jonathan; Bensimhon, Daniel; Peberdy, Mary Ann; Ashley, Euan; West, Erin; Forman, Daniel E; Pinkstaff, Sherry; Lavie, Carl J; Guazzi, Marco

2013-01-01

74

Cardiopulmonary exercise testing and prognosis in severe heart failure: 14 mL\\/kg\\/min revisited  

Microsoft Academic Search

Background Accurately establishing prognosis in severe heart failure has become increasingly important in assessing the efficacy of treatment modalities and in appropriately allocating scarce resources for transplantation. Peak exercise oxygen uptake appears to have an important role in risk stratification of patients with heart failure, but the optimal cutpoint value to separate survivors from nonsurvivors is not clear. Methods Six

Jonathan Myers; Lars Gullestad; Randall Vagelos; Dat Do; Daniel Bellin; Heather Ross; Michael B. Fowler

2000-01-01

75

Cardiopulmonary Exercise Test Characteristics in Patients with Chronic Obstructive Pulmonary Disease and Associated Pulmonary Hypertension  

Microsoft Academic Search

Background: Pulmonary hypertension (PH) is a well-known complication of chronic obstructive pulmonary disease (COPD). It remains unclear whether exercise parameters can be used to discriminate between COPD patients with associated PH (COPD-PH) and COPD patients without associated PH (COPD-nonPH). Objective: To study whether the existence of pulmonary hypertension in COPD is related to characteristic findings in gas exchange and circulatory

Sebastiaan Holverda; Harm J. Bogaard; H. Groepenhoff; Pieter E. Postmus; Anco Boonstra; Anton Vonk-Noordegraaf

2008-01-01

76

MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study  

PubMed Central

Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p < 0.001), the SPO2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p < 0.001 respectively) and the desaturation index (r = .634, p = 0.001) for the 6MWT; the MRC score and VO2 peak/kg (r = -.731, p < 0.001), SPO2 at peak exercise (r = -. 682, p < 0.001), VE/VCO2 slope (r = .731, p < 0.001), VE/VCO2 at AT (r = .630, p = 0.002) and the Borg scale at peak exercise (r = .50, p = 0.01) for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT. Conclusion In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.

2010-01-01

77

Cardiopulmonary Stress Testing in Children Who Have Had Congenital Heart Disease Surgery. Physical Exercise Recommendations During School Hours  

Microsoft Academic Search

Introduction and objectivesTo analyze and discover if stress testing with exhaled gases in children who have had congenital heart surgery is useful so we could make physical exercise recommendations according to heart disease, type of surgery performed, present hemodynamic state and level of exercise practiced.

Ricard Serra-Grima; Maite Doñate; Xavier Borrás; Miquel Rissech; Teresa Puig; Dimpna C. Albert; Joaquim Bartrons; Ferran Gran; Begoña Manso; Queralt Ferrer; Josep Girona; Jaume Casaldáliga; Maite Subirana

2011-01-01

78

A comparison of the diagnostic performance of the ST/HR hysteresis with cardiopulmonary stress testing parameters in detecting exercise-induced myocardial ischemia.  

PubMed

BACKGROUND: Because ST segment depression has limited diagnostic performance at exercise electrocardiography (ECG), ST segment depression/heart rate (ST/HR) hysteresis and cardiopulmonary exercise test (CPET)-derived parameters have been proposed as alternatives to diagnose exercise-induced myocardial ischemia. We compared the diagnostic performance of such parameters. METHODS: We studied 56 subjects (45 men, 11 women, age 59.7±13.6years) referred for suspected exercise-induced myocardial ischemia with an equivocal ECG exercise test. All subjects serially underwent CPET and a myocardial single-photon emission computerized tomography (SPECT) perfusion imaging (as the gold standard for ischemia). Maximum ST depression at peak exercise (ST-max), the ST/HR hysteresis, ?VO(2)/?WR b-b(1) slope, ?VO(2)/?WR (aa(1)-bb(1)), VO(2)/HR flattening duration and other CPET parameters were derived in all subjects. RESULTS: On the basis of SPECT, 23 subjects (41%) were considered ischemic and 33 subjects (59%) non-ischemic. ST/HR hysteresis was higher (0.026mV; 95% CI: 0.003 to 0.049 vs -0.016mV; 95% CI: -0.031 to -0.001mV) and ST-max was lower (-0.105mV; 95% CI: -0.158 to -0.052 vs 0.032mV; 95% CI: -0.001 to -0.066mV) in ischemic vs non-ischemic subjects (P=0.004 and P=0.001, respectively). Among CPET parameters, ?VO(2)/?WR b-b(1) slope was lower (9.4±3.8) and ?VO(2)/?WR (aa(1)-bb(1)) was higher (2.1±2.6) in ischemic vs non-ischemic subjects (11.4±2.3, P=0.005, and 1.1±1.5, P=0.001, respectively). The ST/HR hysteresis had the highest area under the curve value, better (P<0.05) than any other parameters tested, thus showing the highest overall diagnostic performance. CONCLUSION: The ST/HR hysteresis is superior to CPET-derived parameters for detecting exercise-induced myocardial ischemia in patients with equivocal ECG exercise test results. PMID:23260751

Zimarino, Marco; Barnabei, Luca; Madonna, Rosalinda; Palmieri, Giuseppe; Radico, Francesco; Tatasciore, Alfonso; Bellisarii, Francesco Iachini; Perrucci, Gianni Mauro; Corazzini, Alessandro; De Caterina, Raffaele

2012-12-20

79

Human Investigations into the Arterial and Cardiopulmonary Baroreflexes during Exercise  

PubMed Central

After considerable debate and key experimental evidence, the importance of the arterial baroreflex in contributing to and maintaining the appropriate neural cardiovascular adjustments to exercise is now well accepted. Indeed, the arterial baroreflex resets during exercise in an intensity-dependent manner to continue to regulate blood pressure as effectively as at rest. Studies have indicated that the exercise resetting of the arterial baroreflex is mediated by both the feed-forward mechanism of central command and the feed-back mechanism associated with skeletal muscle afferents (the exercise pressor reflex). Another perhaps less appreciated neural mechanism involved in evoking and maintaining neural cardiovascular responses to exercise is the cardiopulmonary baroreflex. The limited information available regarding the cardiopulmonary baroreflex during exercise provides evidence for a role in mediating sympathetic nerve activity and blood pressure responses. In addition, recent investigations have demonstrated an interaction between cardiopulmonary baroreceptors and the arterial baroreflex during dynamic exercise, which contributes to the magnitude of exercise-induced increases in blood pressure as well as the resetting of the arterial baroreflex. Furthermore, neural inputs from the cardiopulmonary baroreceptors appear to play an important role in establishing the operating point of the arterial baroreflex. This symposium review will highlight recent studies in these important areas indicating that the interactions of four neural mechanisms (central command, the exercise pressor reflex, the arterial baroreflex and cardiopulmonary baroreflex) are integral in mediating the neural cardiovascular adjustments to exercise.

Fadel, Paul J.; Raven, Peter B.

2011-01-01

80

Does Obstructive Sleep Apnea Impair the Cardiopulmonary Response to Exercise?  

PubMed Central

Study Objectives: The aim of this study was to evaluate cardiopulmonary exercise performance in lean and obese patients with obstructive sleep apnea (OSA) compared with controls. Design: Case-control study. Setting: The study was carried out in Sao Paulo Sleep Institute, Sao Paulo, Brazil. Patients and Participants: Individuals with similar ages were allocated into groups: 22 to the lean OSA group, 36 to the lean control group, 31 to the obese OSA group, and 26 to the obese control group. Interventions: The participants underwent a clinical evaluation, polysomnography, a maximum limited symptom cardiopulmonary exercise test, two-dimensional transthoracic echocardiography, and spirometry. Measurements and Results: The apnea-hypopnea index, arousal index, lowest arterial oxygen saturation (SaO2) and time of SaO2 < 90% were different among the groups. There were differences in functional capacity based on the following variables: maximal oxygen uptake (VO2max), P < 0.01 and maximal carbon dioxide production (VCO2max), P < 0.01. The obese patients with OSA and obese controls presented significantly lower VO2max and VCO2max values. However, the respiratory exchange ratio (RER) and anaerobic threshold (AT) did not differ between groups. Peak diastolic blood pressure (BP) was higher among the obese patients with OSA but was not accompanied by changes in peak systolic BP and heart rate (HR). When multiple regression was performed, body mass index (P < 0.001) and male sex in conjunction with diabetes (P < 0.001) independently predicted VO2max (mL/kg/min). Conclusions: The results of this study suggest that obesity alone and sex, when associated with diabetes but not OSA, influenced exercise cardiorespiratory function. Citation: Rizzi CF; Cintra F; Mello-Fujita L; Rios LF; Mendonca ET; Feres MC; Tufik S; Poyares D. Does obstructive sleep apnea impair the cardiopulmonary response to exercise? SLEEP 2013;36(4):547-553.

Rizzi, Camila F.; Cintra, Fatima; Mello-Fujita, Luciane; Rios, Lais F.; Mendonca, Elisangela T.; Feres, Marcia C.; Tufik, Sergio; Poyares, Dalva

2013-01-01

81

Clinical Correlates and Prognostic Significance of Six-minute Walk Test in Patients with Primary Pulmonary Hypertension Comparison with Cardiopulmonary Exercise Testing  

Microsoft Academic Search

The six-minute walk test is a submaximal exercise test that can be performed even by a patient with heart failure not tolerating maximal exercise testing. To elucidate the clinical significance and prog- nostic value of the six-minute walk test in patients with primary pulmonary hypertension (PPH), we sought ( 1 ) to assess the relation between distance walked during the

SHOICHI MIYAMOTO; NORITOSHI NAGAYA; TORU SATOH; SHINGO KYOTANI; FUMIO SAKAMAKI; MASATOSHI FUJITA; NORIFUMI NAKANISHI; KUNIO MIYATAKE

82

Health-related quality of life compared with cardiopulmonary exercise testing at the midterm follow-up visit after tetralogy of Fallot repair: a study of the German competence network for congenital heart defects.  

PubMed

This nationwide study aimed to evaluate health-related quality of life (QoL) experienced by children after tetralogy of Fallot repair and to compare self-reported physical ability with objective exercise performance. This prospective nonrandomized, government-funded multicenter study enrolled 168 patients (70 girls; ages 8-16 years) after tetralogy of Fallot repair at eight German heart centers. Health-related QoL was analyzed by the self-reported KINDL-R quality-of-life questionnaire. The patients' actual exercise capacity was evaluated by a cardiopulmonary exercise test. Health-related QoL and cardiopulmonary exercise capacity were compared with those of an age-matched German standard population. Correlation of health-related QoL with self-estimated physical rating and cardiopulmonary exercise capacity were analyzed. Health-related QoL in children and adolescents after tetralogy of Fallot repair is without limitation. Compared with the standard population, all the items evaluated by the KINDL-R questionnaire showed better or similar values, whereas objective exercise capacity compared with that of the standard population was impaired. Peak oxygen uptake correlated significantly with the physical well-being (p = 0.002) and the total score (p = 0.01) of the KINDL-R questionnaire. Health-related QoL experienced by children and adolescents after tetralogy of Fallot repair is comparable with that of the healthy standard population. However, closer inspection shows that self-estimated physical functioning is significantly overestimated compared with actual exercise capacity. Quality-of-life instruments and exercise tests, therefore, should be used in a complementary manner with children to avoid eventually fatal misinterpretation of patient-estimated physical ability. PMID:23263026

Mueller, Goetz C; Sarikouch, Samir; Beerbaum, Philipp; Hager, Alfred; Dubowy, Karl-Otto; Peters, Brigitte; Mir, Thomas S

2012-12-20

83

Cardiopulmonary exercise testing and prognosis in heart failure due to systolic left ventricular dysfunction: a validation study of the European Society of Cardiology Guidelines and Recommendations (2008) and further developments  

Microsoft Academic Search

Aims: The study aims were to validate the cardiopulmonary exercise testing (CPET) parameters recommended by the European Society of Cardiology 2008 Guidelines for risk assessment in heart failure (HF) (ESC-predictors) and to verify the predictive role of 11 supplementary CPET (S-predictors) parameters.Methods and results: We followed 749 HF patients for cardiovascular death and urgent heart transplantation for 3 years: 139

Ugo Corrà; Andrea Giordano; Alessandro Mezzani; Marco Gnemmi; Massimo Pistono; Roberto Caruso; Pantaleo Giannuzzi

2012-01-01

84

The initial slope of the VCO 2 \\/VO 2 -curve (s1) in cardiopulmonary exercise testing is a strong and independent predictor of outcome in patients with previous myocardial infarction  

Microsoft Academic Search

Background  Detecting heart failure (HF) patients at risk is a relevant clinical problem. Our goal was to define associations of clinical\\u000a HF-markers and exercise parameters with respect to their prognostic power in HF-patients.\\u000a \\u000a \\u000a \\u000a Methods  We performed cardiopulmonary exercise testing (CPET) in 103 ischemic HF-patients. CPET-parameters included peak VO2, VO2 at AT, peak oxygen pulse, minimal CO2 and O2 equivalents, VE\\/VCO2 and s1,

Joerg Honold; Lenka Geiger; Birgit Assmus; Ulrich Fischer-Rasokat; Volker Schaechinger; Andreas M. Zeiher; Ioakim Spyridopoulos

2008-01-01

85

Evaluation of right ventricular functions and B-type natriuretic peptide levels by cardiopulmonary exercise test in patients with pulmonary regurgitation after repair of tetralogy of Fallot.  

PubMed

Impairment of right ventricular functions, especially due to chronic pulmonary regurgitation (PR), is a well-known entity in patients with tetralogy of Fallot (ToF) after repair. The aim of this study was to examine the relation between B-type natriuretic peptide (BNP) levels and right ventricular dysfunction by cardiopulmonary exercise test (ET) in patients after repair of ToF. Twenty-five patients with a mean age of 14.1 +/- 4.4 years at follow-up who underwent repair of ToF at a mean age of 4.9 +/- 5.1 years and 29 age- and sex-matched healthy children at a mean age of 13.1 +/- 2.8 years were enrolled in this study. Plasma BNP levels were measured at baseline and at maximal exercise. The volume of right ventricle (RV) and the degree of PR were assessed by two-dimensional echocardiography and color Doppler. Plasma BNP levels were significantly higher in patients with ToF than in controls (28.3 +/- 24.1 vs 7.4 +/- 2.3 pg/mL, p = 0.0001). Exercise was associated with increased plasma BNP levels in both groups. A greater increase in BNP was noted in patients with ToF than in controls (37.6 +/- 27.5 vs 11.3 +/- 4.5 pg/mL, p = 0.0001). Forced vital capacity (FVC%) (84.9 +/- 16.9 vs 98.4 +/- 18.2, p = 0.01) and forced expiratory volume during the 1st second (FEV1%) (91.5 +/- 19.3 vs 103.8 +/- 16.1, p = 0.02) were decreased, exercise duration (ED) (10.1 +/- 1.9 vs 11.4 +/- 1.7 min, p = 0.02), maximum heart rate (HRmax) (171.2 +/- 18.9 vs 186.4 +/- 13.9 /min, p = 0.004), and maximum oxygen uptake (VO(2)max) (1.56 +/- 0.53 vs 2.1 +/- 0.6 L/min, p = 0.007) were lower in patients with ToF. There were significant correlations between the degree of PR and ED (r =-0.3, p = 0.009), HRmax (r =-0.4, p = 0.001), and VO(2)max (r =-0.4, p = 0.001). The correlations were significant both before and after exercise, being more pronounced after exercise between BNP level and the degree of PR (r = 0.6, p = 0.0001). As a result, the severity of PR has a negative influence on right ventricular functions and there is significant relation between right ventricular functions and exercise capacity after repair of tetralogy of Fallot. PMID:18928486

Cetin, Ilker; Tokel, Kür?ad; Varan, Birgül; Orün, Utku Arman; Gökdemir, Mahmut; Cindik, Nimet; Eyübo?lu, Füsun; Ulubay, Gaye; A?lamaci, Sait

86

Pre-operative cardiopulmonary exercise testing predicts adverse post-operative events and non-progression to adjuvant therapy after major pancreatic surgery.  

PubMed

BACKGROUND: Surgery followed by chemotherapy is the primary modality of cure for patients with resectable pancreatic cancer but is associated with significant morbidity. The aim of the present study was to evaluate the role of cardiopulmonary exercise testing (CPET) in predicting post-operative adverse events and fitness for chemotherapy after major pancreatic surgery. METHODS: Patients who underwent a pancreaticoduodenectomy or total pancreatectomy for pancreatic head lesions and had undergone pre-operative CPET were included in this retrospective study. Data on patient demographics, comorbidity and results of pre-operative evaluation were collected. Post-operative adverse events, hospital stay and receipt of adjuvant therapy were outcome measures. RESULTS: One hundred patients were included. Patients with an anaerobic threshold less than 10?ml/kg/min had a significantly greater incidence of a post-operative pancreatic fistula [International Study Group for Pancreatic Surgery (ISGPS) Grades A-C, 35.4% versus 16%, P = 0.028] and major intra-abdominal abscesses [Clavien-Dindo (CD) Grades III-V, 22.4% versus 7.8%, P = 0.042] and were less likely to receive adjuvant therapy [hazard ratio (HR) 6.30, 95% confidence interval (CI) 1.25-31.75, P = 0.026]. A low anaerobic threshold was also associated with a prolonged hospital stay (median 20 versus 14 days, P = 0.005) but not with other adverse events. DISCUSSION: CPET predicts a post-operative pancreatic fistula, major intra-abdominal abscesses as well as length of hospital stay after major pancreatic surgery. Patients with a low anaerobic threshold are less likely to receive adjuvant therapy. PMID:23458160

Chandrabalan, Vishnu V; McMillan, Donald C; Carter, Roger; Kinsella, John; McKay, Colin J; Carter, C Ross; Dickson, Euan J

2013-02-20

87

Genetics of ?2-Adrenergic Receptors and the Cardiopulmonary Response to Exercise  

PubMed Central

Exercise elicits a number of physiologic responses to increase oxygen delivery to working muscles. The ?2-adrenergic receptors (ADRB2) play a role in the cardiopulmonary response to exercise. This review is focused on how the gene that encodes the ADRB2 influences the cardiopulmonary response to exercise. In addition, we discuss possible interactions between ADRB2 and other genes important in exercise performance.

Snyder, Eric M.; Johnson, Bruce D.; Joyner, Michael J.

2009-01-01

88

Cardiopulmonary adaptation to exercise in coal miners  

SciTech Connect

Twenty-six coal miners, without associated functional chronic obstructive lung disease (COLD), assessed by normal airway resistance, were divided into three groups: (1) Group C, normal x-ray; (2) Group S1, micronodular silicosis; and (3) Group S2, complicated silicosis. All subjects were evaluated while at rest and during exercise. Significant lung volume reduction was observed in the S2 Group only. Blood gases, pulmonary pressure, and cardiac output were found to be within the normal range for all three groups when at rest. The pulmonary pressure and pulmonary vascular resistance were higher, however, for the S1 and S2 Groups when compared to the C Group. During exercise, pulmonary hypertension was observed in 50% of the patients with complicated silicosis. When all data (N = 26) were included, the high values for pulmonary pressure and pulmonary vascular resistance correlated well with the loss in vital capacity (VC) and the decrease in forced expiratory volume in 1 sec (FEV/sub 1/ /sub 0/). From the initial 26 patients, 19 were selected on the basis of their normal airway resistance and FEV/sub 1/ /sub 0//VC ratio. This selection did not alter the differences noted for the pulmonary pressure and total pulmonary vascular resistance, which previously existed between the groups, even though the correlations were not statistically significant. We conclude that silicosis without associated COLD leads to minimal hemodynamic impairment at rest and during exercise, and that airway resistance does not detect impairment of flow as effectively as FEV/sub 1/ /sub 0/ reduction. The increased pulmonary vascular resistance observed, especially in complicated silicosis, may be best explained by the loss of lung parenchyma and possible impairment of small airways.

Scano, G.; Garcia-Herreros, P.; Stendardi, D.; Degre, S.; De Coster, A.; Sergysels, R.

1980-11-01

89

Prognostic value of cardiopulmonary exercise testing using percent achieved of predicted peak oxygen uptake for patients with ischemic and dilated cardiomyopathy  

Microsoft Academic Search

Objectives. We tested the hypothesis that percent achieved of predicted peak oxygen uptake (predicted V02max) improves the prognostic accuracy of identifying high risk ambulatory patients with congestive heart failure considered for heart transplantation compared with absolute peak oxygen uptake (V02max) in 181 patients with ischemic or dilated cardiomyopathy.Background. Peak oxygen uptake during exercise has been shown to be a useful

Arthur M. Stelken; Liwa T. Younis; Stephen H. Jennison; D. Douglas Miller; Leslie W. Miller; Leslee J. Shaw; Debra Kargl; Bernard R. Chaitman

1996-01-01

90

The prognostic value of estimated glomerular filtration rate, amino-terminal portion of the pro-hormone B-type natriuretic peptide and parameters of cardiopulmonary exercise testing in patients with chronic heart failure  

PubMed Central

The aim of this study was to evaluate the prognostic value of renal function in relation to amino-terminal portion of the pro-hormone B-type natriuretic peptide (NT-proBNP) and parameters of cardiopulmonary exercise testing in predicting mortality and morbidity in patients with moderate chronic heart failure (CHF). Sixty-one CHF patients were included in the study. Patients' characteristics were: age 64.3±11.6 years; New York Heart Association class I/II/III: 14/37/10; left ventricular ejection fraction: 0.30±0.13 (%); NT-proBNP: 252.2±348.0 (ng/L); estimated creatinine clearance (e-CC): 73.6±31.4 (mL/min); estimated glomerular filtration rate (e-GFR): 66.1±24.6 (mL/min/1.73 m2); the highest O2 uptake during exercise (VO2-peak): 1.24±0.12 mL/kg/min; VO2/workload: 8.52±1.81 (mL/min/W)]. During follow up (59.5±4.0 months) there were 15 cardiac deaths and 16 patients were hospitalized due to progression of heart failure. NT-proBNP and VO2/workload were independently associated with cardiac death (P=0.007 and P=0.006, respectively). Hospitalization for progressive CHF was only associated with NT-proBNP (P=0.002). The combined cardiac events (cardiac death and hospitalization) were associated with NT-proBNP and VO2/ workload (P=0.007 and P=0.005, respectively). The addition of estimates of renal function (neither serum creatinine nor e-GFR) did not improve the prognostic value for any of the models.In conclusion, in patients with moderate CHF, increased NT-proBNP and reduced VO2/ work-load identify those with increased mortality and morbidity, irrespective of estimates of renal function.

Verberne, Hein J.; van der Spank, Aukje; Bresser, Paul; Somsen, G. Aernout

2012-01-01

91

Relationship between cardiopulmonary response to exercise and adiposity in survivors of childhood malignancy  

Microsoft Academic Search

Many long term sequelae result from previous treatment for malignancy in childhood. However, little information exists on cardiopulmonary response and energy expenditure during exercise and their possible associations with excess body fat. Measurements of body composition and exercise capacity both at low intensity and maximal aerobic capacity were made on 56 long term survivors of childhood malignancy (35 survivors of

J T Warner; W Bell; D K H Webb; J W Gregory

1997-01-01

92

Stage-related changes in functional capacity in Hodgkin’s disease: assessment by cardiopulmonary exercise testing before initiation of treatment  

Microsoft Academic Search

Our aim was to examine indices of cardiorespiratory capacity at rest and during exercise before initiation of therapy for Hodgkin’s disease. We prospectively studied 24 patients divided into two groups according to the disease stage. Group 1 included eight patients in stage IA and four in stage IIA; group 2 included four patients in stage IIB, six in stage III,

Eric Page; David Assouline; Catherine Durand; Odile Brun; David Coeffic; Danièle Fric; Claire Garnier; Cécile Leyronnas; Véronique Alcalay; Bernard Aguilaniu

2006-01-01

93

Kalp Yetersizliinde Bisoprolol Tedavi Etkinliinin Kardiyopulmoner Egzersiz Testi ile Deerlendirilmesi Assessment of the Efficacy of Bisoprolol Administration by Cardiopulmonary Exercise Testing in Patients with Heart Failure  

Microsoft Academic Search

Objective: It is well known that long-term therapy with beta-blockers reduces morbidity and mortality, improves left vent- ricular function in patients with heart failure. However the effect of beta-blockade on exercise tolerance in patients with heart failure remains unclear. In the present study we evaluated effects of the addition of bisoprolol to standart therapy with a diuretic and an angiotensin

Sait Terzi

94

Atrial Septal Defect in Adults: Cardiopulmonary Exercise Capacity Before and 4 Months and 10 Years After Defect Closure  

Microsoft Academic Search

Objectives. The purpose of the study was to evaluate the cardiopulmonary exercise capacity and ventilatory function in adults with atrial septal defect (ASD) preoperatively and 4 months and 10 years postoperatively.Background. Only few data are available on cardiopulmonary exercise tolerance after ASD closure, but detailed knowledge might be helpful for indication for defect closure in certain patients.Methods. The study was

Uwe Helber; Reinhard Baumann; Hartwig Seboldt; Ulrich Reinhard; Hans Martin Hoffmeister

1997-01-01

95

Cardio-pulmonary fitness test by ultra-short heart rate variability  

PubMed Central

Objectives: It is known that exercise induces cardio-respiratory autonomic modulation. The aim of this study was to assess the cardio-pulmonary fitness by ultra-short heart rate variability. Materials and Methods: Study population was divided into 3 groups: Group-1 (n = 40) consisted of military sports man. Group-2 (n = 40) were healthy age-matched sedentary male subjects with normal body mass index [BMI = 19 - 25 kg/m2). Group-3 (n = 40) were healthy age-matched obese male subjects [BMI > 29 kg/m2). Standard deviation of normal-to-normal QRS intervals (SDNN) was recorded over 15 minutes. Bruce protocol treadmill test was used; and, maximum oxygen consumption (VO2max) was calculated. Results: When the study population was divided into quartiles of SDNN (first quartile: < 60 msec; second quartile: > 60 and < 100 msec; third quartile: > 100 and <140 msec; and fourth quartile: >140 msec), progressive increase was found in VO2max; and, SDNN was significantly linked with estimated VO2max. Conclusion: In conclusion, the results of this study demonstrate that exercise training improves cardio-respiratory autonomic function (and increases heart rate variability). Improvement in cardio-respiratory autonomic function seems to translate into a lower rate of long term mortality. Ultra-short heart rate variability is a simple cardio-pulmonary fitness test which just requires 15 minutes, and involves no exercise such as in the treadmill or cycle test.

Aslani, Arsalan; Aslani, Amir; Kheirkhah, Jalal; Sobhani, Vahid

2011-01-01

96

Measuring the Effects of Massage on Exercise Performance and Cardiopulmonary Response in Children With and Without Heart Disease: A Pilot Study  

PubMed Central

Background Congenital heart disease, a common and serious birth defect, affects 8 per 1000 live-born infants. Decreased exercise capacity and development of obesity is common in this population. These children may benefit from therapies, such as massage therapy, that could enhance cardiovascular and skeletal muscle function when they exercise. Purpose A pilot study conducted at the pediatric cardiology clinic of the Mattel Children’s Hospital of the University of California–Los Angeles examined the safety and feasibility of measuring the effects of pre-exercise massage on exercise performance and cardiopulmonary response in children with and without heart disease. Participants and Methods Sixteen children (mean age: 9.2 ± 2.2 years) participated in the study. Ten participants had various forms of heart disease, and six children were healthy. A female certified massage therapist with specialized training in pediatric massage provided a 30-minute massage to the participants. Using a standard protocol, each participant underwent two exercise tests: one test with and one without pre-exercise massage. Heart rate, blood pressure, and oxygen uptake (VO2) were measured in the participants. Results All recruited participants completed the study. No adverse events occurred during any of the exercise tests or massage sessions. Measurements during exercise with or without a preceding massage were compared, and the pre-exercise massage condition yielded a significantly higher heart rate and higher minute ventilation. Measurements during exercise in children with heart disease and in healthy participants showed no significant differences in peak heart rate, blood pressure, peak VO2, peak work rate, minute ventilation, or respiratory quotient. Conclusions In this study, peak heart rate, peak VO2, and peak minute ventilation were higher when children received a massage before exercise testing. Larger studies will be needed to investigate the strength of this finding. Future studies should include measurements of anxiety and psychological factors in addition to cardiopulmonary measures.

Beider, Shay; Boulanger, Karen T.; Joshi, Milind; Pan, Yann Ping; Chang, Ruey-Kang R.

2010-01-01

97

Role of exercise and nutrition on cardiopulmonary fitness and pulmonary functions on residential and non-residential school children.  

PubMed

Physical fitness is the prime criterion for survival and to lead a healthy life. Our aim is to find out effect of exercise and nutrition on physical fitness on growing children with scientific records. The present study was designed on healthy school children of a Residential-Sainik (100) and Non-Residential (100) school children (12-16 yrs) of Bijapur. To evaluate cardiopulmonary fitness parameters included are VO2Max (ml/kg/min) and Physical Fitness Index (PFI %). Harvard Step Test determined VO2 Max and PFI. Also recorded pulmonary function parameters like Forced Expiratory Volume in 1 sec (FEV1 in %) by recording spirometry. Peak Expiratory Flow Rate (PEFR in L/Min) by Peak flow meter and Maximal Expiratory Pressure (MEP in mmHg) by modified Black's apparatus. We found statistically significant higher values (p = 0.000) of VO2Max, PFI, FEV1, PEFR and MEP in residential school children compared to nonresidential school children higher. So, our study shows that regular exercise and nutritious food increase the cardiopulmonary fitness values and pulmonary functions in Residential school children. PMID:23734438

Khodnapur, Jyoti P; Dhanakshirur, Gopal B; Aithala, Manjunatha

98

Amelioration of Depressed Cardiopulmonary Reflex Control of Sympathetic Nerve Activity by Short-Term Exercise Training in Male Rabbits with Heart Failure  

Microsoft Academic Search

Abstract The reflex regulation of sympathetic nerve activity has been demonstrated,to be impaired in the chronic heart failure (CHF) state compared,to the normal condition. Exercise training (EX) appears to be beneficial to patients with CHF and has been shown to reduce sympathetic outflow in this disease state. We tested the hypothesis that EX corrects the reduced cardiopulmonary,(CP) reflex response to

R. U. Pliquett; K. G. Cornish; K. P. Patel; H. D. Schultz; J. D. Peuler; I. H. Zucker

2003-01-01

99

Sample Proficiency Test exercise  

SciTech Connect

The current format of the OPCW proficiency tests has multiple sets of 2 samples sent to an analysis laboratory. In each sample set, one is identified as a sample, the other as a blank. This method of conducting proficiency tests differs from how an OPCW designated laboratory would receive authentic samples (a set of three containers, each not identified, consisting of the authentic sample, a control sample, and a blank sample). This exercise was designed to test the reporting if the proficiency tests were to be conducted. As such, this is not an official OPCW proficiency test, and the attached report is one method by which LLNL might report their analyses under a more realistic testing scheme. Therefore, the title on the report ''Report of the Umpteenth Official OPCW Proficiency Test'' is meaningless, and provides a bit of whimsy for the analyses and readers of the report.

Alcaraz, A; Gregg, H; Koester, C

2006-02-05

100

Exercising your patient: which test(s) and when?  

PubMed

With the introduction of the stair climb test of surgical patients in the 1950s, the role of exercise-based testing as a useful diagnostic tool and an adjunct to conventional cardiopulmonary testing was established. Since then, we have witnessed a rapid development of numerous tests, varying in their protocols and clinical applications. The relatively simple "field tests" (shuttle walks, stair climb, 6-minute walk test) require minimal equipment and technical support, and so are generally available to physicians and patients. At the other end of the spectrum is the cardiopulmonary exercise test (CPET), more complex in its equipment requirements, technical support, and with an often complex interpretive strategy. The 6-minute walk test (6MWT), in particular, has evolved into a versatile study with diagnostic utility in many disorders, including COPD, pulmonary hypertension, interstitial lung disease, congestive heart failure, and in the pre-surgical evaluation of patients, among others. With the added dimensions of optional O(2) saturation monitoring and calculated post-exercise heart rate recovery, the 6MWT is providing important clinical information well beyond the measure of distance walked. Is it sufficiently robust and informative to replace the more demanding and less available CPET? In many instances, the clinical applications are overlapping, with the 6MWT functioning as an adequate surrogate. However, in the initial evaluation of unexplained dyspnea, in formal evaluation of impairment and disability, in detailed evaluation of congestive heart failure, and in the selected lung cancer patient prior to resection, CPET remains superior. Investigations of portable metabolic and cardiovascular monitoring devices aiming to enhance the diagnostic capabilities of 6MWT may further narrow or close the remaining gap between these two exercise studies. PMID:22222129

Pichurko, Bohdan M

2012-01-01

101

Standard anaerobic exercise tests.  

PubMed

Anaerobic tests are divided into tests measuring anaerobic power and anaerobic capacity. Anaerobic power tests include force-velocity tests, vertical jump tests, staircase tests, and cycle ergometer tests. The values of maximal anaerobic power obtained with these different protocols are different but generally well correlated. Differences between tests include factors such as whether average power or instantaneous power is measured, active muscle mass is the same in all the protocols, the legs act simultaneously or successively, maximal power is measured at the very beginning of exercise or after several seconds, inertia of the devices and body segments are taken into account. Force-velocity tests have the advantage of enabling the estimation of the force and velocity components of power, which is not possible with tests such as a staircase test, a vertical jump, the Wingate test and other long-duration cycle ergometer protocols. Maximal anaerobic capacity tests are subdivided into maximal oxygen debt test, ergometric tests (all-out tests and constant load tests), measurement of oxygen deficit during a constant load test and measurement of peak blood lactate. The measurement of the maximal oxygen debt is not valid and reliable enough to be used as an anaerobic capacity test. The aerobic metabolism involvement during anaerobic capacity tests, and the ignorance of the mechanical efficiency, limit the validity of the ergometric tests which are only based on the measurement of work. The amount of work performed during the Wingate test depends probably on glycolytic and aerobic power as well as anaerobic capacity. The fatigue index (power decrease) of the all-out tests is not reliable and depends probably on aerobic power as well as the fast-twich fibre percentage. Reliability of the constant load tests has seldom been studied and has been found to be rather low. In theory, the measure of the oxygen deficit during a constant load test is more valid than the other tests but its reliability is unknown. The validity and reliability of postexercise blood lactate as a test of maximal anaerobic capacity are probably not better than that of the current erogmetric tests. The choice of an anaerobic test depends on the aims and subjects of a study and its practicability within a testing session. PMID:3306867

Vandewalle, H; Pérès, G; Monod, H

102

A new method for data presentation in incremental cardiorespiratory exercise testing  

Microsoft Academic Search

In incremental cardiopulmonary exercise testing, the averaging of data is usually performed to provide group mean data for\\u000a statistical purposes. They are usually presented as averaged maximum values, or as averaged data at different exercise levels.\\u000a However, during incremental exercise testing the change in metabolic status may vary between subjects, thus averaging data\\u000a may not classify the metabolic status accurately.

Joachim Fichter; Claudius A. Stahl; Ishrid Sturm; Gerhard W. Sybrecht

1997-01-01

103

The contribution of exercise testing in the prescription and outcome evaluation of exercise training in pulmonary rehabilitation.  

PubMed

Pulmonary rehabilitation is a comprehensive therapeutic intervention with proven efficacy in relieving symptoms and increasing exercise tolerance in patients with chronic respiratory diseases.One of the main components of a pulmonary rehabilitation program is lower limbs exercise training. There are several ways of establishing the optimal intensity of the exercise training, using the target heart rate, symptom scores, walking tests and laboratory exercise tests with or without ventilation or gas exchange measurements. Each of these methods has advantages and disadvantages.The gold standard in exercise capacity evaluation is cardiopulmonary exercise testing (CPET) which brings a high level of objectivity in exercise tolerance evaluation and provides information on mechanisms responsible for its decline; this allows a better training prescription and a correct evaluation of rehabilitation outcomes. PMID:23118826

Stroescu, Carmen; Ionita, Diana; Croitoru, Alina; Toma, Claudia; Paraschiv, Bianca

2012-01-01

104

Submaximal Exercise Testing Treadmill and Floor Walking.  

National Technical Information Service (NTIS)

Exercise testing has been used as the basis for exercise prescriptions for a variety of patients. Exercise tests are performed using standardized ergometers such as a treadmill, bicycle, or steps. There have been, however, several drawbacks to these ergom...

W. L. Rohrig

1978-01-01

105

Effect of beta blockade on the neurohumoral and cardiopulmonary response to dynamic exercise in cardiac transplant recipients.  

PubMed Central

OBJECTIVE--To determine the effects of a small dose of beta blocker on neurohumoral and cardiopulmonary responses after cardiac transplantation. BACKGROUND--Cardiac transplant recipients have a reduced exercise capacity and abnormal cardiovascular responses to exercise. The sympathoadrenal response to exercise has been shown to be abnormal with high venous noradrenaline. The effect of beta blockade on these neurohumoral mechanisms has not been defined. METHODS--10 non-rejecting cardiac transplant recipients were studied. Patients carried out graded exercise to a symptom limited maximum. Blood samples were taken during exercise. Concentrations of noradrenaline, adrenaline, and atrial natriuretic peptide and plasma renin activity were measured. The next day, the exercise and sampling procedure were repeated after an oral dose of propranolol (40 mg). RESULTS--Patients tolerated exercise poorly after beta blockade, which was reflected in the maximum workload reached. Heart rate and blood pressure were significantly higher at rest and during exercise before beta blockade. Although there was no significant difference when resting, mean (SEM) noradrenaline concentrations during peak exercise were higher after beta blockade (16.2 (2) v 23.6 (2.9) nmol/l, p = 0.001). Adrenaline concentrations at peak exercise were also greater after beta blockade (0.89 (0.31) v 1.18 (0.38) nmol/l, p = 0.055). Atrial natriuretic peptide concentrations tended to be higher after beta blockade (118.75 (50.2) v 169.79 (39.3) pmol/l, p = 0.36). There was no significant change in plasma renin activity. CONCLUSIONS--A small oral dose of a competitive beta blocker such as propranolol has an adverse effect on exercise tolerance and cardiovascular response to exercise in cardiac transplant recipients. There are also increased concentrations of circulating noradrenaline and therefore, sympathetic activity during exercise. beta blockers should be used with caution in cardiac transplant recipients.

Kushwaha, S. S.; Banner, N. R.; Patel, N.; Cox, A.; Patton, H.; Yacoub, M. H.

1994-01-01

106

Correlation of Subjective Questionnaires With Cardiac Function as Determined by Exercise Testing in a Pediatric Population  

Microsoft Academic Search

Background: Although exercise testing is an important objective method used to assess cardiopulmonary function, subjective assessment\\u000a often is used as a proxy in the clinical setting. This study aimed to determine whether responses to a subjective functional\\u000a capacity questionnaire administered to parents and patients in a pediatric exercise laboratory correlate with objective assessment\\u000a of functional capacity, measured by peak oxygen

Rebekah Burns; Inger Olson; Jeffrey Kazmucha; Raymond Balise; Rita Chin; Clifford Chin

2010-01-01

107

Exercise testing in pulmonary sarcoidosis  

PubMed Central

The change in transfer coefficient (Kco) with increasing heart rate during exercise was studied in 25 normal subjects and in 21 patients with pulmonary sarcoidosis. The slope of the Kco response against heart rate was found to be 0·0053 mmol min?1 kPa?1 l?1 per beat in the normal group but in many of the patients was two standard deviations or more below this normal slope, even when their routine function tests were normal. This response of Kco to exercise is a more sensitive index of changed function than more routine function tests in pulmonary sarcoidosis.

Ingram, CG; Reid, Patricia C; Johnston, RN

1982-01-01

108

Specificity of a Maximal Step Exercise Test  

ERIC Educational Resources Information Center

|To adhere to the principle of "exercise specificity" exercise testing should be completed using the same physical activity that is performed during exercise training. The present study was designed to assess whether aerobic step exercisers have a greater maximal oxygen consumption (max VO sub 2) when tested using an activity specific, maximal…

Darby, Lynn A.; Marsh, Jennifer L.; Shewokis, Patricia A.; Pohlman, Roberta L.

2007-01-01

109

[The integrative cardiorespiratory exercise test].  

PubMed

The cardiorespiratory incremental maximal exercise test is being used increasingly for clinical evaluation. It is based on the fact that during physical effort the output of the cardiovascular and respiratory systems increase to maintain a higher metabolic rate and stroke volume. Cardiac output increases by increase in both heart rate and stroke volume. Ventilation increases by increase in respiratory rate and tidal volume. All changes are synchronous, so that blood composition and gas partial pressures are constant over a wide range of work intensities. The response of a normal sedentary subject to incremental exercise is presented, as well as the improvement in an athlete's physical performance as a result of training. An obese subject, despite normal maximal oxygen uptake, felt compromised due to the high energy cost of moving his heavy torso. The large normal breathing reserve during exercise was demonstrated in 2 subjects who, despite lung disease, responded normally to the test. It is likely that this test will be widely used for evaluation of patients with heart and lung disease. PMID:2792924

Ben-Dov, I; Oren, A

1989-05-10

110

Influence of repeated maximal exercise testing on biomarkers and fatigue in sarcoidosis.  

PubMed

Fatigue in the immune mediated inflammatory disease sarcoidosis is thought to be associated with impaired exercise tolerance. This prospective study assessed fatigue and recuperative capacity after repeated exercise, and examined whether changing concentrations in biomarkers upon exercise are associated with fatigue. Twenty sarcoidosis patients and 10 healthy volunteers performed maximal cardiopulmonary exercise tests on two successive days. Concentrations of cytokines, stress hormones, ACE and CK were assessed before and after the two exercise tests, and 3 days thereafter. All participants completed a sleep diary. Severely fatigued patients showed significant lower VO2 max (p=0.038, p=0.022) and maximal workload (p=0.034, p=0.028) on both exercise tests compared to healthy controls. No impairment of maximal exercise testing was demonstrated during the second cycling test in any group. Fatigue was not correlated with changes in concentrations of biomarkers upon exercise. Severely fatigued patients rated both tests as significantly more fatiguing, and reported significant lower mean subjective night sleeping time during the testing period. Fatigue in sarcoidosis patients cannot be objectified by reduction of exercise capacity after repeated maximal exercise testing, and is not correlated with significant changes in biomarkers. Severe fatigue is only and consistently featured by patient reported outcomes. PMID:23727274

Braam, A W E; de Haan, S N; Vorselaars, A D M; Rijkers, G T; Grutters, J C; van den Elshout, F J J; Korenromp, I H E

2013-05-29

111

Effect of long-term enalapril therapy on cardiopulmonary exercise performance in men with mild heart failure and previous myocardial infarction.  

