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1

Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing  

PubMed Central

The cardiopulmonary exercise test (CPET) is an important physiological investigation that can aid clinicians in their evaluation of exercise intolerance and dyspnea. Maximal oxygen consumption (V?O2max) is the gold-standard measure of aerobic fitness and is determined by the variables that define oxygen delivery in the Fick equation (V?O2 = cardiac output × arterial-venous O2 content difference). In healthy subjects, of the variables involved in oxygen delivery, it is the limitations of the cardiovascular system that are most responsible for limiting exercise, as ventilation and gas exchange are sufficient to maintain arterial O2 content up to peak exercise. Patients with lung disease can develop a pulmonary limitation to exercise which can contribute to exercise intolerance and dyspnea. In these patients, ventilation may be insufficient for metabolic demand, as demonstrated by an inadequate breathing reserve, expiratory flow limitation, dynamic hyperinflation, and/or retention of arterial CO2. Lung disease patients can also develop gas exchange impairments with exercise as demonstrated by an increased alveolar-to-arterial O2 pressure difference. CPET testing data, when combined with other clinical/investigation studies, can provide the clinician with an objective method to evaluate cardiopulmonary physiology and determination of exercise intolerance. PMID:23213518

Stickland, Michael K.; Butcher, Scott J.; Marciniuk, Darcy D.; Bhutani, Mohit

2012-01-01

2

Cardiopulmonary exercise testing: current applications.  

PubMed

Cardiopulmonary exercise testing (CPET) is under-utilized in assessing patients with prominent complaints of dyspnea or exercise limitation and should be one of the early tests used to assess exercise intolerance. The standard 12-lead ECG treadmill stress test focuses on coronary artery disease and is inadequate to assess the various subsystems (i.e., heart, lung, pulmonary vascular, peripheral vascular, muscle and psychological motivation) that can contribute individually, or more commonly in an interrelated fashion, to cause exercise limitation. The additional gas exchange information from CPET is very helpful in the identification of a more precise diagnosis, assessment of the severity of the impairment, determination of response to treatment and prediction of mortality. This special report will highlight some of the recent important applications of CPET to clinical medicine with specific references to heart failure, preoperative risk assessment, and regenerative and rehabilitative medicine, and the evidence that currently exists in the medical literature to support routine CPET use. It will also detail the recent evidence regarding the association of VO2max and survival in health and disease. PMID:20406084

Stringer, William W

2010-04-01

3

[From walk test to cardiopulmonary exercise test].  

PubMed

Cardiopulmonary exercise test is a new respiratory functional test used for sick children. It demonstrates the integrated response of all the systems involved in exercise (especially cardiac and respiratory ones) and consequently evaluates exercise adaptations during chronic disease. This dynamic test assesses exercise tolerance, and so quality of life more objectively than a resting test. Values measured (especially oxygen uptake and ventilatory threshold) are quantifiable and reproducible, allowing the follow-up of a disease and the initiation and individualization of exercise training. Moreover, it is also useful for diagnosis and assessment of abnormal symptoms during exercise (as dyspnea), especially abnormalities that are undetectable during rest. The six-minute walk test, the step test and the shuttle test are rapid, simple and low-cost field tests that give adequate information on the daily physical performance (walking, climbing stairs, or running) of the sick child. They allow a closed follow-up, especially during an exercise training period. However, only the cardio-pulmonary exercise test can allow the physical practise in sick children, eliminating the contra-indications. PMID:18280913

Karila, C

2007-12-01

4

[Cardiopulmonary exercise testing and unexpected dyspnea].  

PubMed

Cardiopulmonary exercise testing (CPET) is the examination of choice to understand mechanisms responsible for dyspnea in patients without significant medical history. The three observations illustrate the major interest of the CPET in this frequent situation in clinical practice. A 68-year-old man who has severe dyspnea in her leisure time hiking in the mountains, a 25-year cyclist presenting disabling dyspnea follow competitors racing neo-professional cyclists, and a 37-year woman who developed a persistent dyspnea, 6 months after delivery. In these three situations, CPET determined the disorder responsible for the symptoms without increasing the diagnostic tests. PMID:24314709

Aguilaniu, B; Tercé, G; Wallaert, B

2013-12-01

5

Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery  

PubMed Central

Introduction An anaerobic threshold (AT) of <11ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing (CPET) in predicting cardiopulmonary complications in high risk patients undergoing oesophagogastric cancer resection. Methods Between March 2008 and October 2010, 108 patients (83 men, 25 women) with a median age of 66 years (range: 38–84 years) underwent CPET before potentially curative resections for oesophagogastric cancers. Measured CPET variables included AT and maximum oxygen uptake at peak exercise (VO2 peak). Outcome measures were length of high dependency unit stay, length of hospital stay, unplanned intensive care unit (ICU) admission, and postoperative morbidity and mortality. Results The mean AT and VO2 peak were 10.8ml/min/kg (standard deviation [SD]: 2.8ml/min/kg, range: 4.6–19.3ml/min/kg) and 15.2ml/min/kg (SD: 5.3ml/min/kg, range: 5.4–33.3ml/min/kg) respectively; 57 patients (55%) had an AT of <11ml/min/ kg and 26 (12%) had an AT of <9ml/min/kg. Postoperative complications occurred in 57 patients (29 cardiopulmonary [28%] and 28 non-cardiopulmonary [27%]). Four patients (4%) died in hospital and 21 (20%) required an unplanned ICU admission. Cardiopulmonary complications occurred in 42% of patients with an AT of <9ml/min/kg compared with 29% of patients with an AT of ?9ml/min/kg but <11ml/min/kg and 20% of patients with an AT of ?11ml/min/kg (p=0.04). There was a trend that those with an AT of <11ml/min/kg and a low VO2 peak had a higher rate of unplanned ICU admission. Conclusions This study has shown a correlation between AT and the development of cardiopulmonary complications although the discriminatory ability was low. PMID:23484995

McCaffer, CJ; Carter, RC; Fullarton, GM; Mackay, CK; Forshaw, MJ

2013-01-01

6

Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing  

PubMed Central

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

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

2013-01-01

7

Predicted Values of Cardiopulmonary Exercise Testing in Healthy Individuals (A Pilot Study)  

PubMed Central

Background Cardiopulmonary exercise testing evaluates the ability of one's cardiovascular and respiratory system in maximal exercise. This was a descriptive cross-sectional pilot study conducted at Masih Daneshvari Hospital in order to determine predicted values of cardiopulmonary exercise testing in individuals with normal physical activity patterns. Materials and Methods Thirty four individuals (14 women, 20 men) between 18-57 years of age were chosen using simple sampling method and evaluated with an incremental progressive cycle-ergometer test to a symptom-limited maximal tolerable work load. Subjects with a history of ischemic heart disease, pulmonary disease or neuromuscular disease were excluded from the study. Smokers were included but we made sure that all subjects had normal FEV1 and FEV1/FVC. This study aimed to compare measured values of VO2, VCO2, VO2/Kg, RER, O2pulse, HRR, HR, Load, Ant, BF, BR, VE, EQCO2, and EQO2 with previously published predicted values. Results We found that our obtained values for VO2 max, HRR max and HR max were different from standard tables but such difference was not observed for other understudy variables. Multiple linear regression analysis was done for height, weight and age (due to the small number of samples, no difference was detected between males and females). VO2 max and load max had reverse correlation with age and direct correlation with weight and height (P < 0.05) but the greatest correlation was observed for height. Conclusion Due to the small number of samples and poor correlations it was not possible to do regression analysis for other variables. In the next study with a larger sample size predicted values for all variables will be calculated. If the future study also indicates a significant difference between the predicted values and the reference values, we will need standard tables made specifically for our own country, Iran. PMID:25191396

Mohammad, Majid Malek; Dadashpour, Shahdak

2012-01-01

8

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

Microsoft Academic Search

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

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

2011-01-01

9

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

PubMed

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

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

2014-02-01

10

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

Microsoft Academic Search

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

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

2001-01-01

11

Standards for the use of cardiopulmonary exercise testing for the functional evaluation of cardiac patients: a report from the Exercise Physiology Section of the European Association for Cardiovascular Prevention and Rehabilitation  

Microsoft Academic Search

Cardiopulmonary exercise testing (CPET) is a methodology that has profoundly affected the approach to patients' functional evaluation, linking performance and physiological parameters to the underlying metabolic substratum and providing highly reproducible exercise capacity descriptors. This study provides professionals with an up-to-date review of the rationale sustaining the use of CPET for functional evaluation of cardiac patients in both the clinical

Alessandro Mezzania; Piergiuseppe Agostonib; Alain Cohen-Solald; Ugo Corraa; Anna Jegierf; Evangelia Kouidig; Sanja Mazich; Philippe Meurine; Massimo Piepolic; Attila Simoni; Christophe Van Laethemj; Luc Vanheesk

2009-01-01

12

A novel cardiopulmonary exercise test protocol and criterion to determine maximal oxygen uptake in chronic heart failure  

PubMed Central

Cardiopulmonary exercise testing for peak oxygen uptake (V?o2peak) can evaluate prognosis in chronic heart failure (CHF) patients, with the peak respiratory exchange ratio (RERpeak) commonly used to confirm maximal effort and maximal oxygen uptake (V?o2max). We determined the precision of RERpeak in confirming V?o2max, and whether a novel ramp-incremental (RI) step-exercise (SE) (RISE) test could better determine V?o2max in CHF. Male CHF patients (n = 24; NYHA class I–III) performed a symptom-limited RISE-95 cycle ergometer test in the format: RI (4–18 W/min; ?10 min); 5 min recovery (10 W); SE (95% peak RI work rate). Patients (n = 18) then performed RISE-95 tests using slow (3–8 W/min; ?15 min) and fast (10–30 W/min; ?6 min) ramp rates. Pulmonary gas exchange was measured breath-by-breath. V?o2peak was compared within patients by unpaired t-test of the highest 12 breaths during RI and SE phases to confirm V?o2max and its 95% confidence limits (CI95). RERpeak was significantly influenced by ramp rate (fast, medium, slow: 1.21 ± 0.1 vs. 1.15 ± 0.1 vs. 1.09 ± 0.1; P = 0.001), unlike V?o2peak (mean n = 18; 14.4 ± 2.6 ml·kg?1·min?1; P = 0.476). Group V?o2peak was similar between RI and SE (n = 24; 14.5 ± 3.0 vs. 14.7 ± 3.1 ml·kg?1·min?1; P = 0.407); however, within-subject comparisons confirmed V?o2max in only 14 of 24 patients (CI95 for V?o2max estimation averaged 1.4 ± 0.8 ml·kg?1·min?1). The RERpeak in CHF was significantly influenced by ramp rate, suggesting its use to determine maximal effort and V?o2max be abandoned. In contrast, the RISE-95 test had high precision for V?o2max confirmation with patient-specific CI95 (without secondary criteria), and showed that V?o2max is commonly underestimated in CHF. The RISE-95 test was well tolerated by CHF patients, supporting its use for V?o2max confirmation. PMID:22653993

Bowen, T. Scott; Cannon, Daniel T.; Begg, Gordon; Baliga, Vivek; Witte, Klaus K.

2012-01-01

13

Cardiopulmonary Exercise Testing is equally Prognostic in Young, Middle-Aged and Older Individuals Diagnosed with Heart Failure  

PubMed Central

Background Although previous research has demonstrated the prognostic value of cardiopulmonary exercise testing (CPX), these studies have exclusively focused on elderly patients with heart failure (HF). Investigations that have comprehensively examined the value of CPX across different age groups are lacking. The purpose of the present investigation was to evaluate the prognostic value of CPX in young, middle-aged and older patients with HF. Methods A total of 1605 subjects (age: 59.2 ±13.7 years, 78% male) underwent CPX and were subsequently tracked for major cardiac events. Ventilatory efficiency (VE/VCO2 slope) and peak oxygen consumption (VO2), both absolute and percent-predicted, were determined. The prognostic value of these CPX variables was assessed in ?45, 46-65 and ?66 year subgroups. Results The three year event rates for major cardiac events in the ?45, 46-65 and ?66 year subgroups were 8.8%, 6.0% and 5.7%, respectively. The VE/VCO2 slope (Hazard ratio ?1.07, p<0.001), peak VO2 (Hazard ratio ?0.87, p<0.001) and percent-predicted peak VO2 (Hazard ratio ?0.98, p<0.001) were all significant prognostic markers in each age subgroup. While the VE/VCO2 slope carried the greatest prognostic strength, peak VO2 and percent-predicted peak VO2 were retained in multivariate analyses (Residual Chi-Square?5.2, p<0.05). With respect to peak VO2, the actual value was the more robust prognostic marker in the ?45 and ?66 year subgroups while the percent-predicted expression provided better predictive resolution in subjects who were 46-65 years old. Conclusions These results indicate that, irrespective of a patient's age at presentation, CPX provides valuable prognostic information in the HF population. PMID:20580105

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

2010-01-01

14

Risk stratification by pre-operative cardiopulmonary exercise testing improves outcomes following elective abdominal aortic aneurysm surgery: a cohort study  

PubMed Central

Background In 2009, the NHS evidence adoption center and National Institute for Health and Care Excellence (NICE) published a review of the use of endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs). They recommended the development of a risk-assessment tool to help identify AAA patients with greater or lesser risk of operative mortality and to contribute to mortality prediction. A low anaerobic threshold (AT), which is a reliable, objective measure of pre-operative cardiorespiratory fitness, as determined by pre-operative cardiopulmonary exercise testing (CPET) is associated with poor surgical outcomes for major abdominal surgery. We aimed to assess the impact of a CPET-based risk-stratification strategy upon perioperative mortality, length of stay and non-operative costs for elective (open and endovascular) infra-renal AAA patients. Methods A retrospective cohort study was undertaken. Pre-operative CPET-based selection for elective surgical intervention was introduced in 2007. An anonymized cohort of 230 consecutive infra-renal AAA patients (2007 to 2011) was studied. A historical control group of 128 consecutive infra-renal AAA patients (2003 to 2007) was identified for comparison. Comparative analysis of demographic and outcome data for CPET-pass (AT ? 11 ml/kg/min), CPET-fail (AT < 11 ml/kg/min) and CPET-submaximal (no AT generated) subgroups with control subjects was performed. Primary outcomes included 30-day mortality, survival and length of stay (LOS); secondary outcomes were non-operative inpatient costs. Results Of 230 subjects, 188 underwent CPET: CPET-pass n = 131, CPET-fail n = 35 and CPET-submaximal n = 22. When compared to the controls, CPET-pass patients exhibited reduced median total LOS (10 vs 13 days for open surgery, n = 74, P < 0.01 and 4 vs 6 days for EVAR, n = 29, P < 0.05), intensive therapy unit requirement (3 vs 4 days for open repair only, P < 0.001), non-operative costs (£5,387 vs £9,634 for open repair, P < 0.001) and perioperative mortality (2.7% vs 12.6% (odds ratio: 0.19) for open repair only, P < 0.05). CPET-stratified (open/endovascular) patients exhibited a mid-term survival benefit (P < 0.05). Conclusion In this retrospective cohort study, a pre-operative AT > 11 ml/kg/min was associated with reduced perioperative mortality (open cases only), LOS, survival and inpatient costs (open and endovascular repair) for elective infra-renal AAA surgery. PMID:24472159

2013-01-01

15

Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation  

PubMed Central

Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing (CPET)—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio (NLR) and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold (AT) and malignancy. In a first cohort of 240 colorectal patients, AT was identified as the sole factor associated with higher NLR (P = 0.03) and absolute and relative lymphopenia (P = 0.01). Preoperative leukocyte subsets and monocyte CD14+ expression (downregulated by endotoxin and indicative of chronic inflammation) were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte CD14+ expression was lower in gastrointestinal patients (n = 43) compared to age-matched orthopaedic patients (n = 31). The circulating CD14+CD16? monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome. PMID:25061264

Sultan, Pervez; Edwards, Mark R.; Gutierrez del Arroyo, Ana; Cain, David; Sneyd, J. Robert; Struthers, Richard; Minto, Gary; Ackland, Gareth L.

2014-01-01

16

Acute effects of low-level laser therapy on physiologic and electromyographic responses to the cardiopulmonary exercise testing in healthy untrained adults.  

PubMed

Despite the positive effects of low-level laser therapy (LLLT) on muscle fatigue before exercises using a single muscle group, the acute effects of LLLT on performance in cardiopulmonary exercise testing (CPET) are poorly understood. We aimed to assess the acute effects of LLLT on physiologic and electromyographic responses to the CPET in healthy adults. A randomized, double-blind, placebo-controlled crossover trial was performed with 18 untrained participants (nine males, 22?±?2 years). We applied LLLT or placebo on quadriceps and gastrocnemius 10 min before two rapidly incremental CPETs randomly performed in alternate days on a cycle ergometer. Participants received LLLT using a multidiode cluster, 20 s/site (850 nm, 100 mW/diode, 14 J/site). Physiological responses to the CPET were continuously monitored using a gas analyzer. The electromyographic fatigue threshold (EMGth) was assessed through surface electrodes on vastus lateralis. The root mean square (RMS) was plotted every 5 s against the exercise intensity, and its breakpoint values throughout the CPET was identified as EMGth. Compared to placebo, the LLLT significantly increased peak O2 uptake (V'O2 33?±?10 vs. 31?±?9 mL/min/kg). We observed a shallower slope of the ?heart rate/?V'O2 during the CPET after LLLT compared to placebo, i.e., increased cardiovascular efficiency (56?±?24 vs. 66?±?30 bpm/L/min). There were no LLLT-related changes in EMGth. The LLLT acutely increases exercise performance in healthy untrained adults probably due to increased O2 extraction by peripheral muscles without causing a significant impact on muscle fatigue. PMID:24925070

da Silva Alves, Mariana Agnes; Pinfildi, Carlos Eduardo; Neto, Luiz Nilsen; Lourenço, Rebeca Palomo; de Azevedo, Paulo Henrique Silva Marques; Dourado, Victor Zuniga

2014-11-01

17

Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea.  

PubMed

Information regarding the safety of maximal cardiopulmonary exercise testing (CPET) or the mechanisms of exercise limitation in obstructive sleep apnea (OSA) patients is fairly limited. In the present study, we addressed the problem of exercise capacity in moderate-to-severe OSA patients. Nineteen non-consecutive patients (three female, 16 male) with moderate-to-severe OSA and 11 age and body mass index matched control subjects (four female, seven male) underwent respiratory function tests during pre-exercise resting period and volitionally limited cardiopulmonary exercise testing on an electronically braked cycle ergometer. All participants completed CPET without any complication. Control subjects were exercise limited due to deconditioning. None of the patients revealed mechanical ventilatory limitation to exercise or had evidence of cardiac ischaemia. Five patients had no limitation to exercise. Six patients had low VO2peak, low anaerobic treshold (AT), and low peak O2 pulse, a pattern consistent with ventricular dysfunction. Six patients had low VO2peak, low AT, and peak heart rate less than 85% predicted. This pattern is consistent with exercise limitation due to peripheral vascular disease. Two patients had low VO2peak, low AT without peak oxygen pulse and peak heart rate abnormalities consistent with deconditioning. We concluded that moderate-to-severe OSA patients have impaired exercise capacity. Exercise limitation seems to originate from cardiovascular reasons namely left ventricular dysfunction and/or peripheral vascular impairment; and finally, maximal CPET can be tolerated by these patient group without serious complications. PMID:15765282

Oztürk, Levent Mukadder; Metin, Gökhan; Cuhadaro?lu, Ca?lar; Utkusava?, Ayfer; Tutluo?lu, Bülent

2005-01-01

18

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

NASA Technical Reports Server (NTRS)

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.

Moore, Alan D.

2011-01-01

19

Cardiopulmonary exercise capacity and ventilation effectiveness in patients after clinical cure of acute irritant gas poisoning.  

