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Sample records for cardiopulmonary exercise tests

  1. The Role of Cardiopulmonary Exercise Test in IPF Prognosis

    PubMed Central

    Triantafillidou, Christina; Manali, Effrosyni; Lyberopoulos, Panagiotis; Kolilekas, Likourgos; Gyftopoulos, Sotirios; Kotanidou, Anastasia; Alchanatis, Manos; Papiris, Spyros A.

    2013-01-01

    Background. In IPF, defects in lung mechanics and gas exchange manifest with exercise limitation due to dyspnea, the most prominent and disabling symptom. Aim. To evaluate the role of exercise testing through the 6MWT (6-minute walk test) and CPET (cardiopulmonary exercise testing) in the survival of patients with IPF. Methods. This is a prospective, observational study evaluating in 25 patients the relationship between exercise variables through both the 6MWT and CPET and survival. Results. By the end of the observational period 17 patients were alive (33% mortality). Observation ranged from 9 to 64 months. VE/VCO2 slope (slope of relation between minute ventilation and CO2 production), VO2 peak/kg (peak oxygen consumption/kg), VE/VCO2 ratio at anaerobic threshold, 6MWT distance, desaturation, and DLCO% were significant predictors of survival while VE/VCO2 slope and VO2 peak/kg had the strongest correlation with outcome. The optimal model for mortality risk estimation was VO2 peak/kg + DLCO% combined. Furthermore, VE/VCO2 slope and VO2 peak/kg were correlated with distance and desaturation during the 6MWT. Conclusion. The integration of oxygen consumption and diffusing capacity proved to be a reliable predictor of survival because both variables reflect major underlying physiologic determinants of exercise limitation. PMID:24288606

  2. Cardiopulmonary exercise testing after laryngectomy: A connection conundrum

    PubMed Central

    Overstreet, Shana; Parekh, Kalpaj R.; Gross, Thomas J.

    2015-01-01

    A patient presents with a new bronchogenic carcinoma 5 years after laryngectomy for recurrent laryngeal tumor and 13 years after chemoradiation for concurrent lung cancer with synchronous base-of-tongue tumor. Due to his complex history and perceived limited respiratory reserve, he was felt high risk for the completion pneumonectomy needed for resection of this new tumor. The attending surgeon requested a full cardiopulmonary exercise test for risk assessment prior to surgery. We found that there was no commercially available connector that would allow our CPET equipment to reliably collect respiratory gases from a patient with tracheostomy stoma or tube. We report here a simple coupling devised “in house” that allowed for the performance of an interpretable test leading to a significant change in medical care.

  3. [Cardiopulmonary exercise testing (CPET) – indication and clinical impact].

    PubMed

    Hansen, Jörg; Rassouli, Frank; Brutsche, Martin H

    2015-05-01

    Dyspnoea is a common symptom of exercice intolerance. Tests performed at rest often leave the reason open. Cardiopulmonary exercise testing (CPET) is a tool for the qualitative and quantitative assessment of the cardio-circulatory, pulmonary and metabolic response to exercise. It is the gold-standard in the evaluation of dyspnoea and identifying its etiology (obstructive/restrictive lung disease, heart failure, physical fitness …). CPET is particularly useful, if previous evaluations including history, physical examination, ECG, pulmonary function testing (PFT), X-ray, blood tests, and blood gases do not lead to a decisive diagnosis. The measurement of peak oxygen consumption, carbon dioxide production, minute ventilation and heart rate provides substantial diagnostic and prognostic information in a wide variety of clinical settings. Interpreting CPET requires pathophysiological knowledge and can sometimes be challenging. An easy-to-use algorithm may provide a useful assistance for interpretation the results. In addition to its use as a diagnostic tool, CPET can be used to support sportsmen reaching their training goals and evaluate subject's ability to work. PMID:26098070

  4. Cardiopulmonary exercise testing in congenital heart disease: equipment and test protocols

    PubMed Central

    Takken, T.; Blank, A.C.; Hulzebos, E.H.; van Brussel, M.; Groen, W.G.; Helders, P.J.

    2009-01-01

    Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests as performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are very rare in children. The main indications for CPET in children are evaluation of exercise capacity and the identification of exercise-induced arrhythmias. In this article we will review exercise equipment and test protocols for CPET in children with congenital heart disease. (Neth Heart J 2009;17:339-44.19949476) PMID:19949476

  5. Protocol for exercise hemodynamic assessment: performing an invasive cardiopulmonary exercise test in clinical practice

    PubMed Central

    Berry, Natalia C.; Manyoo, Agarwal; Oldham, William M.; Stephens, Thomas E.; Goldstein, Ronald H.; Waxman, Aaron B.; Tracy, Julie A.; Leary, Peter J.; Leopold, Jane A.; Kinlay, Scott; Opotowsky, Alexander R.; Systrom, David M.

    2015-01-01

    Abstract Invasive cardiopulmonary exercise testing (iCPET) combines full central hemodynamic assessment with continuous measurements of pulmonary gas exchange and ventilation to help in understanding the pathophysiology underpinning unexplained exertional intolerance. There is increasing evidence to support the use of iCPET as a key methodology for diagnosing heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension as occult causes of exercise limitation, but there is little information available outlining the methodology to use this diagnostic test in clinical practice. To bridge this knowledge gap, the operational protocol for iCPET at our institution is discussed in detail. In turn, a standardized iCPET protocol may provide a common framework to describe the evolving understanding of mechanism(s) that limit exercise capacity and to facilitate research efforts to define novel treatments in these patients. PMID:26697168

  6. Protocol for exercise hemodynamic assessment: performing an invasive cardiopulmonary exercise test in clinical practice.

    PubMed

    Berry, Natalia C; Manyoo, Agarwal; Oldham, William M; Stephens, Thomas E; Goldstein, Ronald H; Waxman, Aaron B; Tracy, Julie A; Leary, Peter J; Leopold, Jane A; Kinlay, Scott; Opotowsky, Alexander R; Systrom, David M; Maron, Bradley A

    2015-12-01

    Invasive cardiopulmonary exercise testing (iCPET) combines full central hemodynamic assessment with continuous measurements of pulmonary gas exchange and ventilation to help in understanding the pathophysiology underpinning unexplained exertional intolerance. There is increasing evidence to support the use of iCPET as a key methodology for diagnosing heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension as occult causes of exercise limitation, but there is little information available outlining the methodology to use this diagnostic test in clinical practice. To bridge this knowledge gap, the operational protocol for iCPET at our institution is discussed in detail. In turn, a standardized iCPET protocol may provide a common framework to describe the evolving understanding of mechanism(s) that limit exercise capacity and to facilitate research efforts to define novel treatments in these patients. PMID:26697168

  7. Cardiopulmonary Exercise Test in Patients with Hypertension: Focused on Hypertensive Response to Exercise

    PubMed Central

    Youn, Jong-Chan; Kang, Seok-Min

    2015-01-01

    The cardiopulmonary exercise test (CPET) provides integrative exercise responses including the cardiovascular, pulmonary and skeletal muscle systems. It can be used for the identification of myocardial ischemia, evaluation of exercise capacity and tolerance, and the assessment of chronotropic competence or arrhythmias with the addition of ventilatory and gas exchange measurement information. Among them, hypertensive response to exercise (HRE) is known to be related with higher risk of future heart failure and cardiovascular events in patients with hypertension. Proposed underlying mechanisms of HRE can be found in ventricular-vascular uncoupling including decreased aortic distensibility, increased left ventricular mass, endothelial dysfunction, and diastolic dysfunction. The CPET might be useful in the identification of masked hypertension and the assessment of antihypertensive treatment efficacy in patients with hypertension. PMID:26587460

  8. Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

    PubMed Central

    Takken, T.; Blank, A.C.; Hulzebos, E.H.; van Brussel, M.; Groen, W.G.; Helders, P.J.

    2009-01-01

    Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are rare in children. The main indications for CPET in children are evaluation of exercise capacity and the identification of exercise-induced arrhythmias. In this article we will review the main indications for CPET in children with congenital heart disease, the contraindications for exercise testing and the indications for terminating an exercise test. Moreover, we will address the interpretation of gas exchange data from CPET in children with congenital heart disease. (Neth Heart J 2009;17:385-92.19949648) PMID:19949648

  9. Reference values for cardiopulmonary exercise testing in healthy adults: a systematic review.

    PubMed

    Paap, Davy; Takken, Tim

    2014-12-01

    Reference values (RV) for cardiopulmonary exercise testing (CPET) provide the comparative basis for answering important questions concerning the normality of exercise response in patients and significantly impacts the clinical decision-making process. The aim of this study is to systematically review the literature on RV for CPET in healthy adults. A secondary aim is to make appropriate recommendations for the practical use of RV for CPET. Systematic searches of MEDLINE, EMBASE and PEDro databases up to March 2014 were performed. In the last 30 years, 35 studies with CPET RV were published. There is no single set of ideal RV; characteristics of each population are too diverse to pool the data in a single equation. Therefore, each exercise laboratory must select appropriate sets of RV that best reflect the characteristics of the population/patient tested, and equipment and methodology utilized. PMID:25418758

  10. Prediction of organ-specific complications following abdominal aortic aneurysm repair using cardiopulmonary exercise testing.

    PubMed

    Barakat, H M; Shahin, Y; McCollum, P T; Chetter, I C

    2015-06-01

    This study aimed at assessing whether measures of aerobic fitness can predict postoperative cardiac and pulmonary complications, 30-day mortality and length of hospital stay following elective abdominal aortic aneurysm repair. We prospectively collected cardiopulmonary exercise testing data over two years for 130 patients. Upon multivariate analysis, a decreased anaerobic threshold (OR (95% CI) 0.55 (0.37-0.84); p = 0.005) and open repair (OR (95% CI) 6.99 (1.56-31.48); p = 0.011) were associated with cardiac complications. Similarly, an increased ventilatory equivalent for carbon dioxide (OR (95% CI) 1.18 (1.05-1.33); p = 0.005) and open repair (OR (95% CI) 14.29 (3.24-62.90); p < 0.001) were associated with pulmonary complications. Patients who had an endovascular repair had shorter hospital and critical care lengths of stay (p < 0.001). Measures of fitness were not associated with 30-day mortality or length of hospital stay. Cardiopulmonary exercise testing variables, therefore, seem to predict different postoperative complications following abdominal aortic aneurysm repair, which adds value to their routine use in risk stratification and optimisation of peri-operative care. PMID:25656939

  11. Reliability and Responsiveness of Cardiopulmonary Exercise Testing in Fatigued Persons with Multiple Sclerosis and Low to Mild Disability

    PubMed Central

    Heine, Martin; van den Akker, Lizanne Eva; Verschuren, Olaf; Visser-Meily, Anne; Kwakkel, Gert

    2015-01-01

    Background Peak oxygen uptake (VO2peak) via cardiopulmonary exercise testing is considered the gold standard for testing aerobic capacity in healthy participants and people with various medical conditions. The reliability and responsiveness of cardiopulmonary exercise testing outcomes in persons with MS (PwMS) have not been extensively studied. Objective (1) to investigate the reliability of cardiopulmonary exercise parameters in PwMS; (2) to determine the responsiveness, in terms of the smallest detectable change (SDC), for each parameter. Design Two repeated measurements of cardiopulmonary exercise outcomes were obtained, with a median time interval of 16 days. Methods Thirty-two PwMS suffering from subjective fatigue performed cardiopulmonary exercise tests on a cycle ergometer, to voluntary exhaustion. We calculated the reliability, in terms of the intra-class correlation coefficient (ICC [2,k]; absolute agreement), and the measurement error, in terms of standard error of measurement (SEM) and SDC at individual (SDCindividual) and group level (SDCgroup). Results The ICC for VO2peak was 0.951, with an SEM of 0.131 L?min?1 and an SDCindividual of 0.364 L?min?1. When corrected for bodyweight, the ICC of VO2peak was 0.933, with an SEM of 1.7 mL?kg?1?min?1 and in an SDCindividual of 4.6 mL?kg?1?min?1. Limitations Generalization of our study results is restricted to fatigued PwMS with a low to mild level of disability. Conclusions At individual level, cardiopulmonary exercise testing can be used reliably to assess physical fitness in terms of VO2peak, but less so to determine significant changes. At group level, VO2peak can be reliably used to determine physical fitness status and establish change over time. PMID:25789625

  12. Near-infrared spectroscopic monitoring during cardiopulmonary exercise testing detects anaerobic threshold.

    PubMed

    Rao, Rohit P; Danduran, Michael J; Loomba, Rohit S; Dixon, Jennifer E; Hoffman, George M

    2012-06-01

    Cardiopulmonary exercise testing (CPET) provides assessment of the integrative responses involving the pulmonary, cardiovascular, and skeletal muscle systems. Application of exercise testing remains limited to children who are able to understand and cooperate with the exercise protocol. Near-infrared spectroscopy (NIRS) provides a noninvasive, continuous method to monitor regional tissue oxygenation (rSO2). Our specific aim was to predict anaerobic threshold (AT) during CPET noninvasively using two-site NIRS monitoring. Achievement of a practical noninvasive technology for estimating AT will increase the compatibility of CPET. Patients without structural or acquired heart disease were eligible for inclusion if they were ordered to undergo CPET by a cardiologist. Data from 51 subjects was analyzed. The ventilatory anaerobic threshold (VAT) was computed on [Formula: see text] and respiratory quotient post hoc using the standard V-slope method. The inflection points of the regional rSO2 time-series were identified as the noninvasive regional NIRS AT for each of the two monitored regions (cerebral and kidney). AT calculation made using an average of kidney and brain NIRS matched the calculation made by VAT for the same patient. Two-site NIRS monitoring of visceral organs is a predictor of AT. PMID:22349729

  13. Effect of modality on cardiopulmonary exercise testing in male and female COPD patients.

    PubMed

    Holm, Siri M; Rodgers, Wendy; Haennel, Robert G; MacDonald, G Fred; Bryan, Tracey L; Bhutani, Mohit; Wong, Eric; Stickland, Michael K

    2014-02-01

    The purpose of this study was to examine the physiological responses to treadmill and cycle cardiopulmonary exercise testing (CPET) in male and female COPD patients. Fifty-five patients [28 males (FEV1=58.2±19.5% predicted), and 27 females (FEV1=65.3±16.6% predicted)] completed a treadmill and a cycle CPET in random order on two separate days. Respiratory and cardiovascular data were obtained. Compared to the cycle CPET, the treadmill elicited greater peak power output and peak oxygen uptake, while arterial saturation at peak exercise was lower with the treadmill; however, there were no differences between the responses in men and women. No differences were observed in heart rate, ventilation, tidal volume/breathing frequency, inspiratory capacity, or dyspnea responses between modalities or sex. The physiological responses between treadmill and cycle CPET protocols are largely similar for both men and women with COPD, indicating that either modality can be used in mild/moderate COPD patients. PMID:24316218

  14. The Relationship Between Body Mass Index and Cardiopulmonary Exercise Testing in Chronic Systolic Heart Failure

    PubMed Central

    Horwich, Tamara B.; Leifer, Eric S.; Brawner, Clinton A.; Fitz-Gerald, Meredith B.; Fonarow, Gregg C.

    2009-01-01

    Background Cardiopulmonary exercise testing (CPX) in patients with systolic heart failure (HF) is important for determining HF prognosis and helping guide timing of heart transplantation. Although approximately 20–30% of patients with HF are obese (body mass index [BMI]>30kg/m2), the impact of BMI on CPX results is not well established. The objective of the present study was to assess the relationship between BMI and CPX variables, including peak oxygen uptake, VO2 at ventilatory threshold, O2 pulse, and ventilation / carbon dioxide production ratio. Methods Consecutive systolic HF patients (n=2324) enrolled in the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) trial who had baseline BMI recorded were included in the present study. Subjects were divided into strata based on BMI: underweight (BMI< 18.5 kg/m2), normal weight (BMI 18.5 – 24.9 kg/m2), overweight (BMI 25.0 – 29.9 kg/m2), obese I (BMI 30 – 34.9 kg/m2), obese II (BMI 35–39.9 kg/m2), and obese III (BMI ? 40 kg/m2). Results Obese III, but not overweight, obese I, or obese II, was associated with decreased peak oxygen uptake (mL/kg/min) compared to normal weight status. Increasing BMI category was inversely related to ventilation / carbon dioxide production (VE/VCO2) ratio (p< 0.0001). On multivariable analysis, BMI was a significant independent predictor of peak oxygen uptake (partial R2 = 0.07, p< 0.0001) and VE/VCO2 slope (partial R2 = 0.03, p< 0.0001) in patients with chronic systolic HF. Conclusions BMI is significantly associated with key CPX fitness variables in HF patients. The influence of BMI on the prognostic value of CPX in HF requires further evaluation in longitudinal studies. PMID:19782786

  15. Difference in Physiological Components of VO2 Max During Incremental and Constant Exercise Protocols for the Cardiopulmonary Exercise Test

    PubMed Central

    Yamamoto, Junshiro; Harada, Tetsuya; Okada, Akinori; Maemura, Yuko; Yamamoto, Misaki; Tabira, Kazuyuki

    2014-01-01

    [Purpose] VO2 is expressed as the product of cardiac output and O2 extraction by the Fick equation. During the incremental exercise test and constant high-intensity exercise test, VO2 results in the attainment of maximal O2 uptake at exhaustion. However, the differences in the physiological components, cardiac output and muscle O2 extraction, have not been fully elucidated. We tested the hypothesis that constant exercise would result in higher O2 extraction than incremental exercise at exhaustion. [Subjects] Twenty-five subjects performed incremental exercise and constant exercise at 80% of their peak work rate. [Methods] Ventilatory, cardiovascular, and muscle oxygenation responses were measured using a gas analyzer, Finapres, and near-infrared spectroscopy, respectively. [Results] VO2 was not significantly different between the incremental exercise and constant exercise. However, cardiac output and muscle O2 saturation were significantly lower for the constant exercise than the incremental exercise at the end of exercise. [Conclusion] These findings indicate that if both tests produce a similar VO2 value, the VO2 in incremental exercise would have a higher ratio of cardiac output than constant exercise, and VO2 in constant exercise would have a higher ratio of O2 extraction than incremental exercise at the end of exercise. PMID:25202198

  16. Reduced fitness and abnormal cardiopulmonary responses to maximal exercise testing in children and young adults with sickle cell anemia

    PubMed Central

    Liem, Robert I; Reddy, Madhuri; Pelligra, Stephanie A; Savant, Adrienne P; Fernhall, Bo; Rodeghier, Mark; Thompson, Alexis A

    2015-01-01

    Physiologic contributors to reduced exercise capacity in individuals with sickle cell anemia (SCA) are not well understood. The objective of this study was to characterize the cardiopulmonary response to maximal cardiopulmonary exercise testing (CPET) and determine factors associated with reduced exercise capacity among children and young adults with SCA. A cross-sectional cohort of 60 children and young adults (mean 15.1 ± 3.4 years) with hemoglobin SS or S/?0 thalassemia and 30 matched controls (mean 14.6 ± 3.5 years) without SCA or sickle cell trait underwent maximal CPET by a graded, symptom-limited cycle ergometry protocol with breath-by-breath, gas exchange analysis. Compared to controls without SCA, subjects with SCA demonstrated significantly lower peak VO2 (26.9 ± 6.9 vs. 37.0 ± 9.2 mL/kg/min, P < 0.001). Subjects demonstrated slower oxygen uptake (?VO2/?WR, 9 ± 2 vs. 12 ± 2 mL/min/watt, P < 0.001) and lower oxygen pulse (?VO2/?HR, 12 ± 4 vs. 20 ± 7 mL/beat, P < 0.001) as well as reduced oxygen uptake efficiency (?VE/?VO2, 42 ± 8 vs. 32 ± 5, P < 0.001) and ventilation efficiency (?VE/?VCO2, 30.3 ± 3.7 vs. 27.3 ± 2.5, P < 0.001) during CPET. Peak VO2 remained significantly lower in subjects with SCA after adjusting for age, sex, body mass index (BMI), and hemoglobin, which were independent predictors of peak VO2 for subjects with SCA. In the largest study to date using maximal CPET in SCA, we demonstrate that children and young adults with SCA have reduced exercise capacity attributable to factors independent of anemia. Complex derangements in gas exchange and oxygen uptake during maximal exercise are common in this population. PMID:25847915

  17. Reduced fitness and abnormal cardiopulmonary responses to maximal exercise testing in children and young adults with sickle cell anemia.

    PubMed

    Liem, Robert I; Reddy, Madhuri; Pelligra, Stephanie A; Savant, Adrienne P; Fernhall, Bo; Rodeghier, Mark; Thompson, Alexis A

    2015-04-01

    Physiologic contributors to reduced exercise capacity in individuals with sickle cell anemia (SCA) are not well understood. The objective of this study was to characterize the cardiopulmonary response to maximal cardiopulmonary exercise testing (CPET) and determine factors associated with reduced exercise capacity among children and young adults with SCA. A cross-sectional cohort of 60 children and young adults (mean 15.1 ± 3.4 years) with hemoglobin SS or S/?(0) thalassemia and 30 matched controls (mean 14.6 ± 3.5 years) without SCA or sickle cell trait underwent maximal CPET by a graded, symptom-limited cycle ergometry protocol with breath-by-breath, gas exchange analysis. Compared to controls without SCA, subjects with SCA demonstrated significantly lower peak VO2 (26.9 ± 6.9 vs. 37.0 ± 9.2 mL/kg/min, P < 0.001). Subjects demonstrated slower oxygen uptake (?VO2/?WR, 9 ± 2 vs. 12 ± 2 mL/min/watt, P < 0.001) and lower oxygen pulse (?VO2/?HR, 12 ± 4 vs. 20 ± 7 mL/beat, P < 0.001) as well as reduced oxygen uptake efficiency (?VE/?VO2, 42 ± 8 vs. 32 ± 5, P < 0.001) and ventilation efficiency (?VE/?VCO2, 30.3 ± 3.7 vs. 27.3 ± 2.5, P < 0.001) during CPET. Peak VO2 remained significantly lower in subjects with SCA after adjusting for age, sex, body mass index (BMI), and hemoglobin, which were independent predictors of peak VO2 for subjects with SCA. In the largest study to date using maximal CPET in SCA, we demonstrate that children and young adults with SCA have reduced exercise capacity attributable to factors independent of anemia. Complex derangements in gas exchange and oxygen uptake during maximal exercise are common in this population. PMID:25847915

  18. Role of the cardio-pulmonary exercise test and six-minute walking test in the evaluation of exercise performance in patients with late-onset Pompe disease.

    PubMed

    Crescimanno, G; Modica, R; Lo Mauro, R; Musumeci, O; Toscano, A; Marrone, O

    2015-07-01

    In patients with late-onset Pompe disease, we explored the role of the Cardiopulmonary Exercise Test (CPET) and the Six-Minute Walking Test (6MWT) in the assessment of exercise capacity and in the evaluation of the effects of enzyme replacement therapy (ERT). Eight patients affected by late-onset Pompe disease, followed up at the Centre for Neuromuscular Diseases and treated with ERT, underwent a baseline evaluation with a spirometry, a CPET and a 6MWT. Four of them were restudied after 36 months of treatment. Three patients showed a reduction in exercise capacity as evaluated by peak oxygen uptake (VO2) measured at the CPET and Distance Walked (DW) measured at the 6MWT (median % predicted: 67.1 [range 54.3-99.6] and 67.3 [56.6-82.6], respectively). Cardiac and respiratory limitations revealed by the CPET were correlated to peak VO2, but not to the DW. Nevertheless, percent of predicted values of peak VO2 and DW were strongly correlated (rho?=?0.85, p?=?0.006), and close to identity. In the longitudinal evaluation forced vital capacity decreased, while peak VO2 and DW showed a trend to a parallel improvement. We concluded that although only the CPET revealed causes of exercise limitation, which partially differed among patients, CPET and 6MWT showed a similar overall degree of exercise impairment. That held true in the longitudinal assessment during ERT, where both tests demonstrated similar small improvements, occurring despite deterioration in forced vital capacity. PMID:25908581

  19. Estimating equations for cardiopulmonary exercise testing variables in Fontan patients: derivation and validation using a multicenter cross-sectional database.

    PubMed

    Butts, Ryan J; Spencer, Carolyn T; Jackson, Lanier; Heal, Martha E; Forbus, Geoffrey; Hulsey, Thomas C; Atz, Andrew M

    2015-02-01

    Cardiopulmonary exercise testing (CPET) is a common method of evaluating patients with a Fontan circulation. Equations to calculate predicted CPET values are based on children with normal circulation. This study aims to create predictive equations for CPET variables solely based on patients with Fontan circulation. Patients who performed CPET in the multicenter Pediatric Heart Network Fontan Cross-Sectional Study were screened. Peak variable equations were calculated using patients who performed a maximal test (RER > 1.1) and anaerobic threshold (AT) variable equations on patients where AT was adequately calculated. Eighty percent of each cohort was randomly selected to derive the predictive equation and the remaining served as a validation cohort. Linear regression analysis was performed for each CPET variable within the derivation cohort. The resulting equations were applied to calculate predicted values in the validation cohort. Observed versus predicted variables were compared in the validation cohort using linear regression. 411 patients underwent CPET, 166 performed maximal exercise tests and 317 had adequately calculated AT. Predictive equations for peak CPET variables had good performance; peak VO2, R (2) = 0.61; maximum work, R (2) = 0.61; maximum O2 pulse, R (2) = 0.59. The equations for CPET variables at AT explained less of the variability; VO2 at AT, R (2) = 0.15; work at AT, R (2) = 0.39; O2 pulse at AT, R (2) = 0.34; VE/VCO2 at AT, R (2) = 0.18; VE/VO2 at AT, R (2) = 0.14. Only the models for VE/VCO2 and VE/VO2 at AT had significantly worse performance in validation cohort. Of the 8 equations for commonly measured CPET variables, six were able to be validated. The equations for peak variables were more robust in explaining variation in values than AT equations. PMID:25179464

  20. Physiology of oxygen uptake kinetics: Insights from incremental cardiopulmonary exercise testing in the Study of Health in Pomerania

    PubMed Central

    Barron, Anthony J.; Dhutia, Niti M.; Gläser, Sven; Koch, Beate; Ewert, Ralf; Obst, Anne; Dörr, Marcus; Völzke, Henry; Francis, Darrel P.; Wensel, Roland

    2015-01-01

    Background Cardiopulmonary exercise testing allows for assessment of cardiac and respiratory limitation, but is often affected by patient effort. Indices of oxygen kinetics, including the oxygen uptake efficiency slope (OUES), oxygen uptake–work-rate slope (VO2–WR slope) and the heart rate–oxygen uptake slope (HR–VO2 slope) are relatively effort independent but may be affected by patient characteristics. The objective of this study is to identify the impact of factors, such as age, gender, body size, respiratory function, smoking and beta-blockade on these parameters, as well as generate predictive equations. Methods 1708 volunteers from the population-based Study of Health in Pomerania underwent an incremental bicycle exercise protocol. Markers of oxygen kinetics were calculated. Participants with structural heart disease, echocardiographic or lung function pathology were excluded, leaving 577 males and 625 females. Age, height, weight, smoking, forced expiratory volume in 1 s (FEV1) and beta-blockers were analysed for their influencing power by gender. Quantile regression analysis determined the reference equations for each parameter. Results Age, gender, height, weight and FEV1 (but not percent predicted FEV1) are strongly related to OUES. Participants using beta-blockers and male smokers had significantly lower OUES values. VO2–WR slope was minimally affected by age, gender, weight and FEV1. Gender, height, weight and beta-blocker use, but not FEV1 and smoking status, were related to the HR–VO2 slope whilst age was only related in females. Conclusions Markers of oxygen kinetics are differentially affected by patient characteristics. This study provides normal reference values for these variables thereby facilitating interpretation of oxygen uptake kinetics in health and disease. PMID:26339572

  1. Personalized pulmonary rehabilitation and occupational therapy based on cardiopulmonary exercise testing for patients with advanced chronic obstructive pulmonary disease

    PubMed Central

    Maekura, Ryoji; Hiraga, Toru; Miki, Keisuke; Kitada, Seigo; Miki, Mari; Yoshimura, Kenji; Yamamoto, Hiroshi; Kawabe, Toshiko; Mori, Masahide

    2015-01-01

    Take-home summary Personalized pulmonary rehabilitation including occupational therapy improves the prognosis of patients with advanced COPD. Purpose We previously reported that patients with chronic obstructive pulmonary disease (COPD) exhibit three exercise-induced life-threatening conditions: hypoxemia, sympathetic overactivity, and respiratory acidosis. We aimed to verify whether mortality in patients with advanced COPD could be reduced by a personalized pulmonary rehabilitation (PPR) program in hospital, which determines individual safe ranges and includes occupational therapy (PPR-OT), to prevent desaturation and sympathetic nerve activation during daily activities. Patients and methods The novel PPR-OT program was evaluated in a retrospective study of patients with COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Grade D) who underwent cardiopulmonary exercise testing (CPET) between April 1990 and December 1999. They received regular treatment without the proposed therapy (control group: n=61; male-to-female ratio [M:F] =57:4; mean age: 68.5±6.7 years) or with the proposed therapy (PPR-OT group: n=46; M:F =44:2; mean age: 68.7±7.1 years). A prospective observational study included patients with COPD receiving home oxygen therapy (HOT) between April 1995 and March 2007 to compare the survival rates of the control group (n=47; M:F ratio =34:13; mean age: 71.3±10.0 years) and the PPR-OT group (n=85; M:F =78:7; mean age: 70.7±6.1 years) who completed the proposed therapy. Survival after CPET or HOT was analyzed using Cox proportional-hazards regression and Kaplan–Meier analyses. Results In both studies, the program significantly improved all-cause mortality (retrospective study: risk ratio =0.389 [range: 0.172–0.800]; P=0.0094; log-rank test, P=0.0094; observational study: risk ratio =0.515 [range: 0.296–0.933]; P=0.0291; log-rank test, P=0.0232]. At 5 years and 7 years, all-cause mortality was extremely low in patients in the PPR-OT group receiving HOT (18.8% and 28.2%, respectively), compared to that in the control group (34.0% and 44.7%, respectively). Survival of patients with life-threatening pathophysiological conditions also greatly improved. Conclusion The PPR-OT program improved the survival of patients with advanced COPD probably because it modified life-threatening conditions. PMID:26366071

  2. Pulmonary Hypertension and Cardiopulmonary Exercise in Heart Failure

    PubMed Central

    Kim, Chul-Ho; Jae, Sae Young; Johnson, Bruce D.

    2014-01-01

    In heart failure (HF), pulmonary hypertension (PH) is initially associated with a rise in the left ventricular filling pressure. PH is defined by pulmonary hemodynamic measurements including pulmonary capillary wedge pressure, mean pulmonary arterial pressure and pulmonary vascular resistance. Eventually, PH in HF may become more of a reactive process. Although the mechanism of the reactive PH development is not clearly understood, vascular dysfunction induced by remodeling, vasoactive substances and genetic variation appear to contribute significantly to this form of PH. Noninvasive cardiopulmonary exercise testing has been extensively utilized to assess disease severity in HF patients. It provides integrated information that is dependent on cardiopulmonary hemodynamics, lung mechanics, breathing pattern and strategy. In this review, we will discuss the mechanisms of PH development in HF and how noninvasive gas exchange measures obtained with submaximal exercise are influenced by PH in this population. PMID:26389080

  3. Pulmonary Hypertension and Cardiopulmonary Exercise in Heart Failure.

    PubMed

    Kim, Chul-Ho; Jae, Sae Young; Johnson, Bruce D

    2014-05-01

    In heart failure (HF), pulmonary hypertension (PH) is initially associated with a rise in the left ventricular filling pressure. PH is defined by pulmonary hemodynamic measurements including pulmonary capillary wedge pressure, mean pulmonary arterial pressure and pulmonary vascular resistance. Eventually, PH in HF may become more of a reactive process. Although the mechanism of the reactive PH development is not clearly understood, vascular dysfunction induced by remodeling, vasoactive substances and genetic variation appear to contribute significantly to this form of PH. Noninvasive cardiopulmonary exercise testing has been extensively utilized to assess disease severity in HF patients. It provides integrated information that is dependent on cardiopulmonary hemodynamics, lung mechanics, breathing pattern and strategy. In this review, we will discuss the mechanisms of PH development in HF and how noninvasive gas exchange measures obtained with submaximal exercise are influenced by PH in this population. PMID:26389080

  4. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men

    PubMed Central

    Costa, D. C.; de Santi, G. L.; Crescêncio, J. C.; Seabra, L. P.; Carvalho, E. E. V.; Papa, V.; Marques, F.; Gallo, L.; Schmidt, A.

    2015-01-01

    This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG) was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V?O2)peak(predicted)and V?O2peak(real)(nonparametric Wilcoxon test). In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V?O2peak(real)was 40% lower than V?O2peak(predicted)(nonparametric Wilcoxon test). There was no agreement between the real and predicted measurements as analyzed by Lin’s coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer. PMID:26397972

  5. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men.

    PubMed

    Costa, D C; Santi, G L de; Crescêncio, J C; Seabra, L P; Carvalho, E E V; Papa, V; Marques, F; Gallo Junior, L; Schmidt, A

    2015-12-01

    This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG) was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V?O2)peak(predicted)and V?O2peak(real)(nonparametric Wilcoxon test). In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V?O2peak(real)was 40% lower than V?O2peak(predicted)(nonparametric Wilcoxon test). There was no agreement between the real and predicted measurements as analyzed by Lin's coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer. PMID:26397972

  6. Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery: A study for 342 cases

    PubMed Central

    Gao, Ke; Yu, Peng-ming; Su, Jian-hua; He, Cheng-qi; Liu, Lun-xu; Zhou, Yu-bin; Pu, Qiang; Che, Guo-wei

    2015-01-01

    Background An evaluation of cardiopulmonary exercise testing (CPET) screening and pre-operative pulmonary rehabilitation in reducing postoperative complications and improving fast-track recovery in high-risk patients who undergo resection for lung cancer. Methods Of 342 potential lung cancer cases, 142 high-risk patients were finally divided into two groups: group R (n = 71) underwent an intensive pre-operative pulmonary rehabilitation program (PRP), followed by lobectomy; group S (n = 71) underwent only lobectomy with conventional management. Postoperative complications, average days in hospital, postoperative days in hospital, and cost were analyzed. Results The 142 high-risk patients were screened by smoking history and CPET. Sixty-eight patients had bronchial hyperresponsiveness (BHR) and 47 patients had peak expiratory flow <250?L/minute by CPET. The rate of postoperative total complications in group R (16.90%) was significantly lower than in group S (83.31%) (P = 0.00), as was the rate of postoperative pulmonary complications PPC: group R (12.81%) versus?S (13.55%) (P = 0.009); the PPC in the left lung (17.9%) was higher than in the right lung (2.3%) (P = 0.00). The average days in hospital in group S was significantly higher than in group R (P = 0.03). There was no difference between groups in average hospital cost (P = 0.304). Conclusion Pre-operative screening using CPET is conducive to identifying high-risk patients for lung resection. Pre-operative pulmonary rehabilitation is helpful to reduce postoperative complications and improve fast-track recovery. PMID:26273399

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

    PubMed Central

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

    2009-01-01

    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. PMID:18362692

  8. Orbital Fitness: An Overview of Space Shuttle Cardiopulmonary Exercise Physiology Findings

    NASA Technical Reports Server (NTRS)

    Moore, Alan D.

    2011-01-01

    Limited observations regarding the cardiopulmonary responses to aerobic exercise had been conducted during short-duration spaceflight before the Space Shuttle program. This presentation focuses on the findings regarding changes observed in the cardiopulmonary exercise responses during and following Shuttle flights. During flight, maximum oxygen uptake (VO2max) remained unchanged as did the maximum work rate achievable during cycle exercise testing conducted during the last full flight day. Immediately following flight, the ubiquitous finding, confirmed by investigations conducted during the Spacelab Life Sciences missions 1 and 2 and by NASA Detailed Supplemental Objective studies, indicated that VO2max was reduced; however, the reduction in VO2max was transient and returned to preflight levels within 7 days following return. Studies regarding the influence of aerobic exercise countermeasures performed during flight on postflight performance were mostly limited to the examination of the heart rate (HR) response to submaximal exercise testing on landing day. These studies revealed that exercise HR was elevated in individuals who performed little to no exercise during their missions as compared to individuals who performed regular exercise. In addition, astronauts who performed little to no aerobic exercise during flight demonstrated an increased HR and lowered pulse pressure response to the standard stand test on landing day, indicating a decrease in orthostatic function in these individuals. With regard to exercise modality, four devices were examined during the Shuttle era: two treadmills, a cycle ergometer, and a rowing device. Although there were limited investigations regarding the use of these devices for exercise training aboard the Shuttle, there was no clear consensus reached regarding which proved to be a "superior" device. Each device had a unique operational or physiologic limitation associated with its use. In conclusion, exercise research conducted during the Shuttle Program demonstrated that attenuation of postflight deconditioning was possible through use of exercise countermeasures and the Shuttle served as a test bed for equipment destined for use on the International Space Station. Learning Objective: Overview of the Space Shuttle Program research results related to aerobic capacity and performance, including what was learned from research and effectiveness of exercise countermeasures.

  9. Exercise stress test

    MedlinePLUS

    ... EKG - exercise treadmill; Stress ECG; Exercise electrocardiography; Stress test - exercise treadmill ... This test is done at a medical center or health care provider's office. The technician will place 10 flat, ...

  10. Brugada syndrome, exercise, and exercise testing.

    PubMed

    Masrur, Shihab; Memon, Sarfaraz; Thompson, Paul D

    2015-05-01

    There are few data on the risk of exercise and the role of exercise stress testing in Brugada syndrome. We sought to address this deficiency using a systematic literature review. We identified 98 English-language articles possibly addressing exercise in Brugada syndrome by searching PubMed and Google Scholar from January 1990 through November 2013 using the keywords "Brugada syndrome," "exercise," "exercise testing," and "syncope" alone and in combinations. Abstracts were reviewed, and those articles pertaining to Brugada syndrome and exercise were reviewed in full. We identified 18 articles reporting on Brugada syndrome and exercise. This pool included 2 large studies of 93 and 50 Brugada subjects undergoing exercise testing, plus 16 case reports. There were no reports of exercise-related sudden death, but there were 4 cases of syncope after exercise. We identified 166 Brugada patients who underwent exercise testing. During exercise testing, there were 2 reports of ventricular tachycardia and 1 report of multiple ventricular extrasystoles. ST-segment elevation increased (ST augmentation) during the early recovery phase of exercise in 57% of patients. Exercise unmasked a Brugada electrocardiographic pattern in 5 patients. Exercise is associated with syncope and ST augmentation after exercise and may be helpful in unmasking Brugada syndrome. There are insufficient data on the risks of exercise in Brugada syndrome to make recommendations for exercise, but the observations that exercise can worsen the ST abnormalities in Brugada and produce ventricular arrhythmias suggest that patients with Brugada syndrome should be restricted from vigorous exercise. PMID:25955277

  11. Effect of Regular Exercise on Cardiopulmonary Fitness in Males With Spinal Cord Injury

    PubMed Central

    Lee, Young Hee; Kong, In Deok; Kim, Sung Hoon; Shinn, Jong Mock; Kim, Jong Heon; Yi, Dongsoo; Lee, Jin Hyeong; Chang, Jae Seung; Kim, Tae-ho; Kim, Eun Ju

    2015-01-01

    Objective To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. Methods We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to the exercise protocol and was stopped when the subject was exhausted or when VO2 reached an equilibriu Results Among the 40 subjects, there were 10 subjects with cervical cord injury, 27 with thoracic cord injury, and 3 with lumbar cord injury. Twenty-five subjects who were exercised regularly showed statistically higher results of VO2max than those who did not exercise regularly. Subjects with cervical injury showed statistically lower VO2max than the subjects with thoracic or lumbar injury out of the 40 subjects with neurologic injury. In addition, higher age showed a statistically lower VO2max. Lastly, the regularly exercising paraplegic group showed higher VO2max than the non-exercising paraplegic group. Conclusion There are differences in VO2max of subjects with spinal cord injury according to the degree of neurologic injury, age, and whether the subject participates in regular exercise. We found that regular exercise increased the VO2max in individuals with spinal cord injury. PMID:25750877

  12. Effect of exercise training on cardiopulmonary baroreflex control of forearm vascular resistance in humans

    NASA Technical Reports Server (NTRS)

    Mack, G. W.; Convertino, V. A.; Nadel, E. R.

    1993-01-01

    We studied the stimulus-response characteristics of cardiopulmonary baroreflex control of forearm vascular resistance (FVR) in four groups of male volunteer subjects: i) unfit, ii) physically fit, iii) before and after 10 wk of endurance training (chronic blood volume expansion), and iv) before and after acute blood volume expansion. We assessed the relationship between reflex stimulus, i.e., changes in central venous pressure and response, i.e., FVR, during unloading of cardiopulmonary mechanoreceptors with lower body negative pressure (LBNP, 0 to -20 mm Hg). The slope of the linear relationship between FVR and CVP, the index of the responsiveness of this baroreflex, was significantly diminished (> 50%) in the fit subjects compared with the unfit. The slope of the FVR-CVP relationship was inversely correlated with the subject's total blood volume, suggesting that blood volume expansion was related to the attenuated CP baroreflex. In the exercise training study, maximal oxygen consumption and blood volume increased following 10 wk of endurance training (N = 14) but were unchanged in the time control group (N = 7). The slope of the FVR-CVP relationship was significantly reduced (32%) following 10 wk of training but was unchanged in the time control group. The reduction in slope of the FVR-CVP relationship was inversely related to the increase in blood volume associated with exercise training. Acute blood volume expansion 8 ml.kg-1 body weight with 5% human serum albumin solution) significantly reduced the slope of the FVR-CVP relationship. These data support the hypothesis that the attenuated forearm vascular reflex in physically fit individuals is related to a training-induced hypervolemia.(ABSTRACT TRUNCATED AT 250 WORDS).

  13. Exercise Stress Testing in Children with Metabolic or Neuromuscular Disorders

    PubMed Central

    Takken, Tim; Groen, Wim G.; Hulzebos, Erik H.; Ernsting, Cornelia G.; van Hasselt, Peter M.; Prinsen, Berthil H.; Helders, Paul J.; Visser, Gepke

    2010-01-01

    The role of exercise as a diagnostic or therapeutic tool in patients with a metabolic disease (MD) or neuromuscular disorder (NMD) is relatively underresearched. In this paper we describe the metabolic profiles during exercise in 13 children (9 boys, 4 girls, age 5–15 yrs) with a diagnosed MD or NMD. Graded cardiopulmonary exercise tests and/or a 90-min prolonged submaximal exercise test were performed. During exercise, respiratory gas-exchange and heart rate were monitored; blood and urine samples were collected for biochemical analysis at set time points. Several characteristics in our patient group were observed, which reflected the differences in pathophysiology of the various disorders. Metabolic profiles during exercises CPET and PXT seem helpful in the evaluation of patients with a MD or NMD. PMID:20706686

  14. Sample Proficiency Test exercise

    SciTech Connect

    Alcaraz, A; Gregg, H; Koester, C

    2006-02-05

    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.

  15. Pulmonary artery pressure measurement during exercise testing in patients with suspected pulmonary hypertension.

    PubMed

    Raeside, D A; Smith, A; Brown, A; Patel, K R; Madhok, R; Cleland, J; Peacock, A J

    2000-08-01

    It is recognized that exercise produces abnormally large increases in pulmonary artery pressure in patients with pulmonary vascular disease as a consequence of a variety of disorders, but the relationship between pressure and cardiopulmonary exercise performance is poorly understood. This lack of understanding is due (in part) to difficulty making measurements of pulmonary haemodynamics using conventional fluid filled catheters. This article seeks to improve understanding by comparing variables measured during formal exercise testing with simultaneous measurements of pulmonary artery pressure using a micro-manometer tipped catheter. Ten patients with suspected pulmonary hypertension were studied using a micromanometer tipped pulmonary artery catheter, during cardiopulmonary exercise testing. Ventilatory equivalents for oxygen and carbon dioxide correlated with the pulmonary artery pressure measured on exercise, but oxygen pulse and oxygen uptake did not. Ventilatory equivalents, noninvasively measured during exercise, may merit further study as potential surrogates of pulmonary artery pressure and hence be useful in identifying individuals at risk of developing pulmonary hypertension. PMID:10968504

  16. Heparin Sensitivity Test for Patients Requiring Cardiopulmonary Bypass

    PubMed Central

    DeBois, William J.; Liu, Junli; Elmer, Barbara; Ebrahimi, Haleh; Voevidko, Lilia; Lee, Leonard Y.; Krieger, Karl H.; Isom, Wayne W.; Girardi, Leonard N.

    2006-01-01

    Abstract: Anticoagulation for the open heart surgery patient undergoing cardiopulmonary bypass (CPB) is achieved with the use of heparin. The industry standard of activated clotting time (ACT) was used to measure the effect of heparin. The commonly acceptable target time of anticoagulation adequacy is 480 seconds or greater. Some patients, however, exhibit resistance to standard dosing of heparin and do not reach target anticoagulation time (480 seconds). Antithrombin III deficiency has been previously cited as the cause of heparin resistance. Early detection of heparin resistance (HR) may avoid both the delayed start of CPB and inadequate anticoagulation, if emergency bypass is required. An anticoagulation sensitivity test (AST) was developed by adding 12 units of porcine mucosa heparin to the ACT tube (International Technidyne, celite type). Before anticoagulation, 4 mL of blood was drawn from the patient arterial line. Following the manufacturer’s instructions, 2 mL of blood was added to each tube (ACT-baseline and ACT-AST). Three minutes after anticoagulation with 4 mg heparin/kg body weight, a second sample (ACT-CPB) was taken to determine anticoagulation adequacy. The ACT times of each sample were recorded for 300 procedures occurring during 2004 and were retrospectively reviewed. Heparin resistance occurred in ?20% of the patients (n = 61). In 54 patients, heparin resistance was predicted by the ACT-AST. This was determined by the presence of an ACT-AST time and an ACT-CPB that were both <480 seconds. The positive predictive value was 90%, with a false positive rate of 3%. Heparin resistance occurs in patients undergoing CPB. We describe a simple and reliable test to avoid the delays of assessing anticoagulation for CPB (90% positive predictive value). Depending on program guidelines, patients can be given additional heparin or antithrombin III derivatives to aid in anticoagulation. An additional ACT must be performed and reach target times before CPB initiation. Testing of patient blood before the time of incision for sensitivity to heparin is a way to avoid a delay that can be critical in the care of the patient. Commercial tests are available, but efficacy data are limited, and they lead to added inventory expense. This method of titrating a diluted heparin additive, mixed with patient blood in a familiar ACT test, has proven to be an inexpensive and reliable test to predict patient’s sensitivity to heparin. PMID:17312901

  17. Maximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: the development of an appropriate test strategy.

    PubMed

    McManus, A; Leung, M

    2000-04-01

    Implicit in deciding upon an exercise test strategy to elucidate cardiopulmonary function in children with congenital heart disease are appropriate application of gas exchange techniques and the significance of the data collected to the specific congenital heart disorder. Post-operative cardiopulmonary responses to exercise in cyanotic disorders are complex and, despite a large body of extant literature in paediatric patients, there has been much difficulty in achieving quality and consistency of data. Maximal oxygen uptake is widely recognised as the best single indicator of cardiopulmonary function and has therefore been the focus of most clinical exercise tests in children. Many children with various heart anomalies are able to exercise to maximum without adverse symptoms, and it is essential that test termination is based on the same criteria for these children. Choosing appropriate, valid indicators of maximum in children with congenital heart disease is beset by difficulties. Such maximal intensity exercise testing procedures have been challenged on the grounds that they do not give a good indication of cardiopulmonary function that is relevant to real life situations. Furthermore, they are prone to much interindividual variability and error in the definition of maximal exertion. Alternative strategies have been proposed which focus upon dynamic submaximal and kinetic cardiopulmonary responses, which are thought to be less dependent on maximal voluntary effort and more suited to the daily activity patterns of children. These methods are also not without problems. Variability in anaerobic threshold measurements and controversy regarding its physiological meaning have been debated. It is recommended that an appropriate cardiopulmonary exercise gas exchange test strategy, which provides clinically useful information for children with cyanotic congenital heart disease, should include both maximal and submaximal data. The inclusion of oxygen uptake kinetics and ventilatory data are encouraged, since they may allow the distinction between a pulmonary, cardiovascular or inactivity related exercise limitation. PMID:10783899

  18. Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study

    PubMed Central

    Kim, Kyoung; Lee, Hye-Young; Lee, Do-Youn; Nam, Chan-Woo

    2015-01-01

    [Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after the Rockport 1 mile walking test in males, and significant improvements in forced vital capacity, forced expiratory volume at 1?s, maximal inspiratory pressure, and maximal expiratory pressure were observed after the Rockport 1 mile walking test in females. However, the maximal oxygen uptake was not significantly different. [Conclusion] Our findings indicate that the Rockport 1 mile walking test changes cardiopulmonary function in males and females, and that it may improve cardiopulmonary function in middle-aged and older adults and provide basic data on cardiopulmonary endurance. PMID:26356048

  19. Specificity of a Maximal Step Exercise Test

    ERIC Educational Resources Information Center

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

    2007-01-01

    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 step…

  20. Exercise stress testing

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1975-01-01

    Positive maximum stress tests in the management of coronary patients are discussed. It is believed that coronary angiography would be the ultimate test to predict the future of patients with coronary heart disease. Progression of angina, myocardial infarction, and death due to heart disease were analyzed.

  1. Cardiopulmonary Response to Exercise in COPD and Overweight Patients: Relationship between Unloaded Cycling and Maximal Oxygen Uptake Profiles

    PubMed Central

    Ba, Abdoulaye; Brégeon, Fabienne; Delliaux, Stéphane; Cissé, Fallou; Samb, Abdoulaye; Jammes, Yves

    2015-01-01

    Cardiopulmonary response to unloaded cycling may be related to higher workloads. This was assessed in male subjects: 18 healthy sedentary subjects (controls), 14 hypoxemic patients with chronic obstructive pulmonary disease (COPD), and 31 overweight individuals (twelve were hypoxemic). They underwent an incremental exercise up to the maximal oxygen uptake (VO2max), preceded by a 2?min unloaded cycling period. Oxygen uptake (VO2), heart rate (HR), minute ventilation (VE), and respiratory frequency (fR) were averaged every 10?s. At the end of unloaded cycling period, HR increase was significantly accentuated in COPD and hypoxemic overweight subjects (resp., +14 ± 2 and +13 ± 1.5?min?1, compared to +7.5 ± 1.5?min?1 in normoxemic overweight subjects and +8 ± 1.8?min?1 in controls). The fR increase was accentuated in all overweight subjects (hypoxemic: +4.5 ± 0.8; normoxemic: +3.9 ± 0.7?min?1) compared to controls (+2.5 ± 0.8?min?1) and COPDs (+2.0 ± 0.7?min?1). The plateau VE increase during unloaded cycling was positively correlated with VE values measured at the ventilatory threshold and VO2max. Measurement of ventilation during unloaded cycling may serve to predict the ventilatory performance of COPD patients and overweight subjects during an exercise rehabilitation program. PMID:25866778

  2. Proprioceptive isokinetic exercise test

    NASA Technical Reports Server (NTRS)

    Dempster, P. T.; Bernauer, E. M.; Bond, M.; Greenleaf, J. E.

    1993-01-01

    Proprioception, the reception of stimuli within the body that indicates position, is an important mechanism for optimal human performance. People exposed to prolonged bed rest, microgravity, or other deconditioning situations usually experience reduced proprioceptor and kinesthetic stimuli that compromise body balance, posture, and equilibrium. A new proprioceptive test is described that utilizes the computer-driven LIDO isokinetic ergometer. An overview of the computer logic, software, and testing procedure for this proprioceptive test, which can be performed with the arms or legs, is described.

  3. Neurohumoral and cardiopulmonary response to sustained submaximal exercise in the dog.

    PubMed

    Kirlin, P C; Kittleson, M D; Johnson, L E

    1987-03-01

    Neurohumoral, cardiovascular, and respiratory parameters were evaluated during sustained submaximal exercise (3.2 km/h, 15 degrees elevation) in normal adult mongrel dogs. At the level of activity achieved (fivefold elevation of total body O2 consumption and threefold elevation of cardiac output), significant (P less than 0.05) increases in plasma norepinephrine and epinephrine concentration (from 150 +/- 23 to 341 +/- 35 and from 127 +/- 27 to 222 +/- 31 pg/ml, respectively) were present, as well as smaller but significant increases in plasma renin activity and plasma aldosterone concentration (from 2.2 +/- 0.3 to 3.1 +/- 0.6 ng X ml-1 X h-1 and from 98 +/- 8 to 130 +/- 6 pg/ml, respectively). Plasma arginine vasopressin increased variably and insignificantly. The cardiovascular response (heart rate, systemic arterial and pulmonary arterial pressures, left ventricular filling pressure, and calculated total peripheral and pulmonary arteriolar resistance) closely paralleled that of human subjects. Increased hemoglobin concentration was induced by exercise in the dogs. The ventilatory response of the animals was characterized by respiratory alkalosis. These data suggest similarities between canine and human subjects in norepinephrine, plasma renin activity, and plasma aldosterone responses to submaximal exercise. Apparent species differences during submaximal exertion include greater alterations of plasma epinephrine concentration and a respiratory alkalosis in dogs. PMID:3553138

  4. Computer Based System for Breath-By-Breath Analysis of Cardio-Pulmonary Responses to Exercise

    PubMed Central

    Pearce, David H.; Milhorn, H. T.

    1977-01-01

    A computer based system for measurement of respiratory variables is presented. Tidal volume, respiratory frequency, minute ventilation, alveolar ventilation, dead space, oxygen transfer, carbon dioxide transfer, respiratory exchange ratio, end-tidal oxygen, end-tidal carbon dioxide, and heart rate are determined on a breath-to-breath basis. The computer is programmed to control the duration and intensity of the work involved. This program instructs the subject when to start and stop exercising, controls switching of the ergometer from an idle speed, and selects the work load. The computer system analyzes the data, averages multiple experiments and plots averages of multiple experiments along with standard error bars. Plotting time scales can be expanded to inspect selected portions of an experiment. The system is especially adapted to careful observation of the responses within the first few seconds of a change in work load. Appropriate computer programs and mathematical equations are presented. The results of several experiments are compared with data from other sources and found to be in good agreement.

  5. Reversibility of cardiopulmonary impairment after laparoscopic repair of large hiatal hernia

    PubMed Central

    Asti, Emanuele; Bonavina, Luigi; Lombardi, Massimo; Bandera, Francesco; Secchi, Francesco; Guazzi, Marco

    2015-01-01

    Giant hiatus hernia with or without intrathoracic gastric volvulus often presents with symptoms suggestive of both cardiac and pulmonary compression. Cardiopulmonary impairment may be reversible in these patients by laparoscopic crural repair and fundoplication as shown in this case report. Cardiac magnetic resonance and the cardiopulmonary exercise test may help selecting patients for surgery. These preliminary findings led us to start a prospective study using this multimodality diagnostic approach. PMID:26210719

  6. Eccentric exercise testing and training

    NASA Technical Reports Server (NTRS)

    Clarkson, Priscilla M.

    1994-01-01

    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 controversy may be based on a lack of understanding of the physiology of eccentric actions. This review will present data concerning eccentric exercise in strength training, the physiological characteristics of eccentric exercise, and the possible stimulus for strength development. Also a discussion of strength needs for extended exposure to microgravity will be presented. Not only is the use of eccentric exercise controversial, but the name itself is fraught with problems. The correct pronunciation is with a hard 'c' so that the word sounds like ekscentric. The confusion in pronunciation may have been prevented if the spelling that Asmussen used in 1953, excentric, had been adopted. Another problem concerns the expressions used to describe eccentric exercise. Commonly used expressions are negatives, eccentric contractions, lengthening contractions, resisted muscle lengthenings, muscle lengthening actions, and eccentric actions. Some of these terms are cumbersome (i.e., resisted muscle lengthenings), one is slang (negatives), and another is an oxymoron (lengthening contractions). Only eccentric action is appropriate and adoption of this term has been recommended by Cavanagh. Despite the controversy that surrounds eccentric exercise, it is important to note that these types of actions play an integral role in normal daily activities. Eccentric actions are used during most forms of movement, for example, in walking when the foot touches the ground and the center of mass is decelerated and in lowering objects, such as placing a bag of groceries in the car.