PubMed

Forty-one men with documented myocardial infarction greater than 6 months previously were randomized to long-term (48 weeks) therapy with placebo or enalapril on a double-blind basis. All patients were receiving concurrent therapy with digitalis and a diuretic drug for symptomatic heart failure (functional class II or III). The mean age was 64 +/- 7.3 years and no patient suffered from exertional chest pain. Patients underwent maximal cardiopulmonary exertional chest pain. Patients underwent maximal cardiopulmonary exercise testing to exhaustion on an ergometer cycle nine times over the course of 48 weeks. Gas exchange data were collected on a breath by breath basis with use of a continuous ramp protocol. In the placebo group (n = 21), the mean (+/- SD) peak oxygen consumption (VO2) at baseline was 18.8 +/- 5.2 versus 18.5 +/- 5.5 ml/kg per min at 48 weeks (-1.4%, p = NS). In the enalapril group (n = 20), the corresponding values were 18.1 +/- 3.1 versus 18.3 +/- 2.6 ml/kg per min (+2.8%, p = NS). The mean VO2 at the anaerobic threshold for the placebo group at baseline study was 13.1 +/- 3.5 versus 12.8 +/- 2.1 ml/kg per min at 48 weeks (-2.2%, p = NS). The corresponding values for the enalapril group were 11.8 +/- 2.3 versus 11.8 +/- 2.4 ml/kg per min (+1.4%, p = NS). The mean total exercise duration in the placebo group at baseline study was 589 +/- 153 versus 620 +/- 181 s at 48 weeks (+5.4%, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1856429

Dickstein, K; Barvik, S; Aarsland, T

1991-08-01

112

Coagulation tests during cardiopulmonary bypass correlate with blood loss in children undergoing cardiac surgery  

Microsoft Academic Search

Objectives: To examine whether coagulation tests, sampled before and during cardiopulmonary bypass (CPB), are related to blood loss and blood product transfusion requirements, and to determine what test value(s) provide the best sensitivity and specificity for prediction of excessive hemorrhage.Design: Prospective.Setting: University-affiliated, pediatric medical center.Participants: Four hundred ninety-four children.Interventions: Coagulation tests.Measurements and Main Results: Demographic, coagulation test, blood loss, and

Glyn D. Williams; Susan L. Bratton; Elizabeth C. Riley; Chandra Ramamoorthy

1999-01-01

113

Exercise Testing of the Child with Obesity  

Microsoft Academic Search

.   As the prevalence of childhood obesity increases, exercise testing of obese children is likely to increase as well. This\\u000a article discusses the implications of pediatric obesity for exercise testing and provides some recommendations for conducting\\u000a tests and evaluating results. Studies comparing obese and nonobese children during exercise testing indicate that obese children\\u000a are capable of meeting the challenges of

S. Owens; B. Gutin

1999-01-01

114

Environmental Factors for Exercise Testing and Exercise Prescription.  

National Technical Information Service (NTIS)

The clinical use of exercise testing to evaluate an individual's cardiorespiratory reserve and to enable the appropriate prescription of aerobic activity has attained wide medical acceptance. The physiologic stress from the metabolic intensity imposed by ...

S. N. Cheuvront M. N. Sawka K. B. Pandolf

2005-01-01

115

Cardiopulmonary Effects of Acute Stressful Exercise at Altitude of Individuals with Sickle Cell Trait (SCT).  

National Technical Information Service (NTIS)

A spectrum of exercise induced complications including sudden unexpected death has been reported in individuals with sickle cell trait (SCT). The etiology of these results and the role that sickling may play remain uncertain. We have previously demonstrat...

I. M. Weisman R. J. Zeballos

1989-01-01

116

Testing an Exercise Intervention to Improve Aerobic Conditioning and Autonomic Function after an Implantable Cardioverter Defibrillator (ICD)  

PubMed Central

Background Implantable cardioverter defibrillators (ICDs) are an increasingly common treatment for survivors of sudden cardiac arrest or others with life-threatening ventricular arrhythmias. Health-care providers are often reluctant to prescribe exercise for this group because of the belief that it will provoke ventricular arrhythmias and cardiac arrest; patients are often afraid to exercise because of concern over receiving an ICD shock. A social cognitive theory-driven exercise intervention aimed at stabilizing cardiac arrhythmias and reducing ICD shocks by increasing parasympathetic autonomic nervous system control is described. Methods The exercise intervention has two phases that include an 8-week aerobic conditioning component followed by a 16-week exercise maintenance component. The aerobic exercise intervention is expected to have significant impact on cardiopulmonary function, ventricular arrhythmias, cardiac autonomic function, and self-efficacy in persons who have an ICD. The exercise intervention is currently being tested using a randomized clinical trial format, the results of which will be available in 2012. Conclusion The exercise after ICD trial is one of the first clinical trials to test the effects of aerobic exercise on cardiopulmonary outcomes after receiving an ICD for primary or secondary prevention of sudden cardiac arrest.

DOUGHERTY, CYNTHIA M.; GLENNY, ROBB W.; KUDENCHUK, PETER J.; MALINICK, TODD E.; FLO, GAYLE L.

2010-01-01

117

Eccentric Exercise Testing and Training.  

National Technical Information Service (NTIS)

Some researchers and practitioners have touted the benefits of including eccentric exercise in strength training programs. However, others have challenged its use because they believe that eccentric actions are dangerous and lead to injuries. Much of the ...

P. M. Clarkson

1994-01-01

118

Exercise electrocardiogram testing and imaging in women  

Microsoft Academic Search

The increased awareness of the incidence and risk of coronary heart disease (CHD) has increased the efforts of physicians\\u000a to identify women with CHD as early as possible. Exercise electrocardiogram (ECG) testing and imaging have been used in this\\u000a manner for men and women but represent unique challenges with regard to women. Exercise ECG testing, which determines the\\u000a presence of

Richard A. Stein; Nieca Goldberg

2007-01-01

119

Exercise thallium testing in ventricular preexcitation  

Microsoft Academic Search

Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular

S. Archer; C. Gornick; F. Grund; R. Shafer; E. K. Weir

1987-01-01

120

Exercise thallium testing in ventricular preexcitation  

SciTech Connect

Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation.

Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

1987-05-01

121

Benefits of HIV testing during military exercises.  

PubMed

During U.S. Marine Corps Reserve summer 2-week active duty for training periods, 6,482 people were tested for human immunodeficiency virus (HIV). Testing at an initial exercise, Solar Flare, trained a cadre of contact teams to, in turn, train other personnel in phlebotomy and the HIV protocol at three other exercises (141 Navy Reserve and Inspector-Instructor hospital corpsmen were trained). Corpsmen could be trained with an indoctrination of 120 minutes and a mean of 15 phlebotomies. After 50 phlebotomies, the administration, identification, and labeling process plus phlebotomy could be completed in 90 seconds. HIV testing during military exercises is both good for training and cost-effective. PMID:2513526

Gross, M L; Rendin, R W; Childress, C W; Kerstein, M D

1989-12-01

122

A comparative study analysing the two methods of assessing cardiopulmonary resuscitation - multiple choices versus free response question test formats  

Microsoft Academic Search

Summary Background and objective. The purpose of the study was to compare two different methods of assessing the knowledge of cardiopulmonary resuscitation (CPR), multiple choices versus free response question test formats and to evaluate, which was better. Methods. The research was undertaken in 2004 and 2005 on a representative group of 150 fourth year medical students and 150 doctors one

Thomas J. Maliakal

123

Comparison of exercise tolerance and chest pain during exercise stress testing in three different ethnic groups  

Microsoft Academic Search

Background: Exercise tolerance and exertional chest pain are important prognostic tools for assessing patients with suspected or known ischemic heart disease. The purpose of this study was to evaluate whether exercise time and exertional chest pain differ between African Americans (AA), Caucasians (C) and Hispanics (H).Methods: We evaluated 507 patients who underwent exercise stress testing using standard Bruce protocol with

O. J Rodriguez; V. N Iyer; M Lue; K. T Hickey; D. K Blood; S. R Bergmann; S Bokhari

2004-01-01

124

A new model of centrifugal blood pump for cardiopulmonary bypass: design improvement, performance, and hemolysis tests.  

PubMed

A new model of blood pump for cardiopulmonary bypass (CPB) application has been developed and evaluated in our laboratories. Inside the pump housing is a spiral impeller that is conically shaped and has threads on its surface. Worm gears provide an axial motion of the blood column. Rotational motion of the conical shape generates a centrifugal pumping effect and improves pumping performance. One annular magnet with six poles is inside the impeller, providing magnetic coupling to a brushless direct current motor. In order to study the pumping performance, a mock loop system was assembled. Mock loop was composed of Tygon tubes (Saint-Gobain Corporation, Courbevoie, France), oxygenator, digital flowmeter, pressure monitor, electronic driver, and adjustable clamp for flow control. Experiments were performed on six prototypes with small differences in their design. Each prototype was tested and flow and pressure data were obtained for rotational speed of 1000, 1500, 2000, 2500, and 3000 rpm. Hemolysis was studied using pumps with different internal gap sizes (1.35, 1.45, 1.55, and 1.7 mm). Hemolysis tests simulated CPB application with flow rate of 5 L/min against total pressure head of 350 mm Hg. The results from six prototypes were satisfactory, compared to the results from the literature. However, prototype #6 showed the best results. Best hemolysis results were observed with a gap of 1.45 mm, and showed a normalized index of hemolysis of 0.013 g/100 L. When combined, axial and centrifugal pumping principles produce better hydrodynamic performance without increasing hemolysis. PMID:21595709

Leme, Juliana; Fonseca, Jeison; Bock, Eduardo; da Silva, Cibele; da Silva, Bruno Utiyama; Dos Santos, Alex Eugênio; Dinkhuysen, Jarbas; Andrade, Aron; Biscegli, José F

2011-05-01

125

Can Self-Reported Tolerance of Exercise Intensity Play a Role in Exercise Testing?  

Microsoft Academic Search

EKKEKAKIS, P., E. LIND, E. E. HALL, and S. J. PETRUZZELLO. Can Self-Reported Tolerance of Exercise Intensity Play a Role in Exercise Testing? Med. Sci. Sports Exerc., Vol. 39, No. 7, pp. 1193-1199, 2007. Introduction\\/Purpose: To examine the relationship between self-reported tolerance of exercise intensity, measured by the Preference for and Tolerance of Exercise Intensity Questionnaire, and the amount of

PANTELEIMON EKKEKAKIS; ERIK LIND; ERIC E. HALL; STEVEN J. PETRUZZELLO

2007-01-01

126

Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?  

PubMed Central

In patients with fibrotic idiopathic interstitial pneumonia (f-IIP), the diffusing capacity for carbon monoxide (DLCO) has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-a)O2 at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT). Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF, n = 88) and fibrotic nonspecific interstitial pneumonias (NSIP, n = 33). All but 3 patients (97.5%) had low DLCO values (35?mmHg) and 100 (83%) demonstrated significant oxygen desaturation during 6MWT (>4%). Interestingly 27 patients had low DLCO and normal P(A-a)O2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-a)O2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-a)O2, peak, or 6MWT SpO2.

Wallaert, Benoit; Wemeau-Stervinou, Lidwine; Salleron, Julia; Tillie-Leblond, Isabelle; Perez, Thierry

2012-01-01

127

Effects of Oxides of Nitrogen, Carbon Monoxide and Photochemical Oxidants on the ECG During Exercise and on Cardiopulmonary Function.  

National Technical Information Service (NTIS)

The effect on arterial blood oxygenation of exposure to 0.2 ppm ozone in purified air for two hours, with intermittent light exercise and heat stress was assessed. Twelve healthy, volunteer subjects had blood gases measured before and during exposure thro...

W. S. Linn J. D. Hackney

1978-01-01

128

Cardiopulmonary Effects of Acute Stressful Exercise at Altitude (2300m) of Individuals With Sickle Cell Trait (SCT).  

National Technical Information Service (NTIS)

The possible health hazards for persons with Sickle Cell Trait (SCT) when engaged in strenuous exercise and/or environmental hypoxia is not fully defined. During Phase I and II (Annual Reports No. 1, 1985 and No. 2, 1986) of our Sickle Cell Trait research...

I. M. Weisman R. J. Zeballos T. W. Martin

1987-01-01

129

Paleoecological exercise: Testing competition among Paleozoic brachiopods  

NSDL National Science Digital Library

Students use the procedure outlined by Casey Hermoyian and colleagues (2002) to test whether competition played a role in structuring a strophomenid brachiopod community in the Middle Devonian Onondaga limestone of western New York. It is not necessary to use these particular brachiopods; brachs from other localities, ages, and species could work, too, if chosen well. Students sort through a collection of brachiopods, separating them into groups of species defined by mutual agreement. They then use measurements of the commissure length to test two predictions made by Robert MacArthur's (1972) theory of how Hutchinson's (1959) niche partitioning would be evidenced: nonoverlapping resource use among former competitors but with very little distance between them. Students graph results, calculate ratio sums of their measurements and z statistics to test whether their results are significant. Finally, students prepare a conference-type abstract based on their results. The activity gives students practice in observing differences among groups, measurement, graphing, statistical calculation, synthesizing results, and clear presentation of their synthesis. Students also practice group and individual work in this exercise.

Kendrick, David

130

Energy System Contributions During Incremental Exercise Test  

PubMed Central

The main purpose of this study was to determine the relative contributions of the aerobic and glycolytic systems during an incremental exercise test (IET). Ten male recreational long-distance runners performed an IET consisting of three-minute incremental stages on a treadmill. The fractions of the contributions of the aerobic and glycolytic systems were calculated for each stage based on the oxygen uptake and the oxygen energy equivalents derived by blood lactate accumulation, respectively. Total metabolic demand (WTOTAL) was considered as the sum of these two energy systems. The aerobic (WAER) and glycolytic (WGLYCOL) system contributions were expressed as a percentage of the WTOTAL. The results indicated that WAER (86-95%) was significantly higher than WGLYCOL (5-14%) throughout the IET (p < 0.05). In addition, there was no evidence of the sudden increase in WGLYCOL that has been previously reported to support to the “anaerobic threshold” concept. These data suggest that the aerobic metabolism is predominant throughout the IET and that energy system contributions undergo a slow transition from low to high intensity. Key Points The aerobic metabolism contribution is the predominant throughout the maximal incremental test. The speed corresponding to the aerobic threshold can be considered the point in which aerobic metabolism reaches its maximal contribution. Glycolytic metabolism did not contribute largely to the energy expenditure at intensities above the anaerobic threshold.

Bertuzzi, Romulo; Nascimento, Eduardo M.F.; Urso, Rodrigo P.; Damasceno, Mayara; Lima-Silva, Adriano E.

2013-01-01

131

Consistency of the counting talk test for exercise prescription.  

PubMed

The purpose of this study was to assess the consistency of the counting talk test (CTT) method for estimating exercise intensity across various modes of exercise in healthy young adults. Thirty-six individuals completed the study, which required participation in 3 separate sessions within a 2-week time period. During the first session, the individuals completed a maximal effort treadmill test from which each individual's heart rate reserve (HRR) was calculated. During the second and third sessions, the subjects participated in 2 modes of exercise in each session for a total of 4 different modes of exercise. The individuals exercised at 40% HRR, 50% HRR, 60% HRR, 75% HRR, and 85% HRR. The heart rate (HR), CTT, and rating of perceived exertion (RPE) were recorded at each workload. Based on the individual's resting CTT (CTT(rest)), the %CTT for each exercise stage was then calculated. Pearson correlations demonstrated moderate to good correlations between the CTT and HRR methods and the CTT and RPE methods for estimating exercise intensity. This study found that for the individuals with CTT(rest) <25, moderate to vigorous intensity exercise as recommended by the American College of Sports Medicine HRR guidelines could be achieved by exercising at a level of 40-50% CTT(rest). Individuals with a CTT(rest) ?25, exercising at a level of 30-40% CTT(rest) would place them in the moderate to vigorous exercise intensity range. A high degree of reliability was demonstrated using the CTT method across the various modes of aerobic exercise. As such, independent of the exercise mode, the CTT was found to be an easy and consistent method for prescribing moderate to vigorous aerobic exercise intensity. PMID:21904237

Loose, Brant D; Christiansen, Ann M; Smolczyk, Jill E; Roberts, Kelsey L; Budziszewska, Anna; Hollatz, Crystal G; Norman, Joseph F

2012-06-01

132

Exercise Intolerance in Adult Congenital Heart Disease Comparative Severity, Correlates, and Prognostic Implication  

Microsoft Academic Search

Background—Although some patients with adult congenital heart disease (ACHD) report limitations in exercise capacity, we hypothesized that depressed exercise capacity may be more widespread than superficially evident during clinical consultation and could be a means of assessing risk. Methods and Results—Cardiopulmonary exercise testing was performed in 335 consecutive ACHD patients (age, 3313 years), 40 non- congenital heart failure patients (age,

Gerhard-Paul Diller; Konstantinos Dimopoulos; Darlington Okonko; Wei Li; Sonya V. Babu-Narayan; Craig S. Broberg; Bengt Johansson; Beatriz Bouzas; Michael J. Mullen; Philip A. Poole-Wilson; Darrel P. Francis; Michael A. Gatzoulis

133

Exercise Testing and Training in Patients with (Chronic) Pain  

Microsoft Academic Search

A vast body of literature supports the idea that exercise training is an important modality in the treatment and rehabilitation\\u000a of the chronic pain patient. Exercise testing and prescription should therefore be incorporated in the therapeutic armamentarium\\u000a of health care professionals working with chronic pain patients. In this chapter we present the scientific basis of the positive\\u000a effects regular exercise

Harriët Wittink; Tim Takken

134

Testing an Exercise Intervention in Cancer Patients.  

National Technical Information Service (NTIS)

The purpose of this study was to investigate the feasibility of an exercise program patterned after a phase II cardiac rehabilitation program to positively influence selected physiological and psychological parameters of health in patients with cancer.

S. Young-McCaughan

2001-01-01

135

Prognostic Relevance of Changes in Exercise Test Variables in Pulmonary Arterial Hypertension  

PubMed Central

Introduction Exercise variables determined in patients with pulmonary arterial hypertension (PAH) at the time of diagnosis, predict survival. It is unknown whether upon treatment, subsequent changes in these exercise variables reflect improvements in survival. The aim of this study was to determine changes in exercise variables in PAH patients and to relate these changes to survival. Methods Baseline cardiopulmonary exercise test (CPET) variables and six-minute-walk-distance (6MWD) were available from 65 idiopathic PAH patients (50 females; mean age 45±2yrs). The same variables were determined after treatment (13months) in a sub group of 43 patients. To estimate the association between changes in exercise variables and changes in cardiac function, right-ventricle ejection fraction (RVEF) was measured by cardiac MRI at baseline and after treatment in 34 patients. Mean follow-up time after the second CPET was 53 (range: 4-111) months. Kaplan-Meier analysis was used to relate survival to baseline and treatment-associated changes in exercise variables. Results Survivors showed a significantly greater change in maximal oxygen uptake than non-survivors and this change in aerobic capacity was significantly related to changes in RVEF. From baseline until the end of the study period, two patients underwent a lung transplantation and 19 patients died. Survival analysis showed that baseline 6MWD (p<0.0001), maximal heart rate (p<0.0001) and the slope relating ventilation with carbon dioxide production (p?0.05) were significant predictors of survival, whereas baseline oxygen uptake and oxygen pulse held no predictive value. Treatment associated changes in 6MWD (p<0.01), maximal heart rate (p<0.05), oxygen uptake (p<0.001) and oxygen pulse predicted survival (p<0.05), whereas changes in the slope relating ventilation with carbon dioxide production did not. Conclusion Exercise variables with prognostic significance when determined at baseline, retain their prognostic relevance after treatment. However, when changes in exercise variables upon treatment are considered, a different set of variables provides prognostic information.

Groepenhoff, Herman; Vonk-Noordegraaf, Anton; van de Veerdonk, Marielle C.; Boonstra, Anco; Westerhof, Nico; Bogaard, Harm J.

2013-01-01

136

Mean Platelet Volume and Exercise Stress Test  

Microsoft Academic Search

Background: Long-term moderate or strenuous physical activity is associated with a considerable reduction in cardiovascular morbidity and mortality. However acute exercise leads to a transient activation of the thrombotic system. Healthy individuals can react this by increasing their fibrinolytic capacity acutely. However, patients with ischemic heart disease, lacking fibrinolytic potential, may be at considerable risk for acute ischemic events if

Mehmet Birhan Yilmaz; Ersin Saricam; Senay Funda Biyikoglu; Yesim Guray; Umit Guray; Hatice Sasmaz; Sule Korkmaz

2004-01-01

137

Exercise testing and hemodynamic performance in healthy elderly persons  

SciTech Connect

To determine the effect of age on cardiovascular performance, 39 healthy elderly men and women, 70 to 83 years old, underwent treadmill thallium-201 exercise perfusion imaging and radionuclide equilibrium angiography at rest and during supine bicycle exercise. Five volunteers who had a positive exercise thallium test response were excluded from the study. Radionuclide left ventricular ejection fraction, regional wall abnormalities, relative cardiac output, stroke volume, end-diastolic volume and end-systolic volume were measured. Seventy-four percent of the subjects maintained or increased their ejection fraction with exercise. With peak exercise, mean end-diastolic volume did not change, end-systolic volume decreased and cardiac output and stroke volume increased. Moreover, in 35% of the subjects, minor regional wall motion abnormalities developed during exercise. There was no significant difference in the response of men and women with regard to these variables. However, more women than men had difficulty performing bicycle ergometry because they had never bicycled before. Subjects who walked daily performed the exercise tests with less anxiety and with a smaller increase in heart rate and systolic blood pressure.

Hitzhusen, J.C.; Hickler, R.B.; Alpert, J.S.; Doherty, P.W.

1984-11-01

138

The Submaximal Clinical Exercise Tolerance Test (SXTT) to Establish Safe Exercise Prescription Parameters for Patients with Chronic Disease and Disability  

PubMed Central

Purpose To describe how to perform a Submaximal Clinical Exercise Tolerance Test (SXTT) as part of an exercise evaluation in the physical therapy clinic to determine an appropriate exercise prescription and to establish safety of exercise for physical therapy clients. Summary of Key Points Physical activity is crucial for general health maintenance. An exercise evaluation includes a comprehensive patient history, physical examination, exercise testing, and exercise prescription. The SXTT provides important clinical data that form the foundation for an effective and safe exercise prescription. Observations obtained during the exercise evaluation will identify at-risk patients who should undergo further medical evaluation before starting an exercise program. Two case examples of SXTTs administered to individuals with multiple sclerosis are presented to demonstrate the application of these principles. Statement of Recommendations Due to their unique qualifications, physical therapists shall assume responsibility to design and monitor safe and effective physical activity programs for all clients and especially for individuals with chronic disease and disability. To ensure safety and efficacy of prescribed exercise interventions, physical therapists need to perform an appropriate exercise evaluation including exercise testing before starting their clients on an exercise program.

Gappmaier, Eduard

2012-01-01

139

[Value of the exercise test in asymptomatic myocardial ischemia].  

PubMed

To evaluate the predictive value of ischemic ST segment depression without associated chest pain during exercise testing, data were analyzed from 7305 studies. Two hundred thirty six patients were included in this study and were separated in 2 groups. Group A consisted of 169 patients without chest pain who, during exercise testing, showed a positive ST segment response (at least 1.5 mm of horizontal or downward ST segment depression for at least 0.08 second, compared with the resting baseline value), and Group B consisted of 67 patients who had both chest pain and a positive ST segment response. Selective coronary angiogram was performed on all patients. Each Group was separated into 3 sub-group according to the Cohn criteria: sub-group I (asymptomatic persons 8.3 vs 19.4%); sub-group II (patients with history of Myocardial Infarction 36.7% vs 19.4%); sub-group III (patients with chronic angina 55% vs 61.2%). The clinical characteristics, coronary risk factors, distribution of coronary artery disease, and exercise test response were similar in both groups. During treadmill exercise, the mean heart rate was 140.6 +/- 22 in group A versus 127.1 +/- 23 in the group B. The pressure-rate product was 2.4 +/- 0.8 versus 1.9 +/- 0.5, respectively (P less than or equal to 0.05). The predictive value for severe coronary artery disease of an exercise test in patients with asymptomatic ischemia was 77.5% as compared with 89.6% in the group with angina. This study confirms the high frequency of asymptomatic myocardial ischemia during exercise testing, compared with patients who had angina during exercise testing, with high percentage of prediction (77.5%) for coronary artery disease. PMID:2344225

Iturralde, P; Hernández, D; de Micheli, A; Colín, L; Romero, L; Villarreal, A; Férez, S; Miguel Casanova, J; Barrera, M; González-Hermosillo, J A

140

Field exercise testing for assessing fitness in French standardbred trotters.  

PubMed

This review considers standardized exercise testing which is, routinely used for French Trotters in the field. Track testing provides a more limited range of measurements than treadmill testing, but has the advantage of being performed in the horse's natural environment. Various measurements such as heart rate during exercise and blood lactate concentration after exercise may be measured on the track and lead to the calculation of physiological variables such as V200 (velocity corresponding to a 200 bpm heart rate) and V4 (velocity corresponding to a 4 mmol/L blood lactate concentration). V4 is related to the onset of blood lactate accumulation and relates to the aerobic capacity of the horse, as horses with high values for V4 have higher aerobic capacities. Although V4 is calculated during submaximal intensity exercise, it is related to racing performance and seems to be the most important measurement to assess changes in fitness. V200 represents the cardiac capacity of the horse during exercise and is close to V4 in mature horses. To explain further the clinical usefulness of track testing, and to help interpret both V4 and V200 variables, examples of exercise tests in 3-year-old French Trotters are presented here. These results show that changes may occur in V4 and V200 according to different factors such as the horse's physical ability and either training or disease states. It underlines the importance of exercise tests for both trainers and veterinarians and how they may help in the evaluation of a horse's performance ability; in defining the intensity of a training program, and also in the early detection of underlying diseases. PMID:10204407

Couroucé, A

1999-03-01

141

An Exercise for Illustrating the Logic of Hypothesis Testing  

ERIC Educational Resources Information Center

Hypothesis testing is one of the more difficult concepts for students to master in a basic, undergraduate statistics course. Students often are puzzled as to why statisticians simply don't calculate the probability that a hypothesis is true. This article presents an exercise that forces students to lay out on their own a procedure for testing a…

Lawton, Leigh

2009-01-01

142

An examination of exercise mode on ventilatory patterns during incremental exercise.  

PubMed

Both cycle ergometry and treadmill exercise are commonly employed to examine the cardiopulmonary system under conditions of precisely controlled metabolic stress. Although both forms of exercise are effective in elucidating a maximal stress response, it is unclear whether breathing strategies or ventilator efficiency differences exist between exercise modes. The present study examines breathing strategies, ventilatory efficiency and ventilatory capacity during both incremental cycling and treadmill exercise to volitional exhaustion. Subjects (n = 9) underwent standard spirometric assessment followed by maximal cardiopulmonary exercise testing utilising cycle ergometry and treadmill exercise using a randomised cross-over design. Respiratory gases and volumes were recorded continuously using an online gas analysis system. Cycling exercise utilised a greater portion of ventilatory capacity and higher tidal volume at comparable levels of ventilation. In addition, there was an increased mean inspiratory flow rate at all levels of ventilation during cycle exercise, in the absence of any difference in inspiratory timing. Exercising V(E)/VCO?slope and the lowest V(E)/VCO?value, was lower during cycling exercise than during the treadmill protocol indicating greater ventilatory efficiency. The present study identifies differing breathing strategies employed during cycling and treadmill exercise in young, trained individuals. Exercise mode should be accounted for when assessing breathing patterns and/or ventilatory efficiency during incremental exercise. PMID:20556417

Elliott, Adrian D; Grace, Fergal

2010-06-17

143

Screening for childhood asthma using an exercise test.  

PubMed Central

BACKGROUND. Screening for asthma in children in the community could have advantages at a time when prevalence rates of the condition and associated hospital admission rates are rising. AIM. The aim of this study was to assess the usefulness of a standard exercise test as a marker of asthma or potential asthma in children, and to examine the relationship between asthma and other respiratory tract illnesses. METHOD. In 1985 a cross-sectional research study was undertaken in 10 primary schools in West Glamorgan; the children were followed up over six years until 1991. The exercise test involved measuring peak expiratory flow rate before and after the children ran as fast as they could for six minutes. A control group of children with a negative exercise test result were compared with those not known to have asthma who had a positive result (fall in peak expiratory flow rate of 15% or greater), using clinical data. Similar clinical comparisons were undertaken between the children known to have asthma and a control group. RESULTS. Of 864 children not known to have asthma, 60 had a positive exercise result. Of 92 children known to have asthma, 33 had a positive test result and seven were unable to finish the test because of bronchospasm, a sensitivity of 43% and a specificity of 93%. Follow up of 55 of the 60 children not known to have asthma but who had an abnormal response to the test showed that 32 had developed clinically recognizable asthma six years later. There was a significantly higher prevalence of atopic and respiratory illnesses (otitis media, hay fever and eczema) in the group of children with bronchial hyperreactivity demonstrated on exercise than in those without bronchial hyperreactivity. CONCLUSION. This research shows that bronchial hyperreactivity demonstrated by an exercise test can be a marker for childhood asthma. The study has also identified other respiratory tract illnesses which appear to belong to the same spectrum as asthma.

Jones, A; Bowen, M

1994-01-01

144

A non-invasively determined surrogate of cardiac power ('circulatory power') at peak exercise is a powerful prognostic factor in chronic heart failure  

Microsoft Academic Search

Objectives This study was designed to assess the prognostic value of a new variable derived from a cardiopulmonary exercise test, the circulatory power, a surrogate of cardiac power, at peak exercise, in patients with chronic heart failure. Background Peak exercise cardiac power and stroke work are invasive parameters with recently proven prognostic value. It is unclear whether these variables have

A. Cohen-Solal; J. Y. Tabet; D. Logeart; P. Bourgoin; M. Tokmakova; M. Dahan

2002-01-01

145

Effects of two successive maximal exercise tests on pulmonary gas exchange in athletes  

Microsoft Academic Search

Pulmonary extravascular water accumulation may be involved in exercise-induced hypoxaemia in highly aerobically trained athletes. We hypothesized that if such an alteration were present in elite athletes performing a maximal exercise test, the impairment of gas exchange would be worse during a second exercise test following the first one. Eight male athletes performed two incremental exercise tests separated by a

Corinne F. Caillaud; Florence M. Anselme; Christian G. Prefaut

1996-01-01

146

Can a submaximal exercise test predict peak exercise performance in dancers?  

Microsoft Academic Search

Professional dancers are artistic athletes who require high aerobic conditioning to perform at their best. Moreover, high aerobic conditioning may control overtraining and prevent injuries. A submaximal exercise test that is easy to administer and allows prediction of maximal oxygen consumption in dancers would be a powerful tool for coaches, physiotherapists, and sports medicine physicians to screen physical fitness and

Dirk Vissers; Nathalie Roussel; Wilhelm Mistiaen; Bram Crickemans; Steven Truijen; Jo Nijs; Wilfried De Backer

2011-01-01

147

The dobutamine stress test as an alternative to exercise testing after acute myocardial infarction.  

PubMed Central

Three weeks after myocardial infarction in 50 patients the effect of the infusion of a graded dose of dobutamine was compared with that of symptom limited treadmill exercise testing. The following variables were measured: blood pressure, heart rate, ST segment changes, Doppler aortic blood flow, and cross sectional echocardiographic dimensions. The heart rate and double product increased more during exercise than during dobutamine infusion, while maximum acceleration in the ascending aorta increased more during dobutamine infusion than during exercise. Significant ST depression was recorded in 22 patients during exercise and in 24 during dobutamine infusion; the concordance between the two tests was 88%. In all cases in which ST segment depression occurred in both tests the site of ST depression was the same. Dobutamine stress testing is an alternative to exercise testing in patients after myocardial infarction.

Mannering, D; Cripps, T; Leech, G; Mehta, N; Valantine, H; Gilmour, S; Bennett, E D

1988-01-01

148

Exercise Training After Burn Injury: A Survey of Practice.  

PubMed

Exercise programs capable of contributing positively to the long-term rehabilitation of burn patients should be included in outpatient rehabilitation programs. However, the extent and intensity of the resistance and cardiopulmonary exercise prescribed are unclear. This study was conducted to investigate the existence, design, content, and prescription of outpatient cardiopulmonary and resistance exercise programs within outpatient burn rehabilitation. A survey was designed to gather information on existing exercise programs for burn survivors and to assess the extent to which these programs are included in overall outpatient rehabilitation programs. Three hundred and twenty-seven surveys were distributed in the licensed physical and occupational therapists part of the American Burn Association Physical Therapy/Occupational Therapy Special Interest Group. One hundred and three surveys were completed. Eighty-two percent of respondents indicated that their institutions offered outpatient therapy after discharge. The frequency of therapists' contact with patients during this period varied greatly. Interestingly, 81% of therapists stated that no hospital-based cardiopulmonary endurance exercise programs were available. Patients' physical function was infrequently determined through the use of cardiopulmonary parameters (oxygen consumption and heart rate) or muscle strength. Instead, more subjective parameters such as range of motion (75%), manual muscle testing (61%), and quality of life (61%) were used. Prescription and follow-up assessment of cardiopulmonary endurance training are inconsistent among institutions, underscoring the need for greater awareness of the importance of exercise in any burn rehabilitation program. Identification of cardiopulmonary and progressive resistance parameters for establishing and tracking exercise training is also needed to maximize exercise-induced benefits. PMID:23511288

Diego, Alejandro M; Serghiou, Michael; Padmanabha, Anand; Porro, Laura J; Herndon, David N; Suman, Oscar E

2013-03-18

149

Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension.  

PubMed

Exercise tolerance in pulmonary arterial hypertension (PAH) is most commonly assessed by the 6-min walk test (6MWT). Whether endurance exercise tests are more responsive than the 6MWT remains unknown. 20 stable PAH patients (mean±sd age 53±15 years and mean pulmonary arterial pressure 44±16 mmHg) already on PAH monotherapy completed the 6MWT, the endurance shuttle walk test (ESWT) and the cycle endurance test (CET) before and after the addition of sildenafil citrate 20 mg three times daily or placebo for 28 days in a randomised double-blind crossover setting. Pre- or post-placebo tests were used to assess repeatability of each exercise test, whereas pre- or post-sildenafil citrate tests were used to assess their responsiveness. Sildenafil citrate led to placebo-corrected changes in exercise capacity of 18±25 m (p = 0.02), 58±235 s (p = 0.58) and 29±77 s (p = 0.09) for the 6MWT, the ESWT and the CET, respectively. The 6MWT was associated with a lower coefficient of variation between repeated measures (3% versus 18% versus 13%), resulting in a higher standardised response mean compared with endurance tests (0.72, 0.25 and 0.38 for the 6MWT, the ESWT and the CET, respectively). The 6MWT had the best ability to capture changes in exercise capacity when sildenafil citrate was combined with patients' baseline monotherapy, supporting its use as an outcome measure in PAH. PMID:23100508

Mainguy, Vincent; Malenfant, Simon; Neyron, Anne-Sophie; Bonnet, Sébastien; Maltais, François; Saey, Didier; Provencher, Steeve

2012-10-25

150

Peak exercise capacity prediction from a submaximal exercise test in coronary artery disease patients.  

PubMed

The purpose of this study was to determine whether a rating of perceived exertion scale (RPE) obtained during submaximal exercise could be used to predict peak exercise capacity (METpeak) in coronary artery disease (CAD) patients. Angiographically documented CAD patients (n = 124, 87% on ? blockade) completed a symptom-limited peak exercise test on a bicycle ergometer, reporting RPE values at every second load on a scale of 6-20. Regression analysis was used to develop equations for predicting METpeak. We found that submaximal METs at a workload of 60/75 W (for women and men, respectively) and the corresponding RPE (METs/RPE ratio) was the most powerful predictor of METpeak (r = 0.67, p < 0.0001). The final model included the submaximal METs/RPE ratio, body mass index (BMI), sex, resting heart rate, smoking history, age, and use of a ? blockade (r = 0.86, p < 0.0001, SEE 0.98 METs). These data suggest that RPE at submaximal exercise intensity is related to METpeak in CAD patients. The model based on easily measured variables at rest and during "warm-up" exercise can reasonably predict absolute METpeak in patients with CAD. PMID:24027537

Hautala, Arto J; Kiviniemi, Antti M; Karjalainen, Jaana J; Piira, Olli-Pekka; Lepojärvi, Samuli; Mäkikallio, Timo; Huikuri, Heikki V; Tulppo, Mikko P

2013-09-04

151

Peak exercise capacity prediction from a submaximal exercise test in coronary artery disease patients  

PubMed Central

The purpose of this study was to determine whether a rating of perceived exertion scale (RPE) obtained during submaximal exercise could be used to predict peak exercise capacity (METpeak) in coronary artery disease (CAD) patients. Angiographically documented CAD patients (n = 124, 87% on ? blockade) completed a symptom-limited peak exercise test on a bicycle ergometer, reporting RPE values at every second load on a scale of 6–20. Regression analysis was used to develop equations for predicting METpeak. We found that submaximal METs at a workload of 60/75 W (for women and men, respectively) and the corresponding RPE (METs/RPE ratio) was the most powerful predictor of METpeak (r = 0.67, p < 0.0001). The final model included the submaximal METs/RPE ratio, body mass index (BMI), sex, resting heart rate, smoking history, age, and use of a ? blockade (r = 0.86, p < 0.0001, SEE 0.98 METs). These data suggest that RPE at submaximal exercise intensity is related to METpeak in CAD patients. The model based on easily measured variables at rest and during “warm-up” exercise can reasonably predict absolute METpeak in patients with CAD.

Hautala, Arto J.; Kiviniemi, Antti M.; Karjalainen, Jaana J.; Piira, Olli-Pekka; Lepojarvi, Samuli; Makikallio, Timo; Huikuri, Heikki V.; Tulppo, Mikko P.

2013-01-01

152

Exercise in hypertrophic cardiomyopathy.  

PubMed

The risk of sudden cardiac death (SCD) associated with vigorous athletic competition in individuals with hypertrophic cardiomyopathy (HCM) is well documented, and is the basis for recommended exclusion from competitive sports independent of other risk factors. Although SCD risk with recreational exercise is less well defined, published guidelines for participation in recreational sports, based on a consensus of expert opinion, offer a valuable framework for counseling patients. Exercise stress testing is an important diagnostic and prognostic tool in the evaluation of HCM patients, providing an objective measure of functional capacity, physiologic hemodynamic responses to stress, presence of ischemia, and provocable left ventricular outflow tract obstruction. The value of cardiopulmonary exercise testing in HCM is less well studied than in the heart failure population, but can be used to set a safe target for exercise intensity as part of an individualized exercise prescription. The long-term effects of exercise on HCM pathophysiology are largely theoretical at this stage. Potential harmful effects of fatiguing exercise include prolonged contractile dysfunction resulting from microvascular ischemia and energetic compromise. Conversely, several animal studies have shown that voluntary exercise prevents or reverses many pathologic features of HCM, including those related to apoptosis and energetics. Substantial evidence for health-promoting benefits of exercise in the general population, in addition to promising safety and efficacy data in patients with chronic heart failure, emphasizes the need to attain a reasonable balance between potential risks and benefits of aerobic fitness in individuals with HCM. PMID:20559999

Day, Sharlene M

2009-10-14

153

Samara Dispersal in Boxelder: An Exercise in Hypothesis Testing.  

ERIC Educational Resources Information Center

|Presents a fun, inexpensive, and pedagogically useful laboratory exercise that involves indoor studies of the dispersal properties of the winged fruits (samaras) of boxelder trees. Engages students in the process of hypothesis testing, experimental design, and data analysis as well as introducing students to important concepts related to…

Minorsky, Peter V.; Willing, R. Paul

1999-01-01

154

Exercise  

MedlinePLUS

... Hip Knee Ankle Foot, Heel, & Toe View All Exercise Videos From yoga to strength training, get step- ... to your inbox. Sign up now. Read More Exercise Overview Exercise is an essential part of treatment ...

155

Safeguards system testing WSRC Insider Exercise Program (U)  

SciTech Connect

One of the major concerns related to the control and accountability of nuclear material located at DOE facilities is the theft or diversion of material by an insider. Many complex safeguards and security systems have been installed to provide timely detection and prevention of the removal of nuclear materials. The Westinghouse Savannah River Company's (WSRC) Material Control and Accountability (MC and A) section has implemented an insider exercise program designed to evaluate the effectiveness of these safeguards systems. Exercises consist of limited scope performance test. This paper describes the structure and controls for the insider exercise program at the Savannah River Site, the lessons learned over the past several years, and methods being utilized to improve the program.

Robichaux, J.J. (Material Control and Accountability, Westinghouse Savannah River Co., Aiken, SC (US))

1991-01-01

156

[Exercise test in patients with permanent pacemakers].  

PubMed

From June 1988 to June 1990 we studied fifty patients who had implantation of a pacemaker. (31 females and 19 males). All of them underwent stress test with Bruce's protocol. Patients were divided in two groups; pacemaker-independent (PI) and pacemaker-dependent (PD). Over 50% of the patients inhibited the pacemaker with their own rhythm, most of them had sinus dysfunction. Complete A-V block was predominant in PD. The group of PI achieved more mets and had more oxygen consumption. Blood pressure response was similar in both groups. PMID:1929668

Esturau, R; Iturralde, P; Férez, S; Galván, O; Rosado, J; Pérez, G; González Hermosillo, J A

157

Aerobic exercise physiology in a professional rugby union team  

Microsoft Academic Search

Introduction: In professional rugby, different positional roles may require different levels of aerobic fitness. Forward and backline players from a team of elite rugby players were tested to evaluate the differences between the two groups. Methods: 28 male players, 15 backs and 13 forwards, underwent maximal treadmill cardiopulmonary exercise testing (CPX), lung spirometry, a 3 km timed run, and body

Adam C Scott; Nigel Roe; Andrew J. S Coats; Massimo F Piepoli

2003-01-01

158

Cardio-Pulmonary Function Testing. Continuing Education Curriculum for Respiratory Therapy.  