PubMed

The aim of this study is to assess the medium to long-term effect of acute irritant gas poisoning on cardiopulmonary exercise function in patients after clinical cure. Fourteen patients after an average of 18.5 months of clinical cure of acute irritant gas poisoning were recruited, and 14 healthy individuals were selected as control. All subjects were examined by resting pulmonary function testing (RPFT), cardiopulmonary exercise testing (CPET), and arterial blood gas (ABG) analysis. No statistically significant differences were found between poisoning and control groups for baseline parameters (age, height, and weight) or ABG values (pH, PaO2, PaCO2, and SaO2) (P > 0.05). For most RPFT parameters, including FEV1/FVC, FEV1, FEV1%pred, RV/TLC, DLCO%, and FVC%, no statistically significant differences were observed between poisoning and control groups (P > 0.05). However, MVV% was significantly lower in poisoning group compared with healthy individuals (P < 0.05). Statistically significant differences were observed for some CPET parameters, including peak VO2, peak VO2/kg, peak VE, and lowest VE/VCO2 (P < 0.05), and peak load, V D/V T, and peak PETCO2 (P < 0.01) between the two groups. However, there were no statistically significant differences in peak VO2%pred or peak O2 pulse between poisoning and control groups (P > 0.05). Compared with controls, patients with acute irritant gas poisoning had decreased cardiopulmonary exercise capacity and ventilation effectiveness after clinical cure. PMID:25480428

Yan, Rong; Yang, Wenlan; Liu, Jinming; Gao, Beilan; Guo, Kongrong; Sun, Daoyuan

2015-03-01

20

Association between preoperative haemoglobin concentration and cardiopulmonary exercise variables: a multicentre study  

PubMed Central

Background Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake (V?O2 peak) and anaerobic threshold (AT) in elective surgical patients. Methods Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], V?O2 peak and AT were analysed by linear regression and covariance. Results In 436 (24.5%) patients, [Hb] was <12 g dl-1 and, in 83 of these, <10 g dl-1. Both AT and V?O2 peak rose modestly with increasing [Hb] (r2 = 0.24, P <0.0001 and r2 = 0.30, P <0.0001, respectively). After covariate adjustment, an increase in [Hb] of one standard deviation was associated with a 6.7 to 9.7% increase in V?O2 peak, and a rise of 4.4 to 6.0% in AT. Haemoglobin concentration accounted for 9% and 6% of the variation in V?O2 peak and AT respectively. Conclusions To a modest extent, lower haemoglobin concentrations are independently associated with lower oxygen uptake during preoperative cardiopulmonary exercise testing. It is unknown whether this association is causative. PMID:24472426

2013-01-01

21

Exercise and NO production: relevance and implications in the cardiopulmonary system  

PubMed Central

This article reviews the existing knowledge about the effects of physical exercise on nitric oxide (NO) production in the cardiopulmonary system. The authors review the sources of NO in the cardiopulmonary system; involvement of three forms of NO synthases (eNOS, nNOS, and iNOS) in exercise physiology; exercise-induced modulation of NO and/or NOS in physiological and pathophysiological conditions in human subjects and animal models in the absence and presence of pharmacological modulators; and significance of exercise-induced NO production in health and disease. The authors suggest that physical activity significantly improves functioning of the cardiovascular system through an increase in NO bioavailability, potentiation of antioxidant defense, and decrease in the expression of reactive oxygen species-forming enzymes. Regular physical exercises are considered a useful approach to treat cardiovascular diseases. Future studies should focus on detailed identification of (i) the exercise-mediated mechanisms of NO exchange; (ii) optimal exercise approaches to improve cardiovascular function in health and disease; and (iii) physical effort thresholds. PMID:25610830

Nosarev, Alexei V.; Smagliy, Lyudmila V.; Anfinogenova, Yana; Popov, Sergey V.; Kapilevich, Leonid V.

2015-01-01

22

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

PubMed

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

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

2012-01-01

23

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

PubMed Central

Accepted 8 November 1996? Many long term sequelae result from previous treatment for malignancy in childhood. However, little information exists on cardiopulmonary response and energy expenditure during exercise and their possible associations with excess body fat. Measurements of body composition and exercise capacity both at low intensity and maximal aerobic capacity were made on 56 long term survivors of childhood malignancy (35 survivors of acute lymphoblastic leukaemia (ALL) and 21 survivors of other malignancies) and 32 siblings acting as controls. Female survivors of ALL had significantly greater mean (SD) body fat than survivors of other malignancies and siblings (32.5 (6.4)% v 24.3 (4.4)% and 26.3 (8.5)% respectively, p<0.005). Energy expenditure at low intensity exercise was reduced in survivors of ALL, and negatively correlated with body fat after controlling for weight (partial r range ?0.21 to ?0.47, p<0.05). Stroke volume, measured indirectly, was reduced and heart rate raised in ALL survivors at submaximal exercise levels. Peak oxygen consumption was significantly reduced in girls and boys treated for ALL compared with siblings (30.5 v 41.3 ml/kg/min for girls, p<0.05 and 39.9 v 47.6 ml/kg/min for boys, p<0.05 respectively). Reduced exercise capacity may account in part for the excess adiposity observed in long term survivors of ALL.?? PMID:9166019

Warner, J; Bell, W; Webb, D; Gregory, J

1997-01-01

24

Effects of metformin and exercise training, alone or in association, on cardio-pulmonary performance and quality of life in insulin resistance patients  

PubMed Central

Background Metformin (MET) therapy exerts positive effects improving glucose tolerance and preventing the evolution toward diabetes in insulin resistant patients. It has been shown that adding MET to exercise training does not improve insulin sensitivity. The aim of this study was to determine the effect of MET and exercise training alone or in combination on maximal aerobic capacity and, as a secondary end-point on quality of life indexes in individuals with insulin resistance. Methods 75 insulin resistant patients were enrolled and subsequently assigned to MET (M), MET with exercise training (MEx), and exercise training alone (Ex). 12-weeks of supervised exercise-training program was carried out in both Ex and MEx groups. Cardiopulmonary exercise test and SF-36 to evaluate Health-Related Quality of Life (HRQoL) was performed at basal and after 12-weeks of treatment. Results Cardiopulmonary exercise test showed a significant increase of peak VO2 in Ex and MEx whereas M showed no improvement of peak VO2 (? VO2 [CI 95%] Ex +0.26 [0.47 to 0.05] l/min; ? VO2 MEx +0.19 [0.33 to 0.05] l/min; ? VO2 M -0.09 [-0.03 to -0.15] l/min; M vs E p?cardiopulmonary negative effects showed by MET therapy may be counterbalanced with the combination of exercise training. Given that exercise training associated with MET produced similar effects to exercise training alone in terms of maximal aerobic capacity and HRQoL, programmed exercise training remains the first choice therapy in insulin resistant patients. PMID:24884495

2014-01-01

25

Cardiopulmonary function in exercising bar-headed geese during normoxia and hypoxia.  

PubMed

To investigate possible physiologic mechanisms that allow the bar-headed goose to perform strenuous physical activity when flying at high altitude (e.g., above 9,000 m), we measured cardiopulmonary variables during running exercise (treadmill; 0.6 m.sec-1; 2 degrees incline) while the bird breathed either normoxic (21% O2) or hypoxic (7% O2) gases via a face mask. 1. During normoxic exercise, O2 uptake rate doubled and both ventilation and cardiac output increased. Blood gases and pH in arterial, mixed venous and blood from the leg, however, remained virtually unaltered. 2. Hypoxia at rest stimulated ventilation to rise but not cardiac output. The birds reached a steady state with virtually unaltered O2 uptake. 3. Exercise during hypoxia further stimulated ventilation, resulting in elevated arterial PO2 and O2 content compared to hypoxia at rest. However, O2 uptake increased only slightly, and cardiac output did not rise over the resting hypoxic value. The hyperventilation resulted in respiratory alkalosis and increased CO2 output, with R values being as high as 2.0. 4. It is concluded that neither ventilation nor pulmonary gas transfer were the limiting step in supplying O2 to the working muscles during hypoxic exercise in our experiments. It is more likely that muscle blood flow or diffusion from muscle capillaries to mitochondria, or both, determined the aerobic capacity under these conditions. PMID:2506620

Fedde, M R; Orr, J A; Shams, H; Scheid, P

1989-08-01

26

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

PubMed

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) PMID:8321110

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

1993-06-01

27

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

NASA Technical Reports Server (NTRS)

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).

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

1993-01-01

28

Sample Proficiency Test exercise  

SciTech Connect

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

Alcaraz, A; Gregg, H; Koester, C

2006-02-05

29

Exercise testing with concurrent beta-blocker usage: Is it useful? What do we learn?  

Microsoft Academic Search

Cardiopulmonary exercise testing (CPET) has been used for the assessment of severity of heart failure (HF), secondary to left\\u000a ventricular systolic dysfunction. Initial studies determined that oxygen consumption (VO2) during exercise, as a measure of functional capacity, correlated well with the hemodynamic responses related to chronic\\u000a HF. These studies led to the use of peak VO2 as a prognostic indicator

Eugene E. Wolfel

2006-01-01

30

Software Testing FSM-Based Testing Exercises  

E-print Network

Software Testing FSM-Based Testing Exercises Discount Normal MRNMRD Coffee TeaD TeaN Tea/Wait 1euro. Discount Normal MRNMRD Coffee TeaD TeaN Tea/Wait 1euro/sound 1euro/sound Coffee/Wait Dispose/Tea+20ct

Mousavi, Mohammad

31

Oxidative stress and antioxidant defense mechanisms linked to exercise during cardiopulmonary and metabolic disorders  

PubMed Central

Oxidative stress has been implicated in the pathophysiology of multiple human diseases, in addition to the aging process. Although various stimuli exist, acute exercise is known to induce a transient increase in reactive oxygen and nitrogen species (RONS), evident by several reports of increased oxidative damage following acute bouts of aerobic and anaerobic exercise. Although the results are somewhat mixed and appear disease dependent, individuals with chronic disease experience an exacerbation in oxidative stress following acute exercise when compared to healthy individuals. However, this increased oxidant stress may serve as a necessary “signal” for the upregulation in antioxidant defenses, thereby providing protection against subsequent exposure to prooxidant environments within susceptible individuals. Here we present studies related to both acute exercise-induced oxidative stress in those with disease, in addition to studies focused on adaptations resulting from increased RONS exposure associated with chronic exercise training in persons with disease. PMID:20046644

Fisher-Wellman, Kelsey; Bell, Heather K

2009-01-01

32

An update on exercise stress testing.  

PubMed

Exercise stress testing is the most commonly used noninvasive method to evaluate for coronary artery disease in men and women. Although emphasis has been placed on the diagnostic value of ST-segment depression, the exercise stress test provides other valuable diagnostic and prognostic data, beyond ST-segment depression. The value of these variables, which include exercise capacity, chronotropic response, heart rate recovery, blood pressure response, and the Duke Treadmill Score, are reviewed in this article. In addition, the gender differences seen with these exercise testing variables are reviewed. In this modern era of exercise stress testing, making use of all the information from a stress test and creating a comprehensive stress testing report are recommended in the evaluation of patients with suspected coronary artery disease who undergo exercise stress testing. PMID:22469057

Sharma, Kavita; Kohli, Priya; Gulati, Martha

2012-05-01

33

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

PubMed Central

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.

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

1977-01-01

34

Exercise electrocardiogram testing in two brothers with different outcome - a case study exercise testing in master cyclists.  

PubMed

The cases of two brothers training and competing as master cyclists and both preparing for a cycling tour are presented. The older brother aged 66 years went first to the primary care physician and presented with an asymptomatic depression in the exercise stress test of the ST segment in V5 and V6 during recovery after complete exhaustion. Coronary angiography revealed a multi vessel coronary artery disease and he underwent bypass surgery. One year later, he successfully completed his planned cycling tour of ~600 km in seven stages and covering ~12,000 m of total ascent. The younger brother aged 59 years went a few months later to the primary care physician and also performed asymptomatic exercise stress testing without changes in the ST segments. Unfortunately, 2 months later he suffered a cardiac arrest during his cycling tour and survived following immediate successful cardiopulmonary resuscitation on the road by his cycling colleagues. Immediate invasive coronary arteriography showed a complete stenosis of the trunk of arteria coronaria sinistra (left coronary artery), a 40%-50% stenosis of ramus circumflexus, and a 20% stenosis of arteria coronaria dextra (right coronary artery). The left coronary artery was dilated and he continued cycling 2 months later. In both brothers, familial hypercholesterolemia was the main cardiovascular risk factor for the multi vessel coronary artery disease. A negative exercise electrocardiogram in siblings with an increased risk for coronary artery disease seemed not to exclude an advanced multi vessel coronary artery disease. In master athletes with asymptomatic exercise electrocardiogram but a positive family history, further examinations should be performed in order to detect relevant stenosis in coronary arteries. PMID:23825929

Rüst, Christoph Alexander; Knechtle, Beat; Rosemann, Thomas

2013-01-01

35

Exercise electrocardiogram testing in two brothers with different outcome – a case study exercise testing in master cyclists  

PubMed Central

The cases of two brothers training and competing as master cyclists and both preparing for a cycling tour are presented. The older brother aged 66 years went first to the primary care physician and presented with an asymptomatic depression in the exercise stress test of the ST segment in V5 and V6 during recovery after complete exhaustion. Coronary angiography revealed a multi vessel coronary artery disease and he underwent bypass surgery. One year later, he successfully completed his planned cycling tour of ~600 km in seven stages and covering ~12,000 m of total ascent. The younger brother aged 59 years went a few months later to the primary care physician and also performed asymptomatic exercise stress testing without changes in the ST segments. Unfortunately, 2 months later he suffered a cardiac arrest during his cycling tour and survived following immediate successful cardiopulmonary resuscitation on the road by his cycling colleagues. Immediate invasive coronary arteriography showed a complete stenosis of the trunk of arteria coronaria sinistra (left coronary artery), a 40%–50% stenosis of ramus circumflexus, and a 20% stenosis of arteria coronaria dextra (right coronary artery). The left coronary artery was dilated and he continued cycling 2 months later. In both brothers, familial hypercholesterolemia was the main cardiovascular risk factor for the multi vessel coronary artery disease. A negative exercise electrocardiogram in siblings with an increased risk for coronary artery disease seemed not to exclude an advanced multi vessel coronary artery disease. In master athletes with asymptomatic exercise electrocardiogram but a positive family history, further examinations should be performed in order to detect relevant stenosis in coronary arteries. PMID:23825929

Rüst, Christoph Alexander; Knechtle, Beat; Rosemann, Thomas

2013-01-01

36

Evaluation of cardiac arrhythmias by exercise testing.  

PubMed

Exercise testing is an important noninvasive method for the exposure of arrhythmias. It provides complementary information to that obtained from ambulatory monitoring or electrophysiologic testing. By producing a number of important physiologic changes, especially activation of the sympathetic nervous system and an increase in circulating catecholamines, exercise testing provides a more complete assessment. On continuous monitoring, exercise-induced ventricular premature beats may be found in up to 34% of healthy subjects, in 60 to 70% of those with heart disease and in all patients who have experienced sustained ventricular tachycardia. Couplets or nonsustained ventricular tachycardia can be found during exercise in 0 to 6% of healthy subjects, in 15 to 31% of patients with heart disease and in 75% of those with sustained ventricular tachycardia. Even in patients with heart disease, there is only a small risk of inducing sustained ventricular tachycardia or ventricular fibrillation during exercise. The prognostic relevance of exercise-induced ventricular arrhythmias in patients with coronary artery disease or cardiomyopathy has not been clearly established. There appears to be an increased risk, however, in patients with ventricular premature beats as well as ST-segment depression or in patients with repetitive forms of ventricular arrhythmias during exercise which cannot be medically controlled. In healthy subjects, exercise-induced ventricular premature beats are of no prognostic relevance. In particular, for patients in whom arrhythmias are induced by exercise, exercise testing should be used to assess the effectiveness of antiarrhythmic drug treatment. Importantly, serious cardiac toxicity, often not observed at rest or during routine activities, may become apparent during exercise testing. It should be a standard part of arrhythmia assessment and management. PMID:1690168

Candinas, R A; Podrid, P J

1990-02-01

37

Eccentric exercise testing and training  

NASA Technical Reports Server (NTRS)

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.

Clarkson, Priscilla M.

1994-01-01

38

Exercise thallium testing in ventricular preexcitation  

SciTech Connect

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

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

1987-05-01

39

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

PubMed

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

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

2014-11-01

40

Exercise stress testing in the management of cardiac rhythm disorders.  

PubMed

Exercise testing is an important tool for exposing symptomatic arrhythmias as well as asymptomatic but potentially serious ventricular tachyarrhythmias. When evaluating the effect of antiarrhythmic drugs, exercise testing is an adjunctive modality. PMID:6492932

Podrid, P J; Graboys, T B

1984-09-01

41

Software Testing Solutions to FSM-Based Testing Exercise  

E-print Network

Software Testing Solutions to FSM-Based Testing Exercise Discount Normal MRNMRD Coffee TeaD TeaN the homing sequence (next(B,x)) Input(s) {Disc., Nor., MRN, MRD, TeaN, TeaD, Coffee} Code, {Disc.}, {Disc., MRN, MRD, TeaN, TeaD, Coffee} Dispose, {Disc.}, {Nor.}, {Disc., MRN, MRD} Tea · Dispose, {Disc.}, {Nor

Mousavi, Mohammad

42

Work-rate-guided exercise testing in patients with incomplete spinal cord injury using a robotics-assisted tilt-table.  

PubMed

Abstract Purpose: Robotics-assisted tilt-table (RTT) technology allows neurological rehabilitation therapy to be started early thus alleviating some secondary complications of prolonged bed rest. This study assessed the feasibility of a novel work-rate-guided RTT approach for cardiopulmonary training and assessment in patients with incomplete spinal cord injury (iSCI). Methods: Three representative subjects with iSCI at three distinct stages of primary rehabilitation completed an incremental exercise test (IET) and a constant load test (CLT) on a RTT augmented with integrated leg-force and position measurement and visual work rate feedback. Feasibility assessment focused on: (i) implementation, (ii) limited efficacy testing, (iii) acceptability. Results: (i) All subjects were able follow the work rate target profile by adapting their volitional leg effort. (ii) During the IETs, peak oxygen uptake above rest was 304, 467 and 1378?ml/min and peak heart rate (HR) was 46, 32 and 65 beats/min above rest (subjects A, B and C, respectively). During the CLTs, steady-state oxygen uptake increased by 42%, 38% and 162% and HR by 12%, 20% and 29%. (iii) All exercise tests were tolerated well. Conclusion: The novel work-rate guided RTT intervention is deemed feasible for cardiopulmonary training and assessment in patients with iSCI: substantial cardiopulmonary responses were observed and the approach was found to be tolerable and implementable. Implications for Rehabilitation Work-rate guided robotics-assisted tilt-table technology is deemed feasible for cardiopulmonary assessment and training in patients with incomplete spinal cord injury. Robotics-assisted tilt-tables might be a good way to start with an active rehabilitation as early as possible after a spinal cord injury. During training with robotics-assisted devices the active participation of the patients is crucial to strain the cardiopulmonary system and hence gain from the training. PMID:24712412

Laubacher, Marco; Perret, Claudio; Hunt, Kenneth J

2014-04-01

43

Impact of the exercise mode on heart rate recovery after maximal exercise  

Microsoft Academic Search

Heart rate recovery 1 min after exercise termination (HRR-1) is a prognostic predictor. However, the influence of the exercise\\u000a mode on HRR-1 is incompletely characterised. Twenty-nine young and healthy subjects and 16 elderly patients with chronic heart\\u000a failure underwent cardiopulmonary exercise testing using cycle ergometer and treadmill ramp protocols in random order. HRR-1\\u000a and heart rate recovery 2 and 3

Micha Tobias Maeder; Peter Ammann; Hans Rickli; Hans Peter Brunner-La Rocca

2009-01-01

44

Excessive ventilation during early phase of exercise: A new predictor of poor long-term outcome in patients with chronic heart failure  

Microsoft Academic Search

Background: Studies demonstrating prognostic value of excessive exercise ventilation in chronic heart failure (CHF) have focused on data derived from the whole cardiopulmonary exercise test (CPET). Whether ventilatory response to early phase of exercise is useful for risk stratification in CHF is unknown. Methods and results: We evaluated 216 patients with systolic CHF who underwent CPET (age: 60±11 years, NYHA

Ewa A. Jankowska; Tomasz Witkowski; Beata Ponikowska; Krzysztof Reczuch; Ludmila Borodulin-Nadzieja; Stefan D. Anker; Massimo F. Piepoli; Waldemar Banasiak; Piotr Ponikowski

2007-01-01

45

Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: A meta-analysis.  

PubMed

Exercise-induced ischemic preconditioning (IPC) can be assessed with the second exercise stress test during sequential testing. Exercise-induced IPC is defined as the time to 1?mm ST segment depression (STD), the rate-pressure product (RPP) at 1?mm STD, the maximal ST depression and the rate-pressure product at peak exercise. The purpose of this meta-analysis is to validate the parameters used to assess exercise-induced IPC in the scientific community. A literature search was performed using electronic database. The main key words were limited to human studies, which were (a) ischemic preconditioning, (b) warm-up phenomenon, and (c) exercise. Meta-analyses were performed on the study-specific mean difference between the clinical measures obtained in the two consecutive stress tests (second minus first test score). Random effect models were fitted with inverse variance weighting to provide greater weight to studies with larger sample size and more precise estimates. The search resulted in 309 articles of which 34 were included after revision (1053 patients). Results are: (a) time to 1?mm ST segment depression increased by 91?s (95% confidence interval (CI): 75-108), p?exercise-induced ischemic preconditioning in sequential stress testing. The results of this first meta-analysis on the sequential stress test confirm what is presented in the literature by independent studies on exercise-induced ischemic preconditioning. From now on, the results could be used in further research to set standardized parameters to assess the phenomenon. PMID:23983070

Lalonde, François; Poirier, Paul; Sylvestre, Marie-Pierre; Arvisais, Denis; Curnier, Daniel

2015-01-01

46

The role of exercise testing in evaluation of arrhythmias.  