  7. Exercise testing in metabolic myopathies.

    PubMed

    Tarnopolsky, Mark

    2012-02-01

    Metabolic myopathies are a group of genetic disorders specifically affecting glucose/glycogen, lipid, and mitochondrial metabolism. The main metabolic myopathies that are evaluated in this article are the mitochondrial myopathies, fatty acid oxidation defects, and glycogen storage disease. This article focuses on the usefulness of exercise in the evaluation of genetic metabolic myopathies. PMID:22239882

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

    PubMed

    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

    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

  9. Exercise tolerance in obese vs. lean adolescents: a systematic review and meta-analysis.

    PubMed

    Hansen, D; Marinus, N; Remans, M; Courtois, I; Cools, F; Calsius, J; Massa, G; Takken, T

    2014-11-01

    To prescribe feasible and medically safe exercise interventions for obese adolescents, it remains to be determined whether exercise tolerance is altered and whether anomalous cardiopulmonary responses during maximal exercise testing are present. Studies that examined cardiopulmonary responses to maximal exercise testing in obese adolescents were searched: cardiopulmonary exercise tests with respiratory gas exchange measurements of peak oxygen uptake (VO2peak) were performed and comparisons between obese and lean adolescents were made. Study quality was assessed using a standardized item list. By meta-analyses VO2peak, peak cycling power output (Wpeak) and peak heart rate (HRpeak) were compared between groups. Nine articles were selected (333 obese vs. 145 lean adolescents). VO2peak (L min(-1)), HRpeak and Wpeak were not different between groups (P ? 0.10), while a trend was found for a reduced VO2peak (mL min(-1) kg(-1) lean tissue mass) (P=0.07) in obese vs. lean adolescents. It remained uncertain whether anomalous cardiopulmonary responses occur during maximal exercise testing in obese adolescents. In conclusion, a trend was found for lowered VO2peak (mL?min(-1)kg(-1) lean tissue mass) in obese vs. lean adolescents. Whether cardiopulmonary anomalies during maximal exercise testing would occur in obese adolescents remains uncertain. Studies are therefore warranted to examine the cardiopulmonary response during maximal exercise testing in obese adolescents. PMID:25132188

  10. Exercise Testing and Prescription in Patients with Congenital Heart Disease

    PubMed Central

    ten Harkel, A. D. J.; Takken, T.

    2010-01-01

    The present paper provides a review of the literature regarding exercise testing, exercise capacity, and the role of exercise training in patients with congenital heart disease (CHD). Different measures of exercise capacity are discussed, including both simple and more advanced exercise parameters. Different groups of patients, including shunt lesions, pulmonary valvar stenosis, patients after completion of Fontan circulation, and patients with pulmonary arterial hypertension are discussed separately in more detail. It has been underscored that an active lifestyle, taking exercise limitations and potential risks of exercise into account is of utmost importance. Increased exercise capacity in these patients is furthermore correlated with an improvement of objective and subjective quality of life. PMID:20871857

  11. Cardiopulmonary performance at rest and during exercise in seven patients with increased transradiancy of one lung (`Macleod's syndrome')

    PubMed Central

    Warrell, D. A.; Hughes, J. M. B.; Rosenzweig, D. Y.

    1970-01-01

    A group of seven patients with increased transradiancy of one lung included four with chronic bronchitis. The function of the two lungs combined was assessed by measurement of the lung volumes, airway resistance, and carbon monoxide uptake at rest, and by measurement of pulmonary ventilation, gas exchange, blood gases, and cardiac output at rest and during steady state exercise. The contribution of the hypertransradiant lung to the overall functional abnormalities at rest was estimated using a radioactive gas technique. All the patients had airway obstruction. Pulmonary gas exchange was only mildly affected at rest because of equal reduction of ventilation and perfusion in the abnormal lung, but during exercise ventilation-perfusion inequality increased in some of the patients. Cardiac output was low in five patients during exercise and in four there was excessive lactate production. The greatest physiological abnormalities were seen in two of the chronic bronchitics who had abnormalities of ventilation and perfusion in both lungs. We suggest that a pulmonary vascular abnormality resulting in reduced cardiac output, as well as ventilatory impairment due to airway obstruction, may contribute to the limited exercise capacity of these patients. PMID:5489183

  12. Predictive Accuracy of Exercise Stress Testing the Healthy Adult.

    ERIC Educational Resources Information Center

    Lamont, Linda S.

    1981-01-01

    Exercise stress testing provides information on the aerobic capacity, heart rate, and blood pressure responses to graded exercises of a healthy adult. The reliability of exercise tests as a diagnostic procedure is discussed in relation to sensitivity and specificity and predictive accuracy. (JN)

  13. Physiological and perceptual responses to incremental exercise testing in healthy men: effect of exercise test modality.

    PubMed

    Muscat, Kristina M; Kotrach, Houssam G; Wilkinson-Maitland, Courtney A; Schaeffer, Michele R; Mendonca, Cassandra T; Jensen, Dennis

    2015-11-01

    In a randomized cross-over study of 15 healthy men aged 20-30 years, we compared physiological and perceptual responses during treadmill and cycle exercise test protocols matched for increments in work rate - the source of increased locomotor muscle metabolic and contractile demands. The rates of O2 consumption and CO2 production were higher at the peak of treadmill versus cycle testing (p ? 0.05). Nevertheless, work rate, minute ventilation, tidal volume (VT), breathing frequency (fR), inspiratory capacity (IC), inspiratory reserve volume (IRV), tidal esophageal (Pes,tidal) and transdiaphragmatic pressure swings (Pdi,tidal), peak expiratory gastric pressures (Pga,peak), the root mean square of the diaphragm electromyogram (EMGdi,rms) expressed as a percentage of maximum EMGdi,rms (EMGdi,rms%max), and dyspnea ratings were similar at the peak of treadmill versus cycle testing (p > 0.05). Ratings of leg discomfort were higher at the peak of cycle versus treadmill exercise (p ? 0.05), even though peak O2 consumption was lower during cycling. Oxygen consumption, CO2 production, minute ventilation, fR, Pes,tidal, Pdi,tidal and Pga,peak were higher (p ? 0.05), while VT, IC, IRV, EMGdi,rms%max, and ratings of dyspnea and leg discomfort were similar (p > 0.05) at all or most submaximal work rates during treadmill versus cycle exercise. Our findings highlight important differences (and similarities) in physiological and perceptual responses at maximal and submaximal work rates during incremental treadmill and cycle exercise testing protocols. The lack of effect of exercise test modality on peak work rate advocates for the use of this readily available parameter to optimize training intensity determination, regardless of exercise training mode. PMID:26501683

  14. Automated assessment of C++ programming exercises with unit tests

    E-print Network

    Paech, Barbara

    Automated assessment of C++ programming exercises with unit tests Tom-Michael Hesse, Axel Wagner}@informatik.uni-heidelberg.de, axel.wagner@stud.uni-heidelberg.de Keywords: Automated testing, C++ testing, Automated source code of handed-in solutions for coding exercises, a dynamic test has to be performed. However, almost no systems

  15. The Sunflower Cardiopulmonary Research Project of Children.

    ERIC Educational Resources Information Center

    Greene, Leon

    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.…

  16. Home-based mobile cardio-pulmonary rehabilitation consultant system.

    PubMed

    Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

    2011-01-01

    Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise. PMID:22254478

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

    ERIC Educational Resources Information Center

    Saint Paul Technical Vocational Inst., MN.

    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,…

  18. Exercise testing and hemodynamic performance in healthy elderly persons

    SciTech Connect

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

    1984-11-01

    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.

  19. An Exercise for Illustrating the Logic of Hypothesis Testing

    ERIC Educational Resources Information Center

    Lawton, Leigh

    2009-01-01

    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…

  20. Inflight exercise affects stand test responses after space flight

    NASA Technical Reports Server (NTRS)

    Lee, S. M.; Moore, A. D. Jr; Fritsch-Yelle, J. M.; Greenisen, M. C.; Schneider, S. M.

    1999-01-01

    PURPOSE: The purpose of this study was to determine whether exercise performed by Space Shuttle crew members during short-duration space flights (9-16 d) affects the heart rate (HR) and blood pressure (BP) responses to standing within 2-4 h of landing. METHODS: Thirty crew members performed self-selected inflight exercise and maintained exercise logs to monitor their exercise intensity and duration. Two subjects participated in this investigation during two different flights. A 10-min stand test, preceded by at least 6 min of quiet supine rest, was completed 10-15 d before launch (PRE) and within 4 h of landing (POST). Based upon their inflight exercise records, subjects were grouped as either high (HIex: > or = 3 times/week, HR > or = 70% HRmax, > or = 20 min/session, N = 11), medium (MEDex: > or = 3 times/week, HR < 70% HRmax, > or = 20 min/session, N = 10), or low (LOex: < or = 3 times/week, HR and duration variable, N = 11) exercisers. HR and BP responses to standing were compared between groups (ANOVA, P < or = 0.05). RESULTS: There were no PRE differences between the groups in supine or standing HR and BP. Although POST supine HR was similar to PRE, all groups had an increased standing HR compared with PRE. The increase in HR upon standing was significantly greater after flight in the LOex group (36 +/- 5 bpm) compared with HIex or MEDex groups (25 +/- 1 bpm; 22 +/- 2 bpm). Similarly, the decrease in pulse pressure (PP) from supine to standing was unchanged after space flight in the MEDex and HIex groups but was significantly greater in the LOex group (PRE: -9 +/- 3; POST: -19 +/- 4 mm Hg). CONCLUSIONS: Thus, moderate to high levels of inflight exercise attenuated HR and PP responses to standing after space flight.

  1. Cardiopulmonary adaptation to weightlessness

    NASA Technical Reports Server (NTRS)

    Prisk, G. K.; Guy, H. J.; Elliott, A. R.; West, J. B.

    1994-01-01

    The lung is profoundly affected by gravity. The absence of gravity (microgravity) removes the mechanical stresses acting on the lung paranchyma itself, resulting in a reduction in the deformation of the lung due to its own weight, and consequently altering the distribution of fresh gas ventilation within the lung. There are also changes in the mechanical forces acting on the rib cage and abdomen, which alters the manner in which the lung expands. The other way in which microgravity affects the lung is through the removal of the gravitationally induced hydrostatic gradients in vascular pressures, both within the lung itself, and within the entire body. The abolition of a pressure gradient within the pulmonary circulation would be expected to result in a greater degree of uniformity of blood flow within the lung, while the removal of the hydrostatic gradient within the body should result in an increase in venous return and intra-thoracic blood volume, with attendant changes in cardiac output, stroke volume, and pulmonary diffusing capacity. During the 9 day flight of Spacelab Life Sciences-1 (SLS-1) we collected pulmonary function test data on the crew of the mission. We compared the results obtained in microgravity with those obtained on the ground in both the standing and supine positions, preflight and in the week immediately following the mission. A number of the tests in the package were aimed at studying the anticipated changes in cardiopulmonary function, and we report those in this communication.

  2. Exercises

    MedlinePLUS

    ... Sack, MS, PT Physical Therapist View full profile COPD: Lifestyle Management Exercise An exercise program is another ... Calendar Read the News View Daily Pollen Count COPD Program This program offers comprehensive, individualized care for ...

  3. Brain derived neurotrophic factor, cardiopulmonary fitness and cognition in patients with coronary artery disease

    PubMed Central

    Swardfager, W.; Herrmann, N.; Marzolini, S.; Saleem, M.; Shammi, P.; Oh, P.I.; Albert, P.R.; Daigle, M.; Kiss, A.; Lanctôt, K.L.

    2015-01-01

    Objective To assess serum brain derived neurotrophic factor (BDNF) concentrations as a correlate of cardiopulmonary fitness and as a predictor of cognitive performance in subjects with coronary artery disease (CAD). Methods Serum BDNF concentrations were assayed by ELISA and fitness was assessed using a standardized exercise stress test. The Mini Mental Status Examination (MMSE), California Verbal Learning Test 2nd Ed., Stroop, Trail Making Test B and the Digit Symbol-Coding task were administered. The val66met BDNF genotype and serum interleukin-6 (IL-6) and tumor necrosis factor-? (TNF-?) concentrations were determined as potential confounders. Results In subjects with CAD (n = 88; 85.2% male, mean age 62.8 ± 10.5 yr), cardiopulmonary fitness was associated with higher serum BDNF concentrations (? = .305, p = .013). Higher serum BDNF concentrations were associated with higher MMSE scores (F(1, 87) = 15.406, p < .0005) and better performance on the Digit Symbol-Coding task (F(1, 87) = 9.620, p = .003). IL-6, TNF-? and the val66met genotype did not influence these results. Conclusion Serum BDNF concentrations were associated with cardiopulmonary fitness, psychomotor processing speed and overall cognition in subjects with CAD. PMID:21554945

  4. Neutrophil elastase inhibitors for the treatment of (cardio)pulmonary diseases: Into clinical testing with pre-adaptive pharmacophores.

    PubMed

    von Nussbaum, Franz; Li, Volkhart M-J

    2015-10-15

    Alpha-1 antitrypsin deficiency is linked with an increased risk of suffering from lung emphysema. This discovery from the 1960s led to the development of the protease-antiprotease (im)balance hypothesis: Overshooting protease concentrations, especially high levels of elastase were deemed to have an destructive effect on lung tissue. Consequently, it was postulated that efficient elastase inhibitors could alleviate the situation in patients. However, despite intensive drug discovery efforts, even five decades later, no neutrophil elastase inhibitors are available for a disease-modifying treatment of (cardio)pulmonary diseases such as chronic obstructive pulmonary disease. Here, we critically review the attempts to develop effective human neutrophil elastase inhibitors while strongly focussing on recent developments. On purpose and with perspective distortion we focus on recent developments. One aim of this review is to classify the known HNE inhibitors into several generations, according to their binding modes. In general, there seem to be three major challenges in the development of suitable elastase inhibitors: (1) assuring sufficient potency, (2) securing selectivity, and (3) achieving metabolic stability especially under pathophysiological conditions. Impressive achievements have been made since 2001 with the identification of potent nonreactive, reversible small molecule inhibitors. The most modern inhibitors bind HNE via an induced fit with a frozen bioactive conformation that leads to a significant boost in potency, selectivity, and stability ('pre-adaptive pharmacophores'). These 5th generation inhibitors might succeed in re-establishing the protease-antiprotease balance in patients for the first time. PMID:26358162

  5. Predicting utility of exercise tests based on history/holter in patients with premature ventricular contractions.

    PubMed

    Robinson, Brad; Xie, Li; Temple, Joel; Octavio, Jenna; Srayyih, Maytham; Thacker, Deepika; Kharouf, Rami; Davies, Ryan; Gidding, Samuel S

    2015-01-01

    Premature ventricular contractions (PVCs) are considered benign in patients with structurally normal hearts, particularly if they suppress with exercise. Catecholaminergic polymorphic ventricular tachycardia (CPVT) requires exercise testing to unmask the malignant phenotype. We studied risk factors and Holter monitor variables to help predict the necessity of exercise testing in patients with PVCs. We retrospectively reviewed 81 patients with PVCs that suppressed at peak exercise and structurally normal hearts referred to the exercise laboratory in 2011. We reviewed 11 patients from 2003 to 2012 whose PVCs were augmented at peak exercise (mean age 13 ± 4 years; 52 % male, 180 exercise studies). We recorded clinical risk factors and comorbidities (family history of arrhythmia or sudden unexpected death [SUD], presence of syncope) and Holter testing parameters. Family history of VT or SUD (P = 0.011) and presence of VT on Holter (P = 0.011) were significant in predicting failure of PVCs to suppress at peak heart rate on exercise testing. Syncope was not statistically significant in predicting suppression (P = 0.18); however, CPVT was diagnosed in four patients with syncope during exercise. Quantity of PVCs, Lown grade, couplets on Holter, monomorphism, and PVC elimination at peak heart rate on Holter were not predictors of PVC suppression on exercise testing. Patients with syncope during exercise, family history of arrhythmia or SUD, or a Holter monitor showing VT warrant exercise testing to assess for CPVT. PMID:25135604

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

    SciTech Connect

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

    1988-02-01

    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.

  7. Cardiopulmonary discipline science plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Life sciences research in the cardiopulmonary discipline must identify possible consequences of space flight on the cardiopulmonary system, understand the mechanisms of these effects, and develop effective and operationally practical countermeasures to protect crewmembers inflight and upon return to a gravitational environment. The long-range goal of the NASA Cardiopulmonary Discipline Research Program is to foster research to better understand the acute and long-term cardiovascular and pulmonary adaptation to space and to develop physiological countermeasures to ensure crew health in space and on return to Earth. The purpose of this Discipline Plan is to provide a conceptual strategy for NASA's Life Sciences Division research and development activities in the comprehensive area of cardiopulmonary sciences. It covers the significant research areas critical to NASA's programmatic requirements for the Extended-Duration Orbiter, Space Station Freedom, and exploration mission science activities. These science activities include ground-based and flight; basic, applied, and operational; and animal and human research and development. This document summarizes the current status of the program, outlines available knowledge, establishes goals and objectives, identifies science priorities, and defines critical questions in the subdiscipline areas of both cardiovascular and pulmonary function. It contains a general plan that will be used by both NASA Headquarters Program Offices and the field centers to review and plan basic, applied, and operational (intramural and extramural) research and development activities in this area.

  8. Systolic Blood Pressure Response During Exercise Stress Testing: The Henry Ford ExercIse Testing (FIT) Project

    PubMed Central

    O’Neal, Wesley T; Qureshi, Waqas T; Blaha, Michael J; Keteyian, Steven J; Brawner, Clinton A; Al-Mallah, Mouaz H

    2015-01-01

    Background The prognostic significance of modest elevations in exercise systolic blood pressure response has not been extensively examined. Methods and Results We examined the association between systolic blood pressure response and all-cause death and incident myocardial infarction (MI) in 44 089 (mean age 53±13 years, 45% female, 26% black) patients who underwent exercise treadmill stress testing from the Henry Ford ExercIse Testing (FIT) Project (1991–2010). Exercise systolic blood pressure response was examined as a categorical variable (>20 mm Hg: referent; 1 to 20 mm Hg, and ?0 mm Hg) and per 1 SD decrease. Cox regression was used to compute hazard ratios (HR) and 95% CI for the association between systolic blood pressure response and all-cause death and incident MI. Over a median follow-up of 10 years, a total of 4782 (11%) deaths occurred and over 5.2 years, a total of 1188 (2.7%) MIs occurred. In a Cox regression analysis adjusted for demographics, physical fitness, and cardiovascular risk factors, an increased risk of death was observed with decreasing systolic blood pressure response (>20 mm Hg: HR=1.0, referent; 1 to 20 mm Hg: HR=1.13, 95% CI=1.05, 1.22; ?0 mm Hg: HR=1.21, 95% CI=1.09, 1.34). A trend for increased MI risk was observed (>20 mm Hg: HR=1.0, referent; 1 to 20 mm Hg: HR=1.09, 95% CI=0.93, 1.27; ?0 mm Hg: HR=1.19, 95% CI=0.95, 1.50). Decreases in systolic blood pressure response per 1 SD were associated with an increased risk for all-cause death (HR=1.08, 95% CI=1.05, 1.11) and incident MI (HR=1.09, 95% CI=1.03, 1.16). Conclusions Our results suggest that modest increases in exercise systolic blood pressure response are associated with adverse outcomes. PMID:25953655

  9. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    PubMed Central

    Cortinas, Inés Vidal; Beretta, Mario; Alonso, Omar; Mut, Fernando

    2015-01-01

    Background Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. Objectives In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. Methods In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Results Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (? 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ? 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ? 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). Conclusions The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP. PMID:26039661

  10. Exercise Testing, Training, and Beta-Adrenergic Blockade.

    ERIC Educational Resources Information Center

    Wilmore, Jack H.

    1988-01-01

    This article summarizes the current knowledge on the effects of beta-adrenergic blocking drugs, used widely for treatment of cardiovascular diseases, on exercise performance, training benefits, and exercise prescription. (IAH)

  11. Exercise

    MedlinePLUS

    ... The Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis can help adults with mild to moderate disability, resulting from relapsing or ... Publication Exercise as Part of Everyday Life Physical activity can be a regular part of ...

  12. Clinical test responses to different orthoptic exercise regimes in typical young adults

    PubMed Central

    Horwood, Anna; Toor, Sonia

    2014-01-01

    Purpose The relative efficiency of different eye exercise regimes is unclear, and in particular the influences of practice, placebo and the amount of effort required are rarely considered. This study measured conventional clinical measures following different regimes in typical young adults. Methods A total of 156 asymptomatic young adults were directed to carry out eye exercises three times daily for 2 weeks. Exercises were directed at improving blur responses (accommodation), disparity responses (convergence), both in a naturalistic relationship, convergence in excess of accommodation, accommodation in excess of convergence, and a placebo regime. They were compared to two control groups, neither of which were given exercises, but the second of which were asked to make maximum effort during the second testing. Results Instruction set and participant effort were more effective than many exercises. Convergence exercises independent of accommodation were the most effective treatment, followed by accommodation exercises, and both regimes resulted in changes in both vergence and accommodation test responses. Exercises targeting convergence and accommodation working together were less effective than those where they were separated. Accommodation measures were prone to large instruction/effort effects and monocular accommodation facility was subject to large practice effects. Conclusions Separating convergence and accommodation exercises seemed more effective than exercising both systems concurrently and suggests that stimulation of accommodation and convergence may act in an additive fashion to aid responses. Instruction/effort effects are large and should be carefully controlled if claims for the efficacy of any exercise regime are to be made. PMID:24471739

  13. Testing a Collaborative DDoS Defense in a Red Team/Blue Team Exercise

    E-print Network

    California at Los Angeles, University of

    mechanism for security testing. They partition researchers into two competing teams of attackers and defenders, enabling them to create challenging and realistic test scenarios. While such exercises provide, and performed October 2002 to May 2003. The goal of the exercise was to evaluate a collaborative DDoS defense

  14. Prediction of functional aerobic capacity without exercise testing

    NASA Technical Reports Server (NTRS)

    Jackson, A. S.; Blair, S. N.; Mahar, M. T.; Wier, L. T.; Ross, R. M.; Stuteville, J. E.

    1990-01-01

    The purpose of this study was to develop functional aerobic capacity prediction models without using exercise tests (N-Ex) and to compare the accuracy with Astrand single-stage submaximal prediction methods. The data of 2,009 subjects (9.7% female) were randomly divided into validation (N = 1,543) and cross-validation (N = 466) samples. The validation sample was used to develop two N-Ex models to estimate VO2peak. Gender, age, body composition, and self-report activity were used to develop two N-Ex prediction models. One model estimated percent fat from skinfolds (N-Ex %fat) and the other used body mass index (N-Ex BMI) to represent body composition. The multiple correlations for the developed models were R = 0.81 (SE = 5.3 ml.kg-1.min-1) and R = 0.78 (SE = 5.6 ml.kg-1.min-1). This accuracy was confirmed when applied to the cross-validation sample. The N-Ex models were more accurate than what was obtained from VO2peak estimated from the Astrand prediction models. The SEs of the Astrand models ranged from 5.5-9.7 ml.kg-1.min-1. The N-Ex models were cross-validated on 59 men on hypertensive medication and 71 men who were found to have a positive exercise ECG. The SEs of the N-Ex models ranged from 4.6-5.4 ml.kg-1.min-1 with these subjects.(ABSTRACT TRUNCATED AT 250 WORDS).

  15. EKGs and Exercise Stress Tests: When You Need Them for Heart Disease - and When You Don't

    MedlinePLUS

    ... Resources EKGs and Exercise Stress Tests EKGs and Exercise Stress Tests When you need them—and when you don’t DOWNLOAD PDF EKGs and stress tests ... or electrocardiogram, measures your heart’s activity. In an exercise stress test, you have an EKG while you ...

  16. Cardiopulmonary Responses to Supine Cycling during Short-Arm Centrifugation

    NASA Technical Reports Server (NTRS)

    Vener, J. M.; Simonson, S. R.; Stocks, J.; Evettes, S.; Bailey, K.; Biagini, H.; Jackson, C. G. R.; Greenleaf, J. E.; Dalton, Bonnie P. (Technical Monitor)

    2001-01-01

    The purpose of this study was to investigate cardiopulmonary responses to supine cycling with concomitant +G(sub z) acceleration using the NASA/Ames Human Powered Short-Arm Centrifuge (HPC). Subjects were eight consenting males (32+/-5 yrs, 178+/-5 cm, 86.1+/- 6.2 kg). All subjects completed two maximal exercise tests on the HPC (with and without acceleration) within a three-day period. A two tailed t-test with statistical significance set at p less than or equal to 0.05 was used to compare treatments. Peak acceleration was 3.4+/-0.1 G(sub z), (head to foot acceleration). Peak oxygen uptake (VO2(sub peak) was not different between treatment groups (3.1+/-0.1 Lmin(exp -1) vs. 3.2+/-0.1 Lmin(exp -1) for stationary and acceleration trials, respectively). Peak HR and pulmonary minute ventilation (V(sub E(sub BTPS))) were significantly elevated (p less than or equal to 0.05) for the acceleration trial (182+/-3 BPM (Beats per Minute); 132.0+/-9.0 Lmin(exp -1)) when compared to the stationary trial (175+/-3 BPM; 115.5+/-8.5 Lmin(exp -1)). Ventilatory threshold expressed as a percent of VO2(sub peak) was not different for acceleration and stationary trials (72+/-2% vs. 68+/-2% respectively). Results suggest that 3.4 G(sub z) acceleration does not alter VO2(sub peak) response to supine cycling. However, peak HR and V(sub E(sub BTPS)) response may be increased while ventilatory threshold response expressed as a function of percent VO2(sub peak) is relatively unaffected. Thus, traditional exercise prescription based on VO2 response would be appropriate for this mode of exercise. Prescriptions based on HR response may require modification.

  17. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

    Kangas, Lars J. (Richland, WA); Keller, Paul E. (Richland, WA)

    1997-01-01

    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.

  18. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

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

    1997-10-28

    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.

  19. The Effect of Estrogen Usage on Eccentric Exercise-Induced Damage in Rat Testes

    PubMed Central

    Can, Serpil; Selli, Jale; Buyuk, Basak; Aydin, Sergulen; Kocaaslan, Ramazan; Guvendi, Gulname Findik

    2015-01-01

    Background: Recent years, lots of scientific studies are focused on the possible mechanism of inflammatory response and oxidative stress which are the mechanism related with tissue damage and exercise fatigue. It is well-known that free oxygen radicals may be induced under invitro conditions as well as oxidative stress by exhaustive physical exercise. Objectives: The aim of this study was to investigate the effects of anabolic steroids in conjunction with exercise in the process of spermatogenesis in the testes, using histological and stereological methods. Materials and Methods: Thirty-six male Sprague Dawley rats were divided to six groups, including the control group, the eccentric exercise administered group, the estrogen applied group, the estrogen applied and dissected one hour after eccentric exercise group, the no estrogen applied and dissected 48 hours after eccentric exercise group and the estrogen applied and dissected 48 hours after eccentric exercise group. Eccentric exercise was performed on a motorized rodent treadmill and the estrogen applied groups received daily physiological doses by subcutaneous injections. Testicular tissues were examined using specific histopathological, immunohistochemical and stereological methods. Sections of the testes tissue were stained using the TUNEL method to identify apoptotic cells. Apoptosis was calculated as the percentage of positive cells, using stereological analysis. A statistical analysis of the data was carried out with one-way analysis of variance (ANOVA) for the data obtained from stereological analysis. Results: Conventional light microscopic results revealed that testes tissues of the eccentric exercise administered group and the estrogen supplemented group exhibited slight impairment. In groups that were both eccentrically exercised and estrogen supplemented, more deterioration was detected in testes tissues. Likewise, immunohistochemistry findings were also more prominent in the eccentrically exercised and estrogen supplemented groups. Conclusions: The findings suggest that estrogen supplementation increases damage in testicular tissue due to eccentric exercise. PMID:26023337

  20. Realistic Exercises for Assessing Learning. I. Conceptual Design and Testing. Report 04-93.

    ERIC Educational Resources Information Center

    Gronlund, Wayne R.; And Others

    Researchers at the Coast Guard Academy have designed and tested a series of exercises for assessing the development of intellectual skills in an interdisciplinary context and providing career-related motivation for continued learning. These exercises are based on realistic situations that cadets might encounter as commissioned officers in the…

  1. Flow for Exercise Adherence: Testing an Intrinsic Model of Health Behavior

    ERIC Educational Resources Information Center

    Petosa, R. Lingyak; Holtz, Brian

    2013-01-01

    Background: Health behavior theory generally does not include intrinsic motivation as a determinate of health practices. Purpose: The purpose of this study was to test the flow theory of exercise adherence. Flow theory posits that exercise can be intrinsically rewarding if the experiences of self/time transcendence and control/mastery are achieved…

  2. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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...

  3. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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...

  4. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...

  5. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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...

  6. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  7. The effects of space flight on the cardiopulmonary system

    NASA Technical Reports Server (NTRS)

    Nicogossian, Arnauld E.; Gaffney, F. Andrew; Garshnek, Victoria

    1989-01-01

    Alterations of the human cardiopulmonary system in space flight are examined, including fluid shifts, orthostatic intolerance, changes in cardiac dynamics and electromechanics, and changes in pulmonary function and exercise capacity. Consideration is given to lower body negative pressure data from Skylab experiments and studies on the Space Shuttle. Also, echocardiography, cardiac dysrhythmias during spaceflight, and the role of neural mechanisms in circulatory control after spaceflight are discussed.

  8. Validity and Reproducibility of an Incremental Sit-To-Stand Exercise Test for Evaluating Anaerobic Threshold in Young, Healthy Individuals

    PubMed Central

    Nakamura, Keisuke; Ohira, Masayoshi; Yokokawa, Yoshiharu; Nagasawa, Yuya

    2015-01-01

    Sit-to-stand exercise (STS) is a common activity of daily living. The objectives of the present study were: 1) to assess the validity of aerobic fitness measurements based on anaerobic thresholds (ATs), during incremental sit-to-stand exercise (ISTS) with and without arm support compared with an incremental cycle-ergometer (CE) test; and 2) to examine the reproducibility of the AT measured during the ISTSs. Twenty-six healthy individuals randomly performed the ISTS and CE test. Oxygen uptakes at the AT (AT-VO2) and heart rate at the AT (AT-HR) were determined during the ISTSs and CE test, and repeated-measures analyses of variance and Tukey’s post-hoc test were used to evaluate the differences between these variables. Pearson correlation coefficients were used to assess the strength of the relationship between AT-VO2 and AT-HR during the ISTSs and CE test. Data analysis yielded the following correlations: AT-VO2 during the ISTS with arm support and the CE test, r = 0.77 (p < 0.05); AT-VO2 during the ISTS without arm support and the CE test, r = 0.70 (p < 0.05); AT-HR during the ISTS with arm support and the CE test, r = 0.80 (p < 0.05); and AT-HR during the ISTS without arm support and the CE test, r = 0.66 (p < 0.05). The AT-VO2 values during the ISTS with arm support (18.5 ± 1.9 mL·min-1·kg-1) and the CE test (18.4 ± 1.8 mL·min-1·kg-1) were significantly higher than those during the ISTS without arm support (16.6 ± 1.8 mL·min-1·kg-1; p < 0.05). The AT-HR values during the ISTS with arm support (126 ± 10 bpm) and the CE test (126 ± 13 bpm) were significantly higher than those during the ISTS without arm support (119 ± 9 bpm; p < 0.05). The ISTS with arm support may provide a cardiopulmonary function load equivalent to the CE test; therefore, it is a potentially valid test for evaluating AT-VO2 and AT-HR in healthy, young adults. Key points The ISTS is a simple test that varies only according to the frequency of standing up, and requires only a small space and a chair. The ISTS with arm support is valid and reproducible, and is a safe test for evaluating AT in healthy young adults. For evaluating the AT, the ISTS may serve as a valid alternative to conventional CPX, using either a cycle ergometer or treadmill, in cases where the latter methods are difficult to implement. PMID:26664266

  9. Validity and Reproducibility of an Incremental Sit-To-Stand Exercise Test for Evaluating Anaerobic Threshold in Young, Healthy Individuals.

    PubMed

    Nakamura, Keisuke; Ohira, Masayoshi; Yokokawa, Yoshiharu; Nagasawa, Yuya

    2015-12-01

    Sit-to-stand exercise (STS) is a common activity of daily living. The objectives of the present study were: 1) to assess the validity of aerobic fitness measurements based on anaerobic thresholds (ATs), during incremental sit-to-stand exercise (ISTS) with and without arm support compared with an incremental cycle-ergometer (CE) test; and 2) to examine the reproducibility of the AT measured during the ISTSs. Twenty-six healthy individuals randomly performed the ISTS and CE test. Oxygen uptakes at the AT (AT-VO2) and heart rate at the AT (AT-HR) were determined during the ISTSs and CE test, and repeated-measures analyses of variance and Tukey's post-hoc test were used to evaluate the differences between these variables. Pearson correlation coefficients were used to assess the strength of the relationship between AT-VO2 and AT-HR during the ISTSs and CE test. Data analysis yielded the following correlations: AT-VO2 during the ISTS with arm support and the CE test, r = 0.77 (p < 0.05); AT-VO2 during the ISTS without arm support and the CE test, r = 0.70 (p < 0.05); AT-HR during the ISTS with arm support and the CE test, r = 0.80 (p < 0.05); and AT-HR during the ISTS without arm support and the CE test, r = 0.66 (p < 0.05). The AT-VO2 values during the ISTS with arm support (18.5 ± 1.9 mL·min(-1)·kg(-1)) and the CE test (18.4 ± 1.8 mL·min(-1)·kg(-1)) were significantly higher than those during the ISTS without arm support (16.6 ± 1.8 mL·min(-1)·kg(-1); p < 0.05). The AT-HR values during the ISTS with arm support (126 ± 10 bpm) and the CE test (126 ± 13 bpm) were significantly higher than those during the ISTS without arm support (119 ± 9 bpm; p < 0.05). The ISTS with arm support may provide a cardiopulmonary function load equivalent to the CE test; therefore, it is a potentially valid test for evaluating AT-VO2 and AT-HR in healthy, young adults. Key pointsThe ISTS is a simple test that varies only according to the frequency of standing up, and requires only a small space and a chair.The ISTS with arm support is valid and reproducible, and is a safe test for evaluating AT in healthy young adults.For evaluating the AT, the ISTS may serve as a valid alternative to conventional CPX, using either a cycle ergometer or treadmill, in cases where the latter methods are difficult to implement. PMID:26664266

  10. Pulmonary thallium-201 uptake following dipyridamole-exercise combination compared with single modality stress testing.

    PubMed

    Hurwitz, G A; O'Donoghue, J P; Powe, J E; Gravelle, D R; MacDonald, A C; Finnie, K J

    1992-02-01

    Angiographic and clinical determinants of pulmonary uptake of thallium-201 were assessed in a laboratory setting where supine bicycle exercise is used for stress testing in the absence of limiting pharmacologic or physical factors, and where symptom-limited exercise is added to intravenous dipyridamole infusion in other cases. Angiographic correlation was available in 400 patients, including 130 tested with exercise, 94 in whom only handgrip or abbreviated bicycle exercise could be used after dipyridamole, and 176 in whom intravenous dipyridamole was combined with a significant level of exercise. For each test mode, lung/myocardial ratios on the immediate image were highly correlated (p less than or equal to 0.001) with a score based on the number of critical coronary artery stenoses, with grading by contrast ventriculography, and with the number of stenosed (greater than or equal to 50%) arteries; relationships (p less than 0.05) to history of myocardial infarction and to gender were also present. Multiple regression analysis showed the critical stenosis score and ventricular dysfunction to be the only significant determinants. When dipyridamole based tests were compared with exercise, curves of receiver-operating characteristics showed a tendency to better diagnostic performance. When dipyridamole is incorporated in stress testing, the value of increased lung uptake as an ancillary diagnostic sign is similar to that established for exercise. PMID:1734642

  11. Comparison of Peak Cardiopulmonary Performance Parameters on a Robotics-Assisted Tilt Table, a Cycle and a Treadmill

    PubMed Central

    Saengsuwan, Jittima; Nef, Tobias; Laubacher, Marco; Hunt, Kenneth J.

    2015-01-01

    Robotics-assisted tilt table (RATT) technology provides body support, cyclical stepping movement and physiological loading. This technology can potentially be used to facilitate the estimation of peak cardiopulmonary performance parameters in patients who have neurological or other problems that may preclude testing on a treadmill or cycle ergometer. The aim of the study was to compare the magnitude of peak cardiopulmonary performance parameters including peak oxygen uptake (VO2peak) and peak heart rate (HRpeak) obtained from a robotics-assisted tilt table (RATT), a cycle ergometer and a treadmill. The strength of correlations between the three devices, test-retest reliability and repeatability were also assessed. Eighteen healthy subjects performed six maximal exercise tests, with two tests on each of the three exercise modalities. Data from the second tests were used for the comparative and correlation analyses. For nine subjects, test-retest reliability and repeatability of VO2peak and HRpeak were assessed. Absolute VO2peak from the RATT, the cycle ergometer and the treadmill was (mean (SD)) 2.2 (0.56), 2.8 (0.80) and 3.2 (0.87) L/min, respectively (p < 0.001). HRpeak from the RATT, the cycle ergometer and the treadmill was 168 (9.5), 179 (7.9) and 184 (6.9) beats/min, respectively (p < 0.001). VO2peak and HRpeak from the RATT vs the cycle ergometer and the RATT vs the treadmill showed strong correlations. Test-retest reliability and repeatability were high for VO2peak and HRpeak for all devices. The results demonstrate that the RATT is a valid and reliable device for exercise testing. There is potential for the RATT to be used in severely impaired subjects who cannot use the standard modalities. PMID:25860019

  12. Comparison of peak cardiopulmonary performance parameters on a robotics-assisted tilt table, a cycle and a treadmill.

    PubMed

    Saengsuwan, Jittima; Nef, Tobias; Laubacher, Marco; Hunt, Kenneth J

    2015-01-01

    Robotics-assisted tilt table (RATT) technology provides body support, cyclical stepping movement and physiological loading. This technology can potentially be used to facilitate the estimation of peak cardiopulmonary performance parameters in patients who have neurological or other problems that may preclude testing on a treadmill or cycle ergometer. The aim of the study was to compare the magnitude of peak cardiopulmonary performance parameters including peak oxygen uptake (VO2peak) and peak heart rate (HRpeak) obtained from a robotics-assisted tilt table (RATT), a cycle ergometer and a treadmill. The strength of correlations between the three devices, test-retest reliability and repeatability were also assessed. Eighteen healthy subjects performed six maximal exercise tests, with two tests on each of the three exercise modalities. Data from the second tests were used for the comparative and correlation analyses. For nine subjects, test-retest reliability and repeatability of VO2peak and HRpeak were assessed. Absolute VO2peak from the RATT, the cycle ergometer and the treadmill was (mean (SD)) 2.2 (0.56), 2.8 (0.80) and 3.2 (0.87) L/min, respectively (p < 0.001). HRpeak from the RATT, the cycle ergometer and the treadmill was 168 (9.5), 179 (7.9) and 184 (6.9) beats/min, respectively (p < 0.001). VO2peak and HRpeak from the RATT vs the cycle ergometer and the RATT vs the treadmill showed strong correlations. Test-retest reliability and repeatability were high for VO2peak and HRpeak for all devices. The results demonstrate that the RATT is a valid and reliable device for exercise testing. There is potential for the RATT to be used in severely impaired subjects who cannot use the standard modalities. PMID:25860019

  13. Cardiopulmonary Syndromes—Patient Version

    Cancer.gov

    Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

  14. Discordance of exercise thallium testing with coronary arteriography in patients with atypical presentations

    NASA Technical Reports Server (NTRS)

    Bungo, M. W.; Leland, O. S., Jr.

    1983-01-01

    Eighty-one patients with diagnostically difficult clinical presentations suggesting coronary artery disease underwent symptom-limited maximal-exercise treadmill testing (ETT) and exercise radionuclide scanning with thallium-201 followed by coronary angiography. Results showed that in nearly half of the patients (47%) these tests were in agreement, while either exercise thallium or ETT was positive in 94% of patients with coronary artery disease. It was found that agreement between exercise thallium and ETT tests predicted disease in 92% of the instances or excluded disease in 82% of the instances. It is concluded that despite frequent discord between these two tests in 53% of the cases, a significant gain in exclusive diagnostic capability is realized when applied to a patient population anticipated to have a disease prevalence equal to the 67% encountered in this study.

  15. Prognostic value of radionuclide exercise testing after myocardial infarction

    SciTech Connect

    Schocken, D.D.

    1984-08-01

    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.

  16. Test --November 29, 2013 Exercise 1 [6 points

    E-print Network

    De Luca, Alessandro

    robot link that rotates in the horizontal plane around a joint axis passing through its base. The motor a picture of the robot (mounted on an inclined base) and a few snaphots of the robot in motion (mounted, 3, 5, and 7 are on a common plane, while joint axes 2, 4, and 6 are normal to this plane Exercise 3

  17. Percolation Tests for Septic Systems: A Laboratory Exercise.

    ERIC Educational Resources Information Center

    Tinker, John R., Jr.

    1978-01-01

    Describes how the procedures by which a certificate soil tester evaluates a parcel of land for its suitability as a site for a private sewage system or septic tank can be used by college students as a laboratory exercise in environmental geology. (HM)

  18. The Response of Circulating Leptin Levels to Exercise Stress Testing in Subjects Diagnosed with Metabolic Syndrome

    PubMed Central

    Pop, Dana; D?dârlat, Alexandra; Bodizs, Gyorgy; Stanca, Liana; Zdrenghea, Dumitru

    2014-01-01

    Aim. To assess the plasma leptin responses after exercise stress testing in patients with metabolic syndrome (MS). Material and Methods. We investigated 67 patients with MS, with mean age of 55 ± 7 years. They underwent exercise stress testing on cycloergometer. The lot was divided into three groups: group 1—10 patients with a true positive test, group 2—18 patients with a true negative test, and group 3—39 patients with a false negative test. Leptin levels were measured using the ELISA method. Results. Leptin levels decreased after effort in patients with MS (9.42 ± 11.08?ng/mL before and 8.18 ± 11.5?ng/mL after the exercise stress test, P = 0.0005, r = 0.874). In groups 1 (8.98 ± 9.09 at rest versus 5.98 ± 8.73?ng/mL after the exercise test, P = 0.002) and 3 (8.6 ± 10.53 at rest versus 6.91 ± 9.07?ng/mL, P = 0.0005), lower leptin levels were recorded immediately after exercise testing. Leptin levels were not significantly lower in group 2 before effort (9.49 ± 11.36?ng/ml) and after (9.46 ± 13.81?ng/mL). We found no correlation between leptinemia and exercise stress testing parameters, regardless of group. Conclusion. Our research showed that short-term exercise lowers leptin levels in coronary patients, without a relationship between its parameters and leptin values. PMID:24616817

  19. Effects of early postmyocardial infarction exercise testing on self-perception and subsequent physical activity.

    PubMed

    Ewart, C K; Taylor, C B; Reese, L B; DeBusk, R F

    1983-04-01

    The effects of exercise testing 3 weeks after clinically uncomplicated myocardial infarction (MI) on subsequent physical activity were evaluated in 40 consecutive men with a mean age of 52 +/- 9 years. Patients' confidence in their ability to perform various physical activities was evaluated with self-efficacy scales which patients completed before and after a symptom-limited treadmill exercise test. Increases in confidence (self-efficacy) for activities similar to treadmill exercise (walking, stair climbing, and running) were greatest after treadmill exercise, whereas increases for dissimilar activities (sexual intercourse and lifting) were greatest after test results were explained by a physician and nurse. The intensity and duration of subsequent physical activity at home were more highly correlated with self-efficacy after treadmill exercise than with peak treadmill heart rate. Of the 8 patients whose treadmill tests were limited by angina pectoris, 7 had self-efficacy scores which remained low after treadmill testing or which decreased from initially high values after treadmill testing. These patients had lower peak heart rates and work loads than patients whose self-efficacy increased or remained high after treadmill testing. After MI, patients' perception of their capacity for physical activity and their actual patterns of subsequent physical activity are influenced by early treadmill testing in a manner which is congruent with these patients' treadmill performance. PMID:6837450

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

    ERIC Educational Resources Information Center

    Zwiren, Linda D.; And Others

    1991-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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 completed…

  2. Department of Cardiopulmonary Science JUNIOR YEAR

    E-print Network

    Department of Cardiopulmonary Science Curriculum JUNIOR YEAR Summer Semester Respiratory Therapy 3 CPSC 3220 Cardiopulmonary Physiology 3 9 9 Fall Semester Respiratory Therapy Track Cardiovascular 3200 Respiratory Therapy Fundamentals 3 CPSC 3282 Clinical Echocardiography I 4 CPSC 3285 Respiratory

  3. A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD.

    PubMed

    Rector, Neil A; Richter, Margaret A; Lerman, Bethany; Regev, Rotem

    2015-01-01

    The majority of "responders" to first-line cognitive-behavioural therapy (CBT) and pharmacological treatments for obsessive-compulsive disorder (OCD) are left with residual symptoms that are clinically relevant and disabling. Therefore, there is pressing need for widely accessible efficacious alternative and/or adjunctive treatments for OCD. Accumulating evidence suggests that physical exercise may be one such intervention in the mood and anxiety disorders broadly, although we are aware of only two positive small-scale pilot studies that have tested its clinical benefits in OCD. This pilot study aimed to test the feasibility and preliminary efficacy of adding a structured physical exercise programme to CBT for OCD. A standard CBT group was delivered concurrently with a 12-week customized exercise programme to 11 participants. The exercise regimen was individualized for each participant based on peak heart rate measured using an incremental maximal exercise test. Reports of exercise adherence across the 12-week regimen exceeded 80%. A paired-samples t-test indicated very large treatment effects in Yale-Brown Obsessive-Compulsive Scale scores from pre- to post-treatment in CBT group cohorts led by expert CBT OCD specialists (d = 2.55) and junior CBT clinician non-OCD specialists (d = 2.12). These treatment effects are very large and exceed effects typically observed with individual and group-based CBT for OCD based on leading meta-analytic reviews, as well as previously obtained treatment effects for CBT using the same recruitment protocol without exercise. As such, this pilot work demonstrates the feasibility and significant potential clinical utility of a 12-week aerobic exercise programme delivered in conjunction with CBT for OCD. PMID:25738234

  4. Comparison between treadmill and bicycle ergometer exercise tests in mild-to-moderate hypertensive Nigerians

    PubMed Central

    Abiodun, Olugbenga O; Balogun, Michael O; Akintomide, Anthony O; Adebayo, Rasaaq A; Ajayi, Olufemi E; Ogunyemi, Suraj A; Amadi, Valentine N; Adeyeye, Victor O

    2015-01-01

    Background Comparative cardiovascular responses to treadmill and bicycle ergometer (bike) exercise tests in hypertensive Nigerians are not known. This study compared cardiovascular responses to the two modes of exercise testing in hypertensives using maximal exercise protocols. Methods One hundred and ten male subjects with mild-to-moderate hypertension underwent maximal treadmill and bike test one after the other at a single visit in a simple random manner. Paired-sampled t-test was used to compare responses to both exercise tests while chi-squared test was used to compare categorical variables. Results The maximal heart rate (P<0.001), peak systolic blood pressure (P=0.02), rate pressure product (P<0.001), peak oxygen uptake (P<0.001), and exercise capacity (P<0.001) in metabolic equivalents were signifcantly higher on the treadmill than on the bike. Conclusion Higher cardiovascular responses on treadmill in Nigerian male hypertensives in this study, similar to findings in non-hypertensives and non-Nigerians in earlier studies, suggest that treadmill may be of better diagnostic utility in our population. PMID:26316811

  5. Reliability of Strength Testing using the Advanced Resistive Exercise Device and Free Weights

    NASA Technical Reports Server (NTRS)

    English, Kirk L.; Loehr, James A.; Laughlin, Mitzi A.; Lee, Stuart M. C.; Hagan, R. Donald

    2008-01-01

    The Advanced Resistive Exercise Device (ARED) was developed for use on the International Space Station as a countermeasure against muscle atrophy and decreased strength. This investigation examined the reliability of one-repetition maximum (1RM) strength testing using ARED and traditional free weight (FW) exercise. Methods: Six males (180.8 +/- 4.3 cm, 83.6 +/- 6.4 kg, 36 +/- 8 y, mean +/- SD) who had not engaged in resistive exercise for at least six months volunteered to participate in this project. Subjects completed four 1RM testing sessions each for FW and ARED (eight total sessions) using a balanced, randomized, crossover design. All testing using one device was completed before progressing to the other. During each session, 1RM was measured for the squat, heel raise, and deadlift exercises. Generalizability (G) and intraclass correlation coefficients (ICC) were calculated for each exercise on each device and were used to predict the number of sessions needed to obtain a reliable 1RM measurement (G . 0.90). Interclass reliability coefficients and Pearson's correlation coefficients (R) also were calculated for the highest 1RM value (1RM9sub peak)) obtained for each exercise on each device to quantify 1RM relationships between devices.

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

    ERIC Educational Resources Information Center

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

    2006-01-01

    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…

  7. The Stress Exercise Test and Oxygen Uptake in Normal Korean Men

    PubMed Central

    Shim, Wan Joo; Suh, Soon Kyu

    1986-01-01

    In order to observe physiologic responses to exercise and measure the normal value of maximal oxygen uptake, an exercise stress test, using a bicycle ergometer, was carried out on 82 normal males, 20 to 60 years of age. The exercise test consisted of 1 minute of unloaded cycling with an increment of 25 watts each minute to the point of exhaustion. Oxygen uptake, anaerobic threshold(AT), minute ventilation, and CO2 output were measured with an automatic gas analyzer and a pneumotachograph during the exercise. The results are summarized as follows: The maximal oxygen uptake in the 20–29 year-old group of subjects was 39.6ml/min/kg, and it decreased with advancing age.The anaerobic threshold was 1.22–1.5 L/min in all age groups. No significant differences by age were observed. The mean ratio of the anaerobic threshold to the maximal oxygen uptake was 57%.The minute ventilation at maximal exercise was 65% of the maximal voluntary ventilation. This means that the subject cannot perform exercise at all, because of shortness of breath, that some potentially useful ventilation is left. PMID:3154608

  8. Relation of Risk of Atrial Fibrillation With Systolic Blood Pressure Response During Exercise Stress Testing (from the Henry Ford ExercIse Testing Project).

    PubMed

    O'Neal, Wesley T; Qureshi, Waqas T; Blaha, Michael J; Ehrman, Jonathan K; Brawner, Clinton A; Nasir, Khurram; Al-Mallah, Mouaz H

    2015-12-15

    Decreases in systolic blood pressure during exercise may predispose to arrhythmias such as atrial fibrillation (AF) because of underlying abnormal autonomic tone. We examined the association between systolic blood pressure response and incident AF in 57,442 (mean age 54 ± 13 years, 47% women, and 29% black) patients free of baseline AF who underwent exercise treadmill stress testing from the Henry Ford ExercIse Testing project. Exercise systolic blood pressure response was examined as a categorical variable across clinically relevant categories (>20 mm Hg: referent; 1 to 20 mm Hg, and ?0 mm Hg) and per 1-SD decrease. Cox regression, adjusting for demographics, cardiovascular risk factors, medications, history of coronary heart disease, history of heart failure, and metabolic equivalent of task achieved, was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between systolic blood pressure response and incident AF. Over a median follow-up of 5.0 years, a total of 3,381 cases (5.9%) of AF were identified. An increased risk of AF was observed with decreasing systolic blood pressure response (>20 mm Hg: HR 1.0, referent; 1 to 20 mm Hg: HR 1.09, 95% CI 0.99, 1.20; ?0 mm Hg: HR 1.22, 95% CI 1.06 to 1.40). Similar results were obtained per 1-SD decrease in systolic blood pressure response (HR 1.08, 95% CI 1.04 to 1.12). The results were consistent when stratified by age, sex, race, hypertension, and coronary heart disease. In conclusion, our results suggest that a decreased systolic blood pressure response during exercise may identify subjects who are at risk for developing AF. PMID:26603907

  9. Influence of running stride frequency in heart rate variability analysis during treadmill exercise testing.

    PubMed

    Bailón, Raquel; Garatachea, Nuria; de la Iglesia, Ignacio; Casajús, Jose Antonio; Laguna, Pablo

    2013-07-01

    The analysis and interpretation of heart rate variability (HRV) during exercise is challenging not only because of the nonstationary nature of exercise, the time-varying mean heart rate, and the fact that respiratory frequency exceeds 0.4 Hz, but there are also other factors, such as the component centered at the pedaling frequency observed in maximal cycling tests, which may confuse the interpretation of HRV analysis. The objectives of this study are to test the hypothesis that a component centered at the running stride frequency (SF) appears in the HRV of subjects during maximal treadmill exercise testing, and to study its influence in the interpretation of the low-frequency (LF) and high-frequency (HF) components of HRV during exercise. The HRV of 23 subjects during maximal treadmill exercise testing is analyzed. The instantaneous power of different HRV components is computed from the smoothed pseudo-Wigner-Ville distribution of the modulating signal assumed to carry information from the autonomic nervous system, which is estimated based on the time-varying integral pulse frequency modulation model. Besides the LF and HF components, the appearance is revealed of a component centered at the running SF as well as its aliases. The power associated with the SF component and its aliases represents 22±7% (median±median absolute deviation) of the total HRV power in all the subjects. Normalized LF power decreases as the exercise intensity increases, while normalized HF power increases. The power associated with the SF does not change significantly with exercise intensity. Consideration of the running SF component and its aliases is very important in HRV analysis since stride frequency aliases may overlap with LF and HF components. PMID:23358950

  10. Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  11. Diagnostic Algorithm for Glycogenoses and Myoadenylate Deaminase Deficiency Based on Exercise Testing Parameters: A Prospective Study

    PubMed Central

    Rannou, Fabrice; Uguen, Arnaud; Scotet, Virginie; Le Maréchal, Cédric; Rigal, Odile; Marcorelles, Pascale; Gobin, Eric; Carré, Jean-Luc; Zagnoli, Fabien; Giroux-Metges, Marie-Agnès

    2015-01-01

    Aim Our aim was to evaluate the accuracy of aerobic exercise testing to diagnose metabolic myopathies. Methods From December 2008 to September 2012, all the consecutive patients that underwent both metabolic exercise testing and a muscle biopsy were prospectively enrolled. Subjects performed an incremental and maximal exercise testing on a cycle ergometer. Lactate, pyruvate, and ammonia concentrations were determined from venous blood samples drawn at rest, during exercise (50% predicted maximal power, peak exercise), and recovery (2, 5, 10, and 15 min). Biopsies from vastus lateralis or deltoid muscles were analysed using standard techniques (reference test). Myoadenylate deaminase (MAD) activity was determined using p-nitro blue tetrazolium staining in muscle cryostat sections. Glycogen storage was assessed using periodic acid-Schiff staining. The diagnostic accuracy of plasma metabolite levels to identify absent and decreased MAD activity was assessed using Receiver Operating Characteristic (ROC) curve analysis. Results The study involved 51 patients. Omitting patients with glycogenoses (n = 3), MAD staining was absent in 5, decreased in 6, and normal in 37 subjects. Lactate/pyruvate at the 10th minute of recovery provided the greatest area under the ROC curves (AUC, 0.893 ± 0.067) to differentiate Abnormal from Normal MAD activity. The lactate/rest ratio at the 10th minute of recovery from exercise displayed the best AUC (1.0) for discriminating between Decreased and Absent MAD activities. The resulting decision tree achieved a diagnostic accuracy of 86.3%. Conclusion The present algorithm provides a non-invasive test to accurately predict absent and decreased MAD activity, facilitating the selection of patients for muscle biopsy and target appropriate histochemical analysis. PMID:26207760

  12. The effect of regular Taekwondo exercise on Brain-derived neurotrophic factor and Stroop test in undergraduate student

    PubMed Central

    Kim, Youngil

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of Taekwondo exercise on Brain-derived neurotrophic factor and the Stroop test in undergraduate students. [Methods] Fourteen male subjects participated in this study. They were separated into a Control group (N = 7) and an Exercise group (N = 7). Subjects participated in Taekwondo exercise training for 8 weeks. They underwent to Taekwondo exercise training for 85 minutes per day, 5 times a week at RPE of 11~15. The taekwondo exercise training comprised an aerobic exercise (20min) mode and a dynamic exercise (65min) mode. All data were analyzed by repeated measures two-way ANOVA. [Results] There were no significant differences in the physical characteristics of the subjects. Although weight and BMI showed a tendency to decreased in the exercise group (EG). Also, neurotrophic factors (BDNF, NGF, IGF-1) were not significantly different after 8 weeks in the two groups. However, BDNF and IGF-1 showed a tendency to increase in the exercise group (EG). Finally, the Stroop test (word, color) results were significantly different(p < .05) in the exercise group (EG). [Conclusion] These finding suggest that 8 weeks of regular Taekwondo exercise training may increase cognitive functions (Stroop test). However the training did not statistically affect neurotrophic factors (BDNF, NGF, IGF-1) in undergraduate students. PMID:26244125

  13. Antecedent acute cycling exercise affects attention control: an ERP study using attention network test

    PubMed Central

    Chang, Yu-Kai; Pesce, Caterina; Chiang, Yi-Te; Kuo, Cheng-Yuh; Fong, Dong-Yang

    2015-01-01

    The purpose of this study was to investigate the after-effects of an acute bout of moderate intensity aerobic cycling exercise on neuroelectric and behavioral indices of efficiency of three attentional networks: alerting, orienting, and executive (conflict) control. Thirty young, highly fit amateur basketball players performed a multifunctional attentional reaction time task, the attention network test (ANT), with a two-group randomized experimental design after an acute bout of moderate intensity spinning wheel exercise or without antecedent exercise. The ANT combined warning signals prior to targets, spatial cueing of potential target locations and target stimuli surrounded by congruent or incongruent flankers, which were provided to assess three attentional networks. Event-related brain potentials and task performance were measured during the ANT. Exercise resulted in a larger P3 amplitude in the alerting and executive control subtasks across frontal, central and parietal midline sites that was paralleled by an enhanced reaction speed only on trials with incongruent flankers of the executive control network. The P3 latency and response accuracy were not affected by exercise. These findings suggest that after spinning, more resources are allocated to task-relevant stimuli in tasks that rely on the alerting and executive control networks. However, the improvement in performance was observed in only the executively challenging conflict condition, suggesting that whether the brain resources that are rendered available immediately after acute exercise translate into better attention performance depends on the cognitive task complexity. PMID:25914634

  14. Daily exercise routines

    NASA Technical Reports Server (NTRS)

    Anderson, Patrick L.; Amoroso, Michael T.