ERIC Educational Resources Information Center

Compiled from interviews with personnel in pulmonary function testing (PFT) laboratories in the Minneapolis/St. Paul area, this competency-based curriculum guide is intended to provide a knowledge of PFT for persons who provide respiratory care. The guide contains 20 sections covering the following topics: vital capacity, flow measurements,…

Saint Paul Technical Vocational Inst., MN.

159

Effect of coronary collateral circulation on exercise stress test.  

PubMed

In this study, patients who have recovery-only ST segment depression in exercise stress test were chosen. It is proposed that coronary collateral circulation could improve with stress-increased coronary perfusion, and accordingly, patients with recovery-only ST segment depression were evaluated by coronary angiography for grading the coronary collateral circulation. Twenty-one men and five women were assigned to the study group. Sixteen men and two women who had exercise-induced ST segment depression were assigned to the control group. Age and gender of both groups were not statistically different (p>0.05). The reason for terminating the exercise stress test was chest pain in two of 26 patients in the study group versus 15 of 18 in the control group (p<0.001). In both groups coronary collateral frequency and grade were directly correlated with the severity of the coronary artery disease (p<0.001 in the study group, and p<0.05 in the control group). When both groups were compared for the frequency of significant coronary collateral circulation, 14 of 26 patients in the study group versus 4 of 18 patients in the control group had significant coronary collateral circulation (p=0.035). The authors conclude that recovery-only ST segment depression correlates well with the frequency of significant coronary collateral circulation, and coronary collaterals may prevent myocardial ischemia during exercise. PMID:9717891

Kumbasar, S D; Pamir, G; Ca?lar, N; Oral, D; Aslan, S M

1998-08-01

160

[Silent myocardial ischemia in diabetics--by treadmill exercise testing].  

PubMed

We examined silent myocardial ischemia in diabetics by treadmill exercise testing. There were 28 diabetic men and 64 diabetic woman without angina, with a mean age of 59 +/- 11 years. Symptom-limited treadmill exercise testing was performed, and we used the electrocardiogram during exercise and immediately after exercise for judgement. ST segment depression was defined as positive if there was at least 0.1 mV of ST depression 80 ms from the J point. It was defined as negative if max heart rate (HR) was more than 80% of target HR and there was no significant ST depression. It was defined as equivocal if there was no significant ST depression but max HR was less than 80% of target HR. In 92 diabetics, 21 patients (23%) showed positive ST depression, 35 (38%) showed negative ST depression, 36 (39%) showed equivocal ST depression. In 56 diabetics exclusive of treadmill equivocal patients, 38% of patients showed positive ST depression. Treadmill positive diabetics had a significantly higher rate of smokers, patients with hypertension, and a higher triglyceride level as compared with treadmill negative diabetics. Coronary arteriography, which was performed in six treadmill positive diabetics, revealed coronary stenosis of more than 75% in four patients. PMID:2236961

Tanaka, T; Hashimoto, A; Oohashi, Y; Takeuchi, M; Tanaka, R; Shiozaki, A; Fukui, A; Hamaguchi, K; Houda, N

1990-09-01

161

Exercise thallium stress testing compared with coronary angiography in patients without exclusions for suboptimal exercise or cardioactive medications  

Microsoft Academic Search

From 1293 patients who underwent thallium stress testing and 1099 patients who had coronary angiography, a consecutive series of 122 who had both studies is evaluated. This group includes suboptimally exercised patients and those receiving one or several cardiovascular drugs that were not discontinued prior to exercise. When compared with the EKG stress test, thallium stress imaging was superior in

NORMAN R. VINCENT; LEONARD DENIS

1986-01-01

162

Influência da massa magra corporal nas repercussões cardiopulmonares durante o teste de caminhada de seis minutos em pacientes com DPOC* Influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with COPD  

Microsoft Academic Search

Objective: Although lean body mass (LBM) has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM depletion, prior to and after the six-minute walk test (6MWT). Methods: We evaluated COPD patients, 32 with LBM depletion

Nilva Regina; Gelamo Pelegrino; Paulo Adolfo Lucheta; Fernanda Figueirôa Sanchez; Márcia Maria Faganello; Renata Ferrari; Irma de Godoy

2009-01-01

163

Influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with COPD* Influência da massa magra corporal nas repercussões cardiopulmonares durante o teste de caminhada de seis minutos em pacientes com DPOC  

Microsoft Academic Search

Objective: Although lean body mass (LBM) has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM depletion, prior to and after the six-minute walk test (6MWT). Methods: We evaluated COPD patients, 32 with LBM depletion

Nilva Regina; Gelamo Pelegrino; Paulo Adolfo Lucheta; Fernanda Figueirôa Sanchez; Márcia Maria Faganello; Renata Ferrari; Irma de Godoy

2009-01-01

164

[Positive exercise test in hypertensive patients correlated with coronary angiography].  

PubMed

With the purpose of evaluate the state of the coronary arteries in hypertensive patients with positive exercise test, 82 patients were selected, 50 male and 32 female with mean age of 56.9 +/- 13.2 years. Angiography was normal in 25 patients thirteen patients had a single coronary arteries narrow of less than 50% and 44 cases with significant coronary arteries lesions of more than 50%. The parameters obtained in the exercise test are not significant for statistic purposes. Systolic hypertension or flat response was more frequent in the group with advanced coronary lesions with a predicted positive value in coronary obstructions of 66 and 75%. We conclude that 70% of hypertensive patients have obstructive coronary lesions of some degree. PMID:1929669

Rosado, J; de los Santos, C; Iturralde, P; Pérez, G; Romero, L; Colín, L; González Hermosillo, A; Casanova, J M

165

The Sunflower Cardiopulmonary Research Project of Children.  

ERIC Educational Resources Information Center

A three year project designed to determine the value of a health program incorporating a cardiopulmonary fitness program is described. The instructional programs were in heart health, pulmonary health, nutrition, and physical fitness. A noncompetitive exercise and fitness period was employed in addition to the normal physical education time.…

Greene, Leon

166

The Sunflower Cardiopulmonary Research Project of Children.  

ERIC Educational Resources Information Center

|A three year project designed to determine the value of a health program incorporating a cardiopulmonary fitness program is described. The instructional programs were in heart health, pulmonary health, nutrition, and physical fitness. A noncompetitive exercise and fitness period was employed in addition to the normal physical education time.…

Greene, Leon

167

Relative Cardiac Efficiency and ST Depression during Progressive Exercise Test  

Microsoft Academic Search

The ratio of calculated myocardial oxygen consumption to estimated oxygen uptake of the body (MVO2\\/VO2) provides insight into relative cardiac efficiency. The authors investigated the relation of ST depression to the calculated MVO2\\/VO2 ratio during a progressive bicycle exercise test in 23 patients with good chronotropic capacity after acute myocardial infarction. ST depression of 0.2 mV or more was required

István Berényi; Géza Ludwig

1981-01-01

168

Transient left ventricular apical ballooning and exercise induced hypertension during treadmill exercise testing: is there a common hypersympathetic mechanism?  

PubMed Central

Objective To describe two cases of Takotsubo like myocardial contractile pattern during exercise stress test secondary to hypertensive response. Background Treadmill exercise testing is known to cause sympathetic stimulation, leading to increased levels of catecholamine, resulting in alteration in vascular tone. Hypertensive response during exercise testing can cause abnormal consequences, resulting in false positive results. Cases We present the cases of two patients experiencing apical and basal akinesis during exercise stress echocardiography, in whom normal wall motion response was observed on subsequent pharmacologic stress testing. The first patient developed transient left ventricular (LV) apical akinesis during exercise stress echocardiography. Due to high suspicion that this abnormality might be secondary to hypertensive response, pharmacologic stress testing was performed after three days, which was completely normal and showed no such wall motion abnormality. Qualitative assessment of myocardial perfusion using contrast was also performed, which showed good myocardial blood flow, indicating low probability for significant obstructive coronary artery disease. The second patient developed LV basal akinesis as a result of hypertensive response during exercise testing. Coronary angiogram was not performed in either patient due to low suspicion for coronary artery disease, and subsequently negative stress studies. Results Transient stress induced cardiomyopathy can develop secondary to hypertensive response during exercise stress testing. Conclusion These cases provide supporting evidence to the hyper-sympathetic theory of left ventricular ballooning syndrome.

Dhoble, Abhijeet; Abdelmoneim, Sahar S; Bernier, Mathieu; Oh, Jae K; Mulvagh, Sharon L

2008-01-01

169

Serial exercise testing in children, adolescents and young adults with Senning repair for transposition of the great arteries  

PubMed Central

Background Patients with Senning repair for complete transposition of the great arteries (d-TGA) show an impaired exercise tolerance. Our aim was to investigate changes in exercise capacity in children, adolescents and adults with Senning operation. Methods Peak oxygen uptake (peak VO2), oxygen pulse and heart rate were assessed by cardiopulmonary exercise tests (CPET) and compared to normal values. Rates of change were calculated by linear regression analysis. Right ventricular (RV) function was assessed by echocardiography. Results Thirty-four patients (22 male) performed 3.5 (range 3–6) CPET with an interval of ? 6 months. Mean age at first assessment was 16.4 ± 4.27 years. Follow-up period averaged 6.8 ± 2 years. Exercise capacity was reduced (p<0.0005) and the decline of peak VO2 (?1.3 ± 3.7 %/year; p=0.015) and peak oxygen pulse (?1.4 ± 3.0 %/year; p=0.011) was larger than normal, especially before adulthood and in female patients (p<0.01). During adulthood, RV contractility changes were significantly correlated with the decline of peak oxygen pulse (r= ?0.504; p=0.047). Conclusions In patients with Senning operation for d-TGA, peak VO2 and peak oxygen pulse decrease faster with age compared to healthy controls. This decline is most obvious during childhood and adolescence, and suggests the inability to increase stroke volume to the same extent as healthy peers during growth. Peak VO2 and peak oxygen pulse remain relatively stable during early adulthood. However, when RV contractility decreases, a faster decline in peak oxygen pulse is observed.

2012-01-01

170

Cardiovascular reserve ability and exercise capacity on bicycle ergometer exercise stress test in children with ventricular premature beat  

Microsoft Academic Search

Background: This study was undertaken to evaluate the cardiovascular reserve ability and exercise capacity on bicycle ergometer exercise stress test to determine the effect of anti-arrhythmic therapy in children with ventricular premature beat (VPB). Methods: Ruled out those with organic cardiac disease by physical examination, echocardiography and myocardial enzyme analysis, 123 children with VPB (aged 2-17 years) were included in

Zheng-Hai Qu; Zi-Pu Li

2007-01-01

171

Comparison of cardiocirculatory and thermal strain of male firefighters during fire suppression to exercise stress test and aerobic exercise testing.  

PubMed

Firefighters face a highly increased risk of sudden cardiac death during fire suppression. Medical examinations and physical performance tests are used to screen endangered firefighters. The aim of this study was to determine cardiocirculatory and thermal strain during fire suppression in firefighters and compare it with the strain during medical and performance evaluations. Forty-nine young professional male firefighters were studied during a 30-minute fire operation (FO) in a large fire simulation plant. Measurements were obtained immediately before, during, and after the FO. During the FO, maximum heart rates of 177 +/- 23 beats/min were recorded on average, with 7 subjects exceeding the age-predicted maximum. Body core temperature increased by 0.9 +/- 0.5 degrees C (p <0.001), body weight decreased by 0.6 +/- 0.2 kg (p <0.001), and blood parameters changed accordingly. Sixteen percent of subjects developed asymptomatic postural hypotension. In an exercise stress test as part of the mandatory medical examination, subjects were limited to heart rates of 176 +/- 3.3 beats/min. They reached 155 +/- 13 beats/min during the annual aerobic exercise in turnout gear. During the FO, maximum heart rate was higher than during the stress test in 66% and higher than during the aerobic exercise in 84% of subjects. In conclusion, fire suppression caused an extreme cardiocirculatory strain, with high heart rates that were not sufficiently tested in medical examinations. To increase the yield of screening for firefighters at risk of death during fire suppression, the exercise should equal requirements in a real emergency; in other words, be limited by exhaustion or age-predicted maximum heart rate. PMID:19026313

Angerer, Peter; Kadlez-Gebhardt, Silke; Delius, Michael; Raluca, Petru; Nowak, Dennis

2008-10-01

172

[Myocardial infarct immediately after a normal exercise test].  

PubMed

Two cases of myocardial infarction immediately following a normal stress testing, are described. The incidence and possible pathophysiological mechanisms are discussed. In one of the patients it was difficult to establish the pathophysiological mechanism which was the cause of the ischemic event. In the other, the coronary arteriography revealed only minimal obstructive disease. Therefore, coronary vasospasm with thrombus formation as a cause of the infarction ia an interesting speculative possibility in view of the angiographic findings. Acute myocardial infarction after a normal electrocardiographic response to maximal exercise testing is extremely rare, and the precise pathophysiologic mechanism that leads to his complication is not clear. PMID:2344228

Gómez-Jaume, A; González-Hermosillo, J A; Iturralde, P; Romero, L; Colín, L; Villarreal, A

173

Exercise \\  

Microsoft Academic Search

FOCUS POINTS • Exercise behavior occurs commonly in anorexia nervosa (AN) and appears to be highly reinforcing to individuals with this disorder. • Authors adapted a clinical survey used to mea- sure dependence to drugs of abuse to assess exercise behavior among subjects with AN. • Forty-eight percent of individuals assessed endorsed symptoms consistent with exercise dependence in the previous

Diane A. Klein; Andrew S. Bennett; Janet Schebendach; Richard W. Foltin; Michael J. Devlin; B. Timothy Walsh

2004-01-01

174

Comparison of dipyridamole-handgrip test and bicycle exercise test for thallium tomographic imaging  

SciTech Connect

Seventy-three patients with angina pectoris and 20 with atypical chest pain, who underwent coronary angiography, were examined by single-photon emission computed thallium tomography (TI-SPECT) using a combined dipyridamole-handgrip stress test. Perfusion defects were detected in 78 of 81 patients with angiographically significant coronary artery disease (CAD) (sensitivity 96%). In 9 of 12 patients without CAD, the thallium images were normal (specificity 75%). Thirty-five patients with CAD were reexamined by TI-SPECT using a dynamic bicycle exercise stress test. The sensitivity of the dipyridamole-handgrip test did not differ from the bicycle exercise test in diagnosing the CAD (97% vs 94%). Multiple thallium defects were seen in 19 of 22 (86%) patients with multivessel CAD by the dipyridamole-handgrip test but only in 14 of 22 (64%) by the bicycle exercise test. Noncardiac side-effects occurred in 17 of 93 (18%) patients after dipyridamole infusion. Cardiac symptoms were less common during the dipyridamole-handgrip test than during the bicycle exercise (15% vs 76%, p less than 0.01). These data suggest that the dipyridamole-handgrip test is a useful alternative stress method for thallium perfusion imaging, particularly in detecting multivessel CAD.

Huikuri, H.V.; Korhonen, U.R.; Airaksinen, J.; Ikaeheimo, M.J.H.; Heikkilae, J.T.; Takkunen, J.T.

1988-02-01

175

The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test  

Microsoft Academic Search

Currently, it is not possible to prescribe isometric exercise at an intensity that corresponds to given heart rates or systolic blood pressures. This might be useful in optimizing the effects of isometric exercise training. Therefore, the aim of this study was to explore the relationships between isometric exercise intensity and both heart rate and systolic blood pressure during repeated incremental

Jonathan D. Wiles; Simon R. Allum; Damian A. Coleman; Ian L. Swaine

2008-01-01

176

The influence of exercise test protocol on perceived exertion at submaximal exercise intensities in children.  

PubMed

This study examined ratings of perceived exertion (RPE) using Borg's 6-20 scale at 50 W, 80 W, and ventilatory threshold (VT) in 10-year-old children (n = 15) during two different graded exercise tests. Power output was increased by 10 W.min(-1) in one protocol and by 30 W.3 min(-1) in the other. The cardiorespiratory responses at VT and peak exercise were similar between protocols. At 50 W and 80 W the cardiorespiratory responses were generally lower (P < 0.05) in the 10W trial. However, RPE was 11.5 +/- 2.9 and 12.1 +/- 3.2 at 50 W and 15.1 +/- 2.7 and 15.3 +/- 2.8 at 80 W in the 10-W and 30-W trials, respectively (P > 0.05). The RPE at VT was 13.9 +/- 2.4 in the 10-W trial and 12.4 +/- 2.4 in the 30-W trial (P < 0.05). In that variations in submaximal RPE did not coincide with variations in central mediators of exertion, locals cues of exertion may have provided the dominate sensory signal. PMID:12671195

Mahon, Anthony D; Plank, David M; Hipp, Molly J

2003-02-01

177

The value of combining noninvasive techniques in exercise testing.  

PubMed

A 3-stage cycle ergometer exercise test which combines the noninvasive measurement of systolic time intervals (STI's), stroke volume (SV), mean systolic ejection rate (MSER) and blood pressure was administered to 2 groups of middle-aged men. Group 1 included 15 healthy men. Group 2 consisted of 20 men with coronary artery disease (CAD), confirmed by a proven myocardial infarction. The groups were matched for age, weight and height. Over the range of heart rates (HR's) encountered (70--173 beats min-1) the STI's described an inversely linear relationship with HT. At all exercise HR's, group 2 displayed higher values for total electromechanical systole (QS2), left ventricular ejection time (LVET) and the pre-ejection period (PEP), and lower values for SV and MSER. Statistical comparison of all variables at a common HR of 100 beats min-1 indicated that QS2 and MSER best discriminated between the groups. It was concluded that this test is sufficiently sensitive to detect differences in cardiac performance in groups of subjects, but not for the diagnosis of CAD in individual patients. PMID:7402057

Wolfe, L A; Cunningham, D A; Paulseth, J E; Rechnitzer, P A

1980-01-01

178

Maximal Exercise Capacity in Chronic Obstructive Pulmonary Disease: A Limited Indicator of the Health Status  

Microsoft Academic Search

Background: Dyspnoea and diminished functional status are pivotal features of the health status (HS) in chronic obstructive pulmonary disease (COPD). However, it is still not fully understood how pulmonary function tests and cardiopulmonary exercise testing relate to these aspects. This may be due to incomplete assessment and\\/or deficient definitions of HS. Especially regarding peak oxygen consumption, inconsistent results have been

T. L. Verhage; J. H. M. M. Vercoulen; H. A. C. van Helvoort; J. B. Peters; J. Molema; P. N. R. Dekhuijzen; Y. F. Heijdra

2010-01-01

179

Relation of ventricular-vascular coupling to exercise capacity in ischemic cardiomyopathy: a cardiac multi-modality imaging study  

Microsoft Academic Search

The purpose of this study was to examine the relationship between noninvasive measurements of ventricular-vascular coupling\\u000a (VVC) with exercise tolerance, and compared the value of VVC versus other traditional determinants of exercise capacity in\\u000a this population. 43 patients with ischemic CMP (age 59 ± 9 years, mean EF 24 ± 8%) underwent cardiopulmonary exercise testing,\\u000a echocardiography and cardiac magnetic resonance (CMR). VVC was defined non-invasively

Raymond C. Wong; Carlos A. Dumont; Bethany A. Austin; Deborah H. Kwon; Scott D. Flamm; James D. Thomas; Randall C. Starling; Milind Y. Desai

2010-01-01

180

Effect of Age and End Point on the Prognostic Value of the Exercise Test  

Microsoft Academic Search

Background: The clinical and exercise test variables chosen for predicting prognosis vary in the available studies. This could be due to the effect of age of the patients tested and the choice of outcomes used as end points in these follow-up studies. Objective: To evaluate the effect of age and end points on exercise test variables chosen as significantly and

Takuya Yamazaki; Jonathan Myers; Victor F. Froelicher

181

Exercise  

MedlinePLUS

... better bladder and bowel function, less fatigue and depression, a more positive attitude, and increased participation in social activities. Since 1996, several additional studies have confirmed the benefits of exercise. Inactivity in people with or without MS can ...

182

Exercise  

MedlinePLUS

... part of any spondylitis program, along with good posture habits and medication to reduce pain and stiffness. ... spondylitis exercise program will help you maintain good posture, flexibility and eventually help to lessen pain. In ...

183

Delayed heart rate recovery after adenosine stress testing with supplemental arm exercise predicts mortality  

Microsoft Academic Search

Background  Delayed heart rate (HR) recovery after treadmill exercise testing predicts mortality. Patients with suspected ischemic heart\\u000a disease who cannot perform adequate treadmill exercise are typically evaluated with pharmacological stress myocardial perfusion\\u000a imaging (MPI) studies, but little prognostic significance has been attributed to the hemodynamic response to vasodilator stress\\u000a testing with low-level exercise. We hypothesized that a delay in HR recovery

Yasushi Akutsu; Shawn A. Gregory; Arash Kardan; Gerasimos D. Zervos; Gregory S. Thomas; Henry Gewirtz; Tsunehiro Yasuda

2009-01-01

184

Effect of exercise testing protocol on parameters of aerobic function.  

PubMed

Four different patterns of increasing work rate (ramp and 1-min, 2-min, and 3-min steps) to maximum tolerance were studied in eight normal male subjects during cycle ergometer exercise testing to determine the effect of the work rate protocol on the parameters of aerobic function. The overall rate of work rate increase was kept constant. Measurements included VO2max, anaerobic threshold (AT), and the O2 uptake increase with respect to work rate increase (delta VO2/delta WR). VO2, VCO2, VE, respiratory exchange ratio (R), PETCO2, and PETO2 were calculated breath-by-breath. No significant difference was found in VO2max, AT, AT/VO2max, and delta VO2/delta WR among the four work rate protocols. Other measurements such as total work, maximal work rate, VCO2, VE, R, HR, O2 pulse, and the VO2 at which VE increases disproportionately to VCO2 (ventilatory compensation point) were also similar among the four protocols. Both the ramp and 1-min step work rate tests had no step pattern in either VO2 or VCO2, and the step pattern for the 2-min and 3-min step tests was attenuated or disappeared at work rates above AT. We conclude that the parameters of aerobic function, and other physiological responses at maximum work rate, were independent of the pattern of work rate increase, provided that the overall rate of work rate increase was the same. PMID:2072842

Zhang, Y Y; Johnson, M C; Chow, N; Wasserman, K

1991-05-01

185

Relevance of simultaneous ST segment elevation and depression in an exercise treadmill test  

Microsoft Academic Search

Simultaneous ST segment elevation and depression recorded during an exercise treadmill test and its correlation with coronary angiogram is a new finding that does not find a place in medical literature. We conclude that in the presence of simultaneous ST segment elevation and ST segment depression during exercise treadmill test (1) the localizing value of isolated ST elevation is lost

D. Prabhakar; D. Vaidiyanathan

2001-01-01

186

Safety of exercise testing in the chest pain unit: 31-mm ST elevation in variant angina  

Microsoft Academic Search

We discuss a patient who presented with symptoms classic for variant angina with dramatic 31-mm ST elevation secondary to exercise testing in the chest pain unit, in whom neither myocardial infarction nor severe arrhythmia resulted. Although exercise testing is deemed generally safe, it has not been studied for safety per se in patients with variant angina. Further studies are needed

Fausan S. Tsai; Shahriar Heidary; Radha Sarma; Uri Elkayam

2006-01-01

187

Heart Rate Variability Measurements During Exercise Test May Improve the Diagnosis of Ischemic Heart Disease.  

National Technical Information Service (NTIS)

In this work we have analyzed changes in the heart rate variability (HRV) during exercise test comparing them with the ST deviation criteria to improve the diagnostic value of the exercise test. Coronary angiography was considered as gold standard to esta...

J. Mateo P. Serrano R. Bailon J. Garcia A. Ferreira

2001-01-01

188

Evaluating exercise capacity in patients with pulmonary arterial hypertension.  

PubMed

Cardiopulmonary exercise testing (CPET), performed in a clinical laboratory setting, has long been used to evaluate persons with suspected or confirmed cardiopulmonary disease. This form of testing is now recognized as the gold standard for evaluating a person's aerobic exercise performance. In addition, simplified submaximal approaches to assessing functional capacity are readily available; perhaps the most recognized being the 6-min walk test. With the growing interest in CPET for evaluating patients with pulmonary artery hypertension (PAH), gaining a better understanding of the significance of the various outcomes used and how they are relevant to evaluating patients with PAH is a an important endeavor. This review highlights the utility of CPET; the various outcomes that can be derived from this assessment and the various functional tests commonly used as well as related tests that may have a role in clinical assessment of patients with PAH. PMID:23750682

Babu, Abraham Samuel; Myers, Jonathan; Arena, Ross; Maiya, Arun G; Padmakumar, Ramachandran

2013-06-01

189

The e? ects of frequency of encouragement on performance during maximal exercise testing  

Microsoft Academic Search

maximal exercise test (V. O2max) on a treadmill without any verbal encouragement. The participants were matched according to their pre-test V. O2max and placed into either a control group or one of three experimental groups. They performed a second exercise test (post-test) 1 week later. During the second test, the control group received no verbal encouragement; the 20 s (20E),

JOSEPH L. ANDREACCI; STEVEN L. COHEN; ETHAN A. URBANSKY; SARA A. CHELLAND

2002-01-01

190

Acute effects of trimetazidine evaluated by exercise testing  

Microsoft Academic Search

A single dose of 60 mg trimetazidine (the normal daily dose) improved exercise capacity in angina pectoris, as reflected by an increase in the duration of exercise, total work performed, and improvement in ECG signs of ischaemia. All these effects occurred without any detectable chronotropic or vasomotor effect. The importance of this study is to demonstrate that these beneficial effects,

P. Sellier; P. Audouin; B. Payen; P. Corona; T. C. Duong; P. Ourbak

1987-01-01

191

Skin testing with food, codeine, and histamine in exercise-induced anaphylaxis.  

PubMed

A 33-year-old Chinese woman with exercise-induced anaphylaxis after ingesting Chinese seafood noodle soup, was studied for skin test reactivity to food, histamine, and codeine. Prick skin tests were negative for shrimp, wheat, and chicken soup base, but were positive at 5 to 6 mm (wheal diameter) to the whole broth after it had been combined with the other ingredients. No significant (> 3 mm) wheals were observed in eight controls who were simultaneously tested with the broth. To assess the role of exercise, three series of skin tests were performed with histamine, codeine, and whole broth before and after aerobic exercise on two occasions. Codeine elicited consistent increases in wheal size after exercise compared with pre-exercise skin tests. Histamine and whole broth wheal sizes did not increase significantly. Three control subjects also had codeine and histamine skin tests before and after exercise, No exercise-associated increases were noted for codeine. Potential insights into mast cell abnormalities in exercise-induced anaphylaxis may be gained by skin testing patterns with codeine and other mast cell degranulating agents. PMID:8507042

Lin, R Y; Barnard, M

1993-06-01

192

Exercise  

Microsoft Academic Search

Many athletes, especially female athletes and participants in endurance and aesthetic sports and sports with weight classes, are chronically energy deficient. This energy deficiency impairs performance, growth and health. Reproductive disorders in female athletes are caused by low energy availability (defined as dietary energy intake minus exercise energy expenditure), perhaps specifically by low carbohydrate availability, and not by the stress

F A Hellebrandt

1940-01-01

193

Cardiopulmonary Syndromes (PDQ)  

MedlinePLUS

... that takes blood back to the heart). This summary is about cardiopulmonary syndromes in adults and children with cancer. Section titles show when the information is about ... Other Versions: Mobile | Español U.S. Department of ...

194

The relationship between heart rate and oxygen consumption in heart transplant recipients during a cardiopulmonary exercise test  

Microsoft Academic Search

BackgroundIn healthy subjects, the percentage of heart rate reserve (%HRR) versus the percentage of oxygen consumption reserve (%VO2R) is the closest relationship between heart rate and VO2 and it seems also to be true to heart failure patients only if they are under optimized beta-blocker therapy.

Vitor Oliveira Carvalho; Edimar Alcides Bocchi; Lucas Nóbilo Pascoalino; Guilherme Veiga Guimarães

2010-01-01

195

Cardiopulmonary Resuscitation in Trauma  

Microsoft Academic Search

Cardiopulmonary resuscitation (CPR) in a patient with multiple injuries involves a different approach than in a nontrauma\\u000a patient. Although the basic principles are the same as dealt with in other chapters of this book, CPR in the trauma victim\\u000a has to address prevention of cardiopulmonary failure from problems exclusive to the injured patient. This chapter concentrates\\u000a on these issues and

Rao R. Ivatury; Kevin R. Ward

196

Testing the effectiveness of the exercise plus program in older women post-hip fracture  

Microsoft Academic Search

Background: Exercise is an important strategy with potential to improve recovery in older adults following a hip fracture.Purpose: The purpose of this study was to test the impact of a self-efficacy based intervention, the Exercise Plus Program, and the\\u000a different components of the intervention, on self-efficacy, outcome expectations, and exercise behavior among older women\\u000a post-hip fracture.Methods: Participants were randomized to

Barbara Resnick; Denise Orwig; Janet Yu-Yahiro; William Hawkes; Michelle Shardell; J. Richard Hebel; Sheryl Zimmerman; Justine Golden; Michele Werner; Jay Magaziner

2007-01-01

197

The Effects of Oxitropium Bromide on Exercise Performance in Patients with Stable Chronic Obstructive Pulmonary Disease A Comparison of Three Different Exercise Tests  

Microsoft Academic Search

The purpose of the present study was to compare the characteris- tics of three different exercise tests in evaluating the effects of oxitropium bromide on exercise performance. Thirty-eight males with stable chronic obstructive pulmonary disease (COPD) (FEV 1 5 40.8 6 16.5% predicted; mean 6 SD) completed randomized, double-blind, placebo-controlled, crossover studies for each exer- cise test. The exercise tests

TORU OGA; KOICHI NISHIMURA; MITSUHIRO TSUKINO; TAKASHI HAJIRO; AKIHIKO IKEDA; TAKATERU IZUMI

198

Six minute walking test for assessing exercise capacity in chronic heart failure  

Microsoft Academic Search

Twenty six patients, mean age 58 years (range 36-68), with stable chronic heart failure, New York Heart Association class II-III, and 10 normal subjects of a similar age range were studied. Exercise capacity was assessed by determining oxygen consumption reached during a maximal treadmill exercise test and by measuring the distance each patient walked in six minutes. There were significant

D P Lipkin; A J Scriven; T Crake; P A Poole-Wilson

1986-01-01

199

Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing  

Microsoft Academic Search

The prevalence of silent myocardial ischemia was prospectively assessed in a group of 103 consecutive patients (mean age 59 +\\/- 10 years, 79% male) undergoing symptom-limited exercise thallium-201 scintigraphy. Variables that best correlated with the occurrence of painless ischemia by quantitative scintigraphic criteria were examined. Fifty-nine patients (57%) had no angina on exercise testing. A significantly greater percent of patients

Christine M. Gasperetti; Lawrence R. Burwell; George A. Beller

1990-01-01

200

Slow upsloping ST-segment depression during exercise: Does it really signify a positive stress test?  

Microsoft Academic Search

Background Slow upsloping ST-segment depression during stress is thought to represent an ischemic response to exercise treadmill testing (ETT). Aim We used modern single-photon emission computed tomography (SPECT) imaging protocols to determine the incidence of ischemia in patients with slow upsloping ST depression during exercise and whether this response signifies more or less severe coronary artery disease (CAD) and risk

Milind Y. Desai; Sharon Crugnale; Jennifer Mondeau; Kristy Helin; Finn Mannting

2002-01-01

201

Blood Pressure Response to Heart Rate During Exercise Test and Risk of Future Hypertension  

Microsoft Academic Search

Previous works have shown that exaggerated blood pressure response to exercise is a valid risk marker for future hypertension, yet the use of an exercise test as a means of early prediction of hypertension still requires methodological development and confirmation. The purpose of this study was to determine abnormal ranges of blood pressure responses in relation to heart rate increase

Nobuyuki Miyai; Mikio Arita; Kazuhisa Miyashita; Ikuharu Morioka; Tatsuo Shiraishi; Ichiro Nishio

202

A model to predict multivessel coronary artery disease from the exercise thallium-201 stress test  

Microsoft Academic Search

The aim of this study was to (1) determine whether nonimaging variables add to the diagnostic information available from exercise thallium-201 images for the detection of multivessel coronary artery disease; and (2) to develop a model based on the exercise thallium-201 stress test to predict the presence of multivessel disease. The study populations included 383 patients referred to the University

Stewart G. Pollock; Robert D. Abbott; Charles A. Boucher; Denny D. Watson; Sanjiv Kaul

1991-01-01

203

Cancer and the cardiopulmonary system  

SciTech Connect

This volume addresses the problems induced in the cardiopulmonary function by certain advanced diagnostic techniques and treatment modalities for cancer, reviews the cardiopulmonary changes resulting from cancer itself, and assesses the limitations to surgical and nonsurgical management of diverse neoplastic conditions. Information on the effects of various tumors on cardiopulmonary function and on the spectrum of adverse cardiopulmonary reactions caused by chemotherapy and radiation theorapy is provided, with specific practical guidance on diagnosis and treatment.

Khalil, A.M.; Ewer, M.S.

1984-01-01

204

Test-Retest Reliability of the Aerobic Power Index Submaximal Exercise Test in Cancer Patients  

PubMed Central

The purpose of this study was to investigate the reliability of the Aerobic Power Index (API) submaximal cardiorespiratory exercise test, as well as associated variables of oxygen uptake (ml·kg-1·min-1) and ratings of perceived exertion (RPE) in cancer patients who are generally unable to complete maximal or lengthy aerobic fitness tests. Twenty male and female participants (11 male; 9 female) aged between 18 and 70 y (mean = 53.28 ± 11. 82 y) were recruited with medical consent within 4 weeks of completing chemotherapy treatment for a lymphohaematopoietic cancer (LHC). Of the twenty recruited participants’ 2 were excluded from analysis due to disease relapse or complications unrelated to testing occurring within the month following testing. Intra-class correlation coefficient (ICC) scores for power output (W·kg-1) and oxygen uptake (ml·kg-1·min-1) were highly reliable (R1 = 0.96 and 0.96, respectively) and the ICC for RPE was moderately reliable (R1 = 0.83). Technical error of measurement results for power output (W·kg-1), oxygen uptake (ml·kg-1·min-1) and RPE were 0.11W·kg-1, 1.18 ml·kg-1·min-1 and 1.0 respectively. A Pearson’s product-moment correlation demonstrated a strong relationship between power output (W·kg-1) and oxygen uptake (ml·kg-1·min-1) for both trials (r = 0.93 and 0.89, respectively). Results demonstrate that the API test is a highly reliable protocol for use with a LHC population and can be considered a clinically feasible, safe and tolerable exercise test. Key points The API test is a highly reliable protocol for use within a haematological cancer population. The API test of cardiovascular fitness can be considered a clinically feasible, safe and tolerable exercise test in cancer patients. Intra-class correlation coefficient (ICC) scores for power output (W·kg-1) and oxygen uptake (ml·kg-1·min-1) were highly reliable and a correlations demonstrated a strong relationship between power output (W·kg-1) and oxygen uptake (ml·kg-1·min-1).

Furzer, Bonnie J.; Wallman, Karen E.; Ackland, Timothy R.; Joske, David J.L.

2012-01-01

205

Exercise testing in hypertensive patients for assessing the cardiovascular protective potential of antihypertensive drugs.  

PubMed

Exercise testing is an established noninvasive tool in cardiology used to diagnose and guide treatment in individuals with suspected or confirmed coronary artery disease. Owing to the wealth of information it provides, exercise testing is also being utilized to evaluate prehypertensive stages, characterize hypertension, assess tolerance to exercise and the efficacy of antihypertensive therapies, and predict target organ damage and cardiovascular risk. The literature on exercise tolerance tests is relatively limited since these studies are difficult to conduct although they represent a valuable test for evaluating the benefits of antihypertensive therapies beyond their blood-pressure-lowering efficacy at rest or during exercise. Such a setting can be immensely useful for the evaluation and for the differentiation of treatments, especially in patients with evident rises in systolic blood pressure and with concomitant diseases, who are at higher risk of stroke. Exercise-induced increase in systolic blood pressure from rest to peak exercise should therefore be used as the primary efficacy variable. There is growing evidence that central pressure is a better predictor for cardiovascular risk than peripheral blood pressure, since this variable takes into account the overall effect of vascular aging and increased arterial stiffness that age and other concomitant diseases may induce. It is also important to include central aortic blood pressure and biomarkers of hypertension and cardiac disease in the overall assessment. PMID:23475015

Brunel, Patrick; Baschiera, Fabio; Cifkova, Renata

2013-03-08

206

Prognostic value of radionuclide exercise testing after myocardial infarction  

SciTech Connect

Abnormal systolic ventricular function and persistent ischemia are sensitive indicators of poor prognosis following myocardial infarction. The use of exercise improves the utility of both radionuclide ventriculography and myocardial perfusion scintigraphy in the identification of postinfarction patients at high risk of subsequent cardiac events. 51 references.

Schocken, D.D.

1984-08-01

207

Hemodynamic Responses to the Stroop and Cold Pressor Tests after Submaximal Cycling Exercise in Normotensive Males  

Microsoft Academic Search

PROBST, M., R. BULBULIAN AND C. KNAPP.Hemodynamic responses to the Stroop and cold pressor tests after submaximal cycling exercise in normotensive males.PHYSIOL BEHAV 62(6) 1283–1290, 1997.—The effect of 30 min of cycling exercise at 60% Vo2max on hemodynamic responses to the Stroop and cold pressor tests in 12 normotensive males was examined. Subjects were randomly assigned in a counterbalanced design

Manuel Probst; Ronald Bulbulian; Charles Knapp

1997-01-01

208

Complications of exercise and pharmacologic stress tests: Differences in younger and elderly patients  

Microsoft Academic Search

Background  Age characteristics of patients undergoing various types of stress tests are important because of differences in clinical\\u000a background and exercise performance between the young and elderly. Adverse effects of pharmacologic agents are known to be\\u000a more common in the elderly, who are less able to perform vigorous exercise stress testing. We investigated the clinical background,\\u000a performance characteristics, and complication rate

Akiyoshi Hashimoto; Edwin L. Palmer; James A. Scott; Stephen A. Abraham; Alan J. Fischman; Thomas L. Force; John B. Newell; Carlos A. Rabito; Gerasimos D. Zervos; Tsunehiro Yasuda

1999-01-01

209

Common trends in time series of exercise testing (WAnT)  

Microsoft Academic Search

In this paper we analyze time series related to pediatric exercise tests. A group of young athletes with two years of training practice were assessed in exercise laboratories in order to measure their anaerobic power output. The 30-s all-out Wingate Anaerobic Test (WAnT) was applied to assess performance of peak muscle power and local muscle endurance for both upper and

Paula Marta; Fernando Duarte; Renato Fernandes

210

Hypothesis Testing as a Laboratory Exercise: A Simple Analysis of Human Walking, With a Physiological Surprise  

NSDL National Science Digital Library

This paper describes a laboratory exercise designed to provide students with experience testing a hypothesis by systematically isolating and controlling determinant variables. The study involves an analysis of walking and is performed by the students on a subject from within their lab group. The study requires use of a motorized treadmill, tape measure, stop watch, metronome, personal cassette player, and calculator. The exercise is designed to include factors that the students are familiar with, so they can focus on the isolation of variables without being confused about the process they are investigating. However, the exercise will not turn out as the students anticipate, meaning they will be forced to reevaluate the assumptions that formed the basis of their original hypothesis. This exercise is designed for a college-level course in exercise science, physiology, or biology but could easily be managed by a high school honors class with appropriate guidance.

PhD John E. A. Bertram (Florida State University Dept. of Nutrition, Food, and Exercise Sciences)

2002-06-01

211

Hypothesis testing as a laboratory exercise: a simple analysis of human walking, with a physiological surprise.  

PubMed

This paper describes a laboratory exercise designed to provide students with experience testing a hypothesis by systematically isolating and controlling determinant variables. The study involves an analysis of walking and is performed by the students on a subject from within their lab group. The study requires use of a motorized treadmill, tape measure, stop watch, metronome, personal cassette player, and calculator. The exercise is designed to include factors that the students are familiar with, so they can focus on the isolation of variables without being confused about the process they are investigating. However, the exercise will not turn out as the students anticipate, meaning they will be forced to reevaluate the assumptions that formed the basis of their original hypothesis. This exercise is designed for a college-level course in exercise science, physiology, or biology but could easily be managed by a high school honors class with appropriate guidance. PMID:12031943

Bertram, John E A

2002-12-01

212

Validity of the step test for exercise prescription: no extension to a larger age range.  

PubMed

The purpose of this study was to determine the validity of a submaximal exercise test, the Step Test Exercise Prescription (STEP), in a broad age range and in individuals in the earliest stages of Alzheimer's disease (AD). Individuals (n = 102) underwent treadmill-based maximal exercise testing and a STEP. The STEP failed to predict peak oxygen consumption (VO2peak), and was a biased estimate of VO2peak (p < .0001). Only 43% of subjects' STEP results were within 3.5 ml · kg-1 · min-1 of VO2peak. When categorized into fitness levels these 2 measures demonstrated moderate agreement (kappa = .59). The validity of the STEP was not supported in our participants, including those with AD. The STEP may not be appropriate in the clinic as a basis for exercise recommendations in these groups, although it may continue to have utility in classifying fitness in research or community health screenings. PMID:23238135

Vidoni, Eric D; Mattlage, Anna; Mahnken, Jonathan; Burns, Jeffrey M; McDonough, Joe; Billinger, Sandra A

2012-12-10

213

Teaching schoolchildren cardiopulmonary resuscitation  

Microsoft Academic Search

Forty-one children aged 11–12 years received tuition in cardiopulmonary resuscitation (CPR) and subsequently completed questionnaires to assess their theoretical knowledge and attitudes regarding their likelihood of performing CPR. Although most children scored well on theoretical knowledge, this did not correlate with an assessment of practical ability using training manikins. In particular only one child correctly called for help after the

Carolyn Lester; Peter Donnelly; Clive Weston; Michelle Morgan

1996-01-01

214

Hypoxaemia during cardiopulmonary bypass  

PubMed Central

Blood oxygenation was studied in patients undergoing cardiopulmonary bypass using the Rygg-Kyvsgaard bubble oxygenator. Oxygenation was satisfactory in perfusions carried out at normothermia and during hypothermia. During the rewarming phase of hypothermic perfusions hypoxaemia occurred. This could be prevented by a ganglion blocking agent (trimetaphan) given during the cooling phase.