PubMed

Exercise testing has been widely applied for the evaluation of patients with coronary artery disease. The principles underlying its use for this indication make it a useful adjunctive technique, when combined with ambulatory monitoring, to diagnose arrhythmias and monitor antiarrhythmic drug therapy. During exercise, there is a withdrawal of vagal tone and a marked increase in circulating catecholamines and sympathetic inputs to the heart. These changes may directly cause arrhythmias (e.g., catecholamines can enhance automaticity and delayed afterpotentials and can shorten myocardial conduction time and refractory periods). However, they also augment myocardial oxygen demands by increasing myocardial inotropy, heart rate and blood pressure. Such changes may cause ischemia in patients with heart disease, which is a powerful stimulus for arrhythmia, or lead to dysfunction in left ventricular contraction and increased myocardial wall stress, factors that also may precipitate arrhythmia. In approximately 10% of patients with a history of serious arrhythmia, exercise represents the only means for exposing arrhythmia. Importantly, this technique is useful for evaluating the effect of antiarrhythmic drugs. These agents work by reducing membrane automaticity, slowing impulse conduction through the myocardium and prolonging membrane refractoriness. In contrast, catecholamines, which are secreted in response to exercise, have the opposite effect. Thus, exercise may negate the important effects of the antiarrhythmic drugs. Additionally, exercise testing may expose potentially serious toxic drug reactions that may not be obvious at rest. These include conduction abnormalities, negative inotropic effects, congestive heart failure and aggravation of arrhythmia. Although the presence and frequency of arrhythmia with exercise is highly variable in patients with benign arrhythmia, results are more consistent in patients with a history of serious arrhythmia. If arrhythmia is reproducibly provoked with exercise, this technique can be used to judge drug effect. Thus, exercise testing is an important, reliable and helpful technique for exposing arrhythmia, evaluating drug efficacy and identifying potentially serious toxic drug effects. PMID:3052006

Podrid, P J; Venditti, F J; Levine, P A; Klein, M D

1988-10-19

47

Exercise-induced ST-segment elevation during the recovery phase of an exercise stress test  

PubMed Central

To the authors’ knowledge, the present report represents the first case in the medical literature in which an ST-segment elevation during the recovery phase of an exercise stress test indicated significant left main coronary artery stenosis. Although the patient did not complain of chest pain during the test, the ST-segment elevation persisted 20 min into recovery. PMID:23940454

Ibrahim, Morhaf; Hasan, Reham; Pitonak, Peter

2013-01-01

48

An Improved Simple Exercise Test for Evaluation of Physical Fitness  

Microsoft Academic Search

A simple exercise test for estimating physical fitness is described. It seems superior to the standard Harvard Step Test because of the extreme simplicity of its administration; the fact that it does not limit subjects' performance largely through local muscular fatigue; and because no special equipment is necessary for its performance. This test also seems to be able to appraise

S. R. DATTA; B. B. CHATTEKJEE; B. N. ROY

1974-01-01

49

Exercise Physiology for Graded Exercise Testing: A Primer for the Primary Care Clinician  

Microsoft Academic Search

Exercise testing is an advanced clinical procedure used by providers to assess functional capacity for the purpose of guiding\\u000a cardiovascular and pulmonary diagnoses and therapies. Numerous clinical guidelines, texts, and consensus statements have been\\u000a published to assist clinicians in the identification of indications and criteria for treadmill stress testing, as well as\\u000a procedures for test performance and interpretation [1-4]. However,

Francis G. O’Connor; Matthew T. Kunar; Patricia A. Deuster

50

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

ERIC Educational Resources Information Center

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

Saint Paul Technical Vocational Inst., MN.

51

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

PubMed Central

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

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

2013-01-01

52

Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension.  

PubMed

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

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

2013-08-01

53

Samara Dispersal in Boxelder: An Exercise in Hypothesis Testing.  

ERIC Educational Resources Information Center

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

Minorsky, Peter V.; Willing, R. Paul

1999-01-01

54

Influence of successive bouts of fatiguing exercise on perceptual and physiological markers during an incremental exercise test.  

PubMed

The purpose of this study was to examine the effects of a succession of fatiguing stages, on ratings of perceived exertion (RPE) and estimated time limits (ETL) during an incremental exercise test. Twenty-seven cyclists performed a continuous incremental test and a discontinuous test with randomized workloads. A linear mixed model was used to compare the RPE, ETL, respiratory gas, heart rate, and blood data obtained during the two exercise tests. RPE and ETL were not significantly different between the tests. Ventilation, breathing frequency, heart rate, and blood lactate concentration were significantly higher during the last incremental test workloads. In conclusion, although the incremental exercise test generated higher cardiorespiratory and muscular workloads than observed during the randomized exercise test, most likely due to a greater fatiguing process, these higher workloads did not influence the perceptual response. PMID:18823413

Coquart, Jeremy B J; Legrand, Renaud; Robin, Sophie; Duhamel, Alain; Matran, Regis; Garcin, Murielle

2009-01-01

55

An insulinoma presenting as hypoglycaemia associated with exercise stress testing  

PubMed Central

A 68-year-old man presented to the accident and emergency department with a history of central chest pain associated with exertion. He was admitted for assessment and when an acute coronary syndrome was excluded, he underwent exercise stress testing. His exercise stress testing was discontinued due to lightheadedness. His capillary glucose was checked and it showed hypoglycaemia (2.2?mmol/l). In light of this, a 72?h supervised fast was performed and it became positive within 24?h with low plasma glucose, inappropriately high insulin and C peptide levels. Sulfonylurea screen was negative. CT, MRI and endoscopic ultrasound revealed a 2?cm pancreatic tail insulinoma. He underwent successful surgical enucleation of this lesion. PMID:23420730

Lainis, Fredolin; Fahy, Eoin; Murphy, Matthew

2013-01-01

56

How many electrocardiographic leads are required for exercise treadmill tests  

SciTech Connect

Forty-four consecutive patients who had perfusion defects on thallium-201 scanning and positive exercise treadmill tests were prospectively studied. Thirty-eight (86%) subjects had diagnostic ST segment changes in lead V5, 37 (84%) in lead V4, and 44 (100%) in either lead V4, V5 or both. Thirty patients had ST segment changes in the inferior leads, 20 in lead aVR, and only four in lead I and/or aVL. All of these latter subjects had diagnostic ST segments in lead V4 and/or V5. It is concluded that: combined electrocardiographic leads V4 and V5 detect the vast majority of ischemic changes during exercise treadmill testing, regardless of the site of perfusion defects detected by thallium-201 scanning; and monitoring the inferior and lateral leads rarely provides more diagnostic information.

Miller, T.D.; Desser, K.B.; Lawson, M.

1987-04-01

57

Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease.  

PubMed

Cardiopulmonary exercise training is beneficial to people with coronary artery disease (CAD). Nevertheless, the correlation between aerobic capacity, and functional mobility and quality of life in elderly CAD patients is less addressed. The purpose of the current study is to investigate the beneficial effects of exercise training in elderly people with CAD, integrating exercise stress testing, functional mobility, handgrip strength, and health-related quality of life. Elderly people with CAD were enrolled from the outpatient clinic of a cardiac rehabilitation unit in a medical center. Participants were assigned to the exercise training group (N = 21) or the usual care group (N = 15). A total of 36 sessions of exercise training, completed in 12 weeks, was prescribed. Echocardiography, exercise stress testing, the 6-minute walking test, Timed Up and Go test, and handgrip strength testing were performed, and the Short-Form 36 questionnaire (SF-36) was administered at baseline and at 12-week follow-up. Peak oxygen consumption improved significantly after training. The heart rate recovery improved from 13.90/minute to 16.62/minute after exercise training. Functional mobility and handgrip strength also improved after training. Significant improvements were found in SF-36 physical function, social function, role limitation due to emotional problems, and mental health domains. A significant correlation between dynamic cardiopulmonary exercise testing parameters, the 6-minute walking test, Timed Up and Go test, handgrip strength, and SF-36 physical function and general health domains was also detected. Twelve-week, 36-session exercise training, including moderate-intensity cardiopulmonary exercise training, strengthening exercise, and balance training, is beneficial to elderly patients with CAD, and cardiopulmonary exercise testing parameters correlate well with balance and quality of life. PMID:25438684

Chen, Chia-Hsin; Chen, Yi-Jen; Tu, Hung-Pin; Huang, Mao-Hsiung; Jhong, Jing-Hui; Lin, Ko-Long

2014-10-01

58

Role of exercise stress test in master athletes  

PubMed Central

Background: The effectiveness of cardiovascular screening in minimising the risk of athletic field deaths in master athletes is not known. Objective: To evaluate the prevalence and clinical significance of ST segment depression during a stress test in asymptomatic apparently healthy elderly athletes. Methods: A total of 113 male subjects aged over 60 were studied (79 trained and 34 sedentary); 88 of them (62 trained and 26 sedentary) were followed up for four years (mean 2.16 years for athletes, 1.26 years for sedentary subjects), with a resting 12 lead electrocardiogram (ECG), symptom limited exercise ECG on a cycle ergometer, echocardiography, and 24 hour ECG Holter monitoring. Results: A significant ST segment depression at peak exercise was detected in one athlete at the first evaluation. A further case was seen during the follow up period in a previously "negative" athlete. Both were asymptomatic, and single photon emission tomography and/or stress echocardiography were negative for myocardial ischaemia. The athletes remained symptom-free during the period of the study. One athlete died during the follow up for coronary artery disease: he showed polymorphous ventricular tachycardia during both the exercise test and Holter monitoring, but no significant ST segment depression. Conclusions: The finding of false positive ST segment depression in elderly athletes, although still not fully understood, may be related to the physiological cardiac remodelling induced by regular training. Thus athletes with exercise induced ST segment depression, with no associated symptoms and/or complex ventricular arrhythmias, and no adverse findings at second level cardiological testing, should be considered free from coronary disease and safe to continue athletic training. PMID:16046336

Pigozzi, F; Spataro, A; Alabiso, A; Parisi, A; Rizzo, M; Fagnani, F; Di, S; Massazza, G; Maffulli, N

2005-01-01

59

Exercise testing and stress imaging in valvular heart disease.  

PubMed

The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association and the European Society of Cardiology/European Association of Cardiothoracic Surgery have recently put emphasis on the role of exercise testing to clarify symptom status and the use of stress imaging to assess the dynamic component of valvular abnormalities and unmask subclinical myocardial dysfunction that could be missed at rest. Recent studies have demonstrated the incremental prognostic value of exercise echocardiography for asymptomatic patients with severe aortic stenosis, moderate-severe mitral stenosis, and severe primary mitral regurgitation. In patients with low-flow, low-gradient aortic stenosis, dobutamine stress echocardiography is recommended to differentiate true severe from pseudosevere aortic stenosis. Data on the prognostic value of stress echocardiography in aortic regurgitation and functional mitral regurgitation are less robust. Data are sparse on the use of stress imaging in right-sided VHD, however recent studies using stress cardiovascular magnetic resonance imaging offer some prognostic information. Although the strongest recommendations for surgical treatment continue to be based on symptom status and resting left ventricular repercussions, stress imaging can be useful to optimize risk stratification and timing of surgery in VHD. Randomized clinical trials are required to confirm that clinical decision-making based on stress imaging can lead to improved outcomes. PMID:25151284

Henri, Christine; Piérard, Luc A; Lancellotti, Patrizio; Mongeon, François-Pierre; Pibarot, Philippe; Basmadjian, Arsène J

2014-09-01

60

The Effect of Age on the Cardiovascular Responses to Isometric Exercise: A Test of Autonomic Function  

Microsoft Academic Search

Isometric exercise, promulgated as a test of autonomic function, has not been investigated in the elderly. Increasing age does not affect the cardiovascular responses to isometric exercise. Variability studies during fatiguing isometric exercise confirm that it is a valuable test of autonomic function in the elderly.Copyright © 1985 S. Karger AG, Basel

P. W. Goldstraw; D. J. Warren

1985-01-01

61

Exercise Standards for Testing and Training A Statement for Healthcare Professionals From the American Heart Association  

Microsoft Academic Search

he purpose of this report is to provide revised standards and guidelines for the exercise testing and training of individuals who are free from clinical manifestations of cardiovascular disease and those with known cardiovascular disease. These guidelines are intended for physicians, nurses, exercise physiologists, specialists, technologists, and other healthcare professionals involved in exercise testing and training of these populations. This

Gerald F. Fletcher; Gary J. Balady; Vice Chair; Ezra A. Amsterdam; Bernard Chaitman; Robert Eckel; Jerome Fleg; Victor F. Froelicher; Arthur S. Leon; Ileana L. Pina; Roxanne Rodney; Denise G. Simons-Morton; Mark A. Williams; Terry Bazzarre

62

Exercise capacity as a pulmonary rehabilitation outcome.  

PubMed

Disabled patients with chronic respiratory disease and peripheral skeletal muscle disorders have limitations in their exercise capacity, which may be improved after specific training in a pulmonary rehabilitation (PR) program. Individual assessment of exercise capacity by clinically available exercise tests represents an important patient-centered outcome that should be embedded in the rehabilitation process. These measurements include laboratory (treadmill and/or cycle ergometer) and field (walking) tests. The cardiopulmonary exercise test, both performed with incremental (incremental-load test) or predetermined (constant-load or endurance test) loading, is an excellent means to describe the profile of an individual's maximal exercise capacity and to record its change after PR. Among the variety of field-based tests, 6-min walking and shuttle walking are 2 simple tests widely used during PR. These tests are inexpensive and provide information on an individual's functional abilities: the 6-min walking test has been shown to provide level of disability and functional status, whereas the shuttle walking test has been shown to be more suitable to detect change of physical performance following PR. Overall, several available physiologically targeted tests are useful to measure the patient's tolerance to exercise, and many are even sensitive to change once intervention has taken place. In particular, endurance modality tests seem to provide better measurement of changes after PR than incremental exercise tests. PMID:19246958

Clini, Enrico M; Crisafulli, Ernesto

2009-01-01

63

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

PubMed

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

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

2015-01-01

64

Cardiopulmonary Syndromes (PDQ®)  

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.

65

Cardiopulmonary Resuscitation in Trauma  

Microsoft Academic Search

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

Rao R. Ivatury; Kevin R. Ward

66

Cardiopulmonary Bypass and Cardioplegia  

Microsoft Academic Search

\\u000a This chapter describes the history and techniques of cardiopulmonary bypass, a process that effectually excludes the heart\\u000a from the general circulation and leaves it empty so that it can accommodate open cardiac surgical intervention. Since its\\u000a first implementation, cardiopulmonary bypass has improved significantly to become a very highly sophisticated, but reliably\\u000a performed procedure. The near future promises even more improvements

J. Ernesto Molina

67

Genetic research and testing in sport and exercise science: A review of the issues  

Microsoft Academic Search

This review is based on the BASES position stand on “Genetic Research and Testing in Sport and Exercise Science”. Our aims are first to introduce the reader to research in sport and exercise genetics and then to highlight ethical problems arising from such research and its applications. Sport and exercise genetics research in the form of transgenic animal and human

Henning Wackerhage; Andy Miah; Roger C. Harris; Hugh E. Montgomery; Alun G. Williams

2009-01-01

68

Exercise  

MedlinePLUS

Exercise - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Sign In In Your Area ... now Download now Publication Stretching for People with MS Illustrated manual showing range of motion, stretching, and ...

69

Responsiveness of Various Exercise-Testing Protocols to Therapeutic Interventions in COPD  

PubMed Central

Exercise intolerance is a key element in the pathophysiology and course of Chronic Obstructive Pulmonary Disease (COPD). As such, evaluating exercise tolerance has become an important part of the management of COPD. A wide variety of exercise-testing protocols is currently available, each protocol having its own strengths and weaknesses relative to their discriminative, methodological, and evaluative characteristics. This paper aims to review the responsiveness of several exercise-testing protocols used to evaluate the efficacy of pharmacological and nonpharmacological interventions to improve exercise tolerance in COPD. This will be done taking into account the minimally important difference, an important concept in the interpretation of the findings about responsiveness of exercise testing protocols. Among the currently available exercise-testing protocols (incremental, constant work rate, or self-paced), constant work rate exercise tests (cycle endurance test and endurance shuttle walking test) emerge as the most responsive ones for detecting and quantifying changes in exercise capacity after an intervention in COPD. PMID:23431439

Borel, Benoit; Provencher, Steeve; Saey, Didier; Maltais, François

2013-01-01

70

Home-based mobile cardio-pulmonary rehabilitation consultant system  

Microsoft Academic Search

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

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

2011-01-01

71

Evaluation and treatment of the asymptomatic patient with a positive exercise tolerance test  

SciTech Connect

A positive exercise study in an asymptomatic patient presents a clinical dilemma. Many of these asymptomatic positive studies are false-positive, but a subset of these patients have silent coronary artery disease. Other noninvasive tests can be used in conjunction with exercise testing to help identify this subset of patients, but coronary angiography is often ultimately necessary to ensure an accurate diagnosis. An algorithm for the evaluation and treatment of the patient with an asymptomatic positive exercise study is proposed.

Imperi, G.A.; Conti, C.R.

1986-11-01

72

A Simple Exercise Test for the Prediction of Relative Heat Tolerance  

Microsoft Academic Search

A medical screening exercise test is presented which accurately predicts relative heat tolerance during work in very hot environments. The test consisted of 15–20?min of exercise at a standard absolute intensity of about 600?kcal\\/hr (140?W) with the subject wearing a vapor-barrier suit. Five minutes after the subject exercised, recovery heart rate was measured. When this heart rate is used, a

W. LARRY KENNEY; DEBRA A. LEWIS; RUTH K. ANDERSON; E. KAMON

1986-01-01

73

Cardiopulmonary discipline science plan  

NASA Technical Reports Server (NTRS)

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.

1991-01-01

74

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

PubMed

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

Lin, R Y; Barnard, M

1993-06-01

75

Significant sex differences in the correlation of electrocardiographic exercise testing and coronary arteriograms.  

PubMed

Two hundred fifty-one patients (195 male and 56 females) referred for evaluation of chest pain were studied by multistage submaximal stress testing and selective coronary arteriography. In men with positive exercise tests the incidence rate of true positive exercise test results--that is, positive tests associated with 75 percent of greater coronary stenosis--was 89 percent in contrast to a 33 percent incidence rate of true positive exercise test results in women. The incidence rate of false positive excercise test results--that is, positive tests associated with no coronary stenosis or less than 50 percent stenosis--was 8 percent in men in contrast to 67 percent in women. Conversely, the incidence rate of false negative exercise test results (that is, negative exercise tests associated with 75 percent or greater coronary stenosis) was higher in men (37 percent) than in women (12 percent). It is concluded that in men a positive multistage stress test is useful in predicting the presence of significant coronary artery disease although a negative stress test cannot be relied upon to rule out the presence of significant disease. In women, a positive exercise test is of little value in predicting the presence of significant coronary artery disease, whereas a negative test is quite useful in ruling out the presence of significant disease. New criteria should be developed for stress testing of women. PMID:1155337

Sketch, M H; Mohiuddin, S M; Lynch, J D; Zencka, A E; Runco, V

1975-08-01

76

Combined Home Exercise Is More Effective Than Range-of-Motion Home Exercise in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial  

PubMed Central

Home exercise is often recommended for management of patients with ankylosing spondylitis (AS); however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB) and range-of-motion home exercise (ROM) in patients with AS. Nineteen subjects with AS completed either COMB (n = 9) or ROM (n = 10) program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI), and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P = 0.008) and BASFI (P = 0.028), and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P = 0.033). This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability. PMID:25276785

Chuang, Chih-Cheng; Tseng, Ching-Shiang; Wei, James Cheng-Chung; Hsu, Wei-Chun; Lin, Yi-Jia

2014-01-01

77

Exercise testing after beta-blockade: improved specificity and predictive value in detecting coronary heart disease.  