    1990-01-01

    Viewgraphs on daily exercise routines are presented. Topics covered include: daily exercise and periodic stress testings; exercise equipment; physiological monitors; exercise protocols; physiological levels; equipment control; control systems; and fuzzy logic control.

  15. Physiological basis of cardiopulmonary rehabilitation in patients with lung or heart disease

    PubMed Central

    Louvaris, Zafeiris

    2015-01-01

    Educational Aims To illustrate the common mechanisms limiting exercise tolerance in patients with chronic lung and heart disease To highlight the impact of lung and heart disease on daily physical activity levels To outline the effects of cardiopulmonary rehabilitation on functional capacity in patients with chronic lung and heart disease To discuss an innovative tele-rehabilitation intervention using information and communications technologies to improve functional capacity in patients with chronic lung and heart disease Summary Shortness of breath associated with cardiorespiratory abnormalities and peripheral muscle discomfort are the major factors that limit exercise capacity in patients with chronic obstructive pulmonary disease (COPD) and those with congestive heart failure (CHF). Both of these symptoms negatively impact on patients’ daily physical activity levels. In turn, poor daily physical activity is commonly associated with increased rates of morbidity and mortality. Cardiopulmonary rehabilitation programmes partially reverse muscle weakness and dysfunction and increase functional capacity in both COPD and CHF. However, benefits gained from participation in cardiopulmonary rehabilitation programmes are regressing soon after the completion of these programmes. Moreover, several barriers limit access and uptake of cardiopulmonary rehabilitation programmes by eligible patients. A potential solution to the underutilisation of cardiopulmonary rehabilitation is the implementation of tele-rehabilitation interventions at home using information and communications technologies. Thus, tele-rehabilitation may be useful to encourage and educate patients with COPD or CHF on how best to maintain and/or further enhance daily physical activity levels. PMID:26306112

  16. Importance of early cardiac rehabilitation on changes in exercise capacity: a retrospective pilot study.

    PubMed

    McPhee, Patrick G; Winegard, Karen J; MacDonald, Maureen J; McKelvie, Robert S; Millar, Philip J

    2015-12-01

    Graded cardiopulmonary exercise tests were analyzed from 62 coronary artery disease patients (n = 48 males; age, 72 ± 10 years; body mass index, 27 ± 4 kg/m(2)) before and after 18 ± 2 months of cardiac rehabilitation (CR). Early initiation of CR (<114 days) produced greater increases in peak metabolic equivalents (METs) compared with the late (?114 days) CR group (68% ± 51% vs. 41% ± 39%, p < 0.05). A negative correlation was found between CR delay and peak METs (r = -0.32; p = 0.02). Early initiation of CR may be important to maximize cardiorespiratory adaptations to chronic exercise training. PMID:26575102

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

    SciTech Connect

    Gasperetti, C.M.; Burwell, L.R.; Beller, G.A. )

    1990-07-01

    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.

  18. Cardiac arrhythmias during exercise testing in healthy men.

    NASA Technical Reports Server (NTRS)

    Beard, E. F.; Owen, C. A.

    1973-01-01

    Clinically healthy male executives who participate in a long-term physical conditioning program have demonstrated cardiac arrhythmia during and after periodic ergometric testing at submaximal and maximal levels. In 1,385 tests on 248 subjects, it was found that 34% of subjects demonstrated an arrhythmia at some time and 13% of subjects developed arrhythmia on more than one test. Premature systoles of ventricular origin were most common, but premature systoles of atrial origin, premature systoles of junctional origin, paroxysmal atrial tachycardia, atrioventricular block, wandering pacemaker, and pre-excitation were also seen. Careful post-test monitoring and pulse rate regulated training sessions are suggested for such programs.

  19. Results of the International Space Station Interim Resistance Exercise Device Man-in-the-Loop Test

    NASA Technical Reports Server (NTRS)

    Moore, A. D., Jr.; Amonette, W. E.; Bentley, J. R.; Rapley, M. G.; Blazine, K. L.; Loehr, J. A.; Collier, K. R.; Boettcher, C. R.; Skrocki, J. S.; Hohrnann, R. J.

    2004-01-01

    The Interim Resistance Exercise Device (iRED), developed for the International Space Station (ISS), was evaluated using human subjects for a Man-In-The-Loop Test (MILT). Thirty-two human subjects exercised using the iRED in a test that was conducted over a 63-working-day period. The subjects performed the same exercises will be used on board ISS, and the iRED operating constraints that are to be used on ISS were followed. In addition, eight of the subjects were astronauts who volunteered to be in the evaluation in order to become familiar with the iRED and provide a critique of the device. The MILT was scheduled to last for 57,000 exercise repetitions on the iRED. This number of repetitions was agreed to as a number typical of that expected during a 3-person, 17-week ISS Increment. One of the canisters of the iRED failed at the 49,683- repetition mark (87.1% of targeted goal). The remaining canister was operated using the plan for operations if one canister fails during flight (contingency operations). This canister remained functional past the 57,000-repetition mark. This report details the results of the iRED MILT, and lists specific recommendations regarding both operation of the iRED and future resistance exercise device development.

  20. Methods for "indirect" challenge tests including exercise, eucapnic voluntary hyperpnea, and hypertonic aerosols.

    PubMed

    Anderson, Sandra D; Brannan, John D

    2003-02-01

    Bronchial provocation tests that use stimuli that act indirectly to cause airway narrowing have a high specificity for identifying people with active asthma who have the potential to respond to treatment with antiinflammatory drugs. The first test to be developed was exercise and it was used to assess the efficacy of drugs such as sodium cromoglycate. Eucapnic voluntary hyperpnea was developed later, as a surrogate test for exercise. Hypertonic aerosols were introduced to mimic the dehydrating effects of evaporative water loss that occurs during hyperpnea. A wet aerosol of 4.5% saline or a dry powder formulation of mannitol is used. At present the indirect challenge tests are becoming increasingly recognised as appropriate for monitoring treatment with inhaled steroids. Indirect tests identify those with potential for exercise-induced bronchoconstriction, an important problem for some occupations, such as the defence forces, fire fighters and the police force and for some athletic activities. The advantage in using an indirect challenges, over a direct challenge with a single pharmacological agonist, is that a positive response indicates that inflammatory cells and their mediators (prostaglandins, leukotrienes and histamine) are present in the airways in sufficient numbers and concentration to indicate that asthma is active at the time of testing. The corollary to this is that a negative test in a known asthmatic indicates good control or mild disease. Another advantage is that healthy subjects do not have significant airway narrowing to indirect challenge tests. The protocols used for challenge with indirectly acting stimuli are presented in detail. PMID:12644717

  1. Exercise Stress Testing Programs in the United States: A 1975 Status Study

    ERIC Educational Resources Information Center

    Sparling, Phillip B.

    1977-01-01

    This survey of exercise stress testing programs in the United States concludes that the rapid growth and diversity of these services have created a need for increased communication and cooperation among professionals concerning standards relative to procedures, protocols, and personnel. (Author/MJB)

  2. Comparison of laboratory- and field-based exercise tests for COPD: a systematic review

    PubMed Central

    Fotheringham, Iain; Meakin, Georgina; Punekar, Yogesh Suresh; Riley, John H; Cockle, Sarah M; Singh, Sally J

    2015-01-01

    Exercise tests are often used to evaluate the functional status of patients with COPD. However, to the best of our knowledge, a comprehensive systematic comparison of these tests has not been performed. We systematically reviewed studies reporting the repeatability and/or reproducibility of these tests, and studies comparing their sensitivity to therapeutic intervention. A systematic review identified primary manuscripts in English reporting relevant data on the following exercise tests: 6-minute walk test (6MWT) and 12-minute walk test, incremental and endurance shuttle walk tests (ISWT and ESWT, respectively), incremental and endurance cycle ergometer tests, and incremental and endurance treadmill tests. We identified 71 relevant studies. Good repeatability (for the 6MWT and ESWT) and reproducibility (for the 6MWT, 12-minute walk test, ISWT, ESWT, and incremental cycle ergometer test) were reported by most studies assessing these tests, providing patients were familiarized with them beforehand. The 6MWT, ISWT, and particularly the ESWT were reported to be sensitive to therapeutic intervention. Protocol variations (eg, track layout or supplemental oxygen use) affected performance significantly in several studies. This review shows that while the validity of several tests has been established, for others further study is required. Future work will assess the link between these tests, physiological mechanisms, and patient-reported measures. PMID:25834421

  3. Comparison of laboratory- and field-based exercise tests for COPD: a systematic review.

    PubMed

    Fotheringham, Iain; Meakin, Georgina; Punekar, Yogesh Suresh; Riley, John H; Cockle, Sarah M; Singh, Sally J

    2015-01-01

    Exercise tests are often used to evaluate the functional status of patients with COPD. However, to the best of our knowledge, a comprehensive systematic comparison of these tests has not been performed. We systematically reviewed studies reporting the repeatability and/or reproducibility of these tests, and studies comparing their sensitivity to therapeutic intervention. A systematic review identified primary manuscripts in English reporting relevant data on the following exercise tests: 6-minute walk test (6MWT) and 12-minute walk test, incremental and endurance shuttle walk tests (ISWT and ESWT, respectively), incremental and endurance cycle ergometer tests, and incremental and endurance treadmill tests. We identified 71 relevant studies. Good repeatability (for the 6MWT and ESWT) and reproducibility (for the 6MWT, 12-minute walk test, ISWT, ESWT, and incremental cycle ergometer test) were reported by most studies assessing these tests, providing patients were familiarized with them beforehand. The 6MWT, ISWT, and particularly the ESWT were reported to be sensitive to therapeutic intervention. Protocol variations (eg, track layout or supplemental oxygen use) affected performance significantly in several studies. This review shows that while the validity of several tests has been established, for others further study is required. Future work will assess the link between these tests, physiological mechanisms, and patient-reported measures. PMID:25834421

  4. Impact of exercise stress testing on diagnostic gene expression in patients with obstructive and nonobstructive coronary artery disease.

    PubMed

    Filsoof, David M; Safford, Robert E; Newby, Kristin; Rosenberg, Steven; Kontras, Dana G; Baker, Alice; Odunukan, Olufunso W; Fletcher, Gerald

    2015-05-15

    A blood-based gene expression test can diagnose obstructive coronary artery disease (CAD). The test is sensitive to inflammatory and immune processes associated with atherosclerosis. Acute exercise engages short-term inflammatory pathways, and exercise stress testing may affect results of gene expression testing during the same diagnostic workup. The objective of this study was to evaluate the effect of exercise on diagnostic gene expression testing. Ten patients with obstructive CAD (?50% stenosis) and 10 with no/minimal CAD (?20% stenosis) were identified by angiography. Blood samples for gene expression were obtained at baseline, peak exercise, 30 to 60 minutes after testing, and 24 to 36 hours after testing. Core-lab gene expression analysis yielded raw gene expression scores (GES) for each time point. Linear models were used to estimate changes in GES, adjusting for CAD status and other covariates. GES increased during peak exercise across both genders, with no significant differences as a function of CAD status. The overall adjusted mean GES increase at peak exercise was 0.29 (95% confidence interval 0.22 to 0.36; p <0.001). GES after exercise were not significantly different from baseline. The change in gene expression levels during peak exercise may reflect a transient inflammatory response to acute exercise that may be independent of patient gender or CAD status. In conclusion, CAD GES increase at peak exercise testing and rapidly return to baseline. Such may reflect a transient inflammatory response to acute exercise independent of gender or extent of CAD. PMID:25776454

  5. Effect of In-Flight Exercise and Extravehicular Activity on Postflight Stand Tests

    NASA Technical Reports Server (NTRS)

    Lee, Stuart M. C.; Moore, Alan D., Jr.; Fritsch-Yelle, Janice; Greenisen, Michael; Schneider, Suzanne M.; Foster, Philip P.

    2000-01-01

    The purpose of this study was to determine whether exercise performed by Space Shuttle crewmembers during short-duration spaceflights (9-16 days) affects the heart rate (HR) and blood pressure (BP) responses to standing within 2-4 hr of landing. Thirty crewmembers performed self-selected in-flight exercise and maintained exercise logs to monitor their exercise intensity and duration. A 10min stand test, preceded by at least 6 min of quiet supine rest, was completed 10- 15 d before launch (PRE) and within four hours of landing (POST). Based upon their in-flight exercise records, subjects were grouped as either high (HIex: = 3x/week, HR = 70% ,HRMax, = 20 min/session, n = 11), medium (MEDex: = 3x/week, HR = 70% HRmax, = 20 min/session, n = 10), or low (LOex: = 3x/week, HR and duration variable, n = 11) exercisers. HR and BP responses to standing were compared between groups (ANOVA, or analysis of variance, P < 0.05). There were no PRE differences between the groups in supine or standing HR and BP. Although POST supine HR was similar to PRE, all groups had an increased standing HR compared to PRE. The increase in HR upon standing was significantly greater after flight in the LOex group (36+/-5 bpm) compared to HIex or MEDex groups (25+/-1bpm; 22+/-2 bpm). Similarly, the decrease in pulse pressure (PP) from supine to standing was unchanged after spaceflight in the MEDex and HIex groups, but was significantly less in the LOex group (PRE: -9+/- 3, POST: -19+/- 4 mmHg). Thus, moderate to high levels of in-flight exercise attenuated HR and PP responses to standing after spaceflight compared.

  6. Self-priming Hemodynamic Reservoir and Inline Flow Meter for a Cardiopulmonary Bypass Simulation

    PubMed Central

    Raasch, David; Austin, Jon; Tallman, Richard

    2010-01-01

    Abstract: 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

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

    PubMed Central

    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

    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. PMID:21857990

  8. Palliative care in cardiopulmonary transplantation.

    PubMed

    McKenna, Maria; Clark, Stephen C

    2015-12-01

    Cardiopulmonary transplantation is a life-prolonging therapy available to a select population of patients with cardiac or respiratory failure. Transplantation is associated with significant morbidity, mortality and unmet palliative care need. Despite recommendations that palliative care should be a core component of the heart and lung transplant process, collaboration within clinical practice is extremely rare. A key reason for this is the misperception among patients, their families and transplant clinicians, that palliative care is analogous with end of life care. Other challenges include prognostication, communication, and the balance of hope and reality. We suggest a change in clinical practice within cardiopulmonary transplantation, whereby palliative care takes place alongside active management. Greater partnership working will demonstrate clinical credibility and highlight the impact of palliative care interventions. Education is required to address current misperceptions and further research should explore the effect of initiatives to improve palliative care provision for this patient group. PMID:25812577

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

    PubMed

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

    2012-03-01

    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

  10. The value of spirometry and exercise challenge test to diagnose and monitor children with asthma

    PubMed Central

    van den Wijngaart, Lara S; Roukema, Jolt; Merkus, Peter JFM

    2015-01-01

    Asthma is defined as a chronic inflammatory disease of the airways with characteristic symptoms including recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. It may result in abnormalities of ventilator function, which can be assessed by different pulmonary function tests. In this case report, we present a 15-year-old boy with asthma and illustrate the value and limitations of spirometry and exercise challenge test in daily practice. PMID:25802746

  11. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870.4400...4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  12. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870.4400...4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  13. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870.4400...4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  14. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870.4400...4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  15. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870... § 870.4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  16. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section 870.4280 ...870.4280 Cardiopulmonary prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming...

  17. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Cardiopulmonary bypass pulsatile flow generator. 870.4320 Section 870.4320...Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and...

  18. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Cardiopulmonary bypass pulsatile flow generator. 870.4320 Section 870.4320...Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and...

  19. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Cardiopulmonary bypass pulsatile flow generator. 870.4320 Section 870.4320...Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and...

  20. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Cardiopulmonary bypass pulsatile flow generator. 870.4320 Section 870.4320...Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and...

  1. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Cardiopulmonary bypass pulsatile flow generator. 870.4320 Section 870.4320...Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and...

  2. Ventilatory regulation of arterial H(+) (pH) during exercise.

    PubMed

    Wasserman, Karlman; Cox, Timothy A; Sietsema, Kathy E

    2014-01-01

    We hypothesized that exercise ventilation and arterial H(+) ([H(+)]a) are mutually interactive, [H(+)]a stimulating V(E) and V(E) regulating [H(+)]a increase. Fifty-five patients were studied, 10 normal and 45 with cardio-respiratory disorders. Each patient underwent cardiopulmonary exercise testing with simultaneous serial arterial blood gas and pH measurements. Subsequently, they were classified into one of 7 clinical groups: (1) normal, (2) exercise-induced hypoxemia (PaO2<50mmHg), (3) exercise-induced myocardial ischemia, (4) heart failure, (5) COPD, (6) interstitial lung disease, and (7) pulmonary vasculopathy. The average resting pHa was 7.42 or 7.43 for each group. At anaerobic (lactic acidosis) threshold (AT), [H(+)]a increased due to PaCO2 increase (+2mmHg), primarily. At peak exercise, [H(+)]a increased further due to arterial HCO3(-) decrease. In summary, [H(+)]a appears to be closely regulated at rest to AT and further to peak exercise by CO2 elimination from the venous return. No evidence was observed for over-ventilation of CO2, causing the arterial blood to become more alkaline during exercise in the patient groups studied. PMID:24369924

  3. Self-exercising checkers for unified built-in self-test (UBIST)

    NASA Astrophysics Data System (ADS)

    Nicolaidis, Michael

    1989-03-01

    An original built-in self-test (BIST) scheme is proposed aimed at covering some of the shortcomings of self-checking circuits and applicable to all tests needed for integrated circuits. In this scheme, self-checking techniques and built-in self-test techniques are combined in a original way to take advantage of each other. The result is a unified BIST scheme (UBIST), allowing high fault coverage for all tests needed for integrated circuits, e.g., offline test (design verification, manufacturing test, maintenance test) and online concurrent error detection. An important concept introduced is that of self-exercising checkers. The strongly code-disjoint property of the checkers is ensured for a very large class of fault hypotheses by internal test pattern generation, and the design of the checkers is simplified.

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

    SciTech Connect

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

    1987-12-01

    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.

  5. Routine initial exercise stress testing for treatment stratification in comprehensive cardiac rehabilitation.

    PubMed

    Salzwedel, Annett; Rieck, Angelika; Reibis, Rona K; Völler, Heinz

    2015-12-01

    There is evidence of substantial benefit of cardiac rehabilitation (CR) for patients with low exercise capacity at admission. Nevertheless, some patients are not able to perform an initial exercise stress test (EST). We aimed to describe this group using data of 1094 consecutive patients after a cardiac event (71±7 years, 78% men) enrolled in nine centres for inpatient CR. We analysed sociodemographic and clinical variables (e.g. cardiovascular risk factors, comorbidities, complications at admission), amount of therapy (e.g. exercise training, nursing care) and the results of the initial and the final 6-min walking test (6MWT) with respect to the application of an EST. Fifteen per cent of patients did not undergo an EST (non-EST group). In multivariable analysis, the probability of obtaining an EST was higher for men [odds ratio (OR) 1.89, P=0.01], a 6MWT (per 10?m, OR 1.07, P<0.01) and lower for patients with diabetes mellitus (OR 0.48, P<0.01), NYHA-class III/IV (OR 0.27, P<0.01), osteoarthritis (OR 0.39, P<0.01) and a longer hospital stay (per 5 days, OR 0.87, P=0.02). The non-EST group received fewer therapy units of exercise training, but more units of nursing care and physiotherapy than the EST group. However, there were no significant differences between both groups in the increase of the 6MWT during CR (123 vs. 108?m, P=0.122). The present study confirms the feasibility of an EST at the start of CR as an indicator of disease severity. Nevertheless, patients without EST benefit from CR even if exercising less. Thus, there is a justified need for individualized, comprehensive and interdisciplinary CR. PMID:26397275

  6. A prototype gas exchange monitor for exercise stress testing aboard NASA Space Station

    NASA Technical Reports Server (NTRS)

    Orr, Joseph A.; Westenskow, Dwayne R.; Bauer, Anne

    1989-01-01

    This paper describes an easy-to-use monitor developed to track the weightlessness deconditioning aboard the NASA Space Station, together with the results of testing of a prototype instrument. The monitor measures the O2 uptake and CO2 production, and calculates the maximum O2 uptake and anaerobic threshold during an exercise stress test. The system uses two flowmeters in series to achieve a completely automatic calibration, and uses breath-by-breath compensation for sample line-transport delay. The monitor was evaluated using two laboratory methods and was shown to be accurate. The system's block diagram and the bench test setup diagram are included.

  7. Use of the single-breath method of estimating cardiac output during exercise-stress testing.

    NASA Technical Reports Server (NTRS)

    Buderer, M. C.; Rummel, J. A.; Sawin, C. F.; Mauldin, D. G.

    1973-01-01

    The single-breath cardiac output measurement technique of Kim et al. (1966) has been modified for use in obtaining cardiac output measurements during exercise-stress tests on Apollo astronauts. The modifications involve the use of a respiratory mass spectrometer for data acquisition and a digital computer program for data analysis. The variation of the modified method for triplicate steady-state cardiac output measurements was plus or minus 1 liter/min. The combined physiological and methodological variation seen during a set of three exercise tests on a series of subjects was 1 to 2.5 liter/min. Comparison of the modified method with the direct Fick technique showed that although the single-breath values were consistently low, the scatter of data was small and the correlation between the two methods was high. Possible reasons for the low single-breath cardiac output values are discussed.

  8. Reliability of Force-Velocity Tests in Cycling and Cranking Exercises in Men and Women.

    PubMed

    Jaafar, Hamdi; Attiogbé, Elvis; Rouis, Majdi; Vandewalle, Henry; Driss, Tarak

    2015-01-01

    The present study examined the reliability of the force-velocity relationship during cycling and arm cranking exercises in active males and females. Twenty male and seventeen female physical education students performed three-session tests with legs and three-session tests with arms on a friction-loaded ergometer on six different sessions in a randomized order. The reliability of maximal power (P max), maximal pedal rate (V 0), and maximal force (F 0) were studied using the coefficient of variation (CV), the intraclass correlation coefficient (ICC) and the test-retest correlation coefficient (r). Reliability indices were better for men (1.74 ? CV ? 4.36, 0.82 ? ICC ? 0.97, and 0.81 ? r ? 0.97) compared with women (2.34 ? CV ? 7.04, 0.44 ? ICC ? 0.98, and 0.44 ? r ? 0.98) and in cycling exercise (1.74 ? CV ? 3.85, 0.88 ? ICC ? 0.98, and 0.90 ? r ? 0.98) compared with arm exercise (2.37 ? CV ? 7.04, 0.44 ? ICC ? 0.95, and 0.44 ? r ? 0.95). Furthermore, the reliability indices were high for P max and F 0 whatever the expression of the results (raw data or data related to body dimensions). P max and F 0 could be used in longitudinal physical fitness investigations. However, further studies are needed to judge V 0 reliability. PMID:26539544

  9. Reliability of Force-Velocity Tests in Cycling and Cranking Exercises in Men and Women

    PubMed Central

    Jaafar, Hamdi; Attiogbé, Elvis; Rouis, Majdi; Vandewalle, Henry; Driss, Tarak

    2015-01-01

    The present study examined the reliability of the force-velocity relationship during cycling and arm cranking exercises in active males and females. Twenty male and seventeen female physical education students performed three-session tests with legs and three-session tests with arms on a friction-loaded ergometer on six different sessions in a randomized order. The reliability of maximal power (Pmax), maximal pedal rate (V0), and maximal force (F0) were studied using the coefficient of variation (CV), the intraclass correlation coefficient (ICC) and the test-retest correlation coefficient (r). Reliability indices were better for men (1.74 ? CV ? 4.36, 0.82 ? ICC ? 0.97, and 0.81 ? r ? 0.97) compared with women (2.34 ? CV ? 7.04, 0.44 ? ICC ? 0.98, and 0.44 ? r ? 0.98) and in cycling exercise (1.74 ? CV ? 3.85, 0.88 ? ICC ? 0.98, and 0.90 ? r ? 0.98) compared with arm exercise (2.37 ? CV ? 7.04, 0.44 ? ICC ? 0.95, and 0.44 ? r ? 0.95). Furthermore, the reliability indices were high for Pmax and F0 whatever the expression of the results (raw data or data related to body dimensions). Pmax and F0 could be used in longitudinal physical fitness investigations. However, further studies are needed to judge V0 reliability. PMID:26539544

  10. Sex differences in response to maximal exercise stress test in trained adolescents

    PubMed Central

    2012-01-01

    Background Sex comparisons between girls and boys in response to exercise in trained adolescents are missing and we investigated similarities and differences as a basis for clinical interpretation and guidance. Methods A total of 24 adolescent females and 27 adolescent males aged 13–19?years underwent a maximal bicycle exercise stress test with measurement of cardiovascular variables, cardiac output, lung volumes, metabolic factors/lactate concentrations and breath-by-breath monitoring of ventilation, and determination of peak VO2. Results Maximum heart rate was similar in females (191?±?9?bpm) and males (194?±?7?bpm), cardiac index at maximum exercise was lower in females (7.0?±?1.0?l/min/m2) than in males (8.3?±?1.4?l/min/m2, P?exercise were similar (females: 1.04?±?0.06 vs. males: 1.05?±?0.05). Peak VO2 was lower in females (2.37?±?0.34?l/min) than in males (3.38?±?0.49?l/min, P?exercise is the key factor responsible for the greater peak VO2 in adolescent boys compared to girls. Conclusions Differences in peak VO2 in adolescent boys and girls disappear when peak VO2 is normalized to estimated leg muscle mass and therefore provide a tool to conduct individual and intersex comparisons of fitness when evaluating adolescent athletes in aerobic sports. PMID:22906070

  11. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  12. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass coronary pressure gauge... 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...

  13. NASA's Functional Task Test: High Intensity Exercise Improves the Heart Rate Response to a Stand Test Following 70 Days of Bedrest

    NASA Technical Reports Server (NTRS)

    Laurie, Steven S.; Lee, Stuart M. C.; Phillips, Tiffany R.; Dillon, E. Lichar; Sheffield-Moore, Melinda; Urban, Randall J.; Ploutz-Snyder, Lori; Stenger, Michael B.; Bloomberg, Jacob J.

    2015-01-01

    Cardiovascular adaptations due to spaceflight are modeled with 6deg head-down tilt bed rest (BR) and result in decreased orthostatic tolerance. We investigated if high-intensity resistive and aerobic exercise with and without testosterone supplementation would improve the heart rate (HR) response to a 3.5-min stand test and how quickly these changes recovered following BR. During 70 days of BR male subjects performed no exercise (Control, n=10), high intensity supine resistive and aerobic exercise (Exercise, n=9), or supine exercise plus supplemental testosterone (Exercise+T, n=8; 100 mg i.m., weekly in 2-week on/off cycles). We measured HR for 2 min while subjects were prone and for 3 min after standing twice before and 0, 1, 6, and 11 days after BR. Mixed-effects linear regression models were used to evaluate group, time, and interaction effects. Compared to pre-bed rest, prone HR was elevated on BR+0 and BR+1 in Control, but not Exercise or Exercise+T groups, and standing HR was greater in all 3 groups. The increase in prone and standing HR in Control subjects was greater than either Exercise or Exercise+T groups and all groups recovered by BR+6. The change in HR from prone to standing more than doubled on BR+0 in all groups, but was significantly less in the Exericse+T group compared to the Control, but not Exercise group. Exercise reduces, but does not prevent the increase in HR observed in response to standing. The significantly lower HR response in the Exercise+T group requires further investigation to determine physiologic significance.

  14. 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

    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

    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…

  15. Validity of the 6min walk test in outpatients with bipolar disorder.

    PubMed

    Vancampfort, Davy; Buys, Roselien; Sienaert, Pascal; Wyckaert, Sabine; De Herdt, Amber; De Hert, Marc; Probst, Michel

    2015-12-15

    Cardiorespiratory fitness is a major modifiable risk factor for cardiovascular diseases. People with bipolar disorder have a reduced cardiorespiratory fitness and its assessment within a multidisciplinary treatment therefore is necessary. We investigated the validity of the 6min walk test in people with bipolar disorder. A secondary aim was to assess clinical and demographic characteristics that might interfere with cardiorespiratory fitness performance. 19 (5?) outpatients (47.1±8.3 years) underwent a 6min walk test and a maximal cardiopulmonary exercise test on a cycle ergometer and completed the Positive-and-Negative-Affect-Schedule (PANAS) and Beck Depression Inventory (BDI). The distance achieved on the 6min walk test correlated moderately with peak oxygen uptake obtained during the maximal cardiopulmonary exercise test. The variance in age, weight and the PANAS negative score explained 70% of the variance in the distance achieved on the 6min walk test. The 6min walk test can be used as a measure-of-proxy to gauge cardiorespiratory fitness in people with bipolar disorder when maximal cardiopulmonary exercise test equipment is not available. Negative mood should be considered when evaluating the cardiorespiratory fitness of this vulnerable population. PMID:26526768

  16. Usefulness of C-Reactive Protein Plasma Levels to Predict Exercise Intolerance in Patients With Chronic Systolic Heart Failure.

    PubMed

    Canada, Justin McNair; Fronk, Daniel Taylor; Cei, Laura Freeman; Carbone, Salvatore; Erdle, Claudia Oddi; Abouzaki, Nayef Antar; Melchior, Ryan David; Thomas, Christopher Scott; Christopher, Sanah; Turlington, Jeremy Shane; Trankle, Cory Ross; Thurber, Clinton Joseph; Evans, Ronald Kenneth; Dixon, Dave L; Van Tassell, Benjamin Wallace; Arena, Ross; Abbate, Antonio

    2016-01-01

    Patients with heart failure (HF) have evidence of chronic systemic inflammation. Whether inflammation contributes to the exercise intolerance in patients with HF is, however, not well established. We hypothesized that the levels of C-reactive protein (CRP), an established inflammatory biomarker, predict impaired cardiopulmonary exercise performance, in patients with chronic systolic HF. We measured CRP using high-sensitivity particle-enhanced immunonephelometry in 16 patients with ischemic heart disease (previous myocardial infarction) and chronic systolic HF, defined as a left ventricular ejection fraction ?50% and New York Heart Association class II-III symptoms. All subjects with CRP >2 mg/L, reflecting systemic inflammation, underwent cardiopulmonary exercise testing using a symptom-limited ramp protocol. CRP levels predicted shorter exercise times (R = -0.65, p = 0.006), lower oxygen consumption (VO2) at the anaerobic threshold (R = -0.66, p = 0.005), and lower peak VO2 (R = -0.70, p = 0.002), reflecting worse cardiovascular performance. CRP levels also significantly correlated with an elevated ventilation/carbon dioxide production slope (R = +0.64, p = 0.008), a reduced oxygen uptake efficiency slope (R = -0.55, p = 0.026), and reduced end-tidal CO2 level at rest and with exercise (R = -0.759, p = 0.001 and R = -0.739, p = 0.001, respectively), reflecting impaired gas exchange. In conclusion, the intensity of systemic inflammation, measured as CRP plasma levels, is associated with cardiopulmonary exercise performance, in patients with ischemic heart disease and chronic systolic HF. These data provide the rationale for targeted anti-inflammatory treatments in HF. PMID:26546248

  17. 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

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

    1984-05-01

    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.

  18. Cerebrovascular responses to submaximal exercise in women with COPD

    PubMed Central

    2014-01-01

    Background COPD patients have decreased physical fitness, and have an increased risk of vascular disease. In the general population, fitness is positively associated with resting cerebral blood flow velocity, however, little is known about the cerebrovascular response during exercise particularly in COPD patients. We hypothesized that COPD patients would have lower cerebral blood flow during exercise secondary to decreased physical fitness and underlying vascular disease. Methods Cardiopulmonary exercise testing was conducted in 11 women with GOLD stage I-II COPD, and 11 healthy controls to assess fitness. Cerebro- and cardio-vascular responses were compared between groups during two steady-state exercise tests (50% peak O2 consumption and 30 W). The main outcome variable was peak middle cerebral artery blood flow velocity (V¯P) during exercise using transcranial Doppler ultrasonography. Results Physical fitness was decreased in COPD patients. V¯P was comparable between COPD and controls (25?±?22% versus 15?±?13%, respectively; P?>?0.05) when exercising at the same relative intensity, despite patients having higher blood pressure and greater arterial desaturation. However, V¯P was elevated in COPD (31?±?26% versus 13?±?10%; P???0.05) when exercising at the same workload as controls. Conclusions Our results are contradictory to our a-priori hypothesis, suggesting that during matched intensity exercise, cerebral blood flow velocity is similar between COPD and controls. However, exercise at a modestly greater workload imposes a large physical demand to COPD patients, resulting in increased CBF compared to controls. Normal activities of daily living may therefore impose a large cerebrovascular demand in COPD patients, consequently reducing their cerebrovascular reserve capacity. PMID:24898136

  19. Preliminary Testing of the Role of Exercise and Predator Recognition for Bonytail and Razorback Sucker

    USGS Publications Warehouse

    Mueller, Gordon A.; Carpenter, Jeanette; Krapfel, Robert; Figiel, Chester

    2007-01-01

    SUMMARY Hatchery-reared juvenile, 45-cm TL) flathead catfish. Predator-nai??ve juveniles (20- to 25-cm TL) exhibited no discernable preference when provided areas with and without (52 percent and 48 percent, n = 16 observations; 46 percent and 54 percent, n = 20 observations) large flathead catfish. However, once predation occurred, use of predator-free areas nearly doubled in two trials (36 percent and 64 percent, n = 50 observations; 33 percent and 67 percent, n = 12 observations). A more stringent test examining available area indicated predator-savvy razorback suckers used predator-free areas (88 percent, n = 21) illustrating predator avoidance was a learned behavior. Razorback suckers exercised (treatment) in water current (<0.3 m/s) for 10 weeks exhibited greater swimming stamina than unexercised, control fish. When exercised and unexercised razorback suckers were placed together with large predators in 2006, treatment fish had significantly fewer (n = 9, z = 1.69, p = 0.046) mortalities than control fish, suggesting increased stamina improved predator escape skills. Predator/prey tests comparing razorback suckers that had been previously exposed to a predation event with control fish, found treatment fish also had significantly fewer losses than predator-nai??ve fish (p = 0.017). Similar tests exposing predator-savvy and predator-nai??ve bonytail with largemouth bass showed a similar trend; predator-savvy bonytail suffered 38 percent fewer losses than control fish. However, there was not a statistically significant difference between the test groups (p = 0.143) due to small sample size. All exercise and predator exposure trials increased the survival rate of razorback sucker and bonytail compared to untreated counterparts.

  20. Pulmonary complications of cardiopulmonary bypass.

    PubMed

    Huffmyer, Julie L; Groves, Danja S

    2015-06-01

    Pulmonary complications after the use of extracorporeal circulation are common, and they range from transient hypoxemia with altered gas exchange to acute respiratory distress syndrome (ARDS), with variable severity. Similar to other end-organ dysfunction after cardiac surgery with extracorporeal circulation, pulmonary complications are attributed to the inflammatory response, ischemia-reperfusion injury, and reactive oxygen species liberated as a result of cardiopulmonary bypass. Several factors common in cardiac surgery with extracorporeal circulation may worsen the risk of pulmonary complications including atelectasis, transfusion requirement, older age, heart failure, emergency surgery, and prolonged duration of bypass. There is no magic bullet to prevent or treat pulmonary complications, but supportive care with protective ventilation is important. Targets for the prevention of pulmonary complications include mechanical, surgical, and anesthetic interventions that aim to reduce the contact activation, systemic inflammatory response, leukocyte sequestration, and hemodilution associated with extracorporeal circulation. PMID:26060028

  1. Effects of moderate exercise over different phases on age-related physiological dysfunction in testes of SAMP8 mice.

    PubMed

    Zhao, Xiujun; Bian, Yanqing; Sun, Yichong; Li, Li; Wang, Lixuan; Zhao, Chunfang; Shen, Yongqing; Song, Qingliang; Qu, Yine; Niu, Siyun; Wu, Wenshuang; Gao, Fulu

    2013-09-01

    Oxidative stress and chronic inflammation have been implicated in the testicular aging process. Different types and moderate-intensity of regular exercise may reduce age-related physiological dysfunction associated with inflammation and oxidative stress, but such effects of moderate-intensity of exercise over different phases of life in testes have not been reported. In this study, male SAMP8 mice, a senescence-accelerated strain, were maintained as sedentary (sed) or subjected to daily 15-min periods of swimming exercise between ages of 2-7 months (lifelong), 2-4 months (earlier) or 5-7 months (late). Age-related changes, including serum testosterone levels and biomarkers of inflammation and oxidative stress were analyzed at the end of the experiment. All exercise groups showed significantly greater serum testosterone levels and decreased age-related inflammation and oxidative stress compared with the sedentary group. Exercise also increased expression and activity of the nuclear factor erythroid 2-related factor (Nrf2), a transcriptional regulator of the cellular anti-oxidant system, and decreased expression and activity of nuclear factor kappa beta (NF-?B), a mediator of inflammatory molecules, in the nucleus of testicular cells. However, lifelong and earlier groups generally showed significantly better protective effects than the late group against age-related physiological dysfunction in testes. Thus, lifelong exercise and earlier phase exercise were most effective in counteracting oxidative stress and inflammation and in preserving testes function through regulation of Nrf2 and NF-?B. These results advocate the benefits of lifelong exercise and emphasize a greater protection against male aging by instituting exercise earlier rather than late in life. PMID:23751407

  2. Rationale and design of the Henry Ford Exercise Testing Project (the FIT project).

    PubMed

    Al-Mallah, Mouaz H; Keteyian, Steven J; Brawner, Clinton A; Whelton, Seamus; Blaha, Michael J

    2014-08-01

    Although physical fitness is a powerful prognostic marker in clinical medicine, most cardiovascular population-based studies do not have a direct measurement of cardiorespiratory fitness. In line with the call from the National Heart Lung and Blood Institute for innovative, low-cost, epidemiologic studies leveraging electronic medical record (EMR) data, we describe the rationale and design of the Henry Ford ExercIse Testing Project (The FIT Project). The FIT Project is unique in its combined use of directly measured clinical exercise data retrospective collection of medical history and medication treatment data at the time of the stress test, retrospective supplementation of supporting clinical data using the EMR and administrative databases and epidemiologic follow-up for cardiovascular events and total mortality via linkage with claims files and the death registry. The FIT Project population consists of 69?885 consecutive physician-referred patients (mean age, 54?±?10?years; 54% males) who underwent Bruce protocol treadmill stress testing at Henry Ford Affiliated Hospitals between 1991 and 2009. Patients were followed for the primary outcomes of death, myocardial infarction, and need for coronary revascularization. The median estimated peak metabolic equivalent (MET) level was 10, with 17% of the patients having a severely reduced fitness level (METs < 6). At the end of the follow-up duration, 15.9%, 5.6%, and 6.7% of the patients suffered all-cause mortality, myocardial infarction, or revascularization procedures, respectively. The FIT Project is the largest study of physical fitness to date. With its use of modern electronic clinical epidemiologic techniques, it is poised to answer many clinically relevant questions related to exercise capacity and prognosis. PMID:25138770

  3. A protocol of rope skipping exercise for primary school children: A pilot test

    NASA Astrophysics Data System (ADS)

    Radzi, A. N. M.; Rambely, A. S.; Chellapan, K.

    2014-06-01

    This paper aims to investigate the methods and sample used in rope skipping as an exercise approach. A systematic literature review was approached in identifying skipping performance in the related researches. The methods were compared to determine the best methodological approach for the targeted skipping based research measure. A pilot test was performed among seven students below 12 years old. As the outcome of the review, a skipping protocol design has been proposed for 10 years old primary school students. The proposed protocol design is to be submitted to PPUKM Ethical Committee for approval prior to its implementation in investigation memory enhancement in relation to designed skipping activities.

  4. Cardiopulmonary Syndromes—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

  5. Cardiopulmonary Syndromes (PDQ)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

  6. Cardiopulmonary helminths in foxes from the Pyrenees.

    PubMed

    Garrido-Castañé, Ignasi; Ortuño, Anna; Marco, Ignasi; Castellà, Joaquim

    2015-12-01

    The present survey was carried out to investigate the prevalence of cardiopulmonary helminths in red foxes in Pyrenees area and to evaluate the role of foxes in the eco-epidemiology of these nematodes. Hearts and entire respiratory tracts were obtained from 87 foxes from Vall d'Aran region, Pyrenees, Catalonia, north-eastern Spain. The cardiopulmonary tracts were dissected, flushed and examined for nematodes using sedimented flushing water. Of the 87 examined foxes, 53 (61%) were positive for cardiopulmonary helminths. The identified nematodes were Crenosoma vulpis (44.8%), Eucoleus aerophilus (29.9%) and Angiostrongylus vasorum (3.4%). Statistical differences were observed only on comparing age and C.vulpis prevalence, with young foxes being more infected than adults. The high prevalence of cardiopulmonary nematodes suggested that red foxes may play an important role in their transmission and maintenance in the studied area. PMID:26408595

  7. Cardiopulmonary Syndromes (PDQ)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

  8. Cardiopulmonary effects of traditional Thai dance on menopausal women: a randomized controlled trial

    PubMed Central

    Janyacharoen, Taweesak; Phusririt, Chonticha; Angkapattamakul, Sariya; Hurst, Cameron P.; Sawanyawisuth, Kittisak

    2015-01-01

    [Purpose] This study evaluated the effects of Thai dance on cardiopulmonary factors in menopausal women. [Subjects] Sixty-six menopausal women aged 40?years or more. [Methods] Subjects were randomly assigned to either the Thai dance or control group. The Thai dance group performed a traditional Thai dancing exercise program for 60 minutes, 3 times per week for 6 weeks. The control group received general health guidance. The 6-minutewalk test, peak expiratory flow, forced vital capacity, forced expiratory volume in one second, maximal voluntary ventilation, and chest expansion were assessed at baseline and at the end of the study. [Results] Sixty-six menopausal women were eligible. At the end of the study, all variables were significantly better in the Thai dance group than the control group. Moreover, all variables improved significantly compared to baseline in the Thai dance group but not in the control group. For example, the mean 6-minutewalk test result in Thai dance group at the end of the study was 285.4 m, which was significantly higher than that at baseline (254.8 m) and the control group at baseline (247.0 m). [Conclusion] A 6-week Thai dance program improves cardiorespiratory endurance in menopausal women. PMID:26357441

  9. Functional state assessment on the dynamics of interparametric concatenations during exercise tests.

    PubMed

    Poderys, Jonas; Venskaityt?, Eurelija; Poderien?, Kristina; Buliuolis, Alfonsas; Vainoras, Alfonsas

    2010-01-01

    The aim of this study was to complement an analytical approach by new methodology of data sequences analysis of muscular and cardiovascular indices during the assessments of functional state. The participants of the study were 14 elite Greco-roman wrestlers and they underwent two exercise tests 30 squats per 45 s while 12-lead ECG was recorded continuously and 30-s vertical jumps test while the height, contact and flight times of each jump recorded. The parametric interactions parameters and their sequences analysis based on a mathematical method founded upon a matrix theory were applied. The obtained results enabled to identify dynamical changes of the independence of parameters or an opposite phenomenon - interaction. The dynamics of ECG or performance parameters did not allowed to find out the moments of critical changes during the exercising. The dynamics of concatenation between the time of push-off and the height of jumps while performing repeated jumps has a tendency to increase in the values of discriminant and the fluctuations at some point of jumping task comes on. Analysis of concatenation between ECG or muscle performance parameters allows distinguishing the individual peculiarities which could be in value of discriminant, in time of exercising before the fluctuations occurs, in character how the body behave as to compensate fatigue. It was concluded that assessment the dynamics of inter-parametric concatenation of physiological parameters based on the data sequences analysis provide a new approach in the field of functional state assessment allowing to reveal features of functional preparedness and fatigability during workloads. PMID:20944452

  10. Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests.

    PubMed

    Shamsi, Mohammad Bagher; Sarrafzadeh, Javad; Jamshidi, Aliashraf

    2015-02-01

    It is a matter of controversy whether core stability exercise is preferred to other types of exercise for chronic low back pain. Lumbopelvic stability is an important element in low back pain. No study was found using lumbopelvic stability tests in comparing core stability and other exercises. The single leg squat, dip test, and runner pose test appear to be suitable as tests for lumbopelvic stability. The aim of this study was to compare "core stability" and "traditional trunk exercise" using these tests and also the Oswestry disability questionnaire and pain intensity. Twenty-nine non-specific chronic low back pain subjects were alternately allocated in one of the two exercise groups. For both groups, a 16-sessions exercise program was provided. Before and after training: (1) video was recorded while subjects performed the tests; (2) Oswestry disability questionnaire was completed; and (3) pain intensity was measured by visual analogue scale. The test videos were scored by three physiotherapists. Statistical analysis revealed a significant improvement in stability test scores (p?=?0.020 and p?=?0.041) and reduction in disability (p?tests to assess stability change in two groups after training given the relatively small sample size. PMID:25317504

  11. Evaluation of the Best-designed Graded Exercise Test to Assess Peak Treadmill Speed.

    PubMed

    Peserico, C S; Zagatto, A M; Machado, F A

    2015-08-01

    This study examined the influence of different speed increments during treadmill exercise tests on peak treadmill speed (Vpeak) and its relationship with a 1-h treadmill running performance. 18 male recreational and amateur runners (10-km running pace: 10-15?km·h(-1)) performed, in an alternate order, 3 continuous incremental exercise tests with different speed increments (0.5, 1.0 and 2.0?km·h(-1)) on a motorized treadmill to determine Vpeak. Thereafter they undertook a 1-h time trial on a treadmill. Vpeak was determined as either (a) the highest speed that could be maintained for a complete minute (Vpeak-60?s), (b) the speed of the last complete stage (Vpeak-C), or (c) the speed of the last complete stage added to the product of the speed increment and the completed fraction of the incomplete stage (Vpeak-P). The Vpeak values were highly influenced by the different speed-incremented rates and the Vpeak-P determined during the protocol comprising speed increments of 1?km·h(-1) presented the highest correlation with 1-h time trial performance (r=0.89). The results suggest that a protocol with speed increments comprising 1?km·h(-1) and with a 3-min stage duration should be used as standard for the determination of Vpeak to assess aerobic fitness and predict endurance performance in recreational runners. Furthermore, the Vpeak-P should be used for the determination of Vpeak. PMID:25875318

  12. Exercise response

    NASA Technical Reports Server (NTRS)

    Rummel, J. A.; Sawin, C. F.; Michel, E. L.

    1975-01-01

    The bicycle ergometer and a graded stress protocol were used to conduct exercise stress tests for the Apollo project. The graded exercise tests permitted a progressive evaluation of physiological control system response and provided a better understanding of safe stress limits; heart rate was used for determining stress levels. During each test, workload, heart rate, blood pressure, and respiratory gas exchange (oxygen consumption, carbon dioxide production, and minute volume) measurements were made. The results are presented and discussed.

  13. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia.

    PubMed

    Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2014-11-01

    Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.Fundamento: Estudos têm demonstrado a acurácia diagnóstica e o valor prognóstico da ecocardiografia com estresse físico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela ecocardiografia com estresse físico em pacientes com teste ergométrico positivo para isquemia miocárdica. Métodos: Trata-se de uma coorte retrospectiva em que foram estudados 866 pacientes consecutivos, com teste ergométrico positivo para isquemia miocárdica, submetidos à ecocardiografia com estresse físico. Os pacientes foram divididos em dois grupos: ecocardiografia com estresse físico negativa (G1) ou positiva (G2) para isquemia miocárdica. Os desfechos avaliados foram mortalidade por qualquer causa e eventos cardíacos maiores, definidos como óbito cardíaco e infarto agudo do miocárdio não fatal. Resultados: O G2 constituiu-se de 205 (23,7%) pacientes. Durante o seguimento médio de 85,6 ± 15,0 meses, ocorreram 26 óbitos, sendo seis por causa cardíaca, e 25 casos de infarto agudo do miocárdio não fatais. Os preditores independentes de mortalidade foram idade, diabetes melito e a ecocardiografia com estresse físico + (hazard ratio: 2,69; intervalo de confiança de 95%: 1,20 - 6,01; p = 0,016), com os seguintes eventos cardíacos maiores: idade, doença arterial coronária prévia, ecocardiografia com estresse físico + (hazard ratio: 2,75; intervalo de confiança de 95%: 1,15 - 6,53; p = 0,022) e ausência do incremento de 10% na fração de ejeção. A mortalidade por qualquer causa e os eventos cardíacos maiores foram significativamente superiores no G2 (p < 0, 001 e p = 0,001, respectivamente). Conclusão: A ecocardiografia com estresse físico oferece informações prognósticas adicionais em pacientes com teste ergométrico positivo para isquemia miocárdica. PMID:25352460

  14. Soluble Fibrin Monomer Complex and Cardiopulmonary Bypass

    PubMed Central

    Bonk, Ryan; Trowbridge, Cody; Stammers, Alfred; Klayman, Myra; Marko, Molly; Brindisi, Nicholas; Pezzuto, James

    2009-01-01

    Abstract: Soluble fibrin monomer complexes (SFMCs) are precursors of fibrin polymer formation. Laboratory tests can be used to detect SFMCs in plasma. The purpose of this study was to determine whether a positive SFMC test is associated with pre-operative, intra-operative, and post-operative variables for patients that have undergone cardiopulmonary bypass (CPB). Pre-operative, operative, post-operative, and laboratory data from 120 consecutive adults patients (July 3, 2006 to June 29, 2007) that had undergone cardiac surgery with the use of CPB were obtained from a prospective quality control database. Two groups were created. Group 1 was all negative (NEG). This group had no SFMC test with a positive result (n = 60) and no positive SFMCs (POS, n = 60). Group 2 was any positive (POS). This group had at least one positive SFMC test (n = 60). The POS group had more patients with endocarditis (11.7% vs. 3.3%, p < .001), chronic obstructive pulmonary disease (COPD) (18% vs. 8.3%, p = .005), longer CPB time (172 ± 64 vs. 151 ± 53 minutes, p = .047), and fewer minimally invasive procedures (31.7% vs. 51.7%, p = .002). The POS group required intraoperative (70.0% vs. 53.3%, p = .010) and post-operative (75.5% vs. 45.0%, p < .001) transfusions more frequently than the NEG group, despite similar amounts of blood loss. SFMC tests in CPB may be associated with patient pre-operative status and an increase in transfusion requirements. PMID:19806798

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

    PubMed

    Lehtinen, R; Vänttinen, H; Sievänen, H; Malmivuo, J

    1996-06-01

    The ST-segment depression/heart rate (ST/HR) 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 ST/HR analysis have been introduced; the ST/HR slope, the ST/HR index and the ST/HR hysteresis. The latter utilises both the exercise and recovery phases of the exercise ECG test, whereas the two former are based on the exercise phase only. This present article presents a computer program which not only calculates the above three diagnostic variables but also plots the full diagrams of ST-segment depression against heart rate during both exercise and recovery phases for each ECG lead from given ST/HR data. The program can be used in the exercise ECG diagnosis of daily clinical practice provided that the ST/HR data from the ECG measurement system can be linked to the program. At present, the main purpose of the program is to provide clinical and medical researchers with a practical tool for comprehensive clinical evaluation and development of the ST/HR analysis. PMID:8835841

  16. Identification of false positive exercise tests with use of electrocardiographic criteria: A possible role for atrial repolarization waves

    SciTech Connect

    Sapin, P.M.; Koch, G.; Blauwet, M.B.; McCarthy, J.J.; Hinds, S.W.; Gettes, L.S. )

    1991-07-01

    Atrial repolarization waves are opposite in direction to P waves, may have a magnitude of 100 to 200 mu V and may extend into the ST segment and T wave. It was postulated that exaggerated atrial repolarization waves during exercise could produce ST segment depression mimicking myocardial ischemia. The P waves, PR segments and ST segments were studied in leads II, III, aVF and V4 to V6 in 69 patients whose exercise electrocardiogram (ECG) suggested ischemia (100 mu V horizontal or 150 mu V upsloping ST depression 80 ms after the J point). All had a normal ECG at rest. The exercise test in 25 patients (52% male, mean age 53 years) was deemed false positive because of normal coronary arteriograms and left ventricular function (5 patients) or normal stress single photon emission computed tomographic thallium or gated blood pool scans (16 patients), or both (4 patients). Forty-four patients with a similar age and gender distribution, anginal chest pain and at least one coronary stenosis greater than or equal to 80% served as a true positive control group. The false positive group was characterized by (1) markedly downsloping PR segments at peak exercise, (2) longer exercise time and more rapid peak exercise heart rate than those of the true positive group, and (3) absence of exercise-induced chest pain. The false positive group also displayed significantly greater absolute P wave amplitudes at peak exercise and greater augmentation of P wave amplitude by exercise in all six ECG leads than were observed in the true positive group.