Muir, A. L.; Davidson, I. A.

1971-01-01

215

Ventilation\\/carbon dioxide production ratio in early exercise predicts poor functional capacity in congestive heart failure  

Microsoft Academic Search

OBJECTIVES: To evaluate whether changes in the ventilation\\/carbon dioxide production ratio during early exercise could reliably serve as a surrogate marker for maximal oxygen consumption in heart failure patients. Maximal oxygen consumption is an important determinant of the severity of congestive heart failure with values > 14 ml\\/kg\\/min conferring a good 2-year survival. However, many patients undergoing cardiopulmonary exercise testing

R. V. Milani; M. R. Mehra; T. K. Reddy; C. J. Lavie; H. O. Ventura

1996-01-01

216

Exercise-induced biphasic increase in circulating NT-proBNP levels in patients with chronic heart failure  

Microsoft Academic Search

Background: Exercise increases natriuretic peptide levels in chronic heart failure (CHF) patients, but the effect is considered minor. We assessed acute and short-term release (b24 h) of NT-proBNP in CHF patients after a maximal cardiopulmonary exercise test (CPET) and 2 different submaximal training sessions. Methods and results: 102 CHF patients either performed CPET (Group 1), a 1 h endurance (Group

Viviane M. A. Conraads; Cathérine De Maeyer; Paul Beckers; Nadine Possemiers; Manuella Martin; Viviane Van Hoof; Christiaan J. Vrints

217

Arm exercise testing with myocardial scintigraphy in asymptomatic patients with peripheral vascular disease  

SciTech Connect

Arm exercise with myocardial scintigraphy and oxygen consumption determinations was performed by 33 men with peripheral vascular disease, 40 to 74 years of age (group 2). None had evidence of coronary disease. Nineteen age-matched male control subjects (group 1) were also tested to determine the normal endurance and oxygen consumption during arm exercise in their age group and to compare the results with those obtained during a standard treadmill performance. The maximal heart rate, systolic blood pressure, pressure rate product, and oxygen consumption were all significantly lower for arm than for leg exercise. However, there was good correlation between all these parameters for both types of exertion. The maximal heart rate, work load and oxygen consumption were greater for group 1 subjects than in patients with peripheral vascular disease despite similar activity status. None of the group 1 subjects had abnormal arm exercise ECGs, while six members of group 2 had ST segment changes. Thallium-201 scintigraphy performed in the latter group demonstrated perfusion defects in 25 patients. After nine to 29 months of follow-up, three patients who had abnormal tests developed angina and one of them required coronary bypass surgery. Arm exercise with myocardial scintigraphy may be an effective method of detecting occult ischemia in patients with peripheral vascular disease. Those with good exercise tolerance and no electrocardiographic changes or /sup 201/T1 defects are probably at lower risk for the development of cardiac complications, while those who develop abnormalities at low exercise levels may be candidates for invasive studies.

Goodman, S.; Rubler, S.; Bryk, H.; Sklar, B.; Glasser, L.

1989-04-01

218

Different effects of exercise tests on the antioxidant enzyme activities in lymphocytes and neutrophils  

Microsoft Academic Search

We have determined the effects of maximal and submaximal cycloergometer tests on the antioxidant enzyme defences of neutrophils and lymphocytes. We also compared the neutrophil and lymphocyte basal enzyme antioxidant activities. A total of 17 well-trained amateur athletes, runners, and cyclists participated in this study. Two tests were performed on an electromagnetic reduction cycloergometer: the maximal exercise test, and the

Pedro Tauler; Antoni Aguiló; Isabel Gimeno; Pilar Guix; Josep A Tur; Antoni Pons

2004-01-01

219

Submaximal Treadmill Exercise Test to Predict VO[subscript 2]max in Fit Adults  

ERIC Educational Resources Information Center

|This study was designed to develop a single-stage submaximal treadmill jogging (TMJ) test to predict VO[subscript 2]max in fit adults. Participants (N = 400; men = 250 and women = 150), ages 18 to 40 years, successfully completed a maximal graded exercise test (GXT) at 1 of 3 laboratories to determine VO[subscript 2]max. The TMJ test was…

Vehrs, Pat R.; George, James D.; Fellingham, Gilbert W.; Plowman, Sharon A.; Dustman-Allen, Kymberli

2007-01-01

220

Estimation of VO2 Max: A Comparative Analysis of Five Exercise Tests.  

ERIC Educational Resources Information Center

|Thirty-eight healthy females measured maximal oxygen uptake (VO2max) on the cycle ergometer and treadmill to compare five exercise tests (run, walk, step, and two tests using heart-rate response on the bicycle ergometer) in predicting VO2max. Results indicate that walk and run tests are satisfactory predictors of VO2max in 30- to 39-year-old…

Zwiren, Linda D.; And Others

1991-01-01

221

Attenuated Heart Rate Recovery Following Exercise Testing in Overweight Young Men with Untreated Obstructive Sleep Apnea  

PubMed Central

Study Objective: To evaluate whether cardiovascular responses to maximal exercise testing and recovery are altered with obstructive sleep apnea (OSA) in overweight young adult men. Design: Three sedentary subject groups were recruited: Overweight with OSA (OSA), overweight without OSA (No-OSA), and normal weight without OSA (Control). Presence of OSA was screened via portable diagnostic device. Body composition was measured with dual-energy X-ray absorptiometry. Subjects performed maximal ramping exercise testing (RXT) on a cycle ergometer with 5 minutes of active recovery. Exercise measurements included heart rate (HR), blood pressure (BP), respiratory exchange ratio (RER), and oxygen consumption (VO2). Recovery HR was converted to a HR difference (HRdiff) calculation (HRpeak ? HR each minute recovery), and BP was converted to a recovery ratio for each minute. Setting: The study was carried out on the campus of Virginia Tech, Department of Human Nutrition, Foods, and Exercise, Blacksburg, Virginia. Participants: 14 OSA, 16 No-OSA, and 14 Control volunteers. Intervention: N/A Measurements and Results: In OSA subjects, HR recovery was significantly attenuated compared to the No-OSA and Control groups throughout recovery (P = 0.009). No differences were noted in the HR or BP response to exercise in any group. The VO2, adjusted for fat-free soft tissue mass, did not differ between groups. Conclusions: We found that OSA elicits alterations in the cardiovascular response post exercise, reflected by an attenuated HR recovery. This may indicate an imbalance in the autonomic regulation of HR. Exercise tests may provide utility in risk stratification for those at risk for OSA. Citation: Hargens TA; Guill SG; Zedalis D; Gregg JM; Nickols-Richardson SM; Herbert WG. Attenuated heart rate recovery following exercise testing in overweight young men with untreated obstructive sleep apnea. SLEEP 2008;31(1):104-110.

Hargens, Trent A.; Guill, Stephen G.; Zedalis, Donald; Gregg, John M.; Nickols-Richardson, Sharon M.; Herbert, William G.

2008-01-01

222

Metabolic and cardioventilatory responses during a graded exercise test before and 24?h after a triathlon  

Microsoft Academic Search

Previous studies have reported respiratory, cardiac and muscle changes at rest in triathletes 24?h after completion of the\\u000a event. To examine the effects of these changes on metabolic and cardioventilatory variables during exercise, eight male triathletes\\u000a of mean age 21.1 (SD 2.5) years (range 17–26 years) performed an incremental cycle exercise test (IET) before (pre) and the\\u000a day after (post)

Daniel Le Gallais; Maurice Hayot; Olivier Hue; Dieudonné Wouassi; Alain Boussana; Michèle Ramonatxo; Christian Préfaut

1999-01-01

223

Exercise tolerance test for predicting coronary heart disease in asymptomatic individuals: A review  

Microsoft Academic Search

In symptom-free subjects, exercise tolerance testing (ETT) has a doubtful utility for detecting latent coronary heart disease (CHD) because of frequent false positives, but it may be valuable for predicting future CHD. To clarify the latter question, we calculated CHD incidence associated with presence or absence of ETT-induced abnormalities of ST-segment depression, exercise capacity, and heart rate using published prospective

Jean-Louis Mégnien; Alain Simon

2009-01-01

224

Significance of Slow Upsloping ST-Segment Depression on Exercise Stress Testing  

Microsoft Academic Search

The supplementary value of varying degrees of upsloping ST-segment depression observed during treadmill exercise testing to the accuracy of the exercise ST-segment response for detection of ischemia was determined by employing a reversible thallium-201 (201Tl) defect as the criteria for ischemia. A group of 199 consecutive patients (168 men) with ?1 reversible 201Tl defects on quantitative planar perfusion imaging, and

1997-01-01

225

Significance of the Walk-Through Angina Phenomenon during Exercise Testing  

Microsoft Academic Search

Out of 3,900 patients who performed an exercise test at our clinic, 3 patients demonstrated a walk-through phenomenon (WTP), defined as the occurrence of mild angina during the first stages of exercise with disappearance of chest pain at higher workloads despite a greater pressure-rate product. 2 patients had variant angina, one with normal coronary arteries and the other with single

Antonello Gavazzi; Stefano De Servi; Carlo Cornalba; Colomba Falcone; Pier Mario Scuri; Giuseppe Specchia

1986-01-01

226

MAXIMAL EXERCISE TESTING USING THE ELLIPTICAL CROSS-TRAINER AND TREADMILL  

Microsoft Academic Search

MAXIMAL EXERCISE TESTING USING THE ELLIPTICAL CROSS-TRAINER AND TREADMILL. Lance C. Dalleck, Len Kravitz, Robert A. Robergs. JEPonline 2004;7(3):94-101. The purpose of this study was to compare the physiological responses during incremental exercise to fatigue using the elliptical cross-trainer and treadmill running. Twenty recreationally active individuals (10 men and 10 women, mean age, height, weight, and body composition = 29.5±7.1

LANCE C. DALLECK; LEN KRAVITZ; ROBERT A. ROBERGS

227

Prognosis in patients achieving ?10 METS on exercise stress testing: Was SPECT imaging useful?  

Microsoft Academic Search

Background  The benefit of myocardial perfusion imaging (MPI) over exercise ECG stress testing alone is unclear in individuals attaining\\u000a a workload of ?10 METS. The purpose of this prospective study is to determine mortality and nonfatal cardiac events in patients\\u000a at either intermediate pretest risk for CAD or patients with known CAD, achieving ?10 METS regardless of peak exercise heart\\u000a rate.

Jamieson M. Bourque; George T. Charlton; Benjamin H. Holland; Christopher M. Belyea; Denny D. Watson; George A. Beller

2011-01-01

228

Factorial Validity and Invariance Testing of the Exercise Dependence Scale-Revised in Swedish and Portuguese Exercisers  

ERIC Educational Resources Information Center

|The present study investigated the factorial validity and factorial invariance of the 21-item Exercise Dependence Scale-Revised using 162 Swedish and 269 Portuguese exercisers. In addition, the prevalence of exercise dependence symptoms and links to exercise behavior, gender, and age in the two samples was also studied. Confirmatory factor…

Lindwall, Magnus; Palmeira, Antonio

2009-01-01

229

Exercise: friend or foe in adult congenital heart disease?  

PubMed

Exercise training is beneficial in healthy adults as well as patients with acquired cardiovascular disease such as coronary artery disease and heart failure. While a reduced exercise capacity is common in adults with congenital heart disease, it is not clear if these patients stand to benefit from exercise training or if it could be potentially detrimental. International recommendations encourage regular exercise in these patients but the evidence base is limited. Data from cardiopulmonary exercise testing suggest a relatively low risk of adverse events during exercise in adults with congenital heart disease. This is also supported by studies investigating the mode of death in this patient group, reporting that only a minority of patients die during exercise. Regarding the benefits of exercise training in adults with congenital heart disease only a few studies with relatively small sample sizes are available pointing to beneficial effects in selected patients. Encouragingly, in none of these short-term studies were detrimental effects observed. Therefore, adult congenital heart disease patients should not be categorically discouraged from physical activity or from participating in non-competitive sports. However, individual exercise prescriptions should be based on a comprehensive assessment of the underlying cardiac condition, possible sequelae, cardiac function, arrhythmias, pulmonary hypertension, and aortic dimensions. Furthermore, the intensity of exercise should be adapted to individual exercise capacity. PMID:24057770

Tutarel, Oktay; Gabriel, Harald; Diller, Gerhard-Paul

2013-11-01

230

Pathophysiology of cardiopulmonary bypass: current issues.  

PubMed

Much of the research related to cardiopulmonary bypass in recent years has been directed toward defining the changes in plasma and blood cells during bypass. In this review, recent information is reexamined for six areas of current interest. These areas are complement activation, immune response, anaphylactic reactions, coagulation, and cerebral dysfunction. Complement may be activated by either the classical or alternate pathway during cardiopulmonary bypass and protamine administration. Membrane oxygenators appear to diminish the degree of complement activation. Complement is a major factor in the whole body inflammatory response; which often accompanies cardiopulmonary bypass. A product of complement activation, C5a- desArg, causes activation and aggregation of granulocytes. Other products of complement activation lead to lysis of blood cells including granulocytes and red cells. Bubble oxygenators appear to have a distinct disadvantage compared to membrane oxygenators regarding infection. Airborne microorganisms are more likely to be entrained into circulating blood with bubble oxygenators than with membrane oxygenators. Bubble oxygenators cause a greater decrease in leukocyte number and function than membrane oxygenators. Anaphylactic reactions have been associated with use of antibiotics, blood products, protamine, and volume expanders during cardiopulmonary bypass. Protamine reactions may be on an immunological basis or due to direct toxicity of the drug. Free radicals including superoxide, hydrogen peroxide, and the hydroxyl radical may be generated during cardiopulmonary bypass and reperfusion. Free radical scavengers including; vitamin E, coenzyme Q, vitamin C, mannitol, and glutathione have been studied. The avoidance of blood transfusion because of risk of transmitted infection including AIDS has become a major goal in cardiac surgery. Factors that correlate with increased transfusion requirement include low hematocrit, female gender, increased age, small body size, low ejection fraction, reoperation, and emergency operation. Heparin resistance due to antithrombin III deficiency is being recognized more commonly. Antithrombin III deficiency may be corrected with fresh frozen plasma. Patients with heparin induced thrombocytopenia may be difficult to manage. Several management protocols are suggested. The most straightforward appears to be the use of aspirin preoperatively and platelet transfusions postoperatively. The incidence of cerebral dysfunction after cardiopulmonary bypass depends on the sensitivity of the test or indicator used. Perioperative stroke is associated with intrinsic cerebrovascular disease and atherosclerosis of the ascending aorta. Retinal angiograms during cardiopulmonary bypass show that microemboli are very common. Cerebroplegia has been shown to extend the period of safe circulatory arrest in animals. Much of the new knowledge concerning cardiopulmonary bypass is the result of close collaboration between cardiac surgeons and nonsurgical scientists. PMID:2133841

Utley, J R

1990-09-01

231

A computer program for comprehensive ST-segment depression\\/heart rate analysis of the exercise ECG test  

Microsoft Academic Search

The ST-segment depression\\/heart rate (STHR) analysis has been found to improve the diagnostic accuracy of the exercise ECG test in detecting myocardial ischemia. Recently, three different continuous diagnostic variables based on the STHR analysis have been introduced; the STHR slope, the STHR index and the STHR hysteresis. The latter utilises both the exercise and recovery phases of the exercise ECG

Rami Lehtinen; Henri Vänttinen; Harri Sievänen; Jaakko Malmivuo

1996-01-01

232

Assessment of preoperative exercise capacity in hepatocellular carcinoma patients with chronic liver injury undergoing hepatectomy  

PubMed Central

Background Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy. Methods Sixty-one HCC patients underwent preoperative cardiopulmonary exercise testing to determine their anaerobic threshold (AT). The AT was defined as the break point between carbon dioxide production and oxygen consumption per unit of time (VO2). Postoperative events including recurrence of HCC, death, liver failure, and complications of cirrhosis were recorded. Univariate and multivariate analyses were performed to evaluate associations between 35 clinical factors and outcomes, and identify independent prognostic indicators of event-free survival and maintenance of Child-Pugh class. Results Multivariate analyses identified preoperative branched-chain amino acid/tyrosine ratio (BTR) <5, alanine aminotransferase level ?42 IU/l, and AT VO2 <11.5 ml/min/kg as independent prognostic indicators of event-free survival. AT VO2 <11.5 ml/min/kg and BTR <5 were identified as independent prognostic indicators of maintenance of Child-Pugh class. Conclusions This study identified preoperative exercise capacity as an independent prognostic indicator of event-free survival and maintenance of Child-Pugh class in HCC patients with chronic liver injury undergoing hepatectomy.

2013-01-01

233

Effects of maximal oxygen uptake test and prolonged cycle ergometer exercise on sway density plot of postural control  

Microsoft Academic Search

This work aims at testing the influence of the maximal oxygen uptake test and prolonged cycle ergometer exercise on sway density plot (SDP) parameters of postural control. Sixteen healthy male subjects were submitted to stabilometric tests with eye open and closed, before and after two different exercises. The maximal oxygen uptake test caused decrease of the mean duration of peaks

Roger G. T. Mello; Liliam F. Oliveira; Jurandir Nadal

2009-01-01

234

Changes in QT interval during exercise testing in patients with VVI pacemakers.  

PubMed

The changes in QT intervals were studied in nine patients with normal sinus node function who had VVI pacemakers. Though PP intervals uniformly shortened during exercise, the change in QaT* intervals during exercise was variable. The correlation between PP and QaT intervals varied from case to case. A good correlation was found in only two cases (r = +0.816 or +0.897); a fair correlation was found in four cases (r = +0.672, +0.615, +0.615, or -0.669) and in the remaining three, the correlation was poor (r = +0.494, +0.467 or -0.424). In patients who are candidates for VTI pacemaker implantation, changes in QaT intervals should be assessed during exercise stress testing to determine if the intervals shorten during exercise or not. PMID:2419854

Oda, E

1986-01-01

235

Effect of Semirecumbent and Upright Body Position on Maximal and Submaximal Exercise Testing  

ERIC Educational Resources Information Center

|The study was designed to determine the effect of upright-posture (UP) versus semirecumbent (SR) cycling on commonly used measures of maximal and submaximal exercise capacity. Nine healthy, untrained men (M age = 27 years, SD = 4.8 years) underwent steady-state submaximal aerobic testing followed by a ramped test to determine maximal oxygen…

Scott, Alexander; Antonishen, Kevin; Johnston, Chris; Pearce, Terri; Ryan, Michael; Sheel, A. William; McKenzie, Don C.

2006-01-01

236

Platelet dysfunction associated with cardiopulmonary bypass.  

PubMed

The clinical significance and pathogenesis of the platelet dysfunction following cardiopulmonary bypass were studied in conjunction with the degree of functional impairment associated with the use of membrane and bubble oxygenators. Forty consecutive patients had the following tests preoperatively and postoperatively: complete blood count (CBC), platelet count, prothrombin consumption time, bleeding time, prothrombin time, partial thromboplastin time, fibrinogen, euglobulin clot lysis, fibrin degradation products, and platelet aggregation tests. Six patients were given 14C-serotonin tests before and after operation, and preoperative and postoperative electron micrographs were made of the platelets of 3 patients. The amount of blood lost, the blood transfused, and plasma hemoglobin levels were also measured. Abnormal aggregation of platelets was found, with no difference between the membrane and bubble oxygenators. In vitro aggregation tests with protamine sulfate and hemoglobin solutions, as well as the 14C-serotonin studies and electron micrographs, suggest that platelets acquire storage pool deficiency and an abnormal membrane during cardiopulmonary bypass. PMID:345986

Friedenberg, W R; Myers, W O; Plotka, E D; Beathard, J N; Kummer, D J; Gatlin, P F; Stoiber, D L; Ray, J F; Sautter, R D

1978-04-01

237

Assessment of the Talk Test and Rating of Perceived Exertion for Exercise Intensity Prescription in Persons With Paraplegia  

PubMed Central

Background: Physical activity recommendations require accurate estimations of exercise intensity. Rating of Perceived Exertion (RPE) and talk test (TT) are 2 commonly recommended techniques to gauge intensity. It is not known whether these are valid to select an exercise intensity that would elicit a training effect for persons with spinal cord injury (SCI). Objective: To define the exercise intensity of each TT stage and RPE exercise intensity category and assess whether persons with paraplegia are able to use the TT to select a “comfortable” exercise workload they could maintain for 15 minutes. Methods: Twelve participants with paraplegia completed 2 arm crank exercise tests on nonconsecutive days within 14 days. Test 1 was an incremental peak effort assessment. Test 2 was a 15-minute simulated exercise session at a participant-selected fixed workload. During each test, participants reported their RPE and performed a TT at 2-minute intervals. Results: The intensity of the first negative TT stage was vigorous (75 ± 15 %VO2R); at low and moderate intensities, perceived effort was greater than measured intensity; at vigorous and maximal intensities, perceived effort matched measured intensity. Individuals successfully used the TT to select an exercise workload they could maintain for 15 minutes. RPE, but not exercise intensity, increased during the 15-minute session. Conclusions: During arm crank exercise when speaking is not comfortable (ie, first negative TT), persons with paraplegia are exercising at vigorous intensity, which is sufficient to elicit training effects. During incremental peak exercise testing, RPE does not appear to accurately index low-moderate exercise intensities. During the simulated exercise session, RPE appeared to index peripheral fatigue.

Cowan, Rachel E.; Ginnity, Kelly L.; Kressler, Jochen; Nash, Mark S.; Nash, Mark S.

2012-01-01

238

Acute cardiovascular response in anabolic androgenic steroid users performing maximal treadmill exercise testing.  

PubMed

The purpose of this study was to investigate the cardiovascular effects of anabolic androgenic steroid (AAS) use, specifically the hemodynamic response, during maximal treadmill exercise testing by comparing the exercise response between users of AAS (U-AAS) and non-AAS users (N-AAS). Twenty-four men (n=12; 29+/-3.4 years and n=12; 29.5+/-8.2 years for the U-AAS and N-AAS groups, respectively) with regular participation in both resistance (mean=6 d.wk) and aerobic exercise (mean=2 d.wk) volunteered for the study. Both groups of subjects completed a ramp-protocol maximal treadmill exercise test to volitional fatigue. Several hemodynamic and metabolic measures were obtained before, during, and after testing. The results demonstrate for the first time that chronic administration of high doses of AAS (355.4+/-59.47 mg.wk) lead to hemodynamic and metabolic response impairment. In conclusion, the chronotropic significant incompetence in the current study was reflected by an exaggerated hemodynamic response to exercise. Furthermore, the findings suggest that nonusers of AAS showed increases in VO2max when compared to the AAS group. Therefore, this study provides a contraindication to AAS use, especially in those at increased risk of cardiovascular events. PMID:20508475

Maior, Alex S; Simão, Roberto; de Salles, Belmiro Freitas; Alexander, Jeffrey L; Rhea, Matthew; Nascimento, José H M

2010-06-01

239

Long term cardiopulmonary effects of closed repair of pectus excavatum.  

PubMed

The closed or "Nuss" repair of pectus excavatum is widely accepted for correction of moderate to severe deformities. Patients typically report significant subjective improvements in pulmonary symptoms, and short and medium term evaluations (up to 2 years with the bar in place) suggest modest improvement to cardiac function but a decrease in pulmonary function. This study examined the effects at 3 months post-bar removal of closed repair of pectus on pulmonary function, exercise tolerance and cardiac function. Patients were followed prospectively after initial evaluation for operation. All patients underwent preoperative and post-bar removal evaluation with CT scan, complete pulmonary function and exercise testing to anaerobic threshold, as well as echocardiogram. Twenty-six patients have completed the follow up protocol. Preoperative CT index was 4.5 +/- 1.3, average age at operation was 13.2 years, and average tanner stage was 3.5 +/- 0.5. At 3 months or greater follow-up post-bar removal, patients reported an improvement in subjective ability to exercise and appearance (P < 0.05 by wilcoxin matched pairs). Objective measures of FEV1, total lung capacity, diffusing lung capacity, O(2) pulse, VO(2max), and respiratory quotient all showed significant improvement compared to preoperative values, while normalized values of cardiac index at rest did not (All values normalized for height and age, comparisons P < 0.05 by student's paired t test). These results demonstrate a sustained improvement in cardiopulmonary function after bar removal following closed repair of pectus excavatum. These findings contrast with results from previous studies following the open procedure, or with the closed procedure at earlier time points; the long term physiological effects of closed repair of pectus excavatum include improved aerobic capacity, likely through a combination of pulmonary and cardiac effects. PMID:17252283

Sigalet, David L; Montgomery, Mark; Harder, Joyce; Wong, Victor; Kravarusic, Dragan; Alassiri, Ali

2007-05-01

240

Differential behavioral and neurochemical effects of exercise, reboxetine and citalopram with the forced swim test  

PubMed Central

Aims In this study, we investigated whether short-term exercise, known to promote hippocampal BDNF expression, would also enhance activity in the Porsolt forced swim test (FST), a model for assessing antidepressant efficacy. We also wished to determine whether exercise combined with antidepressants would be more effective at modifying behavior in the FST than either intervention alone. In parallel with this, we also expected that these interventions would preserve post-stress levels of BDNF, and that antidepressants designed to selectively enhance noradrenergic or serotonergic neurotransmission (reboxetine or citalopram, respectively) would have differential effects on behavior and BDNF expression. Main methods Male Sprague-Dawley rats were treated with exercise (voluntary wheel running), reboxetine, citalopram, or the combination of exercise and each antidepressant, for 1 week. At the end of this period, a subset of animals from each treatment group underwent the FST. Post-stress levels of hippocampal BDNF mRNA were then quantified via in situ hybridization. Key findings Our results indicate that while both exercise and antidepressant treatment preserved post-stress levels of hippocampal BDNF mRNA, each intervention led to a unique behavioral profile in the FST. We found that antidepressant treatment increased swimming time in the FST, but that exercise decreased swimming time. While the combination of reboxetine-plus-exercise led to an increase in climbing and diving, citalopram-plus-exercise reduced these behaviors. Significance It is possible that active behaviors during the FST, though specific to antidepressant medications, may not reflect increased hippocampal BDNF expression or other survival- associated benefits.

Arunrut, Teda; Alejandre, Hilda; Chen, Michael; Cha, Joseph; Russo-Neustadt, Amelia

2009-01-01

241

Reliability of using the D-max method to define physiological responses to incremental exercise testing.  

PubMed

The purpose of this study was to examine the reliability of using a mathematical method, D-max, to define blood lactate kinetics in response to an incremental exercise test, and to compare the physiological responses corresponding to the workload at D-max with those at the traditional 4 mmol l-1 lactate threshold and ventilatory thresholds. Ten male endurance trained athletes, with an average (+/- SD) age of 25.6 +/- 8.2 years and maximal oxygen consumption of 64.0 +/- 1.7 ml kg-1 min-1, performed an incremental cycling test on two occasions separated by four weeks. The expired gas was analysed on-line and plasma lactate concentration was analysed for each workload and at exhaustion. The lactate response to exercise was represented by a third-order polynomial regression curve. The D-max was defined as the point on the regression curve that yields the maximal distance to the straight line formed by the two end points of the curve. The results demonstrated a high test-retest reliability (intraclass correlation coefficients 0.77-0.93, p < 0.01) in oxygen consumption, heart rate and exercise intensity at both D-max point and exhaustion. No significant differences were found in the mean values of the variables between the two tests. It is concluded that the D-max appears to be a reliable method for defining the individual physiological responses to exercise tests, with the advantage of objectivity. However, there is no evidence to support the theory that the exercise intensity defined by the D-max method is superior to that defined by other methods to prescribe training intensity or predict aerobic performance for athletes. Further investigations are warranted to examine the validity of using this method in exercise prescription. PMID:9183808

Zhou, S; Weston, S B

1997-05-01

242

Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing  

SciTech Connect

The prevalence of silent myocardial ischemia was prospectively assessed in a group of 103 consecutive patients (mean age 59 +/- 10 years, 79% male) undergoing symptom-limited exercise thallium-201 scintigraphy. Variables that best correlated with the occurrence of painless ischemia by quantitative scintigraphic criteria were examined. Fifty-nine patients (57%) had no angina on exercise testing. A significantly greater percent of patients with silent ischemia than of patients with angina had a recent myocardial infarction (31% versus 7%, p less than 0.01), had no prior angina (91% versus 64%, p less than 0.01), had dyspnea as an exercise test end point (56% versus 35%, p less than 0.05) and exhibited redistribution defects in the supply regions of the right and circumflex coronary arteries (50% versus 35%, p less than 0.05). The group with exercise angina had more ST depression (64% versus 41%, p less than 0.05) and more patients with four or more redistribution defects. However, there was no difference between the two groups with respect to mean total thallium-201 perfusion score, number of redistribution defects per patient, multi-vessel thallium redistribution pattern or extent of angiographic coronary artery disease. There was also no difference between the silent ischemia and angina groups with respect to antianginal drug usage, prevalence of diabetes mellitus, exercise duration, peak exercise heart rate, peak work load, peak double (rate-pressure) product and percent of patients achieving greater than or equal to 85% of maximal predicted heart rate for age. Thus, in this study group, there was a rather high prevalence rate of silent ischemia (57%) by exercise thallium-201 criteria.

Gasperetti, C.M.; Burwell, L.R.; Beller, G.A. (Univ. of Virginia Health Sciences Center, Charlottesville (USA))

1990-07-01

243

Peak exercise capacity estimated from incremental shuttle walking test in patients with COPD: a methodological study  

PubMed Central

Background In patients with COPD, both laboratory exercise tests and field walking tests are used to assess physical performance. In laboratory tests, peak exercise capacity in watts (W peak) and/or peak oxygen uptake (VO2 peak) are assessed, whereas the performance on walking tests usually is expressed as distance walked. The aim of the study was to investigate the relationship between an incremental shuttle walking test (ISWT) and two laboratory cycle tests in order to assess whether W peak could be estimated from an ISWT. Methods Ninety-three patients with moderate or severe COPD performed an ISWT, an incremental cycle test (ICT) to measure W peak and a semi-steady-state cycle test with breath-by-breath gas exchange analysis (CPET) to measure VO2 peak. Routine equations for conversion between cycle tests were used to estimate W peak from measured VO2 peak (CPET). Conversion equation for estimation of W peak from ISWT was found by univariate regression. Results There was a significant correlation between W peak and distance walked on ISWT × body weight (r = 0.88, p < 0.0001). The agreement between W peak measured by ICT and estimated from ISWT was similar to the agreement between measured W peak (ICT) and W peak estimated from measured VO2 peak by CPET. Conclusion Peak exercise capacity measured by an incremental cycle test could be estimated from an ISWT with similar accuracy as when estimated from peak oxygen uptake in patients with COPD.

Arnardottir, Ragnhei?ur Harpa; Emtner, Margareta; Hedenstrom, Hans; Larsson, Kjell; Boman, Gunnar

2006-01-01

244

Heparin-bonded cardiopulmonary bypass circuits reduce cognitive dysfunction  

Microsoft Academic Search

Objective: To determine the incidence of cerebral dysfunction in cardiac surgical patients exposed to heparin-bonded cardiopulmonary bypass (HB-CPB) versus nonheparin-bonded cardiopulmonary bypass (NH-CPB) circuits through neuropsychometric testing and to correlate these findings with markers of the systemic inflammatory response to CPB. Design: Prospective, randomized, blinded clinical trial. Setting: University hospital. Participants: Sixty-one patients undergoing elective cardiac surgery. Interventions: A cohort

Eric J. Heyer; Kevin S. Lee; Heather E. Manspeizer; Linda Mongero; Talia B. Spanier; Xzabia Caliste; Barry Esrig; Craig Smith

2002-01-01

245

An acceptable exercise test to study microalbuminuria in type 1 diabetes.  

PubMed

A modified test for studying the response of urinary albumin excretion (UAV) to exercise in diabetic patients is described. It is designed to produce a standardized increase in pulse rate (by 90-110%) rather than a standardized workload. Thirty-three normotensive Type 1 diabetic patients with normal pre-exercise UAV (less than 10 micrograms min-1) on the day of the test were compared with 25 non-diabetic subjects matched for age and sex. The patients developed a significantly greater increase in the median UAV (p less than 0.05) and systolic blood pressure (p less than 0.01) during exercise, despite the use of lower workloads (p less than 0.05). During exercise, the albumin excretion in the patients was not related to their heart rate, blood pressure, workload or fall in blood glucose; nor was it related to duration of diabetes, glycosylated haemoglobin or insulin dose. An exercise UAV greater than 15 micrograms min-1 was found in 10 of the 33 patients; it was significantly correlated (p less than 0.01) with the frequency of previous overnight microalbuminuria (greater than 10 micrograms min-1), and was associated with a greater progression of microalbuminuria (p less than 0.05) over a mean period of 24 months. Retinol-binding protein excretion rate was also measured as an indicator of proximal tubular function and did not increase in either group. PMID:2533038

Watts, G F; Williams, I; Morris, R W; Mandalia, S; Shaw, K M; Polak, A

1989-12-01

246

Validity of criteria for establishing maximal O 2 uptake during ramp exercise tests  

Microsoft Academic Search

The incremental or ramp exercise test to the limit of tolerance has become a popular test for determination of maximal O2 uptake $$(\\\\dot{V}{\\\\hbox{O}}_{{{{\\\\rm 2max}}}}).$$ However, many subjects do not evidence a definitive plateau of the $$\\\\dot{V}{\\\\hbox{O}}_{{{2}}} $$ -work rate relationship on this test and secondary criteria based upon respiratory exchange ratio (RER), maximal heart rate\\u000a (HRmax) or blood [lactate] have

David C. Poole; Daryl P. Wilkerson; Andrew M. Jones

2008-01-01

247

Attitudes About Treatment of Coronary Heart Disease Among Women and Men Presenting for Exercise Testing  

Microsoft Academic Search

To assess attitudes that could contribute to gender differences in the use of coronary procedures, we surveyed 322 patients presenting for exercise testing at a major teaching hospital. Adjusting for sociodemographic and clinical factors, women and men did not differ significantly in their willingness to seek a second opinion, reduce physical activity, or take drugs to avoid major cardiac surgery,

John Z. Ayanian; Arnold M. Epstein

1997-01-01

248

The effect of exercise on cognitive performance in soccer-specific tests  

Microsoft Academic Search

Two experiments were carried out to examine the effect of moderate and maximal exercise on the cognitive performance of experienced soccer players. Experiment 1 examined the speed and visual search in familiar (game) and unfamiliar (non-game) contexts. Participants had to detect, as quickly as possible, the presence or absence of a ball in tachistoscopically presented slides. Participants were tested at

Terry McMorris; Jan Graydon

1997-01-01

249

The Cardiorespiratory Responses and Energy Expenditure of Windsurfers during Cycle Ergometer And Windsurfing Simulator Exercise Tests  

Microsoft Academic Search

The aim of the study was a comparative assessment of cardio-respiratory responses and energy expenditures in Polish windsurfers (male) during cycloergometer and windsurfing simulator exercise tests with progressive load till exhaustion. For reproduction of resistance during sail movements on the windsurfing simulator (own design) the rowing ergometer was used, the rope of which was fastened to the middle part of

Jaroslaw Jaszczur-Nowicki

250

Prognostic utility of intravenous dipyridamole thallium-201 imaging and exercise testing after an acute infarction  

Microsoft Academic Search

To define the prognosis in asymptomatic survivors of acute infarcts (MI), coronary vasodilation was induced with I.V. dipyridamole, followed by Thallium-201 (T1) imaging in 26 patients just prior to discharge. All patients (pts) also had a modified exercise treadmill (MET) test. During the imaging protocol, 10 (39%) pts experienced transient adverse effects and 12 (46%) pts had either angina or

Leppo

1984-01-01

251

Angina pectoris and ST-Segment Depression during Exercise Testing Early following Acute Myocardial Infarction  

Microsoft Academic Search

This study evaluates the prognostic value of ST-segment depression and angina pectoris occurring alone or in combination during exercise testing performed 3 weeks after myocardial infarction in 281 of 570 consecutive survivors of acute myocardial infarction. Neither angina pectoris (36 patients) nor ST-segment depression of at least 1 mm (46 patients) correlated with the occurrence of acute coronary events (cardiac

Louis Abboud; Jamal Hir; Iris Eisen; Walter Markiewicz

1994-01-01

252

Should Troponin-T Be Assessed During Exercise Stress Testing in Patients with Stable Angina Pectoris?  

Microsoft Academic Search

Objective: This study was planned to investigate whether or not troponin-T positivity has occurred during exercise stress testing in patients with stable angina pectoris and if yes, its relationship with the severity of the disease. Methods: One hundred patients with stable angina pectoris who presented with typical chest pain were inc- luded in this study. They were subjected to the

Kemal Eryol; Emrullah Baflar; Yüksel Çiçek; Adnan Abac; Abdurahman Ouzhan; Ramazan Topsakal; Servet Çetin

253

Analysis of heart rate variability during exercise stress testing using respiratory information  

Microsoft Academic Search

This paper presents a novel method for the analysis of heart rate variability (HRV) during exercise stress testing enhanced with respiratory information. The instantaneous frequency and power of the low frequency (LF) and high frequency (HF) bands of the HRV are estimated by parametric decomposition of the instantaneous autocorrelation function (ACF) as a sum of damped sinusoids. The instantaneous ACF

Raquel Bailón; Luca Mainardi; Michele Orini; Leif Sörnmo; Pablo Laguna

2010-01-01

254

Reliability of using the D-max method to define physiological responses to incremental exercise testing  

Microsoft Academic Search

The purpose of this study was to examine the reliability of using a mathematical method, D-max, to define blood lactate kinetics in response to an incremental exercise test, and to compare the physiological responses corresponding to the workload at D-max with those at the traditional lactate threshold and ventilatory thresholds. Ten male endurance trained athletes, with an average () age

Shi Zhou; Shane B Weston

1997-01-01

255

Mental Exercises: A Study of the Effect of Mental Exercise as a Warm-Up on the Test Scores of Students.  

ERIC Educational Resources Information Center

To determine if performing mental exercises (thinking skills which activate cognitive mental alertness) before taking a test affected test results, a study examined spelling test results of three ninth-grade English classes instructed by the same teacher. Subjects were of similar educational background and had similar characteristics…

Hogan, Carolyn

256

[Usefulness of exercise tests in the evaluation of the effects of treatment in chronic cardiac insufficiency].  

PubMed

Before it reaches the decompensation stage, heart failure is characterized by symptoms which occur only during exercise. It is therefore rational to believe that the effectiveness of treatments of heart failure should be evaluated by the improvement they produce in tolerance to stress. This tolerance can be evaluated by exercise tests which may take different forms. The most common is a progressive load test on bicycle ergometer or treadmill. Among the indices used to assess tolerance to stress, the total duration of the exercise test until symptoms develop is a variable subject to fluctuations which may be independent of the patient's cardiovascular state. Measurement of oxygen consumption at peak exercise level is usually preferred, being unrelated to the nature of the stress and much more reproducible and sensitive to changes. Among the pharmacological treatments of heart failure, only chronic vasodilator therapy, notably with angiotensin-converting enzyme inhibitors, has proved constantly effective on the various ergometric indices. In the literature, the effects of digitalis compounds, dihydralazine and alpha-blockers are inconstant. Among the new treatments of heart failure, phosphodiesterase inhibitors may improve tolerance to stress, as does Corwin which may prolong the total duration of exercise. Its effect on oxygen consumption has not yet been evaluated. Performance at exercise is almost never improved by acute treatment with any pharmacological agent, and the same remarks applies to short-term heart transplantation. The reason for this is that heart failure is associated with a physical deconditioning syndrome due to abnormalities of the arterial dilatation capacity in skeletal muscles, and with muscular metabolic abnormalities due to a defective oxygen utilization by these muscles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2267563

Zannad, F

1990-10-11

257

The impact of adjunctive adenosine infusion during exercise myocardial perfusion imaging: Results of the Both Exercise and Adenosine Stress Test (BEAST) trial  

Microsoft Academic Search

Background  Failure to achieve an adequate heart rate limits the sensitivity of exercise myocardial perfusion imaging (MPI) for the detection\\u000a of coronary artery disease. In addition, it is often not possible to discontinue medications that may blunt the heart rate\\u000a response to exercise, because of conditions such as hypertension or angina. However, if pharmacologic stress testing is performed,\\u000a the ability to

Thomas A. Holly; Aaron Satran; David S. Bromet; Jennifer H. Mieres; Martin J. Frey; Michael D. Elliott; Gary V. Heller; Robert C. Hendel

2003-01-01

258

Value and limitations of exercise stress testing to predict the functional results of coronary artery bypass grafting  

Microsoft Academic Search

To assess the value of exercise stress testing to predict the functional result of revascularization, 90 patients were evaluated by coronary angiography and exercise testing pre and postoperatively. Patients were classified on the basis of the postoperative angiogram in a group with successful surgery and a group with usuccessful surgery. The predictive accuracy positive of ST segmet depression to detect

Frans C. Visser; Linda van Campen; Pim J. de Feyter

1993-01-01

259

Artificial neural network cardiopulmonary modeling and diagnosis  

DOEpatents

The present invention is a method of diagnosing a cardiopulmonary condition in an individual by comparing data from a progressive multi-stage test for the individual to a non-linear multi-variate model, preferably a recurrent artificial neural network having sensor fusion. The present invention relies on a cardiovascular model developed from physiological measurements of an individual. Any differences between the modeled parameters and the parameters of an individual at a given time are used for diagnosis. 12 figs.

Kangas, L.J.; Keller, P.E.

1997-10-28

260

Comparative ergoespirometric adaptations to a treadmill exercise test in untrained show Andalusian and Arabian horses.  