PubMed Central

The value of exercise testing in detecting myocardial ischaemia resulting from coronary atheroma remains controversial. In order to increase the reliability of exercise testing, all its components (asymptomatic, haemodynamic, and electrocardiographic) have been scrutinised. In this study, concerned only with the electrocardiographic response to exercise, the incorporation of beta-blockade into the standard exercise procedure has improved specificity and predictive value without affecting sensitivity. Fifty patients with anginal pain and 50 asymptomatic subjects with an abnormal electrocardiogram were investigated by exercise testing before and after beta-blockade (oxprenolol). All subjects had coronary arteriograms and left ventriculograms, and the results of exercise testing were related to the presence or absence of obstructive coronary artery disease. Possible causes of false positive exercise tests were eliminated by echocardiography. Though beta-blockade was unreliable in distinguishing ischaemic from non-ischaemic resting electrocardiograms, it eliminated all the false positive electrocardiographic responses to exercise in both groups and did not abolish any of the true positive electrocardiographic responses. Thus, specificity and predictive value were improved without reduction in sensitivity. This technique may not necessarily be applicable to other groups of patients or to a random population, but the results of this study suggest it will be a useful additional routine procedure in the investigation of coronary heart disease. PMID:7437172

Marcomichelakis, J; Donaldson, R; Green, J; Joseph, S; Kelly, H B; Taggart, P; Somerville, W

1980-01-01

78

Effect of continuous and interval exercise training on the PETCO2 response during a graded exercise test in patients with coronary artery disease  

PubMed Central

OBJECTIVE: The purpose of this study was to evaluate the following: 1) the effects of continuous exercise training and interval exercise training on the end-tidal carbon dioxide pressure (PETCO2) response during a graded exercise test in patients with coronary artery disease; and 2) the effects of exercise training modalities on the association between PETCO2 at the ventilatory anaerobic threshold (VAT) and indicators of ventilatory efficiency and cardiorespiratory fitness in patients with coronary artery disease. METHODS: Thirty-seven patients (59.7±1.7 years) with coronary artery disease were randomly divided into two groups: continuous exercise training (n?=?20) and interval exercise training (n?=?17). All patients performed a graded exercise test with respiratory gas analysis before and after three months of the exercise training program to determine the VAT, respiratory compensation point (RCP) and peak oxygen consumption. RESULTS: After the interventions, both groups exhibited increased cardiorespiratory fitness. Indeed, the continuous exercise and interval exercise training groups demonstrated increases in both ventilatory efficiency and PETCO2 values at VAT, RCP, and peak of exercise. Significant associations were observed in both groups: 1) continuous exercise training (PETCO2VAT and cardiorespiratory fitness r?=?0.49; PETCO2VAT and ventilatory efficiency r?=?-0.80) and 2) interval exercise training (PETCO2VAT and cardiorespiratory fitness r?=?0.39; PETCO2VAT and ventilatory efficiency r?=?-0.45). CONCLUSIONS: Both exercise training modalities showed similar increases in PETCO2 levels during a graded exercise test in patients with coronary artery disease, which may be associated with an improvement in ventilatory efficiency and cardiorespiratory fitness. PMID:22760902

Rocco, Enéas A; Prado, Danilo M L; Silva, Alexandre G; Lazzari, Jaqueline M. A.; Bortz, Pedro C; Rocco, Débora F. M.; Rosa, Carla G; Furlan, Valter

2012-01-01

79

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

ERIC Educational Resources Information Center

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…

Petosa, R. Lingyak; Holtz, Brian

2013-01-01

80

Open-loop control to achieve linear heart rate increase in the treadmill exercise test  

Microsoft Academic Search

A linear increase in heart rate was achieved by an open-loop controlled protocol that increases walking speed logarithmically in the treadmill exercise test. These results are reproducible. Such results however, were not achieved by feedback control. This result suggests that open-loop control is the more appropriate protocol for achieving a predetermined heart rate change during exercise

H. Saito; T. Togawa

1998-01-01

81

The prognostic value of body mass index and standard exercise testing in male Veterans with congestive heart failure  

Microsoft Academic Search

Objective: To evaluate the prognostic characteristics of body mass index (BMI) and standard exercise test variables in a consecutive series of patients with mild to moderate congestive heart failure (CHF) referred for standard exercise tests. Background: Controversy exists regarding the prognostic importance of BMI, etiology, and exercise test variables in patients with CHF. Methods: All patients referred for evaluation at

Lynette W. Lissin; Andre J. Gauri; Victor F. Froelicher; Afshin Ghayoumi; Jonathan Myers; John Giacommini

2002-01-01

82

T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test  

Microsoft Academic Search

Aims As a part of the Finnish Cardiovascular Study, we tested the hypothesis that T-wave alternans (TWA) predicts mortality in a general population of patients referred for a clinical exercise test. Methods and results A total of 1037 consecutive patients (mean age+SD of 58+13 years, 673 men and 364 women) with a clinically indicated exercise test and with technically successful

Tuomo Nieminen; Terho Lehtimaki; Jari Viik; Rami Lehtinen; Kjell Nikus; Tiit Koobi; Kari Niemela; V ainoTurjanmaa; Willi Kaiser; Heini Huhtala; Richard L. Verrier; Heikki Huikuri; Mika Kahonen

2007-01-01

83

Narrative and framing: a test of an integrated message strategy in the exercise context.  

PubMed

Health communication interventions encouraging exercise may aid in mitigating the obesity crisis in the United States. Although much research has investigated behavioral predictors of exercise, little work has explored message characteristics most persuasive in the exercise context. The purpose of this study, therefore, was to test a message strategy drawing on previous work in health behavior theory combined with persuasion theories (exemplification theory and prospect theory) to encourage positive exercise attitudes, control beliefs, and intentions. The authors report the results of a controlled experiment testing messages using gain or loss frames and narrative or statistical evidence. Results indicate that gain-framed messages are significantly more successful in promoting positive exercise variables and are perceived as more effective than are loss-framed or control messages. The authors discuss the implications of the results for future research. PMID:21058142

Gray, Jennifer B; Harrington, Nancy G

2011-03-01

84

A simple semipaced 3-minute chair rise test for routine exercise tolerance testing in COPD  

PubMed Central

The functional work capacity of chronic obstructive pulmonary disease (COPD) patients is usually assessed with walk tests such as the 6-minute walk test (6MWT) or the shuttle test. Because these exercise modalities require a controlled environment which limits their use by pulmonologists and severely restricts their use among general practitioners, different modalities of a short (1 minute or less) sit-to-stand test were recently proposed. In this study, we evaluated a new modality of a semipaced 3-minute chair rise test (3CRT) in 40 patients with COPD, and compared the reproducibility of physiological responses and symptoms during the 3CRT and their interchangeability with the 6MWT. The results demonstrate that physiological variables, heart rate, pulse oxygen saturation, work done, and symptoms (Borg dyspnea and fatigue scores), during the 3CRT were highly reproducible, and that the physiological responses and symptoms obtained during the 3CRT and the 6MWT were interchangeable for most patients. Moreover, these preliminary data suggest that patients able to perform more than 50 rises during 3 minutes had no significant disability. The simplicity and ease of execution of the 3CRT will facilitate the assessment of exercise symptoms and disability in COPD patients during routine consultations with pulmonologists and general practitioners, and will thus contribute to the improved management of COPD patients. PMID:25285001

Aguilaniu, Bernard; Roth, Hubert; Gonzalez-Bermejo, Jesus; Jondot, Marie; Maitre, Jocelyne; Denis, François; Similowski, Thomas

2014-01-01

85

Early exercise stress testing is safe after primary percutaneous coronary intervention  

PubMed Central

Background: The optimal timing of exercise stress testing post primary percutaneous coronary intervention is uncertain with anecdotal evidence suggesting an increased risk of acute myocardial infarction and/or death if performed too early. This has translated into a delayed return to normal life activities following an acute myocardial infarction resulting in an increase in socio-economic burden. Aims: We hypothesize that early (within 7 days of primary percutaneous coronary intervention) exercise stress testing is safe. Methods: A prospective study of consecutive patients enrolled into the Cardiac Rehabilitation Program at a tertiary referral centre that underwent primary percutaneous coronary intervention, and who were able to perform a treadmill stress test were recruited. Timing of exercise stress testing was within 7 days post primary percutaneous coronary intervention and outcomes of death, acute myocardial infarction and other major adverse cardiac event were assessed 24 hours post exercise stress testing. Results: Recruited patients (n=230) aged between 29 and 78 (mean age 56 ± 10 years) with 191 being males (83%) and 39 being females (17%). While 28 patients had a positive stress test (12.2%), there were no deaths, acute myocardial infarction or any other major adverse cardiac event within 24 hours of performing the exercise stress testing. Mean METS achieved were 8.1 ± 2.3. Conclusions: Early exercise stress testing after primary percutaneous coronary intervention appears safe. PMID:24062903

Tan, Timothy C; Zecchin, Robert P; Denniss, Alan Robert

2012-01-01

86

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

Microsoft Academic Search

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

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

1999-01-01

87

Prognostic Value of Exercise Treadmill Testing in Asymptomatic Chronic Nonischemic Mitral Regurgitation  

PubMed Central

In many heart diseases, exercise treadmill testing(ETT) has useful functional correlates and/or prognostic value. However, its predictive value in mitral regurgitation(MR) is undefined. To determine whether ETT descriptors predict death or indications for mitral valve surgery among patients with MR, we prospectively followed, for 7±3 endpoint-free years, a cohort of 38 patients with chronic severe nonischemic MR who underwent modified Bruce ETT; all lacked surgical indications at study entry. Their baseline exercise descriptors also were compared with those from 46 patients with severe MR who, at entry, already had reached surgical indications. Endpoints during follow-up among the cohort included sudden death(n=1), heart failure symptoms(n=2), atrial fibrillation(n=4), LVEF<60%(n=2), LV systolic dimensions(IDs)?45 mm(n=12) and LVIDs>40mm(n=11), LVEF<60%+LVIDs 45 mm(n=3), and heart failure+LVIDs 45mm+LVEF<60%(n=1). In univariate analysis, exercise duration(p=.004), chronotropic response(p=.007), percent predicted peak heart rate(p=.01) and heart rate recovery(p<.02) predicted events; in multivariate analysis, only exercise duration was predictive(p<.02). Average annual event risk was 5-fold lower(4.62%) with exercise duration?15 minutes vs. <15 minutes(average annual risk=23.48%, p=.004). Relative risks among patients with and without exercise-inducible ST segment depression were comparable(?1.3[NS]) whether defined at entry and/or during follow-up. Exercise duration, but not prevalence of exercise-inducible ST segment depression, was lower(p<.001) among patients with surgical indications at entry vs. initially endpoint-free patients. In conclusion, among asymptomatic patients with chronic severe nonischemic MR and no objective criteria for operation, progression to surgical indications generally is rapid. However, those with excellent exercise tolerance have a relatively benign course. Exercise-inducible ST segment depression has no prognostic value in this population. We followed, for 7±3 endpoint-free years, 38 patients with chronic severe nonischemic mitral regurgitation (MR) who underwent modified Bruce exercise treadmill testing (ETT) to determine whether ETT descriptors predict death or indications for mitral valve surgery. At study entry, all lacked surgical indications. Exercise duration independently predicted subsequent events; event risks among patients with and without exercise-inducible ST segment depression were comparable. We conclude that among asymptomatic patients with chronic severe nonischemic MR and no objective criteria for operation, those with excellent exercise tolerance have a relatively benign course. Exercise-inducible ST segment depression has no prognostic value in this population. PMID:17920370

Supino, Phyllis G.; Borer, Jeffrey S.; Schuleri, Karlheinz; Gupta, Anuj; Hochreiter, Clare; Kligfield, Paul; Herrold, Edmund McM.; Preibisz, Jacek J.

2007-01-01

88

Artificial neural network cardiopulmonary modeling and diagnosis  

DOEpatents

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

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

1997-10-28

89

Artificial neural network cardiopulmonary modeling and diagnosis  

DOEpatents

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

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

1997-01-01

90

Exercise Intensity during Treadmill Walking with Gait Patterned FES among Patients with Incomplete Spinal Cord Injury: Case Series  

E-print Network

SCI. Further investigations are required to determine the clinical relevance of the exercise. Key to maximize the physiological benefits of cardiopulmonary training, exercise at an appropriate intensity- 1 - Exercise Intensity during Treadmill Walking with Gait Patterned FES among Patients

Popovic, Milos R.

91

The effects of space flight on the cardiopulmonary system  

NASA Technical Reports Server (NTRS)

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.

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

1989-01-01

92

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

Microsoft Academic Search

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

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

1999-01-01

93

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

PubMed Central

Study Objective: To evaluate whether cardiovascular responses to maximal exercise testing and recovery are altered with obstructive sleep apnea (OSA) in overweight young adult men. Design: Three sedentary subject groups were recruited: Overweight with OSA (OSA), overweight without OSA (No-OSA), and normal weight without OSA (Control). Presence of OSA was screened via portable diagnostic device. Body composition was measured with dual-energy X-ray absorptiometry. Subjects performed maximal ramping exercise testing (RXT) on a cycle ergometer with 5 minutes of active recovery. Exercise measurements included heart rate (HR), blood pressure (BP), respiratory exchange ratio (RER), and oxygen consumption (VO2). Recovery HR was converted to a HR difference (HRdiff) calculation (HRpeak ? HR each minute recovery), and BP was converted to a recovery ratio for each minute. Setting: The study was carried out on the campus of Virginia Tech, Department of Human Nutrition, Foods, and Exercise, Blacksburg, Virginia. Participants: 14 OSA, 16 No-OSA, and 14 Control volunteers. Intervention: N/A Measurements and Results: In OSA subjects, HR recovery was significantly attenuated compared to the No-OSA and Control groups throughout recovery (P = 0.009). No differences were noted in the HR or BP response to exercise in any group. The VO2, adjusted for fat-free soft tissue mass, did not differ between groups. Conclusions: We found that OSA elicits alterations in the cardiovascular response post exercise, reflected by an attenuated HR recovery. This may indicate an imbalance in the autonomic regulation of HR. Exercise tests may provide utility in risk stratification for those at risk for OSA. Citation: Hargens TA; Guill SG; Zedalis D; Gregg JM; Nickols-Richardson SM; Herbert WG. Attenuated heart rate recovery following exercise testing in overweight young men with untreated obstructive sleep apnea. SLEEP 2008;31(1):104-110. PMID:18220083

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

2008-01-01

94

21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

95

21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

96

21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.  

Code of Federal Regulations, 2014 CFR

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

2014-04-01

97

Comparison of the use of downstream tests after exercise treadmill testing by cardiologists versus noncardiologists.  

PubMed

Although exercise treadmill testing (ETT) is a useful initial test for patients with suspected cardiovascular (CV) disease, there is concern regarding the use of downstream imaging tests especially in the setting of equivocal or positive ETTs. Patients with no history of coronary artery disease who underwent ETT between 2009 and 2010 were prospectively included. Referring physicians were categorized as cardiologists and noncardiologists. Downstream tests included nuclear perfusion imaging, coronary computed tomography angiography, stress echocardiography, stress magnetic resonance, and invasive coronary angiography performed up to 6 months after the ETT. Patients were followed for CV death, myocardial infarction, and coronary revascularization for a median of 2.7 years. Among 3,656 patients, the ETT were negative in 2,876 (79%), positive in 132 (3.6%), and inconclusive in 643 (18%). Cardiologists ordered less downstream tests than noncardiologists (9.5% vs 12.2%, p=0.02), with less noninvasive tests (5.9% vs 10.4%, p<0.0001) and more invasive angiography (3.6% vs 1.8%, p<0.0001). After adjustment for confounding, patients evaluated by cardiologists were less likely to undergo additional testing after equivocal (odds ratio: 0.65, p=0.02) or positive ETT results (odds ratio: 0.39, p=0.02), whereas after negative ETT, the odds ratio was 1.7 (p=0.06). There was no difference in the rate of adverse CV events between patients referred by cardiologists versus noncardiologists. In conclusion, patients referred for ETT by cardiologists are less likely to undergo additional testing, particularly noninvasive tests, than those referred by noncardiologists. The lower rate of tests is driven by a lower rate of tests after positive or inconclusive ETT. PMID:24874162

Bittencourt, Marcio S; Christman, Mitalee P; Hulten, Edward; Divakaran, Sanjay; Skali, Hicham; Kwong, Raymond Y; Hainer, Jon; Forman, Daniel E; Kirshenbaum, James M; Dorbala, Sharmila; Di Carli, Marcelo F; Blankstein, Ron

2014-07-15

98

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

NASA Technical Reports Server (NTRS)

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.

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

2008-01-01

99

Muscular exercise can cause highly pathological liver function tests in healthy men  

PubMed Central

Aim To investigate the effect of intensive muscular exercise (weightlifting) on clinical chemistry parameters reflecting liver function in healthy men. Methods Fifteen healthy men, used to moderate physical activity not including weightlifting, performed an 1 h long weightlifting programme. Blood was sampled for clinical chemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LD), gamma-glutamyl transferase (?GT), alkaline phosphatase (ALP), bilirubin, creatine kinase (CK) and myoglobin] at repeated intervals during 7 days postexercise and at a follow-up examination 10–12 days postexercise. Results Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and myoglobin) increased significantly after exercise (P < 0.01) and remained increased for at least 7 days postexercise. Bilirubin, ?GT and ALP remained within the normal range. Conclusion The liver function parameters, AST and ALT, were significantly increased for at least 7 days after the exercise. In addition, LD and, in particular, CK and myoglobin showed highly elevated levels. These findings highlight the importance of imposing restrictions on weightlifting prior to and during clinical studies. Intensive muscular exercise, e.g. weightlifting, should also be considered as a cause of asymptomatic elevations of liver function tests in daily clinical practice. What is already known about this subject The occurrence of idiosyncratic drug hepatotoxicity is a major problem in all phases of clinical drug development and the leading cause of postmarketing warnings and withdrawals.Physical exercise can result in transient elevations of liver function tests.There is no consensus in the literature on which forms of exercise may cause changes in liver function tests and to what extent. What this study adds Weightlifting results in profound increases in liver function tests in healthy men used to moderate physical activity, not including weightlifting.Liver function tests are significantly increased for at least 7 days after weightlifting.It is important to impose relevant restrictions on heavy muscular exercise prior to and during clinical studies. PMID:17764474

Pettersson, Jonas; Hindorf, Ulf; Persson, Paula; Bengtsson, Thomas; Malmqvist, Ulf; Werkström, Viktoria; Ekelund, Mats

2008-01-01

100

Myocardial electrotonic response to submaximal exercise in dogs with healed myocardial infarctions: evidence for ?-adrenoceptor mediated enhanced coupling during exercise testing  

PubMed Central

Introduction: Autonomic neural activation during cardiac stress testing is an established risk-stratification tool in post-myocardial infarction (MI) patients. However, autonomic activation can also modulate myocardial electrotonic coupling, a known factor to contribute to the genesis of arrhythmias. The present study tested the hypothesis that exercise-induced autonomic neural activation modulates electrotonic coupling (as measured by myocardial electrical impedance, MEI) in post-MI animals shown to be susceptible or resistant to ventricular fibrillation (VF). Methods: Dogs (n = 25) with healed MI instrumented for MEI measurements were trained to run on a treadmill and classified based on their susceptibility to VF (12 susceptible, 9 resistant). MEI and ECGs were recorded during 6-stage exercise tests (18 min/test; peak: 6.4 km/h @ 16%) performed under control conditions, and following complete ?-adrenoceptor (?-AR) blockade (propranolol); MEI was also measured at rest during escalating ?-AR stimulation (isoproterenol) or overdrive-pacing. Results: Exercise progressively increased heart rate (HR) and reduced heart rate variability (HRV). In parallel, MEI decreased gradually (enhanced electrotonic coupling) with exercise; at peak exercise, MEI was reduced by 5.3 ± 0.4% (or -23 ± 1.8?, P < 0.001). Notably, exercise-mediated electrotonic changes were linearly predicted by the degree of autonomic activation, as indicated by changes in either HR or in HRV (P < 0.001). Indeed, ?-AR blockade attenuated the MEI response to exercise while direct ?-AR stimulation (at rest) triggered MEI decreases comparable to those observed during exercise; ventricular pacing had no significant effects on MEI. Finally, animals prone to VF had a significantly larger MEI response to exercise. Conclusions: These data suggest that ?-AR activation during exercise can acutely enhance electrotonic coupling in the myocardium, particularly in dogs susceptible to ischemia-induced VF.

del Rio, Carlos L.; Clymer, Bradley D.; Billman, George E.

2015-01-01

101

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

ERIC Educational Resources Information Center

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

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

2006-01-01

102

Treatment with enalapril fails to prevent impaired cardiopulmonary baroreflex control in dogs with left ventricular dysfunction  

Microsoft Academic Search

That the cardiopulmonary baroreflex control of sympathetic nerve activity is impaired in dogs with left ventricular (LV) dysfunction has been shown previously. This study tested the hypothesis that treatment with the angiotensin-converting enzyme inhibitor enalapril prevents or delays the development of abnormalities of cardiopulmonary baroreflexes in dogs with LV dysfunction. Serial changes in LV volumes and neurohumoral profiles (plasma norepinephrine

Toru Kinugawa; Mark E. Dibner-Dunlap; Domenic A. Sica; Marc D. Thames

1995-01-01

103

[Cardiopulmonary resuscitation through centuries].  

PubMed

THE ANCIENT TIMES: Many early civilisations left testimonies about ancient times and resuscitation, as well. Some of them did it successfully and some of them did it less successfully; however, all of them wished to help a dying person and to bring him back to life. The first trustworthy note can be found in the Bible--Old Testament as a very realistic description of resuscitation of a child. THE MIDDLE AGES: The medieval scientists, Paracelsus and Vesalius, described first successful resuscitation attempts in the 15th and 16th century. These two men successfully applied ventilation methods by air inflation with blacksmith bellows. THE MODERN ERA: The first defibrillation was recorded in the 18th century in England, which was conducted by one of the volunteer society members. With the development of mechanics and techniques, the first precursors of modern respirators were introduced in the 19th century. The age of modern cardiopulmonary resuscitation began in the middle of 20th century, when Dr Peter Safar brought in the combination of artificial ventilation and chest compressions as the standard for implementing resuscitation. Adrenalin and defibrillation were introduced into the resuscitation techniques by Dr Redding and Dr Kouwenhaven, respectively; thus beginning the advance life support administration, which has been applied, with minor changes, until today. PMID:21905608

Gaji?, Vladimir

2011-01-01

104

Does exercise test modality influence dyspnoea perception in obese patients with COPD?  