  17. Dynamic laryngeal narrowing during exercise: a mechanism for generating intrinsic PEEP in COPD?

    PubMed Central

    Baz, M; Haji, G S; Menzies-Gow, A; Tanner, R J; Polkey, M I; Hull, J H

    2015-01-01

    Introduction Patients with COPD commonly exhibit pursed-lip breathing during exercise, a strategy that, by increasing intrinsic positive end-expiratory pressure, may optimise lung mechanics and exercise tolerance. A similar role for laryngeal narrowing in modulating exercise airways resistance and the respiratory cycle volume–time course is postulated, yet remains unstudied in COPD. The aim of this study was to assess the characteristics of laryngeal narrowing and its role in exercise intolerance and dynamic hyperinflation in COPD. Methods We studied 19 patients (n=8 mild–moderate; n=11 severe COPD) and healthy age and sex matched controls (n=11). Baseline physiological characteristics and clinical status were assessed prior to an incremental maximal cardiopulmonary exercise test with continuous laryngoscopy. Laryngeal narrowing measures were calculated at the glottic and supra-glottic aperture at rest and peak exercise. Results At rest, expiratory laryngeal narrowing was pronounced at the glottic level in patients and related to FEV1 in the whole cohort (r=?0.71, p<0.001) and patients alone (r=?0.53, p=0.018). During exercise, glottic narrowing was inversely related to peak ventilation in all subjects (r=?0.55, p=0.0015) and patients (r=?0.71, p<0.001) and peak exercise tidal volume (r=?0.58, p=0.0062 and r=?0.55, p=0.0076, respectively). Exercise glottic narrowing was also inversely related to peak oxygen uptake (% predicted) in all subjects (r=?0.65, p<0.001) and patients considered alone (r=?0.58, p=0.014). Exercise inspiratory duty cycle was related to exercise glottic narrowing for all subjects (r=?0.69, p<0.001) and patients (r=?0.62, p<0.001). Conclusions Dynamic laryngeal narrowing during expiration is prevalent in patients with COPD and is related to disease severity, respiratory duty cycle and exercise capacity. PMID:25586938

  18. Breakpoints in ventilation, cerebral and muscle oxygenation, and muscle activity during an incremental cycling exercise

    PubMed Central

    Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

    2014-01-01

    The aim of this study was to locate the breakpoints of cerebral and muscle oxygenation and muscle electrical activity during a ramp exercise in reference to the first and second ventilatory thresholds. Twenty-five cyclists completed a maximal ramp test on an electromagnetically braked cycle-ergometer with a rate of increment of 25 W/min. Expired gazes (breath-by-breath), prefrontal cortex and vastus lateralis (VL) oxygenation [Near-infrared spectroscopy (NIRS)] together with electromyographic (EMG) Root Mean Square (RMS) activity for the VL, rectus femoris (RF), and biceps femoris (BF) muscles were continuously assessed. There was a non-linear increase in both cerebral deoxyhemoglobin (at 56 ± 13% of the exercise) and oxyhemoglobin (56 ± 8% of exercise) concomitantly to the first ventilatory threshold (57 ± 6% of exercise, p > 0.86, Cohen's d < 0.1). Cerebral deoxyhemoglobin further increased (87 ± 10% of exercise) while oxyhemoglobin reached a plateau/decreased (86 ± 8% of exercise) after the second ventilatory threshold (81 ± 6% of exercise, p < 0.05, d > 0.8). We identified one threshold only for muscle parameters with a non-linear decrease in muscle oxyhemoglobin (78 ± 9% of exercise), attenuation in muscle deoxyhemoglobin (80 ± 8% of exercise), and increase in EMG activity of VL (89 ± 5% of exercise), RF (82 ± 14% of exercise), and BF (85 ± 9% of exercise). The thresholds in BF and VL EMG activity occurred after the second ventilatory threshold (p < 0.05, d > 0.6). Our results suggest that the metabolic and ventilatory events characterizing this latter cardiopulmonary threshold may affect both cerebral and muscle oxygenation levels, and in turn, muscle recruitment responses. PMID:24782786

  19. Exercise Countermeasures Demonstration Project During the Lunar-Mars Life Support Test Project Phase 2A

    NASA Technical Reports Server (NTRS)

    Lee, Stuart M. C.; Guilliams, Mark E.; Moore, Alan D., Jr.; Williams, W. Jon; Greenisen, M. C.; Fortney, S. M.

    1998-01-01

    This demonstration project assessed the crew members' compliance to a portion of the exercise countermeasures planned for use onboard the International Space Station (ISS) and the outcomes of their performing these countermeasures. Although these countermeasures have been used separately in other projects and investigations, this was the first time they'd been used together for an extended period (60 days) in an investigation of this nature. Crew members exercised every day for six days, alternating every other day between aerobic and resistive exercise, and rested on the seventh day. On the aerobic exercise days, subjects exercised on an electronically braked cycle ergometer using a protocol that has been previously shown to maintain aerobic capacity in subjects exposed to a space flight analogue. On the resistive exercise days, crew members performed five major multijoint resistive exercises in a concentric mode, targeting those muscle groups and bones we believe are most severely affected by space flight. The subjects favorably tolerated both exercise protocols, with a 98% compliance to aerobic exercise prescription and a 91% adherence to the resistive exercise protocol. After 60 days, the crew members improved their peak aerobic capacity by an average 7%, and strength gains were noted in all subjects. These results suggest that these exercise protocols can be performed during ISS, lunar, and Mars missions, although we anticipate more frequent bouts with both protocols for long-duration spaceflight. Future projects should investigate the impact of increased exercise duration and frequency on subject compliance, and the efficacy of such exercise prescriptions.

  20. Lung function and the response to exercise in systemic sclerosis

    PubMed Central

    Godfrey, Simon; Bluestone, Rodney; Higgs, Brenda E.

    1969-01-01

    Cardiopulmonary function has been studied at rest and during graded exercise in 11 patients with systemic sclerosis. All patients had multi-system disease, five complained of breathlessness, and four had radiographic evidence of pulmonary fibrosis. All patients had gross effort intolerance. Lung volumes were reduced in half the patients, as was the transfer factor for CO when corrected for lung volume. Airway resistance was normal. Four patients hyperventilated on exercise, but the tidal volume was normal; three developed arterial desaturation during exercise. Six patients had an excessive elevation of blood lactate on exercise and three of these had evidence of muscle disease. Analysis of the exercise data suggested that in seven patients cardiac output and dead space were normal. In four patients there was a pattern of normal cardiac output, increased dead space, and increased venous admixture, suggesting ventilation/perfusion imbalance. There was no correlation between the results of the physiological tests and the extent of clinical involvement with the disease. The possible reasons for this and for the effort intolerance are reviewed. PMID:5795644

  1. Effect of DNase on exercise capacity in cystic fibrosis.

    PubMed

    Barker, Michael; Franke, Egbert; Böhle, Martin; Pfannenstiel, Claus; Heimann, Gerhard

    2004-07-01

    DNase can reduce viscosity and facilitate expectoration of airway secretions in cystic fibrosis (CF) lung disease. We evaluated its effect on exercise performance in relation to resting pulmonary function. Fifteen sputum-producing CF patients (aged 9-28 years; FEV1 22-83% predicted) performed spirometry, body plethysmography, nitrogen washout, and incremental cardiopulmonary exercise testing before and after 8 weeks of first-time treatment with daily inhaled rhDNase. Most subjects reported increased amounts and fluidity of sputum. The effect on objective parameters was heterogeneous, without statistical significance. Groupwise, FEV1 increased by 6% without correlation to baseline values; individual patients gained up to 40%. Indices of hyperinflation and air trapping were slightly raised. Maximal workload and oxygen uptake (V'O2) increased by up to 20% in a number of patients. The treatment effect on V'O2 was neither related to baseline levels of pulmonary function and exercise capacity nor to the change in FEV1. Ventilatory equivalents for oxygen and carbon dioxide during exercise were slightly but insignificantly lower after DNase treatment; minimal O2 saturation was unaffected. We conclude that improvement of exercise performance with DNase is restricted to a subgroup of CF patients and may not be predicted or identified by spirometry and subject report alone. PMID:15170876

  2. Evaluation of cardiopulmonary resuscitation techniques in microgravity

    NASA Technical Reports Server (NTRS)

    Billica, Roger; Gosbee, John; Krupa, Debra T.

    1991-01-01

    Cardiopulmonary resuscitation (CPR) techniques were investigated in microgravity with specific application to planned medical capabilities for Space Station Freedom (SSF). A KC-135 parabolic flight test was performed with the goal of evaluating and quantifying the efficacy of different types of microgravity CPR techniques. The flight followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. Three experiments were involved chosen for their clinical background, certification, and practical experience in prior KC-135 parabolic flight. The CPR evaluation was performed using a standard training mannequin (recording resusci-Annie) which was used in practice prior to the actual flight. Aboard the KC-135, the prototype medical restraint system (MRS) for the SSF Health Maintenance Facility (HMF) was used for part of the study. Standard patient and crew restraints were used for interface with the MRS. During the portion of study where CPR was performed without MRS, a set of straps for crew restraint similar to those currently employed for the Space Shuttle program were used. The entire study was recorded via still camera and video.

  3. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings.

    PubMed

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

    2013-09-01

    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 (VO(2max)) provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, VO(2max) assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [VO(2max) 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 VO(2max) 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 VO(2max) 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 VO(2max), 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 VO(2max) assessments. In conclusion, the need for a low-risk, low-cost, low-supervision, and objective evaluation of VO(2max) 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

  4. Current Approaches to Cardiopulmonary Resuscitation.

    PubMed

    Truong, Huu Tam; Low, Li Shien; Kern, Karl B

    2015-07-01

    Real progress has been made in improving long-term outcome after out-of-hospital cardiac arrest in the past 10 years. Many communities have doubled their survival-to-hospital-discharge rate during this period. Common features of such successful programs include the following: (1) 911 dispatcher-assisted cardiopulmonary resuscitation (CPR) instruction, (2) bystander chest compression-only CPR program, (3) public access defibrillation, including targeted automated external defibrillator programs, (4) renewed emphasis on minimally interrupted chest compressions by emergency medical services responders, and (5) aggressive postresuscitation care, including targeted temperature management and early coronary angiography and intervention. An important lesson from these successful community efforts is that multiple, simultaneous changes to the local cardiac arrest response system are necessary to improve survival. The next exciting step in this quest appears to be the treatment of refractory cardiac arrest with the combination of mechanical CPR, intra-arrest hypothermia, extracorporeal CPR with mechanical circulatory support devices, and early coronary intervention. PMID:26071014

  5. Cardiac Arrest During Medically-Supervised Exercise Training: A Report of Fifteen Successful Defibrillations.

    ERIC Educational Resources Information Center

    Pyfer, Howard R.; And Others

    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…

  6. Exaggerated blood pressure response during the exercise treadmill test as a risk factor for hypertension

    PubMed Central

    Lima, S.G.; Albuquerque, M.F.P.M.; Oliveira, J.R.M.; Ayres, C.F.J.; Cunha, J.E.G.; Oliveira, D.F.; Lemos, R.R.; Souza, M.B.R.; Silva, O. Barbosa e

    2013-01-01

    Exaggerated blood pressure response (EBPR) during the exercise treadmill test (ETT) has been considered to be a risk factor for hypertension. The relationship of polymorphisms of the renin-angiotensin system gene with hypertension has not been established. Our objective was to evaluate whether EBPR during exercise is a clinical marker for hypertension. The study concerned a historical cohort of normotensive individuals. The exposed individuals were those who presented EBPR. At the end of the observation period (41.7 months = 3.5 years), the development of hypertension was analyzed within the two groups. Genetic polymorphisms and blood pressure behavior were assessed as independent variables, together with the classical risk factors for hypertension. The I/D gene polymorphism of the angiotensin-converting enzyme and M235T of angiotensinogen were ruled out as risk factors for hypertension. EBPR during ETT is not an independent influence on the chances of developing hypertension. No differences were observed between the hypertensive and normotensive individuals regarding gender (P = 0.655), skin color (P = 0.636), family history of hypertension (P = 0.225), diabetes mellitus (P = 0.285), or hypertriglyceridemia (P = 0.734). The risk of developing hypertension increased with increasing body mass index (BMI) and advancing age. The risk factors, which independently influenced the development of hypertension, were age and BMI. EBPR did not constitute an independent risk factor for hypertension and is probably a preclinical phase in the spectrum of normotension and hypertension. PMID:23598646

  7. Exaggerated blood pressure response during the exercise treadmill test as a risk factor for hypertension.

    PubMed

    Lima, S G; Albuquerque, M F P M; Oliveira, J R M; Ayres, C F J; Cunha, J E G; Oliveira, D F; Lemos, R R; Souza, M B R; Barbosa e Silva, O

    2013-04-01

    Exaggerated blood pressure response (EBPR) during the exercise treadmill test (ETT) has been considered to be a risk factor for hypertension. The relationship of polymorphisms of the renin-angiotensin system gene with hypertension has not been established. Our objective was to evaluate whether EBPR during exercise is a clinical marker for hypertension. The study concerned a historical cohort of normotensive individuals. The exposed individuals were those who presented EBPR. At the end of the observation period (41.7 months = 3.5 years), the development of hypertension was analyzed within the two groups. Genetic polymorphisms and blood pressure behavior were assessed as independent variables, together with the classical risk factors for hypertension. The I/D gene polymorphism of the angiotensin-converting enzyme and M235T of angiotensinogen were ruled out as risk factors for hypertension. EBPR during ETT is not an independent influence on the chances of developing hypertension. No differences were observed between the hypertensive and normotensive individuals regarding gender (P = 0.655), skin color (P = 0.636), family history of hypertension (P = 0.225), diabetes mellitus (P = 0.285), or hypertriglyceridemia (P = 0.734). The risk of developing hypertension increased with increasing body mass index (BMI) and advancing age. The risk factors, which independently influenced the development of hypertension, were age and BMI. EBPR did not constitute an independent risk factor for hypertension and is probably a preclinical phase in the spectrum of normotension and hypertension. PMID:23598646

  8. Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial?

    PubMed Central

    Lee, Seung-Hun; Jung, Jae-Seung; Lee, Kwang-Hyung; Kim, Hee-Jung; Son, Ho-Sung; Sun, Kyung

    2015-01-01

    Background With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently, many reports have shown good outcomes in cases where extracorporeal membrane oxygenation (ECMO) was used during prolonged CPR. Accordingly, we attempted to evaluate the impact of extracorporeal cardiopulmonary resuscitation (ECPR) on the survival of patients who experienced a prolonged cardiac arrest and compared it with that of conventional CPR (CCPR). Methods Between March 2009 and April 2014, CPR, including both in-hospital and out-of-hospital CPR, was carried out in 955 patients. The ECPR group, counted from the start of the ECPR program in March 2010, included 81 patients in total, and the CCPR group consisted of 874 patients. All data were retrospectively collected from the patients’ medical records. Results The return of spontaneous circulation (ROSC) rate was 2.24 times better in CPR of in-hospital cardiac arrest (IHCA) patients than in CPR of out-of-hospital CA (OHCA) patients (p=0.0012). For every 1-minute increase in the CPR duration, the ROSC rate decreased by 1% (p=0.0228). Further, for every 10-year decrease in the age, the rate of survival discharge increased by 31%. The CPR of IHCA patients showed a 2.49 times higher survival discharge rate than the CPR of OHCA patients (p=0.03). For every 1-minute increase in the CPR duration, the rate of survival discharge was decreased by 4%. ECPR showed superiority in terms of the survival discharge in the univariate analysis, although with no statistical significance in the multivariate analysis. Conclusion The survival discharge rate of the ECPR group was comparable to that of the CCPR group. As the CPR duration increased, the survival discharge and the ROSC rate decreased. Therefore, a continuous effort to reduce the time for the decision of ECMO initiation and ECMO team activation is necessary, particularly during the CPR of relatively young patients and IHCA patients. PMID:26509125

  9. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Devices § 870.4390 Cardiopulmonary bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to flow...

  10. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing the coronary arteries. (b) Classification. Class II (performance...

  11. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing the coronary arteries. (b) Classification. Class II (performance...

  12. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing the coronary arteries. (b) Classification. Class II (performance...

  13. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing the coronary arteries. (b) Classification. Class II (performance...

  14. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing the coronary arteries. (b) Classification. Class II (performance...

  15. Physiological responses to a tap dance choreography: comparisons with graded exercise test and prescription recommendations.

    PubMed

    Oliveira, Samantha M L; Simões, Herbert G; Moreira, Sergio R; Lima, Ricardo M; Almeida, Jeeser A; Ribeiro, Fabiana M R; Puga, Guilherme M; Campbell, Carmen S G

    2010-07-01

    The aim of this study was to analyze the physiological responses to a tap dance choreography and to compare with those observed during a maximal treadmill exercise test, in tap dancers. Eight women (19.6 +/- 2.4 years; 162.3 +/- 4.4 cm; 54.0 +/- 2.3 kg; 20.5 +/- 1.4 kg.m; and 5.1 +/- 2.6 years of tap dance training) were submitted to the following procedures: (a) graded exercise test (GXT) on a treadmill until volitional exhaustion with 0.8 km.h of increment at each 3 and 1 minute of interval between stages and (b) tap dance choreography (TAP)-"The Shim Sham Shimmy"-consisting of 9 stages of 3 minutes with 1-minute rest between stages. Expired gas analyses were performed in all experimental sessions, providing breath-by-breath values for respiratory exchange rate (RER), oxygen uptake (VO(2)), and carbon dioxide production (CO2). Heart rate (HR) and rate of perceived exertion (RPE) were also measured. During the rest period between stages, blood samples (25 microl) were collected from the ear lobe for lactate threshold (LT) determination. It was observed that at the end of the TAP, subjects achieved an average of 83.8 +/- 6.2% of the HRmax and 68.9 +/- 11.3% of the VO(2)max, both previously identified in the GXT. The choreography demanded 204.7 +/- 31.3 kcal, an average RER of 0.88 +/- 0.05 and mean RPE of 13 +/- 2. The VO(2), HR, and RPE values did not significantly differ from those at the LT intensity identified during the GTX. Based on the present results, it was concluded that the TAP performance in the "The Shim Sham Shimmy" choreography elicited acute physiologic responses similar to those observed at the LT intensity, thus suggesting that Tap Dance constitutes a useful exercise modality for aerobic fitness and cardiovascular health improvements. PMID:20555280

  16. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow....

  17. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow....

  18. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow....

  19. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow....

  20. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow....

  1. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger....

  2. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger....

  3. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger....

  4. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger....

  5. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger....

  6. Factor XII Deficiency and Cardiopulmonary Bypass

    PubMed Central

    Uppal, Victor; Rosin, Mark

    2014-01-01

    Abstract: Factor XII deficiency is a laboratory finding in patients who normally do not present with bleeding tendencies. This deficiency is important in the patient undergoing cardiopulmonary bypass because activated clotting times are not helpful in determining proper levels of heparin anticoagulation and its reversal. We present a case of a patient with factor XII deficiency that had coronary artery bypass grafting and cardiopulmonary bypass using heparin for anticoagulation. Cardiopulmonary bypass was successfully carried out by monitoring heparin concentration ensuring adequate heparinization during the procedure. Results from activated clotting time, heparin dose–response, and heparin protamine titration are given. Heparin anticoagulation in patients with factor XII deficiency can be safely carried out with heparin concentration monitoring. PMID:26357792

  7. “Orpheus” Cardiopulmonary Bypass Simulation System

    PubMed Central

    Morris, Richard W.; Pybus, David A.

    2007-01-01

    Abstract: In this paper we describe a high-fidelity perfusion simulation system intended for use in the training and continuing education of perfusionists. The system comprises a hydraulic simulator, an electronic interface unit and a controlling computer with associated real-time computer models. It is designed for use within an actual operating theatre, or within a specialized simulation facility. The hydraulic simulator can be positioned on an operating table and physically connected to the circuit of the institutional heart-lung machine. The institutional monitoring system is used to display the arterial and central venous pressures, the ECG and the nasopharyngeal temperature using appropriate connections. The simulator is able to reproduce the full spectrum of normal and abnormal events that may present during the course of cardiopulmonary bypass. The system incorporates a sophisticated blood gas model that accurately predicts the behavior of a modern, hollow-fiber oxygenator. Output from this model is displayed in the manner of an in-line blood gas electrode and is updated every 500 msecs. The perfusionist is able to administer a wide variety of drugs during a simulation session including: vasoconstrictors (metaraminol, epinephrine and phenylephrine), a vasodilator (sodium nitroprusside), chronotropes (epinephrine and atropine), an inotrope (epinephrine) and modifiers of coagulation (heparin and protamine). Each drug has a pharmacokinetic profile based on a three-compartment model plus an effect compartment. The simulation system has potential roles in the skill training of perfusionists, the development of crisis management protocols, the certification and accreditation of perfusionists and the evaluation of new perfusion equipment and/or techniques. PMID:18293807

  8. Cardiovascular Effects of 1 Year of Alagebrium and Endurance Exercise Training in Healthy Older Individuals

    PubMed Central

    Fujimoto, Naoki; Hastings, Jeffrey L.; Carrick-Ranson, Graeme; Shafer, Keri M.; Shibata, Shigeki; Bhella, Paul S.; Abdullah, Shuaib M.; Barkley, Kyler W.; Adams-Huet, Beverley; Boyd, Kara N.; Livingston, Sheryl A.; Palmer, Dean; Levine, Benjamin D.

    2014-01-01

    Background Lifelong exercise training maintains a youthful compliance of the left ventricle (LV), whereas a year of exercise training started later in life fails to reverse LV stiffening, possibly because of accumulation of irreversible advanced glycation end products. Alagebrium breaks advanced glycation end product crosslinks and improves LV stiffness in aged animals. However, it is unclear whether a strategy of exercise combined with alagebrium would improve LV stiffness in sedentary older humans. Methods and Results Sixty-two healthy subjects were randomized into 4 groups: sedentary+placebo; sedentary+alagebrium (200 mg/d); exercise+placebo; and exercise+alagebrium. Subjects underwent right heart catheterization to define LV pressure–volume curves; secondary functional outcomes included cardiopulmonary exercise testing and arterial compliance. A total of 57 of 62 subjects (67±6 years; 37 f/20 m) completed 1 year of intervention followed by repeat measurements. Pulmonary capillary wedge pressure and LV end-diastolic volume were measured at baseline, during decreased and increased cardiac filling. LV stiffness was assessed by the slope of LV pressure–volume curve. After intervention, LV mass and end-diastolic volume increased and exercise capacity improved (by ?8%) only in the exercise groups. Neither LV mass nor exercise capacity was affected by alagebrium. Exercise training had little impact on LV stiffness (training×time effect, P=0.46), whereas alagebrium showed a modest improvement in LV stiffness compared with placebo (medication×time effect, P=0.04). Conclusions Alagebrium had no effect on hemodynamics, LV geometry, or exercise capacity in healthy, previously sedentary seniors. However, it did show a modestly favorable effect on age-associated LV stiffening. PMID:24130005

  9. The measurement of peripheral blood volume reactions to tilt test by the electrical impedance technique after exercise in athletes

    NASA Astrophysics Data System (ADS)

    Melnikov, A. A.; Popov, S. G.; Nikolaev, D. V.; Vikulov, A. D.

    2013-04-01

    We have investigated the distribution of peripheral blood volumes in different regions of the body in response to the tilt-test in endurance trained athletes after aerobic exercise. Distribution of peripheral blood volumes (ml/beat) simultaneously in six regions of the body (two legs, two hands, abdomen, neck and ECG) was assessed in response to the tilt-test using the impedance method (the impedance change rate (dZ/dT). Before and after exercise session cardiac stroke (CSV) and blood volumes in legs, arms and neck were higher in athletes both in lying and standing positions. Before exercise the increase of heart rate and the decrease of a neck blood volume in response to tilting was lower (p <0.05) but the decrease of leg blood volumes was higher (p<0.001) in athletes. The reactions in arms and abdomen blood volumes were similar. Also, the neck blood volumes as percentage of CSV (%/CSV) did not change in the control but increased in athletes (p <0.05) in response to the tilt test. After (10 min recovery) the aerobic bicycle exercise (mean HR = 156±8 beat/min, duration 30 min) blood volumes in neck and arms in response to the tilting were reduced equally, but abdomen (p<0.05) and leg blood volumes (p <0.001) were lowered more significantly in athletes. The neck blood flow (%/CSV) did not change in athletes but decreased in control (p<0.01), which was offset by higher tachycardia in response to tilt-test in controls after exercise. The data demonstrate greater orthostatic tolerance in athletes both before and after exercise during fatigue which is due to effective distribution of blood flows aimed at maintaining cerebral blood flow.

  10. Exercise Tolerance Testing in a Prospective Cohort of Adolescents with Chronic Fatigue Syndrome and Recovered Controls Following Infectious Mononucleosis

    PubMed Central

    Katz, Ben Z.; Boas, Steven; Shiraishi, Yukiko; Mears, Cynthia J.; Taylor, Renee

    2010-01-01

    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. PMID:20447647

  11. Hepatic and renal effects of cardiopulmonary bypass.

    PubMed

    Di Tomasso, Nora; Monaco, Fabrizio; Landoni, Giovanni

    2015-06-01

    Although associated with low morbidity and mortality, cardiopulmonary bypass remains a "non-physiologic" device that carries a set of complications. Hepatic and renal impairment are associated with a poor outcome. The knowledge of pathophysiology, risk factors and therapeutic interventions can help the anaesthesiologist in preventing these complications in daily practice. The present narrative review provides an update of the literature on the effects of cardiopulmonary bypass on hepatic and renal functions, focussing on markers of hepatic and renal injuries, perioperative strategies in preserving organ function and replacement therapies. PMID:26060027

  12. Factors affecting sensitivity and specificity of a diagnostic test: the exercise thallium scintigram

    SciTech Connect

    Detrano, R.; Janosi, A.; Lyons, K.P.; Marcondes, G.; Abbassi, N.; Froelicher, V.F.

    1988-04-01

    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.

  13. A Maximal Graded Exercise Test to Accurately Predict VO2max in 18-65-Year-Old Adults

    ERIC Educational Resources Information Center

    George, James D.; Bradshaw, Danielle I.; Hyde, Annette; Vehrs, Pat R.; Hager, Ronald L.; Yanowitz, Frank G.

    2007-01-01

    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…

  14. The Free-Running Asthma Screening Test: An Approach to Screening for Exercise-Induced Asthma in Rural Alabama.

    ERIC Educational Resources Information Center

    Heaman, Doris J.; Estes, Jenny

    1997-01-01

    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)

  15. Improvement of Orthography Test Performance by Relaxation Exercises: Results of a Controlled Field Experiment in Basic Secondary Education

    ERIC Educational Resources Information Center

    Krampen, Gunter

    2010-01-01

    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…

  16. Physiological response to exercise after space flight - Apollo 7 to Apollo 11.

    NASA Technical Reports Server (NTRS)

    Rummel, J. A.; Michel, E. L.; Berry, C. A.

    1973-01-01

    Exercise response tests were conducted preflight and postflight on Apollo missions 7 to 11. The primary objective of these tests was to detect any changes in the cardiopulmonary response to exercise that were associated with the space flight environment and that could have limited lunar surface activities. A heart-rate-controlled bicycle ergometer was used to produce three heart rate stress levels: 120 beats per minute for 6 minutes; 140 beats per minute for 3 minutes and 160 beats per minute per 3 minutes. Work load, blood pressure and respiratory gas exchange were measured during each stress level. Significant decreases were observed immediately postflight in the following dependent variables at a heart rate of 160 beats per minute: work load, oxygen consumption, systolic blood pressure, and diastolic blood pressure. No changes occurred in work efficiency at 100 watts or the ventilatory equivalent for oxygen at 2.0 liters per minute.

  17. 4-Second Exercise Test: Reference Values for Ages 18–81 Years

    PubMed Central

    Araújo, Claudio Gil; de Castro, Claudia Lucia Barros; Franca, João Felipe; Ramos, Plínio Santos

    2015-01-01

    Background Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. Objective To present reference data for 4sET in healthy adults. Methods After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults (61% men) aged between 18 and 81 years subjected to 4sET were evaluated between 1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by calculating the ratio between the duration of two RR intervals in the electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling exercise. Results CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and slopes of the linear regressions between CVI and age were similar for men and women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the distribution of the CVI values according to age, we chose to express the reference values in percentiles for eight age groups (years): 18–30, 31–40, 41–45, 46–50, 51–55, 56–60, 61–65, and 66+, obtaining progressively lower median CVI values ranging from 1.63 to 1.24. Conclusion The availability of CVI percentiles for different age groups should promote the clinical use of 4sET, which is a simple and safe procedure for the evaluation of vagal modulation of cardiac chronotropism. PMID:25830712

  18. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions.

    PubMed

    Rizk, Melissa; Lalanne, Christophe; Berthoz, Sylvie; Kern, Laurence; Godart, Nathalie

    2015-01-01

    "Hyperactivity" has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1) To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2) To examine how core eating disorder symptoms and the dimensions of emotional profile are associated with these different definitions and the impact of these definitions on the assessment of patients' quality of life. Exercise was evaluated in terms of duration, intensity, type and compulsion using a semi-structured questionnaire administered to 180 women suffering from severe anorexia nervosa. Seven different definitions of problematic exercise were identified in the literature: three entailing a single dimension of problematic exercise (duration, compulsion or intensity) and four combining these different dimensions. Emotional profile scores, obsessive-compulsive symptoms, eating disorder symptomatology, worries and concerns about body shape, self-esteem and quality of life were assessed using several established questionnaires. The prevalence of problematic exercise varied considerably from, 5% to 54%, depending on the number of criteria used for its definition. The type and level of eating disorder symptomatology was found to be associated with several definitions of problematic exercise. Surprisingly, a better self-reported quality of life was found among problematic exercisers compared to non-problematic exercisers in three of the definitions. The different definitions of problematic exercise explain the broad prevalence ranges and the conflicting associations generally reported in the literature between problematic exercise and eating disorder-related psychological parameters. There is an urgent need for a valid consensus on the definition of problematic exercise in anorexia nervosa. This will support the development of further research on the etiology and treatment of problematic exercise. PMID:26618359

  19. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions

    PubMed Central

    Rizk, Melissa; Lalanne, Christophe; Berthoz, Sylvie; Kern, Laurence; Godart, Nathalie

    2015-01-01

    “Hyperactivity” has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1) To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2) To examine how core eating disorder symptoms and the dimensions of emotional profile are associated with these different definitions and the impact of these definitions on the assessment of patients’ quality of life. Exercise was evaluated in terms of duration, intensity, type and compulsion using a semi-structured questionnaire administered to 180 women suffering from severe anorexia nervosa. Seven different definitions of problematic exercise were identified in the literature: three entailing a single dimension of problematic exercise (duration, compulsion or intensity) and four combining these different dimensions. Emotional profile scores, obsessive-compulsive symptoms, eating disorder symptomatology, worries and concerns about body shape, self-esteem and quality of life were assessed using several established questionnaires. The prevalence of problematic exercise varied considerably from, 5% to 54%, depending on the number of criteria used for its definition. The type and level of eating disorder symptomatology was found to be associated with several definitions of problematic exercise. Surprisingly, a better self-reported quality of life was found among problematic exercisers compared to non-problematic exercisers in three of the definitions. The different definitions of problematic exercise explain the broad prevalence ranges and the conflicting associations generally reported in the literature between problematic exercise and eating disorder-related psychological parameters. There is an urgent need for a valid consensus on the definition of problematic exercise in anorexia nervosa. This will support the development of further research on the etiology and treatment of problematic exercise. PMID:26618359

  20. Exercise: Benefits of Exercise

    MedlinePLUS Videos and Cool Tools

    ... please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You Can ... yourself. Studies have shown that exercise provides many health benefits and that older adults can gain a ...

  1. AGONIST-MEDIATED AIRWAY CHALLENGE: CARDIOPULMONARY INTERACTIONS MODULATE GAS EXCHANGE AND RECOVERY

    EPA Science Inventory

    ABSTRACT
    To better understand the early phase response (0-60 minutes) to airway challenge, we examined cardiopulmonary reactions during ovalbumin (OVA), histamine, and methacholine aerosol challenge tests in guinea pigs. Propranolol and 100% O2 were used to modify the reacti...

  2. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children

    PubMed Central

    Huh, Seokwon; Kim, Nam Kyun; Jung, Jo Won; Choi, Jae Young; Kim, Hak Sun

    2015-01-01

    Purpose Idiopathic scoliosis is a structural lateral curvature of the spine of unknown etiology. The relationship between degree of spine curvature and cardiopulmonary function has not yet been investigated. The purpose of this study was to determine the association between scoliosis and cardiopulmonary characteristics. Methods Ninety children who underwent preoperative pulmonary or cardiac evaluation at a single spine institution over 41 months were included. They were divided into the thoracic-dominant scoliosis (group A, n=78) and lumbar-dominant scoliosis (group B, n=12) groups. Scoliosis severity was evaluated using the Cobb method. In each group, relationships between Cobb angles and cardiopulmonary markers such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, left ventricular ejection fraction, pulmonary artery flow velocity, and tissue Doppler velocities (E/E', E'/A') were analyzed by correlation analysis linear regression. Results In group A, 72 patients (92.3%) underwent pulmonary function tests (PFTs), and 41 (52.6%) underwent echocardiography. In group B, 9 patients (75.0%) underwent PFT and 8 (66.7%) underwent echocardiography. Cobb angles showed a significant negative correlation with FVC and FEV1 in group A (both P<0.05), but no such correlation in group B, and a significant negative correlation with mitral E/A ratio (P<0.05) and tissue Doppler E'/A' (P<0.05) in group A, with a positive correlation with mitral E/A ratio (P<0.05) in group B. Conclusion Pulmonary and cardiac function was significantly correlated with the degree of scoliosis in patients with thoracic-dominant scoliosis. Myocardial diastolic function might be impaired in patients with the most severe scoliosis. PMID:26213550

  3. A Laboratory Exercise on Photoperiodic Changes in the Testes of the Mongolian Gerbil.

    ERIC Educational Resources Information Center

    Treagust, David F.; And Others

    1980-01-01

    A laboratory exercise using a gerbil is described for use in the high school biology class and in accordance with the National Science Teachers Association guidelines. The authors cite references that deal with current awareness of the moral status concerning animals. The exercise includes measurement and calculations. (SA)

  4. Prevalence and clinical significance of painless ST segment depression during early postinfarction exercise testing

    SciTech Connect

    Gibson, R.S.; Beller, G.A.; Kaiser, D.L.

    1987-03-01

    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.

  5. How Does Exercise Benefit Performance on Cognitive Tests in Primary-School Pupils?

    ERIC Educational Resources Information Center

    Hill, Liam J. B.; Williams, Justin H. G.; Aucott, Lorna; Thomson, Jenny; Mon-Williams, Mark

    2011-01-01

    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…

  6. Effects of the oral contraceptive pill cycle on physiological responses to hypoxic exercise

    NASA Technical Reports Server (NTRS)

    Sandoval, Darleen A.; Matt, Kathleen S.

    2003-01-01

    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.

  7. Optimizing the 6-Min Walk Test as a Measure of Exercise Capacity in COPD

    PubMed Central

    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.

    2012-01-01

    Background: It is uncertain whether the effort and expense of performing a second walk for the 6-min walk test improves test performance. Hence, we attempted to quantify the improvement in 6-min 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 to 10 weeks of pulmonary rehabilitation performed two 6-min walks on consecutive days (N = 396). Patients also performed two 6-min 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 with the change in the first walk distance, change in the average-of-two and best-of-two walk distances had better validity and precision. Specifically, 6 months after randomization to lung volume reduction surgery, changes in the average-of-two (r = 0.66 vs r = 0.58, P = .01) and best-of-two walk distances (r = 0.67 vs r = 0.58, P = .04) better correlated with the change in maximal exercise capacity (ie, better validity). Additionally, the variance of change was 14% to 25% less for the average-of-two walk distances and 14% to 33% less for the best-of-two walk distances than the variance of change in the single walk distance, indicating better precision. Conclusions: Adding a second walk to the 6-min walk test significantly improves its performance in measuring response to a therapeutic intervention, improves the validity of COPD clinical trials, and would result in a 14% to 33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in patients with COPD. PMID:23364913

  8. Cardiopulmonary function in bicycle racing over mountainous terrain at moderate altitude

    NASA Astrophysics Data System (ADS)

    Terasawa, K.; Sakai, A.; Yanagidaira, Y.; Takeoka, M.; Asano, K.; Fujiwara, T.; Yanagisawa, K.; Kashimura, O.; Ueda, G.

    1995-09-01

    To examine cardiopulmonary function during exercise in a mountainous region at moderate altitude, we measured cardiac frequency, oxygen consumptionleft( {dot VO_2 } right), and percentage arterial hemoglobin oxygen saturation (%SaO2) before and after a bicycle race with a starting point at 638 m and finishing point at 1980 m. The time required to ascend an elevation of 10 m was prolonged with increasing altitude, and heart rate also increased with altitude. The %SaO2 at the starting point and at the finishing point differed significantly ( P<0.01). Faster cyclists exhibited higher %SaO2 and lowerdot VO_2 , while slower cyclists exhibited a reduction in %SaO2 and an increase indot VO_2 immediately after the race. The %SaO2 recovery time was significantly correlated with the racing time ( r=0.54, P<0.001). Therefore, the faster cyclists' oxygen debt upon completion of the race may be small and recovery of cardiopulmonary function may be fast, while the slower cyclists' oxygen debt may be large and recovery of cardiopulmonary function may be slow.

  9. Effects of Respiratory Muscle and Endurance Training using an Individualized Training Device on Pulmonary Function and Exercise Capacity in Stroke Patients

    PubMed Central

    Kim, JinHong; Park, Jun Hyuck; Yim, Jongeun

    2014-01-01

    Background Because respiratory muscle function plays a strong role in exercise capacity and cardiopulmonary response to exercise, systematic training and measurement of respiratory muscle function should be considered in stroke patients. The purpose of this study was to determine whether an individualized respiratory muscle training device combined with conventional physical therapy exercise can improve the pulmonary function and exercise capacity of stroke patients. Material/Methods Twenty stroke patients were randomly assigned to an exercise group (n=10) or a control group (n=10). Over 4 weeks, each group participated in exercise training interventions 3 times per week. In each session, the control group received basic exercise treatments for 30 min, followed by an automated full-body workout for 20 min. The exercise group performed the same exercise regimen as the control group, as well as an additional respiratory muscle training regimen using a respiratory exercise device for 20 min. Results Pulmonary function of forced vital capacity (FVC), forced expiratory volume at 1 s (FEV1), FEV1/FVC, and peak expiratory flow (PEF) and exercise capacity of a 6-min walking test and Shortness of Breath Modified Borg Dyspnea Scale (SBMBDS) scores were assessed before and after the training. A significant intergroup difference was observed in the FVC, FEV1, PEF, 6MWT, and SBMBDS scores (p<0.05). Conclusions These findings suggest that exercise of the respiratory muscles using an individualized respiratory device had a positive effect on pulmonary function and exercise capacity and may be used for breathing rehabilitation in stroke patients. PMID:25488849

  10. Functional exercise capacity and health-related quality of life in people with asbestos related pleural disease: an observational study

    PubMed Central

    2013-01-01

    Background Functional exercise capacity in people with asbestos related pleural disease (ARPD) is unknown and there are no data on health-related quality of life (HRQoL). The primary aims were to determine whether functional exercise capacity and HRQoL were reduced in people with ARPD. The secondary aim was to determine whether functional exercise capacity was related to peak exercise capacity, HRQoL, physical activity or respiratory function. Methods In participants with ARPD, exercise capacity was measured by the six-minute walk test (6MWT) and incremental cycle test (ICT); HRQoL by the St George’s Respiratory Questionnaire and physical activity by an activity monitor worn for one week. Participants also underwent lung function testing. Results 25 males completed the study with a mean (SD) age of 71 (6) years, FVC 82 (19)% predicted, FEV1/FVC 66 (11)%, TLC 80 (19)% predicted and DLCO 59 (13)% predicted. Participants had reduced exercise capacity demonstrated by six-minute walk distance (6MWD) of 76 (11)% predicted and peak work rate of 71 (21)% predicted. HRQoL was also reduced. The 6MWD correlated with peak work rate (r=0.58, p=0.002), St George’s Respiratory Questionnaire Total score (r=-0.57, p=0.003), metabolic equivalents from the activity monitor (r=0.45, p<0.05), and FVC % predicted (r=0.52, p<0.01). Conclusions People with ARPD have reduced exercise capacity and HRQoL. The 6MWT may be a useful surrogate measure of peak exercise capacity and physical activity levels in the absence of cardiopulmonary exercise testing and activity monitors. Trial registration ANZCTR12608000147381 PMID:23305075

  11. Cardiovascular Response to Exercise Testing in Children and Adolescents Late After Kawasaki Disease According to Coronary Condition Upon Onset.

    PubMed

    Gravel, Hugo; Curnier, Daniel; Dallaire, Frédéric; Fournier, Anne; Portman, Michael; Dahdah, Nagib

    2015-10-01

    Multiple cardiovascular sequelae have been reported late after Kawasaki disease (KD), especially in patients with coronary artery lesions. In this perspective, we hypothesized that exercise response was altered after KD in patients with coronary aneurysms (CAA-KD) compared to those without history of coronary aneurysms (NS-KD). This study is a post hoc analysis of exercise data from an international multicenter trial. A group of 133 CAA-KD subjects was compared to a group of 117 NS-KD subjects. Subjects underwent a Bruce treadmill test followed to maximal exertion. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed at each stage of the test including recovery. Myocardial perfusion was evaluated by stress and rest Tc-99m sestamibi SPECT imaging. Endurance time was similar between NS-KD and CAA-KD (11.3 ± 2.6 vs. 11.0 ± 2.6 min; p = 0.343). HR, SBP, and DBP responses to exercise were similar between groups (p = 0.075-0.942). Myocardial perfusion defects were present in 16.5 % CAA-KD versus 22.2 % NS-KD (p = 0.255). Analysis based on myocardial perfusion status identified a lower heart rate at 1 min into recovery as well as lower DBP at 1 and 5 min into recovery in patients with abnormal SPECT imaging (p = 0.017-0.042). Compared to patients without CA involvement, the presence of coronary aneurysms at the subacute phase of KD does not induce a differential effect on exercise parameters. In contrast, exercise-induced myocardial perfusion defect late after the onset of KD correlates with abnormal recovery parameters. PMID:25951815

  12. Testing the recovery of stellar rotation signals from Kepler light curves using a blind hare-and-hounds exercise

    E-print Network

    Aigrain, S; Ceillier, T; Chagas, M L das; Davenport, J R A; Garcia, R A; Hay, K L; Lanza, A F; McQuillan, A; Mazeh, T; de Medeiros, J R; Nielsen, M B; Reinhold, T

    2015-01-01

    We present the results of a blind exercise to test the recoverability of stellar rotation and differential rotation in Kepler light curves. The simulated light curves lasted 1000 days and included activity cycles, Sun-like butterfly patterns, differential rotation and spot evolution. The range of rotation periods, activity levels and spot lifetime were chosen to be representative of the Kepler data of solar like stars. Of the 1000 simulated light curves, 770 were injected into actual quiescent Kepler light curves to simulate Kepler noise. The test also included five 1000-day segments of the Sun's total irradiance variations at different points in the Sun's activity cycle. Five teams took part in the blind exercise, plus two teams who participated after the content of the light curves had been released. The methods used included Lomb-Scargle periodograms and variants thereof, auto-correlation function, and wavelet-based analyses, plus spot modelling to search for differential rotation. The results show that th...

  13. Safety and Feasibility of Regadenoson Use for Suboptimal Heart Rate Response During Symptom-Limited Standard Bruce Exercise Stress Test

    PubMed Central

    Partington, Sara L.; Lanka, Viswanatha; Hainer, Jon; Blankstein, Ron; Skali, Hicham; Forman, Daniel E.; Di Carli, Marcelo F.; Dorbala, Sharmila

    2012-01-01

    Background Regadenoson during exercise stress test (ETT) can provide maximal hyperemia for myocardial perfusion imaging (MPI), along with exercise information. Our aim was to study the feasibility and safety of regadenoson injection at peak ETT for sub-maximal heart rate (HR) response. Methods Consecutive patients who underwent SPECT MPI with standard Bruce ETT or supine regadenoson (supine-Reg) were analyzed. ETT patients were grouped as ETT-Max [maximal HR >0.85* (220-age), N=1,522], ETT-Submax (submaximal HR no regadenoson, N=504), ETT-Reg (submaximal HR and regadenoson, N=211). Results The HR during ETT was submaximal in 715 (32%) patients. Of these, 211 patients (30%) underwent ETT-Reg (mean exercise duration: 5.5 ± 2.5 minutes). ETT-Reg patients had a higher frequency of hypertension, diabetes, smoking and beta-blocker use, similar rest systolic blood pressure (SBP), but lower rest and peak HR and peak SBP compared to ETT-Max patients. There were no serious complications with regadenoson. Side effects (49% vs. 6%, P<0.0001) were fewer and aminophylline use was lower with ETT-Reg compared to supine-Reg (.0.5% vs. 8.1%, P =0.001). Conclusions Sub-maximal HR response to ETT is common. ETT-Reg is safe, feasible and well-tolerated. ETT-Reg facilitates a diagnostic MPI with reporting of functional capacity, exercise ECG/hemodynamic changes and MPI at maximal hyperemia. PMID:22565239

  14. An analysis of the physiological strain of submaximal exercise in patients with chronic obstructive bronchitis.

    PubMed Central

    Spiro, S G; Hahn, H L; Edwards, R H; Pride, N B

    1975-01-01

    An increasing work rate was performed by 40 patients with chronic obstructive bronchitis, split into two groups according to FEV1 (group M, mean FEV1 1-451. and group S, mean FEV1 0-621.), and by 20 normal, non-athletic men of similar age to the patients. Values for cardiac frequency and ventilation were interpolated to standard oxygen uptakes of 0-75, 1-0, and, where possible, 1-5 min-1. The tidal volume at a ventilation of 20 and 30 1 min-1 was also determined. The cardiac frequencies at oxygen uptake of 0-75 and 1-01 min-1 were significantly higher in the patient groups than in the normal men, and were highest in patient group S. The cardiac output when related to the oxygen uptake was in the normal range in all three groups of subjects, so that the patients had smaller stroke volumes than the normal men. Ventilation at oxygen uptakes of 0-75 and 1-01 min-1 was significantly higher in both patient groups than in the normal subjects; there were no significant differences between the two patient groups, Values for dead space/tidal volume ration, alveolar-arterial oxygen gradient, and the percent venous admixture measured during a constant work rate test were significantly greater than normal in the patient groups. Possible factors limiting exercise tolerance in these patients were assessed by extending the increasing work rate test from submaximum to maximum exercise. Changes in blood gas tensions and blood lactate concentrations from resting levels were small, and probably did not limit exercise performance. Measurements at maximum exercise did not add appreciably to the analysis of the disturbed cardiopulmonary function. This study has shown that major disturbances in cardiopulmonary function can be demonstrated without the need for stressing a patient to the limit of his effort tolerance. PMID:1179325

  15. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... false Cardiopulmonary bypass heart-lung machine console. 870.4220 Section...4220 Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

  16. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... false Cardiopulmonary bypass heart-lung machine console. 870.4220 Section...4220 Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

  17. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... false Cardiopulmonary bypass heart-lung machine console. 870.4220 Section...4220 Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

  18. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... false Cardiopulmonary bypass heart-lung machine console. 870.4220 Section...4220 Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

  19. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... false Cardiopulmonary bypass heart-lung machine console. 870.4220 Section...4220 Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

  20. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section 870.4410...Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the...

  1. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section 870.4410...Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the...

  2. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section 870.4410...Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the...

  3. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Roller-type cardiopulmonary bypass blood pump. 870.4370 Section 870.4370... Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a...

  4. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Nonroller-type cardiopulmonary bypass blood pump. 870.4360 Section 870...Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a...

  5. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section 870.4410...Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the...

  6. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Cardiopulmonary bypass cardiotomy suction line blood filter. 870.4270 Section 870.4270 ...Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas...

  7. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Cardiopulmonary bypass arterial line blood filter. 870.4260 Section 870.4260...Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a...

  8. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section 870.4410...Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures...

  9. Fluid distribution kinetics during cardiopulmonary bypass

    PubMed Central

    Törnudd, Mattias; Hahn, Robert G.; Zdolsek, Joachim H.

    2014-01-01

    OBJECTIVE: The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass. METHODS: Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166. RESULTS: The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p<0.02). The mass balance of sodium indicated a translocation from the intracellular to the extracellular fluid space in 8 of the 10 patients, with a median volume of 236 ml. CONCLUSIONS: The distribution half-time of Ringer's solution during isovolumetric cardiopulmonary bypass was 8 minutes, which is the same as for crystalloid fluid infusions in healthy subjects. The intravascular albumin mass increased. Most patients were hypovolemic prior to the start of anesthesia. Intracellular edema did not occur. PMID:25141112

  10. [Cardiopulmonary syndrome in hantavirus infection (an overview)].

    PubMed

    Mukhetdinova, G A; Fazlyeva, R M; Fazlyev, M M

    2012-06-01

    The article provides an overview of domestic and foreign literature on modern aspects of hantavirus infection. Hemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome have a high epidemiological significance for Russia's Armed Forces and the armies of many foreign countries. Current knowledge of the various manifestations of the disease contribute to the improvement of diagnosis and timely delivery of medical and preventive measures. PMID:22888702

  11. Effect of L-carnitine on exercise performance in patients with mitochondrial myopathy

    PubMed Central

    Gimenes, A.C.; Bravo, D.M.; Nápolis, L.M.; Mello, M.T.; Oliveira, A.S.B.; Neder, J.A.; Nery, L.E.

    2015-01-01

    Exercise intolerance due to impaired oxidative metabolism is a prominent symptom in patients with mitochondrial myopathy (MM), but it is still uncertain whether L-carnitine supplementation is beneficial for patients with MM. The aim of our study was to investigate the effects of L-carnitine on exercise performance in MM. Twelve MM subjects (mean age±SD=35.4±10.8 years) with chronic progressive external ophthalmoplegia (CPEO) were first compared to 10 healthy controls (mean age±SD=29±7.8 years) before they were randomly assigned to receive L-carnitine supplementation (3 g/daily) or placebo in a double-blind crossover design. Clinical status, body composition, respiratory function tests, peripheral muscle strength (isokinetic and isometric torque) and cardiopulmonary exercise tests (incremental to peak exercise and at 70% of maximal), constant work rate (CWR) exercise test, to the limit of tolerance [Tlim]) were assessed after 2 months of L-carnitine/placebo administration. Patients with MM presented with lower mean height, total body weight, fat-free mass, and peripheral muscle strength compared to controls in the pre-test evaluation. After L-carnitine supplementation, the patients with MM significantly improved their Tlim (14±1.9 vs 11±1.4 min) and oxygen consumption (V?O2) at CWR exercise, both at isotime (1151±115 vs 1049±104 mL/min) and at Tlim (1223±114 vs 1060±108 mL/min). These results indicate that L-carnitine supplementation may improve aerobic capacity and exercise tolerance during high-intensity CWRs in MM patients with CPEO. PMID:25714882

  12. Feasibility and effectiveness of a home-based exercise training program before lung resection surgery

    PubMed Central

    Coats, Valérie; Maltais, François; Simard, Sébastien; Fréchette, Éric; Tremblay, Lise; Ribeiro, Fernanda; Saey, Didier

    2013-01-01

    BACKGROUND: Patients with lung cancer often experience a reduction in exercise tolerance, muscle weakness and decreased quality of life. Although the effectiveness of pulmonary rehabilitation programs is well recognized in other forms of cancers and in many pulmonary diseases, few researchers have studied its impact in patients with lung cancer, particularly in those awaiting lung resection surgery (LRS). OBJECTIVES: To investigate the feasibility of a short, home-based exercise training program (HBETP) with patients under investigation for non-small cell lung cancer and potential candidates for LRS, and to determine the effectiveness of this program on exercise tolerance, skeletal muscle strength and quality of life. METHODS: Sixteen patients with lung cancer awaiting LRS participated in a four-week HBETP including moderate aerobic activities (walking and cycling) and muscle training performed three times weekly. Before and after the intervention, a cardiopulmonary exercise test, a 6 min walk test and the assessment of muscle strength and quality of life were performed. RESULTS: Thirteen patients completed the four-week HBETP and all the patients completed >75% of the prescribed exercise sessions. The duration of the cycle endurance test (264±79 s versus 421±241 s; P<0.05) and the 6 min walk test distance (540±98 m versus 568±101 m; P<0.05) were significantly improved. Moreover, the strength of the deltoid, triceps and hamstrings were significantly improved (? post-pre training 1.82±2.83 kg, 1.32±1.75 kg and 3.41±3.7 kg; P<0.05, respectively). CONCLUSION: In patients with lung cancer awaiting LRS, HBETP was feasible and improved exercise tolerance and muscle strength. This may be clinically relevant because poor exercise capacity and muscle weakness are predictors of postoperative complications. PMID:23616972

  13. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4230 Cardiopulmonary bypass defoamer. (a) Identification....

  14. 21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4430 Cardiopulmonary bypass intracardiac suction control. (a)...

  15. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary bypass heat exchanger. (a)...

  16. 21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4300 Cardiopulmonary bypass gas control unit. (a)...

  17. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4420 Cardiopulmonary bypass cardiotomy return sucker. (a)...

  18. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4380 Cardiopulmonary bypass pump speed control. (a)...

  19. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4390 Cardiopulmonary bypass pump tubing. (a)...

  20. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4350 Cardiopulmonary bypass oxygenator. (a)...

  1. Exploratory studies of physiological components of motion sickness: Cardiopulmonary differences between high and low susceptibles

    NASA Technical Reports Server (NTRS)

    Naifeh, K.

    1985-01-01

    A comprehensive examination of cardiovascular autonomic response to motion sickness was studied and whether differences in cardiopulmonary function exist in high and low susceptibility groups were determined. Measurement techniques were developed as was test equipment for its ability to provide accurately new measures of interest and to test the adequately of these new measures in differentiating between susceptibility groups. It was concluded that these groups can be differentiated using simple, brief stressors and measurements of cardiodynamic function.

  2. Extraversion and exercise addiction.

    PubMed

    Mathers, S; Walker, M B

    1999-01-01

    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 were more extraverted than nonexercisers. The results are interpreted as evidence against the claim that extraversion is a component of the addictive personality profile. PMID:10022080

  3. Changes in Exercise Capacity of Cardiac Asymptomatic Hereditary Hemochromatosis Subjects over 5-Year Follow up

    PubMed Central

    Shizukuda, Yukitaka; Smith, Kevin P.; Tripodi, Dorothy J.; Arena, Ross; Yau, Yu-Ying; Bolan, Charles D.; Waclawiw, Myron A.; Leitman, Susan F.; Rosing, Douglas R.

    2012-01-01

    Objective A long-term effect of hereditary hemochromatosis (HH) on aerobic exercise capacity (AEC) has not been well described. Design Forty-three HH and 21 volunteer control (VC) subjects who were asymptomatic underwent cardiopulmonary exercise testing using the Bruce protocol. AEC was assessed with minute ventilation (VE), oxygen uptake (VO2), and carbon dioxide production (VCO2) at baseline (BL) at a 5-year follow up (5Y) assessment. A paired t-test was used for analyses of normality data; otherwise, a Wilcoxon singed rank sum test was used. Results Thirty-three HH subjects and 18 VC subjects returned for a repeat CPX at 5Y (80% overall return rate). At 5Y, AEC was not different between the two groups. As compared with BL measurements, exercise time, peak VO2, and the VE/VCO2 slope did not differ statistically at 5Y between both groups. Iron depletion by phlebotomy for 5 years did not significantly affect AEC in newly diagnosed HH subjects at baseline (n=14) and cardiac arrhythmias during exercise tended to decrease after 5 years of therapy in this group. Conclusions The AEC of asymptomatic HH subjects treated with conventional therapy is not statistically affected by the disease over a 5-year period. PMID:22311055

  4. Likelihood of Myocardial Infarction during Stroke Rehabilitation Preceded by Cardiovascular Screening and an Exercise Tolerance Test: The LEAPS Experience

    PubMed Central

    Nadeau, Stephen E.; Rose, Dorian K.; Dobkin, Bruce; Wu, Samuel S.; Dai, Yunfeng E.; Schofield, Richard; Duncan, Pamela W

    2014-01-01

    Background Coronary artery disease is highly prevalent in patients with stroke but, because revascularization does not improve major clinical outcomes in patients with stable coronary artery disease relative to intensive medical therapy, routine evaluation for this disease is not warranted in stroke patients. However, it might be warranted in patients destined to undergo vigorous physical therapy. The Locomotor Experience Applied Post-Stroke (LEAPS) study, a randomized controlled trial of 408 participants that tested the relative efficacy of two rehabilitation techniques on functional walking level, provided the opportunity to address this question. Aim Test the efficacy of screening for cardiovascular disease and an exercise tolerance test in assuring safety among patients undergoing vigorous rehabilitation for gait impairment. Methods All participants were screened for serious cardiovascular and pulmonary conditions. At 6-weeks post-stroke, they also completed a cardiovascular screening inventory and underwent an exercise tolerance test involving bicycle ergometry. Participants received 36 90-minute sessions of a prescribed physical therapy (3/week), initiated at either 2 months or 6 months post-stroke. Results 29 participants were excluded on the basis of the cardiac screening questionnaire and 15 failed the exercise tolerance test for cardiovascular reasons. No participant experienced a cardiac event during a treatment session. Two participants experienced myocardial infarctions but continued in the trial. In 3 additional participants, myocardial infarctions caused or contributed to death. Conclusions The combination of a negative cardiac screen and the absence of ETT failure appeared to have a high negative predictive value for cardiac events during treatment, despite the likelihood of a high prevalence of coronary artery disease in our population. PMID:25156340

  5. Exercise Interventions in Children with Cancer: A Review

    PubMed Central

    Huang, Tseng-Tien; Ness, Kirsten K.