PubMed

Significant differences exist in the respiratory adaptation to exercise in different equine breeds. This research describes the ergoespirometric response to exercise of Andalusian (AN) and Arabian (A) horses, both selected according to morphological criteria. Thirteen untrained male horses (6 AN and 7 A) performed a treadmill exercise test (TET) with a slope of 6%, with workloads starting from 5 m/s and increasing 1 m/s every 3 min until the horses were not able to keep the required velocity. Tidal volume (TV), respiratory rate, minute ventilation (VE), oxygen uptake (VO2), carbon dioxide production, peak oxygen uptake (VO2peak), respiratory exchange ratio (RER), exercise time to fatigue (ETF) and respiratory aerobic threshold (RAT) were determined. AN horses presented higher TV and VE, whereas respiratory rate, VO2 and VCO2 were lower at the same velocities. RER was similar between breeds. ETF was longer in A horses (556.7?±?66.5 in AN vs. 607.1?±?71.1 s in A) and no significant differences were found in RAT (5.50?±?0.50 in AN vs. 5.86?±?1.07 m/s in A). In summary, despite the more intense ventilatory response to exercise at the same velocity, AN horses had lower VO2. The AN horse develops a more intense ventilatory response to fixed velocities than the A horse and it could be interesting to clarify the role of the locomotion characteristics in this response. PMID:22183731

Castejón-Riber, Cristina; Muñoz, Ana; Trigo, Pablo; Riber, Cristina; Santisteban, Rafael; Castejón, Francisco

2011-12-21

261

The Accuracy of the Electrocardiogram during Exercise Stress Test Based on Heart Size  

PubMed Central

Background Multiple studies have shown that the exercise electrocardiogram (ECG) is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy. Hypothesis The purpose of this investigation was to assess the diagnostic accuracy of the exercise ECG based on heart size. Methods We evaluated 1,011 consecutive patients who were referred for an exercise nuclear stress test. Patients were divided into two groups: small heart size defined as left ventricular end diastolic volume (LVEDV) <65 mL (Group A) and normal heart size defined as LVEDV ?65 mL (Group B) and associations between ECG outcome (false positive vs. no false positive) and heart size (small vs. normal) were analyzed using the Chi square test for independence, with a Yates continuity correction. LVEDV calculations were performed via a computer-processing algorithm. SPECT myocardial perfusion imaging was used as the gold standard for the presence of coronary artery disease (CAD). Results Small heart size was found in 142 patients, 123 female and 19 male patients. There was a significant association between ECG outcome and heart size (?2?=?4.7, p?=?0.03), where smaller hearts were associated with a significantly greater number of false positives. Conclusions This study suggests a possible explanation for the poor diagnostic accuracy of exercise stress testing, especially in women, as the overwhelming majority of patients with small heart size were women.

Siegler, Jason C.; Rehman, Shafiq; Bhumireddy, Geetha P.; Abdula, Raushan; Klem, Igor; Brener, Sorin J.; Lee, Leonard; Dunbar, Christopher C.; Saul, Barry; Sacchi, Terrence J.; Heitner, John F.

2011-01-01

262

Hyperventilation provocation in patients with chest pain and a negative treadmill exercise test.  

PubMed

Seventeen (39%) of 44 patients with chest pain but without significant ST depression on treadmill exercise had their usual chest pain reproduced during or after 3 min of voluntary hyperventilation (VHV) at rest. These patients with hyperventilation positive tests had not only significantly more hyperventilation-related symptoms and respiratory complaints but also shorter breath-holding times, lower mean resting end-tidal pCO2 and higher mean respiratory rates than those with negative tests and normal controls. Of the psychological variables, only phobic avoidance scores for agoraphobia were higher in patients with positive tests. These findings suggest that in two fifths of patients with exercise tests negative for ischaemia, chest pain is associated with HV, but abnormalities of breath control and relative hypocapnia are present even in the absence of chest pain. It is possible that a chronic abnormality of respiratory control may interact with attitudinal factors in the experience of non-cardiac chest pain. PMID:2023144

Bass, C; Chambers, J B; Gardner, W N

1991-01-01

263

Gender Differences in the Prognostic Value of Exercise Treadmill Test Characteristics  

PubMed Central

Background Although exercise treadmill testing (ETT) is known to be less sensitive and specific for diagnosis of coronary disease in women, little is known about gender differences in the prognostic importance of ETT variables. Methods We studied9569 consecutive patients (46.8% women) referred for ETT between July 2001- June 2004 in a community-based system. We assessed the association between ETT variables (exercise capacity, symptoms, ST-segment deviations, heart rate recovery, and chronotropic response) and time to all-cause death and myocardial infarction adjusting for patient and stress test characteristics. Models were stratified by gender to determine the relationship between ETT variables and outcomes. Results In the entire population, exercise capacity and heart rate recovery were significantly associated with all-cause death, whereas, exercise capacity, chest pain and ST-segment deviations were significantly associated with subsequent MI. The relationship between ETT variables and outcomes were similar between men and women except for abnormal exercise capacity, which was had a significantly stronger association with death in men (men: HR = 2.89, 95% CI 1.89–4.44; women: HR = 0.99, 95% CI 0.52–1.93; interaction exercise capacity was more prognostically important in men and chronotropic incompetence was more important in women. Future studies should confirm these findings in additional populations.

Daugherty, Stacie L.; Magid, David J.; Kikla, Jennifer R.; Hokanson, John E.; Baxter, Judith; Ross, Colleen A.; Masoudi, Frederick A.

2011-01-01

264

Results of Exercise Stress Testing in Patients with Diffuse Pulmonary Arteriovenous Malformations  

Microsoft Academic Search

Patients with diffuse pulmonary arteriovenous malformations (PAVMs) are subject to frequent complications and need to be followed\\u000a closely. As part of this follow-up, we have employed exercise stress testing (EST) as an aid to assess their status. Twenty\\u000a patients from a cohort of 35 with diffuse PAVMs have undergone EST using a standard cycle ergometer test. All patients had\\u000a previously

Joshua Murphy; Paola Pierucci; Deborah Chyun; Katharine J. Henderson; Jeffrey Pollak; Robert I. White; John Fahey

2009-01-01

265

Exercise-induced ST-segment depression in inferior leads during treadmill exercise testing and coronary artery disease  

Microsoft Academic Search

The exercise electrocardiogram is a commonly used non-invasive and inexpensive method for detection of electrocardiogram (ECG) changes secondary to myocardial ischemia. Reversible ST-segment depression is the characteristic finding associated with exercise-induced, demand-driven ischemia in patients with significant coronary obstruction but no flow limitation at rest. The exercise-induced ST-segment depression in inferior leads has been questioned and it has been reported

Salvatore Patanè; Filippo Marte; Giuseppe Dattilo; Rosario Grassi; Francesco Patanè

2010-01-01

266

[Cardiorespiratory exercise tolerance tests: a preoperative surgical risks assessment in elderly patients].  

PubMed

This study focuses on the most topical issue: non-cardiac surgery safety in elderly patients. According to different authors data, the mortality rate due to cardiovascular pathology %, and postoperative cardiac events incidence -from 2 to 4.4 %. For this reason we decided to conduct prospective risk assessment in the most dificult elderly patients group. Within the framework of this study we performed cardiorespiratory exercise testing (KAREN-test) in 17 elderly patients with various located colon cancer Concomitant diseases were: ischemic heart disease (12 patients), postinfarction cardiosclerosis (4 patients), arterial hypertension (12 patients), rhythm disturbances of varying degrees (11 patients), CHF (2 patients), and others. Patients were aged from 58 to 94 years. Subsequently, 14 of 17 patients were operated on, 11 of them underwent radical intervention. Cardiorespiratory exercise tolerance test was carried out according to moderate treadmill-test protocol for elderly patients developed in our clinic. Test duration was more than 4 minutes in all patients. During exercise stress peak, submaximal heart rate was observed in all patients, the peak oxygen consumption to a maximum current oxygen consumption ratio amounted to 94% on the average in a group, the oxygen consumption at the aerobic threshold level exceeded 11 mI/min/kg in all patients. There was no acute myocardial infarction and cerebrovascular events during perioperative period; the hospital mortality rate was 0%. Actual age by itself is not a contraindication for surgery. KAREN tests should become one of the key components for the assessment and treatment tactics choice. PMID:24000647

267

Assessment of exercise tolerance in chronic bronchitis and interstitial lung disease.  

PubMed

Cardiopulmonary exercise testing has a definitive place in objective evaluation of the subjective sensation of breathlessness. In the present study 21 patients with COPD, 10 with ILD and 17 normals were subjected to stage 1 exercise testing and correlations were sought between Vo2 and work, FVC, FeV1, Ve, respiratory rate and tidal volume and between VCO2 and work. In COPD and ILD the Vo2 correlated with work, Fev1, Fvc and Ve whereas in normals it correlated with the VE but not with the FeV1 and FVC. In COPD VO2 correlated with TV though this was not the case in ILD. Thus stage 1 exercise testing can be a useful additional method to assess the disability in COPD and ILD although differentiation between these two respiratory diseases on basis of exercise testing alone may not be possible. PMID:8226596

Mirchandani, L V; Sharma, R R; John, P J; Kolhatkar, V P; Taskar, V S; Mahashur, A A

1993-03-01

268

A model to predict multivessel coronary artery disease from the exercise thallium-201 stress test  

SciTech Connect

The aim of this study was to (1) determine whether nonimaging variables add to the diagnostic information available from exercise thallium-201 images for the detection of multivessel coronary artery disease; and (2) to develop a model based on the exercise thallium-201 stress test to predict the presence of multivessel disease. The study populations included 383 patients referred to the University of Virginia and 325 patients referred to the Massachusetts General Hospital for evaluation of chest pain. All patients underwent both cardiac catheterization and exercise thallium-201 stress testing between 1978 and 1981. In the University of Virginia cohort, at each level of thallium-201 abnormality (no defects, one defect, more than one defect), ST depression and patient age added significantly in the detection of multivessel disease. Logistic regression analysis using data from these patients identified three independent predictors of multivessel disease: initial thallium-201 defects, ST depression, and age. A model was developed to predict multivessel disease based on these variables. As might be expected, the risk of multivessel disease predicted by the model was similar to that actually observed in the University of Virginia population. More importantly, however, the model was accurate in predicting the occurrence of multivessel disease in the unrelated population studied at the Massachusetts General Hospital. It is, therefore, concluded that (1) nonimaging variables (age and exercise-induced ST depression) add independent information to thallium-201 imaging data in the detection of multivessel disease; and (2) a model has been developed based on the exercise thallium-201 stress test that can accurately predict the probability of multivessel disease in other populations.

Pollock, S.G.; Abbott, R.D.; Boucher, C.A.; Watson, D.D.; Kaul, S. (Univ. of Virginia School of Medicine, Charlottesville (USA))

1991-03-01

269

Polymorphisms of the b2Adrenergic Receptor Determine Exercise Capacity in Patients With Heart Failure  

Microsoft Academic Search

The b2-adrenergic receptor (b2AR) exists in multiple polymorphic forms with different characteristics. Their relevance to heart failure (HF) physiology is unknown. Cardiopulmonary exercise testing was performed on 232 compensated HF patients with a defined b2AR genotype. Patients with the uncommon Ile164 polymorphism had a lower peak VO2 (15.060.9 mL z kg21 z min21) than did patients with Thr164 (17.960.9 mL

Lynne E. Wagoner; Laura L. Craft; Balkrishna Singh; Damodhar P. Suresh; Paul W. Zengel; Nancy McGuire; William T. Abraham; Thomas C. Chenier; Gerald W. Dorn II; Stephen B. Liggett

2010-01-01

270

21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.  

Code of Federal Regulations, 2013 CFR

... false Cardiopulmonary bypass temperature controller. 870.4250 Section...4250 Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to...

2013-04-01

271

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2010 CFR

...false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870...4240 Cardiopulmonary bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting...

2009-04-01

272

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2010 CFR

...false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870...4240 Cardiopulmonary bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting...

2010-04-01

273

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2013 CFR

...false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870...4240 Cardiopulmonary bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting...

2013-04-01

274

Extraversion and Exercise Addiction  

Microsoft Academic Search

Extraversion has been suggested as a factor associated with addiction. This claim was tested in relation to exercise addiction. Twelve exercise addicts were compared with 12 nonaddicted individuals who were committed to regular exercise and with 12 nonexercising individuals drawn from the same student population. Addicted exercisers did not differ from nonaddicted exercisers in extraversion, although exercisers as a group

Sarah Mathers; Michael B. Walker

1999-01-01

275

[Compartment syndrome after cardiopulmonary bypass].  

PubMed

Compartment syndrome of the lower leg is an occasional complication of prolonged ischemia and reperfusion. We present a patient with compartment syndrome of the ipsilateral thigh after femoral arterial and venous cannulation for cardiopulmonary bypass. PMID:20685185

Guillen, G; Llorente, A M; Maseda, R; Belda, S; Olmedilla, M

2010-08-03

276

Cardiopulmonary Resuscitation Artifact during Electroencephalography  

Microsoft Academic Search

Artifacts are signals recorded on the electroencephalogram (EEG) that are not cerebral in origin and can be divided into physiological and non-physiological artifacts. We present here an interesting non-physiological EEG artifact generated by cardiopulmonary resuscitation efforts.

N. K. Sethi; J. Torgovnick; P. K. Sethi; E. Arsura

2008-01-01

277

Motivation contagion when instructing obese individuals: a test in exercise settings.  

PubMed

We examined motivation contagion in a hypothetical exercise setting. Exercise science students (n = 164) were provided with quotes of hypothetical male and female obese exercisers displaying different quality of motivation to start an exercise program. We used a 3 (exerciser motivation) × 2 (exerciser gender) × 2 (student gender) between-subjects experimental design to examine students' (a) motivation to instruct, (b) interpersonal style, (c) perception of barrier efficacy of the exerciser, and (d) effort to identify factors that could maximize the effectiveness of an exercise program for the exerciser. Results showed that students displayed less controlled motivation and rated the exerciser as more capable of overcoming barriers to exercise when they perceived the exerciser to be autonomously motivated. However, students, particularly females, reported more autonomy support and invested more effort toward female exercisers with controlled motivation. Our findings indicate that motivation contagion effects are plausible in exercise settings and may affect interactions between fitness instructors and obese clients. PMID:22889692

Ng, Johan Y Y; Thøgersen-Ntoumani, Cecilie; Ntoumanis, Nikos

2012-08-01

278

Significance of T wave normalization in the electrocardiogram during exercise stress test  

SciTech Connect

Although normalization of previously inverted T waves in the ECG is not uncommon during exercise treadmill testing, the clinical significance of this finding is still unclear. This was investigated in 45 patients during thallium-201 exercise testing. Patients with secondary T wave abnormalities on the resting ECG and ischemic exercise ST segment depression were excluded. On the thallium-201 scans, the left ventricle was divided into anterior-septal and inferior-posterior segments; these were considered equivalent to T wave changes in leads V1 and V5, and aVF, respectively. A positive thallium-201 scan was found in 43 of 45 (95%) patients and in 49 of 52 (94%) cardiac segments that showed T wave normalization. When thallium scans and T wave changes were matched to sites of involvement, 76% of T wave normalization in lead aV, was associated with positive thallium scans in the inferior-posterior segments, and 77% of T wave normalization in V1 and V5 was associated with positive thallium scans in the anterior-septal segments. These site correlations were similar for reversible and fixed thallium defects, and for patients not on digoxin therapy. Similar correlations were noted for the sites of T wave changes and coronary artery lesions in 12 patients who had angiography. In patients with a high prevalence for coronary artery disease, exercise T wave normalization is highly specific for the presence of the disease. In addition, it represents predominantly either previous injury or exercise-induced ischemic changes over the site of ECG involvement, rather than reciprocal changes of the opposite ventricular wall.

Marin, J.J.; Heng, M.K.; Sevrin, R.; Udhoji, V.N.

1987-12-01

279

[Limiting factors of exercise capacity in patients with COPD].  

PubMed

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide. Moderate to severe COPD patients demonstrate severe impairments in exercise performance in daily activities, significantly affecting their quality of life. There are several causes for this limitation found in literature: air-flow limitation, lung hyperinflation, respiratory and peripheral muscles weakness, among others. In this study we intended to identify the potentially relevant factors that influence exercise performance in a group of moderate to severe COPD patients. We studied 24 male patients, 64,13 + 8,46 years old (46-83 years), FEV1: 46,96 + 12,99% predicted, FRC: 144,71 + 26,86% predicted, DLCO: 69,88 + 16,49 % predicted, PaO2: 78,25 + 7,82 mmHg, PaCO2: 40,78 + 4,28 mmHg. Patients performed an incremental symptom-limited cycle exercise. We correlated rest and exercise lung function parameters with peak oxygen uptake, maximal work rate and time span to exertion. The main contributors to exercise limitation were gas exchange abnormalities, ventilatory limitation and smaller values of body mass index. Rest lung hyperinflation didn't correlate with exercise performance. Dynamic exercise hyperinflation contributed greatly to exercise intolerance, through progressive restriction to tidal volume expansion necessary to deal with increasing exercise metabolic demands. Rest lung function parameters didn't correlate with exercise performance, stressing the importance of cardio-pulmonary exercise testing in the detection of exercise limitation factors in each patient. The identification of exercise limitation factors will certainly contribute to towards defining the best therapeutic approach in COPD patients. PMID:15190427

Rodrigues, Fátima

280

Assessment of exercise capacity in African patients with chronic heart failure using six minutes walk test  

PubMed Central

Background: The purpose of this study was to assess the functional capacity during a 6-minute corridor walk and a 6-minute bicycle ergometry exercise in patients with chronic heart failure (CHF). Method: Thirty five patients with stable CHF were recruited for the study. Each subject performed six minutes corridor walk and 6-minute bicycle ergometry testing. The 6-minute walk required the subjects to walk at a self selected speed on a 20 meter marked level ground for 6-minute. All the subjects also performed a 6-minute exercise on a stationary bicycle ergometer with initial resistance of 20 watts and increased by 10 watts after 3-minutes. The perceived rate of exertion was assessed using a modified Borg Scale after each exercise mode. The maximum oxygen consumption was derived using American College of Sport Medicine equations. Results: Result showed high positive correlation between distance walked in the 6-minute and the maximum volume of oxygen (VO2 max) (r = 0.65, P < 0.01). The average distance walked was 327 m ± 12.03 m. The VO2 max estimated during bicycle ergometry was higher (13.7 ± 1.9 L) than during the six minutes walk (8.9 ± 1.2 L). Conclusion: Six minutes walk could be useful to evaluate exercise tolerance in patients with chronic heart failure, while the bicycle ergometer could be more appropriate in the assessment of maximum functional capacity in these patients.

Adedoyin, Rufus A; Adeyanju, Samuel A; Balogun, Michael O; Akintomide, Anthony O; Adebayo, Rasaaq A; Akinwusi, Patience O; Awotidebe, Taofeek O

2010-01-01

281

Mannitol as a Challenge Test to Identify Exercise-induced Bronchoconstriction in Elite Athletes  

Microsoft Academic Search

Bronchial provocation tests provide objective criteria for asthma of temperature and humidity (7). To overcome some of these and exercise-induced bronchoconstriction (EIB) and were recom- problems, the eucapnic voluntary hyperpnea (EVH) chal- mended to justify the use of inhaled 2-agonists by athletes at the lenge with dry air (8-10) has been used and recommended Winter Olympics 2002. Eucapnic voluntary hyperpnea

Karen Holzer; Sandra D. Anderson; Hak-Kim Chan; Jo Douglass

282

Growth hormone response to a standardised exercise test in relation to puberty and stature  

Microsoft Academic Search

Growth hormone (GH) was measured before and 10 minutes after a standardised bicycle exercise test (duration 15 minutes) in 37 short children (group 1: mean (SD) age 12.8 (3.5) years; mean (SD) bone age 10.4 (3.6) years; mean (SD) height standard deviation score (SDS) -2.8 (0.7], 16 tall children (group 2: mean age 12.9 (2.8) years; mean bone age 13.9

S A Greene; T Torresani; A Prader

1987-01-01

283

Optimizing the Exercise Test for Pharmacological Studies in Patients with Angina Pectoris  

Microsoft Academic Search

\\u000a On the basis of the multitude of studies performed over the last 20 years, many recommendations could be made concerning optimizing\\u000a the yield and reliability of information from the exercise test for patients with angina. Many of these suggestions, however,\\u000a have escaped application to clinical pharmaceutical trials. The strength of conclusions made in regard to drug efficacy are\\u000a only as

Jonathan Myers; Victor F. Froelicher

284

Current Practice of Exercise Stress Testing Among Pediatric Cardiology and Pulmonology Centers in the United States  

Microsoft Academic Search

The objective of this study was to characterize current practice patterns for clinical exercise stress testing (EST) in children\\u000a in the United States. We conducted a survey of 109 pediatric cardiology programs and 91 pediatric pulmonology programs at\\u000a children’s hospitals or university hospitals in the United States. A total of 115 programs from 88 hospitals responded (response\\u000a rate, 58%). A

R.-K. R. Chang; M. Gurvitz; S. Rodriguez; E. Hong; T. S. Klitzner

2006-01-01

285

Post-exercise gastric emptying of carbohydrate solutions determined using the 13 C acetate breath test  

Microsoft Academic Search

In an attempt to measure gastric emptying of carbohydrate solutions after exercise, we used the 13C acetate breath test to differentiate the gastric emptying of three approximately isoenergetic carbohydrate solutions (i.e. glucose, glucose polymer and sucrose) from each other and from water. On four separate occasions, six post-absorptive subjects walked on an inclined treadmill at 70% maximum oxygen uptake for

G. P. Leese; J. Bowtell; S. Mudambo; N. Reynolds; J. Thompson; C. M. Scrimgeour; M. J. Rennie

1995-01-01

286

Cardiopulmonary Effects of Stressful Exercise at Altitude (4,000 FT) of Individuals with Sickle Cell Trait (HbAS or SCT). Annual Report April 1, 1985 - April 30, 1986.  

National Technical Information Service (NTIS)

Controversy persists regarding the risks assumed by individuals with SCT while engaged in activities that would involve a greater likelihood of exposure to hypoxic environments and other stress situations such as performing strenuous exercise especially a...

I. M. Weisman R. J. Zeballos

1986-01-01

287

Improving the positive predictive value of exercise testing in women for coronary artery disease.  

PubMed

The exercise treadmill test (ETT) in women has been limited by a low positive predictive value (PPV) for coronary artery disease (CAD). However, the reliability of previous studies was unsatisfactory because of the inclusion of younger women with a low prevalence of CAD. To further evaluate the diagnostic properties of the ETT in women, we evaluated a group of women with chest pain who had a positive ETT result and subsequent coronary angiography. Of the 111 women, 56 had significant CAD on angiogram, yielding a PPV of 51% for the group. However, inclusion in the analysis of several pretest attributes and specific exercise test responses improved the PPV of the ETT. Age had a major effect, with the youngest group (35 to 50 years old) having a PPV of 36% compared to 68% in the oldest group (>65 years old). Several specific exercise responses (ST-segment depression >2 mm and delayed ST-segment recovery >3.0 minutes) further separated true from false positives across all age groups, increasing the PPV to approximately 80%. Onset of ischemia at a relatively low cardiac workload of <80% maximum predicted heart rate was not a significant predictor. In conclusion, the standard ETT should remain the test of choice in ambulatory women with chest pain and no significant abnormalities on baseline electrocardiogram especially in those >65 years of age. PMID:23018079

Levisman, Jeffrey M; Aspry, Karen; Amsterdam, Ezra A

2012-09-24

288

Oxidative stress in response to aerobic and anaerobic power testing: influence of exercise training and carnitine supplementation.  

PubMed

The purpose of this study is to compare the oxidative stress response to aerobic and anaerobic power testing, and to determine the impact of exercise training with or without glycine propionyl-L-carnitine (GPLC) in attenuating the oxidative stress response. Thirty-two subjects were assigned (double blind) to placebo, GPLC-1 (1g PLC/d), GPLC-3 (3g PLC/d) for 8 weeks, plus aerobic exercise. Aerobic (graded exercise test: GXT) and anaerobic (Wingate cycle) power tests were performed before and following the intervention. Blood was taken before and immediately following exercise tests and analyzed for malondialdehyde (MDA), hydrogen peroxide (H2O2), and xanthine oxidase activity (XO). No interaction effects were noted. MDA was minimally effected by exercise but lower at rest for both GPLC groups following the intervention (p = 0.044). A time main effect was noted for H2O2 (p = 0.05) and XO (p = 0.003), with values increasing from pre- to postexercise. Both aerobic and anaerobic power testing increase oxidative stress to a similar extent. Exercise training plus GPLC can decrease resting MDA, but it has little impact on exercise-induced oxidative stress biomarkers. PMID:19266389

Bloomer, Richard J; Smith, Webb A

289

Thallium-201 scintigraphy after intravenous infusion of adenosine compared with exercise thallium testing in the diagnosis of coronary artery disease  

SciTech Connect

Adenosine is an endogenously produced compound that has significant effects as a coronary and systemic vasodilator. Previous studies suggest that intravenous infusion of adenosine, coupled with thallium-201 scintigraphy, may have specific value as a noninvasive means of evaluating coronary artery disease. The purpose of this study was to compare the diagnostic value of adenosine thallium testing with that of standard exercise thallium testing. One hundred subjects were studied with exercise thallium imaging and thallium imaging after adenosine infusion, including 47 with angiographically proved coronary artery disease and 53 control subjects. The overall sensitivity of the thallium procedures was 81% for the exercise study and 83% for the adenosine study (p = NS); the specificity was 74% for the exercise study and 75% for the adenosine study (p = NS). The diagnostic accuracy of the exercise study was 77% and that of the adenosine study was 79%. Ninety-four percent of subjects had an adverse effect due to the adenosine infusion; however, most of these effects were mild and well tolerated. All adverse effects abated within 30 to 45 s of the termination of the study, consistent with the very brief half-life of the agent. Thus, thallium-201 scintigraphy after intravenous infusion of adenosine has a diagnostic value similar to that of exercise thallium testing for evaluation of coronary artery disease. Adenosine thallium testing may be particularly useful in evaluating patients unable to perform treadmill exercise testing.

Coyne, E.P.; Belvedere, D.A.; Vande Streek, P.R.; Weiland, F.L.; Evans, R.B.; Spaccavento, L.J. (Department of Medicine, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas (USA))

1991-05-01

290

Ethical issues in cardiopulmonary resuscitation.  

PubMed

If patients are to benefit from resuscitation, they must regain consciousness and their full faculties. In recent years, we have acquired important information about the natural history of neurological recovery from circulatory arrest. There are clinical tests that predict the outcome, both during ongoing cardiopulmonary resuscitation (CPR) and in the period after restoration of spontaneous circulation. The ability to predict neurological outcome at this stage offers a basis for certain ethical considerations, which are not exclusively centered on "do-not-attempt-resuscitation" (DNAR)- orders. Instead of being forced to make the decision that "I do not want CPR", the patient should be able to decide that "I want resuscitation to be discontinued, if you predict that I will not recover to a level of neurological function that is acceptable to me". Ideally, no competent patient should be given a DNAR-status without his or her consent. No CPR-attempt should be stopped, and no treatment decision for a patient recovering after CPR should be taken without knowing and assessing the available information. Good ethical decision-making requires reliable facts, which we now know are available. PMID:11719139

Holm, S; Jørgensen, E O

2001-08-01

291

Treadmill exercise testing of asymptomatic men and women without evidence of heart disease.  

PubMed

The aim of this study was to test the hypothesis of differences in performance including differences in ST-T wave changes between healthy men and women submitted to an exercise stress test. Two hundred (45.4%) men and 241 (54.6%) women (mean age: 38.7 +/- 11.0 years) were submitted to an exercise stress test. Physiologic and electrocardiographic variables were compared by the Student t-test and the chi-square test. To test the hypothesis of differences in ST-segment changes, data were ranked with functional models based on weighted least squares. To evaluate the influence of gender and age on the diagnosis of ST-segment abnormality, a logistic model was adjusted; P < 0.05 was considered to be significant. Rate-pressure product, duration of exercise and estimated functional capacity were higher in men (P < 0.05). Sixteen (6.7%) women and 9 (4.5%) men demonstrated ST-segment upslope >or=0.15 mV or downslope >or=0.10 mV; the difference was not statistically significant. Age increase of one year added 4% to the chance of upsloping of segment ST >or=0.15 mV or downsloping of segment ST >or=0.1 mV (P = 0.03; risk ratio = 1.040, 95% confidence interval (CI) = 1.002-1.080). Heart rate recovery was higher in women (P < 0.05). The chance of women showing an increase of systolic blood pressure

Chalela, W A; Fukushima, R B; Araujo, F; Lima, A C P; Moffa, P J; Mansur, A J

2009-11-06

292

[A study of cardiac dynamics during multistage exercise tests performed on a bycicle ergometer (author's transl)].  

PubMed

The authors analysed the behaviour of the mechanical systole (electromechanical systole; tension time, left ventricular ejection time), as well as of the diastole (both cardiac and hemodynamic diastole) during exercise tests performed on a bycicle ergometer, with 40, 80, 120 watt workloads. The mechanical systole--as well as its components--duration is influenced, during exercise test, by both heart rate and stroke volume--pulse pressure being assumed as an indirect index of the latter. The study of the correlation between the two above mentioned parameters has a great importance in evaluating the cardiac pump efficiency both in health and disease. The study of the behaviour of diastole is likewise very important, as it provides useful information concerning: a) the length of the cardiac muscle post-exercise recovery phase; b) the coronary available perfusion time; c) the Windkessel (arterial bellows) emptying time. Moreover, the blood pressure fall rate in diastole is an useful indirect measure of the peripheral resistance changes during muscular work. A statistical analysis is made and the correlation coefficients and the regression equations between the various parameters are defined. PMID:904418

Gobbato, F; Fiorito, A; Cornelio, G

1977-05-01

293

Albumin Versus Hydroxyethyl Starch in Cardiopulmonary Bypass Surgery: A Meta-Analysis of Postoperative Bleeding  

Microsoft Academic Search

Background. This meta-analysis tested the hypothesis that cumulative blood loss during the first 24 hours after cardiopulmonary bypass is lower in patients exposed to albumin than hydroxyethyl starch (HES). Methods. Randomized controlled trials comparing al- bumin and HES in cardiopulmonary bypass patients were identified by bibliographic database searches and other methods. Results. Sixteen trials involving 653 randomized pa- tients were

Mahlon M. Wilkes; Roberta J. Navickis; William J. Sibbald

2010-01-01

294

Cost Benefit Analysis of Installing a Recovery Exercise Module (REM) in a Cruise Missile for an Operational Test Launch.  

National Technical Information Service (NTIS)

This thesis provides a cost benefit analysis of installing a Recovery Exercise Module (REM) in a Cruise Missile for an Operational Test Launch. Topics considered include: Should the Cruise Missile Project Office (CMPO) continue development of a new redesi...

H. E. Glassman

1987-01-01

295

Validity of an Exercise Test Based on Habitual Gait Speed in Mobility-Limited Older Adults  

PubMed Central

Objective To evaluate whether a customized exercise tolerance testing (ETT) protocol based on an individual’s habitual gait speed (HGS) on level ground would be a valid mode of exercise testing older adults. Although ETT provides a useful means to risk-stratify adults, age-related declines in gait speed paradoxically limit the utility of standard ETT protocols for evaluating older adults. A customized ETT protocol may be a useful alternative to these standard methods, and this study hypothesized that this alternative approach would be valid. Design We performed a cross-sectional analysis of baseline data from a randomized controlled trial of older adults with observed mobility problems. Screening was performed using a treadmill-based ETT protocol customized for each individual’s HGS. We determined the content validity by assessing the results of the ETTs, and we evaluated the construct validity of treadmill time in relation to the Physical Activity Scale for the Elderly (PASE) and the Late Life Function and Disability Instrument (LLFDI). Setting Outpatient rehabilitation center. Participants Community-dwelling, mobility-limited older adults (N = 141). Interventions Not applicable. Main Outcome Measures Cardiac instability, ETT duration, peak heart rate, peak systolic blood pressure, PASE, and LLFDI. Results Acute cardiac instability was identified in 4 of the participants who underwent ETT. The remaining participants (n = 137, 68% female; mean age, 75.3y) were included in the subsequent analyses. Mean exercise duration was 9.39 minutes, with no significant differences in durations being observed after evaluating among tertiles by HGS status. Mean peak heart rate and mean peak systolic blood pressure were 126.6 beats/ min and 175.0mmHg, respectively. Within separate multivariate models, ETT duration in each of the 3 gait speed groups was significantly associated (P<.05) with PASE and LLFDI. Conclusions Mobility-limited older adults can complete this customized ETT protocol, allowing for the identification of acute cardiac instability and the achievement of optimal exercise parameters.

Li, Xin; Forman, Daniel E.; Kiely, Dan K.; LaRose, Sharon; Hirschberg, Ronald; Frontera, Walter R.; Bean, Jonathan F.

2013-01-01

296

Prognostic utility of the exercise thallium-201 test in ambulatory patients with chest pain: comparison with cardiac catheterization  

Microsoft Academic Search

The goal of this study was to determine the prognostic utility of the exercise thallium-201 stress test in ambulatory patients with chest pain who were also referred for cardiac catheterization. Accordingly, 4 to 8 year (mean +\\/- 1SD, 4.6 +\\/- 2.6 years) follow-up data were obtained for all but one of 383 patients who underwent both exercise thallium-201 stress testing

S. Kaul; D. R. Lilly; J. A. Gascho; D. D. Watson; R. S. Gibson; C. A. Oliner; J. M. Ryan; G. A. Beller

1988-01-01

297

Identification of a Core Set of Exercise Tests for Children and Adolescents with Cerebral Palsy: A Delphi Survey of Researchers and Clinicians  

ERIC Educational Resources Information Center

|Aim: Evidence-based recommendations regarding which exercise tests to use in children and adolescents with cerebral palsy (CP) are lacking. This makes it very difficult for therapists and researchers to choose the appropriate exercise-related outcome measures for this group. This study aimed to identify a core set of exercise tests for children…

Verschuren, Olaf; Ketelaar, Marjolijn; Keefer, Daniel; Wright, Virginia; Butler, Jane; Ada, Louise; Maher, Carol; Reid, Siobhan; Wright, Marilyn; Dalziel, Blythe; Wiart, Lesley; Fowler, Eileen; Unnithan, Viswanath; Maltais, Desiree B.; van den Berg-Emons, Rita; Takken, Tim

2011-01-01

298

Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy  

SciTech Connect

Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets.

Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Bourassa, M.G.

1984-07-01

299

Comparative value of maximal treadmill testing, exercise thallium myocardial perfusion scintigraphy and exercise radionuclide ventriculography for distinguishing high- and low-risk patients soon after acute myocardial infarction  

SciTech Connect

The prognostic value of symptom-limited treadmill exercise electrocardiography, exercise thallium myocardial perfusion scintigraphy and rest and exercise radionuclide ventriculography was compared in 117 men, aged 54 +/- 9 years, tested 3 weeks after a clinically uncomplicated acute myocardial infarction (MI). During a mean follow-up period of 11.6 months, 8 men experienced ''hard'' medical events (cardiac death, nonfatal ventricular fibrillation or recurrent MI) and 14 were hospitalized for unstable angina pectoris, congestive heart failure or coronary bypass surgery (total of 22 combined events). By multivariate analysis (Cox proportional hazards model), peak treadmill work load and the change in left ventricular ejection fraction (EF) during exercise were significant (p less than 0.01) predictors of hard medical events; these 2 risk factors and recurrent ischemic chest pain in the coronary care unit were also significantly predictive (p less than 0.001) for combined events. A peak treadmill work load of 4 METs or less or a decrease in EF of 5% or more below the value at rest during submaximal effort distinguished 22 high-risk patients (20% of the study population) from 89 low-risk patients. The rate of hard medical events within 12 months was 23% (5 of 22 patients), vs 2% (2 of 89 patients) in the high- and low-risk patient subsets, respectively (p less than 0.001). Thus, in patients who underwent evaluation 3 weeks after a clinically uncomplicated MI, exercise radionuclide ventriculography contributed independent prognostic information to that provided by symptom-limited treadmill testing and was superior to exercise thallium scintigraphy for this purpose.

Hung, J.; Goris, M.L.; Nash, E.; Kraemer, H.C.; DeBusk, R.F.; Berger, W.E.; Lew, H.

1984-05-01

300

Test-retest reliability of barbell velocity during the free-weight bench-press exercise.  

PubMed

The purpose of this study was to calculate test-retest reliability statistics for peak barbell velocity during the free-weight bench-press exercise for loads corresponding to 10-90% of the 1-repetition maximum (1RM). Twenty-one healthy, resistance-trained men (mean ± SD age = 23.5 ± 2.7 years; body mass = 90.5 ± 14.6 kg; 1RM bench press = 125.4 ± 18.4 kg) volunteered for this study. A minimum of 48 hours after a maximal strength testing and familiarization session, the subjects performed single repetitions of the free-weight bench-press exercise at each tenth percentile (10-90%) of the 1RM on 2 separate occasions. For each repetition, the subjects were instructed to press the barbell as rapidly as possible, and peak barbell velocity was measured with a Tendo Weightlifting Analyzer. The test-retest intraclass correlation coefficients (model 2,1) and corresponding standard errors of measurement (expressed as percentages of the mean barbell velocity values) were 0.717 (4.2%), 0.572 (5.0%), 0.805 (3.1%), 0.669 (4.7%), 0.790 (4.6%), 0.785 (4.8%), 0.811 (5.8%), 0.714 (10.3%), and 0.594 (12.6%) for the weights corresponding to 10-90% 1RM. There were no mean differences between the barbell velocity values from trials 1 and 2. These results indicated moderate to high test-retest reliability for barbell velocity from 10 to 70% 1RM but decreased consistency at 80 and 90% 1RM. When examining barbell velocity during the free-weight bench-press exercise, greater measurement error must be overcome at 80 and 90% 1RM to be confident that an observed change is meaningful. PMID:21157383

Stock, Matt S; Beck, Travis W; DeFreitas, Jason M; Dillon, Michael A

2011-01-01

301

Significance of repeated exercise testing with thallium-201 scanning in asymptomatic diabetic males  

SciTech Connect

This study was conducted with asymptomatic middle-aged male subjects with diabetes mellitus to detect latent cardiac disease using noninvasive techniques. One group of 38 diabetic males (mean age 50.5 +/- 10.2 years) and a group of 15 normal males (mean age 46.9 +/- 10.0 years) participated in the initial trial; 13 diabetic patients and 7 control subjects were restudied 1-2 years later. Maximal treadmill exercise with a Bruce protocol and myocardial scintigraphy with thallium-201(201Tl) were used. Diabetic subjects on initial examination and retesting achieved a lower maximal heart rate and duration of exercise than control subjects. Abnormal electrocardiographic changes, thallium defects, or both were observed in 23/38 diabetic males (60.5%) on the first study and only one 65-year-old control subject had such findings. On retesting, the control subjects had no abnormalities while 76.9% of diabetic subjects had either 201Tl defects or ECG changes. We conclude that despite the fact that none of diabetic males had any clinical evidence or symptoms of heart disease, this high-risk group demonstrated abnormalities on exercise testing that merit careful subsequent evaluation and followup and could be an effective method of detecting early cardiac disease.

Rubler, S.; Fisher, V.J.

1985-12-01

302

Heart rate recovery in exercise test in diabetic patients with and without microalbuminuria  

PubMed Central

BACKGROUND Diabetes mellitus (DM) has a lot of complications such as macrovessel and microvessel disease. Another complication of DM is cardiac autonomic neuropathy (CAN), which have effect on automatic nervous system of heart. Failure in heart rate slowing after exercise is a presentation of this abnormality. METHODS We selected diabetic patients and divided them to case and control group based on microalbuminuria. Case group comprised of diabetic patients with microalbuminuria and control group included those without microalbuminuria. Patients in both groups exercised on treadmill using Bruce protocol and heart rate was measured in first and second minutes in the recovery period. RESULTS We selected 35 patients with microalbuminuria (case group) and 35 without microalbuminuria (control group) among diabetic patients. No statistically significant difference was seen in sex and age between case and control groups. Heart rate recovery in the first minute of recovery in the case and control groups did not show significant difference; but in the second minute of recovery, it was significantly higher in control group (97 ± 19.4 vs. 101.9 ± 12.4 beat per minute, P = 0.04). CONCLUSION In this study we evaluated the heart rate recovery or deceleration in diabetic patients with albuminuria and without microalbuminuria in recovery phase after exercise test. We found out that heart rate recovery at the second minute in the case and control groups has statistically significant difference but at the first minute, it did not.

Pourmoghaddas, Ali; Moghaddasian, Adrineh; Garakyaraghi, Mohammad; Nezarat, Negin; Mehrabi, Ali

2013-01-01

303

Exercise stress tests for detecting myocardial ischemia in asymptomatic patients with diabetes mellitus.  

PubMed

The predominant cause of death in diabetes mellitus (DM) is coronary artery disease (CAD). Little is known about prevalence of silent ischemia in developing nations. We compared prevalence of silent ischemia in DM to a control group by exercise myocardial perfusion imaging (MPI) and electrocardiogram (ECG) in developing nations. The prospective multinational Ischemia Assessment with Exercise imaging in Asymptomatic Diabetes study recruited participants at 12 sites in Asia, Africa, and Latin America. DM participants were age- and gender-matched 2:1 to non-DM individuals with ?1 CAD risk factor. Subjects underwent exercise tests that were interpreted in core labs in blinded fashion. The study included 392 DM and 205 control participants. Among participants with diagnostic ECGs, a similar proportion of DM and controls had ischemic ECG (15% vs 12%, p = 0.5). A significantly higher proportion of DM group had MPI abnormalities compared with controls (26% vs 14%, p <0.001). In participants with ischemia on MPI, only 17% had ischemic ECG, whereas in those without ischemia on MPI, 10% had ischemic ECG. In a multivariable model, DM was independently associated with abnormal MPI (odds ratio 2.1, 95% confidence interval 1.3-3.5, p = 0.004). Women were less likely to have ischemia by MPI than men (10% vs 30%, p <0.001) and concordance between ECG and MPI was much worse in women. In conclusion, in this large prospective study, asymptomatic DM participants had (1) more ischemia by exercise MPI than ECG, (2) more ischemia by MPI but not ECG than control group, and (3) ischemia by MPI was less in women than men. PMID:23578350

Hage, Fadi G; Lusa, Lara; Dondi, Maurizio; Giubbini, Raffaele; Iskandrian, Ami E

2013-04-08

304

Response to exercise in patients with liver cirrhosis: implications for liver transplantation.  