PubMed

The purpose of this study was to investigate whether differences in physiological responses to weight-bearing (walking) and weight-supported (cycle) exercise influence dyspnoea perception in obese chronic obstructive pulmonary disease (COPD) patients, where such discrepancies are probably exaggerated. We compared metabolic, ventilatory and perceptual responses during incremental treadmill and cycle exercise using a matched linearised rise in work rate in 18 (10 males and eight females) obese (mean ± sd body mass index 36.4 ± 5.0 kg·m(-2)) patients with COPD (forced expiratory volume in 1 s 60 ± 11% predicted). Compared with cycle testing, treadmill testing was associated with a significantly higher oxygen uptake, lower ventilatory equivalent for oxygen and greater oxyhaemoglobin desaturation at a given work rate (p<0.01). Cycle testing was associated with a higher respiratory exchange ratio (p<0.01), earlier ventilatory threshold (p<0.01) and greater peak leg discomfort ratings (p=0.01). Ventilation, breathing pattern and operating lung volumes were similar between tests, as were dyspnoea/work rate and dyspnoea/ventilation relationships. Despite significant between-test differences in physiological responses, ventilation, operating lung volumes and dyspnoea intensity were similar at any given external power output during incremental walking and cycling exercise in obese COPD patients. These data provide evidence that either exercise modality can be selected for reliable evaluation of exertional dyspnoea in this population in research and clinical settings. PMID:24311769

Ciavaglia, Casey E; Guenette, Jordan A; Ora, Josuel; Webb, Katherine A; Neder, J Alberto; O'Donnell, Denis E

2014-06-01

105

Clinical Implications of Referral Bias in the Diagnostic Performance of Exercise Testing for Coronary Artery Disease  

PubMed Central

Background Exercise testing with echocardiography or myocardial perfusion imaging is widely used to risk?stratify patients with suspected coronary artery disease. However, reports of diagnostic performance rarely adjust for referral bias, and this practice may adversely influence patient care. Therefore, we evaluated the potential impact of referral bias on diagnostic effectiveness and clinical decision?making. Methods and Results Searching PubMed and EMBASE (1990–2012), 2 investigators independently evaluated eligibility and abstracted data on study characteristics and referral patterns. Diagnostic performance reported in 4 previously published meta?analyses of exercise echocardiography and myocardial perfusion imaging was adjusted using pooled referral rates and Bayesian methods. Twenty?one studies reported referral patterns in 49 006 patients (mean age 60.7 years, 39.6% women, and 0.8% prior history of myocardial infarction). Catheterization referral rates after normal and abnormal exercise tests were 4.0% (95% CI, 2.9% to 5.0%) and 42.5% (36.2% to 48.9%), respectively, with odds ratio for referral after an abnormal test of 14.6 (10.7 to 19.9). After adjustment for referral, exercise echocardiography sensitivity fell from 84% (80% to 89%) to 34% (27% to 41%), and specificity rose from 77% (69% to 86%) to 99% (99% to 100%). Similarly, exercise myocardial perfusion imaging sensitivity fell from 85% (81% to 88%) to 38% (31% to 44%), and specificity rose from 69% (61% to 78%) to 99% (99% to 100%). Summary receiver operating curve analysis demonstrated only modest changes in overall discriminatory power but adjusting for referral increased positive?predictive value and reduced negative?predictive value. Conclusions Exercise echocardiography and myocardial perfusion imaging are considerably less sensitive and more specific for coronary artery disease after adjustment for referral. Given these findings, future work should assess the comparative ability of these and other tests to rule?in versus rule?out coronary artery disease. PMID:24334965

Ladapo, Joseph A.; Blecker, Saul; Elashoff, Michael R.; Federspiel, Jerome J.; Vieira, Dorice L.; Sharma, Gaurav; Monane, Mark; Rosenberg, Steven; Phelps, Charles E.; Douglas, Pamela S.

2013-01-01

106

Exercise persistence in the face of varying exercise challenges: a test of self-efficacy theory in working mothers.  

PubMed

Self-regulatory efficacy (SRE) should influence persistence towards goals. Mothers attempting to exercise while managing work and young children (N = 49, M(age) = 35.69, M(children) = 1.88) were stratified into high or low concurrent SRE groups, then randomized to read a hypothetical scenario detailing numerous or minimal exercise barrier conditions. Consistent with self-efficacy theory, when exercise barriers were numerous, mothers with higher concurrent SRE demonstrated greater persistence towards exercise goals, and perceived concurrent management of exercise with their other valued goals as more positively challenging, than mothers with lower concurrent SRE. PMID:21441356

Jung, Mary E; Brawley, Lawrence R

2011-07-01

107

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

NASA Technical Reports Server (NTRS)

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.

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

2000-01-01

108

Do LQTS Gene Single Nucleotide Polymorphisms Alter QTc Intervals at Rest and During Exercise Stress Testing?  

PubMed Central

Background The impact of harboring, genetic variants or single nucleotide polymorphisms (LQT-PM) on the repolarization response during exercise and recovery is unknown. Objective To assess the QTc interval adaptation during exercise stress testing (EST) in children with LQT polymorphisms compared to a group of age and gender matched normal controls. Methods One-hundred and forty-eight patients were age and gender matched into two groups: LQT-PM and control. Each patient underwent a uniform exercise protocol employing a cycle ergometer followed by a 9 minute recovery phase with continuous 12-lead electrocardiogram (ECG) monitoring. Intervals (RR, QT and QTc) at rest (supine), peak exercise and in recovery (1, 3, 5, 7, and 9 minutes) were measured. Results Forty three patients were positive for LQT-PM and the control group consisted of 105 patients. A total of 83 SNPs were identified: SCN5A n=31 (37%), KCNE1 n=29 (35%), KCNH2 n=20 (24%), KCNQ1 n=2 (2%) and KCNE2 n=1 (1%). The QTc interval measurements of the LQT-PM were longer at rest, peak exercise and all phases of recovery when compared to the control group. Neither group demonstrated abnormal QTc interval adaptation in response to exercise. Patients with homozygous SNPs had longer resting QTc intervals when compared to patients with only heterozygous SNPs (435±23 ms vs 415±20 ms respectively, P-value <0.006). Conclusions Individuals with LQT-PM may have longer QTc intervals at rest as well as at peak exercise and all phases of the recovery period compared to normal controls. Additionally, subjects with homozygous SNPs had longer resting QTc intervals when compared to those with only heterozygous SNPs. PMID:23714088

Aziz, Peter F; Wieand, Tammy S; Ganley, Jamie; Henderson, Jacqueline; McBride, Michael; Shah, Maully J

2015-01-01

109

Smoking Status and Exercise in relation to PTSD Symptoms: A Test among Trauma-Exposed Adults.  

PubMed

The present investigation examined the interactive effect of cigarette smoking status (i.e., regular smoking versus non-smoking) and weekly exercise (i.e., weekly metabolic equivalent) in terms of posttraumatic stress (PTSD) symptom severity among a community sample of trauma-exposed adults. Participants included 86 trauma-exposed adults (58.1% female; Mage = 24.3). Approximately 59.7% of participants reported regular (? 10 cigarettes per day) daily smoking over the past year. The interactive effect of smoking status by weekly exercise was significantly associated with hyperarousal and avoidance symptom cluster severity (p ? .05). These effects were evident above and beyond number of trauma types and gender, as well as the respective main effects of smoking status and weekly exercise. Follow-up tests indicated support for the moderating role of exercise on the association between smoking and PTSD symptoms, such that the highest levels of PTSD symptoms were observed among regular smokers reporting low weekly exercise levels. Theoretical and clinical implications of the findings are discussed. PMID:24273598

Vujanovic, Anka A; Farris, Samantha G; Harte, Christopher B; Smits, Jasper A J; Zvolensky, Michael J

2013-06-01

110

Comparing Fat Oxidation in an Exercise Test with Moderate-Intensity Interval Training  

PubMed Central

This study compared fat oxidation rate from a graded exercise test (GXT) with a moderate-intensity interval training session (MIIT) in obese men. Twelve sedentary obese males (age 29 ± 4.1 years; BMI 29.1 ± 2.4 kg·m-2; fat mass 31.7 ± 4.4 %body mass) completed two exercise sessions: GXT to determine maximal fat oxidation (MFO) and maximal aerobic power (VO2max), and an interval cycling session during which respiratory gases were measured. The 30-min MIIT involved 5-min repetitions of workloads 20% below and 20% above the MFO intensity. VO2max was 31.8 ± 5.5 ml·kg-1·min-1 and all participants achieved ? 3 of the designated VO2max test criteria. The MFO identified during the GXT was not significantly different compared with the average fat oxidation rate in the MIIT session. During the MIIT session, fat oxidation rate increased with time; the highest rate (0.18 ± 0.11 g·min- 1) in minute 25 was significantly higher than the rate at minute 5 and 15 (p ? 0.01 and 0.05 respectively). In this cohort with low aerobic fitness, fat oxidation during the MIIT session was comparable with the MFO determined during a GXT. Future research may consider if the varying workload in moderate-intensity interval training helps adherence to exercise without compromising fat oxidation. Key Points Fat oxidation during interval exercise is not com-promised by the undulating exercise intensity Physiological measures corresponding with the MFO measured during the GXT correlated well to the MIIT The validity of exercise intensity markers derived from a GXT to reflect the physiological responses during MIIT. PMID:24570605

Alkahtani, Shaea

2014-01-01

111

Cross-Validation of the Recumbent Stepper Submaximal Exercise Test to Predict Peak Oxygen Uptake in Older Adults  

PubMed Central

Background Submaximal exercise testing can have a greater application in clinical settings because peak exercise testing is generally not available. In previous work, a prediction equation was developed to estimate peak oxygen consumption (V?o2) using a total body recumbent stepper (TBRS) and the Young Men's Christian Association (YMCA) protocol in adults who were healthy. Objective The purpose of the present study was to cross-validate the TBRS peak V?o2 prediction equation in older adults. Design A cross-sectional study was conducted. Methods Thirty participants (22 female, 8 male; mean age=66.8 years, SD=5.52; mean weight=68.51 kg, SD=13.39) who previously completed a peak exercise test and met the inclusion criteria were invited to participate in the cross-validation study. Within 5 days of the peak V?o2 test, participants completed the TBRS submaximal exercise test. The TBRS submaximal exercise test equation was used to estimate peak V?o2. The variables in the equation included age, weight, sex, watts (at the end of the submaximal exercise test), and heart rate (at the end of the submaximal exercise test). Results A strong correlation was found between the predicted peak V?o2 and the measured peak V?o2. The difference between the values was 0.9 mL·kg?1·min?1, which was not statistically different. The standard error of the estimate was 4.2 mL·kg?1·min?1. Limitations The sample included individuals who volunteered to perform a peak exercise test, which may have biased the results toward those willing to exercise to fatigue. Conclusion The data suggest the TBRS submaximal exercise test and prediction equation can be used to predict peak V?o2 in older adults. This finding is important for health care professionals wanting to provide information to their patients or clients regarding their fitness level. PMID:24435104

Herda, Ashley A.; Lentz, Angela A.; Mattlage, Anna E.; Sisante, Jason-Flor

2014-01-01

112

Serum enzyme variations in men during an exhaustive “square-wave” endurance exercise test  

Microsoft Academic Search

Summary  The present study was designed to test if both the intensity and duration of the 45-min Square-Wave Endurance Exercise Test (SWEET) would produce changes in serum enzyme activities. Nine men, four sedentary (S) and five athletes (A), performed \\u000a$$\\\\dot V_{{\\\\text{O}}_{\\\\text{2}} }$$\\u000a max and SWEET, at their Maximal Intensity of Endurance (MIE45) as defined by maximal heart rate and the impossibility

Manuel Gimenez; Michel Florentz

1984-01-01

113

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

SciTech Connect

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

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

1987-12-01

114

The Volcanic Ash Strategic Initiative Team (VAST) - operational testing activities and exercises  

NASA Astrophysics Data System (ADS)

The project VAST performs its activities within an ESA (European Space Agency) initiative to enhance the use of Earth Observation (EO) data in volcanic ash monitoring and forecasting. The VAST project aims at further exploring the suitability of EO data for such activities and to improve volcanic ash atmospheric transport forecasting services through exercises and demonstration activities in operational environments. Previous to the in-house deployment of the demonstration service, several exercises on operations and communication exchange are needed and first results are presented here. These exercises include technical in-house settings and conceptual planning of the operations with procedure development, volcanic eruptions drills that trigger the acquiring of data and dispersion/forecasting calculations with preliminary estimates of source terms and finally, an international exercise that provides a test case volcanic event to evaluate response times and the usefulness of the different products obtained. Products also include ensemble dispersion forecasts, on one hand multi-input ensembles utilizing the ECMWF EPS system, and on the other hand multi-model ensembles based on different dispersion models driven with different input data. As part of the work, socio-economic aspects need to be taken into account as well. This includes also the identification of best practices on how results can be presented to the stakeholders, including national authorities and policy makers, and the general public.

Wotawa, Gerhard; Arnold, Delia; Eckhardt, Sabine; Kristiansen, Nina; Maurer, Christian; Prata, Fred; Stohl, Andreas; Zehner, Claus

2013-04-01

115

Validation of the SenseWear Pro3 Armband using an incremental exercise test.  

PubMed

The purpose of this study is to assess the accuracy of a multisensor activity monitor in measuring energy expenditure (EE) using an incremental exercise test. The SenseWear Pro3 Armband (SWA) has been shown a valid and practical tool in measuring the EE of daily living activities but shows significant errors in estimating EE of activities of vigorous and very vigorous intensity. Recently, a new algorithm was developed for SWA (SWA v5.2). The aim of this study was to validate the new SWA algorithm in assessing EE using an incremental exercise test. Data were obtained from 44 students (age, 21.1 ± 1.4 years). During an incremental running test, EE estimates of the SWA were compared with the indirect calorimetry (IC). A paired t-test, Bland and Altman plots, and correlation coefficients were used as statistical techniques. Compared with the IC, the SWA showed no significant difference when walking at 1.5 m·s (p = 0.901) but significantly underestimated EE at higher speeds starting from a jogging speed of 1.67 m·s for men and from a running speed of 2 m·s for women. The underestimation increased significantly with increasing intensity in both male and female participants. The accurate measurement of EE at moderate intensity makes the monitor a valid tool in estimating daily life activities. However, our study results question the applicability of the monitor for individuals willing to monitor their EE during vigorous or very vigorous exercise intensities because a significant underestimation of the new algorithm is still present. In future, the EE algorithm needs to be further adjusted to give an accurate estimate of EE for high-intensity exercises. PMID:25250859

van Hoye, Karen; Mortelmans, Patricia; Lefevre, Johan

2014-10-01

116

Plasma catecholamine responses to four resistance exercise tests in men and women  

Microsoft Academic Search

The plasma adrenaline ([A]) and noradrenaline ([NA]) concentration responses of nine men and eight women were investigated\\u000a in four resistance exercise tests (E80, E60, E40 and E20), in which the subjects had to perform a maximal number of bilateral\\u000a knee extension-flexion movements at a given cycle pace of 0.5?Hz, but at different load levels (80%, 60%, 40% and 20% of

Teemu Pullinen; Caroline Nicol; Ewen MacDonald; Paavo V. Komi

1999-01-01

117

Relationship of exercise test variables to cycling performance in an Ironman triathlon  

Microsoft Academic Search

.   The purpose of this study was, firstly, to investigate the intensity of exercise performanceof highly trained ultra-endurance\\u000a triathletes during the cycling portion of an Ironman triathlon, and, secondly, to examine the anaerobic threshold and its\\u000a relationship to this performance. Following a peak oxygen consumption (VO2peak) test on a cycle ergometer to determine the heart rate (HRTh,vent) and power output

Paul B. Laursen; Edward C. Rhodes; Robert H. Langill; Donald C. McKenzie; Jack E. Taunton

2002-01-01

118

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

Microsoft Academic Search

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

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

2006-01-01

119

Square-Wave Endurance Exercise Test (SWEET) for training and assessment in trained and untrained subjects  

Microsoft Academic Search

Summary  In order to obtain information about physiological and homeostasic responses at the Maximal Intensity of Endurance of the 45 min Square-Wave Endurance Exercise Test (MIE45), three arterial blood samples were taken: (a) at rest; (b) at the 45th min of the SWEET; (c) after 15 min of recovery, to measure paO2, paCO2, [H+], [Hb], and [lactate] in 14 normal male

Manuel Gimenez; Emilio Servera; Claude Saunier; Jacques Lacoste

1982-01-01

120

Square-Wave Endurance Exercise Test (SWEET) for training and assessment in trained and untrained subjects  

Microsoft Academic Search

Summary  A new 45 min Square-Wave Endurance Exercise Test (SWEET) performed on a cycle ergometer and designed for endurance training was studied in 43 normal subjects: Untrained (U), twelve women and seven men and Trained (T), eight women and 16 men. Among them seven were elite sportsmen (E). Preliminary measurements were made of \\u000a$$\\\\dot V\\\\operatorname{O} _2 $$\\u000amax by constant power

Manuel Gimenez; Emilio Servera; Willy Salinas

1982-01-01

121

Incremental “model-build-test” validation exercise for a 1-D biomedical ultrasonic imaging array  

Microsoft Academic Search

Quantitative validation is critical to the effective utilization of large-scale modeling in advanced biomedical ultrasonic imaging applications. This work describes an incremental “model-build-test” validation exercise centered around a nonproprietary, 5 MHz, 1D linear array design. The step-by-step sequence reported here includes piezoceramic slivers, slivers with matching and slivers with both backing and matching. Furthermore, prior to the fabrication process, all

D. J. Powell; G. L. Wojcik; C. S. Desilets; T. R. Gururaja; K. Guggenberger; S. Sherrit; B. K. Mukherjee

1997-01-01

122

Development and evaluation of a treadmill-based exercise tolerance test in cardiac rehabilitation.  

PubMed

Cardiac rehabilitation exercise prescriptions should be based on exercise stress tests; however, limitations in performing stress tests in this setting typically force reliance on subjective measures like the Duke Activity Status Index (DASI). We developed and evaluated a treadmill-based exercise tolerance test (ETT) to provide objective physiologic measures without requiring additional equipment or insurance charges. The ETT is stopped when the patient's Borg scale rating of perceived exertion (RPE) reaches 15 or when any sign/symptom indicates risk of an adverse event. Outcomes of the study included reasons for stopping; maximum heart rate, systolic blood pressure, and rate pressure product; and adverse events. We tested equivalence to the DASI as requiring the 95% confidence interval for the mean difference between DASI and ETT metabolic equivalents (METs) to fall within the range (-1, 1). Among 502 consecutive cardiac rehabilitation patients, one suffered a panic attack; no other adverse events occurred. Most (80%) stopped because they reached an RPE of 15; the remaining 20% were stopped on indications that continuing risked an adverse event. Mean maximum systolic blood pressure, heart rate, and rate pressure product were significantly (P < 0.001) below thresholds of the American Association of Cardiovascular and Pulmonary Rehabilitation. Two patients' heart rates exceeded 150 beats per minute, but their rate pressure products remained below 36,000. The mean difference between DASI and ETT METs was -0.8 (-0.98, -0.65), indicating equivalence at our threshold. In conclusion, the ETT can be performed within cardiac rehabilitation, providing a functional capacity assessment equivalent to the DASI and objective physiologic measures for developing exercise prescriptions and measuring progress. PMID:23814381

Dunagan, Julie; Adams, Jenny; Cheng, Dunlei; Barton, Stephanie; Bigej-Cerqua, Janet; Mims, Lisa; Molden, Jennifer; Anderson, Valerie

2013-07-01

123

Exercise testing in patients with variant angina: results, correlation with clinical and angiographic features and prognostic significance  

SciTech Connect

Eighty-two patients with variant angina underwent a treadmill exercise test using 14 ECG leads, and 67 also underwent exercise thallium-201 scans. The test induced ST elevation in 25 patients (30%), ST depression in 21 (26%) and no ST-segment abnormality in 36 (44%). ST elevation during exercise occurred in the same ECG leads as during spontaneous attacks at rest, and was always associated with a large perfusion defect on the exercise thallium scan. In contrast, exercise-induced ST depression often did not occur in the leads that exhibited ST elevation during episodes at rest. The ST-segment response to exercise did not accurately predict coronary anatomy: Coronary stenoses greater than or equal to 70% were present in 14 of 25 patients (56%) with ST elevation, in 13 of 21 (62%) with ST depression and in 14 of 36 (39%) with no ST-segment abnormality (NS). However, the degree of disease activity did correlate with the result of the exercise test: ST elevation occurred during exercise in 11 of 14 patients who had an average of more than two spontaneous attacks per day, in 12 of 24 who had between two attacks per day and two per week, and in only two of 31 who had fewer than two attacks per week (p<0.005). ST elevation during exercise was reproducible in five of five patients retested during an active phase of their disease, but not in three of three patients who had been angina-free for a least 1 month before the repeat test. We conclude that in variant angina patients, the results of an exercise test correlate well with the degree of disease activity but not with coronary anatomy, and do not define a high-risk subgroup.

Waters, D.D. (Montreal Heart Inst., Quebec, Canada); Szlachcic, J.; Bourassa, M.G.; Scholl, J.-M.; Theroux, P.

1982-02-01

124

Thermoregulation of the intra-abdominal testes of the bottlenose dolphin (Tursiops truncatus) during exercise.  