    2011-01-01

    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. PMID:22121378

  6. Assessing recruitment of lung diffusing capacity in exercising guinea pigs with a rebreathing technique.

    PubMed

    Yilmaz, Cuneyt; Dane, D Merrill; Hsia, Connie C W

    2008-07-01

    Noninvasive techniques for assessing cardiopulmonary function in small animals are limited. We previously developed a rebreathing technique for measuring lung volume, pulmonary blood flow, diffusing capacity for carbon monoxide (Dl(CO)) and its components, membrane diffusing capacity (Dm(CO)) and pulmonary capillary blood volume (Vc), and septal volume, in conscious nonsedated guinea pigs at rest. Now we have extended this technique to study guinea pigs during voluntary treadmill exercise with a sealed respiratory mask attached to a body vest and a test gas mixture containing 0.5% SF(6) or Ne, 0.3% CO, and 0.8% C(2)H(2) in 40% or 98% O(2). From rest to exercise, O(2) uptake increased from 12.7 to 25.5 ml x min(-1) x kg(-1) while pulmonary blood flow increased from 123 to 239 ml/kg. The measured Dl(CO), Dm(CO), and Vc increased linearly with respect to pulmonary blood flow as expected from alveolar microvascular recruitment; body mass-specific relationships were consistent with those in healthy human subjects and dogs studied with a similar technique. The results show that 1) cardiopulmonary interactions from rest to exercise can be measured noninvasively in guinea pigs, 2) guinea pigs exhibit patterns of exercise response and alveolar microvascular recruitment similar to those of larger species, and 3) the rebreathing technique is widely applicable to human ( approximately 70 kg), dog (20-30 kg), and guinea pig (1-1.5 kg). In theory, this technique can be extended to even smaller animals provided that species-specific technical hurdles can be overcome. PMID:18483171

  7. Psychophysiologic effects of Hatha Yoga on musculoskeletal and cardiopulmonary function: a literature review.

    PubMed

    Raub, James A

    2002-12-01

    Yoga has become increasingly popular in Western cultures as a means of exercise and fitness training; however, it is still depicted as trendy as evidenced by an April 2001 Time magazine cover story on "The Power of Yoga." There is a need to have yoga better recognized by the health care community as a complement to conventional medical care. Over the last 10 years, a growing number of research studies have shown that the practice of Hatha Yoga can improve strength and flexibility, and may help control such physiological variables as blood pressure, respiration and heart rate, and metabolic rate to improve overall exercise capacity. This review presents a summary of medically substantiated information about the health benefits of yoga for healthy people and for people compromised by musculoskeletal and cardiopulmonary disease. PMID:12614533

  8. Food Microbiology--Design and Testing of a Virtual Laboratory Exercise

    ERIC Educational Resources Information Center

    Flint, Steve; Stewart, Terry

    2010-01-01

    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 1…

  9. Cardiopulmonary data-acquisition system

    NASA Technical Reports Server (NTRS)

    Crosier, W. G.; Reed, R. A.

    1981-01-01

    Computerized system controls and monitors bicycle and treadmill cardiovascular stress tests. It acquires and reduces stress data and displays heart rate, blood pressure, workload, respiratory rate, exhaled-gas composition, and other variables. Data are printed on hard-copy terminal every 30 seconds for quick operator response to patient. Ergometer workload is controlled in real time according to experimental protocol. Collected data are stored directly on tape in analog form and on floppy disks in digital form for later processing.

  10. Acute Exercise-Induced Response of Monocyte Subtypes in Chronic Heart and Renal Failure

    PubMed Central

    Van Craenenbroeck, Amaryllis H.; Hoymans, Vicky Y.; Verpooten, Gert A.; Vrints, Christiaan J.; Couttenye, Marie M.; Van Craenenbroeck, Emeline M.

    2014-01-01

    Purpose. Monocytes (Mon1-2-3) play a substantial role in low-grade inflammation associated with high cardiovascular morbidity and mortality of patients with chronic kidney disease (CKD) and chronic heart failure (CHF). The effect of an acute exercise bout on monocyte subsets in the setting of systemic inflammation is currently unknown. This study aims (1) to evaluate baseline distribution of monocyte subsets in CHF and CKD versus healthy subjects (HS) and (2) to evaluate the effect of an acute exercise bout. Exercise-induced IL-6 and MCP-1 release are related to the Mon1-2-3 response. Methods. Twenty CHF patients, 20 CKD patients, and 15 HS were included. Before and after a maximal cardiopulmonary exercise test, monocyte subsets were quantified by flow cytometry: CD14++CD16?CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2), and CD14+CD16++CCR2? (Mon3). Serum levels of IL-6 and MCP-1 were determined by ELISA. Results. Baseline distribution of Mon1-2-3 was comparable between the 3 groups. Following acute exercise, %Mon2 and %Mon3 increased significantly at the expense of a decrease in %Mon1 in HS and in CKD. This response was significantly attenuated in CHF (P < 0.05). In HS only, MCP-1 levels increased following exercise; IL-6 levels were unchanged. Circulatory power was a strong and independent predictor of the changes in Mon1 (? = ?0.461, P < 0.001) and Mon3 (? = 0.449, P < 0.001); and baseline LVEF of the change in Mon2 (? = 0.441, P < 0.001). Conclusion. The response of monocytes to acute exercise is characterized by an increase in proangiogenic and proinflammatory Mon2 and Mon3 at the expense of phagocytic Mon1. This exercise-induced monocyte subset response is mainly driven by hemodynamic changes and not by preexistent low-grade inflammation. PMID:25587208

  11. Cardiorespiratory and sensory responses to exercise in adults with mild cystic fibrosis.

    PubMed

    Quon, Bradley S; Wilkie, Sabrina S; Molgat-Seon, Yannick; Schaeffer, Michele R; Ramsook, Andrew H; Wilcox, Pearce G; Guenette, Jordan A

    2015-12-01

    The purpose of this study was to evaluate cardiorespiratory fitness and reasons for exercise curtailment in a contemporary adult cystic fibrosis (CF) cohort with mild lung disease. Adults with mild CF (n = 19, forced expiratory volume in 1 s = 95 ± 17% predicted) were age-, sex-, ethnicity-, and body mass index-matched to healthy controls (n = 19) and underwent a detailed cardiopulmonary cycle exercise test. While CF subjects had a reduced peak oxygen uptake compared with controls, the values were normal when expressed as %predicted in 14/19 (74%) of subjects. Both groups demonstrated a normal cardiovascular limitation to exercise and stopped exercise primarily because of leg fatigue. Despite not being exercise-limited by respiratory factors, there was some evidence of ventilatory abnormalities as patients with mild CF had increased end-inspiratory lung volumes and reached an inflection/plateau in tidal volume relative to minute ventilation at lower exercise intensities compared with controls. Subjects with CF were not more likely to demonstrate expiratory flow limitation compared with controls and did not have evidence of dynamic hyperinflation during exercise. Despite increased end-inspiratory lung volumes and an earlier tidal volume inflection/plateau, CF subjects did not experience higher levels of dyspnea. In an exploratory analysis, a significant inverse correlation was observed between sweat chloride and peak work rate. Adult CF subjects with relatively well preserved spirometry have normal exercise performance relative to reference values and are primarily limited by nonrespiratory factors. However, ventilatory abnormalities were detected even in this mild CF cohort and should be evaluated in future therapeutic trials focused on disease-modifying therapies in mild CF. PMID:26429870

  12. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section... bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction... entitled “Guidance for Extracorporeal Blood Circuit Defoamer 510(k) Submissions.”...

  13. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section... bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction... entitled “Guidance for Extracorporeal Blood Circuit Defoamer 510(k) Submissions.”...

  14. MEASUREMENT OF CARDIOPULMONARY FUNCTION BY REBREATHING METHODOLOGY IN PIGLETS

    EPA Science Inventory

    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) pulmonary capillary blood flow ...

  15. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in... circulation. (b) Classification. Class II (performance standards), except that a reservoir that contains...

  16. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in... circulation. (b) Classification. Class II (performance standards), except that a reservoir that contains...

  17. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in... circulation. (b) Classification. Class II (performance standards), except that a reservoir that contains...

  18. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the...

  19. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the...

  20. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section... prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of... bypass. The device is not used to filter blood. (b) Classification. Class II (performance standards)....

  1. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section... prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of... bypass. The device is not used to filter blood. (b) Classification. Class II (performance standards)....

  2. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section... prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of... bypass. The device is not used to filter blood. (b) Classification. Class II (performance standards)....

  3. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section... prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of... bypass. The device is not used to filter blood. (b) Classification. Class II (performance standards)....

  4. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section... prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of... bypass. The device is not used to filter blood. (b) Classification. Class II (performance standards)....

  5. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870.4240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a...

  6. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870.4240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a...

  7. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870.4240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a...

  8. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870.4240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a...

  9. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870.4240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a...

  10. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  11. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  12. Comparison of Effect of One Course of Intense Exercise (Wingate test) on Serum Levels of Interleukin-17 in Different Groups of Athletes

    PubMed Central

    Tofighee, Asghar; Khazaei, Hossein Ali; Jalili, Arman

    2014-01-01

    Background: Research on the effects of exercise on immune function, has a wide range of sporting activities. Study on the long-term effects of regular exercise on serum levels of cytokines such as interleukin-17 have shown that moderate and regular exercise, has an important role in the prevention and treatment of many diseases. Objectives: Exhaustive exercise has a deep effect on cellular, humoral, innate immunity and the amount of cytokines of an athlete’s immune system. So this study was designed to compare the effect of one course of exhaustive exercise on serum levels of interleukin (IL)-17 in different groups of athletes. Patients and Methods: Forty professional athletes with a mean age of 25.1 ± 5.0 years, divided equally in 4 groups (handball, volleyball, Sepak-takraw and climbing) were selected for this purpose. 30 second Wingate test for each athlete was used to assess anaerobic power. Blood samples before, immediately after and 2 hours after exercise was collected and the amount of serum IL-17 was measured. Results: The results showed that the level of IL-17 in the study groups before and after the two hours exercise did not significantly change in all four groups. Conclusions: The results showed that short anaerobic exercise has no effect on the level of IL-17. PMID:25741409

  13. Influence of prior sprint exercise on the parameters of the 'all-out critical power test' in men.

    PubMed

    Vanhatalo, Anni; Jones, Andrew M

    2009-02-01

    We tested the hypothesis that a prior 30 s sprint exercise bout would significantly reduce the curvature constant (W') but not the power-asymptote (critical power, CP) of the power-duration relationship as assessed using a novel 3 min all-out cycling test. Seven physically active male subjects completed the 3 min all-out test on three occasions in random order: following no prior sprint exercise (control, C); following a 30 s sprint and a 2 min recovery (S2); and following a 30 s sprint and a 15 min recovery period (S15). The CP was estimated from the mean power output sustained over the final 30 s of the test and the W' was estimated as the power-time integral above the end-test power. There were no significant differences in the estimated CP between the control 3 min all-out trial and the two prior sprint conditions (C, 235 +/- 44 W; S2, 223 +/- 46 W; and S15, 232 +/- 50 W; P > 0.05; coefficients of variation 2, 3 and 6% for C-S2, C-S15 and S2-S15, respectively). However, the W' in S2 (16.5 +/- 3.3 kJ) was significantly lower than in C (20.8 +/- 3.9 kJ) and S15 (21.2 +/- 4.5 kJ; P < 0.05). The total work done was lower in S2 than in the other conditions (S2, 56.4 +/- 7.2 kJ; C, 63.5 +/- 6.6 kJ; and S15, 63.0 +/- 6.0 kJ; P < 0.05). The W', but not the CP, is sensitive to a bout of prior sprint exercise which would be expected to result in significant muscle phosphocreatine depletion. These findings support the fundamental principles of the power-duration relationship as applied to all-out exercise. PMID:18996948

  14. The impact of a cold pressor test on brachial artery handgrip exercise-induced flow-mediated dilation.

    PubMed

    Stuckless, Troy J R; Pyke, Kyra E

    2015-10-01

    It is unknown how endothelial-dependent flow-mediated dilation (FMD) stimulated by a sustained, exercise-induced increase in shear stress (EX-FMD) is affected by a simultaneous sympathoexcitatory painful stimulus. The purpose of this study was to examine the impact of a cold pressor test (CPT) on brachial artery EX-FMD elicited by a handgrip exercise-induced increase in shear stress. Participants were healthy males (age 21±2 years) (n=28; 16 Experimental group, 12 Control). Brachial artery diameter and blood velocity were measured using echo and Doppler ultrasound, respectively. Shear stress was estimated by shear rate (shear rate = blood velocity / diameter) and targeted to reach 75 s(-1) in each of two EX-FMD trials in all subjects. In the Experimental group, the second EX-FMD trial was accompanied by simultaneous foot immersion in ice water (simultaneous CPT). The shear rate stimulus did not differ between groups (p=0.823) or trials (p=0.726) (group × trial interaction: p=0.646) (average exercise shear rate (mean ± SD): 67.6±6.2 s(-1)). The CPT (experienced during EX-FMD trial 2 in the Experimental group) increased mean arterial pressure (p<0.001) and heart rate (p=0.002) relative to the Control group. %EX-FMD was not different between groups (p=0.508) or trials (p=0.592) (group × trial interaction: p=0.879) (EX-FMD: Experimental group trial 1: 5.4±3.4%, trial 2: 5.6±2.6%; Control group trial 1: 6.0±3.7%, trial 2: 6.4±2.2%). In conclusion, the CPT did not impact concurrent EX-FMD, and this indicates that an acute painful stimulus does not interfere with conduit artery FMD responses during exercise in young healthy men. PMID:26021703

  15. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine

    PubMed Central

    Passaroni, Andréia Cristina; Silva, Marcos Augusto de Moraes; Yoshida, Winston Bonetti

    2015-01-01

    Objective To provide a brief review of the development of cardiopulmonary bypass. Methods A review of the literature on the development of extracorporeal circulation techniques, their essential role in cardiovascular surgery, and the complications associated with their use, including hemolysis and inflammation. Results The advancement of extracorporeal circulation techniques has played an essential role in minimizing the complications of cardiopulmonary bypass, which can range from various degrees of tissue injury to multiple organ dysfunction syndrome. Investigators have long researched the ways in which cardiopulmonary bypass may insult the human body. Potential solutions arose and laid the groundwork for development of safer postoperative care strategies. Conclusion Steady progress has been made in cardiopulmonary bypass in the decades since it was first conceived of by Gibbon. Despite the constant evolution of cardiopulmonary bypass techniques and attempts to minimize their complications, it is still essential that clinicians respect the particularities of each patient's physiological function. PMID:26107456

  16. Exercise-Induced Pulmonary Artery Hypertension in a Patient with Compensated Cardiac Disease: Hemodynamic and Functional Response to Sildenafil Therapy

    PubMed Central

    Nikolaidis, Lazaros; Memon, Nabeel

    2015-01-01

    We describe the case of a 54-year-old man who presented with exertional dyspnea and fatigue that had worsened over the preceding 2 years, despite a normally functioning bioprosthetic aortic valve and stable, mild left ventricular dysfunction (left ventricular ejection fraction, 0.45). His symptoms could not be explained by physical examination, an extensive biochemical profile, or multiple cardiac and pulmonary investigations. However, abnormal cardiopulmonary exercise test results and a right heart catheterization—combined with the use of a symptom-limited, bedside bicycle ergometer—revealed that the patient's exercise-induced pulmonary artery hypertension was out of proportion to his compensated left heart disease. A trial of sildenafil therapy resulted in objective improvements in hemodynamic values and functional class. PMID:25873799

  17. Cardiopulmonary Bypass in a Glaucoma Patient

    PubMed Central

    Singh, Jaswinder; Dhaliwal, Rajinder Singh; Das, Debasis; Luthra, Suvitesh; Singh, Harkant

    2007-01-01

    Abstract: Cardiopulmonary bypass (CPB) in a patient with glaucoma is a challenge. The glaucomatous eye is at risk during CPB. We report a case of ostium secundum atrial septal defect that was not amenable to device closure. The unique feature in the patient was the presence of congenital glaucoma. She was blind in the left eye, and the visual acuity in the other eye was decreased because of glaucoma. She underwent direct closure of the atrial septal defect under CPB and fibrillatory arrest, with intraoperative monitoring of intraocular pressure. There was no change in visual acuity after 1 year of follow-up. PMID:17486875

  18. Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients

    PubMed Central

    Shan, Xizheng; Liu, Jinming; Luo, Yanrong; Xu, Xiaowen; Han, Zhiqing; Li, Hailing

    2015-01-01

    Objective The nutritional status of chronic obstructive pulmonary disease (COPD) patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients. Methods A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33) and nutritional risk group (n=25) according to the Nutritional Risk Screening (NRS, 2002) criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients. Results Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group (P<0.05). The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group (P<0.05). Besides, the peak VO2 (peak oxygen uptake), peak O2 pulse (peak oxygen pulse), and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group (P<0.05) and there were significantly negative correlations between the NRS score and peak VO2, peak O2 pulse, or peak load (r<0, P<0.05). Conclusion The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study. PMID:26150712

  19. Testing the recovery of stellar rotation signals from Kepler light curves using a blind hare-and-hounds exercise

    NASA Astrophysics Data System (ADS)

    Aigrain, S.; Llama, J.; Ceillier, T.; Chagas, M. L. das; Davenport, J. R. A.; García, R. A.; Hay, K. L.; Lanza, A. F.; McQuillan, A.; Mazeh, T.; de Medeiros, J. R.; Nielsen, M. B.; Reinhold, T.

    2015-07-01

    We present the results of a blind exercise to test the recoverability of stellar rotation and differential rotation in Kepler light curves. The simulated light curves lasted 1000 d and included activity cycles, Sun-like butterfly patterns, differential rotation and spot evolution. The range of rotation periods, activity levels and spot lifetime were chosen to be representative of the Kepler data of solar-like stars. Of the 1000 simulated light curves, 770 were injected into actual quiescent Kepler light curves to simulate Kepler noise. The test also included five 1000-d segments of the Sun's total irradiance variations at different points in the Sun's activity cycle. Five teams took part in the blind exercise, plus two teams who participated after the content of the light curves had been released. The methods used included Lomb-Scargle periodograms and variants thereof, autocorrelation function and wavelet-based analyses, plus spot modelling to search for differential rotation. The results show that the `overall' period is well recovered for stars exhibiting low and moderate activity levels. Most teams reported values within 10 per cent of the true value in 70 per cent of the cases. There was, however, little correlation between the reported and simulated values of the differential rotation shear, suggesting that differential rotation studies based on full-disc light curves alone need to be treated with caution, at least for solar-type stars. The simulated light curves and associated parameters are available online for the community to test their own methods.

  20. Gastroenterology case report of mesalazine-induced cardiopulmonary hypersensitivity

    PubMed Central

    Ferrusquía, José; Pérez-Martínez, Isabel; Gómez de la Torre, Ricardo; Fernández-Almira, María Luisa; de Francisco, Ruth; Rodrigo, Luis; Riestra, Sabino

    2015-01-01

    Mesalazine is a 5-aminosalicylic acid derivative that has been widely used to treat patients with inflammatory bowel disease. Accumulating evidence indicates that mesalazine has a very low rate of adverse drug reactions and is well tolerated by patients. However, a few cases of pulmonary and cardiac disease related to mesalazine have been reported in the past, though infrequently, preventing clinicians from diagnosing the conditions early. We describe the case of a 32-year-old man with ulcerative colitis who was admitted with a two-month history of persistent fever following mesalazine treatment initiated 14 mo earlier. At the time of admission, mesalazine dose was increased from 1.5 to 3.0 g/d, and antibiotic therapy was started with no improvement. Three weeks after admission, the patient developed dyspnea, non-productive cough, and chest pain. Severe eosinophilia was detected in laboratory tests, and a computed tomography scan revealed interstitial infiltrates in both lungs, as well as a large pericardial effusion. The bronchoalveolar lavage reported a CD4/CD8 ratio of 0.5, and an increased eosinophil count. Transbronchial biopsy examination showed a severe eosinophilic infiltrate of the lung tissue. Mesalazine-induced cardiopulmonary hypersensitivity was suspected after excluding other possible etiologies. Consequently, mesalazine treatment was suspended, and corticosteroid therapy was initiated, resulting in resolution of symptoms and radiologic abnormalities. We conclude that mesalazine-induced pulmonary and cardiac hypersensitivity should always be considered in the differential diagnosis of unexplained cardiopulmonary symptoms and radiographic abnormalities in patients with inflammatory bowel disease. PMID:25852295

  1. Temperature Inaccuracies During Cardiopulmonary Bypass

    PubMed Central

    Salah, Mohammad; Sutton, Robin; Tsarovsky, Gary; Djuric, Michael

    2005-01-01

    Abstract: Cerebral hyperthermia caused by perfusate temperature greater than 37°C during the rewarming phase of CPB has been linked to postoperative neurologic deficits. The purpose of this study was to determine the accuracy of the coupled temperature measurement system and the CDI 500 arterial temperature sensor. Seventeen patients undergoing CPB were divided into four groups, each with a different temperature probe coupled to the oxygenator. The coupled temperature measurement system and CDI temperature sensors were compared with an indwelling probe placed in direct contact with the arterial perfusate. Blood, bladder, room and water temperatures, arterial line pressure, blood flow, and hemoglobin were recorded while the patients were supported with CPB. The actual blood temperature was significantly higher than the coupled temperature measurement system for two of the four groups (mean = 1.61°C and 0.91°C, p < 0.0001). A significant positive correlation between the actual temperature and the coupled temperature measurement system error was observed for the same two groups (r = 0.44, p < 0.0001). The actual temperature was significantly higher than the CDI temperature in all patients (mean = 1.2°C, p < 0.0001). The coupling mechanism on the oxygenator generates inconsistent temperature readings. The perfusionist should consider these inconsistencies when using coupled temperature measurements and may consider the use of a direct temperature measurement system. The CDI temperature error is probably the result of inadequate flow through the sensor. On the test circuit, the flow of 170 mL/min was inadequate for circuit temperature accuracy. The accuracy of the CDI temperature drastically improved when the flow-through the sensor was increased to approximately 400 mL/min. Thus, the perfusionist must ensure adequate flow through the sensor in order for the temperature mechanism to function properly. Finally, the perfusionist can prevent cerebral hyperthermia by not allowing water temperature to exceed 37°C, when using a coupled temperature measurement system. PMID:15804155

  2. The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents.

    PubMed

    Pieles, Guido E; Gowing, Lucy; Forsey, Jonathan; Ramanujam, Paramanantham; Miller, Felicity; Stuart, A Graham; Williams, Craig A

    2015-12-15

    Background left ventricular (LV) and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 ± 2.7 yr; stature 159.1 ± 16.4 cm; body mass 49.5 ± 16.6 kg; BSA 1.47 ± 0.33 m(2)) completed an incremental cardiopulmonary exercise test (25 W·3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V?o2peak) of 40.6 ± 8.9 ml·kg(-1)·min(-1) and a work rate of 154 ± 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P < 0.05). LV Sl during exercise was significantly correlated to resting strain, V?o2peak, oxygen pulse, and work rate (0.530 ? r ? 0.784, P < 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology. PMID:26475589

  3. COMPARISON OF CARDIOPULMONARY FUNCTION IN AWAKE FISCHER-344 AND SPRAGUE-DAWLEY RATS EXPOSED TO CARBON DIOXIDE: A COMPUTERIZED TECHNIQUE

    EPA Science Inventory

    A system has been developed to measure simultaneously the effects of inhaled toxicants on cardiopulmonary function in four awake rats before, during and after exposure. ne day prior to testing, Fischer-344 and Sprague-Dawley rats were implanted with an intrapleural or carotid cat...

  4. Exercise after breast cancer treatment: current perspectives

    PubMed Central

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

    Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. PMID:26543382

  5. USE OF A PROGRAMMABLE CALCULATOR IN CARDIOPULMONARY PERFUSION

    PubMed Central

    Mills, J. David; Tallent, Jerome H.

    1978-01-01

    This study describes a hand-held, battery-powered, programmable instrument (Calculator Model SR-52) that can be taken directly into the operating room by cardiopulmonary perfusionists. Three programs are described in detail: 1) Cardiopulmonary perfusion parameters and estimated blood volume; 2) blood gas parameters and saturations, with temperature corrections; and 3) cardiopulmonary oxygen transfer and oxygenator efficiency. This inexpensive calculator allows perfusion personnel to manipulate easily-derived data into values which heretofore have required elaborate nomograms or special slide rules—or were not available within a reasonable computational time. PMID:15216068

  6. USE OF A PROGRAMMABLE CALCULATOR IN CARDIOPULMONARY PERFUSION.

    PubMed

    Mills, J David; Tallent, Jerome H.

    1978-06-01

    This study describes a hand-held, battery-powered, programmable instrument (Calculator Model SR-52) that can be taken directly into the operating room by cardiopulmonary perfusionists. Three programs are described in detail: 1) Cardiopulmonary perfusion parameters and estimated blood volume; 2) blood gas parameters and saturations, with temperature corrections; and 3) cardiopulmonary oxygen transfer and oxygenator efficiency. This inexpensive calculator allows perfusion personnel to manipulate easily-derived data into values which heretofore have required elaborate nomograms or special slide rules-or were not available within a reasonable computational time. PMID:15216068

  7. Opening of Aortic Valve During Exercise Is Key to Preventing Development of Aortic Insufficiency During Ventricular Assist Device Treatment.

    PubMed

    Imamura, Teruhiko; Kinugawa, Koichiro; Nitta, Daisuke; Hatano, Masaru; Ono, Minoru

    2015-01-01

    Although we previously demonstrated that opening of the native aortic valve (AV) at rest prevents development of aortic insufficiency (AI) during continuous-flow (CF) left ventricular assist device (LVAD) support, the clinical impact of native AV opening during exercise remained unknown. We enrolled 37 patients with a closed native AV at rest 3 months after CF LVAD implantation and followed them from 2006 to 2014. Seven patients (19%) who achieved opening of the native AV during cardiopulmonary exercise testing at 3 months (opening AV group) had higher exercise tolerability and improved left ventricular contractility during exercise compared with those with a closed native AV (closed AV group) (p < 0.05 for all). The opening group experienced no AI at 6 months and had a higher readmission-free rate because of cardiovascular events compared with the closed group during the 2 years study period (100% vs. 56%, p = 0.005). Among those with a closed AV, use of the centrifugal pump was a significant predictor of AI-free status (p < 0.05; odds ratio, 5.400). In conclusion, opening of the native AV during exercise and centrifugal pump use were key to preventing the development of AI. Aggressive cardiac rehabilitation may have a prophylactic impact on development of AI during CF LVAD treatment. PMID:25955152

  8. Noninvasive ventilation and exercise tolerance in heart failure: A systematic review and meta-analysis

    PubMed Central

    Bündchen, Daiana C.; Gonzáles, Ana I.; Noronha, Marcos De; Brüggemann, Ana K.; Sties, Sabrina W.; Carvalho, Tales De

    2014-01-01

    Background: Patients with heart failure (HF) usually develop exercise intolerance. In this context, noninvasive ventilation (NIV) can help to increase physical performance. Objective: To undertake a systematic review and meta-analysis of randomized controlled trials that evaluated the effects of NIV on exercise tolerance in patients with HF. Method: Search Strategy: Articles were searched in the following databases: Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (SciELO), and MEDLINE. Selection Criteria: This review included only randomized controlled trials involving patients with HF undergoing NIV, with or without other therapies, that used exercise tolerance as an outcome, verified by the distance travelled in the six-minute walk test (6MWT), VO2peak in the cardiopulmonary test, time spent in testing, and dyspnea. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data were pooled in fixed-effect meta-analysis whenever possible. Results: Four studies were selected. A meta-analysis including 18 participants showed that the use of NIV prior to the 6MWT promoted increased distance, [mean difference 65.29 m (95% CI 38.80 to 91.78)]. Conclusions: The use of NIV prior to the 6MWT in patients with HF may promote increased distance. However, the limited number of studies may have compromised a more definitive conclusion on the subject. PMID:25372000

  9. Skill mastery in cardiopulmonary resuscitation training classes.

    PubMed

    Brennan, R T; Braslow, A

    1995-09-01

    The authors evaluated skill levels of trainees (n = 48) who were taught cardiopulmonary resuscitation (CPR) in "American Red Cross: Adult CPR" classes offered at a work site. The evaluation used a validated skill checklist and a Laerdal Skillmeter mannequin to assess trainee competence. Only 1 in 10 of the trainees could correctly perform all 12 CPR skills assessed by the skill checklist. Fewer than 12% of all compressions met published standards, and fewer than 25% of the ventilations met the standards as evaluated by the Skillmeter mannequin. All trainees felt confident they could use their CPR skills in an actual emergency; 64% were "very confident." Videotape recordings of the practice sessions showed that instructors overlooked many errors in CPR performance and that trainees provided little corrective feedback to one another. The role of instructors in assisting CPR skill practice and in evaluating skill mastery is questioned. PMID:7662050

  10. Insulin levels and HOMA index are associated with exercise capacity in patients with type 2 diabetes and coronary artery disease

    PubMed Central

    2014-01-01

    Background Previous studies on type 2 diabetes have shown an association between exercise capacity and insulin resistance. In patients with coronary artery disease (CAD) exercise capacity is often reduced due to exercise-induced ischemia. We have investigated the association between glucometabolic control, including the homeostatic model assessment (HOMA) of insulin resistance, and exercise capacity in patients with type 2 diabetes and CAD with and without exercise-induced ischemia. Methods In 137 patients (age 63.1?±?7.9) cardiopulmonary exercise testing on treadmill was performed using a modified Balke protocol. The highest oxygen uptake (VO2peak) was reported as 30-s average. Fasting blood samples were drawn for determination of glucose, insulin and HbA1c. Insulin resistance (IR) was assessed by the HOMA2-IR computer model. Exercise-induced ischemia was defined as angina and/ or ST-depression in ECG???0.1 mV during the exercise test. Results HOMA2-IR was inversely correlated to VO2peak (r?=?-0.328, p?exercise-induced ischemia (n?=?86), being numerically stronger in the group with ischemia (r?=?-0.430, p?=?0.003 and r?=?-0.276, p?=?0.014, respectively). Fasting glucose and HbA1c were not correlated with VO2peak or AT. Conclusions Insulin resistance, as estimated by fasting insulin and the HOMA index, was inversely associated with exercise capacity in patients with type 2 diabetes and CAD, the association being more pronounced in the subgroup with exercise-induced ischemia. These results indicate that insulin resistance is related to exercise capacity in type 2 diabetic patients with CAD, possibly even more so in patients with exercise-induced ischemia compared to those without. PMID:24612649

  11. Detection of Autonomic Dysfunction in Hemodialysis Patients Using the Exercise Treadmill Test: The Role of the Chronotropic Index, Heart Rate Recovery, and R-R Variability

    PubMed Central

    Carreira, Maria Angela M. Q.; Nogueira, André B.; Pena, Felipe M.; Kiuchi, Marcio G.; Rodrigues, Ronaldo C.; Rodrigues, Rodrigo R.; Matos, Jorge P. S.; Lugon, Jocemir R.

    2015-01-01

    Autonomic dysfunction is highly prevalent in hemodialysis patients and has been implicated in their increased risk of cardiovascular mortality. Objective To evaluate the ability of different parameters of exercise treadmill test to detect autonomic dysfunction in hemodialysis patients. Methods Cross-sectional study involving hemodialysis patients and a control group. Clinical examination, blood sampling, echocardiogram, 24-hour Holter, and exercise treadmill test were performed. A ramp treadmill protocol symptom-limited with active recovery was employed. Results Forty-one hemodialysis patients and 41 controls concluded the study. There was significant difference between hemodialysis patients and controls in autonomic function parameters in 24h-Holter and exercise treadmill test. Probability of having autonomic dysfunction in hemodialysis patients compared to controls was 29.7 at the exercise treadmill test and 13.0 in the 24-hour Holter. Chronotropic index, heart rate recovery at the 1st min, and SDNN at exercise were used to develop an autonomic dysfunction score to grade autonomic dysfunction, in which, 83% of hemodialysis patients reached a scoring ?2 in contrast to 20% of controls. Hemodialysis was independently associated with either altered chronotropic index or autonomic dysfunction scoring ?2 in every tested model (OR=50.1, P=0.003; and OR=270.9, P=0.002, respectively, model 5). Conclusion The exercise treadmill test was feasible and useful to diagnose of the autonomic dysfunction in hemodialysis patients. Chronotropic index and autonomic dysfunction scoring ?2 were the most effective parameters to differentiate between hemodialysis patients and controls suggesting that these variables portrays the best ability to detect autonomic dysfunction in this setting. PMID:26042678

  12. Exercise Hypertension

    PubMed Central

    Schultz, Martin G.; Sharman, James E.

    2014-01-01

    Irrespective of apparent ‘normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ?210 mm Hg in men or ?190 mm Hg in women or diastolic BP ?110 mm Hg in men or women), a condition termed exercise hypertension or a ‘hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory ‘masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

  13. Questionable Exercises.

    ERIC Educational Resources Information Center

    Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

    1999-01-01

    This publication presents general guidelines for exercise prescription that have an anatomical basis but also consider the exerciser's ability to do the exercise correctly. It reviews various common questionable exercises, explaining how some exercises, especially those designed for flexibility and muscle fitness, can cause harm. Safer…

  14. NAD(P)H oxidase and pro-inflammatory response during maximal exercise: role of C242T polymorphism of the P22PHOX subunit.

    PubMed

    Izzicupo, P; Di Valerio, V; D' Amico, M A; Di Mauro, M; Pennelli, A; Falone, S; Alberti, G; Amicarelli, F; Miscia, S; Gallina, S; Di Baldassarre, A

    2010-01-01

    Intense exercise induces a pro-inflammatory status through a mechanism involving the NAD(P)H oxidase system. We focused our attention on p22phox, a subunit of the NAD(P)H oxidase, and on its allelic polymorphism C242T, which is known to affect the functional activity of the enzyme. We investigated whether the p22phox C242T variants exhibit systemic effects in healthy subjects by analyzing the proinflammatory and cardiocirculatory responses to physical exercise in endurance athletes. The group of study consisted of 97 long distance runners, 37 +/- 4.4 yrs of age, with similar training history. The subjects underwent a maximal stress test during which both inflammatory and cardiopulmonary parameters were monitored. Our results demonstrate that T allele deeply influences the neutrophil activation in response to intense exercise, since T carriers were characterized by significantly lower release of myeloperoxidase (MPO), a classical leukocyte derived pro-inflammatory cytokine. In addition, the presence of T allele was associated with a higher cardiopulmonary efficiency as evidenced by a significantly lower Heart Rate (HR) at the peak of exercise and, when a dominant model was assumed, by a higher maximal oxygen uptake (VO2 max). On the other hand, no effects of 242T mutation on the plasmatic total antioxidant capacity (TAC) and on the cortisol responses to the physical exercise were detected. In conclusion, our data support a systemic role for p22phox C242T polymorphism that, modifying the intensity of the inflammatory response, can influence the cardiovascular adaptations elicited by aerobic training. These results contribute to support the hypothesis of a systemic effect for the C242T polymorphism and of its possible functional rebound in healthy subjects. PMID:20378006

  15. [Full Recovery from Cardiopulmonary Arrest caused by Traumatic Asphyxia].

    PubMed

    Hirade, Tomohiro; Murata, Susumu; Saito, Tsukasa; Ogawa, Kohei; Kodani, Nobuhiro; Sakakibara, Manabu; Hirade, Ritsuko; Kushizaki, Hiroyuki; Matsuda, Takashi; Minami, Kotaro; Nikai, Tetsuro; Nishina, Masayoshi

    2015-03-01

    Traumatic asphyxia is a crush injury of the chest characterized by facial edema, cyanosis, conjunctival hemorrhage, and petechiae on the face and chest. The prognosis depends on the duration of chest compression and early cardiopulmonary resuscitation after cardiopulmonary arrest. Here we report a case of full recovery from cardiopulmonary arrest caused by traumatic asphyxia. The chest of a 56-year-old man was compressed by a machine while working. Immediately, his colleague started cardiopulmonary resuscitation, which was successful. When he was admitted to our hospital, his consciousness level was E1V2M2(Glasgow coma scale). Our treatment included therapeutic hypothermia, the duration of which was 24 hours at 34 °C. Rewarming his body to 36 °C took place over 48 hours. Thereafter, he recovered completely and was discharged on the 12th hospital day without neurologic sequela. Therapeutic hypothermia was possibly effective in this case. PMID:25743548

  16. Sport climbing with pre-existing cardio-pulmonary medical conditions.

    PubMed

    Kuepper, T; Morrison, A; Gieseler, U; Schoeffl, V

    2009-06-01

    Over the past 25 years sport climbing has developed from an elite extreme sport subculture pursued by few into a mainstream recreational sport enjoyed globally by climbers of all ages, climbing abilities, and with pre-existing health conditions. As the demands and grades of climbing difficulty have increased over this period, most scientific literature on sport climbing focused on acute injuries and overuse syndromes, or performance physiology in healthy adult males. The physiological response to sport climbing is more similar to that of resistance training (i.e., body building) rather than a predominantly aerobic sport (i.e., running, cycling), so that heart rate and blood pressure during a climb will be disproportionately high relative to the 'exercise' of climbing, and breathing may be irregular. Therefore this review sought evidence-based recommendations for recreational sport climbing participation by those individuals with pre-existing cardiopulmonary medical conditions including coronary heart disease, chronic heart failure, cardiac dysrhythmia, pulmonary diseases (i.e., asthma) or hypertension. This review defines the criteria that must be fulfilled for safe sport climbing by those with pre-existing cardiopulmonary conditions or those with hypertension. PMID:19199210

  17. Impairment of cardiopulmonary receptor sensitivity in the early phase of heart failure

    PubMed Central

    Modesti, P A; Polidori, G; Bertolozzi, I; Vanni, S; Cecioni, I

    2004-01-01

    Objectives: To characterise the efficiency of the cardiopulmonary baroreflex system in the early phase of heart failure and its relation to limitation of physical activity. Design: Forearm blood flow (venous occlusion plethysmography), vascular resistance, and central venous pressure (CVP), estimated from an antecubital vein, were measured in the supine position at baseline and 15 minutes after application of lower body negative pressure at ?7 and ?14 mm Hg (receptor downloading) or leg raising (receptor loading). Subjects: Heart failure patients without limitation (NYHA class I; n ?=? 18) or with slight limitation of physical activity (NYHA class II; n ?=? 13), and 11 healthy controls. Results: The efficiency of the cardiopulmonary baroreflex function, expressed by the slope of the relation between CVP changes and the corresponding changes of calculated forearm vascular resistance (gain), was reduced both in NYHA class I patients (mean (SD) ?1.99 (0.83) v ?2.78 (0.66) in controls; p < 0.05) and NYHA class II patients (?1.29 (0.5); p<0.001 v controls). However, change in peripheral vascular resistance during preload increase was similar in controls (?3.3 (0.9) units) and in NYHA class I patients (?3.3 (2.1) units; NS v controls), and was significantly reduced only in NYHA class II patients (?1.6 (1.3) units, p < 0.03 v controls). The gain in the cardiopulmonary reflex was related to the distance walked during the six minute corridor test. Conclusions: A reduced tonic efficacy of the cardiopulmonary reflex system is already detectable in the early phase of heart failure, the impairment in acute response to preload increase being detectable only in symptomatic patients. PMID:14676236

  18. Genetic Regulation of Intrinsic Endurance Exercise Capacity in Mice 

    E-print Network

    Courtney, Sean M.

    2013-07-26

    Endurance exercise capacity is a powerful predictor of health status. Having low levels of endurance exercise capacity has been linked with cardiovascular disease. Variation in endurance exercise capacity, measured during a graded exercise test, has...

  19. Standards for Educational and Psychological Testing: More than a Symbolic Exercise.

    ERIC Educational Resources Information Center

    Yoshida, Roland K.; Friedman, Douglas L.

    1986-01-01

    The 1985 edition of the American Psychological Association's "Standards for Educational and Psychological Testing" has greatly expanded its coverage of the testing of handicapped students. Recent surveys of practitioners' knowledge of basic testing and measurement concepts suggest the need for extensive in-service training if these standards are…

  20. Exercise Physiologists

    MedlinePLUS

    ... personal trainers) or athletic trainers . <- Summary Work Environment -> Work Environment About this section Exercise physiologists perform fitness ... of exercise physiologists were self-employed in 2014. Work Schedules Most exercise physiologists work full time. <- What ...

  1. A Novel Rotary Pulsatile Flow Pump for Cardiopulmonary Bypass

    PubMed Central

    Teman, Nicholas R.; Mazur, Daniel E.; Toomasian, John; Jahangir, Emilia; Alghanem, Fares; Goudie, Marcus; Rojas-Peña, Alvaro; Haft, Jonathan W.

    2014-01-01

    It has been suggested that pulsatile blood flow is superior to continuous flow in cardiopulmonary bypass (CPB). However, adoption of pulsatile flow (PF) technology has been limited due to practically and complexity of creating a consistent physiologic pulse. A pediatric pulsatile rotary ventricular pump (PRVP) was designed to address this problem. We evaluated the PRVP in an animal model, and determined its ability to generate PF during CPB. The PRVP (modified peristaltic pump, with tapering of the outlet of the pump chamber) was tested in 4 piglets (10-12kg). Cannulation was performed with right atrial and aortic cannulae, and pressure sensors were inserted into the femoral arteries. Pressure curves were obtained at different levels of flow and compared with both the animal's baseline physiologic function and a continuous flow (CF) roller pump. Pressure and flow waveforms demonstrated significant pulsatility in the PRVP setup compared to CF at all tested conditions. Measurement of hemodynamic energy data, including the percent pulsatile energy and the surplus hydraulic energy, also revealed a significant increase in pulsatility with the PRVP (p <0.001). PRVP creates physiologically significant PF, similar to the pulsatility of a native heart, and has the potential to be easily implemented in pediatric CPB. PMID:24625536

  2. Menstrual cycle phase and carbohydrate ingestion alter immune response following endurance exercise and high intensity time trial performance test under hot conditions

    PubMed Central

    2014-01-01

    Background Sex hormones are known to regulate some responses during exercise. Evaluation of the differences in exercise response with regard to menstrual cycle will help understand the menstrual cycle phase specific adaptations to exercise and athletic performance. Methods We investigated the effects of menstrual cycle phase and carbohydrate (CHO) ingestion on immune response during endurance exercise at 30°C. Six healthy women completed 4 trials comprising 90 min of cycling at 50% peak aerobic power V?O2peak and a high intensity time trial performance test (POST). They ingested a placebo- or CHO-containing beverage during the trials, which were performed during both the follicular and luteal phases of the menstrual cycle. In all trials, thermoregulatory, cardiorespiratory, and immune responses were measured during exercise and after POST. Results Although the thermoregulatory responses differed between the menstrual cycle phases, the cardiorespiratory responses were not different. After placebo ingestion, leukocyte concentration (cells/?L) at POST (15.9?×?103) in the luteal phase was significantly higher than that in the follicular phase (12.9?×?103). The rise in leukocyte concentration was attenuated upon CHO ingestion, and the difference between menstrual cycle phases disappeared. A significant positive correlation was found between leukocyte concentration and serum free fatty acid concentrations. Interleukin-6, calprotectin, and myeloperoxidase concentrations significantly increased at POST in all trials, but no significant differences were observed between menstrual cycle phase or beverage type. Concentrations of other cytokines did not change during exercise in any of the 4 trials. Menstrual cycle phase and beverage type had no significant effect on the POST outcome. Thus, differences in leukocyte mobilization between menstrual cycle phases could result from the effect of sex hormones on substrate utilization. Conclusions The menstrual cycle affected circulating leukocyte concentrations during endurance exercise with POST when a placebo was ingested. Therefore, we recommend ingesting CHO beverages to attenuate immune disturbances, especially in the luteal phase, even though they are unlikely to enhance test performance. PMID:25342934

  3. Unique Testing Capabilities of the NASA Langley Transonic Dynamics Tunnel, an Exercise in Aeroelastic Scaling

    NASA Technical Reports Server (NTRS)

    Ivanco, Thomas G.

    2013-01-01

    NASA Langley Research Center's Transonic Dynamics Tunnel (TDT) is the world's most capable aeroelastic test facility. Its large size, transonic speed range, variable pressure capability, and use of either air or R-134a heavy gas as a test medium enable unparalleled manipulation of flow-dependent scaling quantities. Matching these scaling quantities enables dynamic similitude of a full-scale vehicle with a sub-scale model, a requirement for proper characterization of any dynamic phenomenon, and many static elastic phenomena. Select scaling parameters are presented in order to quantify the scaling advantages of TDT and the consequence of testing in other facilities. In addition to dynamic testing, the TDT is uniquely well-suited for high risk testing or for those tests that require unusual model mount or support systems. Examples of recently conducted dynamic tests requiring unusual model support are presented. In addition to its unique dynamic test capabilities, the TDT is also evaluated in its capability to conduct aerodynamic performance tests as a result of its flow quality. Results of flow quality studies and a comparison to a many other transonic facilities are presented. Finally, the ability of the TDT to support future NASA research thrusts and likely vehicle designs is discussed.

  4. Methods for determining pediatric thoracic force-deflection characteristics from cardiopulmonary resuscitation.

    PubMed

    Maltese, Matthew R; Castner, Thomas; Niles, Dana; Nishisaki, Akira; Balasubramanian, Sriram; Nysaether, Jon; Sutton, Robert; Nadkarni, Vinay; Arbogast, Kristy B

    2008-11-01

    Accurate pediatric thoracic force and deflection data are critical to develop biofidelic pediatric anthropomorphic test devices (ATDs) used in designing motor vehicle safety systems for child occupants. Typically, post-mortem human subject (PMHS) experiments are conducted to gather such data. However, there are few pediatric PMHS available for impact research, therefore novel methods are required to determine pediatric biomechanical data from children. In this study, we have leveraged the application of chest compressions provided in the clinical environment during pediatric cardiopulmonary resuscitation (CPR) to collect this fundamental data. The maximum deflection of the chest during CPR is in the range of chest deflections in PMHS impact experiments and therefore CPR exercises the chest in ways that are meaningful for biofidelity assessment. Thus, the goal of this study was to measure the force-deflection characteristics of the thorax of children and young adults during CPR. To do so, a force and deflection sensor was integrated into a patient monitor-defibrillator used during CPR in the Pediatric Intensive Care Unit and Emergency Department of a children's hospital. The sensor was interposed between the chest of the patient and hands of the rescuer during CPR compressions. Following a CPR event, thoracic force and deflection data were downloaded from the monitor-defibrillator for analysis. Each compression cycle was fit to a parallel spring-damper model, wherein stiffness and damping were linearly dependent on chest deflection. Average maximum chest deflection, force at maximum deflection, linear stiffness, and elastic and viscous model forces are reported for each subject and correlated with age. Eighteen subjects (11 females) ages 8 to 22 years were enrolled in the study and each received a mean of 2000 (Standard Deviation 2339) chest compressions during CPR. Average maximum chest deflection and corresponding force were 39 +/- 5 mm and 309 +/- 55 N respectively. When combined with our previous study of adult CPR data, and other data from the literature, our findings suggest that the stiffness of the thorax increases from youth to middle age, and then decreases in the elderly. CPR has the potential to provide data from a wide range of human subjects with which to study the effect of age on mechanics of thoracic deformation. Future studies will expand the sample size and age range of data collected to further explore the age-related changes in thoracic mechanics. PMID:19085159

  5. Cardiopulmonary data acquisition system. Version 2.0, volume 1: User's guide

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The Cardiopulmonary Data Acquisition System is a computerized method of both collecting and analyzing physiological data on subjects during a treadmill or ergometer stress test in the clinic. The real time acquisition of the physiological data, such as, heart rate, blood pressure, work load, and respiratory gases is accomplished by an LSI-11 microcomputer which displays this data on a hard copy terminal. The data are also concurrently stored on a mass storage device and anytime after the test period a selectable number of copies of the plots or minute reports can be reproduced at the terminal.

  6. Prognostic importance of tissue velocity imaging during exercise echocardiography in patients with systolic heart failure

    PubMed Central

    van Zalen, Jet; Patel, Nikhil R; J Podd, Steven; Raju, Prashanth; McIntosh, Rob; Brickley, Gary; Beale, Louisa; Sturridge, Lydia P

    2015-01-01

    Resting echocardiography measurements are poor predictors of exercise capacity and symptoms in patients with heart failure (HF). Stress echocardiography may provide additional information and can be expressed using left ventricular ejection fraction (LVEF), or diastolic parameters (E/E?), but LVEF has some major limitations. Systolic annular velocity (S?) provides a measure of longitudinal systolic function, which is relatively easy to obtain and shows a good relationship with exercise capacity. The objective of this study was to investigate the relationship among S?, E/E? and LVEF obtained during stress echocardiography and both mortality and hospitalisation. A secondary objective was to compare S? measured using a simplified two-wall model. A total of 80 patients with stable HF underwent exercise stress echocardiography and simultaneous cardiopulmonary exercise testing. Volumetric and tissue velocity imaging (TVI) measurements were obtained, as was peak oxygen uptake (VO2 peak). Of the total number of patients, 11 died and 22 required cardiac hospitalisation. S? at peak exertion was a powerful predictor for death and hospitalisation. Cut-off points of 5.3?cm/s for death and 5.7?cm/s for hospitalisation provided optimum sensitivity and specificity. This study suggests that, in patients with systolic HF, S? at peak exertion calculated from the averaged spectral TVI systolic velocity of six myocardial segments, or using a simplified measure of two myocardial segments, is a powerful predictor of future events and stronger than LVEF, diastolic velocities at rest or exercise and VO2 peak. Results indicate that measuring S? during exercise echocardiography might play an important role in understanding the likelihood of adverse clinical outcomes in patients with HF.

  7. The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance

    PubMed Central

    2013-01-01

    Background Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. Methods The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20?cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user’s arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24?months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45?minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. Results In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0.009). Subjects did not report discomfort or an increase in arm pain with rocking. Improvements were sustained at three months. Conclusions These results demonstrate that a simple mechanical device that snaps onto a manual wheelchair can use resonance to assist arm training, and that such training shows potential for safely increasing arm movement ability for people with severe chronic hemiparetic stroke. PMID:23597303

  8. Pilot Testing a Cognitive-Behavioral Protocol on Psychosocial Predictors of Exercise, Nutrition, Weight, and Body Satisfaction Changes in a College-Level Health-Related Fitness Course

    ERIC Educational Resources Information Center

    Annesi, James J.; Howton, Amy; Johnson, Ping H.; Porter, Kandice J.

    2015-01-01

    Objective: Small-scale pilot testing of supplementing a required college health-related fitness course with a cognitive-behavioral exercise-support protocol (The Coach Approach). Participants: Three classes were randomly assigned to Usual processes (n = 32), Coach Approach-supplemented: Mid-size Groups (n = 32), and Coach Approach-supplemented:…

  9. Baroreflex-mediated heart rate and vascular resistance responses 24 h after maximal exercise

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.

    2003-01-01

    INTRODUCTION: Plasma volume, heart rate (HR) variability, and stimulus-response relationships for baroreflex control of forearm vascular resistance (FVR) and HR were studied in eight healthy men after and without performing a bout of maximal exercise to test the hypotheses that acute expansion of plasma volume is associated with 1) reduction in baroreflex-mediated HR response, and 2) altered operational range for central venous pressure (CVP). METHODS: The relationship between stimulus (DeltaCVP) and vasoconstrictive reflex response (DeltaFVR) during unloading of cardiopulmonary baroreceptors was assessed with lower-body negative pressure (LBNP, 0, -5, -10, -15, -20 mm Hg). The relationship between stimulus (Deltamean arterial pressure (MAP)) and cardiac reflex response (DeltaHR) during loading of arterial baroreceptors was assessed with steady-state infusion of phenylephrine (PE) designed to increase MAP by 15 mm Hg alone and during application of LBNP (PE+LBNP) and neck pressure (PE+LBNP+NP). Measurements of vascular volume and autonomic baroreflex responses were conducted on two different test days, each separated by at least 1 wk. On one day, baroreflex response was tested 24 h after graded cycle exercise to volitional exhaustion. On another day, measurement of baroreflex response was repeated with no exercise (control). The order of exercise and control treatments was counterbalanced. RESULTS: Baseline CVP was elevated (P = 0.04) from a control value of 10.5 +/- 0.4 to 12.3 +/- 0.4 mm Hg 24 h after exercise. Average DeltaFVR/DeltaCVP during LBNP was not different (P = 0.942) between the exercise (-1.35 +/- 0.32 pru x mm Hg-1) and control (-1.32 +/- 0.36 pru x mm Hg-1) conditions. However, maximal exercise caused a shift along the reflex response relationship to a higher CVP and lower FVR. HR baroreflex response (DeltaHR/DeltaMAP) to PE+LBNP+NP was lower (P = 0.015) after maximal exercise (-0.43 +/- 0.15 beats x min-1 x mm Hg-1) compared with the control condition (-0.83 +/- 0.14 beats x min-1 x mm Hg-1). CONCLUSION: Expansion of vascular volume after acute exercise is associated with altered operational range for CVP and reduced HR response to arterial baroreceptor stimulation.

  10. Anisn-Dort Neutron-Gamma Flux Intercomparison Exercise for a Simple Testing Model

    NASA Astrophysics Data System (ADS)

    Boehmer, B.; Konheiser, J.; Borodkin, G.; Brodkin, E.; Egorov, A.; Kozhevnikov, A.; Zaritsky, S.; Manturov, G.; Voloschenko, A.

    2003-06-01

    The ability of transport codes ANISN, DORT, ROZ-6, MCNP and TRAMO, as well as nuclear data libraries BUGLE-96, ABBN-93, VITAMIN-B6 and ENDF/B-6 to deliver consistent gamma and neutron flux results was tested in the calculation of a one-dimensional cylindrical model consisting of a homogeneous core and an outer zone with a single material. Model variants with H2O, Fe, Cr and Ni in the outer zones were investigated. The results are compared with MCNP-ENDF/B-6 results. Discrepancies are discussed. The specified test model is proposed as a computational benchmark for testing calculation codes and data libraries.

  11. Effectiveness of the BBC's 999 training roadshows on cardiopulmonary resuscitation: video performance of cohort of unforewarned participants at home six months afterwards.

    PubMed Central

    Morgan, C. L.; Donnelly, P. D.; Lester, C. A.; Assar, D. H.