PubMed

End-stage liver cirrhosis is a systemic disease carrying a short-term desperate prognosis without liver transplantation. Given the discrepancy between the growing number of candidates and the limited available liver grafts, the pre-transplantation screening process has become a challenging task. Cardiopulmonary exercise testing, by measuring maximal oxygen consumption at peak exercise, provides a global integrative approach of the health status of an individual. In the setting of liver cirrhosis, decreased oxygen consumption at peak exercise may result from a combination of multiple extra-hepatic complications, including deconditioning, malnutrition-associated muscle weakness, anaemia, cirrhotic cardiomyopathy, and hepato-pulmonary syndrome for instance. In addition, oxygen consumption at peak exercise not only correlated with the severity of the liver disease, but it is also independently associated with survival following liver transplantation. The present article aims to review the numerous determinants of impaired aerobic capacity in patients with severe liver disease, and to discuss how useful is cardiopulmonary exercise testing as a critical tool in the pre-transplantation assessment of these patients. PMID:23137795

Lemyze, Malcolm; Dharancy, Sébastien; Wallaert, Benoît

2012-11-06

305

Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation  

PubMed Central

Cardiopulmonary exercise testing (CPET) is an established method for evaluating dyspnea and ventilatory abnormalities. Ventilatory reserve is typically assessed as the ratio of peak exercise ventilation to maximal voluntary ventilation. Unfortunately, this crude assessment provides limited data on the factors that limit the normal ventilatory response to exercise. Additional measurements can provide a more comprehensive evaluation of respiratory mechanical constraints during CPET (e.g., expiratory flow limitation and operating lung volumes). These measurements are directly dependent on an accurate assessment of inspiratory capacity (IC) throughout rest and exercise. Despite the valuable insight that the IC provides, there are no established recommendations on how to perform the maneuver during exercise and how to analyze and interpret the data. Accordingly, the purpose of this manuscript is to comprehensively examine a number of methodological issues related to the measurement, analysis, and interpretation of the IC. We will also briefly discuss IC responses to exercise in health and disease and will consider how various therapeutic interventions influence the IC, particularly in patients with chronic obstructive pulmonary disease. Our main conclusion is that IC measurements are both reproducible and responsive to therapy and provide important information on the mechanisms of dyspnea and exercise limitation during CPET.

Guenette, Jordan A.; Chin, Roberto C.; Cory, Julia M.; Webb, Katherine A.; O'Donnell, Denis E.

2013-01-01

306

Measurement of coronary calcium scores or exercise testing as initial screening tool in asymptomatic subjects with STT changes on the resting ECG: an evaluation study  

Microsoft Academic Search

BACKGROUND: Asymptomatic subjects at intermediate coronary risk may need diagnostic testing for risk stratification. Both measurement of coronary calcium scores and exercise testing are well established tests for this purpose. However, it is not clear which test should be preferred as initial diagnostic test. We evaluated the prevalence of documented coronary artery disease (CAD) according to calcium scores and exercise

Christiane A Geluk; Riksta Dikkers; Jan A Kors; René A Tio; Riemer HJA Slart; Rozemarijn Vliegenthart; Hans L Hillege; Tineke P Willems; Paul E de Jong; Wiek H van Gilst; Matthijs Oudkerk; Felix Zijlstra

2007-01-01

307

Exercise, plasma catecholamine concentrations and decision-making performance of soccer players on a soccer-specific test  

Microsoft Academic Search

The main aim of this study was to compare the decision-making performance of college soccer players on a soccer-specific, tachistoscopically presented test, at rest and while exercising at their adrenaline threshold and at their maximum power output. These were determined following an incremental test to exhaustion on a cycle ergometer. After the initial maximum power test, participants (n= 9) were

STEVE MYERS; WILLIAM W. MacGILLIVARY; JAMES R. SEXSMITH; JOANNE FALLOWFIELD; JAN GRAYDON; DAVID FORSTER

1999-01-01

308

Cardiopulmonary response and body composition changes after prolonged high altitude exposure in women.  

PubMed

Weight loss in men is commonly observed during prolonged high altitude exposure as a result of a daily negative energy balance. Its amount depends mainly on duration of exposure, altitude reached, and level of physical activity. This reduction in body weight often comes with a loss of muscular mass, likely contributing to the decreased physical performance generally reported. Limited data is, however, available on body composition, functional capacity, and cardiopulmonary response to exercise after high altitude exposure in women. The aim of this study was to evaluate the effects of prolonged high altitude exposure on body composition and on cardiopulmonary response to maximal exercise in a group of young, moderately active women. Twelve female subjects, aged 21.5 ± 3.1 (mean ± SD), BMI 22.1 ± 1.9 kg · m(-2) and Vo(2max) 33.8 ± 3.5 mL · kg(-1) · min(-1), participated in this study, by residing for 21 days at high altitude (5050 m, Pyramid, EV-K(2)-CNR laboratory). Before and after high altitude exposure, all subjects underwent both a body composition evaluation using two methods (bioimpedance analysis and DEXA) and a functional evaluation based on a maximal exercise test on a cycle ergometer with breath-by-breath gas analysis. After high altitude exposure, data showed a slight, nonsignificant reduction in body weight, with an average 3:2 reduction ratio between fat and fat-free mass evaluated by DEXA, in addition to a significant decrease in Vo(2max) on the cycle ergometer test (p<0.01). Changes in Vo(2max) correlated to changes of leg muscle mass, evaluated by DEXA (r(2) = 0.72; p<0.0001). No changes were observed in the maximal heart rate, work capacity, and ventilatory thresholds, while the Vo(2)/W slope was significantly reduced (p<0.05). Finally, Ve/Vo(2) and VE/Vco(2max) slopes were increased (p<0.01), suggesting a possible long-term modulation of the exercise ventilatory response after prolonged high altitude exposure. PMID:22206562

Ermolao, Andrea; Bergamin, Marco; Rossi, Alberto Carlo; Dalle Carbonare, Luca; Zaccaria, Marco

2011-01-01

309

High-sensitivity C-reactive protein levels and treadmill exercise test responses in men and women without overt heart disease  

PubMed Central

BACKGROUND: C-reactive protein (CRP) is a marker of systemic inflammatory activity and may be modulated by physical fitness. Treadmill exercise testing is used to evaluate cardiovascular health through different variables including exercise capacity, heart rate and blood pressure responses. It was hypothesized that CRP levels are associated with these variables in men and women without overt heart disease. METHODS: A total of 584 asymptomatic subjects (317 [54.3%] women and 267 [45.7%] men) were enrolled in the present study and underwent clinical evaluation. CRP levels in men and women were examined relative to clinical characteristics and to variables of treadmill exercise testing: peak heart rate, exercise systolic blood pressure, exercise time, chronotropic reserve and heart rate recovery at the first and second minutes after exercise. Multivariate analysis was performed using a log-linear regression model. RESULTS: In women, exercise time on the treadmill exercise test (P=0.009) and high-density lipoprotein cholesterol levels (P=0.002) were inversely associated with CRP levels. Body mass index (P<0.001) and total cholesterol levels (P=0.005) were positively associated with CRP levels. In men, exercise time on the treadmill exercise test was inversely associated with CRP levels (P=0.015). Body mass index (P=0.001) and leukocyte count (P=0.002) were positively associated with CRP levels. CRP levels were not associated with peak heart rate, chronotropic reserve, heart rate recovery at the first and second minutes, or exercise systolic blood pressure. CONCLUSIONS: These findings contribute to the evidence that CRP is lower in individuals with better exercise capacity and demonstrate that this relationship is also apparent in individuals without overt heart disease undergoing cardiovascular evaluation through the treadmill exercise test. Lowering inflammatory markers may be an additional reason to stimulate sedentary individuals with low exercise capacity in the treadmill exercise test to improve physical conditioning through regular exercise.

Nunes, Rafael Amorim Belo; Araujo, Fernando; Correia, Gustavo F; da Silva, Gisela T; Mansur, Alfredo J

2013-01-01

310

Prognostic utility of intravenous dipyridamole thallium-201 imaging and exercise testing after an acute infarction  

SciTech Connect

To define the prognosis in asymptomatic survivors of acute infarcts (MI), coronary vasodilation was induced with I.V. dipyridamole, followed by Thallium-201 (T1) imaging in 26 patients just prior to discharge. All patients (pts) also had a modified exercise treadmill (MET) test. During the imaging protocol, 10 (39%) pts experienced transient adverse effects and 12 (46%) pts had either angina or ST depression with MET. During a mean follow-up of 17 months, 13 (50%) pts had a cardiac event defined as readmission for control of angina, MI or death. In the 13 pts having cardiac events, 4 (31%) had ST depression and 2 (15%) had angina during MET, but 12 (92%) demonstrated T1 redistribution (RD) as determined by at least 1 segment/scan having a transient defect. A logistic regression analysis using several exercise, scintigraphic and general clinical parameters, showed that the presence of T1 RD was the only significant (p <0.001) predictor for future cardiac events. The predicted probability for events in pts with T1 RD was 80 +- 10% (SD) and was 9 +- 9% in those without T1 RD. The mean number of defects per scan was similar in pts with and without cardiac events, but compared to persistent defects, transient ones are associated with potentially ischemic myocardium. Although the pt population is relatively small, dipyridamole T1 imaging after MI appears to be safe and has demonstrated prognostic value. It also offers an alternative and/or addition to exercise testing in the predischarge evaluation after acute MI.

Leppo, J.A.

1984-01-01

311

Differences in blood pressure and heart rate response to exercise stress test between white coat and established hypertensives  

Microsoft Academic Search

To evaluate the circadian variations and exercise response patterns of blood pressure (BP) and heart rate (HR) in white coat (WC-HT) and established hypertensives (E-HT), we performed 48-hr ambulatory BP monitoring (TM-2425, A&D, Japan) and symptom-limited treadmill exercise test (CASE-12, Marquette, USA; STBP-680,Colin, Japan) using a Bruce protocol at 15:00-17:00 in 109 untreated outpatients with mild to moderate essential hypertension.

Hiroshi Ijiri; Isao Kohno; Takashi Iida; Sadayoshi Komori; Kohji Tamura

2001-01-01

312

Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome  

Microsoft Academic Search

In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of

Maria Elena Poyatos; Luis Suarez; Jorge Lerman; Haydee Guibourg; Julio Camps; Albino Perosio

1986-01-01

313

Exercise dysfunction in patients seropositive for the human immunodeficiency virus  

SciTech Connect

To confirm the presence of exercise dysfunction in patients seropositive for the human immunodeficiency virus (HIV), 32 such patients without AIDS were evaluated with cardiopulmonary exercise testing, pulmonary function testing, bronchoalveolar lavage, chest roentgenography, and gallium scanning. No evidence of pulmonary opportunistic infection was found. When compared to an otherwise similar group of HIV-seronegative controls, the patients exercised to a significantly lower workload (195 +/- 30 versus 227 +/- 31 W, p less than 0.001). The ventilatory anaerobic threshold (VAT) values were also significantly lower for the patients (49.2 +/- 13.0 versus 61.9 +/- 9.1% of maximum predicted VO2, p less than 0.001). Nine of the patients had VAT values less than the 95% confidence interval for the controls. This subgroup exercised to a significantly lower maximum VO2 (69.9 +/- 11.2 versus 95.9 +/- 17.5% of maximum predicted VO2, p less than 0.001) and workload (165 +/- 21 versus 227 +/- 31 W) when compared to the control group. These patients demonstrated a mild tachypnea throughout exercise relative to the controls and had a significant increase in the slope of the heart rate to VO2 relationship. These findings are most consistent with a limitation of oxygen delivery to exercising muscles, which may represent occult cardiac disease in this group.

Johnson, J.E.; Anders, G.T.; Blanton, H.M.; Hawkes, C.E.; Bush, B.A.; McAllister, C.K.; Matthews, J.I. (Brooke Army Medical Center, Fort Sam Houston, TX (USA))

1990-03-01

314

Electrocardiographic exercise testing and ambulatory monitoring to identify patients with ischemic heart disease at high risk of sudden death.  

PubMed

Prognostic significance of ambulatory electrocardiographic monitoring and exercise testing was studied in 144 patients with established ischemic heart disease. A follow-up study showed that 10 sudden deaths occurred within 2 years. The univariates most strongly associated with the subsequent occurrence of sudden death included reduced maximal exercise heart rate, exercise-induced frequent ventricular arrhythmias, complex ventricular arrhythmias revealed by 24 hour ambulatory electrocardiographic monitoring and onset of S-T segment depression during exercise testing. Groups of patients at very high and very low risk of sudden death were identified using conjunction and inclusive disjunction of the foregoing variable. The presence of bivariate and trivariate combinations was associated with an increase up to 20-fold in the incidence of sudden death. Patients with the poorest prognosis were those who stopped exercise before achieving a high heart rate and who exhibited either pronounced electrocardiographic abnormalities during stress testing or complex ventricular arrhythmias during ambulatory monitoring. Combinations of exercise variables identified patients at a very high risk of sudden death, whereas combinations of monitoring variables appeared to be preferable for defining groups of patients at very low risk. The results obtained suggest that the two methods carry different prognostic information and, therefore, may complement each other in identifying potential victims of sudden cardiac death. PMID:7377111

Ivanova, L A; Mazur, N A; Smirnova, T M; Sumarokov, A B; Nazarenko, V A; Svet, E A

1980-06-01

315

Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder  

ERIC Educational Resources Information Center

The purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this…

Wu, Sheng K.; Lin, Hsiao-Hui; Li, Yao-Chuen; Tsai, Chia-Liang; Cairney, John

2010-01-01

316

Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder  

ERIC Educational Resources Information Center

|The purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this…

Wu, Sheng K.; Lin, Hsiao-Hui; Li, Yao-Chuen; Tsai, Chia-Liang; Cairney, John

2010-01-01

317

Exercise Treadmill Testing Using a Modified Exercise Protocol in Women With Suspected Myocardial Ischemia: Findings From the National Heart, Lung and Blood Institute–Sponsored Women’s Ischemia Syndrome Evaluation (WISE)  

Microsoft Academic Search

Background Exercise testing, a major diagnostic modality in individuals with suspected coronary artery disease (CAD), has in general demonstrated less overall diagnostic accuracy in women compared to men. As part of the WISE, a modified protocol was examined with the intention of improving reliability of exercise testing. Methods Criteria for entry in the WISE study include clinically indicated coronary angiography.

Jannet F. Lewis; Susan McGorray; L. Lin

2005-01-01

318

Assessment of coronary calcification by electron-beam computed tomography in symptomatic patients with normal, abnormal or equivocal exercise stress test  

Microsoft Academic Search

Aims Exercise stress testing is often used as the initial non-invasive diagnostic test in symptomatic patients with suspected obstructive coronary artery disease. Positive stan- dard ECG criteria are quite specific for obstructive cor- onary artery disease, but there may be a substantial number of false negative tests, including patients with severe cor- onary artery disease. Also, exercise stress tests frequently

A. Schmermund; D. Baumgart; S. Sack; S. Mohlenkamp; D. Gronemeyer; R. Seibel; R. Erbel

2000-01-01

319

Comparison of dobutamine infusion and supine bicycle exercise for radionuclide cardiac stress testing  

SciTech Connect

A comparison is made of the inotropic drug dobutamine to supine bicycle exercise as a means of inducing stress in radionuclide ventriculography studies. Dobutamine has the following properties, making it favorable for widespread usage: 1) ability to be given safely in a peripheral vein, 2) rapid onset, and 3) short duration of action. Each patient underwent supine bicycle progressive resistance testing of 2 minutes per stage followed 30 minutes later by dobutamine administration. Accuracy of diagnosis was 0.93 and sensitivity was 0.89 with dobutamine, while with bicycle the accuracy was 0.93 and sensitivity was 0.94. While not designed to replace supine bicycle testing, incremental infusions of dobutamine appear to be nearly equal in accuracy and sensitivity, providing a satisfactory technique for cardiac evaluation of previously excluded patients.

Freeman, M.L.; Palac, R.; Mason, J.; Barnes, W.E.; Eastman, G.; Virupannavar, S.; Loeb, H.S.; Kaplan, E.

1984-05-01

320

The development and testing of the pelvic floor muscle exercise self-efficacy scale.  

PubMed

The purpose of this study was to establish a reliable and valid instrument to evaluate women' s confidence in performing pelvic floor muscle exercise (PFME). Based on the researcher' s own experience and with extended literature review, social cognitive theory and a health promotion model were utilized to formulate the 17-item Chen pelvic floor muscle exercise self-efficacy (PFMSE) scale. Data were collected from 106 urinarily incontinent women and the reliability and validity of the scale were tested. The results showed that the scale has a high Cronbach' s alpha of .95 for its internal consistency. Test-retest reliability over 6-30 days was r = .86 (p < .001), showing acceptable stability of the Chen PFMSE scale. Exploratory factor analysis was used to test the initial construct validity, and two factors were extracted, which explained 34.16% and 32.55% of the total variance respectively, with a total of 66.71% . The two factors were named as (1) belief in PFME execution and its benefits, and (2) belief in performing PFME as scheduled and despite barriers. It is also evident that the Chen PFMSE scale satisfies concurrent validity when compared with well-developed and tested instruments such as general self-efficacy ( GSE), perceived PFME benefits, and incontinence impact questionnaire-7 (IIQ-7). The results suggest that the Chen PFMSE scale has solid psychometric properties, and is a useful tool for clinicians to design appropriate interventions and to foster positive PFME self-efficacy during treatment for women with urinary incontinence and undergoing PFME training. PMID:15619176

Chen, Shu-Yueh

2004-12-01

321

Early exercise testing after treatment with thrombolytic drugs for acute myocardial infarction: importance of reciprocal ST segment depression.  

PubMed Central

OBJECTIVE--To investigate the clinical importance of reciprocal ST depression induced by exercise testing early after acute myocardial infarction in patients treated with thrombolysis. DESIGN--Prospective observational study. SETTING--District general hospital in London. SUBJECTS--202 patients (170 men) aged 33-69 with acute myocardial infarction treated with thrombolysis. MAIN OUTCOME MEASURES--All patients underwent exercise testing and coronary arteriography. ST depression induced by exercise was classified as either reciprocal (associated with ST elevation) or isolated (occurring on its own). The relation between reciprocal ST depression and the following end points was studied: characteristics of the infarct, left ventricular ejection fraction, extent of coronary artery disease on arteriography, and presence of angina induced by exercise. RESULTS--Reciprocal ST depression occurred almost exclusively in Q wave infarctions and was associated with a lower overall ejection fraction than isolated ST depression. It tended to be associated with persistent occlusion of the coronary artery related to the infarct and did not indicate remote ischaemia due to multivessel coronary disease. Unlike isolated ST depression, reciprocal ST depression was not associated with angina induced by exercise. CONCLUSIONS--Reciprocal ST depression induced by exercise is usually associated with extensive Q wave infarctions and persistent occlusion of the artery related to the infarct. It does not seem to indicate reversible ischaemia and should not be used as a non-invasive marker of multivessel disease in the assessment of requirements for further investigation soon after acute myocardial infarction.

Stevenson, R. N.; Umachandran, V.; Ranjadayalan, K.; Roberts, R. H.; Timmis, A. D.

1994-01-01

322

Testing a self-determination theory-based teaching style intervention in the exercise domain  

Microsoft Academic Search

Drawing from self-determination theory (SDT), this study examined the effect of an autonomy supportive, well structured and interpersonally involving teaching style on exercise class participants' psychological need satisfaction, motivational regulations, exercise behaviour, behavioural intention and affect. Female exercise class participants enrolled in a 10-week exercise program were exposed to an SDT-based (i.e. SDTc; n ¼ 25) or typical (i.e. control

Jemma Edmunds; Nikos Ntoumanis; Joan L Duda

2008-01-01

323

Can a functional postural exercise improve performance in the cranio-cervical flexion test?--a preliminary study.  

PubMed

Deep cervical flexor (DCF) muscle impairment is common in patients with neck pain. Retraining function is often commenced with a motor relearning approach, requiring the patient to practice and hold a cranio-cervical flexion position in supine lying. Motor relearning requires multiple repetitions which is difficult to achieve if only exercising in supine. This preliminary study investigated the effects of training the DCF with a functional exercise: assumption of an upright lumbo-pelvic and spinal postural position, adding a neck lengthening manoeuvre. The exercise effect was evaluated by changes in sternocleidomastoid (SCM) muscle activity in the cranio-cervical flexion test (CCFT). Twenty subjects with neck pain were randomly assigned to an exercise or control group. The exercise group trained for two weeks. Pre and post-intervention, electromyographic (EMG) signals were recorded from the SCM muscles during the five stages of the CCFT. Results indicated that the exercise improved performance. SCM EMG signal amplitudes decreased across all CCFT stages, albeit significant only at the first and third stages of the test; 22 mmHg (p = 0.043) and 26 mmHg (p = 0.003). No differences were evident in the control group (all p > 0.05). There was no difference between groups for pain and disability measures. This initial study indicates that a postural exercise, convenient to perform during the working day, improves the pattern of SCM muscle activity in the CCFT. Whilst further research is necessary, these observations suggest the worth of such an exercise to augment other training in the rehabilitation of patients with neck pain. PMID:22310655

Beer, Alexi; Treleaven, Julia; Jull, Gwendolen

2012-02-04

324

[Effect of beta adrenergic blocking drugs on the prognostic value of ST-segment depression during exercise electrocardiogram testing].  

PubMed

Exercise testing has been shown to be predictive for future cardiac events in patients with established diagnosis of coronary heart disease. Exercise test parameters associated with poor prognosis may be unreliable if patient is receiving beta adrenergic agents. The purpose of this study was: 1) to compare the results of exercise testing performed before and during beta blocking therapy, and 2) to determine the role of beta blockers in the prognostic significance of the ST-segment response recorded during exercise testing. The study population consisted of 518 patients (mean age 52 +/- 7 years) with coronary heart disease. The diagnosis was based on the presence of one of the following three criteria: 1) typical history and significant ST-segment depression on resting or exercise electrocardiogram, 2) history of myocardial infarction, 3) significant coronary angiographic abnormalities. In all patients symptom-limited exercise test was performed before and two weeks after the onset of beta blocker therapy. The data from the first and second tests were estimated for significance of differences between the mean values with following results: maximal heart rate--135 +/- 21 and 123 +/- 19 bpm (p less than 0.001), maximal work load achieved--98 +/- 43 and 109 +/- 44 W (p less than 0.001), maximal systolic blood pressure--171 +/- 28 and 163 +/- 26 mmHg (p less than 0.001). Occurrence of characteristic ST-segment depression was more frequent during the first than during the second test (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1351545

Dabrowski, A; Kubik, L; Piotrowicz, R; Giec, L; Kuch, J; Pasyk, S; Piwowarska, W; Pracka, H; Sadowski, Z; Trusz-Gluza, M

1992-03-01

325

Ambulatory ST-recording has no additional value to exercise test for identification of severe coronary lesions after an episode of unstable coronary artery disease in men  

Microsoft Academic Search

One month after an episode of unstable coronary artery disease, 95 male patients performed coronary angiography, 48 hours ambulatory ST-recording and also an exercise test. ST-depression occurred in 29.5% during the ST-recording and in 44.2% during the exercise test (p<0.05). In patients with ST-depression at ambulatory monitoring, 79% demonstrated the same finding at the exercise test. A high risk response

Jan-Erik Karlsson; Anders Björkholm; Peter Blomstrand; Jan Ohlsson; Lars Wallentin

1993-01-01

326

Accurate detection of coronary artery disease by integrated analysis of the ST-segment depression\\/heart rate patterns during the exercise and recovery phases of the exercise electrocardiography test  

Microsoft Academic Search

In this comparative cross-sectional study, we evaluated whether a novel computerized diagnostic variable, ST-segment depression\\/heart rate (STHR) hysteresis, which integrates the efficient STHR analysis during both the exercise and postexercise recovery phases of the exercise electrocardiography (ECG) test, can detect coronary artery disease more accurately than methods using either exercise or recovery phase alone. The study population comprised 347 clinical

Rami Lehtinen; Harri Sievänen; Jari Viik; Väinö Turjanmaa; Kari Niemelä; Jaakko Malmivuo

1996-01-01

327

Estimation of Maximal Oxygen Uptake via Submaximal Exercise Testing in Sports, Clinical, and Home Settings.  

PubMed

Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake [Formula: see text] provides valuable information about their aerobic power. In the clinical setting, the [Formula: see text] provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, [Formula: see text] assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [Formula: see text] is the most accurate method, it requires a maximal level of exertion, which brings a higher risk of adverse events in individuals with an intermediate to high risk of cardiovascular problems. Estimation of [Formula: see text] during submaximal exercise testing can offer a precious alternative. Over the past decades, many protocols have been developed for this purpose. The present review gives an overview of these submaximal protocols and aims to facilitate appropriate test selection in sports, clinical, and home settings. Several factors must be considered when selecting a protocol: (i) The population being tested and its specific needs in terms of safety, supervision, and accuracy and repeatability of the [Formula: see text] estimation. (ii) The parameters upon which the prediction is based (e.g. heart rate, power output, rating of perceived exertion [RPE]), as well as the need for additional clinically relevant parameters (e.g. blood pressure, ECG). (iii) The appropriate test modality that should meet the above-mentioned requirements should also be in line with the functional mobility of the target population, and depends on the available equipment. In the sports setting, high repeatability is crucial to track training-induced seasonal changes. In the clinical setting, special attention must be paid to the test modality, because multiple physiological parameters often need to be measured during test execution. When estimating [Formula: see text], one has to be aware of the effects of medication on heart rate-based submaximal protocols. In the home setting, the submaximal protocols need to be accessible to users with a broad range of characteristics in terms of age, equipment, time available, and an absence of supervision. In this setting, the smart use of sensors such as accelerometers and heart rate monitors will result in protocol-free [Formula: see text] assessments. In conclusion, the need for a low-risk, low-cost, low-supervision, and objective evaluation of [Formula: see text] has brought about the development and the validation of a large number of submaximal exercise tests. It is of paramount importance to use these tests in the right context (sports, clinical, home), to consider the population in which they were developed, and to be aware of their limitations. PMID:23821468

Sartor, Francesco; Vernillo, Gianluca; de Morree, Helma M; Bonomi, Alberto G; La Torre, Antonio; Kubis, Hans-Peter; Veicsteinas, Arsenio

2013-09-01

328

Self-priming hemodynamic reservoir and inline flow meter for a cardiopulmonary bypass simulation.  

PubMed

Simulator exercises are used at Midwestern University to augment academic and laboratory training toward consolidating particular skills, increasing situation awareness, and preparing the student for practice within the team environment of an operating room. This paper describes an enhanced cardiopulmonary bypass simulator consisting of a self-priming hemodynamic reservoir that includes an inline flow meter. A typical cardiopulmonary bypass adult perfusion circuit was assembled using a roller pump console and integrated oxygenator/heat exchanger/reservoir and primed with 2 liters of water. For patient simulation, a soft-sided reservoir bag was mounted onto an inclined platform. A 1-liter soft-sided bag was placed just above the reservoir, providing an overflow reservoir. The priming line extended to the head of the mannequin. The arterial, venous, and suction lines extended through the open chest. The primed perfusion circuit was connected to ports on the filled reservoir bag. To test the patient simulation, the arterial pump output was adjusted to flow rates ranging from 1-7 liters per minute, with a complete interruption (to zero flow) between each test run. An inline flow meter was added to the bypass circuit and an analog to digital converter board was used to pass flow data into the computer-based simulation program. The use of an inclined hemodynamic reservoir bag proved to be self-priming and functional without problems over a wide range of flows tested. By including a reservoir with the mannequin, plus processing and displaying real-time flow data using the CPB-Sim simulation program, a higher fidelity and more realistic simulation experience was created. PMID:20648900

Raasch, David; Austin, Jon; Tallman, Richard

2010-06-01

329

Effect of atrial fibrillation on outcome in patients with known or suspected coronary artery disease referred for exercise stress testing.  

PubMed

The association of atrial fibrillation (AF) with coronary artery disease (CAD) remains controversial. In addition, the relation of AF to myocardial ischemia and outcomes in patients with known or suspected CAD referred for exercise stress testing has been poorly explored. In this study, 17,100 patients aged > or = 50 years with known or suspected CAD who underwent exercise electrocardiography (n = 11,911) or exercise echocardiography (n = 5,189) were evaluated. End points were all-cause mortality, nonfatal myocardial infarction, and coronary revascularization. Overall, 619 patients presented with AF at the time of the tests. Patients with AF who had interpretable electrocardiograms had a lower likelihood of exercise-induced ischemic ST-segment abnormalities (adjusted odds ratio 0.51, 95% confidence interval 0.34 to 0.76, p = 0.001), and those with AF who underwent exercise echocardiography had a lower likelihood of new or worsening exercise-induced wall motion abnormalities (adjusted odds ratio 0.62, 95% confidence interval 0.44 to 0.87, p = 0.006). During a mean follow-up period of 6.5 + or - 3.9 years, 2,364 patients died, 1,311 had nonfatal myocardial infarctions, 1,615 underwent percutaneous coronary intervention, and 922 underwent coronary artery bypass surgery. The 10-year mortality rate was 43% in patients with AF compared to 19% in those without AF (p <0.001). In multivariate analysis, AF remained an independent predictor of all-cause mortality (adjusted hazard ratio 1.45, 95% confidence interval 1.20 to 1.76, p <0.001), but not of nonfatal myocardial infarction or coronary revascularization. In conclusion, despite being associated with an apparently lower likelihood of myocardial ischemia, AF was an independent predictor of all-cause mortality in patients with known or suspected CAD referred for exercise stress testing. PMID:20403467

Bouzas-Mosquera, Alberto; Peteiro, Jesús; Broullón, Francisco J; Alvarez-García, Nemesio; Mosquera, Victor X; Casas, Sheyla; Pérez, Alberto; Méndez, Elizabet; Castro-Beiras, Alfonso

2010-03-11

330

Detection of residual jeopardized myocardium 3 weeks after myocardial infarction by exercise testing with thallium-201 mycardial scintigraphy  

SciTech Connect

The usefulness of thallium-201 (Tl-201) exercise myocardial scintigraphy in identifying patients with multivessel coronary artery disease (MVCAD) and residual jeopardized myocardium after myocardial infarction (MI) was evaluated in 32 patients 3 weeks after MI. All patients underwent (1) limited multilead submaximal treadmill testing, (2) thallium-201 (Tl) myocardial scintigraphy at end-exercise and at rest, and (3) coronary and left ventricular angiography. Tl-201 perfusion defects were categorized as either reversible (ischemia) or irreversible (scar). The conventional exercise test was designated positive if there was ST depression > = 1mm and/or angina. Jeopardized myocardium (JEP) was defined angiographically as a segment of myocardium with normal or hypokinetic wall motion supplied by a significantly stenotic major coronary artery. MVCAD was defined as two or more significantly stenotic coronary arteries. Significant coronary stenosis was categorized as either 50 to 69% diameter narrowing or > = 70% diameter narrowing, thereby yielding, respectively, two subgroups each of jeopardized myocardium (JEP-50 and JEP-70) and MVCAD (MV-50 and MV-70). Clinical findings of angina, heart failure or ventricular arrhythmias during the late convalescent period after MI occurred in four of 10 patients (40%) with MV-50, five of 16 (31%) with MV-70, four of 10 (40%) with JEP-50 and five of 18 (28%) with JEP-70, and thus were insensitive for detecting MVCAD and JEP. Reversible ischemia and/or a positive conventional exercise test occurred in five of 10 patients (50%) with MV-50, 13 of 16 (81%) with MV-70, four of 10 (40%) with JEP-50 and 15 of 18 (83%) with JEP-70. All eight patients with both Tl-201 reversible ischemia and a positive conventional exercise test had JEP-70. In 30 of 31 patients (97%) with angiographic asynergy, Tl-201 scar was detected. No complications were associated with exercise testing.

Turner, J.D.; Schwartz, K.M.; Logic, J.R.; Sheffield, L.T.; Kansal, S.; Roitman, D.I.; Mantle, J.A.; Russell, R.O.; Rackley, C.E.; Rogers, W.J.

1980-04-01

331

Influence of dynamic versus static core exercises on performance in field based fitness tests.  

PubMed

Minimal evidence supports the claim that core stability training transfers into improved performance and the most effective training method to perform core exercises is still unknown. The purpose of the study was to compare the effects of a 6 week unstable static versus unstable dynamic core training program, on field based fitness tests. A static (n = 6) and dynamic (n = 6) training group performed two 45 min sessions per week for six weeks. Seven performance tests, consisting of three core (plank; double leg lowering; back extensions), one static (standing stork) and three dynamic (overhead medicine ball throw; vertical jump; 20 m sprint), were administered pre- and post training. Between group differences were assessed using a repeated measures MANOVA (P < 0.05). Both training groups improved in each of the core tests (P < 0.05). Neither training group demonstrated improvement in the dynamic field based tests (medicine ball throw, vertical jump height and 20 m sprint) (P > 0.05). Findings indicate that both types of training improved specific measures of core stability but did not transfer into any sport-related skill. PMID:21943626

Parkhouse, Kelly L; Ball, Nick

2010-12-22

332

Pilot-testing the effects of a newly-developed silver yoga exercise program for female seniors.  

PubMed

This study aimed to pilot-test the health promotion effects of a silver yoga exercise program for female seniors. Using a one-group, pre-post test design, a convenience sample of 16 community-dwelling female seniors was recruited. The silver yoga exercise intervention was administered three times a week, 70 minutes per session, for four weeks. Data were collected at baseline and after completion of the four-week intervention. Results indicated that participants' body fat percentage and systolic blood pressure decreased, balance and range of motion on shoulder flexion and abduction improved, and sleep disturbance was minimized (all p < .05). Preliminary evidence supports that the silver yoga exercise program provides positive effects on the promotion of good health in female seniors living in the communities. PMID:18348106

Chen, Kuei-Min; Tseng, Wei-Shyuan

2008-03-01

333

Effects of a Supervised Exercise Intervention on Recovery From Treatment Regimens in Breast Cancer Survivors  

PubMed Central

Purpose/Objectives To investigate the effects of supervised exercise training on cardiopulmonary function and fatigue in cancer survivors undergoing various clinical treatments. Design Pretest and post-test quasiexperimental. Setting Outpatient oncology rehabilitation center. Sample 96 breast cancer survivors undergoing various clinical treatments. Methods Subjects were divided into four groups based on the specific type of clinical treatment: surgery alone (n = 22); surgery and chemotherapy (n = 30); surgery and radiation (n = 17); and surgery, chemotherapy, and radiation (n = 27). Following a comprehensive screening and medical examination, cardiovascular endurance, pulmonary function, and fatigue were assessed, leading to the development of an individualized exercise prescription and a six-month exercise intervention. Repeated-measures analysis of variance and covariance were used to compare the effectiveness of the intervention and differences among treatment groups. Main Research Variables Systolic and diastolic blood pressure, resting heart rate, forced vital capacity, forced expiratory volume, predicted oxygen consumption, time on treadmill, and fatigue. Findings Cardiopulmonary function (predicted maximal oxygen consumption and time on treadmill) significantly increased in all groups after exercise training. In addition, resting heart rate and forced vital capacity significantly improved in those receiving surgery, chemotherapy, and radiation. Psychologically, the exercise intervention resulted in significant reductions in behavioral, affective, sensory, cognitive and mood, and total fatigue scale scores in all three groups who received treatment with surgery. The breast cancer survivors in the surgery-alone group showed significant reductions in behavioral, affective, and total fatigue scale scores but not in sensory and cognitive and mood fatigue scale scores. Conclusions The results suggest that moderate intensity, individualized, prescriptive exercise maintains or improves cardiopulmonary function with concomitant reductions in fatigue regardless of treatment type. Moreover, cancer survivors receiving combination chemotherapy and radiotherapy following surgery appear to benefit to a greater extent as a result of an individualized exercise intervention. Implications for Nursing Clinicians need to be aware of adjuvant therapies such as moderate exercise that attenuate negative side effects of cancer treatments. Symptom management recommendations should be given to cancer survivors concerning the effectiveness of exercise throughout the cancer continuum and the importance of participating in a cancer rehabilitation exercise program.

Hsieh, City C.; Sprod, Lisa K.; Hydock, David S.; Carter, Susan D.; Hayward, Reid; Schneider, Carole M.

2011-01-01

334

Time domain analysis of oxygen uptake during pseudorandom binary sequence exercise tests.  

PubMed

Pseudorandom binary sequence (PRBS) exercise tests involve repeated switching between two work rates (WR) according to a computer-generated pattern. This paper presents an approach to analysis of O2 uptake (VO2) in the time domain. First, the autocorrelation function (ACF) of the input WR was recognized to be a triangular-shaped pulse that can be taken to be equivalent to a ramp increase followed by a ramp decrease in WR. Then the cross-correlation function of the input (WR) and the output (VO2) was treated as if it were the response to a triangular-shaped pulse. The cross-correlation function was analyzed by fitting a linear summation of the ramp form of a two-component exponential function to this triangular pulse. VO2 responses of eight subjects were obtained from two different PRBS tests, as well as step changes in WR. The first PRBS test consisted of 15 units, each 30 s in duration. Its ACF had a base width of 60 s. The ramp increase-ramp decrease model fit the data throughout the range of response. The second PRBS test had 63 units, each 5 s in duration; thus its ACF base width was 10 s. Again, the ramp model fit adequately. The data from the second PRBS test could be fit by the impulse form of the two-component exponential equation, although the fit in the first 30 s tended to be poorer. The time constants of VO2 dynamics estimated from step and PRBS tests were not significantly different. PRBS tests can be analyzed in the time domain, and the indicators of system dynamics reflect physiological properties similar to those investigated during step changes in WR. PMID:1757391

Hughson, R L; Cuervo, L A; Patla, A E; Winter, D A; Xing, H C; Dietrich, B H; Swanson, G D

1991-10-01

335

21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.  

Code of Federal Regulations, 2013 CFR

...false Cardiopulmonary bypass bubble detector. 870.4205 Section 870.4205...4205 Cardiopulmonary bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect...

2013-04-01

336

21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350...870.4350 Cardiopulmonary bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange...

2013-04-01

337

21 CFR 870.4230 - Cardiopulmonary bypass defoamer.  

Code of Federal Regulations, 2010 CFR

...Cardiopulmonary bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood. (b) Classification. Class II...

2009-04-01

338

21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350...870.4350 Cardiopulmonary bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange...

2009-04-01

339

21 CFR 870.4230 - Cardiopulmonary bypass defoamer.  

Code of Federal Regulations, 2013 CFR

...Cardiopulmonary bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood. (b) Classification. Class II...

2013-04-01

340

21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350...870.4350 Cardiopulmonary bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange...

2010-04-01

341

21 CFR 870.4230 - Cardiopulmonary bypass defoamer.  

Code of Federal Regulations, 2010 CFR

...Cardiopulmonary bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood. (b) Classification. Class II...

2010-04-01

342

21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.  

Code of Federal Regulations, 2013 CFR

...Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing the coronary...

2013-04-01

343

Exercise Tolerance Testing in a Prospective Cohort of Adolescents with Chronic Fatigue Syndrome and Recovered Controls Following Infectious Mononucleosis  

PubMed Central

Objective Six months following acute infectious mononucleosis (IM), 13%, of adolescents meet criteria for chronic fatigue syndrome (CFS). We measured exercise tolerance in adolescents with CFS and controls 6 months following IM. Study design 21 adolescents with CFS 6 months following IM and 21 recovered controls performed a maximal incremental exercise tolerance test with breath-by-breath gas analysis. Values expressed are mean ± standard deviation. Results The adolescents diagnosed with CFS and controls did not differ in age, weight, body-mass index or peak work capacity. Lower VO2 (oxygen consumption) peak percent of predicted was seen in adolescents with CFS compared with controls (CFS 99.3 ± 16.6 vs control 110.7 ± 19.9, p = 0.05). Peak oxygen pulse also was lower in adolescents with CFS compared with recovered controls (CFS 12.4 ± 2.9 vs controls 14.9 ± 4.3, p = 0.03). Conclusions Adolescents with CFS 6 months following IM have a lower degree of fitness and efficiency of exercise than recovered adolescents. Whether these abnormal exercise findings are a cause or effect of CFS is unknown. IM can lead to both fatigue and measurable changes in exercise testing in a subset of adolescents.

Katz, Ben Z.; Boas, Steven; Shiraishi, Yukiko; Mears, Cynthia J.; Taylor, Renee

2010-01-01

344

Technetium 99m-labeled tetrofosmin myocardial tomography in patients with coronary artery disease: Comparison between adenosine and dynamic exercise stress testing  

Microsoft Academic Search

Background  Pharmacologic coronary vasodilation with adenosine, combined with myocardial scintigraphy, is a useful test for the diagnosis\\u000a of coronary artery disease (CAD) in patients unable to exercise. It has been demonstrated recently that exercise 99mTc-labeled tetrofosmin cardiac imaging can be used for the detection of CAD. However, no data are available comparing 99mTc-labeled tetrofosmin adenosine and exercise tests in the same

Alberto Cuocolo; Emanuele Nicolai; Andrea Soricelli; Leonardo Pace; Antonio Nappi; Pasquale Sullo; Stefania Cardei; Luigi Argenziano; Peter J. Ell; Marco Salvatore

1996-01-01

345

Factors affecting sensitivity and specificity of a diagnostic test: the exercise thallium scintigram  

SciTech Connect

Technical and methodological factors might affect the reported accuracies of diagnostic tests. To assess their influence on the accuracy of exercise thallium scintigraphy, the medical literature (1977 to 1986) was non-selectively searched and meta-analysis was applied to the 56 publications thus retrieved. These were analyzed for year of publication, sex and mean age of patients, percentage of patients with angina pectoris, percentage of patients with prior myocardial infarction, percentage of patients taking beta-blocking medications, and for angiographic referral (workup) bias, blinding of tests, and technical factors. The percentage of patients with myocardial infarction had the highest correlation with sensitivity (0.45, p = 0.0007). Only the inclusion of subjects with prior infarction and the percentage of men in the study group were independently and significantly (p less than 0.05) related to test sensitivity. Both the presence of workup bias and publication year adversely affected specificity (p less than 0.05). Of these two factors, publication year had the strongest association by stepwise linear regression. This analysis suggests that the reported sensitivity of thallium scintigraphy is higher and the specificity lower than that expected in clinical practice because of the presence of workup bias and the inappropriate inclusion of post-infarct patients.

Detrano, R.; Janosi, A.; Lyons, K.P.; Marcondes, G.; Abbassi, N.; Froelicher, V.F.