PubMed

Dolphins possess a vascular countercurrent heat exchanger (CCHE) that functions to cool their intra-abdominal testes. Spermatic arteries in the posterior abdomen are juxtaposed to veins returning cooled blood from the surfaces of the dorsal fin and tail flukes. In this study, we investigated the effect of exercise on CCHE function in the bottlenose dolphin. The CCHE flanks a region of the bowel in the posterior abdomen and influences colonic temperatures. A rectal probe housing a linear array of seven copper-constantan thermocouples was designed to measure colonic temperatures simultaneously at positions anterior to, within and posterior to the region of the colon flanked by the CCHE. Immediately after vigorous swimming, temperatures at the CCHE decreased relative to resting and pre-swim values: post-swim temperatures at the CCHE were maximally 0.5 degrees C cooler than pre-swim temperatures. These data suggest that the CCHE has an increased ability to cool the arterial blood supply to the testes when the dolphin is swimming. This ability could offset the increased thermal load on the testes is an exercising dolphin. To the best of our knowledge, this is the first report of deep body cooling in an exercising mammal that is not undertaking a dive. PMID:7891036

Pabst, D A; Rommel, S A; McLellan, W A; Williams, T M; Rowles, T K

1995-01-01

125

Comparison of Oxygen Consumption in Rats During Uphill (Concentric) and Downhill (Eccentric) Treadmill Exercise Tests  

PubMed Central

The study of the physiological adaptations of skeletal muscle in response to eccentric (ECC) contraction is based on protocols in which exercise intensities are determined relative to the concentric (CON) reference exercise (as percentage of the CON maximal oxygen consumption, or VO2max). In order to use similar exercise protocols in rats, we compared the VO2 values during uphill (CON) and downhill (ECC) running tests. VO2 was measured in 15 Wistar rats during incremental treadmill running exercises with different slopes: level (0%), positive (+15% incline: CON+15%) and negative (i15% incline: ECC-15%; and 130% incline: ECC-30%). Similar VO2 values were obtained in the ECC-30% and CON+15% running conditions at the three target speeds (15, 25 and 35 cm/sec). Conversely, VO2 values were lower (p < 0.05) in the ECC-15% than in the CON+15% condition (CON+15% VO2/ECC-15% VO2 ratios ranging from 1.86 to 2.05 at the three target speeds). Thus, doubling the downhill slope gradient in ECC condition leads to an oxygen consumption level that is not significantly different as in CON condition. These findings can be useful for designing animal research protocols to study the effects of ECC and CON exercise in ageing population or subjects suffering from cardiovascular diseases. Key Points VO2 in rats during treadmill race in eccentric and concentric conditions were measured. A novel breath-by-breath device allowing direct access to the animal was used. Three different slopes: +15%, -15% and -30% were used. VO2 values obtained in the -30% eccentric and the +15% concentric conditions were not significantly different. PMID:25177200

Chavanelle, Vivien; Sirvent, Pascal; Ennequin, Gaël; Caillaud, Kévin; Montaurier, Christophe; Morio, Béatrice; Boisseau, Nathalie; Richard, Ruddy

2014-01-01

126

Exercise dysfunction in patients seropositive for the human immunodeficiency virus  

SciTech Connect

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

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

1990-03-01

127

Cardiovascular fitness and haemodynamic responses to maximal cycle ergometer exercise test in children 6-8 years of age.  

PubMed

We investigated cardiovascular fitness and haemodynamic responses to maximal cycle ergometer exercise test in children. The participants were a population sample of 425 children (204 girls, 221 boys) aged 6-8 years. Heart rate (HR) and systolic blood pressure (SBP) were measured from the beginning of pre-exercise rest to the end of recovery period. We provided reference values for peak workload and changes in HR and SBP during and after maximal exercise test in girls and boys. Girls had a lower cardiovascular fitness, indicated by peak workload per body weight [mean (2 s) 2.7 (0.9) vs. 3.1 (1.0) W · kg(-1), P < 0.001] and lean mass [mean (2 s) 3.5 (0.9) vs. 3.8 (1.0) W · kg(-1), P < 0.001] than boys. Plateau or decline in SBP close to the end of the test was found in about third of children and was considered a normal SBP response. Girls had a slower HR decrease within 2 min after the test than boys [mean (2 s) 53 (18) vs. 59 (22) beats · min(-1), P < 0.001]. The results are useful for physicians and exercise physiologists to evaluate cardiovascular fitness and haemodynamic responses to exercise in children and to detect children with low exercise tolerance or abnormal haemodynamic responses to exercise. PMID:24279412

Lintu, Niina; Tompuri, Tuomo; Viitasalo, Anna; Soininen, Sonja; Laitinen, Tomi; Savonen, Kai; Lindi, Virpi; Lakka, Timo A

2014-01-01

128

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

ERIC Educational Resources Information Center

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

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

2011-01-01

129

21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.  

Code of Federal Regulations, 2013 CFR

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2013-04-01

130

21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.  

Code of Federal Regulations, 2014 CFR

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2014-04-01

131

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.  

Code of Federal Regulations, 2014 CFR

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2014-04-01

132

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.  

Code of Federal Regulations, 2011 CFR

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2011-04-01

133

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.  

Code of Federal Regulations, 2013 CFR

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2013-04-01

134

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.  

Code of Federal Regulations, 2010 CFR

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2010-04-01

135

21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.  

Code of Federal Regulations, 2010 CFR

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2010-04-01

136

21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.  

Code of Federal Regulations, 2010 CFR

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2010-04-01

137

21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.  

Code of Federal Regulations, 2010 CFR

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2010-04-01

138

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2014 CFR

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2014-04-01

139

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2012 CFR

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2012-04-01

140

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2010 CFR

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2010-04-01

141

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2011 CFR

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2011-04-01

142

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2013 CFR

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2013-04-01

143

Diurnal variation in heart rate variability before and after maximal exercise testing.  

PubMed

As heart-rate variability (HRV) is under evaluation in clinical applications, the authors sought to better define the interdependent impact of age, maximal exercise, and diurnal variation under physiologic conditions. The authors evaluated the diurnal changes in HRV 24-h pre- and post-maximal aerobic exercise testing to exhaustion in young (19-25 yrs, n?=?12) and middle-aged (40-55 yrs, n?=?12) adults. Subjects wore a portable 5-lead electrocardiogram holter for 48?h (24?h prior to and following a maximal aerobic capacity test). Time-, frequency-, time-frequency-, and scale-invariant-domain measures of HRV were computed from RR-interval data analyzed using a 5-min window size and a 2.5-min step size, resulting in a different set of outputs every 2.5?min. Results were averaged (mean?±?SE) over four prespecified time periods during the morning, afternoon, evening, and night on Day 1 and Day 2. Diurnal changes in HRV in young and middle-aged adults were compared using a two-way, repeated-measures analysis of variance (ANOVA). Young adults demonstrated higher HRV compared to middle-aged adults during periods of wakefulness and sleep prior to maximal exercise stress testing (i.e., high-frequency power during Day 1: young adults: morning 1862?±?496?ms(2), afternoon 1797?±?384?ms(2), evening 1908?±?431?ms(2), and night 3202?±?728?ms(2); middle-aged adults: morning 341?±?53?ms(2), afternoon 405?±?68?ms(2), evening 469?±?80?ms(2), and night 836?±?136?ms(2)) (p < .05). Exercise resulted in reductions in HRV such that multiple measures of HRV were not significantly different between age groups during the afternoon and evening periods. All measures of HRV demonstrated between-group differences overnight on Day 2 (p < .05). Young adults are associated with higher baseline HRV during the daytime. Sleep increases variability equally and proportionally to daytime variability. Given the higher baseline awake HRV and equal rise in HRV during sleep, the change in HRV from sleep to morning with exercise is greater in younger subjects. These physiologic results have clinical significance in understanding the pathophysiology of altered variability in ill patients. PMID:21539426

Armstrong, Rachel G; Kenny, Glen P; Green, Geoffrey; Seely, Andrew J E

2011-05-01

144

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

PubMed

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

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

2011-01-01

145

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

USGS Publications Warehouse

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.

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

2007-01-01

146

Muscle oxygen extraction is higher during constant work exercise than during incremental ramp exercise.  

PubMed

A cardiopulmonary exercise test (CPX) can provide objective measures of exercise capacity. Specifically, incremental ramp exercise (IRE) and constant work-rate exercise (CWE) protocols are frequently used in clinical practice and for research. The CWE endurance time has shown larger increases than other indexes assessed by IRE after rehabilitation intervention. Muscle oxygen extraction is one of the important physiological factors of exercise capacity; however, the differences in muscle oxygen kinetics between IRE and CWE remain unclear. The purpose of this study was to compare the muscle oxygen kinetics during IRE and CWE. Each of the 15 participants performed IRE and CWE to exhaustion on a cycle ergometer. Ventilatory and muscle deoxygenation responses were measured during the tests; muscle deoxygenation was determined using near-infrared spectroscopy. No differences in oxygen uptake and heart rate were observed between the two tests. A comparison of the muscle deoxygenation kinetics between the two tests indicated significantly greater deoxygenation during the CWE than during the IRE at all time points (p < 0.05). The muscle deoxygenation kinetics, as percentages of maximal oxygen uptake (VO2max), were higher during CWE than during IRE, except at 80% of VO2max (p < 0.05). These results suggest that skeletal muscle during CWE extracts oxygen at a rate comparable to that during IRE, and that exercise capacity assessed using CWE might be linked to a higher overall O2 extraction. The fact that endurance time during CWE is more sensitive to rehabilitation intervention may be due to improvements in muscle oxygen extraction. PMID:24827381

Yamamoto, Junshiro; Tabira, Kazuyuki

2014-01-01

147

Rationale and design of the henry ford exercise testing project (the FIT project).  

PubMed

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

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

2014-08-01

148

Evaluation of Changes in Correlation Dimension of a Time Series of RR Intervals during a Functional Exercise Test  

Microsoft Academic Search

Changes in the cardiac rhythm (CR) structure were analyzed from the viewpoint of nonlinear dynamics. The purpose was to evaluate the changes in the chaotic element (the correlation dimension D) of CR during a functional exercise test (the Harvard step test) in ten healthy males aged 17–18. Distinct changes in D of CR were observed during the test. Some general

A. S. Eidukaitis

2004-01-01

149

Exercise-induced pulmonary hemorrhage in a nonathlete: case report and review of physiology.  

PubMed

The integrity of the pulmonary blood-gas barrier is vulnerable to intense exercise in elite athletes, similar to the phenomenon of exercise-induced pulmonary hemorrhage in thoroughbred racehorses. A 50-year-old previously healthy man presented with acute onset shortness of breath, dry cough, and hypoxemia after engaging in an extremely vigorous game of handball. CT scan of the chest showed diffuse patchy air-space disease. Bronchoalveolar lavage revealed diffuse alveolar hemorrhage. Infectious etiologies and bleeding diatheses were excluded by laboratory testing. Serological tests for ANCA-associated vasculitis, lupus, and Goodpasture's disease also were negative. A transthoracic echocardiogram was normal. The patient recovered completely on supportive therapy in less than 72 h. This case demonstrates strenuous exercise as a cause of diffuse alveolar hemorrhage in a previously healthy male with no apparent underlying cardiopulmonary disease. PMID:24532148

Diwakar, Amit; Schmidt, Gregory A

2014-04-01

150

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

NASA Astrophysics Data System (ADS)

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.

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

2014-06-01

151

Alternative ventilation strategies in cardiopulmonary resuscitation  

Microsoft Academic Search

The introduction of the 2000 Guidelines for Cardiopulmonary Resuscitation emphasizes a new, evidence-based approach to the science of ventilation during cardiopulmonary resuscitation (CPR). New laboratory and clinical science underemphasizes the role of ventilation immediately after a dysrhythmic cardiac arrest (arrest primarily resulting from a cardiovascular event, such as ventricular defibrillation or asystole). However, the classic airway patency, breathing, and circulation

Andrea Gabrielli; A. Joseph Layon; Volker Wenzel; Volker Dorges; Ahamed H. Idris

2002-01-01

152

Effective risk stratification using exercise myocardial perfusion SPECT in women: Gender-related differences in prognostic nuclear testing  

Microsoft Academic Search

Objectives. This study was designed to evaluate the incremental prognostic value over clinical and exercise variables of rest thallium-201\\/exercise technetium-99m sestamibi single-photon emission computed tomography (SPECT) in women compared with men and to determine whether this test can be used to effectively risk stratify patients of both genders.Background. To minimize the previously described gender-related bias in the evaluation of coronary

Rory Hachamovitch; Daniel S. Berman; Hosen Kiat; C. Noel Bairey Merz; Ishac Cohen; J. Arthur Cabico; John Friedman; Guido Germano; Kenneth F. Van Train; George A. Diamond

1996-01-01

153

Non-invasive cardiac output evaluation during a maximal progressive exercise test, using a new impedance cardiograph device  

Microsoft Academic Search

.   One of the greatest challenges in exercise physiology is to develop a valid, reliable, non-invasive and affordable measurement\\u000a of cardiac output (CO). The purpose of this study was to evaluate the reproducibility and accuracy of a new impedance cardiograph\\u000a device, the Physio Flow, during a 1-min step incremental exercise test from rest to maximal peak effort. A group of

Ruddy Richard; Evelyne Lonsdorfer-Wolf; Anne Charloux; Stéphane Doutreleau; Martin Buchheit; Monique Oswald-Mammosser; Eliane Lampert; Bertrand Mettauer; Bernard Geny; Jean Lonsdorfer

2001-01-01

154

Treadmill exercise testing in a middle-aged Jerusalem population sample. The Jerusalem Lipid Research Clinic Prevalence Study.  

PubMed

We studied determinants of the exercising physical capacity of 1,640 subjects (1,043 men and 597 women) using the Bruce protocol as modified by Sheffield. These participants represented a sample of parents of 17-year-old adolescents living in Jerusalem. Apparently healthy participants underwent a graded treadmill exercise test (88% of the men and 87% of the women). Exercise was terminated when the subject achieved a heart rate of 85 to 90% of the predicted maximal heart rate or could not continue for other reasons, mainly fatigue or weakness. Exercise performance was assessed according to time on the treadmill. On univariate analysis, duration of exercise was related in both sexes to age, country of origin, reported physical exercise, resting heart rate, systolic and diastolic blood pressure, body mass index and plasma lipids and lipoproteins. In multivariate analysis, time was related to age, body mass index, heart rate and habitual physical exercise in both men and women, and to systolic and diastolic blood pressure in men only. Cigarette smoking and plasma lipid levels were not independently related to time on the treadmill in either sex. Ethnic differences were observed. PMID:4044219

Gofin, R; Lewis, B S; Kark, J D; Witt, H; Friedlander, Y; Kimchi, A; Gotsman, M S

1985-07-01

155

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

PubMed

Abstract 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

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

2015-02-01

156

Characteristics of patients with severe heart failure exhibiting exercise oscillatory ventilation.  

PubMed

This study aims to elucidate the characteristics of patients with severe nonischemic heart failure exhibiting exercise oscillatory ventilation (EOV) and the association of these characteristics with the subjective dyspnea. Forty-six patients with nonischemic heart failure who were classified into the New York Heart Association (NYHA) functional class III underwent cardiopulmonary exercise testing (CPX) and were divided into two groups according to the presence or absence of EOV. We evaluated the patients by using the Specific Activity Scale (SAS), biochemical examination, echocardiographic evaluation, results of CPX and symptoms during CPX (Borg scale), and reasons for exercise termination. EOV was observed in 20 of 46 patients. The following characteristics were observed in patients with EOV as compared with those without EOV with statistically significant differences: more patients complaining dyspnea as the reason for exercise termination, lower SAS score, higher N-terminal pro-brain natriuretic peptide level, larger left atrial dimension and volume, left ventricular end-diastolic volume, higher Borg scale score at rest and at the anerobic threshold, higher respiratory rate at rest and at peak exercise, and higher slope of the minute ventilation-to-CO? output ratio, and lower end-tidal CO? pressure at peak exercise. Among the subjects with NYHA III nonischemic heart failure, more patients with EOV had a stronger feeling of dyspnea during exercise as compared with those without EOV, and the subjective dyspnea was an exercise-limiting factor in many cases. PMID:23537269

Matsuki, Ryosuke; Kisaka, Tomohiko; Ozono, Ryoji; Kinoshita, Hiroki; Sada, Yoshiharu; Oda, Noboru; Hidaka, Takayuki; Tashiro, Naonori; Takahashi, Makoto; Sekikawa, Kiyokazu; Ito, Yoshihiro; Kimura, Hiroaki; Hamada, Hironobu; Kihara, Yasuki

2013-01-01

157

A test for evaluation of exercise with apneic episodes in synchronized swimming.  

PubMed

In synchronized swimming, complex maneuvers are developed in the water alternating air breathing and apnea episodes, which activate complex and adjusted mechanisms for respiratory compensation. The aim of this study is to propose a specific laboratory test for the assessment of the functional respiratory adaptations during exercise with apnea periods in synchronized swimmers. We studied 25 women, of which 13 were elite synchronized swimmers and the other 12 were a control group. A laboratory test was performed on a cycle ergometer consisting of 4 minutes pedalling at a constant intensity of 1.5 watts/kg (test 1). After 30 minutes at rest, a new test was performed alternating free respiration and apnea periods of 15 seconds at the same intensity (test 2). In both tests HR, VE, VT, BF, VO2, VCO2, and lactate were analyzed. We observed an increase in VE, VO2, and VCO2 in the 13 swimmers in test 2, with no change in HR and lactate, and a constant relationship between VE and VCO2 equal for tests 1 and 2. In the control group only 6 women completed test 2, the other 6 stopped before the third minute. In this group, important differences were observed in relation to the swimmers: both heart rate and lactate increased in test 2 and showed an increase in the VE vs. VCO2 relationship which involved a different slope for test 1 and test 2. We conclude that functional respiratory adaptations induced by apnea during synchronized swimming are essential in this sport and the test proposed may be a useful tool to assess the physical performance in synchronized swimmers. PMID:17024622

Naranjo, J; Centeno, R A; Carranza, M D; Cayetano, M

2006-12-01

158

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

NASA Technical Reports Server (NTRS)

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.

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

1998-01-01

159

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

PubMed

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

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

1996-06-01

160

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

PubMed

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

Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

2014-01-01

161

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

PubMed Central

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

Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

2014-01-01

162

Relationship between blood pressure response during step exercise test and atherosclerotic markers.  

PubMed

Abstract The relationship between blood pressure (BP) response to exercise and atherosclerotic markers were evaluated in a population based sample of 426 normotensive subjects. The subjects with greater increase of SBP during exercise and delayed recovery of SBP after exercise showed higher hs-CRP and SBP2. Multiple regression analysis revealed that the greater BP response and delayed BP recovery were independently associated with SBP2 after adjusting for resting SBP, age, and gender. These results suggest that early atherosclerosis may contribute to greater BP responses to exercise, supporting the concept that exercise BP adds incremental information of cardiovascular risks to resting BP. PMID:24678855

Idoue, Ayaka; Hirata, Chiaki; Utsumi, Miyoko; Miyai, Nobuyuki; Iwahara, Akihiko; Hattori, Sonomi; Uematsu, Yuji; Shiba, Mitsuru; Buyo, Momoko; Arita, Mikio

2015-01-01

163

Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise  

PubMed Central

Objectives To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and peripheral perfusion capacities that could elicit higher levels of peripheral cardiorepiratory stimulus during exercise. PMID:24838811

Andrade, Marília S.; Lira, Claudio A. B.; Vancini, Rodrigo L.; Nakamoto, Fernanda P.; Cohen, Moisés; Silva, Antonio C.

2014-01-01

164

Respiratory variation and cardiopulmonary interactions.  

PubMed

It is often unclear whether or not a patient's stroke volume will increase following a fluid bolus. Volume responsiveness is defined by an increase in stroke volume following a fluid bolus. For patients being mechanically ventilated, the cardiopulmonary interactions associated with positive pressure ventilation create pulse pressure and stroke volume variation in the arterial pressure waveform that can be used to assess fluid responsiveness, so-called dynamic preload assessment. However, lung-protective ventilation is increasingly being used to avoid the adverse outcomes of higher tidal volume ventilation, and pulse pressure and stroke volume variation do not effectively predict volume responsiveness in the setting of lung-protective ventilation without using special techniques. Dynamic preload assessment is more effective at determining whether a patient will be fluid responsive than static measures of preload, but further studies are needed to more conclusively show that outcomes are improved with this approach to fluid management. PMID:25480770

Roberson, Russell S

2014-12-01

165

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

ERIC Educational Resources Information Center

The Cardio-Pulmonary Research Institute conducted an exercise program for men with a history of coronary heart disease. Over 7 years, there were 15 cases of cardiac arrest during exercise (one for every 6,000 man-hours of exercise). Trained medical personnel were present in all cases, and all were resuscitated by electrical defibrillation with no…

Pyfer, Howard R.; And Others

166

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

SciTech Connect

The goal of this study was to determine the prognostic utility of the exercise thallium-201 stress test in ambulatory patients with chest pain who were also referred for cardiac catheterization. Accordingly, 4 to 8 year (mean +/- 1SD, 4.6 +/- 2.6 years) follow-up data were obtained for all but one of 383 patients who underwent both exercise thallium-201 stress testing and cardiac catheterization from 1978 to 1981. Eighty-three patients had a revascularization procedure performed within 3 months of testing and were excluded from analysis. Of the remaining 299 patients, 210 had no events and 89 had events (41 deaths, nine nonfatal myocardial infarctions, and 39 revascularization procedures greater than or equal to 3 months after testing). When all clinical, exercise, thallium-201, and catheterization variables were analyzed by Cox regression analysis, the number of diseased vessels (when defined as greater than or equal to 50% luminal diameter narrowing) was the single most important predictor of future cardiac events (chi 2 = 38.1) followed by the number of segments demonstrating redistribution on delayed thallium-201 images (chi 2 = 16.3), except in the case of nonfatal myocardial infarction, for which redistribution was the most important predictor of future events. When coronary artery disease was defined as 70% or greater luminal diameter narrowing, the number of diseased vessels significantly (p less than .01) lost its power to predict events (chi 2 = 14.5). Other variables found to independently predict future events included change in heart rate from rest to exercise (chi 2 = 13.0), ST segment depression on exercise (chi 2 = 13.0), occurrence of ventricular arrhythmias on exercise (chi 2 = 5.9), and beta-blocker therapy (chi 2 = 4.3).