    1996-01-01

    OBJECTIVE: To examine the competence of a cohort trained in cardiopulmonary resuscitation by the BBC's 999 training roadshows. DESIGN: Descriptive cohort study applying an innovative testing procedure to a nationwide systematic sample. The test sample received an unsolicited home visit and without warning were required to perform cardiopulmonary resuscitation on a manikin while being videoed. The videos were then analysed for effectiveness and safety using the new test. SETTING: Nine cities and surrounding areas in the United Kingdom. SUBJECTS: 280 people aged between 11 and 72. RESULTS: Thirty three (12%) trainees were able to perform effective cardiopulmonary resuscitation, but of these 14 (5%) performed one or more elements in a way that was deemed to be potentially injurious. Thus only 19 (7%) trainees were able at six months to provide safe cardiopulmonary resuscitation. In addition, large numbers of subjects failed to shout for help, effectively assess the status of the patient, or alert an ambulance. Significantly better performances were recorded by those under 45 years old (31 (14%) v 2 (4%) gave effective performances respectively, P < 0.05), those who had attended a subsequent cardiopulmonary resuscitation course (8 (40%) v 25 (10%) gave effective performances respectively, P < 0.0001), and those confident in their initial ability (26 (20%) v 7 (6%) gave effective performances respectively, P < 0.005). Females were significantly less likely than males to perform procedures in a harmful way (117 (62%) v 10 (12%) performed safely respectively, P < 0.005). CONCLUSION: Television is an effective means of generating large training cohorts. Volunteers will cooperate with unsolicited testing in their home, such testing being a realistic simulation of the stress and lack of forewarning that would surround a real event. Under such conditions the performance of cardiopulmonary resuscitation was disappointing. However, retraining greatly improves performance. PMID:8876093

  12. Video quality of 3G videophones for telephone cardiopulmonary resuscitation.

    PubMed

    Tränkler, Uwe; Hagen, Oddvar; Horsch, Alexander

    2008-01-01

    We simulated a cardiopulmonary resuscitation (CPR) scene with a manikin and used two 3G videophones on the caller's side to transmit video to a laptop PC. Five observers (two doctors with experience in emergency medicine and three paramedics) evaluated the video. They judged whether the manikin was breathing and whether they would give advice for CPR; they also graded the confidence of their decision-making. Breathing was only visible from certain orientations of the videophones, at distances below 150 cm with good illumination and a still background. Since the phones produced a degradation in colours and shadows, detection of breathing mainly depended on moving contours. Low camera positioning produced better results than having the camera high up. Darkness, shaking of the camera and a moving background made detection of breathing almost impossible. The video from the two 3G videophones that were tested was of sufficient quality for telephone CPR provided that camera orientation, distance, illumination and background were carefully chosen. Thus it seems possible to use 3G videophones for emergency calls involving CPR. However, further studies on the required video quality in different scenarios are necessary. PMID:18852326

  13. Utility of Routine Exercise Testing to Detect Rate-Related QRS Widening in Patients Without Structural Heart Disease on Class Ic Antiarrhythmic Agents (Flecainide and Propafenone).

    PubMed

    Vallurupalli, Srikanth; Pothineni, Naga Venkata K; Deshmukh, Abhishek; Paydak, Hakan

    2015-09-01

    Class Ic antiarrhythmic agents are effective in the treatment of various atrial tachyarrhythmias. They are known to cause rate-related QRS widening in the presence of structural heart disease, which can lead to life-threatening arrhythmias. The role of routine exercise electrocardiography in patients without structural heart disease is unknown. All patients initiated on class Ic antiarrhythmic agents and who had exercise electrocardiography performed from June 2009 to June 2013 were included. Symptom-limited treadmill electrocardiography was performed to detect significant QRS widening at peak exercise (defined as an increase of >25% of baseline QRS). Fifty-six patients were included in the study. All patients were screened for structural heart disease before initiation of the medication. Significant QRS widening and atrial tachycardia occurred in a single patient, which terminated with cessation of exercise. This patient had a history of tachycardia-mediated cardiomyopathy with normalization of ejection fraction 3 years before being placed on flecainide. In conclusion, routine exercise testing to detect QRS widening is not warranted in patients with no structural heart disease. PMID:26100588

  14. A Laboratory Exercise for Compatibility Testing of Hazardous Wastes in an Environmental Analysis Course.

    ERIC Educational Resources Information Center

    Chang, J. C.; And Others

    1986-01-01

    Discusses a new program at the University of Michigan in hazardous waste management. Describes a laboratory demonstration that deals with the reactivity and potential violence of several reactions that may be encountered on a hazardous waste site. Provides criteria for selecting particular compatibility testing methods. (TW)

  15. HEAVY-DUTY TRUCK TEST CYCLES: COMBINING DRIVEABILITY WITH REALISTIC ENGINE EXERCISE

    EPA Science Inventory

    Heavy-duty engine certification testing uses a cycle that is scaled to the capabilities of each engine. As such, every engine should be equally challenged by the cycle's power demands. It would seem that a chassis cycle, similarly scaled to the capabilities of each vehicle, could...

  16. Delivery of cardiopulmonary resuscitation in the microgravity environment

    NASA Technical Reports Server (NTRS)

    Barratt, M. R.; Billica, R. D.

    1992-01-01

    The microgravity environment presents several challenges for delivering effective cardiopulmonary resuscitation (CPR). Chest compressions must be driven by muscular force rather than by the weight of the rescuer's upper torso. Airway stabilization is influenced by the neutral body posture. Rescuers will consist of crew members of varying sizes and degrees of physical deconditioning from space flight. Several methods of CPR designed to accommodate these factors were tested in the one G environment, in parabolic flight, and on a recent shuttle flight. Methods: Utilizing study participants of varying sizes, different techniques of CPR delivery were evaluated using a recording CPR manikin to assess adequacy of compressive force and frequency. Under conditions of parabolic flight, methods tested included conventional positioning of rescuer and victim, free floating 'Heimlich type' compressions, straddling the patient with active and passive restraints, and utilizing a mechanical cardiac compression assist device (CCAD). Multiple restrain systems and ventilation methods were also assessed. Results: Delivery of effective CPR was possible in all configurations tested. Reliance on muscular force alone was quickly fatiguing to the rescuer. Effectiveness of CPR was dependent on technique, adequate restraint of the rescuer and patient, and rescuer size and preference. Free floating CPR was adequate but rapidly fatiguing. The CCAD was able to provide adequate compressive force but positioning was problematic. Conclusions: Delivery of effective CPR in microgravity will be dependent on adequate resuer and patient restraint, technique, and rescuer size and preference. Free floating CPR may be employed as a stop gap method until patient restraint is available. Development of an adequate CCAD would be desirable to compensate for the effects of deconditioning.

  17. Impact of percutaneous pulmonary valve implantation for right ventricular outflow tract dysfunction on exercise recovery kinetics.

    PubMed

    Lurz, Philipp; Riede, Frank T; Taylor, Andrew M; Wagner, Robert; Nordmeyer, Johannes; Khambadkone, Sachin; Kinzel, Peter; Derrick, Graham; Schuler, Gerhard; Bonhoeffer, Philipp; Giardini, Alessandro; Daehnert, Ingo

    2014-11-15

    The recovery of cardiopulmonary variables from peak exercise in patients with pulmonary stenosis (PS) or regurgitation (PR) is delayed, but the impact of treating PS or PR on exercise recovery kinetics is unknown. 43 patients (median age 14 years) with PS (n = 23) or PR (n = 20) after repair of congenital heart disease underwent successful percutaneous pulmonary valve implantation (PPVI). Cardiopulmonary exercise tests (CPET) were performed both before and within 1 month after PPVI. Apart from peak oxygen uptake (VO2), the constant decay of VO2, CO2 output (VCO2), minute ventilation (VE), and heart rate (HR) and oxygen pulse were calculated for the first minute of recovery as the first-degree slope of a single linear relation. PPVI led to a significant improvement in NYHA functional class in the PS and PR groups (p<0.001 and p=0.0015, respectively). On CPET, peak VO2 improved post-PPVI only in the PS (25.6 ± 6.2 vs. 27.8 ± 7.9 ml/kg/min; p = 0.01) but not PR group (29.0 ± 9.8 vs. 28.6 ± 8.9 ml/kg/min; p = 0.6). However, VO2 slope improved in the PS (0.40 ± 0.23 vs. 0.65 ± 0.27, p < 0.001) as well as in the PR group (0.56 ± 0.37 vs. 0.67 ± 0.37, p = 0.003) as did VCO2 slope (0.39 ± 0.2 vs. 0.55 ± 0.24, p = 0.002 and 0.42 ± 0.33 vs. 0.53 ± 0.35, p = 0.02: for the PS and PR groups, respectively). The VE and HR slopes did not change after PPVI. Despite the lack of improvement in exercise capacity in the PR group, treatment of PS and PR by PPVI induces significant and similar improvements in the ability of recovering from maximal exercise in the 2 groups. PMID:25499392

  18. Work performance evaluation using the exercising rat model

    SciTech Connect

    Stavert, D.M.; Lehnert, B.E.

    1987-01-01

    A treadmill-metabolic chamber system and a stress testing protocol have been developed to evaluate aerobic work performance on exercising rats that have inhaled toxic substances. The chamber with an enclosed treadmill provides the means to measure the physiologic status of rats during maximal work intensities in terms of O/sub 2/ consumption (V/sub 02/) and CO/sub 2/ production (V/sub c02/). The metabolic chamber can also accommodate instrumented rats for more detailed analyses of their cardiopulmonary status, e.g., ECG, cardiac output, arterial blood gases and pH, and arterial and venous blood pressures. For such studies, an arterial/venous catheter preparation is required. Because of the severe metabolic alterations after such surgery, a post surgical recovery strategy using hyperalimentation was developed to ensure maximal performance of instrumented animals during stress testing. Actual work performance studies are conducted using an eight minute stress test protocol in which the rat is subjected to increasing external work. The metabolic state of the animal is measured from resting levels to maximum oxygen consumption (V/sub 02max/). V/sub 02max/ has been shown to be reproducible in individual rats and is a sensitive indicator of oxidant gas-induced pulmonary damage. 3 tabs.

  19. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Roller-type cardiopulmonary bypass blood pump. 870... Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a revolving roller mechanism to pump the blood through...

  20. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass on-line blood gas monitor... Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in conjunction with a blood gas sensor to measure the level of gases in the...

  1. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonroller-type cardiopulmonary bypass blood pump... Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other than revolving rollers to pump the blood...

  2. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Roller-type cardiopulmonary bypass blood pump. 870... Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a revolving roller mechanism to pump the blood through...

  3. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonroller-type cardiopulmonary bypass blood pump... Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other than revolving rollers to pump the blood...

  4. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class...

  5. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass on-line blood gas monitor... Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in conjunction with a blood gas sensor to measure the level of gases in the...

  6. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class...

  7. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass heart-lung machine console... Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine... heart-lung machine. The console is designed to interface with the basic units used in a gas...

  8. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass heart-lung machine console... Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine... heart-lung machine. The console is designed to interface with the basic units used in a gas...

  9. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass heart-lung machine console... Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine... heart-lung machine. The console is designed to interface with the basic units used in a gas...

  10. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass heart-lung machine console... Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine... heart-lung machine. The console is designed to interface with the basic units used in a gas...

  11. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heart-lung machine console... Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine... heart-lung machine. The console is designed to interface with the basic units used in a gas...

  12. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system to filter...

  13. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system to filter...

  14. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system to filter...

  15. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system to filter...

  16. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system to filter...

  17. Transport of Critically Ill Children on Cardiopulmonary Support Assistance

    PubMed Central

    Eldadah, Maher K.; Olsen, Monica C.; Fakioglu, Harun; DeCampli, William M.

    2010-01-01

    Abstract: Objective: To report two patients helicopter transport on mechanical cardiopulmonary support to a transplant center. Setting: Cardiac intensive care unit (CICU) and transport helicopter. Patients: A 9 kg and 22 kg children who suffer cardiac deterioration needing air transport on mechanical cardiopulmonary support. Interventions and Results: CPS was initiated to support these patients failing cardiac function. Transport on CPS of these two patients to a transplant institution was accomplished after determining that heart transplantation would be their more likely chance for recovery. Conclusion: A cardiac deterioration event that will lead to the need for heart transplantation can be acute and sudden sparing no time for early referral to a transplant center. It is necessary for heart centers to have a plan of action to provide inter-hospital transport on cardiopulmonary support (CPS). This protocol can involve transport by the refer ral institution, the receiving institution or a third institution. PMID:20437797

  18. Dirofilaria immitis infection in dogs: cardiopulmonary biomarker levels.

    PubMed

    Carretón, E; Corbera, J A; Juste, M C; Morchón, R; Simón, F; Montoya-Alonso, J A

    2011-03-22

    Cardiopulmonary biomarkers are biological parameters that can be objectively measured and quantified as indicators of pathogenic processes (heartworm disease) or as indicators of response to therapeutic intervention. To determine levels of cardiopulmonary biomarkers in canine dirofilariasis, measurements of cardiac troponin T, cardiac troponin I, myoglobin, and D-dimer concentrations were performed for dogs with and without evidence of adult heartworm infection. The results showed that levels of cardiac troponin T were undetectable in all dogs studied while levels of cardiac troponin I were higher in dogs infected with Dirofilaria immitis. In healthy dogs, levels of myoglobin and D-dimer were below detection limits of the instrument and were significantly higher in heartworm-infected dogs, notably in microfilaremic dogs. The results suggest the possibility of using troponin I and myoglobin as markers for cardiac damage and the D-dimer as a supportive tool for a diagnosis of pulmonary thromboembolism in dogs with cardiopulmonary dirofilariasis. PMID:21310535

  19. Autonomic adjustments to exercise in humans.

    PubMed

    Fisher, James P; Young, Colin N; Fadel, Paul J

    2015-04-01

    Autonomic nervous system adjustments to the heart and blood vessels are necessary for mediating the cardiovascular responses required to meet the metabolic demands of working skeletal muscle during exercise. These demands are met by precise exercise intensity-dependent alterations in sympathetic and parasympathetic nerve activity. The purpose of this review is to examine the contributions of the sympathetic and parasympathetic nervous systems in mediating specific cardiovascular and hemodynamic responses to exercise. These changes in autonomic outflow are regulated by several neural mechanisms working in concert, including central command (a feed forward mechanism originating from higher brain centers), the exercise pressor reflex (a feed-back mechanism originating from skeletal muscle), the arterial baroreflex (a negative feed-back mechanism originating from the carotid sinus and aortic arch), and cardiopulmonary baroreceptors (a feed-back mechanism from stretch receptors located in the heart and lungs). In addition, arterial chemoreceptors and phrenic afferents from respiratory muscles (i.e., respiratory metaboreflex) are also capable of modulating the autonomic responses to exercise. Our goal is to provide a detailed review of the parasympathetic and sympathetic changes that occur with exercise distinguishing between the onset of exercise and steady-state conditions, when appropriate. In addition, studies demonstrating the contributions of each of the aforementioned neural mechanisms to the autonomic changes and ensuing cardiac and/or vascular responses will be covered. PMID:25880502

  20. Gravity and Development of Cardiopulmonary Reflex

    NASA Astrophysics Data System (ADS)

    Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

    Cardio-pulmonary reflex, which our cardiac activity is synchronized to the respiration by autonomic nervous system regulation, is called as "respiratory sinus arrhythmia" and commonly found in adult. The physiological function of the espiratory sinus arrhythmia is considered to maximize the gas exchange during respiration cycle. This respiration induced heart rate variability (RHRV) is only found in mammals and avian showing a remarkable postnatal development, whereas no RHRV in aquatic species such as fish or amphibian. To elucidate our hypothesis that gravity exposure may plays a key role in the postnatal development of RHRV as well as its evolutional origin in these ground animals, we have studied effects of hypergravity (2G) on the postnatal development of RHRV using rat. Pregnant Wister rats were kept in centrifugal cages system for 38 days from 6th days of pregnant mother to have neonates until 23 days old. Electrocardiograph was recorded from the neonates in 2 to 23 days old in 2G group with simultaneous control (1G) group. The RHRV analysis was performed by calculating a component of Fourier power spectral coincide with the respiration frequency. In both groups, averaged resting heart rate gradually increase from 2 to 23 days old. When comparing the heart rate between the two groups, the 2G group indicated significantly lower (240± 8 bpm) than 1G control (326±21 bpm, p¡0.001) in 2 days old, where as no significance in 23 days old. The RHRV of 2 days old neonates in both groups indicated very small magnitude but significantly lower in 2G group than 1G control (p¡0.01). The RHRV gradually increase during the first 2 weeks and then rapid increased to reached 45 fold of magnitude in 1G control, whereas 69 fold in 2G group. The results strongly suggested that the postnatal innervation from respiration to cardiovascular centers was gravity dependent.

  1. Influence of Endurance Exercise Overloading Patterns on the Levels of Left Ventricular Catechoamines After a Bout of Lactate Threshold Test in Male Wistar Rat

    PubMed Central

    Azad, Ahmad; Ghasemi, Fatemeh; Rahmani, Ahmad

    2015-01-01

    Background: It is well known that exercise training has positive effect on catecholamine response to a given work load. But in this regard, the effective method of training needs to be studied. Objectives: The aim of this study was to compare the effects of 8 weeks endurance exercise with two overloading patterns on the left ventricular catecholamine levels. Materials and Methods: 29 male Wistar rats were randomly assigned to control (n = 9), daily sinusoidal overloading (n = 10) and weekly sinusoidal overloading (n = 10) groups. After the last exercise session, left ventricular blood samples were obtained immediately after lactate threshold test. Plasma concentrations of adrenaline and noradrenaline were measured by ELISA method. One way analysis of variance was used for analysis of the data. Results: Immediately after lactate threshold test, adrenaline level was significantly (P < 0.05) lower in weekly loading group than in control and daily loading groups. Adrenaline was higher in the daily loading group compared with control group but did not reach the significant level. Noradrenaline levels were not significantly (P > 0.05) different between three study groups. Conclusions: The results showed 8 weeks of endurance exercise with weekly sinusoidal overloading pattern could induce a lower adrenal medulla activity (reflection of physical and physiological improvement) than daily sinusoidal loading pattern in response to the same absolute work load. PMID:26715962

  2. Effects of ankle strengthening exercises combined with motor imagery training on the timed up and go test score and weight bearing ratio in stroke patients

    PubMed Central

    Kim, Sung Shin; Lee, Hyung Jin; You, Young Youl

    2015-01-01

    [Purpose] The purpose of the present study was to compare the effects of ankle strengthening exercises combined with motor imagery training and those of ankle strengthening exercises alone in stroke patients. [Subjects and Methods] Thirty stroke patients were randomly assigned to one of the following two groups: experimental group (15 patients) and control group (15 patients). The experimental group underwent motor imagery training for 15 minutes and ankle joint strengthening exercises for 15 minutes, while the control group underwent only ankle joint strengthening exercises for 30 minutes. Each session and training program was implemented four times a week for 4 weeks. The timed up and go (TUG) test score, affected-side weight bearing ratio, and affected-side front/rear weight bearing ratio were assessed. [Results] Both groups demonstrated improvement on the TUG test, and in the affected-side weight bearing ratios, affected-side front/rear weight bearing ratios, and balance errors. The experimental group demonstrated greater improvement than the control group in all variables. [Conclusion] Motor imagery training is an effective treatment method for improving static balance ability in stroke patients. PMID:26311971

  3. Aerobic and anaerobic exercise training in obese adults

    PubMed Central

    Al Saif, Amer; Alsenany, Samira

    2015-01-01

    [Purpose] Obesity is a global health problem and is associated with a multitude of complications. This study was designed to determine changes in cardiopulmonary functions after aerobic and anaerobic exercise training in obese subjects. [Subjects and Methods] Forty obese subjects, whose ages ranged between 18 and 25?years, were divided into 2 equal groups: group A received aerobic exercise training in addition to dietary measures, and group B received anaerobic exercise training for 3 months in addition to dietary measures. Measurements of systolic blood pressure, diastolic blood pressure, heart rate, maximum voluntary ventilation, maximal oxygen consumption, and body mass index were obtained for both groups before and after the exercise program. [Results] The mean body mass index, systolic blood pressure, diastolic blood pressure, heart rate, and maximal oxygen consumption decreased significantly, whereas the mean maximum voluntary ventilation increased significantly after treatment in group A. The mean maximum voluntary ventilation also increased significantly after treatment in group B. There were significant differences between the mean levels of the investigated parameters in groups A and B after treatment. [Conclusion] Aerobic exercise reduces weight and improves cardiopulmonary fitness in obese subjects better than anaerobic exercise. PMID:26180300

  4. Synchronization and Cardio-pulmonary feedback in Sleep Apnea

    NASA Astrophysics Data System (ADS)

    Xu, Limei; Ivanov, Plamen Ch.; Chen, Zhi; Hu, Kun; Paydarfar, David; Stanley, H. Eugene

    2004-03-01

    Findings indicate a dynamical coupling between respiratory and cardiac function. However, the nature of this nonlinear interaction remains not well understood. We investigate transient patterns in the cardio-pulmonary interaction under healthy conditions by means of cross-correlation and nonlinear synchronization techniques, and we compare how these patterns change under pathologic conditions such as obstructive sleep apnea --- a periodic cessation of breathing during sleep. We find that during apnea episodes the nonlinear features of cardio-pulmonary interaction change intermittently, and can exhibit variations characterized by different time delays in the phase synchronization between breathing and heartbeat dynamics.

  5. Effect of cardiopulmonary bypass on gastrointestinal perfusion and function.

    PubMed

    Gaer, J A; Shaw, A D; Wild, R; Swift, R I; Munsch, C M; Smith, P L; Taylor, K M

    1994-02-01

    Gastric mucosal tonometry was used to determine the adequacy of gastrointestinal perfusion in 10 patients undergoing elective myocardial revascularization. Patients were prospectively randomized to receive either pulsatile or nonpulsatile flow during cardiopulmonary bypass. All patients showed a reduction in gastric mucosal perfusion during bypass, manifested by a reduction in the gastric mucosal pH, which occurred independently of variations in the arterial pH. In the group of patients receiving nonpulsatile flow, this reduction was significantly greater (p < 0.05). Cardiopulmonary bypass using nonpulsatile flow is associated with the development of a gastric mucosal acidosis, which may have implications for the development of postoperative complications. PMID:8311598

  6. Proposing a standardized method for evaluating patient report of the intensity of dyspnea during exercise testing in COPD

    PubMed Central

    Hareendran, Asha; Leidy, Nancy K; Monz, Brigitta U; Winnette, Randall; Becker, Karin; Mahler, Donald A

    2012-01-01

    Background Measuring dyspnea intensity associated with exercise provides insights into dyspnea-limited exercise capacity, and has been used to evaluate treatment outcomes for chronic obstructive pulmonary disease (COPD). Three patient-reported outcome scales commonly cited for rating dyspnea during exercise are the modified Borg scale (MBS), numerical rating scale for dyspnea (NRS-D), and visual analogue scale for dyspnea (VAS-D). Various versions of each scale were found. Our objective was to evaluate the content validity of scales commonly used in COPD studies, to explore their ability to capture patients’ experiences of dyspnea during exercise, and to evaluate a standardized version of the MBS. Methods A two-stage procedure was used, with each stage involving one-on-one interviews with COPD patients who had recently completed a clinic-based exercise event on a treadmill or cycle ergometer. An open-ended elicitation interview technique was used to understand patients’ experiences of exercise-induced dyspnea, followed by patients completing the three scales. The cognitive interviewing component of the study involved specific questions to evaluate the patients’ perspectives of the content and format of the scales. Results from Stage 1 were used to develop a standardized version of the MBS, which was then subjected to further content validity assessment during Stage 2. Results Thirteen patients participated in the two-stage process (n = 6; n = 7). Mean forced expiratory volume in 1 second (FEV1) percent predicted was 40%, mean age 57 years, and 54% were male. Participants used a variety of terms to describe the intensity and variability of exercise-induced dyspnea. Subjects understood the instructions and format of the standardized MBS, and were able to easily select a response to report the level of dyspnea associated with their recent standardized exercise. Conclusion This study provides initial evidence in support of using a standardized version of the MBS version for quantifying dyspnea intensity associated with exercise in patients with COPD. PMID:22745534

  7. Can bronchodilators improve exercise tolerance in COPD patients without dynamic hyperinflation? *

    PubMed Central

    Scuarcialupi, Maria Enedina Aquino; Berton, Danilo Cortozi; Cordoni, Priscila Kessar; Squassoni, Selma Denis; Fiss, Elie; Neder, José Alberto

    2014-01-01

    OBJECTIVE: To investigate the modulatory effects that dynamic hyperinflation (DH), defined as a reduction in inspiratory capacity (IC), has on exercise tolerance after bronchodilator in patients with COPD. METHODS: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET). On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometry and submaximal CPET at constant speed up to the limit of tolerance (Tlim). The patients who showed ?IC(peak-rest) < 0 were considered to present with DH (DH+). RESULTS: In this sample, 21 patients (70%) had DH. The DH+ patients had higher airflow obstruction and lower Tlim than did the patients without DH (DH-). Despite equivalent improvement in FEV1 after bronchodilator, the DH- group showed higher ?IC(bronchodilator-placebo) at rest in relation to the DH+ group (p < 0.05). However, this was not found in relation to ?IC at peak exercise between DH+ and DH- groups (0.19 ± 0.17 L vs. 0.17 ± 0.15 L, p > 0.05). In addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60%] vs. 10% [3-53%]; p > 0.05). CONCLUSIONS: Improvement in TLim was associated with an increase in IC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise. PMID:24831394

  8. Left ventricular support adjustment to aortic valve opening with analysis of exercise capacity

    PubMed Central

    2014-01-01

    Background LVAD speed adjustment according to a functioning aortic valve has hypothetic advantages but could lead to submaximal support. The consequences of an open aortic valve policy on exercise capacity and hemodynamics have not yet been investigated systematically. Methods Ambulatory patients under LVAD support (INCOR®, Berlin Heart, mean support time 465?±?257 days, average flow 4.0?±?0.3 L/min) adjusted to maintain a near normal aortic valve function underwent maximal cardiopulmonary exercise testing (CPET) and right heart catheterization (RHC) at rest and during constant work rate exercise (20 Watt). Results Although patients (n?=?8, mean age 45?±?13 years) were in NYHA class 2, maximum work-load and peak oxygen uptake on CPET were markedly reduced with 69?±?13 Watts (35% predicted) and 12?±?2 mL/min/kg (38% predicted), respectively. All patients showed a typical cardiac limitation pattern and severe ventilatory inefficiency with a slope of ventilation to carbon dioxide output of 42?±?12. On RHC, patients showed an exercise-induced increase of mean pulmonary artery pressure (from 16?±?2.4 to 27?±?2.8 mmHg, p?exercise capacity and hemodynamics, which is not reflected by NYHA-class. Unknown compensatory mechanisms can be suspected. Further studies comparing higher vs. lower support are needed for optimization of LVAD adjustment strategies. PMID:24884921

  9. The Effect of Exercise Training on Diastolic and Systolic Function After Acute Myocardial Infarction

    PubMed Central

    Fontes-Carvalho, Ricardo; Azevedo, Ana Isabel; Sampaio, Francisco; Teixeira, Madalena; Bettencourt, Nuno; Campos, Lilibeth; Gonçalves, Francisco Rocha; Ribeiro, Vasco Gama; Azevedo, Ana; Leite-Moreira, Adelino

    2015-01-01

    Abstract After acute myocardial infarction (AMI), diastolic dysfunction is frequent and an important determinant of adverse outcome. However, few interventions have proven to be effective in improving diastolic function. We aimed to determine the effect of exercise training on diastolic and systolic function after AMI. One month after AMI, 188 patients were prospectively randomized (1:1) to an 8-week supervised program of endurance and resistance exercise training (n?=?86; 55.9?±?10.8 years) versus standard of care (n?=?89; 55.4?±?10.3 years). All patients were submitted to detailed echocardiography and cardiopulmonary exercise test, at baseline and immediately after the study. Diastolic function was evaluated by the determination of tissue-Doppler derived early diastolic velocities (E? velocity at the septal and lateral sides of mitral annulus) and by the E/E? (ratio between the E wave velocity from mitral inflow and the E’ velocity) as recommended in the consensus document for diastolic function assessment. At the end of the study, there was no significant change in E? septal velocity or E/E? septal ratio in the exercise group. We observed a small, although nonsignificant, improvement in E? lateral (mean change 0.1?±?2.0?cm/s; P?=?0.40) and E/E? lateral ratio (mean change of ?0.3?±?2.5; P?=?0.24), while patients in the control group had a nonsignificant reduction in E? lateral (mean change ?0.4?±?1.9?cm/s; P?=?0.09) and an increase in E/E? lateral ratio (mean change?+?0.3?±?3.3; P?=?0.34). No relevant changes occurred in other diastolic parameters. The exercise-training program also did not improve systolic function (either tissue Doppler systolic velocities or ejection fraction). Exercise capacity improved only in the exercise-training group, with an increase of 1.6?mL/kg/min in pVO2 (P?=?0.001) and of 1.9?mL/kg/min in VO2 at anaerobic threshold (P?exercise-training program did not significantly improve diastolic or systolic function, although it was associated with an improvement in exercise capacity parameters. PMID:26356698

  10. Identification of three exercise-induced mortality risk factors in patients with COPD.

    PubMed

    Yoshimura, Kenji; Maekura, Ryoji; Hiraga, Toru; Miki, Keisuke; Kitada, Seigo; Miki, Mari; Tateishi, Yoshitaka; Mori, Masahide

    2014-12-01

    The survival rate of chronic obstructive pulmonary disease (COPD) patients with severely reduced exercise capacity is extremely low. We recently identified three life-threatening pathophysiological conditions during cardiopulmonary exercise testing (CPET): (1) exercise-induced hypoxemia, (2) sympathetic overactivity, and (3) progressive respiratory acidosis at low-intensity exercise. The present prospective observation study aimed to determine whether these parameters constitute risk factors of mortality in moderate-to-very severe COPD. Ninety-six COPD patients were followed-up, monthly, for >3 years. Subsequently, spirometry and CPET were performed to examine parameters of exercise-induced hypoxemia ([PaO2 slope, mmHg/L · min(-1)] = Decrease in PaO2/?V? O2 (Difference in ?V? O2 between at rest and at peak exercise)), progression of acidosis ([?pH/?V? O2,/L · min(-1)] = Decrease in pH/?V? O2), and sympathetic overactivity ([?norepinephrine (NE)/?V? O2, ng/mL/L · min(-1)] = Increase in NE/?V? O2). Univariate analysis revealed a significant association between the three conditions with increased mortality. Kaplan-Meier analysis showed that the quartile combining the steepest PaO2 slope (?-55 mmHg/?V? O2 [L/min]), steepest decrease in arterial blood pH (? -1.72/?V? O2 [L/min]), and most rapid increase in plasma NE level (? 5.2 ng/VO2 [L/min]) during incremental exercise was associated with higher all-cause mortality. These conditions showed cumulative effects on COPD patients' survival. Multivariate analyses revealed that these three life-threatening factors are also independent predictors of mortality based on age, heart rate and PaO2 at rest, body mass index, and forced expiratory volume in 1 s. Thus, these new exercise-induced mortality risk factors may lead to more efficient pulmonary rehabilitation programs for COPD patients based on patient-specific exercise-induced pathophysiological profiles. PMID:24914923

  11. Compulsive Exercise

    MedlinePLUS

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... Pregnant? What to Expect Compulsive Exercise KidsHealth > Parents > Emotions & Behavior > Behavior > Compulsive Exercise Print A A A ...

  12. 33 CFR 103.515 - Exercises.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Exercises. 103.515 Section 103... MARITIME SECURITY: AREA MARITIME SECURITY Area Maritime Security (AMS) Plan § 103.515 Exercises. (a) The... exercise at least once each calendar year, with no more than 18 months between exercises, to test...

  13. 33 CFR 103.515 - Exercises.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Exercises. 103.515 Section 103... MARITIME SECURITY: AREA MARITIME SECURITY Area Maritime Security (AMS) Plan § 103.515 Exercises. (a) The... exercise at least once each calendar year, with no more than 18 months between exercises, to test...

  14. 33 CFR 103.515 - Exercises.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Exercises. 103.515 Section 103... MARITIME SECURITY: AREA MARITIME SECURITY Area Maritime Security (AMS) Plan § 103.515 Exercises. (a) The... exercise at least once each calendar year, with no more than 18 months between exercises, to test...

  15. Correlation between Six Minute Walk Test and Spirometry in Chronic Pulmonary Disease

    PubMed Central

    Awad, Nilkanth Tukaram

    2015-01-01

    Introduction Six minute walk test (6MWT), is an exercise test, used as a clinical indicator of the functional capacity, in patients with cardiopulmonary diseases. The present study assessed the correlation of six minute walk test with pulmonary function variables, in patients with chronic pulmonary diseases, in local population. Aims & Objectives The objectives were to study correlation of different spirometry variables with variables of six minute walk test like percent predicted 6 minute walk distance (% Predicted 6MWD) as per Enright et al., formula and Indian reference equation, pre and post exercise pO2 and pCO2 and exercise desaturation. Materials and Methods All consecutive patients with confirmed diagnosis of chronic pulmonary diseases were included from January 2013 to June 2014 in tertiary care institute. 6MWT was performed as per the ATS guidelines. Among 130 patients 108 were also subjected to arterial blood gases pre and post test. Spirometry was performed as per ATS guidelines. Percent (%) predicted 6MWD was calculated. Correlation between spirometry and 6MWT was assessed. Results One hundred and thirty patients with chronic pulmonary disease were taken. Out of them there was 102 patients with obstructive airway disease and 58 patients with interstitial lung disease. FEV1 significantly correlated with %predicted 6MWD &; with basal pO2 and pCO2 and with post exercise pCO2 and pO2. FVC also correlated with %predicted 6MWD, with basal pO2 and pCO2 and post exercise pO2. FEV1/FVC correlated only with post exercise pCO2 while MVV correlated with %predicted 6MWD and only basal pCO2. Exercise desaturation correlated only with FVC. Percent predicted 6MWD also correlated with basal pO2 & post exercise pO2. Conclusion Thus significant correlation found between 6MWT & spirometry variables (FEV1, FVC, MVV & FEV1/FVC). PMID:26435980

  16. Exercise Habit

    MedlinePLUS

    ... aim for the lower end of your target heart rate range. As your exercise program progresses, you can gradually build up to ... family doctor to find out what your target heart rate should be. What is aerobic exercise? Aerobic exercise is the type that moves large ...

  17. Significance of a negative exercise thallium test in the presence of a critical residual stenosis after thrombolysis for acute myocardial infarction

    SciTech Connect

    Sutton, J.M.; Topol, E.J. )

    1991-04-01

    After thrombolytic therapy for acute myocardial infarction, increasing emphasis is placed on early submaximal exercise testing, with further intervention advocated only for demonstrable ischemia. Although significant residual coronary artery lesions after successful thrombolysis are common, many patients paradoxically have no corresponding provokable ischemia. The relation between significant postthrombolytic residual coronary artery disease and a negative early, submaximal exercise thallium-201 tomogram was studied among 101 consecutive patients with uncomplicated myocardial infarction and at least 70% residual stenosis of the infarct artery. A negative test occurred in 49 (48.5%) patients with a mean 88% residual infarct artery stenosis. Further characteristics of the group were as follows: mean time to treatment was 3.1 hours; mean age was 54 +/- 10 years; 80% were male; 47% had anterior infarction; 39% had multivessel disease; mean left ventricular ejection fraction was 53 +/- 14%; and mean peak creatine kinase level was 3,820 +/- 3,123 IU/ml. A similar group of 52 (51.5%) patients, treated within 3.3 hours from symptom onset, with a mean postthrombolysis stenosis of 90%, had a positive exercise test. Characteristics of this group were as follows: age was 58 +/- 10 years; 92% were male; 56% had anterior infarction; 40% had multivessel disease; and mean left ventricular ejection fraction was 54 +/- 15%. The peak creatine kinase level associated with the infarction, however, was lower: 2,605 +/- 1,805 IU/ml (p = 0.04). There was no difference in performance at exercise testing with respect to peak systolic pressure, peak heart rate, or time tolerated on the treadmill between the two groups. By multivariate logistic regression, only peak creatine kinase level predicted a negative stress result in the presence of a significant residual stenosis.

  18. Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

    PubMed Central

    Takara, L.S.; Cunha, T.M.; Barbosa, P.; Rodrigues, M.K.; Oliveira, M.F.; Nery, L.E.; Neder, J.A.

    2012-01-01

    This study evaluated the dynamic behavior of total and compartmental chest wall volumes [(VCW) = rib cage (VRC) + abdomen (VAB)] as measured breath-by-breath by optoelectronic plethysmography during constant-load exercise in patients with stable chronic obstructive pulmonary disease. Thirty males (GOLD stages II-III) underwent a cardiopulmonary exercise test to the limit of tolerance (Tlim) at 75% of peak work rate on an electronically braked cycle ergometer. Exercise-induced dynamic hyperinflation was considered to be present when end-expiratory (EE) VCW increased in relation to resting values. There was a noticeable heterogeneity in the patterns of VCW regulation as EEVCW increased non-linearly in 17/30 “hyperinflators” and decreased in 13/30 “non-hyperinflators” (P < 0.05). EEVAB decreased slightly in 8 of the “hyperinflators”, thereby reducing and slowing the rate of increase in end-inspiratory (EI) VCW (P < 0.05). In contrast, decreases in EEVCW in the “non-hyperinflators” were due to the combination of stable EEVRC with marked reductions in EEVAB. These patients showed lower EIVCW and end-exercise dyspnea scores but longer Tlim than their counterparts (P < 0.05). Dyspnea increased and Tlim decreased non-linearly with a faster rate of increase in EIVCW regardless of the presence or absence of dynamic hyperinflation (P < 0.001). However, no significant between-group differences were observed in metabolic, pulmonary gas exchange and cardiovascular responses to exercise. Chest wall volumes are continuously regulated during exercise in order to postpone (or even avoid) their migration to higher operating volumes in patients with COPD, a dynamic process that is strongly dependent on the behavior of the abdominal compartment. PMID:23250012

  19. Monitoring Microemboli During Cardiopulmonary Bypass with the EDAC® Quantifier

    PubMed Central

    Lynch, John E.; Wells, Christopher; Akers, Tom; Frantz, Paul; Garrett, Donna; Scott, M. Lance; Williamson, Lisa; Agnew, Barbara; Lynch, John K.

    2010-01-01

    Abstract: Gaseous emboli may be introduced into the bypass circuit both from the surgical field and during perfusionist interventions. While circuits provide good protection against massive air embolism, they do not remove gaseous microemboli (GME) from the bypass circuit. The purpose of this preliminary study is to assess the incidence of GME during bypass surgery and determine if increased GME counts were associated with specific events during bypass surgery. In 30 cases divided between 15 coronary artery bypass grafts and 15 valve repairs, GME were counted and sized at the three locations on the bypass circuit using the EDAC® Quantifier (Luna Innovations, Roanoke, VA). A mean of 45,276 GME were detected after the arterial line filter during these 30 cases, with significantly more detected (p = .04) post filter during valve cases (mean = 72,137 ± 22,113) than coronary artery bypass graft cases (mean = 18,416 ± 7831). GME detected post filter were significantly correlated in time with counts detected in the venous line (p < .001). Specific events associated with high counts included the initiation of cardiopulmonary bypass, heart manipulations, insertion and removal of clamps, and the administration of drugs. Global factors associated with increased counts post filter included higher venous line counts and higher post reservoir/bubble trap counts. The mean number of microemboli detected during bypass surgery was much higher than reported in other studies of emboli incidence, most likely due to the increased sensitivity of the EDAC® Quantifier compared to other detection modalities. The results furthermore suggest the need for further study of the clinical significance of these microemboli and what practices may be used to reduce GME incidence. Increased in vitro testing of the air handling capability of different circuit designs, along with more clinical studies assessing best clinical practices for reducing GME activity, is recommended. PMID:21114224

  20. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    SciTech Connect

    Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan

    2009-11-15

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 {mu}m{sup 2}). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0{+-}5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCO{sub DSA}=CO{sub Fick}. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  1. Intrapartum Magnesium Sulfate and the Potential for Cardiopulmonary Drug-Drug Interactions

    PubMed Central

    Campbell, Sarah C.; Stockmann, Chris; Balch, Alfred; Clark, Erin A.S.; Kamyar, Manijeh; Varner, Michael; Korgenski, E. Kent; Bonkowsky, Joshua L.; Spigarelli, Michael G.; Sherwin, Catherine M.T.

    2014-01-01

    Objective This study sought to determine the frequency of possible cardiopulmonary drug-drug interactions among pregnant women who received intrapartum magnesium sulfate (MgSO4). Methods Pregnant women admitted to an Intermountain Healthcare facility between January 2009 and October 2011 were studied if they received one or more doses of MgSO4. Concomitant medications were electronically queried from an electronic health records system. Adverse events were identified using administrative discharge codes. The frequency of cardiopulmonary drug-drug interactions was compared among women who did, and did not, receive aminoglycoside antibiotics, antacids / laxatives, calcium channel blockers, corticosteroids, diuretics, neuromuscular blocking agents, and vitamin D analogs, all of which are contraindicated for patients receiving MgSO4. Results Overall, 683 women received intrapartum MgSO4 during the study period. A total of 219 MgSO4 potentially interacting drugs were identified among 155 (23%) unique patients. The most commonly identified potentially interacting agents included calcium channel blockers (26%), diuretics (25%), and antacids / laxatives (19%). Longer hospital stays were significantly associated with increasing numbers of MgSO4 interacting drugs (P<0.001). Three of 53 (6%) women who received furosemide experienced a cardiac arrest, compared to 0 of 618 (0%) women who did not receive furosemide (Fisher’s Exact Test P<0.001). Conclusion Intrapartum administration of drugs that interact with MgSO4 is common and associated with prolonged hospital stays and potentially cardiopulmonary drug-drug interactions. Caution is warranted when prescribing MgSO4 in combination with known interacting medications. PMID:24487252

  2. The adequacy of oxygenation during cardio-pulmonary resuscitation.

    PubMed

    Heifetz, M; Goldberger, Y; Birkhan, H J; Rosenberg, B; Peleg, H

    1976-02-01

    A series of experiments with eight dogs was carried out to determine the efficiency of oxygenation during cardio-pulmonary resuscitation. High oxygen tensions very near to normal levels were found in most dogs, and this was attributed mainly to normal lung function previous to cardiac arrest. PMID:773207

  3. Efficacy of Cardiopulmonary Resuscitation in the Microgravity Environment

    NASA Technical Reports Server (NTRS)

    Johnston, Smith L.; Campbell, Mark R.; Billica, Roger D.; Gilmore, Stevan M.

    2001-01-01

    End tidal carbon dioxide (EtCO 2) has been previously shown to be an effective non-invasive tool for estimating cardiac output during cardiopulmonary resuscitation (CPR). Animal models have shown that this diagnostic adjunct can be used as a predictor of survival when EtCO 2 values are maintained above 25% of prearrest values.

  4. Rupture of a left internal mammary artery during cardiopulmonary resuscitation

    PubMed Central

    Metting, Austin; Curtis, Brydan; Mixon, Timothy

    2016-01-01

    We present a rare case of a left internal mammary artery rupture during cardiopulmonary resuscitation (CPR). This case demonstrates that intrinsic cardiac/vascular injuries can occur even with manual CPR, and each patient should be monitored closely, considering the very subtle signs that can clue the physicians into the diagnosis. PMID:26722182

  5. Family presence during cardiopulmonary resuscitation and invasive procedures in children

    PubMed Central

    Ferreira, Cristiana Araújo G.; Balbino, Flávia Simphronio; Balieiro, Maria Magda F. G.; Mandetta, Myriam Aparecida

    2014-01-01

    Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes. PMID:24676198

  6. The Emergency Use of Recombinant Hirudin in Cardiopulmonary Bypass

    PubMed Central

    Johnston, Nicklett; Jessen, Michael E.; DiMaio, Michael; Douglass, Debra S.

    2005-01-01

    Abstract: The most common anticoagulant used for cardiopumonary bypass is heparin. An alternate form of anticoagulant therapy is needed for patients who have immune-mediated heparin-associated thrombocytopenia (HIT). Thrombocytopenia causes bleeding and may lead to serious arterial and venous thrombosis. HIT or heparin-induced thrombocytopenia with thrombosis type II (HITT) are both described as adverse reactions to heparin. They are diagnosed with a platelet count less than a 100,000/mcl for 2 consecutive days. HITT, the severe form, is characterized with the thrombocytopenia in combination with thromboembolic complications, such as strokes, myocardial infarctions, and limb ischemia. Two cases are presented in which r-hirudin was used for anticoagulation for aortocoronary bypass surgery and mitral valve replacement. The activated partial prothrombin time (aPTT) was used to monitor coagulation. In the first case, the aPTT was maintained greater than 100 seconds, and at the termination of cardiopulmonary bypass, some clot was noted in the cardiopulmonary bypass circuit. In the second case, a longer cardiopulmonary bypass run was anticipated, the hirudin bolus and infusion rate were increased, and the aPTT was maintained at greater than 200 sec. Adequate coagulation resulted, and, at the end of bypass, no clot was noted. These case studies seem to suggest a higher dosage of r-hirudin may be required for the use of cardiopulmonary bypass and a need to maintain aPTT values greater than 200 sec to help monitor anticoagulation. PMID:16350389

  7. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...-heart surgery. (b) Classification. Class II (special controls). The special control for this device...

  8. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...-heart surgery. (b) Classification. Class II (special controls). The special control for this device...

  9. Atrial Fibrillation, Neurocognitive Decline and Gene Expression After Cardiopulmonary Bypass

    PubMed Central

    Dalal, Rahul S.; Sabe, Ashraf A.; Elmadhun, Nassrene Y.; Ramlawi, Basel; Sellke, Frank W.

    2015-01-01

    OBJECTIVE Atrial fibrillation and neurocognitive decline are common complications after cardiopulmonary bypass. By utilizing genomic microarrays we investigate whether gene expression is associated with postoperative atrial fibrillation and neurocognitive decline. METHODS Twenty one cardiac surgery patients were prospectively matched and underwent neurocognitive assessments pre-operatively and four days postoperatively. The whole blood collected in the pre-cardiopulmonary bypass, 6 hours after-cardiopulmonary bypass, and on the 4th postoperative day was hybridized to Affymetrix Gene Chip U133 Plus 2.0 Microarrays. Gene expression in patients who developed postoperative atrial fibrillation and neurocognitive decline (n=6; POAF+NCD) was compared with gene expression in patients with postoperative atrial fibrillation and normal cognitive function (n=5; POAF+NORM) and patients with sinus rhythm and normal cognitive function (n=10; SR+NORM). Regulated genes were identified using JMP Genomics 4.0 with a false discovery rate of 0.05 and fold change of >1.5 or <-1.5. RESULTS Eleven patients developed postoperative atrial fibrillation. Six of these also developed neurocognitive decline. Of the 12 patients with sinus rhythm, only 2 developed neurocognitive decline. POAF+NCD patients had unique regulation of 17 named genes preoperatively, 60 named genes six hours after cardiopulmonary bypass, and 34 named genes four days postoperatively (P<0.05) compared with normal patients. Pathway analysis demonstrated that these genes are involved in cell death, inflammation, cardiac remodeling and nervous system function. CONCLUSION Patients who developed postoperative atrial fibrillation and neurocognitive decline after cardiopulmonary bypass may have differential genomic responses compared to normal patients and patients with only postoperative atrial fibrillation, suggesting common pathophysiology for these conditions. Further exploration of these genes may provide insight into the etiology and improvements of these morbid outcomes.

  10. Interaction of Cardiopulmonary and Somatic Reflexes in Humans

    PubMed Central

    Walker, John L.; Abboud, Francois M.; Mark, Allyn L.; Thames, Marc D.

    1980-01-01

    Activation of cardiopulmonary receptors with vagal afferents results predominantly in reflex inhibition of efferent sympathetic activity, whereas activation of somatic receptors reflexly increases sympathetic activity to the heart and circulation. Previous studies in experimental animals indicate that there is an important interaction between these excitatory and inhibitory reflexes in the control of the renal circulation. The purpose of this study was to determine whether there is a similar interaction between somatic and cardiopulmonary reflexes in humans. The activity of the cardiopulmonary receptors was altered (reduced) with lower body negative pressure (?5 mm Hg), which causes a decrease in cardiac filling pressure and a small reflex increase in forearm vascular resistance without accompanying changes in arterial pressure. Activation of somatic receptors by isometric handgrip for 2 min at 10 and 20% of maximum voluntary contraction resulted in reflex vasoconstriction in the nonexercising arm. Lower body negative pressure at ?5 mm Hg produced a threefold augmentation in the forearm vasoconstrictor response to isometric handgrip in the nonexercising arm. This increase in resistance was significantly greater (P < 0.05) than the algebraic sum of the increases in resistance resulting from lower body suction alone plus isometric handgrip alone. Furthermore, it occurred despite a greater rise in arterial pressure, which would be expected to decrease forearm vascular resistance through activation of arterial baroreceptors and through passive dilatation of forearm vessels. Thus, removal of the inhibitory influence of cardiopulmonary receptors by pooling blood in the lower extremities enhances the somatic reflex. These data suggest an interaction between cardiopulmonary and somatic reflexes in the control of forearm vascular resistance in man. PMID:7410553

  11. ACE2 and Microbiota: Emerging Targets for Cardiopulmonary Disease Therapy.

    PubMed

    Cole-Jeffrey, Colleen T; Liu, Meng; Katovich, Michael J; Raizada, Mohan K; Shenoy, Vinayak

    2015-12-01

    The health of the cardiovascular and pulmonary systems is inextricably linked to the renin-angiotensin system (RAS). Physiologically speaking, a balance between the vasodeleterious (Angiotensin-converting enzyme [ACE]/Angiotensin II [Ang II]/Ang II type 1 receptor [AT1R]) and vasoprotective (Angiotensin-converting enzyme 2 [ACE2]/Angiotensin-(1-7) [Ang-(1-7)]/Mas receptor [MasR]) components of the RAS is critical for cardiopulmonary homeostasis. Upregulation of the ACE/Ang II/AT1R axis shifts the system toward vasoconstriction, proliferation, hypertrophy, inflammation, and fibrosis, all factors that contribute to the development and progression of cardiopulmonary diseases. Conversely, stimulation of the vasoprotective ACE2/Ang-(1-7)/MasR axis produces a counter-regulatory response that promotes cardiovascular health. Current research is investigating novel strategies to augment actions of the vasoprotective RAS components, particularly ACE2, in order to treat various pathologies. Although multiple approaches to increase the activity of ACE2 have displayed beneficial effects against experimental disease models, the mechanisms behind its protective actions remain incompletely understood. Recent work demonstrating a non-catalytic role for ACE2 in amino acid transport in the gut has led us to speculate that the therapeutic effects of ACE2 can be mediated, in part, by its actions on the gastrointestinal tract and/or gut microbiome. This is consistent with emerging data which suggest that dysbiosis of the gut and lung microbiomes is associated with cardiopulmonary disease. This review highlights new developments in the protective actions of ACE2 against cardiopulmonary disorders, discusses innovative approaches to targeting ACE2 for therapy, and explores an evolving role for gut and lung microbiota in cardiopulmonary health. PMID:26322922

  12. Respiratory muscle training with normocapnic hyperpnea improves ventilatory pattern and thoracoabdominal coordination, and reduces oxygen desaturation during endurance exercise testing in COPD patients

    PubMed Central

    Bernardi, Eva; Pomidori, Luca; Bassal, Faisy; Contoli, Marco; Cogo, Annalisa

    2015-01-01

    Background Few data are available about the effects of respiratory muscle training with normocapnic hyperpnea (NH) in COPD. The aim is to evaluate the effects of 4 weeks of NH (Spirotiger®) on ventilatory pattern, exercise capacity, and quality of life (QoL) in COPD patients. Methods Twenty-six COPD patients (three females), ages 49–82 years, were included in this study. Spirometry and maximal inspiratory pressure, St George Respiratory Questionnaire, 6-minute walk test, and symptom-limited endurance exercise test (endurance test to the limit of tolerance [tLim]) at 75%–80% of peak work rate up to a Borg Score of 8–9/10 were performed before and after NH. Patients were equipped with ambulatory inductive plethysmography (LifeShirt®) to evaluate ventilatory pattern and thoracoabdominal coordination (phase angle [PhA]) during tLim. After four supervised sessions, subjects trained at home for 4 weeks – 10 minutes twice a day at 50% of maximal voluntary ventilation. The workload was adjusted during the training period to maintain a Borg Score of 5–6/10. Results Twenty subjects completed the study. After NH, maximal inspiratory pressure significantly increased (81.5±31.6 vs 91.8±30.6 cmH2O, P<0.01); exercise endurance time (+150 seconds, P=0.04), 6-minute walk test (+30 meters, P=0.03), and QoL (?8, P<0.01) all increased. During tLim, the ventilatory pattern changed significantly (lower ventilation, lower respiratory rate, higher tidal volume); oxygen desaturation, PhA, and dyspnea Borg Score were lower for the same work intensity (P<0.01, P=0.02, and P<0.01, respectively; one-way ANOVA). The improvement in tidal volume and oxygen saturation after NH were significantly related (R2=0.65, P<0.01). Conclusion As expected, NH improves inspiratory muscle performance, exercise capacity, and QoL. New results are significant change in ventilatory pattern, which improves oxygen saturation, and an improvement in thoracoabdominal coordination (lower PhA). These two facts could explain the reduced dyspnea during the endurance test. All these results together may play a role in improving exercise capacity after NH training. PMID:26392764

  13. Reduction of exercise capacity in sarcoidosis in relation to disease severity

    PubMed Central

    Kallianos, Anastasios; Zarogoulidis, Paul; Ampatzoglou, Fotini; Trakada, Georgia; Gialafos, Elias; Pitsiou, Georgia; Pataka, Athanasia; Veletza, Lemonia; Zarogoulidis, Konstantinos; Hohenforst-Schmidt, Wolfgang; Petridis, Dimitris; Kioumis, Ioannis; Rapti, Aggeliki

    2015-01-01

    Introduction Pulmonary function tests (PFTs) do not always predict functional limitations during exercise in sarcoidosis. Cardiopulmonary exercise testing (CPET) may facilitate the recognition of exercise intolerance in these patients. Aim As relevant data in sarcoid patients are limited, the aim of the study reported here was to assess exercise capacity impairment during a maximal CPET and to evaluate potential correlations with PFT measurements and radiological stages of the disease. Method A total of 83 sarcoid patients consecutively referred for evaluation of exertional dyspnea over a 3-year period were studied retrospectively with PFTs, including spirometry, diffusing capacity of the lung for carbon monoxide (DLCO) and lung volumes, and CPET using standard protocol. Patients were grouped according to their radiological stages: Stage I (n=43), Stages II–III (n=31), and Stage IV (n=9). Results Forced expiratory volume in 1 second, forced vital capacity, and total lung capacity were mildly impaired only in Stage IV (means ± standard deviation: 72.44±28.00, 71.33±26.70, and 59.78±21.72, respectively), while DLCO was mildly and moderately reduced in Stages II–III and IV (72.68±14.13 and 51.22±18.50, respectively) and differed significantly between all stages (I vs II–III: P=0.003, I vs IV: P=0.003, and II–III vs IV: P=0.009). Exercise capacity (as expressed by peak oxygen consumption <84% predicted) was decreased in 53% of patients (Stage I: 48%, Stages II–III: 52%, Stage IV: 78%); however, significant differences were noticed only between Stages I and IV (P=0.0025). Of note, significant correlations were found between peak oxygen consumption and DLCO (P=0.0083), minute ventilation (P<0.0001), oxygen pulse (P<0.0001), lactate threshold (P<0.0001), and peak ventilatory threshold (P<0.0001). Conclusion CPET could be considered a useful tool in exercise intolerance evaluation in sarcoid patients with mild PFT abnormalities. Exercise limitation in sarcoidosis may be attributed to both ventilatory and cardiocirculatory impairment. PMID:26316723

  14. The correlation of symptoms, pulmonary function tests and exercise testing with high-resolution computed tomography in patients with idiopathic interstitial pneumonia in a tertiary care hospital in South India

    PubMed Central

    Isaac, Barney Thomas Jesudason; Thangakunam, Balamugesh; Cherian, Rekha A; Christopher, Devasahayam Jesudas

    2015-01-01

    Context: For the follow-up of patients with idiopathic interstitial pneumonias (IIP), it is unclear which parameters of pulmonary function tests (PFT) and exercise testing would correlate best with high-resolution computed tomography (HRCT).. Aim: To find out the correlation of symptom scores, PFTs and exercise testing with HRCT scoring in patients diagnosed as idiopathic interstitial pneumonia. Settings and Design: Cross-sectional study done in pulmonary medicine outpatients department of a tertiary care hospital in South India. Materials and Methods: Consecutive patients who were diagnosed as IIP by a standard algorithm were included into the study. Cough and dyspnea were graded for severity and duration. Pulmonary function tests and exercise testing parameters were noted. HRCT was scored based on an alveolar score, an interstitial score and a total score. The HRCT was correlated with each of the clinical and physiologic parameters. Pearson's/Spearman's correlation coefficient was used for the correlation of symptoms and parameters of ABG, PFT and 6MWT with the HRCT scores. Results: A total of 94 patients were included in the study. Cough and dyspnea severity (r = 0.336 and 0.299), FVC (r = ?0.48), TLC (r = ?0.439) and DLCO and distance saturation product (DSP) (r = ?0.368) and lowest saturation (r = ?0.324) had significant correlation with total HRCT score. Among these, DLCO, particularly DLCO corrected % of predicted, correlated best with HRCT score (r = ?0.721).. Conclusion: Symptoms, PFT and exercise testing had good correlation with HRCT. DLCO corrected % of predicted correlated best with HRCT.