1988-04-01

346

Pharmacological and other nonexercise alternatives to exercise testing to evaluate myocardial perfusion and left ventricular function with radionuclides  

SciTech Connect

Pharmacological vasodilatation with either dipyridamole or adenosine is a safe and accurate alternative to exercise testing to diagnose coronary artery disease with thallium 201 myocardial perfusion imaging. The technique also provides important prognostic information with regard to future cardiac events in patients undergoing diagnostic testing, in those evaluated preoperatively, and in those with recent myocardial infarctions. Multigated equilibrium and first-pass radionuclide ventriculography also are well suited to evaluate the effects of interventional procedures. Success has been achieved using this methodology in a variety of interventions including conventional exercise testing, pharmacological stress testing, atrial pacing, assessment of myocardial viability with nitroglycerin, mental stress testing, and ambulatory monitoring of left ventricular ejection fraction. 67 references.

DePuey, E.G.; Rozanski, A. (St. Luke's-Roosevelt Hospital Center, New York, NY (USA))

1991-04-01

347

The Free-Running Asthma Screening Test: An Approach to Screening for Exercise-Induced Asthma in Rural Alabama.  

ERIC Educational Resources Information Center

|This study documented the prevalence of exercise-induced asthma (EIA) in rural elementary schools, examining the use of a free-running asthma screening test and peak expiratory flow-rate measurement for school screening. Results indicated that 5.7% of the students had EIA. Absenteeism and poverty were related to EIA. (SM)|

Heaman, Doris J.; Estes, Jenny

1997-01-01

348

Improvement of orthography test performance by relaxation exercises: results of a controlled field experiment in basic secondary education  

Microsoft Academic Search

The effects of relaxation exercises on orthography performance in language arts education of fifth to seventh graders were experimentally tested. Participants were 399 basic secondary school students and their language arts teachers from the Hauptschule, a German type of secondary education covering grades five to nine that leads to a basic educational degree. Half of the students were trained in

Günter Krampen

2010-01-01

349

A Maximal Graded Exercise Test to Accurately Predict VO2max in 18-65-Year-Old Adults  

ERIC Educational Resources Information Center

|The purpose of this study was to develop an age-generalized regression model to predict maximal oxygen uptake (VO sub 2 max) based on a maximal treadmill graded exercise test (GXT; George, 1996). Participants (N = 100), ages 18-65 years, reached a maximal level of exertion (mean plus or minus standard deviation [SD]; maximal heart rate [HR sub…

George, James D.; Bradshaw, Danielle I.; Hyde, Annette; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.

2007-01-01

350

21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.  

Code of Federal Regulations, 2013 CFR

...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4300 Cardiopulmonary bypass gas control unit. (a) Identification. A cardiopulmonary...

2013-04-01

351

21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.  

Code of Federal Regulations, 2013 CFR

...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4200 Cardiopulmonary bypass accessory equipment. (a) Identification. Cardiopulmonary...

2013-04-01

352

Modified Total-Body Recumbent Stepper Exercise Test for Assessing Peak Oxygen Consumption in People With Chronic Stroke  

PubMed Central

Background: Assessment of peak oxygen consumption (V?o2peak) using traditional modes of testing such as treadmill or cycle ergometer can be difficult in individuals with stroke due to balance deficits, gait impairments, or decreased coordination. Objective: The purpose of this study was to quantitatively assess the validity and feasibility of a modified exercise test using a total-body recumbent stepper (mTBRS-XT) in individuals after stroke. Design: A within-subject design, with a sample of convenience, was used. Participants. Eleven participants (7 male, 4 female) with a mean of 40.1 months (SD=32.7) after stroke, a mean age of 60.9 years (SD=12.0), and mild to severe lower-extremity Fugl-Myer test scores (range=13–34) completed the study. Methods: Participants performed 2 maximal-effort graded exercise tests on separate days using the mTBRS-XT and a cycle ergometer exercise protocol to assess cardiorespiratory fitness. Measurements of V?o2peak and peak heart rate (peak HR) were obtained during both tests. Results: A strong relationship existed between the mTBRS-XT and the cycle ergometer exercise test for V?o2peak and peak HR (r=.91 and .89, respectively). Mean V?O2peak was significantly higher for the mTBRS-XT (16.6 mL×kg?1×min?1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL×kg?1×min?1 [SD=4.5]). All participants performed the mTBRS-XT. One individual with severe stroke was unable to pedal the cycle ergometer. No significant adverse events occurred. Conclusion: The mTBRS-XT may be a safe, feasible, and valid exercise test to obtain measurements of V?o2peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on V?o2peak values for individuals with mild to severe deficits after stroke.

Billinger, Sandra A; Tseng, Benjamin Y; Kluding, Patricia M

2008-01-01

353

Delayed blood pressure recovery ratio might indicate increased arterial stiffness in hypertensive patients with reduced aerobic exercise capacity.  

PubMed

Abstract Background: Cardiopulmonary fitness is associated with reduced cardiovascular risk. Abnormal systolic blood pressure (SBP) response during recovery has been found to have diagnostic role for detecting cardiovascular risk. Aim of the study was to determine whether increased arterial stiffness associates with reduced aerobic exercise capacity after maximal cardiopulmonary exercise test (CPET) in a cohort of recently diagnosed hypertensive patients with a delayed decline in SBP during recovery. Methods: Eighty-four hypertensive patients with recently diagnosed I-II essential hypertension and under treatment with RAAS antagonists ± HCTZ, underwent pulse wave velocity (PWV) estimation and a maximal CPET. Fifty-four healthy normotensive subjects served as a control group. Blood pressure recovery ratio (BPRR) was defined as the SBP after 3 min recovery divided by SBP at peak exercise. Results: PWV was significantly increased in hypertensives vs normotensives (p < 0.001). A non-independent, reverse association between PWV and VO2PEAK was revealed in hypertensives with delayed BPRR (r = - 0.49, p < 0.05). Age and sex independently predicted VO2PEAK in hypertensives with delayed BPRR. Conclusions: Delayed blood pressure response detected during recovery in treated hypertensives implies a reverse relationship between any given impaired aerobic exercise capacity and expected persistent peripheral vascular resistance during exercise. PMID:23373532

Kontsas, Konstantinos; Triantafyllidi, Helen; Trivilou, Paraskevi; Ikonomidis, Ignatios; Tzortzis, Stavros; Liazos, Ioannis; Alevras, Panagiotis; Paraskevaidis, Ioannis; Kremastinos, Dimitrios; Anastasiou-Nana, Maria; Lekakis, John

2013-02-01

354

Antianginal effects of amlodipine at a single dose on exertional angina patients using treadmill exercise testing—A randomized crossover study in comparison with placebo  

Microsoft Academic Search

With eight cases of stable exertional angina as subjects, the antianginal action and sustained effects of single 10 mg oral doses of new calcium antagonists amlodipine were assessed by treadmill exercise tests in randomized crossover trials with respect to a placebo. Exercise tests were conducted before as well as 4, 8, and 24 hours after administration, and plasma amlodipine concentration

Hiroshi Kishida; Noritake Hata; Toshihiro Kunimi; Hideo Miyagawa; Harumi Nishiyama; Kazuzo Katoh

1992-01-01

355

PreDischarge Exercise Test for Evaluation of Patients with Complete or Incomplete Revascularization following Primary Percutaneous Coronary Intervention: A DANAMI-2 Sub-Study  

Microsoft Academic Search

Objectives: It is unclear whether the completeness of revascularization impacts on the prognostic value of an exercise test after primary percutaneous coronary intervention (PCI). Methods: The DANAMI-2 trial included patients with ST elevation acute myocardial infarction randomized to primary PCI or fibrinolysis. Of the 790 patients randomized to primary PCI, 572 performed an exercise test. Prospectively, 310 patients were classified

Nana Valeur; Peter Clemmensen; Peer Grande; Kristian Wachtell; Kari Saunamäki

2008-01-01

356

High-sensitive Troponin T increase after exercise in patients with pulmonary arterial hypertension  

PubMed Central

Background The current study aimed to investigate the release of myocardial high-sensitive Troponin T (hsTnT) in patients with pulmonary arterial hypertension (PAH) in response to maximal physical exercise. Methods In 24 patients with PAH, symptom-limited cardiopulmonary exercise testing was performed. hsTnT was measured by the novel hsTnT assay with a lower limit of detection of 2?ng/L and a total imprecision of less than 10% at the 99th percentile value. hsTnT was related to NT-proBNP, WHO functional class and right ventricular (RV) function. Serial measurement was performed before and 30?min, 180?min, and 300?min after exercise. Healthy volunteers served as a control group. Results In 21 PAH patients, hsTnT levels were detectable before exercise with a close correlation between hsTnT and NT-proBNP. hsTnT was detectable in all PAH patients after exercise and significantly increased from 7.5?ng/L at baseline to 14.62?ng/L after 300?min, whereas levels of NT-proBNP remained constant with time. Conclusions Using the novel hsTnT assay, the current study provides first evidence that hsTnT levels increase in PAH patients after maximal physical exercise, while levels of other biomarkers remain constant after exercise testing. This might provide new insights into pathophysiology and individual risk assessment in patients with PAH.

2013-01-01

357

Seasonal variations in out of hospital cardiopulmonary arrest  

PubMed Central

OBJECTIVE—To determine whether there are seasonal variations in survival following out of hospital cardiopulmonary arrest.?DESIGN—Prospective cohort study using the Heartstart (Scotland) database.?SETTING—All of Scotland.?PATIENTS—10 890 people who suffered out of hospital cardiopulmonary arrest in the summer or winter between December 1988 and August 1997 inclusive.?INTERVENTION—Univariate comparisons of 5406 arrests occurring in summer with 5484 in winter, in terms of patient characteristics, management, and survival using ?2 and Mann-Whitney U tests. Multivariate analysis of the association between season and survival following adjustment for case mix.?MAIN OUTCOMES MEASURES—Survival to discharge from hospital, survival pre-admission, in-hospital survival.?RESULTS—Only 6% of people who arrested in winter survived to discharge, compared to 8% of those who arrested in summer (odds ratio 0.77, p < 0.001). People who arrested in winter had a poorer risk profile in that they were older, more likely to arrest at home, less likely to have a witness, and less likely to receive defibrillation. However, after adjustment for case mix, people who arrested in winter were still 19% less likely to survive compared to those who arrested in summer. Deaths pre-admission were significantly higher in winter (odds ratio 1.18, p < 0.05) but in-hospital deaths were not.?CONCLUSIONS—People who suffer cardiopulmonary arrest in winter have a significantly lower likelihood of surviving. This is, in part, caused by the higher frequency of a number of recognised risk factors. However, their prognosis remains poorer even after adjustment for these factors.???Keywords: cardiopulmonary arrest; cardiopulmonary resuscitation; seasonal variations; ischaemic heart disease

Pell, J; Sirel, J; Marsden, A; Cobbe, S

1999-01-01

358

Cardiovascular Effects of Desipramine in Children and Adults During Exercise Testing  

Microsoft Academic Search

ObjectiveIn light of recent reports of sudden death in children being treated with desipramine (DMI), 3 of which were associated with physical exercise, the authors examined the effects of DMI on exercise in children and adults before and during DMI treatment.

BRUCE D. WASLICK; B. TIMOTHY WALSH; LAURENCE L. GREENHILL; ELSA-GRACE V. GIARDINA; RICHARD P. SLOAN; J. THOMAS BIGGER; KARINA BILICH

1999-01-01

359

Prevalence and clinical significance of painless ST segment depression during early postinfarction exercise testing  

SciTech Connect

In a recent study of 190 survivors of acute myocardial infarction, the authors sought to determine whether exercise-induced painless ST segments depression indicates residual myocardial ischemia, as defined by /sup 201/Tl scintigraphic criteria. 2 weeks after uncomplicated myocardial infarction, and whether quantitative /sup 201/Tl imaging enhances the prognostic value of such an exercise electrocardiographic response.

Gibson, R.S.; Beller, G.A.; Kaiser, D.L.

1987-03-01

360

Arterial Baroreflex Control of the Sinus Node During Dobutamine Exercise Stress Testing  

Microsoft Academic Search

The contributions of increases in circulating catecholamines, changes in central command, and muscle afferents on baroreflex control of the sinus node during exercise are unclear. We used a dobutamine infusion to induce hemodynamic changes comparable to those of moderate physical exercise in the absence of changes in central command and muscle afferents in 13 healthy subjects. Dobutamine (up to 9

Philippe van de Borne; Shirley Heron; Hung Nguyen; Philippe Unger; Marc Leeman; Jean Louis Vincent; Jean Paul

361

How Does Exercise Benefit Performance on Cognitive Tests in Primary-School Pupils?  

ERIC Educational Resources Information Center

|Aim: We have previously demonstrated improved cognitive performance after a classroom-based exercise regime. In this study, we examined the reproducibility of this effect in a more socio-economically diverse sample and also investigated whether cognitive benefits of exercise were moderated by body mass index (BMI) or symptoms of…

Hill, Liam J. B.; Williams, Justin H. G.; Aucott, Lorna; Thomson, Jenny; Mon-Williams, Mark

2011-01-01

362

Surface-bound heparin fails to reduce thrombin formation during clinical cardiopulmonary bypass  

Microsoft Academic Search

The hypothesis that heparin-coated perfusion circuits reduce thrombin formation and activity; fibrinolysis; and platelet, complement, and neutrophil activation was tested in 20 consecutive, randomized adults who had cardiopulmonary bypass. Twenty identical perfusion systems were used; in 10, all blood-contacting surfaces were coated with partially degraded heparin (Carmeda process; Medtronic Cardiopulmonary, Anaheim, Calif.). All patients received a 300 U\\/kg dose of

Robert C. Gorman; Nicholas P. Ziats; A. Koneti Rao; Nicolas Gikakis; Ling Sun; Mohammed M. H. Khan; Nina Stenach; Suneeti Sapatnekar; Vibhuti Chouhan; Joseph H. Gorman; Stefan Niewiarowski; Robert W. Colman; James M. Anderson; L. Henry Edmunds

1996-01-01

363

Albumin versus hydroxyethyl starch in cardiopulmonary bypass surgery: a meta-analysis of postoperative bleeding  

Microsoft Academic Search

Background. This meta-analysis tested the hypothesis that cumulative blood loss during the first 24 hours after cardiopulmonary bypass is lower in patients exposed to albumin than hydroxyethyl starch (HES).Methods. Randomized controlled trials comparing albumin and HES in cardiopulmonary bypass patients were identified by bibliographic database searches and other methods.Results. Sixteen trials involving 653 randomized patients were included. In 88% of

Mahlon M Wilkes; Roberta J Navickis; William J Sibbald

2001-01-01

364

Cardiopulmonary baroreceptors affect reflexive startle eye blink  

Microsoft Academic Search

Baroafferent signals originating from the ‘high pressure’ arterial vascular system are known to impact reflexive startle eye blink responding. However, it is not known whether baroafferent feedback of the ‘low pressure’ cardiopulmonary system loading status exerts a similar effect.Lower Body Negative Pressure (LBNP) at gradients of 0, ?10, ?20, and ?30mm Hg was applied to unload cardiopulmonary baroreceptors. Acoustic startle

S. Richter; A. Schulz; J. Port; T. D. Blumenthal; H. Schächinger

2009-01-01

365

Optimizing the Six Minute Walk Test as a Measure of Exercise Capacity in COPD.  

PubMed

ABSTRACT BACKGROUND:It is uncertain whether the effort and expense of performing a second walk for the six-minute-walk test improves test performance. Hence, we attempted to quantify the improvement in six-minute-walk distance if an additional walk were to be performed. METHODS:We studied patients consecutively enrolled into the National Emphysema Treatment Trial who, prior to randomization and after 6-10 weeks of pulmonary rehabilitation, performed two six-minute-walks on consecutive days (n=396). Patients also performed two six-minute-walks at 6-month follow up after randomization to lung volume reduction surgery (n=74) or optimal medical therapy (n=64). We compared change in the first-walk distance to change in the second-, average-of-two, and best-of-two walk distances. RESULTS:Compared to change in first-walk distance, change in average-of-two and best-of-two walk distances had better validity and precision. Specifically, six months after randomization to LVRS, changes in average-of-two (r=0.66 vs. 0.58, P=0.01) and best-of-two walk distances (r=0.67, vs. 0.58, P=0.04) better correlated with the change in maximal exercise capacity (i.e. better validity). Also, the variance of change in the average-of-two walk distances was 14-25% less and best-of-two was 14-33% less than the variance of change in the single-walk distance, indicating better precision. CONCLUSIONS:Adding a second walk to the six-minute-walk test significantly improves its performance in determining response to a therapeutic intervention, improves the validity of COPD clinical trials and would result in a 14-33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in COPD patients. PMID:22700776

Chandra, Divay; Wise, Robert A; Kulkarni, Hrishikesh S; Benzo, Roberto P; Criner, Gerard; Make, Barry; Slivka, William A; Ries, Andrew L; Reilly, John J; Martinez, Fernando J; Sciurba, Frank C

2012-06-14

366

Comparison of ST segment changes on standard and Holter electrocardiogram during exercise testing.  

PubMed

In order to compare the ST segment changes recorded simultaneously on Holter (Del Mar Avionics 445B recorder and DCG VII Scanner) and standard electrocardiogram, 22 patients with chest discomfort and normal resting ECG were evaluated during exercise testing. The conventional ECG was recorded using chest lead V5 and a modified lead II. The Holter recording was done using the bipolar chest lead CM5 and the same modified lead II. Bifurcating electrodes permitted simultaneous recording of electrocardiogram on both systems from the same electrode sites. Seven of the 22 patients had a positive test and 15 had a negative test by both systems. In 7 positive cases the amplitude of ST segment depression was compared. The Holter lead CM5 showed higher amplitude of ST segment depressions in 6 cases compared to the conventional lead V5: 3 cases by 0.5 mm; 2 cases by 1 mm and 1 case by 2.5 mm. In 1 case it was identical. The amplitude of ST segment depression in lead CM5 ranged from 1 to 3.5 mm (mean 2.2 +/- 0.6 mm) and in lead V5 from 1 to 2.5 mm (mean 1.5 +/- 0.6 mm). Thus the amplitude of ST depression was higher in lead CM5 by a mean of 0.7 mm compared to the lead V5. ST segment depression was present only in 6 cases in the modified lead II. ST segment depressions were reproduced faithfully in 3 patients and within the variation of 0.5 mm in other 3 cases by the Holter system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1303304

Pothen, P; Maglio, P; Scanavacca, G; Ronsisvalle, G; Castellani, V; Pigato, R; Pessina, A C; Dal Palù, C

1992-12-01

367

The degree of ST-segment depression on symptom-limited exercise testing: Relation to the myocardial ischemic burden as determined by thallium-201 scintigraphy  

Microsoft Academic Search

This study sought to determine the relation between the magnitude of exercise-induced ST depression and the ischemic burden as determined by quantitative thallium-201 scintigraphy. One hundred forty-four consecutive patients were prospectively studied with symptom-limited exercise testing and thallium-201 scintigraphy. Of these patients, 37 had between 1.0 and <2.0 mm (group 1) and 17 had ?2.0 mm (group 2) of exercise-induced

Allen J. Taylor; Matthew C. Sackett; George A. Beller

1995-01-01

368

Aerobic exercise attenuates blood pressure reactivity to cold pressor test in normotensive, young adult African-American women.  

PubMed

Exaggerated blood pressure reactivity to behavioral stress has been observed in the African-American population, and such a pressor response is believed to play a role in hypertension. Regular aerobic exercise has been shown to exert an anti-hypertensive effect, and this may alter the blood pressure hyperreactivity observed in African Americans. To test the hypothesis that aerobic exercise attenuates pressor reactivity in African Americans, we studied eight healthy aerobically-trained normotensive African-American females and five similar sedentary females. The stress stimuli consisted of the cold pressor test with the foot immersed in ice water for two minutes. The aerobic exercise training protocol consisted of six weeks of jogging at 60-70% of peak oxygen uptake (VO2peak), three days/week for 35 min/exercise session. Systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, heart rate, cardiac output, total peripheral resistance, and forearm blood flow were measured. Manifestation of a training effect was illustrated by a 24.1 +/- 0.2% increase in VO2peak (26.9 +/- 1.2 mL x kg(-1) min(-1) vs 35.4 +/- 1.6 mL x kg(-1) min(-1)) (P<.05). Within the exercise-trained group there was a 6.3 +/- .15% decrease in systolic pressure (129 +/- 4.6 mm Hg vs. 121 +/- 5.4 mm Hg) (P<.05), and a 5.0 +/- .05% decrement in mean arterial blood pressure (99 +/- 3.3 mm Hg vs 94 +/- 3.6 mm Hg) (P<.05) during the cold pressor test. Pressor reactivity to cold stress did not change in the untrained group. Measures of heart rate, cardiac output, total peripheral resistance, and forearm blood flow were unaltered during conditions of the cold pressor test. We conclude that aerobic exercise attenuates the blood pressure reactivity to behavioral stress in young, adult normotensive African-American females. A lifestyle change such as exercising may play a role in reducing the risk of hypertension in African-American women. PMID:10355479

Bond, V; Mills, R M; Caprarola, M; Vaccaro, P; Adams, R G; Blakely, R; Roltsch, M; Hatfield, B; Davis, G C; Franks, B D; Fairfax, J; Banks, M

1999-01-01

369

Italian mitochondrial DNA database: results of a collaborative exercise and proficiency testing.  

PubMed

This work is a review of a collaborative exercise on mtDNA analysis undertaken by the Italian working group (Ge.F.I.). A total of 593 samples from 11 forensic genetic laboratories were subjected to hypervariable region (HVS-I/HVS-II) sequence analysis. The raw lane data were sent to MtDNA Population Database (EMPOP) for an independent evaluation. For the inclusion of data for the Italian database, quality assurance procedures were applied to the control region profiles. Only eight laboratories with a final population sample of 395 subjects passed the quality conformance test. Control region haplogroup (hg) assignments were confirmed by restriction fragment length polymorphism (RFLP) typing of the most common European hg-diagnostic sites. A total of 306 unique haplotypes derived from the combined analysis of control and coding region polymorphisms were found; the most common haplotype--CRS, 263, 309.1C, 315.1C/ not7025 AluI--was shared by 20 subjects. The majority of mtDNAs detected in the Italian population fell into the most common west Eurasian hgs: R0a (0.76%), HV (4.81%), H (38.99%), HV0 (3.55%), J (7.85%), T (13.42%), U (11.65%), K (10.13%), I (1.52%), X (2.78%), and W (1.01%). PMID:17952451

Turchi, Chiara; Buscemi, Loredana; Previderè, Carlo; Grignani, Pierangela; Brandstätter, Anita; Achilli, Alessandro; Parson, Walther; Tagliabracci, Adriano

2007-10-20

370

Prognostic value of predischarge low-level exercise thallium testing after thrombolytic treatment of acute myocardial infarction  

SciTech Connect

Low-level exercise thallium testing is useful in identifying the high-risk patient after acute myocardial infarction (AMI). To determine whether this use also applies to patients after thrombolytic treatment of AMI, 64 patients who underwent early thrombolytic therapy for AMI and 107 patients without acute intervention were evaluated. The ability of both the electrocardiogram and thallium tests to predict future events was compared in both groups. After a mean follow-up of 374 days, there were 25 and 32% of cardiac events in the 2 groups, respectively, with versus without acute intervention. These included death, another AMI, coronary artery bypass grafting or angioplasty with 75% of the events occurring in the 3 months after the first infarction. The only significant predictors of outcome were left ventricular cavity dilatation in the intervention group and ST-segment depression and increased lung uptake in the nonintervention group. The sensitivity of exercise thallium was 55% in the intervention group and 81% in the nonintervention group (p less than 0.05). Therefore, in patients having thrombolytic therapy for AMI, nearly half the events after discharge are not predicted by predischarge low-level exercise thallium testing. The relatively weak correlation of outcome with unmasking ischemia in the laboratory before discharge may be due to an unstable coronary lesion or rapid progression of disease after the test. Tests considered useful for prognostication after AMI may not necessarily have a similar value if there has been an acute intervention, such as thrombolytic therapy.

Tilkemeier, P.L.; Guiney, T.E.; LaRaia, P.J.; Boucher, C.A. (Massachusetts General Hospital, Boston (USA))

1990-11-15

371

Tirofiban provides “platelet anesthesia” during cardiopulmonary bypass in baboons  

Microsoft Academic Search

Objective: Tirofiban (Aggrastat) is a reversible, nonpeptide inhibitor of platelet glycoprotein II\\/IIIa receptors. We tested the hypothesis that tirofiban preserves platelet number and function and shortens postoperative bleeding times in baboons after cardiopulmonary bypass. Methods: Four groups were studied: control, n = 12; low-dose tirofiban (0.1 ?g\\/kg per minute), n = 7; high-dose tirofiban (0.3 ?g\\/kg per minute), n =

Yuji Hiramatsu; Nicolas Gikakis; Harry L. Anderson; Joseph H. Gorman; Cezary Marcinkiewicz; Robert J. Gould; Stefan Niewiarowski; L. Henry Edmunds

1997-01-01

372

Cardiac Arrest During Medically-Supervised Exercise Training: A Report of Fifteen Successful Defibrillations.  

ERIC Educational Resources Information Center

The Cardio-Pulmonary Research Institute conducted an exercise program for men with a history of coronary heart disease. Over 7 years, there were 15 cases of cardiac arrest during exercise (one for every 6,000 man-hours of exercise). Trained medical personnel were present in all cases, and all were resuscitated by electrical defibrillation with no…

Pyfer, Howard R.; And Others

373

Cardiac Arrest During Medically-Supervised Exercise Training: A Report of Fifteen Successful Defibrillations.  

ERIC Educational Resources Information Center

|The Cardio-Pulmonary Research Institute conducted an exercise program for men with a history of coronary heart disease. Over 7 years, there were 15 cases of cardiac arrest during exercise (one for every 6,000 man-hours of exercise). Trained medical personnel were present in all cases, and all were resuscitated by electrical defibrillation with no…

Pyfer, Howard R.; And Others

374

An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus  

PubMed Central

With continued debate over the functional significance of adult neurogenesis, identifying an in vivo correlate of neurogenesis has become an important goal. Here we rely on the coupling between neurogenesis and angiogenesis and test whether MRI measurements of cerebral blood volume (CBV) provide an imaging correlate of neurogenesis. First, we used an MRI approach to generate CBV maps over time in the hippocampal formation of exercising mice. Among all hippocampal subregions, exercise was found to have a primary effect on dentate gyrus CBV, the only subregion that supports adult neurogenesis. Moreover, exercise-induced increases in dentate gyrus CBV were found to correlate with postmortem measurements of neurogenesis. Second, using similar MRI technologies, we generated CBV maps over time in the hippocampal formation of exercising humans. As in mice, exercise was found to have a primary effect on dentate gyrus CBV, and the CBV changes were found to selectively correlate with cardiopulmonary and cognitive function. Taken together, these findings show that dentate gyrus CBV provides an imaging correlate of exercise-induced neurogenesis and that exercise differentially targets the dentate gyrus, a hippocampal subregion important for memory and implicated in cognitive aging.

Pereira, Ana C.; Huddleston, Dan E.; Brickman, Adam M.; Sosunov, Alexander A.; Hen, Rene; McKhann, Guy M.; Sloan, Richard; Gage, Fred H.; Brown, Truman R.; Small, Scott A.

2007-01-01

375

Reproducibility of Oxygen Saturation Monitoring During Six-Minute Walk Test and Exercise Stress Test in Patients with Pulmonary Arteriovenous Malformations Associated With Hereditary Hemorrhagic Telangiectasia  

Microsoft Academic Search

Patients with pulmonary arteriovenous malformations (PAVMs) are at risk for multiple complications and require close follow-up.\\u000a We investigated the reproducibility of the 6-minute walk test (6MWT) and exercise stress test (EST) for the evaluation of\\u000a low oxygen saturation in patients with PAVMs. Twenty-two patients with PAVMs, most of whom had hereditary hemorrhagic telangiectasia\\u000a (HHT), participated in a Human Investigations Committee-approved

Walter Li; Bolin Niu; Katherine Henderson; Veronika Northrup; Jeffery S. Pollak; Terence Trow; John Fahey; Robert I. White

2011-01-01

376

The Accuracy of the Electrocardiogram during Exercise Stress Test Based on Heart Size  

Microsoft Academic Search

BackgroundMultiple studies have shown that the exercise electrocardiogram (ECG) is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy.HypothesisThe purpose of this investigation was to assess the diagnostic accuracy of the exercise ECG based on heart size.MethodsWe evaluated 1,011 consecutive patients who were referred for an

Jason C. Siegler; Shafiq Rehman; Geetha P. Bhumireddy; Raushan Abdula; Igor Klem; Sorin J. Brener; Leonard Lee; Christopher C. Dunbar; Barry Saul; Terrence J. Sacchi; John F. Heitner

2011-01-01

377

Evidence-based risk assessment and recommendations for exercise testing and physical activity clearance in apparently healthy individuals.  

PubMed

Increased physical activity (PA) is associated with improved health and quality of life in the general population. A dose-response effect is evident between increasing levels of PA participation and a lower relative risk for cardiovascular disease and all-cause mortality. However, there is also clear evidence that PA acutely increases the risk of an adverse cardiovascular (CV) event and sudden cardiac death (SCD) significantly above levels expected at rest. Adverse CV events during PA may be triggered acutely by the physiological stress of exercise. This investigation will review the available literature describing the CV risks of exercise testing and PA participation in apparently healthy individuals. A systematic review of the literature was performed using electronic databases, including Medline, CINAHL, SPORT discus, EMBASE, Cochrane DSR, ACP Journal Club, and DARE; additional relevant articles were hand-picked and the final grouping was used for the review using the AGREE process to assess the impact and quality of the selected articles. Six hundred and sixteen relevant articles were reviewed with 51 being identified as describing adverse CV events during exercise and PA. Data suggests the risks of fatal and nonfatal events during maximal exercise testing in apparently healthy individuals rarely occur (approximately <0.8 per 10?000 tests or 1 per 10?000 h of testing). The incidence of adverse CV events is extremely low during PA of varying types and intensities, with data limited almost exclusively to fatal CV events, as nonfatal events are rarely reported. However, this risk is reduced by 25%-50% in those individuals who have prior experience with increased levels of PA, particularly vigorous PA. Throughout a wide age range, the risk of SCD and nonfatal events during PA remain extremely low (well below 0.01 per 10?000 participant hours), but both increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, undetected pre-existing disease is present and SCD is typically the first clinical event. The risks of an adverse CV event during exercise testing and PA are rare and are outweighed by the health benefits. Given this risk-benefit relationship, the PAR-Q is an appropriate method to identify those at higher risk across a wide age span and should be used in conjunction with appropriate clinical guidelines for guiding individuals towards graduated PA. There are not adequate data to describe the risks of PA in those individuals considered to be at higher risk but without cardiovascular disease. PMID:21800940

Goodman, Jack M; Thomas, Scott G; Burr, Jamie

2011-07-01

378

Safety and exercise tolerance of acute high altitude exposure (3454 m) among patients with coronary artery disease  

PubMed Central

Objectives To assess the safety and cardiopulmonary adaptation to high altitude exposure among patients with coronary artery disease. Methods 22 patients (20 men and 2 women), mean age 57 (SD 7) years, underwent a maximal, symptom limited exercise stress test in Bern, Switzerland (540?m) and after a rapid ascent to the Jungfraujoch (3454?m). The study population comprised 15 patients after ST elevation myocardial infarction and 7 after a non?ST elevation myocardial infarction 12 (SD 4) months after the acute event. All patients were revascularised either by percutaneous coronary angioplasty (n??=??15) or by coronary artery bypass surgery (n??=??7). Ejection fraction was 60 (SD 8)%. ? blocking agents were withheld for five days before exercise testing. Results At 3454?m, peak oxygen uptake decreased by 19% (p?exercise time by 16% (p?exercise, except at maximum exertion. No ECG signs of myocardial ischaemia or significant arrhythmias were noted. Conclusions Although oxygen demand and lactate concentrations are higher during exercise at high altitude, a rapid ascent and submaximal exercise can be considered safe at an altitude of 3454?m for low risk patients six months after revascularisation for an acute coronary event and a normal exercise stress test at low altitude.

Schmid, J-P; Noveanu, M; Gaillet, R; Hellige, G; Wahl, A; Saner, H

2006-01-01

379

A comparison of dipyridamole-thallium imaging and exercise testing in the prediction of postoperative cardiac complications in patients requiring arterial reconstruction  

SciTech Connect

The individual and combined predictive values of dipyridamole-thallium imaging and exercise testing were compared in a prospective study of 70 patients who had abdominal aortic aneurysms or aortoiliac occlusive disease that required surgical repair. All patients were evaluated clinically by the same cardiologist and had exercise stress testing and dipyridamole-thallium imaging before admission for surgery. Ten patients were excluded from the study because they had evidence of severe ischemia when tested (ST segment depression greater than 2 mm on exercise testing, severe multivessel disease on thallium imaging). The remaining 60 patients were operated on (abdominal aortic aneurysm repair, 40; aortobifemoral repair, 17; femorofemoral graft, 3). The test results were withheld from the surgeon, anesthetist, and cardiologist before surgery. A total of 22 patients experienced major cardiac complications postoperatively (acute pulmonary edema, 17; acute myocardial infarction, 5; cardiac death, 2). Thallium imaging showed myocardial ischemia in 31/60 patients. Exercise testing was positive (greater than or equal to 1 mm ST segment depression) in 10/60 patients. Dipyridamole-thallium imaging with a high sensitivity and reasonable specificity is the initial test of choice. Exercise testing is a poor screening test because of its low sensitivity. The combination of the two tests gives the highest positive predictive value and the greatest likelihood ratio. Thus patients assessed initially and found to have positive thallium scan results may be further stratified by exercise testing.

McPhail, N.V.; Ruddy, T.D.; Calvin, J.E.; Davies, R.A.; Barber, G.G.

1989-07-01

380

Exercise, Heart and Health  

PubMed Central

Regular physical activity provides a variety of health benefits, including improvement in cardiopulmonary or metabolic status, reduction of the risk of coronary artery disease or stroke, prevention of cancer, and decrease in total mortality. Exercise-related cardiac events are occasionally reported during highly competitive sports activity or vigorous exercises. However, the risk of sudden death is extremely low during vigorous exercise, and habitual vigorous exercise actually decreases the risk of sudden death during exercise. The cause of sudden death is ischemic in older subjects (?35 years old), while cardiomyopathies or genetic ion channel diseases are important underlying pathology in younger (<35 years old) victims. The subgroup of patients who are particularly at higher risk of exercise-related sudden death may be identified in different ways, such as pre-participation history taking, physical examination and/or supplementary cardiac evaluation. Limitations exist because current diagnostic tools are not sufficient to predict a coronary artery plaque with potential risk of disruption and/or an acute thrombotic occlusion. Proper and cost-effective methods for identification of younger subjects with cardiac structural problems or genetic ion channel diseases are still controversial.

2011-01-01

381

Control strategies for integration of electric motor assist and functional electrical stimulation in paraplegic cycling: utility for exercise testing and mobile cycling  

Microsoft Academic Search

Aim: The aim of this study was to investigate feedback control strategies for integration of electric motor assist and functional electrical stimulation (FES) for paraplegic cycling, with particular focus on development of a testbed for exercise testing in FES cycling, in which both cycling cadence and workrate are simultaneously well controlled and contemporary physiological measures of exercise performance derived. A

Kenneth J. Hunt; Barry Stone; N.-O. Negard; T. Schauer; M. H. Fraser; A. J. Cathcart; C. Ferrario; S. A. Ward; S. Grant

2004-01-01

382

Prognostic significance of double product and inadequate double product response to maximal symptom-limited exercise stress testing after myocardial infarction in 6296 patients treated with thrombolytic agents  

Microsoft Academic Search

Background The aim of this study was to evaluate the prognostic significance of the pressure-rate product (PRP) obtained during exercise stress testing and of its change from rest to maximal exercise (dPRP) in a population of survivors of acute myocardial infarction treated with thrombolytic agents. Methods And Results Survivors of acute myocardial infarction (n = 6251) from the GISSI-2 database,

Massimo Villella; Alessandro Villella; Simona Barlera; Maria Grazia Franzosi; Aldo P. Maggioni

1999-01-01

383

Investigation of the most effective provocation test for patients with coronary spastic angina: usefulness of accelerated exercise following hyperventilation.  

PubMed

This study sought to compare the clinical usefulness of the hyperventilation plus cold stress test or the hyperventilation combined with accelerated exercise test with other single tests in patients with coronary spastic angina. The study examined 24 patients (23 men, mean age 66 years) with angiographically confirmed coronary spastic angina and less than 50% stenosis. Moreover, none had spontaneous ST segment elevation before the study. Under no medication for at least 24 h prior, 4 procedures were performed from 09.00 h to 11.00 h: (i) a hyperventilation test for 5 min (HV(5)); (ii) HV(5) combined with a cold stress test for the last 2 min (HV(5)+CS(2)); (iii) a treadmill exercise test based on Bruce's protocol (TM(3)); and (iv) a treadmill exercise test accelerated at 1 min intervals according to Bruce's protocol immediately after HV(5) (HV(5)+TM(1)). The rate of appearance of chest pain and ischemia-induced ECG changes due to HV(5)+TM(1) were significantly higher than the other 3 tests. HV(5)+CS(2) was not superior to HV(5) alone. The incidence of provoked ST segment elevation due to HV(5)+TM(1) was higher than with the other 3 procedures. Thus, in patients with coronary spastic angina, no spontaneous ST segment elevation and near normal coronary arteries, HV(5)+CS(2) was no more useful than HV(5) alone. It is recommended that the newly designed HV(5)+TM(1) combination test be used for documenting evidence of ischemia in patients with coronary spastic angina, low disease activity and near normal coronary arteries. PMID:10084369

Sueda, S; Saeki, H; Otani, T; Ochi, N; Kukita, H; Kawada, H; Matsuda, S; Uraoka, T

1999-02-01

384

Effect of exercise position during stress testing on cardiac and pulmonary thallium kinetics and accuracy in evaluating coronary artery disease  

SciTech Connect

We compared the effects of symptom-limited upright and supine exercise on 201Tl distribution and kinetics in the heart and lungs of 100 consecutive patients. Our analysis was based on data obtained with a digital gamma camera in the 45 degrees left anterior oblique position at 5, 40, 240, and 275 min postadministration of (201Tl)chloride. We found significant differences in the results at the 5- and 40-min intervals; viz, higher cardiac and lower pulmonary thallium activity after upright exercise in 94 subjects at both intervals, and greater variability in total and regional cardiac thallium kinetics after supine exercise. With supine exercise, the relatively low initial cardiac activity, relatively high lung activity, and the greater variability in thallium kinetics combined to make interpretation of quantitative data and cardiac images difficult and less accurate with respect to detection of coronary artery disease. These observations have important implications for the interpreting physician when thallium stress tests are performed in the supine position.

Lear, J.L.

1986-06-01

385

Updates in small animal cardiopulmonary resuscitation.  

PubMed

For dogs and cats that experience cardiopulmonary arrest, rates of survival to discharge are 6% to 7%, as compared with survival rates of 20% for people. The introduction of standardized cardiopulmonary resuscitation guidelines and training in human medicine has led to substantial improvements in outcome. The Reassessment Campaign on Veterinary Resuscitation initiative recently completed an exhaustive literature review and generated a set of evidence-based, consensus cardiopulmonary resuscitation guidelines in 5 domains: preparedness and prevention, basic life support, advanced life support, monitoring, and postcardiac arrest care. This article reviews some of the most important of these new guidelines. PMID:23747269

Fletcher, Daniel J; Boller, Manuel

2013-04-12

386

[Provocative tests and electrophysiological study in athletes].  

PubMed

Provocative tests can be divided into three main categories: first-level or screening tests, consisting basically of step test, which all athletes undergo during pre-participation screening; second-level tests, which include exercise test (simple or cardiopulmonary), performed on the basis of specific clinical indications or for the assessment of functional capacity; and third-level tests, consisting of complex methods such as myocardial scintigraphy and stress echo (or exercise echo), which are performed in subjects adequately selected according to clinical characteristics or to the results of first- and second-level tests. The electrophysiological endocavitary study has specific indications in sustained or frequent ventricular arrhythmias, while it is not useful in diagnostic evaluation of athletes with supraventricular arrhythmias, where it has been replaced in most cases by transesophageal electrophysiological study. PMID:23096388

Inama, Giuseppe; Pedrinazzi, Claudio; Durin, Ornella; Gazzaniga, Pietro; Brambilla, Giulio; Donato, Giorgio; Nanetti, Massimiliano

2012-10-01

387

Prognostic value of symptom limited versus low level exercise stress test before discharge in patients with myocardial infarction treated with thrombolytics  

Microsoft Academic Search

OBJECTIVETo evaluate the benefits and risks of symptom limited exercise testing versus low level exercise testing soon after a thrombolytic treated acute myocardial infarction.DESIGN AND PATIENTS98 patients (71 men, 27 women), mean (SD) age 64 (9) years (range 45–75 years), were investigated 5–8 days after admittance to hospital. An ergometer cycle test was used, starting at 30 W with 10

K Jensen-Urstad; B A Samad; F Bouvier; J Hulting; J Höjer; H Ruiz; M Jensen-Urstad

1999-01-01

388

Pathways to complement activation during cardiopulmonary bypass.  

PubMed Central

Complement activation was assessed in 34 patients undergoing cardiopulmonary bypass. Arterial concentrations of complement fragments Ba and C3d rose in all patients, the increase in Ba preceding that of C3d. At the same time as complement fragments were being generated the arterial neutrophil count fell. These findings suggest (a) that complement activation is initiated by the alternative pathway during cardiopulmonary bypass and (b) that complement activation mediates loss of neutrophils during bypass. Complement mediated loss of neutrophils during the analogous setting of haemodialysis is the result of leucosequestration in the pulmonary vasculature. During cardiopulmonary bypass the lungs are out of circuit, so that activated leucocytes may sequester in other target organs. This may be an aetiological factor in the multi-organ failure occasionally seen after uneventful cardiopulmonary bypass.