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

1988-04-01

167

Exercise Intensity Guidelines for Cancer Survivors: a Comparison with Reference Values.  

PubMed

The optimal dose of physical activity (PA) in cancer survivors (CS) is unknown due to the large variety of types of cancer, illness stages and treatments, low cardiorespiratory fitness, and physical inactivity. It is recommended that CS follow current PA guidelines for healthy population. There are no specific exercise prescription guidelines for CS. To know the cardiorespiratory parameters of CS in order to create exercise prescription guidelines for this population, 152 inactive CS were recruited to perform a cardiopulmonary exercise test. Peak oxygen uptake (VO2peak), ventilatory threshold (VT) and respiratory compensation point (RCP) determined 3 exercise intensity zones to create exercise intensity classification guidelines for CS. VO2peak (18.7±4.6?mL·kg(-1)·min(-1)) and peak heart rate (HRpeak) (145.1±17.9?bpm) were lower than the estimated values (p<0.001). Moderate intensity zone for CS was different from the current PA guidelines for healthy population: 41-64% VO2max, 55-70% HRmax, 23-48% HRres, 2.5-4 METs and 8-14 points on RPE scale. Intensities in PA guidelines for healthy population are not adapted to the characteristics of CS. For individual exercise prescription in CS specific PA guidelines should be used in order to maximize the benefits obtained by the use of aerobic exercise training. PMID:25429545

Gil-Rey, E; Quevedo-Jerez, K; Maldonado-Martin, S; Herrero-Román, F

2014-11-27

168

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

PubMed Central

Objective Six months following acute infectious mononucleosis (IM), 13%, of adolescents meet criteria for chronic fatigue syndrome (CFS). We measured exercise tolerance in adolescents with CFS and controls 6 months following IM. Study design 21 adolescents with CFS 6 months following IM and 21 recovered controls performed a maximal incremental exercise tolerance test with breath-by-breath gas analysis. Values expressed are mean ± standard deviation. Results The adolescents diagnosed with CFS and controls did not differ in age, weight, body-mass index or peak work capacity. Lower VO2 (oxygen consumption) peak percent of predicted was seen in adolescents with CFS compared with controls (CFS 99.3 ± 16.6 vs control 110.7 ± 19.9, p = 0.05). Peak oxygen pulse also was lower in adolescents with CFS compared with recovered controls (CFS 12.4 ± 2.9 vs controls 14.9 ± 4.3, p = 0.03). Conclusions Adolescents with CFS 6 months following IM have a lower degree of fitness and efficiency of exercise than recovered adolescents. Whether these abnormal exercise findings are a cause or effect of CFS is unknown. IM can lead to both fatigue and measurable changes in exercise testing in a subset of adolescents. PMID:20447647

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

2010-01-01

169

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

PubMed Central

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

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

170

[Physiological significance and interpretation of plasma lactate concentration and pH in clinical exercise testing].  

PubMed

According to a widely accepted model, based on the theory of the anaerobic threshold (AT), the increase in plasma lactate concentration which develops after the first ventilatory threshold (VT1, considered as an AT) is due to compensation for insufficient aerobic metabolism by anaerobic glycolysis, with accumulation of lactic acid resulting in a decrease in pH. Bicarbonate is the main buffer of protons (>90%) producing non-metabolic CO2 in muscle and thus increasing the CO2 flux to the lungs. This phenomenon, along with the low pH, triggers hyperventilation. Because of this model, great importance has been placed on plasma lactate and pH. We argue that this importance is excessive and these variables should be used with caution in the interpretation of clinical exercise testing, because the model based on AT is not valid: there is no aerobic failure above VT1 and, thus, there is no evidence of an AT; the increase in plasma lactate does not reflect anaerobiosis but is the marker of the increase in the error signal needed for the stimulation of mitochondrial respiration; bicarbonate is not the main buffer during exercise (these are proteins and phosphocreatine breakdown in the muscle; hemoglobin in the blood); non-metabolic CO2 is not produced in the muscle but in the lung because of the low pH and hyperventilation (the control of which remains unknown); and the flux of CO2 to the lung does not increase at faster rate after than before VT1. PMID:25012038

Péronnet, F; Aguilaniu, B

2014-06-01

171

A comparison of dipyridamole-thallium imaging and exercise testing in the prediction of postoperative cardiac complications in patients requiring arterial reconstruction  

Microsoft Academic Search

The individual and combined predictive values of dipyridamole-thallium imaging and exercise testing were compared in a prospective study of 70 patients who had abdominal aortic aneurysms or aortoiliac occlusive disease that required surgical repair. All patients were evaluated clinically by the same cardiologist and had exercise stress testing and dipyridamole-thallium imaging before admission for surgery. Ten patients were excluded from

N. V. McPhail; T. D. Ruddy; J. E. Calvin; R. A. Davies; G. G. Barber

1989-01-01

172

Respiratory symptoms, asthma, exercise test spirometry, and atopy in schoolchildren from a Lima shanty town  

PubMed Central

BACKGROUND—Little is known about the associations between symptoms of asthma, pulmonary function tests, and atopy in developing countries. While asthma in children is often associated with atopy, some studies of wheezing illness have found little or no association, leading to suggestions that there are subgroups of wheezing illness. The ISAAC study recently reported that the prevalence of reported asthma symptoms in Lima, Peru was among the highest in the world, but did not report on the atopic status of the subjects.?METHODS—A cross sectional survey was conducted of children aged 8-10 years who had previously participated in a cohort study of respiratory and diarrhoeal illnesses in infancy. Questionnaires were administered asking about respiratory symptoms and asthma diagnoses, pulmonary function tests were performed before and after exercise on a treadmill, and atopy was determined from skin prick tests and specific serum IgE levels.?RESULTS—A total of 793 children participated in the survey. The prevalence of asthma related symptoms in the last 12 months was 23.2%, but only 3.8% of children reported a recent asthma attack. The mean differences in pretest percentage predicted forced expiratory volume in one second (FEV1) were 8.1% (95% CI 2.4 to 13.8) between children who did and did not report an asthma attack in the last 12 months, and 5.3% (95% CI 2.8 to 7.9) in children who did and did not report respiratory symptoms. The corresponding differences in mean percentage fall in FEV1 after exercise were 3.1% (95% CI -1 to 7.1) and 5.1% (95% CI 3.4 to 6.8). Recent asthma or respiratory symptoms were not associated with atopy in this population (odds ratios 1.29 (95% CI 0.56 to 2.97) and 0.91 (95% CI 0.61 to 1.37), respectively).?CONCLUSIONS—Most asthma in these children was unrecognised and mild. Asthma and asthma symptoms in this population do not seem to be related to atopy.?? PMID:11462062

Penny, M; Murad, S; Madrid, S; Herrera, T; Pineiro, A; Caceres, D; Lanata, C

2001-01-01

173

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

ERIC Educational Resources Information Center

Aim: We have previously demonstrated improved cognitive performance after a classroom-based exercise regime. In this study, we examined the reproducibility of this effect in a more socio-economically diverse sample and also investigated whether cognitive benefits of exercise were moderated by body mass index (BMI) or symptoms of…

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

2011-01-01

174

Impaired hemodynamic response to mental stress in subjects with prehypertension is improved after a single bout of maximal dynamic exercise  

PubMed Central

INTRODUCTION: High blood pressure during mental stress in subjects with prehypertension is associated with blunted vasodilation in skeletal muscles, which might be improved by an acute bout of exercise. OBJECTIVE: To investigate the hemodynamic responses to mental stress before and after a bout of exercise in subjects with prehypertension. METHOD: Eighteen subjects with prehypertension and 16 with normotension underwent a mental stress test before and after a maximal cardiopulmonary exercise test on a treadmill. Blood pressure was measured by auscultation, and forearm blood flow was measured by venous occlusion plethysmography; from these measurements, the vascular conductance was calculated. RESULTS: Subjects with prehypertension had a higher mean blood pressure during mental stress (prehypertension 112±2 vs. normotension 101±3 mm Hg, p<0.05), and their vascular conductance did not increase (baseline 0.025±0.004 vs. mental stress 0.022±0.003 a.u., p>0.05). After the exercise bout, the mean blood pressure during mental stress was lower in subjects with prehypertension (before exercise 112±2 vs. after exercise 107±2 mm Hg, p<0.05), and vascular conductance increased (baseline 0.011±0.001 vs. mental stress 0.024±0.004 a.u., p<0.05). CONCLUSION: Subjects with prehypertension had elevated blood pressure and a blunted vasodilator response during mental stress, but their blood pressure was attenuated and their vasodilator response was normalized after a single bout of maximal dynamic exercise. PMID:22179153

Medeiros, Renata Frauches; Silva, Bruno Moreira; Neves, Fabricia Junqueira; Rocha, Natalia Galito; Sales, Allan Robson Kluser; Nobrega, Antonio Claudio

2011-01-01

175

Evaluation of cardiopulmonary resuscitation techniques in microgravity  

NASA Technical Reports Server (NTRS)

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.

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

1991-01-01

176

[Cardiopulmonary bypass in cardiac surgery].  

PubMed

Cardiopulmonary bypass (CPB) is a standard procedure in cardiac surgery; however, apart from its therapeutic options a CPB might also initiate systemic and organ-specific complications, such as heart failure, renal and pulmonary dysfunction, impaired coagulation as well as neurological and cognitive dysfunction. The immunological response to the extracorporeal circulation generates systemic inflammation which often meets the definition of systemic inflammatory response syndrome (SIRS). The main inducers of SIRS are contact of blood with the artificial surfaces of the CPB, mechanical stress which affects the blood components and the extensive surgical trauma. Hence, a number of technical and surgical developments aim at reduction of the inflammatory response caused by the CPB. By reason of surgical demands, the majority of cardiothoracic procedures still depend on the use of CPB; however, there is an on-going development of new techniques trying to reduce the surgical trauma and the negative consequences of CPB. Here, minimized systems with biocompatible surfaces have been shown to be effective in attenuating the inflammatory response to CPB. Alternative procedures such as off-pump surgery may help to avoid CPB-associated complications but due to specific limitations will not replace conventional bypass surgery. PMID:22971923

Baehner, T; Boehm, O; Probst, C; Poetzsch, B; Hoeft, A; Baumgarten, G; Knuefermann, P

2012-10-01

177

Alternatives to the Six-Minute Walk Test in Pulmonary Arterial Hypertension  

PubMed Central

Introduction The physiological response during the endurance shuttle walk test (ESWT), the cycle endurance test (CET) and the incremental shuttle walk test (ISWT) remains unknown in PAH. We tested the hypothesis that endurance tests induce a near-maximal physiological demand comparable to incremental tests. We also hypothesized that differences in respiratory response during exercise would be related to the characteristics of the exercise tests. Methods Within two weeks, twenty-one PAH patients (mean age: 54(15) years; mean pulmonary arterial pressure: 42(12) mmHg) completed two cycling exercise tests (incremental cardiopulmonary cycling exercise test (CPET) and CET) and three field tests (ISWT, ESWT and six-minute walk test (6MWT)). Physiological parameters were continuously monitored using the same portable telemetric device. Results Peak oxygen consumption (VO2peak) was similar amongst the five exercise tests (p?=?0.90 by ANOVA). Walking distance correlated markedly with the VO2peak reached during field tests, especially when weight was taken into account. At 100% exercise, most physiological parameters were similar between incremental and endurance tests. However, the trends overtime differed. In the incremental tests, slopes for these parameters rose steadily over the entire duration of the tests, whereas in the endurance tests, slopes rose sharply from baseline to 25% of maximum exercise at which point they appeared far less steep until test end. Moreover, cycling exercise tests induced higher respiratory exchange ratio, ventilatory demand and enhanced leg fatigue measured subjectively and objectively. Conclusion Endurance tests induce a maximal physiological demand in PAH. Differences in peak respiratory response during exercise are related to the modality (cycling vs. walking) rather than the progression (endurance vs. incremental) of the exercise tests. PMID:25111294

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

2014-01-01

178

Prognostic value of predischarge low-level exercise thallium testing after thrombolytic treatment of acute myocardial infarction  

SciTech Connect

Low-level exercise thallium testing is useful in identifying the high-risk patient after acute myocardial infarction (AMI). To determine whether this use also applies to patients after thrombolytic treatment of AMI, 64 patients who underwent early thrombolytic therapy for AMI and 107 patients without acute intervention were evaluated. The ability of both the electrocardiogram and thallium tests to predict future events was compared in both groups. After a mean follow-up of 374 days, there were 25 and 32% of cardiac events in the 2 groups, respectively, with versus without acute intervention. These included death, another AMI, coronary artery bypass grafting or angioplasty with 75% of the events occurring in the 3 months after the first infarction. The only significant predictors of outcome were left ventricular cavity dilatation in the intervention group and ST-segment depression and increased lung uptake in the nonintervention group. The sensitivity of exercise thallium was 55% in the intervention group and 81% in the nonintervention group (p less than 0.05). Therefore, in patients having thrombolytic therapy for AMI, nearly half the events after discharge are not predicted by predischarge low-level exercise thallium testing. The relatively weak correlation of outcome with unmasking ischemia in the laboratory before discharge may be due to an unstable coronary lesion or rapid progression of disease after the test. Tests considered useful for prognostication after AMI may not necessarily have a similar value if there has been an acute intervention, such as thrombolytic therapy.

Tilkemeier, P.L.; Guiney, T.E.; LaRaia, P.J.; Boucher, C.A. (Massachusetts General Hospital, Boston (USA))

1990-11-15

179

Pulmonary Vascular Response Patterns During Exercise in Left Ventricular Systolic Dysfunction Predict Exercise Capacity and Outcomes  

PubMed Central

Background Elevated resting pulmonary arterial pressure (PAP) in patients with left ventricular systolic dysfunction (LVSD) purports a poor prognosis. However, PAP response patterns to exercise in LVSD and their relationship to functional capacity and outcomes have not been characterized. Methods and Results Sixty consecutive patients with LVSD (age 60±12 years, LV ejection fraction 0.31±0.07, mean±SD) and 19 controls underwent maximum incremental cardiopulmonary exercise testing with simultaneous hemodynamic monitoring. During low-level exercise (30 Watts), LVSD subjects compared to controls, had greater augmentation in mean PAPs (15±1 vs. 5±1 mmHg), transpulmonary gradients (5±1 vs. 1±1 mmHg), and effective PA elastance (0.05±0.02 vs. ?0.03±0.01 mmHg/ml, p<0.0001 for all). A linear increment in PAP relative to work (0.28±0.12 mmHg/watt) was observed in 65% of LVSD patients, which exceeded that observed in controls (0.07±0.02 mmHg/watt, P<0.0001). Exercise capacity and survival was worse in patients with a PAP/watt slope above the median than in patients with a lower slope. In the remaining 35% of LVSD patients, exercise induced a steep initial increment in PAP (0.41±0.16 mmHg/watt) followed by a plateau. The plateau pattern, compared to a linear pattern, was associated with reduced peak VO2 (10.6±2.6 vs. 13.1±4.0 ml/kg/min, P=0.005), lower right ventricular stroke work index augmentation with exercise (5.7±3.8 vs. 9.7±5.0 g/m2, P=0.002), and increased mortality (HR 8.1, 95% CI 2.7-23.8, P<0.001). Conclusions A steep increment in PAP during exercise and failure to augment PAP throughout exercise are associated with decreased exercise capacity and survival in patients with LVSD, and may therefore represent therapeutic targets. Clinical Trial Information URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00309790) PMID:21292991

Lewis, Gregory D.; Murphy, Ryan M.; Shah, Ravi V.; Pappagianopoulos, Paul P.; Malhotra, Rajeev; Bloch, Kenneth D.; Systrom, David M.; Semigran, Marc J.

2012-01-01

180

Attitudes and exercise adherence: test of the Theories of Reasoned Action and Planned Behaviour.  

PubMed

Three studies of exercise adherence and attitudes are reported that tested the Theory of Reasoned Action and the Theory of Planned Behaviour. In a prospective study of adherence to a private fitness club, structural equation modelling path analysis showed that attitudinal and social normative components of the Theory of Reasoned Action accounted for 13.1% of the variance in adherence 4 months later, although only social norm significantly predicted intention. In a second study, the Theory of Planned Behaviour was used to predict both physical activity and sedentary behaviour. Path analyses showed that attitude and perceived control, but not social norm, predicted total physical activity. Physical activity was predicted from intentions and control over sedentary behaviour. Finally, an intervention study with previously sedentary adults showed that intentions to be active measured at the start and end of a 10-week intervention were associated with the planned behaviour variables. A multivariate analysis of variance revealed no significant multivariate effects for time on the planned behaviour variables measured before and after intervention. Qualitative data provided evidence that participants had a positive experience on the intervention programme and supported the role of social normative factors in the adherence process. PMID:10373037

Smith, R A; Biddle, S J

1999-04-01

181

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

PubMed Central

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

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

2014-01-01

182

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

PubMed Central

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

2013-01-01

183

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...

184

Embolic activity during in vivo cardiopulmonary bypass.  

PubMed

Neurologic injury after cardiac surgery is principally associated with emboli. Although much work has focused on surgical sources of emboli, less attention has been focused on emboli associated with the heart-lung machine. We tested whether emboli are associated with discrete processes during cardiopulmonary bypass (CPB). One hundred patients undergoing cardiothoracic surgery were enrolled between April 2008 and May 2011 at a single medical center. During each surgical procedure, emboli were counted in three CPB locations: the venous side (Channel 1), before the arterial line filter (Channel 2), and after the arterial line filter (Channel 3). We used prespecified event markers to identify perfusionist interventions. Identical circuits were used on all patients. Of the 100 patients enrolled, 62 underwent isolated coronary artery bypass grafting (CABG), 17 underwent isolated valve operations, and 21 underwent CABG plus valve. Median counts across Channels 1, 2, and 3 were 69,853, 3,017, and 1,251, respectively. The greatest contributor to emboli in Channels 1, 2, and 3, respectively, were achieving the calculated CPB flow, opening of the electronic arterial line clamp, and introducing a hemofilter. The circuit technology was efficient in reducing total emboli counts from Channels 1-2 irrespective of the size of the emboli. Nearly 71% of all emboli 30-100 microm in size were removed from the circuit between Channels 2 and 3. No significant association was found between emboli counts and S100B release. Emboli occur frequently during CPB and are predominantly associated with the initiation of bypass, operation of the electronic arterial line clamp, and the initiation of a hemofilter. Continued work to reduce the occurrence of emboli is warranted. PMID:25208432

DeFoe, Gordon R; Dame, Norman A; Farrell, Mark S; Ross, Cathy S; Langner, Craig W; Likosky, Donald S

2014-06-01

185

Evaluating patients with ventricular arrhythmia. Role of the signal-averaged electrocardiogram, exercise test, ambulatory electrocardiogram, and electrophysiologic studies.  

PubMed

There are several methods available for the evaluation of patients with ventricular arrhythmia. The most effective approaches, however, involve the use of techniques that provide objective data. These include ambulatory monitoring and exercise testing (a noninvasive approach), and electrophysiologic testing (invasive). The information derived from these two approaches is complementary, and both are important for patient evaluation and management. These methods are useful for establishing the risk of arrhythmia occurrence in certain patient groups and for establishing the effect of antiarrhythmic agents. The signal-averaged ECG is of help in establishing risk in some patient groups, but it has no role for evaluating drug therapy. PMID:1504970

Podrid, P J; Bumio, F; Fogel, R I

1992-08-01

186

Oxidative stress responses to a graded maximal exercise test in older adults following explosive-type resistance training?  

PubMed Central

We recently demonstrated that low frequency, moderate intensity, explosive-type resistance training (EMRT) is highly beneficial in elderly subjects towards muscle strength and power, with a systemic adaptive response of anti-oxidant and stress-induced markers. In the present study, we aimed to evaluate the impact of EMRT on oxidative stress biomarkers induced in old people (70–75 years) by a single bout of acute, intense exercise. Sixteen subjects randomly assigned to either a control, not exercising group (n=8) or a trained group performing EMRT protocol for 12-weeks (n=8), were submitted to a graded maximal exercise stress test (GXT) at baseline and after the 12-weeks of EMRT protocol, with blood samples collected before, immediately after, 1 and 24 h post-GXT test. Blood glutathione (GSH, GSSG, GSH/GSSG), plasma malonaldehyde (MDA), protein carbonyls and creatine kinase (CK) levels, as well as PBMCs cellular damage (Comet assay, apoptosis) and stress–protein response (Hsp70 and Hsp27 expression) were evaluated. The use of multiple biomarkers allowed us to confirm that EMRT per se neither affected redox homeostasis nor induced any cellular and oxidative damage. Following the GXT, the EMRT group displayed a higher GSH/GSSG ratio and a less pronounced increase in MDA, protein carbonyls and CK levels compared to control group. Moreover, we found that Hsp70 and Hsp27 proteins were induced after GXT only in EMRT group, while any significant modification within 24 h was detected in untrained group. Apoptosis rates and DNA damage did not show any significant variation in relation to EMRT and/or GXT. In conclusion, the adherence to an EMRT protocol is able to induce a cellular adaptation allowing healthy elderly trained subjects to cope with the oxidative stress induced by an acute exercise more effectively than the aged-matched sedentary subjects. PMID:25460722

Ceci, Roberta; Beltran Valls, Maria Reyes; Duranti, Guglielmo; Dimauro, Ivan; Quaranta, Federico; Pittaluga, Monica; Sabatini, Stefania; Caserotti, Paolo; Parisi, Paolo; Parisi, Attilio; Caporossi, Daniela

2013-01-01

187

Prognosis of patients with unstable angina and low-risk exercise test: significance of ST-segment depression on the admission ECG.  