  15. Noncontact accurate measurement of cardiopulmonary activity using a compact quadrature Doppler radar sensor.

    PubMed

    Hu, Wei; Zhao, Zhangyan; Wang, Yunfeng; Zhang, Haiying; Lin, Fujiang

    2014-03-01

    The designed sensor enables accurate reconstruction of chest-wall movement caused by cardiopulmonary activities, and the algorithm enables estimation of respiration, heartbeat rate, and some indicators of heart rate variability (HRV). In particular, quadrature receiver and arctangent demodulation with calibration are introduced for high linearity representation of chest displacement; 24-bit ADCs with oversampling are adopted for radar baseband acquisition to achieve a high signal resolution; continuous-wavelet filter and ensemble empirical mode decomposition (EEMD) based algorithm are applied for cardio/pulmonary signal recovery and separation so that accurate beat-to-beat interval can be acquired in time domain for HRV analysis. In addition, the wireless sensor is realized and integrated on a printed circuit board compactly. The developed sensor system is successfully tested on both simulated target and human subjects. In simulated target experiments, the baseband signal-to-noise ratio (SNR) is 73.27 dB, high enough for heartbeat detection. The demodulated signal has 0.35% mean squared error, indicating high demodulation linearity. In human subject experiments, the relative error of extracted beat-to-beat intervals ranges from 2.53% to 4.83% compared with electrocardiography (ECG) R-R peak intervals. The sensor provides an accurate analysis for heart rate with the accuracy of 100% for p = 2% and higher than 97% for p = 1%. PMID:24235293

  16. Baroreflex regulation of blood pressure during dynamic exercise

    NASA Technical Reports Server (NTRS)

    Raven, P. B.; Potts, J. T.; Shi, X.; Blomqvist, C. G. (Principal Investigator)

    1997-01-01

    From the work of Potts et al. Papelier et al. and Shi et al. it is readily apparent that the arterial (aortic and carotid) baroreflexes are reset to function at the prevailing ABP of exercise. The blood pressure of exercise is the result of the hemodynamic (cardiac output and TPR) responses, which appear to be regulated by two redundant neural control systems, "Central Command" and the "exercise pressor reflex". Central Command is a feed-forward neural control system that operates in parallel with the neural regulation of the locomotor system and appears to establish the hemodynamic response to exercise. Within the central nervous system it appears that the HLR may be the operational site for Central Command. Specific neural sites within the HLR have been demonstrated in animals to be active during exercise. With the advent of positron emission tomography (PET) and single-photon emission computed tomography (SPECT), the anatomical areas of the human brain related to Central Command are being mapped. It also appears that the Nucleus Tractus Solitarius and the ventrolateral medulla may serve as an integrating site as they receive neural information from the working muscles via the group III/IV muscle afferents as well as from higher brain centers. This anatomical site within the CNS is now the focus of many investigations in which arterial baroreflex function, Central Command and the "exercise pressor reflex" appear to demonstrate inhibitory or facilitatory interaction. The concept of whether Central Command is the prime mover in the resetting of the arterial baroreceptors to function at the exercising ABP or whether the resetting is an integration of the "exercise pressor reflex" information with that of Central Command is now under intense investigation. However, it would be justified to conclude, from the data of Bevegard and Shepherd, Dicarlo and Bishop, Potts et al., and Papelier et al. that the act of exercise results in the resetting of the arterial baroreflex. In addition, if, as we have proposed, the cardiopulmonary baroreceptors primarily monitors and reflexly regulates cardiac filling volume, it would seem from the data of Mack et al. and Potts et al. that the cardiopulmonary baroreceptor is also reset at the beginning of exercise. Therefore, investigations of the neural mechanisms of regulation involving Central Command and cardiopulmonary afferents, similar to those being undertaken for the arterial baroreflex, need to be established.

  17. Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds.

    PubMed

    Cunha, F A; Montenegro, R A; Midgley, A W; Vasconcellos, F; Soares, P P; Farinatti, P

    2014-08-01

    The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve (%VO2 R) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and VO2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL · kg(-1) · min(-1) (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and % VO2 R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and % VO2 R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise. PMID:25003546

  18. Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds

    PubMed Central

    Cunha, F.A.; Montenegro, R.A.; Midgley, A.W.; Vasconcellos, F.; Soares, P.P.; Farinatti, P.

    2014-01-01

    The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve (%V?O2?R) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and V?O2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL·kg-1·min-1 (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and %V?O2?R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and %V?O2?R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise. PMID:25003546

  19. Cardiac Parasympathetic Reactivation in Elite Soccer Players During Different Types of Traditional High-Intensity Training Exercise Modes and Specific Tests: Interests and Limits

    PubMed Central

    Dellal, Alexandre; Casamichana, David; Castellano, Julen; Haddad, Monoem; Moalla, Wassim; Chamari, Karim

    2015-01-01

    Background: The cardiac parasympathetic reactivation is currently used in soccer with a daily or weekly monitoring. However, previous studies have not investigated how this cardiac parasympathetic reactivation is in elite soccer players along different types of traditional high-intensity training exercise and specific tests. In this context, the present study aim to analyse it and to determine the interests and limits of this type of physiological information. Objectives: The present study aims to examine how different traditional training exercise modes affect the cardiac parasympathetic reactivation function in elite soccer players. Materials and Methods: Twenty-two international soccer players participating in UEFA Champion’s League took part in this study (age: 24.3 ± 4.2 years; height: 178.1 ± 6.2 cm; body mass: 80.3 ± 5.7 kg). Players performed different training methods including: short-duration intermittent exercises (INT) in-line and with changes of direction (COD) (10 - 10 seconds, 15 - 15 seconds, 30 - 30 seconds, e.g. an alternance of 10 - 10 seconds is 10 seconds of running according to the maximal aerobic speed (MAS) and 10-sec of recovery), INT including agility and technical skills (8 - 24-seconds), small-sided-games (SSGs) with and without goalkeepers (2 vs. 2, 3 vs. 3, 4 vs. 4), and repeated sprint ability (RSA) efforts (10 × 20 m, 10 × 30 m, 15 × 20 m). Heart rate (HR) decline was recorded 3 minutes after each exercise. Results: HR declines were greater after the RSA compared to SSGs (P < 0.001) and INT (P < 0.01), especially at 1 min post-exercise. In addition, when the analysis focused on each type of exercise, greater HR declines were observed in on-field players at 1 minute when there was: inclusion of goalkeepers in SSGs (for 2 vs. 2 and 3 vs. 3, P < 0.01); increase of sprint distances or number of sprint repetitions in RSA (P < 0.01); increase of intensity (% of maximal aerobic speed), and the use of COD or inclusion of technical skills during INT, especially for the 30 - 30-seconds. Conclusions: This study revealed that cardiac parasympathetic reactivation function varied after INT, RSA and SSG, but also according to the rules manipulation. Therefore, this study provides interesting information for the training monitoring and players’ recovery profile, with the aim of facilitating a more efficient planning and manipulation of training recovery strategies according to their fitness markers. PMID:26715972

  20. Dynamic Interactions of Gas Exchange, Body Mass, and Progressive Exercise in Children

    PubMed Central

    Cooper, Dan M.; Leu, Szu-Yun; Galassetti, Pietro; Radom-Aizik, Shlomit

    2014-01-01

    Purpose Cardiopulmonary exercise testing (CPET) is increasingly used as a biomarker of fitness in children. Maximal or peak values remain the most common variables obtained in CPET, but these physiologically challenging high-intensity work rates are often not achieved. We hypothesized that interactions of gas exchange, heart rate (HR), and work rate (WR) CPET variables (slopes) could yield useful mechanistic and clinical insights that might enhance the clinical utility of CPET in children. We further hypothesized that the dependence of the slope on body mass could be predicted by first-principle analysis of body size and physiological response. Methods One hundred sixty-nine healthy participants (8–18 years old, BMI<95th percentile, 82 females) underwent dual X-ray absorptiometry scan to estimate lean body mass (LBM) and performed a ramp-type progressive cycle ergometry exercise protocol with breath-by-breath measurement of gas exchange. Linear regression was used to calculate the slopes among V•O2,V•CO2,V•E, HR, and WR. Results ?WR/?HR (r=0.87) and ?V•O2/?HR(r=0.96) were strongly correlated with peak V•O2, while ?V•O2/?WR(r=0.42) and ?V•E/?V•CO2(r=?0.51) were mildly correlated with peak values. LBM was more highly correlated than was total body mass with those slopes predicted to be body size dependent (p<0.0001). Conclusion The data largely supported our original hypotheses. Unlike peak or maximal values, which are derived from no more than a few data points at the end of a progressive exercise test, the CPET slopes were calculated from a much larger data set obtained throughout the test. Analysis of these slopes might ultimately prove useful clinically and in research studies when peak values are not achieved. PMID:24091992

  1. Climate change. A global threat to cardiopulmonary health.

    PubMed

    Rice, Mary B; Thurston, George D; Balmes, John R; Pinkerton, Kent E

    2014-03-01

    Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies. PMID:24400619

  2. Use of Bivalirudin as an Anticoagulant During Cardiopulmonary Bypass

    PubMed Central

    Veale, James J.; McCarthy, Harry M.; Palmer, George; Dyke, Cornelius M.

    2005-01-01

    Abstract: Bivalirudin is a short-acting direct thrombin inhibitor that has been used in cardiac surgical patients with heparin-induced thrombocytopenia (HIT) or suspected HIT. Although no direct thrombin inhibitor is indicated for anticoagulation during cardiac surgery in patients with heparin-induced thrombocytopenia (HIT) or suspected HIT, use of heparin-alternatives are increasing as the awareness of HIT increases. Reports of anticoagulation with bivalirudin are sporadic, however, with variable dosing and management strategies. In this report, we describe our management techniques for cardiopulmonary bypass with bivalirudin based upon our personal experience. Although the reported clinical experience with bivalirudin in cardiac surgery is reviewed, operative techniques for the perfusionist/surgeon team are discussed in detail. We recognize that the use of bivalirudin during cardiopulmonary bypass is evolving and modifications of technique will undoubtedly occur as further data and experience accumulate. PMID:16350384

  3. Climate Change. A Global Threat to Cardiopulmonary Health

    PubMed Central

    Thurston, George D.; Balmes, John R.; Pinkerton, Kent E.

    2014-01-01

    Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies. PMID:24400619

  4. Strategy analysis of cardiopulmonary resuscitation training in the community.

    PubMed

    Wang, Jin; Ma, Li; Lu, Yuan-Qiang

    2015-07-01

    Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest. This appreciation produced immense efforts by professional organizations to train laypeople for CPR skills. However, the rate of CPR training is low and varies widely across communities. Several strategies are used in order to improve the rate of CPR training and are performed in some advanced countries. The Chinese CPR training in communities could gain enlightenment from them. PMID:26380744

  5. Strategy analysis of cardiopulmonary resuscitation training in the community

    PubMed Central

    Wang, Jin; Ma, Li

    2015-01-01

    Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest. This appreciation produced immense efforts by professional organizations to train laypeople for CPR skills. However, the rate of CPR training is low and varies widely across communities. Several strategies are used in order to improve the rate of CPR training and are performed in some advanced countries. The Chinese CPR training in communities could gain enlightenment from them. PMID:26380744

  6. The Effect of Exercise Training on Diastolic and Systolic Function After Acute Myocardial Infarction: A Randomized Study.

    PubMed

    Fontes-Carvalho, Ricardo; Azevedo, Ana Isabel; Sampaio, Francisco; Teixeira, Madalena; Bettencourt, Nuno; Campos, Lilibeth; Gonçalves, Francisco Rocha; Ribeiro, Vasco Gama; Azevedo, Ana; Leite-Moreira, Adelino

    2015-09-01

    After acute myocardial infarction (AMI), diastolic dysfunction is frequent and an important determinant of adverse outcome. However, few interventions have proven to be effective in improving diastolic function. We aimed to determine the effect of exercise training on diastolic and systolic function after AMI.One month after AMI, 188 patients were prospectively randomized (1:1) to an 8-week supervised program of endurance and resistance exercise training (n?=?86; 55.9?±?10.8 years) versus standard of care (n?=?89; 55.4?±?10.3 years). All patients were submitted to detailed echocardiography and cardiopulmonary exercise test, at baseline and immediately after the study. Diastolic function was evaluated by the determination of tissue-Doppler derived early diastolic velocities (E' velocity at the septal and lateral sides of mitral annulus) and by the E/E' (ratio between the E wave velocity from mitral inflow and the E' velocity) as recommended in the consensus document for diastolic function assessment.At the end of the study, there was no significant change in E' septal velocity or E/E' septal ratio in the exercise group. We observed a small, although nonsignificant, improvement in E' lateral (mean change 0.1?±?2.0?cm/s; P?=?0.40) and E/E' lateral ratio (mean change of -0.3?±?2.5; P?=?0.24), while patients in the control group had a nonsignificant reduction in E' lateral (mean change -0.4?±?1.9?cm/s; P?=?0.09) and an increase in E/E' lateral ratio (mean change?+?0.3?±?3.3; P?=?0.34). No relevant changes occurred in other diastolic parameters. The exercise-training program also did not improve systolic function (either tissue Doppler systolic velocities or ejection fraction).Exercise capacity improved only in the exercise-training group, with an increase of 1.6?mL/kg/min in pVO2 (P?=?0.001) and of 1.9?mL/kg/min in VO2 at anaerobic threshold (P?exercise-training program did not significantly improve diastolic or systolic function, although it was associated with an improvement in exercise capacity parameters. PMID:26356698

  7. Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial

    PubMed Central

    2013-01-01

    Background After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. Methods/Design This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (?20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject’s inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Discussion Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics-assisted treadmill exercise is a relatively recent intervention method and might be used to train and evaluate aerobic capacity in this population. The present pilot trial is expected to provide new insights into the implementation of early cardiovascular exercise for individuals with severe motor impairment. The findings of this study may guide future research to explore the effects of early cardiovascular activation after severe neurological events. Trial registration This trial is registered with the Clinical Trials.gov Registry (NCT01679600). PMID:24053609

  8. Medication Errors in Cardiopulmonary Arrest and Code-Related Situations.

    PubMed

    Flannery, Alexander H; Parli, Sara E

    2016-01-01

    PubMed/MEDLINE (1966-November 2014) was searched to identify relevant published studies on the overall frequency, types, and examples of medication errors during medical emergencies involving cardiopulmonary resuscitation and related situations, and the breakdown by type of error. The overall frequency of medication errors during medical emergencies, specifically situations related to resuscitation, is highly variable. Medication errors during such emergencies, particularly cardiopulmonary resuscitation and surrounding events, are not well characterized in the literature but may be more frequent than previously thought. Depending on whether research methods included database mining, simulation, or prospective observation of clinical practice, reported occurrence of medication errors during cardiopulmonary resuscitation and surrounding events has ranged from less than 1% to 50%. Because of the chaos of the resuscitation environment, errors in prescribing, dosing, preparing, labeling, and administering drugs are prone to occur. System-based strategies, such as infusion pump policies and code cart management, as well as personal strategies exist to minimize medication errors during emergency situations. PMID:26724288

  9. Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Currently the American Red Cross requires that individuals renew their cardiopulmonary resuscitation (CPR) certification annually; this often requires a 4- to 8-hour refresher course. Those trained in CPR often show a decrease in essential knowledge and skills within just a few months after training. New electronic means of communication have expanded the possibilities for delivering CPR refreshers to members of the general public who receive CPR training. The study’s purpose was to determine the efficacy of three novel CPR refreshers - online website, e-mail and text messaging – for improving three outcomes of CPR training - skill retention, confidence for using CPR and intention to use CPR. These three refreshers may be considered “novel” in that they are not typically used to refresh CPR knowledge and skills. Methods The study conducted two randomized clinical trials of the novel CPR refreshers. A mailed brochure was a traditional, passive refresher format and served as the control condition. In Trial 1, the refreshers were delivered in a single episode at 6 months after initial CPR training. In Trial 2, the refreshers were delivered twice, at 6 and 9 months after initial CPR training, to test the effect of a repeated delivery. Outcomes for the three novel refreshers vs. the mailed brochure were determined at 12 months after initial CPR training. Results Assignment to any of three novel refreshers did not improve outcomes of CPR training one year later in comparison with receiving a mailed brochure. Comparing outcomes for subjects who actually reviewed some of the novel refreshers vs. those who did not indicated a significant positive effect for one outcome, confidence for performing CPR. The website refresher was associated with increased behavioral intent to perform CPR. Stated satisfaction with the refreshers was relatively high. The number of episodes of refreshers (one vs. two) did not have a significant effect on any outcomes. Conclusions There was no consistent evidence for the superiority of novel refreshers as compared with a traditional mailed brochure, but the low degree of actual exposure to the materials does not allow a definitive conclusion. An online web-based approach seems to have the most promise for future research on electronic CPR refreshers. PMID:23170816

  10. 21 CFR 870.4290 - Cardiopulmonary bypass adaptor, stopcock, manifold, or fitting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4290 Cardiopulmonary...manifold, or fitting is a device used in cardiovascular diagnostic, surgical, and...

  11. Exercise at Home

    MedlinePLUS

    ... Healthy Lifestyle > Exercise > Exercise at Home Exercise at Home Exercise and staying active are an important part ... Below are some exercises you can do at home, but be sure to discuss any plans to ...

  12. Depressed Adolescents Treated with Exercise (DATE): A pilot randomized controlled trial to test feasibility and establish preliminary effect sizes

    PubMed Central

    Hughes, Carroll W.; Barnes, Shauna; Barnes, Conrad; DeFina, Laura F.; Nakonezny, Paul; Emslie, Graham J.

    2013-01-01

    The Depressed Adolescents Treated with Exercise (DATE) study evaluated a standardized aerobic exercise protocol to treat nonmedicated adolescents that met DSM-IV-TR criteria for major depressive disorder. From an initial screen of 90 individuals, 30 adolescents aged 12-18 years were randomized to either vigorous exercise (EXER) (>12 kg/kcal/week [KKW]) or a control stretching (STRETCH) activity (< 4 KKW) for 12 weeks. The primary outcome measure was the blinded clinician rating of the Children's Depression Rating Scale – Revised (CDRS-R) to assess depression severity and Actical (KKW) accelerometry 24hr/7days a week to assess energy expenditure and adherence. Follow-up evaluations occurred at weeks 26 and 52. The EXER group averaged 77% adherence and the STRETCH group 81% for meeting weekly target goals for the 12 week intervention based on weekly sessions completed and meeting KKW requirements. There was a significant increase in overall weekly KKW expenditures (p < .001) for both groups with the EXER group doubling the STRETCH group in weekly energy expenditure. Depressive symptoms were significantly reduced from baseline for both groups with the EXER group improving more rapidly than STRETCH after six weeks (p < .016) and nine weeks (p < .001). Both groups continued to improve such that there were no group differences after 12 weeks (p = .07). By week 12, the exercise group had a 100% response rate (86% remission), whereas the stretch group response rate was 67% (50% remission) (p = .02). Both groups had improvements in multiple areas of psychosocial functioning related to school and relationships with parents and peers. Anthropometry reflected decreased waist, hip and thigh measurements (p = .02), more so for females than males (p = .05), but there were no weight changes for either gender. The EXER group sustained 100% remission at week 26 and 52. The STRETCH group had 80% response and 70% remission rates at week 26 and by week 52 only one had not fully responded. The study provides support for the use of exercise as a non-medication intervention for adolescents with major depressive disorders when good adherence and energy expenditure (KKW) are achieved. PMID:24244220

  13. A Novel Method to Detect an Oxygenator Defect Prior to Cardiopulmonary Bypass Initiation

    PubMed Central

    Fernandes, Armindo; Laliberte, Eric; Toledano, Karine; Demers, Philippe

    2015-01-01

    Abstract: Cardiopulmonary bypass (CPB) is a common practice in our era. The medical technology used for cardiac surgery goes through rigorous testing to ensure its safety. Unfortunately, it is not fail proof. Oxygenator failures are a rare occurrence but may lead to catastrophic events. We present a case where the preparation for initiating CPB was complicated by an oxygenator defect. After thorough examination, the oxygenator was found leaking from the gas exhaust port suggesting a disruption in continuity of the fibers. This was found by the vigilance of the perfusionist and a creative method to quickly assess the integrity of the oxygenation device. We describe a simple technique to help diagnose an oxygenator leak. PMID:26543253

  14. Compulsive Exercise

    MedlinePLUS

    ... diets, and for some, this may develop into eating disorders such as anorexia and bulimia. And some people ... exercise, especially when it is combined with an eating disorder, can cause serious and permanent health problems, and ...

  15. Morning Exercise 

    E-print Network

    Unknown

    2011-09-05

    Evidence revealing the importance of chronic exercise for improving general physical health and maintaining long?term successful cognitive function is widely available but less information addressing the potential efficacy of an acute bout...

  16. Does Cardiopulmonary Resuscitation Cause Rib Fractures in Children? A Systematic Review

    ERIC Educational Resources Information Center

    Maguire, Sabine; Mann, Mala; John, Nia; Ellaway, Bev; Sibert, Jo R.; Kemp, Alison M.

    2006-01-01

    Background: There is a diagnostic dilemma when a child presents with rib fractures after cardiopulmonary resuscitation (CPR) where child abuse is suspected as the cause of collapse. We have performed a systematic review to establish the evidence base for the following questions: (i) Does cardiopulmonary resuscitation cause rib fractures in…

  17. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange...

  18. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange...

  19. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange...

  20. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange...

  1. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange...

  2. Long-term effects of smoking and smoking cessation on exercise stress testing: Three-year outcomes from a randomized clinical trial

    PubMed Central

    Asthana, Asha; Piper, Megan E.; McBride, Patrick E.; Ward, Ann; Fiore, Michael C.; Baker, Timothy B.; Stein, James H.

    2012-01-01

    Background The long-term effects of smoking and smoking cessation on markers of cardiovascular disease (CVD) prognosis obtained during treadmill stress testing (TST) are unknown. The purpose of this study was to evaluate the long-term effects of smoking cessation and continued smoking on TST parameters that predict CVD risk. Methods In a prospective, double-blind, randomized, placebo-controlled trial of 5 smoking cessation pharmacotherapies, symptom-limited TST was performed to determine peak METs, rate-pressure product (RPP), heart rate (HR) increase, HR reserve, and 60-second HR recovery, before and 3 years after the target smoking cessation date. Relationships between TST parameters and treatments among successful abstainers and continuing smokers were evaluated using multivariable analyses. Results At baseline, the 600 current smokers (61% women) had a mean age of 43.4 (SD 11.5) years and smoked 20.7 (8.4) cigarettes per day. Their exercise capacity was 8.7 (2.3) METs, HR reserve was 86.6 (9.6)%, HR increase was 81.1 (20.9) beats/min, and HR recovery was 22.3 (11.3) beats. Cigarettes per day and pack-years were independently and inversely associated with baseline peak METs (P < .001), RPP (P < .01, pack-years only), HR increase (P < .05), and HR reserve (P < .01). After 3 years, 168 (28%) had quit smoking. Abstainers had greater improvements than continuing smokers (all P < .001) in RPP (2,055 mm Hg beats/min), HR increase (5.9 beats/min), and HR reserve (3.7%), even after statistical adjustment (all P < .001). Conclusions Smokers with a higher smoking burden have lower exercise capacity, lower HR reserve, and a blunted exercise HR response. After 3 years, TST improvements suggestive of improved CVD prognosis were observed among successful abstainers. PMID:22172440

  3. Long-term functional health status and exercise test variables for patients with pulmonary atresia with intact ventricular septum: A Congenital Heart Surgeons Society study

    PubMed Central

    Karamlou, Tara; Poynter, Jeffrey A.; Walters, Henry L.; Rhodes, Jonathan; Bondarenko, Igor; Pasquali, Sara K.; Fuller, Stephanie M.; Lambert, Linda M.; Blackstone, Eugene H.; Jacobs, Marshall L.; Duncan, Kim; Caldarone, Christopher A.; Williams, William G.; McCrindle, Brian W.

    2013-01-01

    Background A bias favoring biventricular (BV) repair exists regarding choice of repair pathway for patients with pulmonary atresia with intact ventricular septum (PAIVS). We sought to determine the implications of moving borderline candidates down a BV route in terms of late functional health status (FHS) and exercise capacity (EC). Methods Between 1987 and 1997, 448 neonates with PAIVS were enrolled in a multi-institutional study. Late EC and FHS were assessed following repair (mean 14 years) using standardized exercise testing and 3 validated FHS instruments. Relationships between FHS, EC, morphology, and 3 end states (ie, BV, univentricular [UV], or 1.5-ventricle repair [1.5V]) were evaluated. Results One hundred two of 271 end state survivors participated (63 BV, 25 UV, and 14 1.5V). Participants had lower FHS scores in domains of physical functioning (P < .001) compared with age- and sex-matched normal controls, but scored significantly higher in nearly all psychosocial domains. EC was higher in 1.5V-repair patients (P = .02), whereas discrete FHS measures were higher in BV-repair patients. Peak oxygen consumption was low across all groups, and was positively correlated with larger initial tricuspid valve z-score (P < .001), with an enhanced effect within the BV-repair group. Conclusions Late patient-perceived physical FHS and measured EC are reduced, regardless of PAIVS repair pathway, with an important dichotomy whereby patients with PAIVS believe they are doing well despite important physical impediments. For those with smaller initial tricuspid valve z-score, achievement of survival with BV repair may be at a cost of late deficits in exercise capacity, emphasizing that better outcomes may be achieved for borderline patients with a 1.5V- or UV-repair strategy. PMID:23374986

  4. Exercise-induced analgesia: fact or artifact?

    PubMed

    Padawer, W J; Levine, F M

    1992-02-01

    This study critically examines the reported exercise-induced analgesia effect in view of the potential stress-induced analgesia of pain testing itself. Two designs were used to test whether previous findings of analgesia were induced by the exercise procedures or by the stress of the pain testing procedures themselves used in such experiments. In the first design, post-test cold pressor pain ratings were obtained from college students following exercise (bicycle ergometry) and two control tasks (minimal exercise and non-exercise). No significant differences between these groups were found. In the second design, exercise and non-exercise groups pre-exposed to cold pressor pain testing were compared to groups that were not pre-exposed to pain testing. There were no significant effects for exercise; however, significant analgesia effects for pain test pre-exposure were demonstrated. Therefore previous research claiming exercise-induced analgesia may have confounded the effects of exercise with the effects of pre-exposure to pain testing itself. PMID:1589230

  5. The influence of exercise identity and social physique anxiety on exercise dependence.

    PubMed

    Cook, Brian; Karr, Trisha M; Zunker, Christie; Mitchell, James E; Thompson, Ron; Sherman, Roberta; Erickson, Ann; Cao, Li; Crosby, Ross D

    2015-09-01

    Background Previous research has identified exercise identity and social physique anxiety as two independent factors that are associated with exercise dependence. Aims The purpose of our study was to investigate the unique and interactive effect of these two known correlates of exercise dependence in a sample of 1,766 female runners. Methods Regression analyses tested the main effects of exercise identity and social physique anxiety on exercise dependence. An interaction term was calculated to examine the potential moderating effect of social physique anxiety on the exercise identity and exercise dependence relationship. Results Results indicate a main effect for exercise identity and social physique anxiety on exercise dependence; and the interaction of these factors explained exercise dependence scores beyond the independent effects. Thus, social physique anxiety acted as a moderator in the exercise identity and exercise dependence relationship. Discussion Our results indicate that individuals who strongly identify themselves as an exerciser and also endorse a high degree of social physique anxiety may be at risk for developing exercise dependence. Conclusions Our study supports previous research which has examined factors that may contribute to the development of exercise dependence and also suggests a previously unknown moderating relationship for social physique anxiety on exercise dependence. PMID:26551910

  6. The influence of exercise identity and social physique anxiety on exercise dependence

    PubMed Central

    Cook, Brian; Karr, Trisha M.; Zunker, Christie; Mitchell, James E.; Thompson, Ron; Sherman, Roberta; Erickson, Ann; Cao, Li; Crosby, Ross D.

    2015-01-01

    Background Previous research has identified exercise identity and social physique anxiety as two independent factors that are associated with exercise dependence. Aims The purpose of our study was to investigate the unique and interactive effect of these two known correlates of exercise dependence in a sample of 1,766 female runners. Methods Regression analyses tested the main effects of exercise identity and social physique anxiety on exercise dependence. An interaction term was calculated to examine the potential moderating effect of social physique anxiety on the exercise identity and exercise dependence relationship. Results Results indicate a main effect for exercise identity and social physique anxiety on exercise dependence; and the interaction of these factors explained exercise dependence scores beyond the independent effects. Thus, social physique anxiety acted as a moderator in the exercise identity and exercise dependence relationship. Discussion Our results indicate that individuals who strongly identify themselves as an exerciser and also endorse a high degree of social physique anxiety may be at risk for developing exercise dependence. Conclusions Our study supports previous research which has examined factors that may contribute to the development of exercise dependence and also suggests a previously unknown moderating relationship for social physique anxiety on exercise dependence. PMID:26551910

  7. A method of automatic control procedures cardiopulmonary resuscitation

    NASA Astrophysics Data System (ADS)

    Bureev, A. Sh.; Zhdanov, D. S.; Kiseleva, E. Yu.; Kutsov, M. S.; Trifonov, A. Yu.

    2015-11-01

    The study is to present the results of works on creation of methods of automatic control procedures of cardiopulmonary resuscitation (CPR). A method of automatic control procedure of CPR by evaluating the acoustic data of the dynamics of blood flow in the bifurcation of carotid arteries and the dynamics of air flow in a trachea according to the current guidelines for CPR is presented. Evaluation of the patient is carried out by analyzing the respiratory noise and blood flow in the interspaces between the chest compressions and artificial pulmonary ventilation. The device operation algorithm of automatic control procedures of CPR and its block diagram has been developed.

  8. Microprocessor-based cardiopulmonary monitoring system

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The system uses a dedicated microprocessor for transducer control and data acquisition and analysis. No data will be stored in this system, but the data will be transmitted to the onboard data system. The data system will require approximately 12 inches of rack space and will consume only 100 watts of power. An experiment specific control panel, through a series of lighted buttons, will guide the operator through the test series providing a smaller margin of error. The experimental validity of the system was verified, and the reproducibility of data and reliability of the system checked. In addition, ease of training, ease of operator interaction, and crew acceptance were evaluated in actual flight conditions.

  9. Traditional games resulted in post-exercise hypotension and a lower cardiovascular response to the cold pressor test in healthy children.

    PubMed

    Rauber, Suliane B; Boullosa, Daniel A; Carvalho, Ferdinando O; de Moraes, José F V N; de Sousa, Ioranny R C; Simões, Herbert G; Campbell, Carmen S G

    2014-01-01

    The present study aimed to verify if blood pressure (BP) reactivity could be reduced through a previous single session of active playing when compared to sedentary leisure. Sixteen pre-pubertal healthy children participated in this study. After familiarization with procedures and anthropometric evaluation, participants performed three sessions in randomized order: (1) 30 min of traditional Brazilian games (PLAY); (2) 30 min of video game playing (DDR); and (3) 30 min of watching TV (TV). Each session lasted 80 min, being 10 min of rest; 30 min of intervention activity; and 40 min of recovery. After recovery, the Cold Pressor Test (CPT) was used for the assessment of acute cardiovascular reactivity. BP was recorded at 30 s and 1 min during the CPT. Analysis of variance showed post-exercise hypotension (PEH) only after PLAY, and that systolic and diastolic BP were significantly increased in all conditions during CPT. However, the magnitude of the CPT-induced BP response was significantly less in PLAY compared to DDR and TV. The PEH observed during recovery and the reduced BP response to CPT following playing traditional games may be due its higher cardiovascular and metabolic demand as was indicated by the increased heart rate, oxygen consumption, and BP. It was concluded that BP reactivity to stress may be reduced through a previous single session of traditional games and that PEH was recorded only after this exercise form. This benefit indicates a potential role of playing strategies for cardiovascular health in childhood. PMID:25009506

  10. Traditional games resulted in post-exercise hypotension and a lower cardiovascular response to the cold pressor test in healthy children

    PubMed Central

    Rauber, Suliane B.; Boullosa, Daniel A.; Carvalho, Ferdinando O.; de Moraes, José F. V. N.; de Sousa, Ioranny R. C.; Simões, Herbert G.; Campbell, Carmen S. G.

    2014-01-01

    The present study aimed to verify if blood pressure (BP) reactivity could be reduced through a previous single session of active playing when compared to sedentary leisure. Sixteen pre-pubertal healthy children participated in this study. After familiarization with procedures and anthropometric evaluation, participants performed three sessions in randomized order: (1) 30 min of traditional Brazilian games (PLAY); (2) 30 min of video game playing (DDR); and (3) 30 min of watching TV (TV). Each session lasted 80 min, being 10 min of rest; 30 min of intervention activity; and 40 min of recovery. After recovery, the Cold Pressor Test (CPT) was used for the assessment of acute cardiovascular reactivity. BP was recorded at 30 s and 1 min during the CPT. Analysis of variance showed post-exercise hypotension (PEH) only after PLAY, and that systolic and diastolic BP were significantly increased in all conditions during CPT. However, the magnitude of the CPT-induced BP response was significantly less in PLAY compared to DDR and TV. The PEH observed during recovery and the reduced BP response to CPT following playing traditional games may be due its higher cardiovascular and metabolic demand as was indicated by the increased heart rate, oxygen consumption, and BP. It was concluded that BP reactivity to stress may be reduced through a previous single session of traditional games and that PEH was recorded only after this exercise form. This benefit indicates a potential role of playing strategies for cardiovascular health in childhood. PMID:25009506

  11. Exercise Performance in Children and Young Adults After Complete and Incomplete Repair of Congenital Heart Disease.

    PubMed

    Rosenblum, Omer; Katz, Uriel; Reuveny, Ronen; Williams, Craig A; Dubnov-Raz, Gal

    2015-12-01

    Few previous studies have addressed exercise capacity in patients with corrected congenital heart disease (CHD) and significant anatomical residua. The aim of this study was to determine the aerobic fitness and peak cardiac function of patients with corrected CHD with complete or incomplete repairs, as determined by resting echocardiography. Children, adolescents and young adults (<40 years) with CHD from both sexes, who had previously undergone biventricular corrective therapeutic interventions (n = 73), and non-CHD control participants (n = 76) underwent cardiopulmonary exercise testing. The CHD group was further divided according to the absence/presence of significant anatomical residua on a resting echocardiogram ("complete"/"incomplete" repair groups). Aerobic fitness and cardiac function were compared between groups using linear regression and analysis of covariance. Peak oxygen consumption, O2 pulse and ventilatory threshold were significantly lower in CHD patients compared with controls (all p < 0.01). Compared with the complete repair group, the incomplete repair group had a significantly lower mean peak work rate, age-adjusted O2 pulse (expressed as % predicted) and a higher VE/VCO2 ratio (all p ? 0.05). Peak oxygen consumption was comparable between the subgroups. Patients after corrected CHD have lower peak and submaximal exercise parameters. Patients with incomplete repair of their heart defect had decreased aerobic fitness, with evidence of impaired peak cardiac function and lower pulmonary perfusion. Patients that had undergone a complete repair had decreased aerobic fitness attributed only to deconditioning. These newly identified differences explain why in previous studies, the lowest fitness was seen in patients with the most hemodynamically significant heart malformations. PMID:25981567

  12. Effects of a 4-Week Multimodal Rehabilitation Program on Quality of Life, Cardiopulmonary Function, and Fatigue in Breast Cancer Patients

    PubMed Central

    Do, Junghwa; Cho, Youngki

    2015-01-01

    Purpose This study examines the effects of a rehabilitation program on quality of life (QoL), cardiopulmonary function, and fatigue in breast cancer patients. The program included aerobic exercises as well as stretching and strengthening exercises. Methods Breast cancer patients (n=62) who had completed chemotherapy were randomly assigned to an early exercise group (EEG; n=32) or a delayed exercise group (DEG; n=30). The EEG underwent 4 weeks of a multimodal rehabilitation program for 80 min/day, 5 times/wk for 4 weeks. The DEG completed the same program during the next 4 weeks. The European Organization for Research and Treatment of Cancer-Core Quality of Life Questionnaire (EORTC QLQ-C30), EORTC Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption (VO2max), and fatigue severity scale (FSS) were used for assessment at baseline, and at 2, 4, 6, and 8 weeks. Results After 8 weeks, statistically significant differences were apparent in global health, physical, role, and emotional functions, and cancer-related symptoms such as fatigue and pain, nausea, and dyspnea on the EORTC QLQ-C30; cancer-related symptoms involving the arm and breast on the EORTC QLQ-BR23; the predicted VO2max; muscular strength; and FSS (p<0.050), according to time, between the two groups. Conclusion The results of our study suggest that a supervised multimodal rehabilitation program may improve the physical symptoms, QoL, and fatigue in patients with breast cancer. PMID:25834616

  13. Effect of pump prime on acidosis, strong-ion-difference and unmeasured ions during cardiopulmonary bypass.

    PubMed

    Liskaser, F; Story, D A; Hayhoe, M; Poustie, S J; Bailey, M J; Bellomo, R

    2009-09-01

    We tested the hypothesis that a cardiopulmonary bypass prime with lactate would be associated with less acidosis than a prime with only chloride anions because of differences in the measured strong-ion-difference. We randomised 20 patients to a 1500 ml bypass prime with either a chloride-only solution (Ringer's Injection; anions: chloride 152 mmol/l) or a lactated solution (Hartmann's solution; anions: chloride 109 mmol/l, lactate 29 mmol/l). Arterial blood was sampled before bypass and then two, five, 15 and 30 minutes after initiating bypass. We used repeated measures analysis of variance to compare groups. In both groups, the base-excess and measured strong-ion-difference decreased markedly from baseline after two minutes of bypass. The chloride-only group had greater acidosis with lower base-excess and pH (P < 0.05), greatest after five minutes of bypass (C5). Contrary to our hypothesis, however, the difference between the groups was not due to a difference in the measured strong-ion-difference, P = 0.88. At C5 when the difference in standard base-excess between the groups was greatest, 1.9 mmol/l (95% confidence interval: 0.1 to 3.6 mmol/l, P < 0.05), the difference in the measured strong-ion-difference was only 0.2 mmol/l (95% confidence interval: -2.4 to 2.7 mmol/l, P > 0.05). There was, however a difference in the net-unmeasured-ions (strong-ion-gap). We conclude that acid-base changes with cardiopulmonary bypass may differ with the prime but that the early differences between chloride-only and lactated primes appear not to be due to differences in the measured strong-ion-difference. We suggest future studies examine other possible mechanisms including unmeasured ions. PMID:19775041

  14. Cardiopulmonary effects of fentanyl-droperidol, nitrous oxide, and atropine sulfate in dogs.

    PubMed

    Krahwinkel, D J; Sawyer, D C; Eyster, G E; Bender, G

    1975-08-01

    The cardiopulmonary effects of droperidol-fentanyl, nitrous oxide, and atropine were evaluated in 12 adult male Beagle dogs. All dogs were surgically instrumented with a cardiac output thermistor and arterial and venous catheters and were prepared with a chronic tracheostomy. Each dog was used as its own control, and data obtained when dogs were nonanesthetized and nonmedicated were compared with data recorded after the test drugs were administered. The dogs were randomly allotted to 3 groups of 4 dogs each. Group I dogs were given droperidol-fentanyl alone intravenously (IV); group II dogs were given droperidol-fentanyl IV with 67% nitrous oxide; and group III dogs were given atropine sulfate intramuscularly followed by droperidol-fentanyl IV with 67% nitrous oxide. Minute volume was decreased in the 3 groups of dogs for 3 to 5 minutes after droperidol-fentanyl was injected. This resulted in respiratory and metabolic acidosis in all dogs, as indicated by increased arterial carbon dioxide tension, decreased pH, and increased base deficit. In addition, droperidol-fentanyl given alone caused a decrease in systolic pressure and a slight decrease in heart rate. Group 1 dogs were sensitive to auditory stimulation. Cardiovascular changes were not seen when nitrous oxide was added; however, analgesia and muscle relaxation were improved. Premedication with atropine sulfate resulted in increased cardiac output, heart rate, and diastolic pressure, and subsequent administration of droperidol-fentanyl with nitrous oxide caused a transient increase in mean arterial and systolic pressure. This last anesthetic regimen, along with assisted or controlled respiration, seems to provide an excellent anesthetic state with minimal cardiopulmonary depression. PMID:1155837

  15. CO2 pulse and acid-base status during increasing work rate exercise in health and disease.

    PubMed

    Kisaka, Tomohiko; Cox, Timothy A; Dumitrescu, Daniel; Wasserman, Karlman

    2015-11-01

    The CO2 pulse (V?CO2/heart rate), analogous to the O2 pulse (V?O2/heart rate), was calculated during cardiopulmonary exercise testing and evaluated in normal and diseased states. Our aim was to define its application in its release in excess of that from V?CO2/heart rate in the presence of impaired cardiovascular and lung function. In the current study, forty-five patients were divided into six physiological states: normal, exercise-induced myocardial ischemia, chronic heart failure, pulmonary vasculopathy, chronic obstructive pulmonary disease, and interstitial lung disease. We subtracted the O2 pulse from the CO2 pulse to determine the exhaled CO2 that could be attributed to CO2 pulse of buffering of lactic acid. The difference between the CO2 pulse and O2 pulse (V?CO2/heart rate-V?O2/heart rate) includes CO2 generated from HCO3(-) buffering of lactic acid. The accumulated CO2 per body mass was found to be significantly correlated with the corresponding [HCO3(-)] decrease (R(2)=0.72; P<0.0001). In summary, the increase in CO2 pulse over the O2 pulse accounted for the anaerobically-generated excess-CO2 in each of the physiological states and correlated with the decreases in the arterial Bicarbonate concentration. PMID:26226561

  16. Gravity and the Evolution of Cardiopulmonary Morphology in Snakes

    PubMed Central

    Lillywhite, Harvey B.; Albert, James S.; Sheehy, Coleman M.; Seymour, Roger S.

    2011-01-01

    Physiological investigations of snakes have established the importance of heart position and pulmonary structure in contexts of gravity effects on blood circulation. Here we investigate morphological correlates of cardiopulmonary physiology in contexts related to ecology, behavior and evolution. We analyze data for heart position and length of vascular lung in 154 species of snakes that exhibit a broad range of characteristic behaviors and habitat associations. We construct a composite phylogeny for these species, and we codify gravitational stress according to species habitat and behavior. We use conventional regression and phylogenetically independent contrasts to evaluate whether trait diversity is correlated with gravitational habitat related to evolutionary transitions within the composite tree topology. We demonstrate that snake species living in arboreal habitats, or which express strongly climbing behaviors, possess relatively short blood columns between the heart and the head, as well as relatively short vascular lungs, compared to terrestrial species. Aquatic species, which experience little or no gravity stress in water, show the reverse – significantly longer heart–head distance and longer vascular lungs. These phylogenetic differences complement the results of physiological studies and are reflected in multiple habitat transitions during the evolutionary histories of these snake lineages, providing strong evidence that heart–to–head distance and length of vascular lung are co–adaptive cardiopulmonary features of snakes. PMID:22079804

  17. A randomized controlled trial undertaken to test a nurse-led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics

    PubMed Central

    Usher, Kim; Park, Tanya; Foster, Kim; Buettner, Petra

    2013-01-01

    Aim To test the effect of a nurse-led intervention on weight gain in people with serious mental illness prescribed and taking second generation antipsychotic medication. Background Weight gain and obesity has reached epidemic proportions in the general population with the prevalence of Metabolic Syndrome reaching 20–25% of the global population. People with serious mental illness are at even higher risk, particularly those taking second generation antipsychotic medication. Design An experimental randomized controlled trial was undertaken. Method The control group received a 12-week healthy lifestyle booklet. In addition to the booklet, the intervention group received weekly nutrition and exercise education, exercise sessions, and nurse support. Participants (n = 101) were assessed at baseline and 12 weeks. Data were collected between March 2008–December 2010. Seven outcome measures were used: body measurements included girth (cm), weight (kg), height (cm), and body mass index (kg/m2); questionnaires included the medication compliance questionnaire, the Drug Attitude Inventory, the Liverpool University Neuroleptic Side Effect Rating Scale, and the Medical Outcomes Study Short Form 36. Differences in primary outcome measures between baseline and 12 weeks follow-up were compared between intervention and control groups using standard bi-variate statistical tests. The study was conducted between 2008–2010. Results The analysis of outcome measures for the control group (n = 50) and intervention group (n = 51) was not statistically significant. There was a mean weight change of ?0·74 kg at 12 weeks for the intervention group (n = 51), while the control group (n = 50) had a mean weight change of ?0·17 kg at 12 weeks. Conclusion The results were not statistically significant. PMID:22973945

  18. Arterial Filter Bypass Loop: What Occurs in this Area during Cardiopulmonary Bypass and Are There Potential Patient Implications

    PubMed Central

    Hawkins, Justin L.; Myers, Gerard J.; Légaré, Jean-Francois; Swyer, Wilfred

    2010-01-01

    Abstract: The arterial filter is an integral part of bypass circuitry. When introduced, manufacturers suggested a bypass loop for retrograde priming and de-airing, and for uninterrupted blood flow in case of malfunction. Practice has shown antegrade priming and de-airing is possible. This questions the necessity of the loop and presents the question—what occurs in the loop during bypass? After obtaining Human Research Ethics Board approval, eight consecutive patients (n = 8) were chosen for this study. Exclusive exclusion criterion was receiving any transfusions during cardiopulmonary bypass, as this could possibly influence results. The choice of patient numbers was based simply on proof of concept. Investigation involved isolation and collection of loop contents after cardiopulmonary bypass was completed. Testing included complete blood count, prothrombin time, international normalized ratio, partial thromboplastin time, activated clotting time, plasma free hemoglobin, slide photography with analysis for platelet clumping, and debris detection. One perfusionist collected samples, providing uniform collection and isolation technique. Regular blood samples were collected from the bypass circuitry, and from patients’ pre-operative blood work. Analysis of data revealed that platelet counts in the bypass loops were statistically lower than control. Evidence of platelet clumping was present in 3 of 8 bypass loop samples, representing 37.5% of the study population. There was no clumping detected in any of the controls. In patients where platelet clumping was present, a positive correlation was noted between mean bypass time and size of platelet clumps. Prothrombin time and international normalized ratio results were immeasurable. Hemoglobin levels were higher in the loop samples. There was no evidence of debris or fibrin monomer present in any of the samples analyzed. The study results indicate that during “normal” cardiopulmonary bypass with an arterial filter bypass loop, platelet aggregates can accumulate in the loop, therefore opening the arterial bypass loop in any case may subject the patient to micro/macro emboli. PMID:20437795

  19. Combined effects of mild-to-moderate obesity and asthma on physiological and sensory responses to exercise.

    PubMed

    Cortés-Télles, Arturo; Torre-Bouscoulet, Luis; Silva-Cerón, Monica; Mejía-Alfaro, Roberto; Syed, Nafeez; Zavorsky, Gerald S; Guenette, Jordan A

    2015-11-01

    Despite the close link between asthma and obesity, there are no studies that have evaluated the sensory and physiological responses to exercise in obese asthmatics. We recently demonstrated that normal weight asthmatics with well controlled disease have preserved cardiorespiratory and sensory responses to exercise relative to non-asthmatic controls. However, these similarities may not hold true in patients with combined obesity and asthma. Accordingly, we sought to determine if combined asthma and obesity was associated with deleterious effects on cardiorespiratory fitness, exercise performance, dyspnoea, and physiological responses to exercise. Fourteen well-controlled obese asthmatics and fourteen age-matched normal weight asthmatics performed routine spirometry and underwent an incremental cardiopulmonary cycle test to assess the ventilatory, pulmonary gas exchange, cardiovascular, and sensory responses to exercise. Groups were well matched for age, height, spirometry, and asthma control. Obese asthmatics had a significantly greater body mass index (33 ± 3 vs. 23 ± 1 kg/m(2), p < 0.001) and lower self-reported activity levels by 47 % relative to normal weight asthmatics (p < 0.05). Obese asthmatics had a significantly lower maximal oxygen uptake (VO2) (82 ± 14 vs. 92 ± 10 %predicted) and work rate (75 ± 8 vs. 89 ± 13 %predicted) relative to normal weight asthmatics (p < 0.05). The anaerobic threshold occurred at a lower VO2 in obese asthmatics vs. normal weight asthmatics (54 ± 15 vs. 66 ± 16 %predicted, p < 0.05). Ventilatory responses were superimposed throughout exercise with no evidence of a ventilatory limitation in either group. Cardiovascular responses were normal in both groups. Dyspnoea responses were similar but the obese asthmatics experienced greater leg fatigue ratings at submaximal work rates. In conclusion, obese individuals with well controlled asthma have reduced cardiorespiratory fitness and greater leg fatigue ratings relative to normal weight asthmatics. The relatively reduced cardiorespiratory fitness and exercise performance in obese compared to normal weight asthmatics is most likely driven by their more sedentary lifestyle and resultant deconditioning rather than due to respiratory factors. PMID:26439178

  20. Exercise apparatus

    NASA Technical Reports Server (NTRS)

    Schaffner, Grant (Inventor); Bentley, Jason R. (Inventor); Loehr, James A. (Inventor); Gundo, Daniel P. (Inventor)

    2006-01-01

    An apparatus and method for exercising whereby the user is supported by various mechanisms in such as way that the user's shoulder area is free to translate and rotate; the user's pelvic area is free to translate and rotate; or in any combination.

  1. Research Quarterly for Exercise and Sport lecture. Statewide physical fitness testing: a big waist or a big waste?

    PubMed

    Morrow, James R; Ede, Alison

    2009-12-01

    Statewide physical fitness testing is gaining popularity in the United States because of increased childhood obesity levels, the relations between physical fitness and academic performance, and the hypothesized relations between adult characteristics and childhood physical activity, physical fitness, and health behaviors. Large-scale physical fitness testing can be fraught with problems unless properly planned and conducted. Legislators, administrators, teachers, and parents should consider the following 10 essential issues when conducting large-scale physical fitness testing purpose of testing, proper planning, training, quality of the data, reporting support, costs, interpretation, programmatic matters, and policies and politics. PMID:20025110

  2. Cardiac examination and the effect of dual-processing instruction in a cardiopulmonary simulator.

    PubMed

    Sibbald, Matt; McKinney, James; Cavalcanti, Rodrigo B; Yu, Eric; Wood, David A; Nair, Parvathy; Eva, Kevin W; Hatala, Rose

    2013-08-01

    Use of dual-processing has been widely touted as a strategy to reduce diagnostic error in clinical medicine. However, this strategy has not been tested among medical trainees with complex diagnostic problems. We sought to determine whether dual-processing instruction could reduce diagnostic error across a spectrum of experience with trainees undertaking cardiac physical exam. Three experiments were conducted using a similar design to teach cardiac physical exam using a cardiopulmonary simulator. One experiment was conducted in each of three groups: experienced, intermediate and novice trainees. In all three experiments, participants were randomized to receive undirected or dual-processing verbal instruction during teaching, practice and testing phases. When tested, dual-processing instruction did not change the probability assigned to the correct diagnosis in any of the three experiments. Among intermediates, there was an apparent interaction between the diagnosis tested and the effect of dual-processing instruction. Among relative novices, dual processing instruction may have dampened the harmful effect of a bias away from the correct diagnosis. Further work is needed to define the role of dual-processing instruction to reduce cognitive error. This study suggests that it cannot be blindly applied to complex diagnostic problems such as cardiac physical exam. PMID:22717993

  3. Resuscitation from cardiopulmonary arrest during accidental hypothermia due to exhaustion and exposure.

    PubMed Central

    Bristow, G.; Smith, R.; Lee, J.; Auty, A.; Tweed, W. A.

    1977-01-01

    A 16-year-old boy with accidental hypothermia and cardiopulmonary arrest due to exhaustion and exposure was resuscitated after warming measures -- hot wet towels, hot water bottles, and hot water enemas and gastric lavage -- had increased his rectal temperature from 25.2 to 28.0 degrees C. Despite prolonged cardiopulmonary arrest, recovery was almost complete, with no evident cerebral damage. Cardiopulmonary resuscitation procedures should not be abandoned until the body temperature is more than 30 degrees C, because the prognosis in cases of accidental hypothermia without associated disease is excellent if cardiac function can be re-established. Images FIG. 1 PMID:880528

  4. An overview of the applied definitions and diagnostic methods to assess exercise oscillatory ventilation--a systematic review.