Collett, B; Alhaq, A; Abdullah, N B; Korjtsas, L; Ware, R J; Dodd, N J; Alimo, E; Ponte, J; Vergani, D

1984-01-01

389

Impaired hemodynamic response to mental stress in subjects with prehypertension is improved after a single bout of maximal dynamic exercise  

PubMed Central

INTRODUCTION: High blood pressure during mental stress in subjects with prehypertension is associated with blunted vasodilation in skeletal muscles, which might be improved by an acute bout of exercise. OBJECTIVE: To investigate the hemodynamic responses to mental stress before and after a bout of exercise in subjects with prehypertension. METHOD: Eighteen subjects with prehypertension and 16 with normotension underwent a mental stress test before and after a maximal cardiopulmonary exercise test on a treadmill. Blood pressure was measured by auscultation, and forearm blood flow was measured by venous occlusion plethysmography; from these measurements, the vascular conductance was calculated. RESULTS: Subjects with prehypertension had a higher mean blood pressure during mental stress (prehypertension 112±2 vs. normotension 101±3 mm Hg, p<0.05), and their vascular conductance did not increase (baseline 0.025±0.004 vs. mental stress 0.022±0.003 a.u., p>0.05). After the exercise bout, the mean blood pressure during mental stress was lower in subjects with prehypertension (before exercise 112±2 vs. after exercise 107±2 mm Hg, p<0.05), and vascular conductance increased (baseline 0.011±0.001 vs. mental stress 0.024±0.004 a.u., p<0.05). CONCLUSION: Subjects with prehypertension had elevated blood pressure and a blunted vasodilator response during mental stress, but their blood pressure was attenuated and their vasodilator response was normalized after a single bout of maximal dynamic exercise.

Medeiros, Renata Frauches; Silva, Bruno Moreira; Neves, Fabricia Junqueira; Rocha, Natalia Galito; Sales, Allan Robson Kluser; Nobrega, Antonio Claudio

2011-01-01

390

Comparison of on-ice and off-ice graded exercise testing in collegiate hockey players.  

PubMed

The purpose of this study was to compare lactate thresholds (LT) and maximal aerobic capacities (VO(2 max) during sport-specific skating (on ice) and cycle ergometry (off ice) in collegiate hockey players. We hypothesized that VO(2 max) and LT would be higher on ice. We also sought to determine if on-ice and off-ice VO(2 max) values were correlated. Twelve collegiate hockey players performed both graded exercise protocols in randomized order to fatigue. Both protocols included 80 s of work during each stage, followed by 40 s of rest to allow for blood lactate sampling. VO(2 max) was significantly higher on ice (46.9 +/- 1.0 mL*kg(-1)*min(-1)) than off ice (43.6 +/- 0.9 mL*kg(-1)*min(-1); p < 0.05). Maximal heart rate (HR(max)) was also higher on ice (192.2 +/- 1.8 beats*min(-1)) than off ice (186.0 +/- 1.5 beats*min(-1); p < 0.01). LT was drastically higher on ice than off ice as a percentage of VO(2 max) (85.9% +/- 1.9% vs. 69.7% +/- 1.3%; p < 0.01) and HR(max) (90.1% +/- 1.3% vs. 79.4% +/- 1.6%; p < 0.01). Finally, no correlation existed between VO(2 max) values off ice and on ice (r = -0.002; p = 0.99). Our results indicate that off-ice VO(2 max) and LT are not adequate predictors of on-ice VO(2 max) and LT in collegiate hockey players. These findings challenge the use of cycle ergometry to assess aerobic capacity at events such as the National Hockey League Entry Draft combine. We suggest that hockey players be tested in a sport-specific manner, regardless of whether those tests are performed on ice or off ice. PMID:20130664

Durocher, John J; Guisfredi, Angela J; Leetun, Darin T; Carter, Jason R

2010-02-01

391

Design and testing of an MRI-compatible cycle ergometer for non-invasive cardiac assessments during exercise  

PubMed Central

Background Magnetic resonance imaging (MRI) is an important tool for cardiac research, and it is frequently used for resting cardiac assessments. However, research into non-pharmacological stress cardiac evaluation is limited. Methods We aimed to design a portable and relatively inexpensive MRI cycle ergometer capable of continuously measuring pedalling workload while patients exercise to maintain target heart rates. Results We constructed and tested an MRI-compatible cycle ergometer for a 1.5 T MRI scanner. Resting and sub-maximal exercise images (at 110 beats per minute) were successfully obtained in 8 healthy adults. Conclusions The MRI-compatible cycle ergometer constructed by our research group enabled cardiac assessments at fixed heart rates, while continuously recording power output by directly measuring pedal force and crank rotation.

2012-01-01

392

Cancer prevention as a source of exercise motivation: An experimental test using protection motivation theory  

Microsoft Academic Search

The present study examined whether cancer prevention is a meaningful source of exercise motivation using Protection Motivation Theory (PMT). Participants were 427 undergraduate students randomly assigned to read one of 16 persuasive communications that independently manipulated perceived vulnerability (PV), perceived severity (PS), response efficacy (RE) and self-efficacy (SE). A factorial ANOVA indicated a significant main effect for PS and a

K. S. Courneya; L.-A. M. Hellsten

2001-01-01

393

Workplace nutrition and exercise climate: Scale development and preliminary model test  

Microsoft Academic Search

Obesity is a major concern in the United States and has a multitude of negative physical and mental health consequences. Proper nutrition and exercise are important elements to initiating and maintaining a healthy lifestyle. Since most people spend a large amount of their time working, it is important that organizations create an atmosphere that is conducive to employees being able

Joseph J Mazzola

2010-01-01

394

Food Microbiology--Design and Testing of a Virtual Laboratory Exercise  

ERIC Educational Resources Information Center

|A web-based virtual laboratory exercise in identifying an unknown microorganism was designed for use with a cohort of 3rd-year university food-technology students. They were presented with a food-contamination case, and then walked through a number of diagnostic steps to identify the microorganism. At each step, the students were asked to select…

Flint, Steve; Stewart, Terry

2010-01-01

395

Comparison of dobutamine infusion and supine bicycle exercise for radionuclide cardiac stress testing  

Microsoft Academic Search

A comparison is made of the inotropic drug dobutamine to supine bicycle exercise as a means of inducing stress in radionuclide ventriculography studies. Dobutamine has the following properties, making it favorable for widespread usage: 1) ability to be given safely in a peripheral vein, 2) rapid onset, and 3) short duration of action. Each patient underwent supine bicycle progressive resistance

MAYNARD L. FREEMAN; ROBERT PALAC; JAMES MASON; W EARL BARNES; GARY EASTMAN; SHEILA VIRUPANNAVAR; HENRY S. LOEB; ERVIN KAPLAN

1984-01-01

396

Comparison of endothelial vasodilator function, inflammatory markers, and N-terminal pro-brain natriuretic peptide in patients with or without chronotropic incompetence to exercise test  

Microsoft Academic Search

Objective: To investigate the role of endothelial function, inflammatory markers, and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with impaired chronotropic response during exercise test.Methods: 86 subjects were enrolled. Treadmill exercise test was conducted according to the modified Bruce protocols. Brachial ultrasound was used to measure endothelium dependent flow mediated vasodilatation (FMD). Chronotropic incompetence was defined as either failure to

P-H Huang; H-B Leu; J-W Chen; T-C Wu; T-M Lu; Y-A Ding; S-J Lin

2006-01-01

397

Can heart rate values obtained from laboratory and field lactate tests be used interchangeably to prescribe exercise intensity for soccer players?  

Microsoft Academic Search

This study was undertaken to investigate the relationship between blood lactate concentration ([La]) and heart rate (HR) values\\u000a obtained during treadmill and field tests at fixed velocities with respect to interchangeability of results to be used in\\u000a exercise prescription. A total of 22 male soccer players participated in the study. Each player performed exercise tests on\\u000a a motorized treadmill and

Bunak Kunduracioglu; Rustu Guner; Bulent Ulkar; Ali Erdogan

2007-01-01

398

Cardiac troponin T levels and exercise stress testing in patients with suspected coronary artery disease: the Akershus Cardiac Examination (ACE) 1 study  

PubMed Central

Whether reversible ischaemia in patients referred for exercise stress testing and MPI (myocardial perfusion imaging) is associated with changes in circulating cTn (cardiac troponin) levels is controversial. We measured cTnT with a sensitive assay before, immediately after peak exercise and 1.5 and 4.5 h after exercise stress testing in 198 patients referred for MPI. In total, 19 patients were classified as having reversible myocardial ischaemia. cTnT levels were significantly higher in patients with reversible myocardial ischaemia on MPI at baseline, at peak exercise and after 1.5 h, but not at 4.5 h post-exercise. In patients with reversible ischaemia on MPI, cTnT levels did not change significantly after exercise stress testing [11.1 (5.2–14.9) ng/l at baseline compared with 10.5 (7.2–16.3) ng/l at 4.5 h post-exercise, P=0.27; values are medians (interquartile range)]. Conversely, cTnT levels increased significantly during testing in patients without reversible myocardial ischaemia [5.4 (3.0–9.0) ng/l at baseline compared with 7.5 (4.6–12.4) ng/l, P<0.001]. In conclusion, baseline cTnT levels are higher in patients with MPI evidence of reversible myocardial ischaemia than those without reversible ischaemia. However, although cTnT levels increase during exercise stress testing in patients without evidence of reversible ischaemia, this response appears to be blunted in patients with evidence of reversible ischaemia. Mechanisms other than reversible myocardial ischaemia may play a role for acute exercise-induced increases in circulating cTnT levels.

R?ysland, Ragnhild; Kravdal, Gunnhild; H?iseth, Arne Didrik; Nygard, Stale; Badr, Pirouz; Hagve, Tor-Arne; Omland, Torbj?rn; R?sj?, Helge

2012-01-01

399

Effects of fitness test type, teacher, and gender on exercise intrinsic motivation and physical self-worth.  

PubMed

This study compared effects on exercise intrinsic motivation and physical self-worth of taking either the President's Challenge or the Fitnessgram fitness test battery. Three teachers administered the battery to seventh and eighth grade students (N = 370). The only significant effect involving fitness test type on intrinsic motivation was a test-teacher-gender interaction on the interest-enjoyment subscale of the Intrinsic Motivation Inventory (IMI). Main effects occurred for gender on intrinsic motivation and physical self-worth (PSW). Finally, using a Fitness Level x Gender x Fitness Test Type design, a main effect occurred for fitness level on all four IMI subscales, and also on PSW. While results supported the construct validity of IMI and PSW scales, they did not support the theory-based premise that fitness test batteries would produce different motivational and self-perception outcomes. Results are discussed with reference to the limitations and delimitations of the field-based study. PMID:2027288

Whitehead, J R; Corbin, C B

1991-01-01

400

Dynamic pulmonary hyperinflation occurs without expiratory flow limitation in chronic heart failure during exercise.  

PubMed

To assess the occurrence of tidal expiratory flow limitation (EFL) and/or dynamic pulmonary hyperinflation (DH) in chronic heart failure (CHF) during exercise 15 patients with stable systolic CHF, aged 69±6yr, underwent pulmonary function testing and incremental cardio-pulmonary exercise testing. They subsequently performed constant load exercise testing at 30, 60 and 90% of respective maximum workload. At each step the presence of EFL, by negative expiratory pressure technique, and changes in inspiratory capacity (IC) were assessed. Ejection fraction amounted to 36±6% and [Formula: see text] , peak (77±19% pred.) was reduced. EFL was absent at any step during constant load exercise. In 6 patients IC decreased more than 10% pred. at highest step. Only in these patients TLC, FRC, RV FEF25-75% and DLCO were decreased at rest. [Formula: see text] , peak correlated with DLCO, TLC and IC at rest and with IC (r(2)=0.59; p<0.001) and decrease in IC (r(2)=0.44; p<0.001) at 90% of maximum workload. During exercise CHF patients do not exhibit EFL, but some of them develop DH that is associated with lower [Formula: see text] , peak. PMID:23851110

Chiari, Stefania; Torregiani, Chiara; Boni, Enrico; Bassini, Sonia; Vizzardi, Enrico; Tantucci, Claudio

2013-07-09

401

Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer  

PubMed Central

BACKGROUND—Resection is the treatment of choice for lung cancer, but may cause impaired cardiopulmonary function with an adverse effect on quality of life. Few studies have considered the effects of thoracotomy alone on lung function, and whether the operation itself can impair subsequent exercise capacity.?METHODS—Patients being considered for lung resection (n = 106) underwent full static and dynamic pulmonary function testing which was repeated 3-6 months after surgery (n =53).?RESULTS—Thoracotomy alone (n = 13) produced a reduction in forced expiratory volume in one second (FEV1; mean (SE) 2.10 (0.16) versus 1.87 (0.15) l; p<0.05). Wedge resection (n = 13) produced a non-significant reduction in total lung capacity (TLC) only. Lobectomy (n = 14) reduced forced vital capacity (FVC), TLC, and carbon monoxide transfer factor but exercise capacity was unchanged. Only pneumonectomy (n = 13) reduced exercise capacity by 28% (PV?O2 23.9 (1.5) versus 17.2 (1.7) ml/min/kg; difference (95% CI) 6.72 (3.15 to 10.28); p<0.01) and three patients changed from a cardiac limitation to exercise before pneumonectomy to pulmonary limitation afterwards.?CONCLUSIONS—Neither thoracotomy alone nor limited lung resection has a significant effect on exercise capacity. Only pneumonectomy is associated with impaired exercise performance, and then perhaps not as much as might be expected.??

Nugent, A; Steele, I; Carragher, A; McManus, K; McGuigan, J; Gibbons, J; Riley, M; Nicholls, D

1999-01-01

402

Effects of the oral contraceptive pill cycle on physiological responses to hypoxic exercise.  

PubMed

To test whether the oral contraceptive pill cycle affects endocrine and metabolic responses to hypoxic (fraction of inspired oxygen = 13%, P(IO2): 95 mmHg; H) versus normoxic (P(IO2):153 mmHg; N) exercise, we examined eight women (28 +/- 1.2 yr) during the third (PILL) and placebo (PLA) weeks of their monthly oral contraceptive pill cycle. Cardiopulmonary, metabolic, and neuroendocrine measurements were taken before, during, and after three 5-min consecutive workloads at 30%, 45%, and 60% of normoxic V(O2peak) in H and N trials. Heart rate response to exercise was greater in H versus N, but was not different between PILL and PLA. Lactate levels were significantly greater during exercise, and both lactate and glucose levels were significantly greater for 30 min after exercise in H versus N (p < 0.0001). When expressed relative to baseline, lactate levels were lower in PILL versus PLA, but glucose was greater in PILL versus PLA (p < 0.001). Cortisol levels were also significantly greater in PILL versus PLA (p < 0.001). Norepinephrine levels were significantly increased during exercise (p < 0.0001) and in H versus N (p < 0.0001). However, epinephrine levels were not different over time or with trial. Thus, the presence of circulating estradiol and progesterone during the PILL phase reduces glucose and lactate responses to hypoxic exercise. PMID:12713713

Sandoval, Darleen A; Matt, Kathleen S

2003-01-01

403

Assessment of ventilatory thresholds during graded and maximal exercise test using time varying analysis of respiratory sinus arrhythmia  

PubMed Central

Objective: To test whether ventilatory thresholds, measured during an exercise test, could be assessed using time varying analysis of respiratory sinus arrhythmia frequency (fRSA). Methods: Fourteen sedentary subjects and 12 endurance athletes performed a graded and maximal exercise test on a cycle ergometer: initial load 75 W (sedentary subjects) and 150 W (athletes), increments 37.5 W/2 min. fRSA was extracted from heart period series using an evolutive model. First (TV1) and second (TV2) ventilatory thresholds were determined from the time course curves of ventilation and ventilatory equivalents for O2 and CO2. Results: fRSA was accurately extracted from all recordings and positively correlated to respiratory frequency (r = 0.96 (0.03), p<0.01). In 21 of the 26 subjects, two successive non-linear increases were determined in fRSA, defining the first (TRSA1) and second (TRSA2) fRSA thresholds. When expressed as a function of power, TRSA1 and TRSA2 were not significantly different from and closely linked to TV1 (r = 0.99, p<0.001) and TV2 (r = 0.99, p<0.001), respectively. In the five remaining subjects, only one non-linear increase was observed close to TV2. Significant differences (p<0.04) were found between athlete and sedentary groups when TRSA1 and TRSA2 were expressed in terms of absolute and relative power and percentage of maximal aerobic power. In the sedentary group, TRSA1 and TRSA2 were 150.3 (18.7) W and 198.3 (28.8) W, respectively, whereas in the athlete group TRSA1 and TRSA2 were 247.3 (32.8) W and 316.0 (28.8) W, respectively. Conclusions: Dynamic analysis of fRSA provides a useful tool for identifying ventilatory thresholds during graded and maximal exercise test in sedentary subjects and athletes.

Blain, G; Meste, O; Bouchard, T; Bermon, S; Segura, R.

2005-01-01

404

Skeletal muscle VO? kinetics from cardio-pulmonary measurements: assessing distortions through O? transport by means of stochastic work-rate signals and circulatory modelling.  

PubMed

During non-steady-state exercise, dynamic changes in pulmonary oxygen uptake (VO?pulm) are dissociated from skeletal muscle VO? (VO?musc) by changes in lung and venous O? concentrations (CvO?), and the dynamics and distribution of cardiac output (CO) between active muscle and remaining tissues (Qrem). Algorithms can compensate for fluctuations in lung O? stores, but the influences of CO and CvO? kinetics complicate estimation of VO?musc from cardio-pulmonary measurements. We developed an algorithm to estimate VO?musc kinetics from VO?pulm and heart rate (HR) during exercise. 17 healthy volunteers (28 ± 7 years; 71 ± 12 kg; 7 females) performed incremental exercise using recumbent cycle ergometry (VO?peak 52 ± 8 ml min(-1) kg(-1)). Participants completed a pseudo-random binary sequence (PRBS) test between 30 and 80 W. VO?pulm and HR were measured, and CO was estimated from HR changes and steady-state stroke volume. VO?musc was derived from a circulatory model and time series analyses, by solving for the unique combination of venous volume and the perfusion of non-exercising tissues that provided close to mono-exponential VO?musc kinetics. Independent simulations showed that this approach recovered the VO?musc time constant (?) to within 7% (R(2) = 0.976). Estimates during PRBS were venous volume 2.96 ± 0.54 L; Qrem 3.63 ± 1.61 L min(-1); ?HR 27 ± 11 s; ?VO?musc 33 ± 8 s; ?VO?pulm 43 ± 14 s; VO?pulm time delay 19 ± 8 s. The combination of stochastic test signals, time series analyses, and a circulatory model permitted non-invasive estimates of VO?musc kinetics. Large kinetic dissociations exist between muscular and pulmonary VO? during rapid exercise transients. PMID:23412541

Hoffmann, U; Drescher, U; Benson, A P; Rossiter, H B; Essfeld, D

2013-02-15

405

Italian mitochondrial DNA database: results of a collaborative exercise and proficiency testing  

Microsoft Academic Search

This work is a review of a collaborative exercise on mtDNA analysis undertaken by the Italian working group (Ge.F.I.). A total\\u000a of 593 samples from 11 forensic genetic laboratories were subjected to hypervariable region (HVS-I\\/HVS-II) sequence analysis.\\u000a The raw lane data were sent to MtDNA Population Database (EMPOP) for an independent evaluation. For the inclusion of data\\u000a for the Italian

Chiara Turchi; Loredana Buscemi; Carlo Previderè; Pierangela Grignani; Anita Brandstätter; Alessandro Achilli; Walther Parson; Adriano Tagliabracci

2008-01-01

406

Responses to training and standardised exercise test in the athlete horse: changes in blood gas profile  

Microsoft Academic Search

In order to assess the relationship between blood gas profile and athletic performance after a specific training programme,\\u000a six clinically healthy Italian saddle horses were used. Each animal was subjected to an adaptation period constituted by horse\\u000a walker exercise, followed by a training programme for 3 months. In the last day of each month, all horses were subjected to\\u000a a standardized

Stefania Casella; Daniela Alberghina; Claudia Giannetto; Giuseppe Piccione

407

A Test of Self-Determination Theory in the Exercise Domain  

Microsoft Academic Search

In accordance with self-determination theory (SDT; Deci & Ryan, 1985), this study examined the relationship between autonomy support, psychological need satis- faction, motivational regulations, and exercise behavior. Participants (N5369) were recruited from fitness, community, and retail settings. Fulfillment of the 3 basic psychological needs (i.e., competence, autonomy, and relatedness) related to more self-determined motivational regulations. Identified and introjected regula- tions

Jemma Edmunds; Nikos Ntoumanis; Joan L. Duda

2006-01-01

408

Exercise testing in late-onset glycogen storage disease type II patients undergoing enzyme replacement therapy  

PubMed Central

Enzyme replacement therapy (ERT) has recently became available for patients with glycogen storage disease type II. Previous studies have demonstrated clinical efficacy of enzyme replacement therapy, however, data on physiological variables related to exercise tolerance are scarce. Four glycogen storage disease type II late-onset patients (45 ± 6 years) performed an incremental exercise on a cycle ergometer, up to voluntary exhaustion, before (BEFORE) and after 12 months of ERT (AFTER). Peak workload, oxygen uptake, heart rate, cardiac output (by impedance cardiography) and vastus lateralis oxygenation indices (by continuous-wave near-infrared spectroscopy, NIRS) were determined. Peak workload and oxygen uptake values significantly increased during ERT (54 ± 30 vs. 63 ± 31 watt, and 17.2 ± 4.4 vs. 19.7 ± 3.5 ml/kg/min, respectively, in BEFORE vs. AFTER). On the other hand, for both peak cardiac output (12.3 ± 5.3 vs. 14.8 ± 4.5 L/min) and the NIRS-determined peak skeletal muscle fractional O2 extraction, expressed as a percentage of the maximal values during a transient limb ischemia (30 ± 39% vs. 38 ± 28%), the observed increases were not statistically significant. Our findings suggest that in glycogen storage disease type II patients enzyme replacement therapy is associated with a mild improvement of exercise tolerance. The findings need to be validated during a longer follow-up on a larger group of patients.

Marzorati, Mauro; Porcelli, Simone; Bellistri, Giuseppe; Morandi, Lucia; Grassi, Bruno

2012-01-01

409

Surface EMG observation and isokinetic test on pressing-kneading manipulations for exercise fatigue of anterior tibial muscle  

Microsoft Academic Search

Objective  To observe the therapeutic effect of An-pressing and Rou-kneading manipulations for exercise fatigue of the anterior tibial\\u000a muscle.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Sixty healthy subjects were randomly divided into two groups, 30 in each group. Isokinetic test training was employed to induce\\u000a left anterior tibial muscle fatigue. After this, subjects in the observation group received 5 min of tuina treatment, while\\u000a subjects in the

Junfeng Zhang; Debin Sun

2011-01-01

410

Cardiopulmonary baroreceptors affect reflexive startle eye blink.  

PubMed

Baroafferent signals originating from the 'high pressure' arterial vascular system are known to impact reflexive startle eye blink responding. However, it is not known whether baroafferent feedback of the 'low pressure' cardiopulmonary system loading status exerts a similar effect. Lower Body Negative Pressure (LBNP) at gradients of 0, -10, -20, and -30mm Hg was applied to unload cardiopulmonary baroreceptors. Acoustic startle noise bursts were delivered 230 and 530ms after spontaneous R-waves, when arterial baroreceptors are either loaded or unloaded. Eye blink responses were measured by EMG, and psychomotor reaction time by button pushes to startle stimuli. The new finding of this study was that unloading of cardiopulmonary baroreceptors increases startle eye blink responsiveness. Furthermore, we replicated the effect of relative loading/unloading of arterial baroreceptors on startle eye blink responsiveness. Effects of either arterial or cardiopulmonary baroreceptor manipulations were not present for psychomotor reaction times. These results demonstrate that the loading status of cardiopulmonary baroreceptors has an impact on brainstem-based CNS processes. PMID:19799919

Richter, S; Schulz, A; Port, J; Blumenthal, T D; Schächinger, H

2009-09-30

411

21 CFR 870.4280 - Cardiopulmonary prebypass filter.  

Code of Federal Regulations, 2013 CFR

...Cardiopulmonary prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of the oxygenator circuit to remove particulates or other debris from the circuit prior to initiating bypass. The device is not used to...

2013-04-01

412

21 CFR 870.4280 - Cardiopulmonary prebypass filter.  

Code of Federal Regulations, 2010 CFR

...Cardiopulmonary prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of the oxygenator circuit to remove particulates or other debris from the circuit prior to initiating bypass. The device is not used to...

2010-04-01

413

Measurement of Cardiopulmonary Function by Rebreathing Methodology in Piglets.  

National Technical Information Service (NTIS)

The use of a multiple gas rebreathing method for the measurement of cardiopulmonary function in mechanically ventilated neonates was evaluated. The following indices of cardiopulmonary function were assessed in 20 piglets (mean weight, 2.3 kg): (1) pulmon...

W. M. Mentz E. E. Lawson M. Friedman

1984-01-01

414

Impaired post exercise heart rate recovery in anabolic steroid users.  

PubMed

Previous study showed that muscle sympathetic nerve activity (MSNA) was augmented in anabolic steroids users (AASU). In the present study, we tested the hypothesis that the heart rate (HR) responses after maximal exercise testing would be reduced in AASU. 10 male AASU and 10 AAS nonusers (AASNU) were studied. Cardiopulmonary exercise was performed to assess the functional capacity and heart rate recovery. MSNA was recorded directly from the peroneal nerve by microneurography technique. Peak oxygen consumption (VO2) was lower in AASU compared to AASNU (43.66±2.24 vs. 52.70±1.68 ml/kg/min, P=0.005). HR recovery (HRR) at first and second minute was lower in AASU than AASNU (21±2 vs. 27±2 bpm, P=0.02 and 37±4 vs. 45±2 bpm, P=0.05, respectively). MSNA was higher in AASU than AASNU (29±3 vs. 20±1 bursts/min, P=0.01). Further analysis showed a correlation between HRR and MSNA (r=- 0.64, P=0.02), HRR at first minute and peak VO2 (r=0.70, P=0.01) and HRR at second minute and peak VO2 (r=0.62, P=0.02). The exacerbated sympathetic outflow associated with a lower parasympathetic activation after maximal exercise, which impairs heart rate recovery, strengthens the idea of autonomic imbalance in AASU. PMID:23606338

Dos Santos, M R; Dias, R G; Laterza, M C; Rondon, M U P B; Braga, A M F W; de Moraes Moreau, R L; Negrão, C E; Alves, M-J N N

2013-04-19

415

The Testing of a Theoretical Model: Effect of a Nutrition Course on the Dimensions of Knowledge, Attitude and Behavior Relative to Diet\\/exercise and Cardiovascular Disease Relationship  

Microsoft Academic Search

LEARNING OUTCOME: Identify the effect of a nutrition course on dimensions of knowledge, attitude and behavior relative to the diet\\/exercise\\/cardiovascular disease relationship.We tested a multidimensional approach to evaluating knowledge, attitudes\\/beliefs; and behavior relative to the relationship of diet\\/exercise to cardiovascular disease development, to better identify specific targets and strategies to successfully effect change in eating\\/ health behavior. We evaluated the

A. J. Blake

1996-01-01

416

Effects of eight weeks of exercise training and orlistat therapy on body composition and maximal exercise capacity in obese females.  

PubMed

A comparative assessment was made of the short-term effects of orlistat therapy and exercise training on body composition and aerobic fitness in obese females. A total of 24 obese patients were enrolled in to the study; 12 received orlistat therapy (DO) and 12 participated in a regular aerobic exercise-training programme (DE). All patients were on hypocaloric diets. Each patient performed three incremental ramp exercise tests (one at Week 0, one at the end of Week 4 and one at the end of Week 8) to exhaustion using an electromagnetically braked cycle ergometer to determine their anaerobic threshold and maximal exercise (Wmax) capacity. Patients in the DE group performed continuous exercise at a work rate that corresponded to the anaerobic threshold. Weight loss and loss of fat mass after 8 weeks were -6.4% (P=0.002) and -13.4% (DE) vs -5.8% (P=0.002) and -6.4% (P=0.008) (DO), respectively. Wmax capacity was 90.8+/-5 W (basal) vs 92.9+/-5 W (Week 4, P=0.1) and 100.4+/-6 W (Week 8, 10.5%, P=0.04) in the DO group, and 96.2+/-6 W (basal) vs 129.1+/-4 W (Week 4, 34.1%, P=0.002) and 137.5+/-5 W(Week 8, 42.9%, P=0.002) in the DE group. Despite similar decreases in body weight in both groups, patients in the DE group achieved a markedly higher level of Wmax, reflecting a better improvement in cardiopulmonary fitness, compared with patients in the DO group. Considering the improvement of aerobic fitness in the short term, an aerobic exercise-training programme should be considered for sedentary obese patients to improve their aerobic fitness and thereby reduce the negative outcomes of obesity. PMID:16198382

Ozcelik, O; Dogan, H; Kelestimur, H

2005-09-29

417

Haemodynamic responses to exercise stress test in postmenopausal women with coronary artery disease.  

PubMed

Coronary artery disease is the leading cause of death and disability in women. The incidence of coronary artery disease increases sharply after menopause. Coronary artery disease results from imbalance between myocardial oxygen supply and oxygen demand of the heart. Myocardial oxygen consumption is a helpful indicator of the response of the coronary circulation to the myocardial oxygen demand. Myocardial oxygen consumption is calculated by indirect methods like Stroke's work, Fick's principle, tension time index and rate pressure product. Rate pressure product is a major determinant of cardiac oxygen consumption. It is the product of heart rate with systolic blood pressure. It indicates that adequate stress was achieved and is an important indicator of ventricular function. It increases progressively with exercise. Peak rate pressure product is the rate pressure product at peak of exercise. Peak rate pressure product gives an accurate reflection of the myocardial oxygen demand and myocardial workload. The higher the peak rate pressure product, more will be the myocardial oxygen consumption. The ability to reach higher peak rate pressure product is associated with more adequate coronary perfusion. Thus the low value of peak rate pressure product suggests significant compromise of coronary perfusion and decreased left ventricular function. In the present study effect of exercise on haemodynamic parameters of postmenopausal women without coronary artery disease and postmenopausal women with coronary artery disease were compared. The percentage increase in systolic blood pressure was significantly more in postmenopausal women without coronary artery disease. The peak rate pressure product was significantly more in postmenopausal women without coronary artery disease (28.04 +/- 0.8293 mm of Hg beats / minute x 10(3)) as compared to postmenopausal women with coronary artery disease (25.14+/- 0.8993 mm of Hg beats/ minute x 10(3)) indicating more compromised coronary perfusion in postmenopausal woman with coronary artery disease. PMID:24000504

Nagpal, Sangeeta; Walia, Lily

2013-01-01

418

Effect of mildly attenuated heart rate response during treadmill exercise testing on cardiovascular outcome in healthy men and women.  

PubMed

Attenuated heart rate (HR) response during exercise is associated with adverse cardiovascular outcome. The acceptable value for HR response is 85% of the age-predicted maximal HR (APMHR). This study hypothesized that mild attenuation of HR response during exercise among healthy subjects is associated with increased cardiovascular risk. The study population comprised 10,323 healthy men and women without known cardiovascular disease (CVD) or diabetes mellitus who underwent a yearly screening program and were followed up during a mean period of 4.3 years. Participants were grouped to 3 tertiles based on the percentage of their APMHR reached at the baseline stress test. The primary end point was the occurrence of CVD or cerebrovascular disease. A total of 1,015 incident cases of CVD occurred during follow-up. A multivariate Cox proportional hazards regression model showed that the CVD risk of subjects who reached 60% to 96% of their APMHR was 35% greater compared with those who reached their APMHR (p = 0.001). A subgroup analysis among subjects who reached 85% of their APMHR showed that even mildly attenuated heart response (in the range of 85% to 96% APMHR) was independently associated with 36% increase in CVD risk (p <0.001). In conclusion, attenuated HR response during exercise is a powerful and independent predictor of adverse cardiovascular events during long-term follow-up among healthy men and women. The prognostic implications of attenuated HR response in this population are apparent even with a minor decrease of the maximal HR to <96% of the APMHR. PMID:23993119

Maor, Elad; Kopel, Eran; Sidi, Yechezkel; Goldenberg, Ilan; Segev, Shlomo; Kivity, Shaye

2013-08-29

419

Increasing combat realism: the effectiveness of stun belt use on soldiers for the enhancement of live training and testing exercises  

NASA Astrophysics Data System (ADS)

The ability to make correct decisions while operating in a combat zone enables American and Coalition warfighters to better respond to any threats they may encounter due to the minimization of negative training the warfighter encountered during their live, virtual, and constructive (LVC) training exercises. By increasing the physical effects encountered by one's senses during combat scenarios, combat realism is able to be increased, which is a key component in the reduction in negative training. The use of LVC simulations for training and testing augmentation purposes depends on a number of factors, not the least of which is the accurate representation of the training environment. This is particularly true in the realm of tactical engagement training through the use of Tactical Engagement Simulation Systems (TESS). The training environment is perceived through human senses, most notably sight and hearing. As with other haptic devices, the sense of touch is gaining traction as a viable medium through which to express the effects of combat battle damage from the synthetic training environment to participants within a simulated training exercise. New developments in this field are promoting the safe use of an electronic stun device to indicate to a trainee that they have been hit by a projectile, from either direct or indirect fire, through the course of simulated combat. A growing number of examples suggest that this added output medium can greatly enhance the realism of a training exercise and, thus, improve the training value. This paper serves as a literature survey of this concept, beginning with an explanation of TESS. It will then focus on how the electronic stun effect may be employed within a TESS and then detail some of the noted pros and cons of such an approach. The paper will conclude with a description of potential directions and work.

Schricker, Bradley C.; Antalek, Christopher

2006-06-01

420

No effect of short-term arginine supplementation on nitric oxide production, metabolism and performance in intermittent exercise in athletes.  

PubMed

Arginine supplementation has been shown to alleviate endothelial dysfunction and improve exercise performance through increasing nitric oxide production in patients with cardiopulmonary diseases. In addition, arginine supplementation could decrease accumulations of lactate and ammonia, metabolites involved in development of muscular fatigue. The aim of this study was to investigate the effect of short-term arginine supplementation on performance in intermittent anaerobic exercise and the underlying mechanism in well-trained male athletes. Ten elite male college judo athletes participated with a randomized crossover, placebo-controlled design. The subjects consumed 6 g/day arginine (ARG trial) or placebo (CON trial) for 3 days then performed an intermittent anaerobic exercise test on a cycle ergometer. Blood samples were collected before supplementation, before and during exercise and 0, 3, 6, 10, 30 and 60 min after exercise. ARG trial had significantly higher arginine concentrations than CON trial at the same time point before, during and after exercise. In both trials, nitrate and nitrite concentration was significantly higher during and 6 min after exercise comparing to the basal concentration. The increase in nitrate and nitrite concentration during exercise in both trials was parallel to the increase in plasma citrulline concentrations. There was no significant difference between the 2 trials in plasma nitrate and nitrite, lactate and ammonia concentrations and peak and average power in the exercise. The results of this study suggested that short-term arginine supplementation had no effect on nitric oxide production, lactate and ammonia metabolism and performance in intermittent anaerobic exercise in well-trained male athletes. PMID:18708287

Liu, Tsung-Han; Wu, Ching-Lin; Chiang, Chi-Wei; Lo, Yu-Wei; Tseng, Hung-Fu; Chang, Chen-Kang

2008-08-15

421

Increased Exhaled Nitric Oxide Levels Following Exercise in Patients with Chronic Systolic Heart Failure with Pulmonary Venous Hypertension  

PubMed Central

Background Fractional exhaled nitric oxide (eNO) is recognized as a marker of pulmonary endothelial function. Oxidative stress is associated to systemic endothelial nitric oxide production but its correlation with eNO in heart failure (HF) patients has not been described. Previous studies have reported increased eNO levels after exercise in symptomatic HF patients but decreased levels in pulmonary arterial hypertension. Our objective is to prospectively examine the potential myocardial and functional determinants of exercise-induced rise of eNO in HF. Methods and Results Thirty-four consecutive ambulatory patients with chronic systolic HF (left ventricular ejection fraction [LVEF] ?45%) underwent symptom-limited cardiopulmonary stress testing and echocardiography. eNO was determined immediately after exercise. Systemic endothelial dysfunction was assessed by asymmetric dimethylarginine (ADMA) and the L-arginine/ADMA ratio. In our study cohort (mean age 53 ±13 years, 76% male, median LVEF 31%, interquartile range [IQR]: 25 to 40), the mean eNO was 23 ±9 ppb. eNO levels were higher in patients with diastolic dysfunction stages 2 or 3 than stage 1 or normal diastology (26.1±9 vs. 19.5±7 ppb, p=0.013). eNO had a positive correlation with estimated systolic pulmonary artery pressure (r= 0.57; p=0.0009) and indexed left atrium volume (r= 0.43; p= 0.014), but did not correlate with cardiopulmonary exercise test parameters, ADMA, or symptom score. Conclusions In contrast to prior reports, the increase in post-exercise eNO observed in stable chronic systolic HF patients may be attributed to the presence of underlying pulmonary venous hypertension probably secondary to advanced diastolic dysfunction.

Schuster, Andres; Thakur, Akanksha; Wang, Zeneng; Borowski, Allen G.; Thomas, James D.; Wilson Tang, W. H.

2012-01-01

422

Early recovery of oxygen kinetics after submaximal exercise test predicts functional capacity in patients with chronic heart failure  

Microsoft Academic Search

Abstract Ž.,Ž . Background: Oxygen O uptake at peak t-slope after maximal and submaximal exercise was reduced in patients with severe exercise intolerance F 9.3, 2 . P 0.001 and F 12.8, P 0.001, respectively . Conclusions: Early recovery O kinetics parameters after maximal and 2 submaximal,exercise,correlate closely with established,indices of exercise,capacity,in patients with CHF and,in healthy volunteers. These findings

Serafim Nanas; John Nanas; Christos Kassiotis; Chara Nikolaou; Eleytheria Tsagalou; Demetrios Sakellariou; Ioannis Terovitis; Ourania Papazachou; Stavros Drakos; Antonios Papamichalopoulos; Charis Roussos

423

Exercise and Memory  

NSDL National Science Digital Library

This activity (on page 2 of the PDF) is a full inquiry investigation into the effects of exercise on short term memory. Groups of learners will set a baseline score with an initial memory test. Then they split into two teams, one participating in physical exercise while the other remains sedentary. After ten minutes, both teams take another memory test to tabulate and graph score changes. Relates to linked video, DragonflyTV: Exercise and Memory.

Twin Cities Public Television, Inc.

2005-01-01

424

Exercise Interventions in Children with Cancer: A Review  

PubMed Central

The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL) diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.

Huang, Tseng-Tien; Ness, Kirsten K.

2011-01-01

425

Pulmonary artery pressure limits exercise capacity at high altitude.  

PubMed

Altitude exposure is associated with decreased exercise capacity and increased pulmonary vascular resistance (PVR). Echocardiographic measurements of pulmonary haemodynamics and a cardiopulmonary exercise test were performed in 13 healthy subjects at sea level, in normoxia and during acute hypoxic breathing (1 h, 12% oxygen in nitrogen), and in 22 healthy subjects after acclimatisation to an altitude of 5,050 m. The measurements were obtained after randomisation, double-blinded to the intake of placebo or the endothelin A receptor blocker sitaxsentan (100 mg·day(-1) for 7 days). Blood and urine were sampled for renal function measurements. Normobaric as well as hypobaric hypoxia increased PVR and decreased maximum workload and oxygen uptake (V'(O(2),max)). Sitaxsentan decreased PVR in acute and chronic hypoxia (both p<0.001), and partly restored V'(O(2),max), by 30 % in acute hypoxia (p<0.001) and 10% in chronic hypoxia (p<0.05). Sitaxsentan-induced changes in PVR and V'(O(2),max) were correlated (p = 0.01). Hypoxia decreased glomerular filtration rate and free water clearance, and increased fractional sodium excretion. These indices of renal function were unaffected by sitaxsentan intake. Selective endothelin A receptor blockade with sitaxsentan improves mild pulmonary hypertension and restores exercise capacity without adverse effects on renal function in hypoxic normal subjects. PMID:20378601

Naeije, R; Huez, S; Lamotte, M; Retailleau, K; Neupane, S; Abramowicz, D; Faoro, V

2010-04-08

426

Plasma histamine profiles in paediatric cardiopulmonary bypass  

Microsoft Academic Search

We have previously reported our findings of very high plasma histamine levels in the extracorporeal blood primes of infants undergoing cardiopulmonary bypass (CPB) for correction of congenital cardiac defects and have now extended this enquiry to examine the whole peri-operative period. In this preliminary study, samples of blood for plasma histamine were drawn from a mixed group of congenital cardiac

A. Marath; W. Man; K. M. Taylor; P. B. Deverall; S. Parsons; O. H. Jones; C. Lincoln; A. Kimberley

1988-01-01

427

Cardiopulmonary Bypass: Studies on Its Damaging Effects  

Microsoft Academic Search

Despite the widespread safe application of cardiopulmonary bypass (CPB) for cardiac surgery, it is inherently a pathologic state. CPB produces a generalized inflammatory reaction involving at least the complement, coagulation, kallikrein, and fibrinolytic cascades.Marked alterations in organ perfusion and metabolism occur during CPB which are further affected by the perfusion flow rate. During hypothermic CPB at 20 °C, there is

James K. Kirklin; Eugene H. Blackstone; John W. Kirklin

1987-01-01

428

Cardiopulmonary bypass and the coagulation system  

Microsoft Academic Search

Cardiopulmonary bypass exerts intended and unintended effects on the enzymatic and formed elements of the coagulation and inflammatory systems. Compared with adults, children are at special risk for known, and unknown, differences in their hemostatic systems. Management of these risks will be presented from a surgical perspective, supporting those strategies with a combination of peer-reviewed data and empiric experience. Preoperatively,

Thomas Yeh; Minoo N. Kavarana

2005-01-01

429

A simple and portable paced step test for reproducible measurements of ventilation and oxygen consumption during exercise.  

PubMed Central

A single work rate paced step test is described. It was designed to allow the measurement of minute ventilation (VI) and oxygen consumption (VO2), under standardised conditions, during exercise in the clinic and lung function laboratory and in field work. The subjects and the operator found the test simple to perform. The values for ventilation at a given oxygen consumption were similar to those from more complex and stressful tests and had a high degree of reproducibility. The ergometer was a 12 inch (30 cm) step with hand rails. The subjects stepped down, once every four seconds in response to a buzzer for 10 minutes. VI and VO2 were measured with a small portable device. In 53 normal subjects of mean weight 69 (range 49-107) kg, mean VO2 measured during the last 5 minutes of the test was 0.89 (range 0.53-1.52) 1/min. Weight and height were independent contributors to the oxygen cost of stepping. The ventilatory equivalent for oxygen (VIO2, which equals VI divided by VO2) increased with age, and was similar to normal values fo