    PubMed

    Cornelis, Justien; Beckers, Paul; Vanroy, Christel; Volckaerts, Tess; Vrints, Christiaan; Vissers, Dirk

    2015-01-01

    The variable "exercise oscillatory ventilation" (EOV), assessed during cardiopulmonary exercise test (CPET), recently became a fundamental prognostic parameter in patients with heart failure. In literature, various definitions are suggested, but an uniformly accepted description to identify EOV still lacks. We performed a systematic review of the literature in order to determine the different definitions and diagnostic techniques to assess EOV. A systematic search strategy was established and executed in seven databases (PubMed, Google Scholar, Cochrane Clinical Trials, Science Direct, Pedro, Web Of Science library and Medline (Ovid)) resulting in 605 citations after de-duplication. Full-text articles (n=124) were assessed for eligibility, resulting in 75 citations. The review accounted 17,440 patients of whom 4,638 subjects presented EOV. Seven studies described EOV in a non-heart failure population accounting 168 EOV subjects. The definitions could be categorized in nine subdivisions of which four (n=43) referred to an original description. The other subdivisions were combinations of the original definitions (n=11), quantifications (n=4), computational (n=3), vaguely described (n=8) or not defined (n=6). Symptom limited maximal exercise tests were conducted to assess EOV, however the modes, protocols, software and data sampling were divers. Heterogeneity in the numerous definitions to identify EOV and the vaguely described assessment methods are hindering the evolution to a standardized uniformly accepted definition and technique to identify this abnormal breathing pattern. Unity in definition and international adopted assessment is warranted to strengthen its validity as a prognostic marker and could promote communication. It may facilitate clinical trials on pathophysiology and origin of EOV. PMID:25918072

  5. Pathophysiological rationale and diagnostic targets for diastolic stress testing.

    PubMed

    Erdei, Tamás; Aakhus, Svend; Marino, Paolo; Paulus, Walter J; Smiseth, Otto A; Fraser, Alan G

    2015-09-01

    Cardiopulmonary functional reserve measured as peak oxygen uptake is predicted better at rest by measures of cardiac diastolic function than by systolic function. Normal adaptations in the trained heart include resting bradycardia, increased LV end-diastolic volume and augmented early diastolic suction on exercise. In normal populations early diastolic relaxation declines with age and end-diastolic stiffness increases, but in healthy older subjects who have exercised throughout their lives diastolic function can be well preserved. The mechanisms by which LV diastolic filling and pressures can be impaired during exercise include reduced early diastolic recoil and suction (which can be exacerbated by increased late systolic loading), increased preload and reduced compliance. Abnormal ventricular-arterial coupling and enhanced ventricular interaction may contribute in particular circumstances. One common final pathway that causes breathlessness is an increase in LV filling pressure and left atrial pressure. Testing elderly subjects with breathlessness of unknown aetiology in order to detect worsening diastolic function during stress is proposed to diagnose heart failure with preserved EF. In invasive studies, the most prominent abnormality is an early and rapid rise in pulmonary capillary wedge pressure. A systematic non-invasive diagnostic strategy would use validated methods to assess different mechanisms of inducible diastolic dysfunction and not just single parameters that offer imprecise estimates of mean LV filling pressure. Protocols should assess early diastolic relaxation and filling as well as late diastolic filling and compliance, as these may be affected separately. Better refined diagnostic targets may translate to more focused treatment. PMID:26001845

  6. Exercise and Quality of Life: Strengthening the Connections

    PubMed Central

    Hacker, Eileen

    2010-01-01

    Exercise improves quality of life (QOL) in people with cancer. Most oncology healthcare providers recognize the statement to be true because the research literature provides strong support for the physical and psychological benefits of exercise. Because the terms exercise, QOL, and people with cancer have different meanings, the contextual connections in which they are used are important to understanding the relationship between exercise and QOL in people with cancer. This article explores the links between exercise and QOL in people with cancer and examines issues that impact the development, implementation, and evaluation of exercise programs for people with cancer. Issues related to exercise goal development, exercise prescription, exercise testing, exercise adherence, and methods to evaluate the efficacy of exercise in relation to QOL are discussed. PMID:19193547

  7. Ventilatory response to exercise in adolescents with cystic fibrosis and mild-to-moderate airway obstruction.

    PubMed

    Bongers, Bart C; Werkman, Maarten S; Takken, Tim; Hulzebos, Erik H J

    2014-01-01

    Data regarding the ventilatory response to exercise in adolescents with mild-to-moderate cystic fibrosis (CF) are equivocal. This study aimed to describe the ventilatory response during a progressive cardiopulmonary exercise test (CPET) up to maximal exertion, as well as to assess the adequacy of the ventilatory response for carbon dioxide (CO2) exhalation. Twenty-two adolescents with CF (12 boys and 10 girls; mean?±?SD age: 14.3?±?1.3 years; FEV1: 78.6?±?17.3% of predicted) performed a maximal CPET. For each patient, data of a sex- and age matched healthy control was included (12 boys and 10 girls; mean?±?SD age: 14.3?±?1.4 years). At different relative exercise intensities of 25%, 50%, 75%, and 100% of peak oxygen uptake (VO2peak), breathing pattern, estimated ventilatory dead space ventilation (VD/VT ratio), minute ventilation (VE) to CO2 production relationship (VE/VCO2-slope), partial end-tidal CO2 tension (PETCO2), and the VE to the work rate (VE/WR) ratio were examined. VO2peak was significantly reduced in CF patients (P?=?0.01). We found no differences in breathing pattern between both groups, except for a significantly higher VE at rest and a trend towards a lower VE at peak exercise in patients with CF. Significantly higher values were found for the estimated VD/VT ratio throughout the CPET in CF patients (P?exercise up to maximal exhaustion in CF patients with mild-to-moderate airway obstruction. PMID:25512888

  8. Exercise Training During +Gz Acceleration

    NASA Technical Reports Server (NTRS)

    Greenleaf, J. E.; Chou, J. L.; Simonson, S. R.; Jackson, C. G. R.; Barnes, P. R.

    1999-01-01

    The overall purpose is to study the effect of passive (without exercise) and active (with exercise) +Gz (head-to-foot) acceleration training, using a short-arm (1.9m radius) centrifuge, on post- training maximal oxygen uptake (VO2 max, work capacity) and 70 deg head-up tilt (orthostatic) tolerance in ambulatory subjects to test the hypothesis that (a) both passive and active acceleration training will improve post-training tilt-tolerance, and (b) there will be no difference in tilt-tolerance between passive and active exercise acceleration training because increased hydrostatic and blood pressures, rather than increased muscular metabolism, will provide the major adaptive stimulus. The purpose of the pilot study was to test the hypothesis that there would be no significant difference in the metabolic responses (oxygen uptake, heart rate, pulmonary ventilation, or respiratory exchange ratio) during supine exercise with moderate +Gz acceleration.

  9. [Wavelet analysis of m. vastus lateralis surface EMG activity in incremental tests till exhaustion using bicycle and knee extension exercises].

    PubMed

    Kuznetsov, S Iu; Popov, D V; Borovik, A S; Vinogradova, O L

    2011-01-01

    Continuous wavelet analyses was applied to investigate the spectral characteristics of m. vastus lateralis EMG activity in two incremental tests till exhaustion: rhythmic knee-joint extensions and cycling. Wavelet analysis of surface EMG revealed differences in the dynamics of time-frequency characteristics of the signal during single cycle of two types of movements with different loads, as well as differences in the slow variations of spectral characteristics associated with the development of muscle fatigue during the tests. It was shown that during cycling with low loads (beginning of the test) maximum of EMG activity was confined within the second half of muscle contraction (the angle in the knee joint approximately 140 degrees), increase of load at the end of the test led to a shift of the peak to the beginning of the active phase of movement, while the median frequency of the "instant" wavelet spectra during muscle contraction remained almost unchanged. During knee-joint extensions the maximum of EMG activity was observed at the end of the active phase of movement for all loads, median frequency increased significantly with increasing the angle at the knee joint. Long-term dynamics of EMG intensity growth during these tests differed as well, whereas dynamics of wavelet-spectra median frequencies were practically the same--during both tests their growths were observed. PMID:22117468

  10. Interdisciplinary Simulation Using the Cardiopulmonary Bypass Simulator (CPBS)©

    PubMed Central

    Mendel, Shaun

    2014-01-01

    Abstract: Interdisciplinary education offerings between students of cardiovascular science and nurse anesthesia are uncommon despite the collaborative nature of these disciplines. The dual purpose of this article is to describe a method for interdisciplinary simulation and to report survey responses provided by participants. An interdisciplinary simulation session using concurrent use of the cardiopulmonary bypass simulator and the emergency care simulator is described. Interdisciplinary perceptions before and after the event were surveyed using the revised Interdisciplinary Education Perception Scale. Statistically significant differences between baseline and final survey responses were observed in the total score and within the areas of competency and perception of cooperation. Emerging simulation technologies and novel combinations of existing devices can facilitate meaningful interdisciplinary educational opportunities for health science students. PMID:26357799

  11. Extensive injury after use of a mechanical cardiopulmonary resuscitation device.

    PubMed

    Wind, J; Bekkers, S C A M; van Hooren, L J H; van Heurn, L W E

    2009-10-01

    We report a case of a 49-year-old woman with a ruptured liver and spleen found at autopsy, which may have been related to the use of a mechanical cardiopulmonary resuscitation (CPR) device (AutoPulse, ZOLL Medical Corporation, Chelmsford, Mass). She was admitted because of an out-of-hospital resuscitation, and under the suspicion of a pulmonary embolism, a thrombolytic agent was administered. Despite prolonged continuation of mechanical CPR, she died of persistent asystole. The evidence for improved outcomes after the use of a mechanical CPR device during resuscitation is still scarce. To prevent the unique complications reported here, regular checking of proper position of the chest band during resuscitation is advised. PMID:19857428

  12. Coronary blood flow during cardiopulmonary resuscitation in swine

    SciTech Connect

    Bellamy, R.F.; DeGuzman, L.R.; Pedersen, D.C.

    1984-01-01

    Recent papers have raised doubt as to the magnitude of coronary blood flow during closed-chest cardiopulmonary resuscitation. We will describe experiments that concern the methods of coronary flow measurement during cardiopulmonary resuscitation. Nine anesthetized swine were instrumented to allow simultaneous measurements of coronary blood flow by both electromagnetic cuff flow probes and by the radiomicrosphere technique. Cardiac arrest was caused by electrical fibrillation and closed-chest massage was performed by a Thumper (Dixie Medical Inc., Houston). The chest was compressed transversely at a rate of 66 strokes/min. Compression occupied one-half of the massage cycle. Three different Thumper piston strokes were studied: 1.5, 2, and 2.5 inches. Mean aortic pressure and total systemic blood flow measured by the radiomicrosphere technique increased as Thumper piston stroke was lengthened (mean +/- SD): 1.5 inch stroke, 23 +/- 4 mm Hg, 525 +/- 195 ml/min; 2 inch stroke, 33 +/- 5 mm Hg, 692 +/- 202 ml/min; 2.5 inch stroke, 40 +/- 6 mm Hg, 817 +/- 321 ml/min. Both methods of coronary flow measurement (electromagnetic (EMF) and radiomicrosphere (RMS)) gave similar results in technically successful preparations (data expressed as percent prearrest flow mean +/- 1 SD): 1.5 inch stroke, EMF 12 +/- 5%, RMS 16 +/- 5%; 2 inch stroke, EMF 30 +/- 6%, RMS 26 +/- 11%; 2.5 inch stroke, EMF 50 +/- 12%, RMS 40 +/- 20%. The phasic coronary flow signal during closed-chest compression indicated that all perfusion occurred during the relaxation phase of the massage cycle. We concluded that coronary blood flow is demonstrable during closed-chest massage, but that the magnitude is unlikely to be more than a fraction of normal.

  13. Reliability of peak O2 uptake and O2 uptake kinetics in step exercise tests in healthy subjects.

    PubMed

    Müller, Paulo de Tarso; Christofoletti, Gustavo; Zagatto, Alessandro Moura; Paulin, Fernanda Viana; Neder, J Alberto

    2015-02-01

    To date little is known about the reliability of peak oxygen consumption (V?O2PEAK) in incremental metronome paced step tests (IST) and the reliability of on-kinetics V?O2 has never been studied. We aimed to study the reliability of both tests. Eleven healthy subjects performed two ISTs until exhaustion. On two different days two duplicate 4min constant metronome paced step tests (CST) were performed. V?O2PEAK, mean response time (MRT) and phase II time constant (?) were tested for reproducibility using the paired t-tests, in addition to the limits of agreement (LOA) and within subject coefficient of variation (COV). With a 95% LOA of 0.38 to 0.26Lmin(-1), -8.7 to 9.1s and -9.9 to 10.5s they exhibit a COV of 3%, 4.5% and 6.9% for V?O2PEAK, MRT and ? respectively. ST are sufficiently reliable for maximal and submaximal aerobic power assessments in healthy subjects and new studies of oxygen uptake kinetics in selected patient groups are warranted. PMID:25511382

  14. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in conjunction with a blood gas sensor to measure the level of gases in the blood. (b) Classification. Class II (performance...

  15. 21 CFR 870.4340 - Cardiopulmonary bypass level sensing monitor and/or control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4340 Cardiopulmonary bypass level sensing monitor and/or control....

  16. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment....

  17. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment....

  18. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment....

  19. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment....

  20. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to cannulate the vessels, perfuse the coronary arteries, and to interconnect the catheters and cannulas with an oxygenator. The device includes accessory bypass equipment....

  1. How Do Beta Blocker Drugs Affect Exercise?

    MedlinePLUS

    ... provider can help to determine your new target heart rate using a brief exercise stress test . This test is used because beta ... medication that has less of an effect on heart rate. This content was last reviewed ... Infographic No time for exercise? Try our Top 10 Tips to get more! ...

  2. Reflex cardiopulmonary responses by stimulation to type J receptors in rats exposed to NO/sub 2/

    SciTech Connect

    Tsubone, H.; Suzuki, A.K.

    1984-01-01

    To examine the role of the vagal pathway on the cardiopulmonary functions in NO/sub 2/-exposed rats, phenyl diguanide, which stimulates type J receptors in the lungs, was injected to control and exposed rats at a constant dose. Based on a statistcal test, a decrease in the heart rate (HR) after the injection was observed in the groups exposed to 20 ppm NO/sub 2/ for 1.5 h and 3 h, and 10 ppm for 24 h. On the other hand, an increase in respiratory rate (RR) was observed in the groups exposed to 10 ppm for 3 h and 4 ppm for 1 wk. No change in HR and RR was found in the group exposed to 0.4 ppm for 4 wk. These results suggest that the augmentation of the reflex cardiopulmonary responses due to stimulation to the type J receptors was produced by exposures with a higher concentration of NO/sub 2/. 24 references, 7 figures, 2 tables.

  3. A Systematic Review of Effects of Concurrent Strength and Endurance Training on the Health-Related Quality of Life and Cardiopulmonary Status in Patients with HIV/AIDS

    PubMed Central

    Ogalha, Cecília; Andrade, Antônio Marcos; Brites, Carlos

    2013-01-01

    Purpose. To determine the effects of concurrent strength and endurance training (concurrent training) on the Health-Related Quality of Life (HRQOL) and cardiopulmonary status among HIV-infected patients, using a systematic search strategy of randomized, controlled trials (RCTs). Methods. A systematic review was performed by two independent reviewers using Cochrane Collaboration protocol. The sources used in this review were Cochrane Library, EMBASE, LILACS, MEDLINE, PEDro and Web of Science from 1950 to August 2012. The PEDro score was used to evaluate methodological quality. Result. Individual studies suggested that concurrent training contributed to improved HRQOL and cardiovascular status. Concurrent training appears to be safe and may be beneficial for medically stable adults living with HIV. The rates of nonadherence were of 16%. Conclusion. Concurrent training improves the HRQOL and cardiopulmonary status. It may be an important intervention in the care and treatment of adults living with HIV. Further research is needed to determine the minimal and optimal duration, frequency, and intensity of exercise needed to produce beneficial changes in the HIV-infected population subgroups. PMID:23691497

  4. Gender differences in myocardial function and arterio-ventricular coupling in response to maximal exercise in adolescent floor-ball players

    PubMed Central

    2014-01-01

    Background The hemodynamic and cardiac responses to exercise have been widely investigated in adults. However, little is known regarding myocardial performance in response to a short bout of maximal exercise in adolescents. We therefore sought to study alterations in myocardial function and investigate sex-influences in young athletes after maximal cardiopulmonary testing. Methods 51 adolescent (13-19 years old) floor-ball players (24 females) were recruited. All subjects underwent a maximal exercise test to determine maximal oxygen uptake (VO2max) and cardiac output. Cardiac performance was investigated using conventional and tissue velocity imaging, as well as 2D strain echocardiography before and 30 minutes following exercise. Arterio-ventricular coupling was evaluated by means of single beat ventricular elastance and arterial elastance. Results Compared to baseline the early diastolic myocardial velocity (E?LV) at the basal left ventricular (LV) segments declined significantly (females: E?LV: 14.7 +/- 2.6 to 13.6 +/- 2.9 cm/s; males: 15.2 +/- 2.2 to 13.9 +/- 2.3 cm/s, p?exercise (2D strain LV: from 21.5 +/- 2.4 to 20.2 +/- 2.7% in females, and from 20 +/- 1 to 17.9 +/- 1.5% in males, p?exercise (p?>?0.05). Arterial elastance) Ea) at baseline was identified as the only predictor of VO2max in males (r?=?0.76, p??0.05). Conclusions The present study demonstrates that vigorous exercise of short duration results in a significant decrease of longitudinal myocardial motion in both sexes. However, in view of unaltered end systolic LV elastance (Ees), these reductions most probably reflect changes in the loading conditions and not an attenuation of myocardial function per se. Importantly, we show that arterial load at rest acts as a strong predictor of VO2max in males but not in female subjects. PMID:25045524

  5. Passive Leg Raising Correlates with Future Exercise Capacity after Coronary Revascularization.

    PubMed

    Huang, Shu-Chun; Wong, May-Kuen; Lin, Pyng-Jing; Tsai, Feng-Chun; Wen, Ming-Shien; Kuo, Chi-Tai; Hsu, Chih-Chin; Wang, Jong-Shyan

    2015-01-01

    Hemodynamic properties affected by the passive leg raise test (PLRT) reflect cardiac pumping efficiency. In the present study, we aimed to further explore whether PLRT predicts exercise intolerance/capacity following coronary revascularization. Following coronary bypass/percutaneous coronary intervention, 120 inpatients underwent a PLRT and a cardiopulmonary exercise test (CPET) 2-12 days during post-surgery hospitalization and 3-5 weeks after hospital discharge. The PLRT included head-up, leg raise, and supine rest postures. The end point of the first CPET during admission was the supra-ventilatory anaerobic threshold, whereas that during the second CPET in the outpatient stage was maximal performance. Bio-reactance-based non-invasive cardiac output monitoring was employed during PLRT to measure real-time stroke volume and cardiac output. A correlation matrix showed that stroke volume during leg raise (SVLR) during the first PLRT was positively correlated (R = 0.653) with the anaerobic threshold during the first CPET. When exercise intolerance was defined as an anaerobic threshold < 3 metabolic equivalents, SVLR / body weight had an area under curve value of 0.822, with sensitivity of 0.954, specificity of 0.593, and cut-off value of 1504·10-3mL/kg (positive predictive value 0.72; negative predictive value 0.92). Additionally, cardiac output during leg raise (COLR) during the first PLRT was related to peak oxygen consumption during the second CPET (R = 0.678). When poor aerobic fitness was defined as peak oxygen consumption < 5 metabolic equivalents, COLR / body weight had an area under curve value of 0.814, with sensitivity of 0.781, specificity of 0.773, and a cut-off value of 68.3 mL/min/kg (positive predictive value 0.83; negative predictive value 0.71). Therefore, we conclude that PLRT during hospitalization has a good screening and predictive power for exercise intolerance/capacity in inpatients and early outpatients following coronary revascularization, which has clinical significance. PMID:26360736

  6. Passive Leg Raising Correlates with Future Exercise Capacity after Coronary Revascularization

    PubMed Central

    Huang, Shu-Chun; Wong, May-Kuen; Lin, Pyng-Jing; Tsai, Feng-Chun; Wen, Ming-Shien; Kuo, Chi-Tai; Hsu, Chih-Chin; Wang, Jong-Shyan

    2015-01-01

    Hemodynamic properties affected by the passive leg raise test (PLRT) reflect cardiac pumping efficiency. In the present study, we aimed to further explore whether PLRT predicts exercise intolerance/capacity following coronary revascularization. Following coronary bypass/percutaneous coronary intervention, 120 inpatients underwent a PLRT and a cardiopulmonary exercise test (CPET) 2–12 days during post-surgery hospitalization and 3–5 weeks after hospital discharge. The PLRT included head-up, leg raise, and supine rest postures. The end point of the first CPET during admission was the supra-ventilatory anaerobic threshold, whereas that during the second CPET in the outpatient stage was maximal performance. Bio-reactance-based non-invasive cardiac output monitoring was employed during PLRT to measure real-time stroke volume and cardiac output. A correlation matrix showed that stroke volume during leg raise (SVLR) during the first PLRT was positively correlated (R = 0.653) with the anaerobic threshold during the first CPET. When exercise intolerance was defined as an anaerobic threshold < 3 metabolic equivalents, SVLR / body weight had an area under curve value of 0.822, with sensitivity of 0.954, specificity of 0.593, and cut-off value of 1504·10-3mL/kg (positive predictive value 0.72; negative predictive value 0.92). Additionally, cardiac output during leg raise (COLR) during the first PLRT was related to peak oxygen consumption during the second CPET (R = 0.678). When poor aerobic fitness was defined as peak oxygen consumption < 5 metabolic equivalents, COLR / body weight had an area under curve value of 0.814, with sensitivity of 0.781, specificity of 0.773, and a cut-off value of 68.3 mL/min/kg (positive predictive value 0.83; negative predictive value 0.71). Therefore, we conclude that PLRT during hospitalization has a good screening and predictive power for exercise intolerance/capacity in inpatients and early outpatients following coronary revascularization, which has clinical significance. PMID:26360736

  7. Exercise and Compulsive Behavior.

    ERIC Educational Resources Information Center

    Polivy, Janet; Clendenen, Vanessa

    Although reports on the positive effects of fitness and exercise predominate in the exercise literature, some researchers describe frequent exercise as compulsive or addictive behavior. This paper addresses these "negative addictions" of exercise. As early as 1970, researchers recognized the addictive qualities of exercise. Short-term studies on…

  8. The Relation of Respiratory Muscle Strength to Disease Severity and Abnormal Ventilation During Exercise in Chronic Heart Failure Patients

    PubMed Central

    Kasahara, Yusuke; Izawa, Kazuhiro P.; Watanabe, Satoshi; Osada, Naohiko; Omiya, Kazuto

    2015-01-01

    Background: Breathlessness is a common problem in chronic heart failure (CHF) patients, and respiratory muscle strength has been proposed to play an important role in causing breathlessness in these patients. Objectives: The aim of this study was to investigate the relation between respiratory muscle strength and the severity of CHF, and the influence of respiratory muscle strength on abnormal ventilation during exercise in CHF patients. Patients and Methods: In this case series study, we assessed clinically stable CHF outpatients (N = 66, age: 57.7 ± 14.6 years). The peak oxygen consumption (peak VO2), the slope relating minute ventilation to carbon dioxide production (VE/VCO2 slope), and the slope relating tidal volume to respiratory rate (TV/RR slope) were measured during cardiopulmonary exercise testing. Respiratory muscle strength was assessed by measuring the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Results: The MIP and MEP decreased significantly as the New York Heart Association functional class increased (MIP, P = 0.021; MEP, P < 0.01). The MIP correlated with the TV/RR slope (r = 0.57, P < 0.001) and the VE/VCO2 slope (r = -0.44, P < 0.001), and the MEP also correlated with the TV/RR slope (r = 0.53, P < 0.001) and the VE/VCO2 slope (r = -0.25, P < 0.040). Stepwise multiple regression analysis revealed that age and MIP were statistically significant predictors of the TV/RR and VE/VCO2 slopes (both P < 0.05). Conclusions: Respiratory muscle strength is related to the severity of CHF, and associated with rapid and shallow ventilation or excessive ventilation during exercise. PMID:26528451

  9. Preferred Exertion across Three Common Modes of Exercise Training.

    ERIC Educational Resources Information Center

    Glass, Stephen C.; Chvala, Angela M.

    2001-01-01

    Examined the influence of exercise mode on self-selected exercise intensities. Participants performed three types of intensity tests. Researchers collected data on VO2 values continuously and recorded 1-minute averages several times for each submaximal test. Participants allowed to self-select exercise intensity chose work rates within the…

  10. An Exercise to Introduce Power

    ERIC Educational Resources Information Center

    Seier, Edith; Liu, Yali

    2013-01-01

    In introductory statistics courses, the concept of power is usually presented in the context of testing hypotheses about the population mean. We instead propose an exercise that uses a binomial probability table to introduce the idea of power in the context of testing a population proportion. (Contains 2 tables, and 2 figures.)

  11. An alternative approach for the safety evaluation of new and existing chemicals, an exercise in integrated testing.

    PubMed

    Gubbels-van Hal, W M L G; Blaauboer, B J; Barentsen, H M; Hoitink, M A; Meerts, I A T M; van der Hoeven, J C M

    2005-08-01

    Various in vitro and in silico methods without animals were applied to 10 substances listed on ELINCS with a complete VIIA base-set available at NOTOX. The hazard assessment for these substances was performed on basis of available non-animal data, QSAR, PBBK-modelling and additional, new in vitro testing was applied. Based on these data predictions on fish toxicity, acute toxicity, skin- and eye-irritation, sensitisation, and toxicity after repeated dosing were made. The predictions were compared with the outcome of the in vivo tests. Nine out of ten predictions on fish LC(50) proved to be correct. For skin- and eye-irritation 70% was predicted correctly. Sensitisation was predicted correctly for 7 out of 10 substances, but three false negatives were found. Acute oral toxicity (LD(50)) and repeated dose toxicity were less successful (5 out of 10 and 2 out of 10 correct predictions, respectively); application of the PBBK model proved successful. Acute dermal toxicity was predicted correctly in 9 out of 10 cases. In general an over-estimation of systemic toxicity was found, which can be explained by an over-prediction of cytotoxicity and worst case assumptions on absorption and binding to (plasma) proteins. This integrated approach leads to a 38% reduction of laboratory animals. PMID:15979772

  12. Exercise and immunity

    MedlinePLUS

    ... know exactly if or how exercise increases your immunity to certain illnesses, but there are several theories ( ... not exercise more intensely just to increase their immunity. Heavy, long-term exercise (such as marathon running ...

  13. Why Exercise Is Cool

    MedlinePLUS

    ... help this important muscle get stronger by doing aerobic (say: air-OH-bik) exercise. Exercise is good ... your lungs. Which of these is your favorite? Aerobic means "with air," so aerobic exercise is a ...

  14. Rotator cuff exercises

    MedlinePLUS

    Shoulder exercises ... A key part in your recovery is doing exercises to make the muscles and tendons in your ... for everyday tasks or sports activities Before doing exercises at home, ask your doctor or physical therapist ...

  15. Name:_____________________________ (Web Exercise)

    E-print Network

    Richardson, David

    Name:_____________________________ (Web Exercise) Model quality, validation exercise. You will need:_____________________________ Model quality, validation exercise (cont'd). Part 2: local comparison of 2Å and 1.25Å structures. One

  16. Cardiopulmonary Resuscitation, Chest Compression Only and Teamwork From the Perspective of Medical Doctors, Surgeons and Anesthesiologists

    PubMed Central

    Krajina, Irena; Kvolik, Slavica; Steiner, Robert; Kovacevic, Kristina; Lovric, Ivan

    2015-01-01

    Background: New resuscitation guidelines that were proposed by the European Resuscitation Council in 2010 have introduced a new method of cardiopulmonary resuscitation (CPR) by chest compressions only for untrained individuals. Objectives: We conducted this study to evaluate differences in attitudes towards CPR among medical doctors, surgeons and anesthesiologists in Osijek University Hospital. A call for help, chest-compression-only resuscitation, mouth-to-mouth ventilation and team-work were recognized as critical points that may influence the outcome. Unfamiliarity with these methods may be indicative of a lack of education in resuscitation and may result in poor outcomes for victims. Patients and Methods: An anonymous survey was conducted on 190 medical professionals: 93 medical doctors, 70 surgeons, and 27 anesthesiologists during year 2012 (mean age 41.9 years). The questions were related to previous education in resuscitation, current resuscitation practices and attitudes towards cardiopulmonary resuscitation. Data were analyzed using ANOVA and Fisher exact test. A P value of < 0.05 was considered statistically significant. Results: The only difference between groups was regarding the male and female ratio, with more male surgeons (45, 55, and 11, P < 0.001). All doctors considered CPR as important, but only anesthesiologists knew how often guidelines in CPR change. Approximately 45% of medical doctors, 48% of surgeons and 77% of anesthesiologists reported that they have renewed their knowledge in CPR within the last five years, whereas 34%, 25% and 22% had never renewed their knowledge in the CPR (P = 0.01 between surgeons anesthesiologists). Furthermore, chest-compression-only was recognized as a valuable CPR technique by 25.8% of medical doctors, 14.3% of surgeons and 59.3% of anesthesiologists (P < 0.001). Anesthesiologists estimated a high risk of infection transmission (62%) and were more likely to refuse mouth-to-mouth ventilation when compared to surgeons (25% vs.10%, P = 0.01). Anesthesiologists are most often called for help by their colleagues, only rarely surgeons call their departmental colleagues and nurses to help in CPR. Conclusions: An insufficient formal education in CPR was registered for all groups, reflecting the lack of familiarity with new CPR methods. A team education, involving doctors and nurses may improve familiarity with CPR and patient outcomes. PMID:26019895

  17. Whole Blood Cardioplegia (Minicardioplegia) Reduces Myocardial Edema After Ischemic Injury and Cardiopulmonary Bypass

    PubMed Central

    McCann, Ulysses G.; Lutz, Charles J.; Picone, Anthony L.; Searles, Bruce; Gatto, Louis A.; Dilip, Karikehalli A.; Nieman, Gary F.

    2006-01-01

    Abstract: While blood:crystalloid cardioplegia is the clinical standard for patients undergoing cardiopulmonary bypass (CPB), it has been postulated that whole blood minicardioplegia may benefit the severely injured heart by reducing cardioplegic volume, thereby reducing myocardial edema. To test this hypothesis, we compared the cardioprotection of a popular 4:1 blood:crystalloid cardioplegia to whole blood minicardioplegia (WB) in a porcine model of acute myocardial ischemia. Yorkshire pigs (n = 20) were placed on atriofemoral bypass and subjected to 30 minutes of global normothermic ischemia. Animals were randomized to receive either 4:1 cold cardioplegia (n = 10) or WB cold cardioplegia (n = 10) delivered antegrade continuously for 90 minutes. Baseline (BL) echocardiographic determination of left ventricular mass (LVM) was compared within groups for cardiac edema (%) measured by histologic morphometrics. All (100%) animals receiving WB were successfully weaned off CPB, whereas only 40% of animals receiving 4:1 were successfully weaned off CPB. Cardiac edema percentage (p < .004) and LVM (p < .05) were significantly decreased in the WB group compared with 4:1. WB cardioplegia increases the number of hearts successfully weaned from CPB and decreases cardiac edema in our porcine model of acute myocardial ischemia. This finding implies whole blood cardioplegia may be more protective in a select group of patients undergoing extended CPB time by decreasing myocardial edema. PMID:16637518

  18. Microemboli from Cardiopulmonary Bypass are Associated with a Serum Marker of Brain Injury

    PubMed Central

    Groom, Robert C.; Quinn, Reed D.; Lennon, Paul; Welch, Janine; Kramer, Robert S.; Ross, Cathy S.; Beaulieu, Peter A.; Brown, Jeremiah R.; Malenka, David J.; O’Connor, Gerald T.; Likosky, Donald S.

    2010-01-01

    Abstract: An increasing number of reports surrounding neurologic injury in the setting of cardiac surgery has focused on utilizing biomarkers as intermediate outcomes. Previous research has associated cerebral microemboli and neurobehavioral deficits with biomarkers. A leading source of cerebral microemboli is the cardiopulmonary bypass (CPB) circuit. This present study seeks to identify a relationship between microemboli leaving the CPB circuit and a biomarker of neurologic injury. We enrolled 71 patients undergoing coronary artery bypass grafting at a single institution from October 14, 2004 through December 5, 2007. Microemboli were monitored using Power-M-Mode Doppler in the inflow and outflow of the CPB circuit. Blood was sampled before and within 48 hours after surgery. Neurologic injury was measured using S100? (microg/L). Significant differences in post-operative S100? relative to microemboli leaving the circuit were tested with analysis of variance and Kruskal-Wallis. Most patients had increased serum levels of S100? (mean .25 microg/L, median .15 microg/L) following surgery. Terciles of microemboli measured in the outflow (indexed to the duration of time spent on CPB) were associated with elevated levels of S100? (p = .03). Microemboli leaving the CPB circuit were associated with increases in postoperative S100? levels. Efforts aimed at reducing microembolic load leaving the CPB circuit should be adopted to reduce brain injury. PMID:20437790

  19. A numerical performance assessment of a commercial cardiopulmonary by-pass blood heat exchanger.

    PubMed

    Consolo, Filippo; Fiore, Gianfranco B; Pelosi, Alessandra; Reggiani, Stefano; Redaelli, Alberto

    2015-06-01

    We developed a numerical model, based on multi-physics computational fluid dynamics (CFD) simulations, to assist the design process of a plastic hollow-fiber bundle blood heat exchanger (BHE) integrated within the INSPIRE(TM), a blood oxygenator (OXY) for cardiopulmonary by-pass procedures, recently released by Sorin Group Italia. In a comparative study, we analyzed five different geometrical design solutions of the BHE module. Quantitative geometrical-dependent parameters providing a comprehensive evaluation of both the hemo- and thermo-dynamics performance of the device were extracted to identify the best-performing prototypical solution. A convenient design configuration was identified, characterized by (i) a uniform blood flow pattern within the fiber bundle, preventing blood flow shunting and the onset of stagnation/recirculation areas and/or high velocity pathways, (ii) an enhanced blood heating efficiency, and (iii) a reduced blood pressure drop. The selected design configuration was then prototyped and tested to experimentally characterize the device performance. Experimental results confirmed numerical predictions, proving the effectiveness of CFD modeling as a reliable tool for in silico identification of suitable working conditions of blood handling medical devices. Notably, the numerical approach limited the need for extensive prototyping, thus reducing the corresponding machinery costs and time-to-market. PMID:25890509

  20. Work, exercise, and space flight. 3: Exercise devices and protocols

    NASA Technical Reports Server (NTRS)

    Thornton, William

    1989-01-01

    Preservation of locomotor capacity by earth equivalent, exercise in space is the crucial component of inflight exercise. At this time the treadmill appears to be the only way possible to do this. Work is underway on appropriate hardware but this and a proposed protocol to reduce exercise time must be tested. Such exercise will preserve muscle, bone Ca(++) and cardiovascular-respiratory capacity. In addition, reasonable upper body exercise can be supplied by a new force generator/measurement system-optional exercise might include a rowing machine and bicycle ergometer. A subject centered monitoring-evaluation program will allow real time adjustments as required. Absolute protection for any astronaut will not be possible and those with hypertrophied capacities such as marathoners or weight lifters will suffer significant loss. However, the program described should return the crew to earth with adequate capacity of typical activity on earth including immediate ambulation and minimal recovery time and without permanent change. An understanding of the practical mechanics and biomechanics involved is essential to a solution of the problem.

  1. Exercise haemodynamics and maximal exercise capacity during beta-adrenoceptor blockade in normotensive and hypertensive subjects.

    PubMed Central

    van Baak, M A; Koene, F M; Verstappen, F T

    1988-01-01

    1. The effects of atenolol administration on maximal exercise capacity and exercise haemodynamics have been compared in eight normotensive and eight mildly hypertensive subjects, matched for sex, age, body weight, and maximal oxygen uptake, and familiar with maximal exercise testing. 2. Supine and exercise blood pressure, and exercise total peripheral resistance were significantly higher, and exercise cardiac output was significantly lower in the hypertensive than in the normotensive subjects. 3. Administration of atenolol (1 X 100 mg day-1) for 3 days reduced supine and exercise systolic blood pressure, heart rate, and cardiac output, and increased exercise stroke volume. Supine and exercise diastolic blood pressure and exercise total peripheral resistance were unaffected by atenolol. The effects of atenolol did not differ in the normotensive and the hypertensive subjects. 4. Maximal work load, maximal oxygen uptake, and maximal heart rate were reduced to a similar extent in normotensive and hypertensive subjects during atenolol treatment. 5. It is concluded that there is no difference in the effects of short-term atenolol administration on exercise haemodynamics and maximal exercise capacity in normotensive and mildly hypertensive subjects. PMID:2896013

  2. An expanding role for cardiopulmonary bypass in trauma

    PubMed Central

    Chughtai, Talat S.; Gilardino, Miroslav S.; Fleiszer, David M.; Evans, David C.; Brown, Rea A.; Mulder, David S.

    2002-01-01

    Objectives To analyze experience at the McGill University Health Centre with cardiopulmonary bypass (CPB) in trauma, complemented by a review of the literature to define its role globally and outline indications for its expanded use in trauma management. Data sources All available published English-language articles from peer reviewed journals, located using the MEDLINE database. Chapters from relevant, current textbooks were also utilized. Study selection Nine relevant case reports, original articles or reviews pertaining to the use of CPB in trauma. Data extraction Original data as well as authors’ opinions pertinent to the application of CPB to trauma were extracted, incorporated and appropriately referenced in our review. Data synthesis Overall mortality in the selected series of CPB used in the trauma setting was 44.4%. Four of 5 survivors had CPB instituted early (first procedure in operative management) whereas 3 of 4 deaths involved late institution of CPB. Conclusions Although CPB has traditionally been used in the setting of cardiac trauma alone, a better understanding of its potential benefit in noncardiac injuries will likely make for improved outcomes in the increasingly diverse number of severely injured patients seen in trauma centres today. Further studies by other trauma centres will allow for standardized indications for the use of CPB in trauma. PMID:11939667

  3. [Cardiopulmonary resuscitation already in Egypt 5,000 years ago?].

    PubMed

    Ocklitz, A

    1997-06-01

    In light of the medically relevant features of the ancient Egyptian mouth-opening ceremony, the question of the effectiveness of medical practices in Egypt thousands of years ago is examined, whereby the religious and cultural framework also plays a significant role. In the Land on the Nile myth and reality clearly generated special conditions which favoured the systematic treatment of questions of resuscitation. Numerous examples show that this had practical consequences in the area of everyday medicine. In addition, rebirth and resurrection were central elements of the cult of the dead which had exact medical equivalents. These equivalents may demonstrate the advanced state of resuscitation practices in Egypt at that time. In this context, a reconstruction of an ancient Egyptian mouth-opening instrument is presented. In the cult of the dead, this instrument played a role which can be compared to the function of a modern laryngoscope. It appears possible that at the time of the pyramids the Egyptians already had an understanding of the technology required to perform instrument-aided artificial respiration. Whether or not they actually possessed a fundamental knowledge of the principles of cardio-pulmonary resuscitation remains unclear. Nevertheless, the astonishingly functional characteristics of the reconstructed mouth-opening instrument suggest that it was developed for more than purely symbolic purposes. PMID:9281230

  4. Accuracy of Temperature Measurement in the Cardiopulmonary Bypass Circuit

    PubMed Central

    Newland, Richard F.; Sanderson, Andrew J.; Baker, Robert A.

    2005-01-01

    Abstract: Oxygenator arterial outlet blood temperature is routinely measured in the cardiopulmonary bypass (CPB) circuit as a surrogate for the temperature of the arterial blood delivered to sensitive organs such as the brain. The aim of this study was to evaluate the accuracy of the temperature thermistors used in the Terumo Capiox® SX25 oxygenator and to compare the temperature measured at the outlet of the oxygenator using the Capiox® CX*TL Luer Thermistor with temperatures measured at distal sites. Five experimental stages were performed in vitro to achieve this aim. Under our experimental conditions, the luer thermistors accurately measured the temperature as referenced by a precision thermometer. In the CPB circuit, the difference between arterial outlet and reference thermometer temperature varied with outlet temperature over-reading at low temperatures and under reading at high temperatures. There was negligible heat loss (?0.4 ± 0.1°C) measured at 4.5 m from the arterial outlet. The Terumo Capiox® CX*TL Luer Thermistor is an accurate and reliable instrument for measuring temperature when incorporated into the Capiox Oxygenator. The accuracy in the measurement of temperature using these thermistors is affected by the thermistor immersion depth. Under reading of the arterial blood temperature by approximately 0.5°C should be considered at normothermic temperatures, to avoid exceeding the maximum arterial blood temperature as described by institutional protocols. The accuracy of blood temperature measurements should be considered for all oxygenator arterial outlet temperature probes. PMID:15804154

  5. Venous obstruction and cerebral perfusion during experimental cardiopulmonary bypass.

    PubMed

    Tovedal, Thomas; Jonsson, Ove; Zemgulis, Vitas; Myrdal, Gunnar; Thelin, Stefan; Lennmyr, Fredrik

    2010-11-01

    To investigate the effects on cerebral perfusion by experimental venous congestion of the superior vena cava (SVC) during bicaval cardiopulmonary bypass (CPB) at 34 °C, pigs were subjected to SVC obstruction at levels of 75%, 50%, 25% and 0% of baseline SVC flow at two arterial flow levels (low, LQ, high, HQ). The cerebral perfusion was examined with near-infrared spectroscopy (NIRS), cerebral microdialysis and blood gas analysis. SVC obstruction caused significant decreases in the NIRS tissue oxygenation index (TOI) and in SVC oxygen saturations (P<0.05, both groups), while the mixed venous saturation was decreased only in the LQ group. Sagittal sinus venous saturations were measured in the HQ group and found significantly reduced in response to venous congestion (P<0.05). No microdialysis changes were seen at the group level, however, individual ischemic patterns in terms of concomitant venous desaturation, decreased TOI and increased lactate/pyruvate occurred in both groups. The total venous drainage remained stabile throughout the experiment, indicating increased flow in the inferior vena cava cannula. The results indicate that SVC congestion may impair cerebral perfusion especially in the case of compromised arterial flow during CPB. Reduced SVC cannula flow may pass undetected during bicaval CPB, if SVC flow is not specifically monitored. PMID:20696750

  6. Rupture of Extra-Corporeal Circuit Tubing During Cardiopulmonary Bypass

    PubMed Central

    Krishna, Cheemalapati Sai; Kumar, Palli Venkata Naresh; Satpathy, Soumya Kanta; Mohan, Kanteti Ram; Babu, Vedangi Ramesh

    2008-01-01

    Abstract: Roller pumps are widely used for cardiopulmonary bypass in developing nations by virtue of proven safety during several years of institutional use and cost effectiveness. However, careful adjustment of roller occlusion is needed because they are known to cause spallation, tubing wear, and the occasional incident of rupture of tubing in the extracorporeal circuit. Rupture of polyvinylchloride tubing in the pump raceway during repair of a ventricular septal defect in a 4-year-old child is discussed. The event was managed by exclusion and replacement of the defective tubing during a short period of arrest. Use of an inappropriate boot pump and failure to detect its inclusion in the bypass circuit was a significant departure from protocol. However, because occlusion settings and duration of perfusion were within acceptable limits, a manufacturing flaw could also have contributed to tubing failure, and the event may or may not have been averted by the use of larger tubing. In conclusion, this incident reiterates the need for adherence to established protocol during assembly of the pump and draws attention to the fact that tubing integrity is not a guarantee and vigilance is warranted to handle its failure. PMID:18389670

  7. Development of a hemodynamically optimized outflow cannula for cardiopulmonary bypass.

    PubMed

    Kaufmann, Tim A S; Schlanstein, Peter; Moritz, Anton; Steinseifer, Ulrich

    2014-11-01

    The jet of the outflow cannula is a potential risk for patients undergoing cardiopulmonary bypass (CPB), because increased jet velocities lead to altered flow conditions and might furthermore mobilize atherosclerotic plaques from calcified aortas. The cannula jet is therefore among the main reasons for cerebral hypoxia and stroke in CPB patients. In the past, we developed a validated computational fluid dynamics (CFD) model to analyze flow conditions during CPB as dependent on cannulation and support modalities. This model is now applied to develop a novel CPB outflow cannula to reduce the jet effect and increase cerebral blood flow. The Multi-Module Cannula (MMC) is based on a generic elbow cannula that was iteratively improved. It features an inner wall to smoothly guide the blood as well as an elliptically shaped outlet diffuser. During standard CPB conditions of 5 L/min, the pressure drop over the MMC is 61 mm Hg, compared with 68 mm Hg with a standard cannula. The maximum velocities are decreased from 3.7 m/s to 3.3 m/s. In the cannula jet of the MMC, the velocities are reduced further, down to 1.6 m/s. The cerebral blood flow is typically reduced during CPB. Using the MMC, however, it reaches almost physiological values at 715 mL/min. These results suggest that the MMC outperforms standard CPB cannulas. Further design improvements and improved insertion techniques are under consideration. PMID:24533575

  8. Cardiopulmonary Bypass in Patients With Pre-existing Coagulopathy

    PubMed Central

    DeBois, William; Liu, Junli; Lee, Leonard; Girardi, Leonard; Ko, Wilson; Tortolani, Anthony; Krieger, Karl; Isom, O. Wayne

    2005-01-01

    Abstract: Patients with pre-existing coagulopathies who undergo surgical interventions are at increased risk for bleeding complications. This risk is especially true in cardiac surgical procedures with cardiopulmonary bypass (CPB) because of the necessity for heparinization and the use of the extracorporeal circuits, which have destructive effects on most of the blood components. In this review, cases of cardiac surgeries in patients with certain pre-existing coagulopathies are summarized, which could shed a light on future managements of such patients undergoing cardiac procedures with CPB. Pre-existing coagulopathies include antithrombin III deficiency, heparin-induced thrombocytopenia, cancer, factor XII deficiency, hemophilia, idiopathic thrombocytopenic purpura, protein S deficiency, and drug-induced platelet inhibition. In summary, pre-existing coagulopathy in patients undergoing open-heart surgeries, if not recognized and appropriately managed, can cause serious complications. Management of patients undergoing cardiac procedures should include a routine coagulation work-up and a thorough past medical history examination. If any of the foregoing is abnormal, further evaluation is warranted. Proper diagnosis and management of the pre-existing coagulopathy disorders is of crucial importance to the surgical outcome and long-term morbidity. PMID:15804152

  9. Capnography during cardiopulmonary resuscitation: Current evidence and future directions.

    PubMed

    Kodali, Bhavani Shankar; Urman, Richard D

    2014-10-01

    Capnography continues to be an important tool in measuring expired carbon dioxide (CO2). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC). Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO2 values can guide the initiation of extracorporeal life support (ECLS) in refractory cardiac arrest (RCA). There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes. PMID:25400399

  10. Exercise Challenge for Exercise-Induced Bronchospasm. Confirming Presence, Evaluating Control.

    ERIC Educational Resources Information Center

    Kaplan, Ted A.

    1995-01-01

    Exercise-induced bronchospasm commonly strikes young people, keeping many away from activity. The exercise challenge test (a powerful tool in diagnosing the condition, fine-tuning treatment, and improving patient compliance) can help get patients back in action. Knowing how to interpret and use test results helps physicians expedite effective…

  11. Reinforcing Science with Web-based Exercises.

    ERIC Educational Resources Information Center

    Loegering, John P.; Edge, W. Daniel

    2002-01-01

    Reports on the creation of web-based exercises to support an existing course and tested their effectiveness. Students' academic performance on course topics associated with the modules they completed was over 3% higher than those they did not complete, and students believed the modules were a worthwhile exercise. (Author/MM)

  12. Musk as a Pheromone? Didactic Exercise.

    ERIC Educational Resources Information Center

    Bersted, Chris T.

    A classroom/laboratory exercise has been used to introduce college students to factorial research designs, differentiate between interpretations for experimental and quasi-experimental variables, and exemplify application of laboratory research methods to test practical questions (advertising claims). The exercise involves having randomly divided…

  13. Teaching and Learning with Individually Unique Exercises

    ERIC Educational Resources Information Center

    Joerding, Wayne

    2010-01-01

    In this article, the author describes the pedagogical benefits of giving students individually unique homework exercises from an exercise template. Evidence from a test of this approach shows statistically significant improvements in subsequent exam performance by students receiving unique problems compared with students who received traditional…

  14. Potato Types and Characteristics: Laboratory Exercises.

    ERIC Educational Resources Information Center

    Pavlista, Alexander D.

    1997-01-01

    Presents a number of simple exercises that demonstrate potato tuber characteristics and are designed for high school biology students and teachers. Exercises include Typing, Grading, Shape, Eye Characteristics, Defects, Specific Gravity, Dry Matter Content, Glucose Content, Baking, Frying/Chipping, and Taste Testing. (JRH)

  15. Testing the effectiveness of a self-efficacy based exercise intervention for adults with venous leg ulcers: protocol of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Exercise and adequate self-management capacity may be important strategies in the management of venous leg ulcers. However, it remains unclear if exercise improves the healing rates of venous leg ulcers and if a self-management exercise program based on self-efficacy theory is well adhered to. Method/design This is a randomised controlled in adults with venous leg ulcers to determine the effectiveness of a self-efficacy based exercise intervention. Participants with venous leg ulcers are recruited from 3 clinical sites in Australia. After collection of baseline data, participants are randomised to either an intervention group or control group. The control group receive usual care, as recommended by evidence based guidelines. The intervention group receive an individualised program of calf muscle exercises and walking. The twelve week exercise program integrates multiple elements, including up to six telephone delivered behavioural coaching and goal setting sessions, supported by written materials, a pedometer and two follow-up booster calls if required. Participants are encouraged to seek social support among their friends, self-monitor their weekly steps and lower limb exercises. The control group are supported by a generic information sheet that the intervention group also receive encouraging lower limb exercises, a pedometer for self-management and phone calls at the same time points as the intervention group. The primary outcome is the healing rates of venous leg ulcers which are assessed at fortnightly clinic appointments. Secondary outcomes, assessed at baseline and 12 weeks: functional ability (range of ankle motion and Tinetti gait and balance score), quality of life and self-management scores. Discussion This study seeks to address a significant gap in current wound management practice by providing evidence for the effectiveness of a home-based exercise program for adults with venous leg ulcers. Theory-driven, evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact in improving the management of people with venous leg ulcers. Information gained from this study will provide much needed information on management of this chronic disease to promote health and independence in this population. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612000475842. PMID:25277416

  16. Effect of the release exercise and exercise position in a patient with carpal tunnel syndrome.

    PubMed

    Yoo, Won-Gyu

    2015-10-01

    [Purpose] This study examined the effect of the release exercise and exercise position in carpal tunnel syndrome (CTS). [Subject] A 40-year-old, right-hand-dominant man presented with CTS, with pain and progressive tingling and numbness in the right hand. [Methods] The subject performed three exercises: (1) release, (2) wrist flexor stretching, and (3) wrist extensor stretching. In session 1, the subject performed exercises 2 and 3 in the standing position for 2 weeks. In session 2, the subject performed all three exercises in the supine position for 2 weeks. [Results] The pressure pain threshold decreased after session 1 and decreased further after session 2, and the Phalen's test and Tinel sign became progressively less positive. [Conclusion] Exercises in the supine position, including release exercises, are recommended for CTS. PMID:26644707

  17. Effect of the release exercise and exercise position in a patient with carpal tunnel syndrome

    PubMed Central

    Yoo, Won-gyu

    2015-01-01

    [Purpose] This study examined the effect of the release exercise and exercise position in carpal tunnel syndrome (CTS). [Subject] A 40-year-old, right-hand-dominant man presented with CTS, with pain and progressive tingling and numbness in the right hand. [Methods] The subject performed three exercises: (1) release, (2) wrist flexor stretching, and (3) wrist extensor stretching. In session 1, the subject performed exercises 2 and 3 in the standing position for 2 weeks. In session 2, the subject performed all three exercises in the supine position for 2 weeks. [Results] The pressure pain threshold decreased after session 1 and decreased further after session 2, and the Phalen’s test and Tinel sign became progressively less positive. [Conclusion] Exercises in the supine position, including release exercises, are recommended for CTS. PMID:26644707

  18. Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease

    PubMed Central

    Guo, Jian; Zheng, Cong; Xiao, Qiang; Gong, Sugang; Zhao, Qinhua; Wang, Lan; He, Jing; Yang, Wenlan; Shi, Xue; Sun, Xingguo; Liu, Jinming

    2015-01-01

    Objective This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). Setting The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base within Shanghai and referrals from centres in other cities as well. Participants 157 Chinese patients with stable severe COPD were divided into 2 groups: the anaemia group (haemoglobin (Hb) <12.0?g/dL for males, and <11?g/dL for females (n=48)) and the non-anaemia group (n=109). Primary and secondary outcome measures Arterial blood gas, PFT and CPET were tested in all patients. Results (1) Diffusing capacity for carbon monoxide (DLCO) corrected by Hb was significantly lower in the anaemia group ((15.3±1.9) mL/min/mm?Hg) than in the non-anaemia group ((17.1±2.1) mL/min/mm?Hg) (p<0.05). A significant difference did not exist in the level of forced expiratory volume in 1?s (FEV1), FEV1%pred, FEV1/forced vital capacity (FVC), inspiratory capacity (IC), residual volume (RV), total lung capacity (TLC) and RV/TLC (p>0.05). (2) Peak Load, Peak oxygen uptake (), Peak %pred, Peak , Peak pulse and the ratio of increase to WR increase () were significantly lower in the anaemia group (p<0.05); however, Peak minute ventilation (VE), Lowest /carbon dioxide output () and Peak dead space/tidal volume ratio (VD/VT) were similar between the 2 groups (p>0.05). (3) A strong positive correlation was found between Hb concentration and Peak in patients with anaemia (r=0.702, p<0.01). Conclusions Anaemia has a negative impact on gas exchange and exercise tolerance during exercise in patients with severe COPD. The decrease in amplitude of Hb levels is related to the quantity of oxygen uptake. PMID:26450428

  19. Exercise Versus +Gz Acceleration Training

    NASA Technical Reports Server (NTRS)

    Greenleaf, John E.; Simonson, S. R.; Stocks, J. M.; Evans, J. M.; Knapp, C. F.; Dalton, Bonnie P. (Technical Monitor)

    2002-01-01

    Decreased working capacity and "orthostatic" intolerance are two major problems for astronauts during and after landing from spaceflight in a return vehicle. The purpose was to test the hypotheses that (1) supine-passive-acceleration training, supine-interval-exercise plus acceleration training, and supine exercise plus acceleration training will improve orthostatic tolerance (OT) in ambulatory men; and that (2) addition of aerobic exercise conditioning will not influence this enhanced OT from that of passive-acceleration training. Seven untrained men (24-38 yr) underwent 3 training regimens (30 min/d x 5d/wk x 3wk on the human-powered centrifuge - HPC): (a) Passive acceleration (alternating +1.0 Gz to 50% Gzmax); (b) Exercise acceleration (alternating 40% - 90% V02max leg cycle exercise plus 50% of HPCmax acceleration); and (c) Combined intermittent exercise-acceleration at 40% to 90% HPCmax. Maximal supine exercise workloads increased (P < 0.05) by 8.3% with Passive, by 12.6% with Exercise, and by 15.4% with Combined; but maximal V02 and HR were unchanged in all groups. Maximal endurance (time to cessation) was unchanged with Passive, but increased (P < 0.05) with Exercise and Combined. Resting pre-tilt HR was elevated by 12.9% (P < 0.05) only after Passive training, suggesting that exercise training attenuated this HR response. All resting pre-tilt blood pressures (SBP, DBP, MAP) were not different pre- vs. post-training. Post-training tilt-tolerance time and HR were increased (P < 0.05) only with Passive training by 37.8% and by 29.1%, respectively. Thus, addition of exercise training attenuated the increased Passive tilt tolerance. Resting (pre-tilt) and post-tilt cardiac R-R interval, stroke volume, end-diastolic volume, and cardiac output were all uniformly reduced (P < 0.05) while peripheral resistance was uniformly increased (P < 0.05) pre-and post-training for the three regimens indicating no effect of any training regimen on those cardiovascular variables. Plasma volume (% delta) was uniformly decreased by 8% to 14% (P < 0.05) at tilt-tolerance pre- vs. post-training for all regimens indicating no effect of these training regimens on the level of vascular fluid shifts.

  20. Benefits, Consequences, and Uncertainties of Conventional (Exercise) Countermeasure Approaches

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, Lori

    2013-01-01

    This presentation will review the pros, cons, and uncertainties of using exercise countermeasures in hypothetical long duration exploration missions. The use of artificial gravity and exercise will be briefly discussed. One benefit to continued use of exercise is related to our extensive experience with spaceflight exercise hardware and programming. Exercise has been a part of each space mission dating back to the 1960's when simple isometric and bungee exercises were performed in the Gemini capsule. Over the next 50 years, exercise hardware improved cumulating in today's ISS suite of exercise equipment: Cycle Ergometer with Vibration Isolation and Stabilization System (CEVIS), Treadmill (T2) and Advanced Resistive Exercise Device (ARED). Today's exercise equipment is the most robust ever to be flown in space and allows the variety and intensity of exercise that might reasonably be expected to maintain muscle mass and function, bone density and cardiovascular fitness. A second benefit is related to the large body of research literature on exercise training. There is a considerable body of supporting research literature including >40,000 peer reviewed research articles on exercise training in humans. A third benefit of exercise is its effectiveness. With the addition of T2 and ARED to our ISS exercise suite, crew member outcomes on standard medical tests have improved. Additionally exercise has other positive side effects such as stress relief, possible improvement of immune function, improved sleep, etc. Exercise is not without its consequences. The major cons to performance of in-flight exercise are the time and equipment required. Currently crew are scheduled 2.5 hrs/day for exercise and there is considerable cost to develop, fly and maintain exercise hardware. While no major injuries have been reported on ISS, there is always some risk of injury with any form of exercise There are several uncertainties going forward; these relate mostly to the development of small compact robust effective exercise devices for the next generation of space vehicles. It is becoming increasingly apparent that high intensity exercise is required for maintenance of fitness and functional capability and so future hardware will need to be developed, tested and implemented that allow for a wide variety of exercise, at high intensity while likely involving low mass, volume and power. There are many unanswered issues related to the minimum number and type of exercise devices required for exploration, optimizing exercise prescriptions for these devices, whether a treadmill is absolutely required, and even whether any single countermeasure can adequately protect muscle, bone, cardiovascular and sensorimotor function.