PubMed

The presence of ST-segment depression on the admission electrocardiogram (ECG) is an important predictor of poor outcome in patients with unstable angina. On the other hand, patients with unstable angina who undergo a low-risk exercise test are supposed to have a favorable prognosis. The objective of the study was to determine the prognostic significance of ST-segment depression on the admission ECG in patients with unstable angina who undergo an exercise test that indicates a low risk of events. An interpretable exercise test was performed in 257 patients with primary unstable angina. A low-risk exercise test was completed by 156 (60%) patients and medical therapy was planned for all these patients. A multivariate analysis was performed in order to determine the independent predictors of events (cardiac death, nonfatal acute myocardial infarction, or admission for unstable angina) during a 12-month follow-up. Among patients with a low-risk exercise test, there were no significant differences between patients with and without ST-segment depression on the presenting ECG with regard to event rate (34 vs. 29%, P=NS). In multivariate analysis, ST-segment depression was not related to a higher incidence of events. Our findings appear to indicate that the presence of ST-segment depression on the admission ECG loses its prognostic significance in patients with primary unstable angina if they complete a low-risk exercise test. PMID:12767536

Castillo-Moreno, Juan A; Molina-Laborda, Eduardo; Florenciano-Sánchez, Rafael; Villanueva-Sánchez, José G; Egea-Beneyto, Santiago; Ortega-Bernal, Juan

2003-06-01

188

Sex-based effects on immune changes induced by a maximal incremental exercise test in well-trained swimmers.  

PubMed

Studies examining the immune response to acute intensive swimming have shown increased leukocytosis and lymphocyte populations. However, studies concerning mucosal immunity and sex differences remain controversial. The objective of the study was to examine sex differences on the immune response to maximal incremental swimming exercise in well trained swimmers. Participants (11 females, controlled for menstrual cycle phase effects; 10 males) performed a maximal incremental 7x200 m front crawl set. Fingertip capillary blood samples were obtained after each 200 m swim for lactate assessment. Venous blood and saliva samples were collected before and 5 minutes after the swimming test to determine total numbers of leukocytes, lymphocytes and subpopulations, and serum and salivary immunoglobulin A (IgA) levels. IgA secretion rate was calculated. Menstrual cycle phase did not influence the immune response to exercise. As for sex differences, exercise induced an increase in leukocytes, total lymphocytes, CD3(+), CD4(+), CD8(+), and CD16(+)/56(+) in males. In females, only leukocytosis, of a lower magnitude than was observed in males, occurred. CD19(+) increased and CD4(+)/CD8(+) ratio decreased in both groups following exercise whilst IgA, SIgA concentrations, and srIgA did not change. Both males and females finished the incremental exercise very close to the targeted race velocity, attaining peak blood lactate concentrations of 14.6±2.25 and 10.4±1.99 mmol.L(-1), respectively. The effect of a maximal incremental swimming task on immunity is sex dependent and more noticeable in men. Males, as a consequence of higher levels of immunosurveillance may therefore be at a lower risk of infection than females. Key PointsMaximal exercise induces an immune response.This study investigated the influence of sex over the leukocytes subpopulations and mucosal immune responses to maximal swimming.Male swimmers showed a stronger increase of T helper, T cytotoxic and NK lymphocytes than females, suggesting they may be at a lower risk of infection, due to a higher immunosurveillance.Mucosal immunity remained unchanged in both sexes. PMID:25177203

Morgado, José P; Monteiro, Cristina P; Matias, Catarina N; Alves, Francisco; Pessoa, Pedro; Reis, Joana; Martins, Fátima; Seixas, Teresa; Laires, Maria J

2014-09-01

189

Test and exercise (TandE) planning manual for the Office of Energy Emergencies, US Department of Energy  

SciTech Connect

This report consists of two independent but related sections. The initial section (Chapter 1) discusses the goals and objectives of the US Department of Energy's Readiness Assurance Program, which is designed to maintain emergency response capability by the Office of Energy Emergencies. This chapter also presents an analysis of the laws, Executive Orders, and related documents which require the Department of Energy to maintain such emergency response capabilities. The second part of the report (the remaining chapters) comprises a test and exercise planning manual, prepared for the Office of Energy Emergencies of DOE. The manual is divided into three sections, each represented by a chapter, concerning energy emergency exercises: the planning phase, the execution phase and the evaluation phase. Several appendices contain additional information on these issues, including gaming. Detailed task requirements are presented for each phase, and included in these tasks are specifications for documents which need to be prepared for exercises, as well as personnel requirements. Also included are requirements for associated supplies and services, including communications, security, transportation and others. 34 refs., 12 figs.

Not Available

1988-04-01

190

Chronic exercise prevents repeated restraint stress-provoked enhancement of immobility in forced swimming test in ovariectomized mice.  

PubMed

We assessed whether chronic treadmill exercise attenuated the depressive phenotype induced by restraint stress in ovariectomized mice (OVX). Immobility of OVX in the forced swimming test was comparable to that of sham mice (CON) regardless of the postoperative time. Immobility was also no difference between restrained mice (exposure to periodic restraint for 21 days; RST) and control mice (CON) on post-exposure 2nd and 9th day, but not 15th day. In contrast, the immobility of ovariectomized mice with repeated stress (OVX?+?RST) was profoundly enhanced compared to ovariectomized mice-alone (OVX), and this effect was reversed by chronic exercise (19 m/min, 60 min/day, 5 days/week for 8 weeks; OVX?+?RST?+?Ex) or fluoxetine administration (20 mg/kg, OVX?+?RST?+?Flu). In parallel with behavioral data, the immunoreactivity of Ki-67 and doublecortin (DCX) in OVX was significantly decreased by repeated stress. However, the reduced numbers of Ki-67- and DCX-positive cells in OVX?+?RST were restored in response to chronic exercise (OVX?+?RST?+?Ex) and fluoxetine (OVX?+?RST?+?Flu). In addition, the expression pattern of cAMP response element-binding protein (CREB) and calcium-calmodulin-dependent kinase IV (CaMKIV) was similar to that of the hippocampal proliferation and neurogenesis markers (Ki-67 and DCX, respectively). These results suggest that menopausal depression may be induced by an interaction between repeated stress and low hormone levels, rather than a deficit in ovarian secretion alone, which can be improved by chronic exercise. PMID:25344674

Han, Tae-Kyung; Lee, Jang-Kyu; Leem, Yea-Hyun

2014-10-26

191

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

PubMed Central

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

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

2014-01-01

192

Square-Wave Endurance Exercise Test (SWEET) for training and assessment in trained and untrained subjects  

Microsoft Academic Search

Summary  The effect of training on \\u000a$$\\\\dot V\\\\operatorname{O} _2 $$\\u000a max, endurance capacity (EC) and ventilation during maximal exercise (\\u000a$$\\\\dot V_E$$\\u000a max) were studied in 17 normal subjects aged 21–51 years. At the beginning of the study 11 of the subjects (eight women and three men) were untrained (U) and six others (three women and three men) trained regularly (T).

Manuel Gimenez; Victor Cereceda; Dan Teculescu; FranÇois Aug; M. Claire Laxenaire

1982-01-01

193

Relation of resting heart rate to risk for all-cause mortality by gender after considering exercise capacity (the Henry Ford exercise testing project).  

PubMed

Whether resting heart rate (RHR) predicts mortality independent of fitness is not well established, particularly among women. We analyzed data from 56,634 subjects (49% women) without known coronary artery disease or atrial fibrillation who underwent a clinically indicated exercise stress test. Baseline RHR was divided into 5 groups with <60 beats/min as reference. The Social Security Death Index was used to ascertain vital status. Cox hazard models were performed to determine the association of RHR with all-cause mortality, major adverse cardiovascular events, myocardial infarction, or revascularization after sequential adjustment for demographics, cardiovascular disease risk factors, medications, and fitness (metabolic equivalents). The mean age was 53 ± 12 years and mean RHR was 73 ± 12 beats/min. More than half of the participants were referred for chest pain; 81% completed an adequate stress test and mean metabolic equivalents achieved was 9.2 ± 3. There were 6,255 deaths over 11.0-year mean follow-up. There was an increased risk of all-cause mortality with increasing RHR (p trend <0.001). Compared with the lowest RHR group, participants with an RHR ?90 beats/min had a significantly increased risk of mortality even after adjustment for fitness (hazard ratio 1.22, 95% confidence interval 1.10 to 1.35). This relationship remained significant for men, but not significant for women after adjustment for fitness (p interaction <0.001). No significant associations were seen for men or women with major adverse cardiovascular events, myocardial infarction, or revascularization after accounting for fitness. In conclusion, after adjustment for fitness, elevated RHR was an independent risk factor for all-cause mortality in men but not women, suggesting gender differences in the utility of RHR for risk stratification. PMID:25439450

Aladin, Amer I; Whelton, Seamus P; Al-Mallah, Mouaz H; Blaha, Michael J; Keteyian, Steven J; Juraschek, Stephen P; Rubin, Jonathan; Brawner, Clinton A; Michos, Erin D

2014-12-01

194

Gender-related associations of genetic polymorphisms of ?-adrenergic receptors, endothelial nitric oxide synthase and bradykinin B2 receptor with treadmill exercise test responses  

PubMed Central

Background Treadmill exercise test responses have been associated with cardiovascular prognosis in individuals without overt heart disease. Neurohumoral and nitric oxide responses may influence cardiovascular performance during exercise testing. Therefore, we evaluated associations between functional genetic polymorphisms of ?-adrenergic receptors, endothelial nitric oxide synthase, bradykinin receptor B2 and treadmill exercise test responses in men and women without overt heart disease. Methods We enrolled 766 (417 women; 349 men) individuals without established heart disease from a check-up programme at the Heart Institute, University of São Paulo Medical School. Exercise capacity, chronotropic reserve, maximum heart-rate achieved, heart-rate recovery, exercise systolic blood pressure (SBP), exercise diastolic blood pressure (DBP) and SBP recovery were assessed during exercise testing. Genotypes for the ?-adrenergic receptors ADRA1A Arg347Cys (rs1048101), ADRA2A 1780 C>T (rs553668), ADRA2B Del 301–303 (rs28365031), endothelial nitric synthase (eNOS) 786 T>C (rs2070744), eNOS Glu298Asp (rs1799983) and BK2R (rs5810761) polymorphisms were assessed by PCR and high-resolution melting analysis. Results Maximum SBP was associated with ADRA1A rs1048101 (p=0.008) and BK2R rs5810761 (p=0.008) polymorphisms in men and ADRA2A rs553668 (p=0.008) and ADRA2B rs28365031 (p=0.022) in women. Maximum DBP pressure was associated with ADRA2A rs553668 (p=0.002) and eNOS rs1799983 (p=0.015) polymorphisms in women. Exercise capacity was associated with eNOS rs2070744 polymorphisms in women (p=0.01) and with eNOS rs1799983 in men and women (p=0.038 and p=0.024). Conclusions The findings suggest that genetic variants of ?-adrenergic receptors and bradykinin B2 receptor may be involved with blood pressure responses during exercise tests. Genetic variants of endothelial nitric oxide synthase may be involved with exercise capacity and blood pressure responses during exercise tests. These responses may be gender-related. PMID:25544888

Nunes, Rafael Amorim Belo; Barroso, Lúcia Pereira; Pereira, Alexandre?da Costa; Krieger, José Eduardo; Mansur, Alfredo José

2014-01-01

195

Management of Cardiopulmonary Complications of Cirrhosis  

PubMed Central

Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax. PMID:21994850

Sawant, Prabha; Vashishtha, C.; Nasa, M.

2011-01-01

196

Management of cardiopulmonary complications of cirrhosis.  

PubMed

Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax. PMID:21994850

Sawant, Prabha; Vashishtha, C; Nasa, M

2011-01-01

197

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

Code of Federal Regulations, 2013 CFR

... 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...

2013-04-01

198

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

Code of Federal Regulations, 2013 CFR

...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...

2013-04-01

199

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

Code of Federal Regulations, 2012 CFR

...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...

2012-04-01

200

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

Code of Federal Regulations, 2012 CFR

...false Cardiopulmonary bypass on-line blood gas monitor. 870.4330 Section...4330 Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in...

2012-04-01

201

21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.  

Code of Federal Regulations, 2013 CFR

...Cardiopulmonary bypass arterial line blood filter. 870.4260 Section 870...Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part...

2013-04-01

202

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

Code of Federal Regulations, 2014 CFR

...false Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section...4410 Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that...

2014-04-01

203

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

Code of Federal Regulations, 2014 CFR

...false Cardiopulmonary bypass on-line blood gas monitor. 870.4330 Section...4330 Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in...

2014-04-01

204

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

Code of Federal Regulations, 2014 CFR

...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...

2014-04-01

205

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

Code of Federal Regulations, 2013 CFR

...false Cardiopulmonary bypass on-line blood gas monitor. 870.4330 Section...4330 Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in...

2013-04-01

206

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

Code of Federal Regulations, 2011 CFR

...false Cardiopulmonary bypass on-line blood gas monitor. 870.4330 Section...4330 Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in...

2011-04-01

207

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

Code of Federal Regulations, 2013 CFR

...false Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section...4410 Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that...

2013-04-01

208

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

Code of Federal Regulations, 2011 CFR

... 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...

2011-04-01

209

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

Code of Federal Regulations, 2014 CFR

...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...

2014-04-01

210

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

Code of Federal Regulations, 2013 CFR

...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...

2013-04-01

211

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

Code of Federal Regulations, 2011 CFR

...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...

2011-04-01

212

21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.  

Code of Federal Regulations, 2014 CFR

...Cardiopulmonary bypass arterial line blood filter. 870.4260 Section 870...Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part...

2014-04-01

213

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

Code of Federal Regulations, 2014 CFR

... 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...

2014-04-01

214

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

Code of Federal Regulations, 2010 CFR

...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...

2010-04-01

215

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

Code of Federal Regulations, 2010 CFR

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

2010-04-01

216

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

Code of Federal Regulations, 2010 CFR

...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 revolving...

2010-04-01

217

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

Code of Federal Regulations, 2010 CFR

... 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...

2010-04-01

218

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

Code of Federal Regulations, 2011 CFR

... 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...

2011-04-01

219

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

Code of Federal Regulations, 2012 CFR

... 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...

2012-04-01

220

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

Code of Federal Regulations, 2013 CFR

... 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...

2013-04-01

221

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

Code of Federal Regulations, 2014 CFR

... 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...

2014-04-01

222

21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.  

Code of Federal Regulations, 2010 CFR

...false Cardiopulmonary bypass arterial line blood filter. 870.4260 Section...4260 Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used...

2010-04-01

223

Extent of cardiac autonomic denervation in relation to angina on exercise test in patients with recent acute myocardial infarction.  

PubMed

According to the current concept, anginal pain results from stimulation of sympathetic nerves within the heart. In this study, we evaluated the role of cardiac adrenergic denervation in exercise-induced angina pectoris in 15 men with recent acute myocardial infarction. Before discharge from the hospital, the patients were subjected to a symptom-limited exercise test. Three months after the infarction, cardiac scintigraphic studies using I-123 metaiodobenzylguanidine (MIBG), I-123 paraphenylpentadecanoic acid (pPPA), and Tc-99m sestamibi (MIBI) were performed in order to determine the extent of denervated myocardium, the size of infarction, and myocardium with reduced perfusion, respectively. MIBG defect (17.2 +/- 7.6% of left ventricular mass) (defect defined as an activity distribution < or = 30% of the maximal myocardial activity) was larger than pPPA defect (8.3 +/- 8.8%, p < 0.001) in all patients, which indicates that the area of myocardial necrosis was surrounded by viable myocardium with sympathetic denervation. The extent of viable but denervated myocardium was significantly greater in patients who developed angina pectoris than in patients without angina pectoris during the early exercise test (13.3 +/- 4.4% vs 5.0 +/- 2.4%, p < 0.001). In addition, patients with silent ischemia tended to have smaller areas of viable but denervated myocardium than patients with painful ischemia (5.7 +/- 3.8% vs 13.8 +/- 5.1%, p = 0.07). Thus, contrary to expectations, the extent of viable but denervated myocardium seems to be associated with increased pain sensitivity in patients with recent myocardial infarction. PMID:7942544

Hartikainen, J; Mäntysaari, M; Kuikka, J; Länsimies, E; Pyörälä, K

1994-10-15

224

21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.  

Code of Federal Regulations, 2013 CFR

...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)...

2013-04-01

225

21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.  

Code of Federal Regulations, 2014 CFR

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

2014-04-01

226

21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.  

Code of Federal Regulations, 2014 CFR

...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)...

2014-04-01

227

21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.  

Code of Federal Regulations, 2014 CFR

...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)...

2014-04-01

228

21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4200 Cardiopulmonary bypass accessory equipment. (a)...

2013-04-01

229

21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

230

21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.  

Code of Federal Regulations, 2014 CFR

...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)...

2014-04-01

231

21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4250 Cardiopulmonary bypass temperature controller. (a)...

2013-04-01

232

21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.  

Code of Federal Regulations, 2013 CFR

...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)...

2013-04-01

233

21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4205 Cardiopulmonary bypass bubble detector. (a)...

2013-04-01

234

21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.  

Code of Federal Regulations, 2014 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4205 Cardiopulmonary bypass bubble detector. (a)...

2014-04-01

235

21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.  

Code of Federal Regulations, 2014 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4200 Cardiopulmonary bypass accessory equipment. (a)...

2014-04-01

236

21 CFR 870.4280 - Cardiopulmonary prebypass filter.  

Code of Federal Regulations, 2014 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4280 Cardiopulmonary prebypass filter. (a)...

2014-04-01

237

Exercise performance in young and middle-aged female patients with subclinical hyperthyroidism.  

PubMed

Subclinical hyperthyroidism (SH) may be responsible for many cardiovascular changes, including an impaired exercise performance. The aim of our study was to evaluate the response to the treadmill cardiopulmonary test in patients with SH. We studied 14 female patients from our endocrine clinic with exogenous SH, free from cardiovascular diseases, with mean age of 38.6 +/- 10.2 years, body mass index (BMI) of 24.4 +/- 4.0 kg/m(2), and disease duration of 4.9 +/- 4.9 years. The mean serum thyrotropin (TSH) was 0.03 +/- 0.03 mU/L, serum free thyroxine (FT(4)), 1.72 +/- 0.21 ng/dL, and serum triiodothyronine level, 137 +/- 32 ng/dL. The control group comprised 15 euthyroid, healthy women, with mean age of 35.4 +/- 7.4 years and BMI of 27.3 +/- 5.9 kg/m(2). Both groups had a sedentary lifestyle and underwent the cardiopulmonary test using a treadmill with the Balke protocol. Gas concentrations and the respiratory outflow were measured and the electrocardiogram (ECG) was registered in real time. We calculated the minute ventilation (V(E)), the oxygen consumption (peak VO(2)), the carbonic gas exhalation (peak VCO(2)) and the anaerobic threshold (AT). The heart rate (HR) at rest (90.9 +/- 15.7 versus 78.9 +/- 8.7 beats per minute; p = 0.03) was higher in the patients from our clinic. There was no difference between groups regarding age, BMI, fat percentage, blood pressure, peak HR, exercise duration, mean treadmill peak inclination, V(E), peak VO(2), peak VCO(2), and AT. There was no correlation between peak VO(2) and FT(4), TSH, or disease duration. Our results show that exercise capacity in young and middle-aged female patients is not significantly affected by exogenous SH. PMID:16910873

Portella, Renata Boschi; Silva, Jefferson Luiz da Costa; Wagman, Márcia Branco; de Oliveira, Fátima Palha; Buescu, Alexandru; Vaisman, Mário

2006-08-01

238

Questionable Exercises.  

ERIC Educational Resources Information Center

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…

Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

1999-01-01

239

Patent Foramen Ovale Is Not Associated with Hypoxemia in Severe Chronic Obstructive Pulmonary Disease and Does Not Impair Exercise Performance  

PubMed Central

Rationale: Patent foramen ovale (PFO) may be disadvantageous in chronic obstructive pulmonary disease (COPD). It is unknown whether right-to-left shunting through PFO increases during exercise impairing exercise performance. Objectives: To determine whether (1) PFO prevalence is greater in hypoxemic versus less hypoxemic patients with COPD, (2) PFO is associated with clinically relevant impairment, and (3) right-to-left shunting increases during exercise and impairs exercise performance. Methods: Patients with COPD and age-matched control subjects underwent contrast transthoracic echocardiography and transcranial Doppler to identify PFO. Patients with COPD with no shunt and patients with large PFO underwent cardiopulmonary exercise tests with contrast transcranial Doppler, esophageal, and gastric balloon catheters. Measurements and Main Results: PFO prevalence was similar in 50 patients with COPD and 50 healthy control subjects (46% vs. 30%; P = 0.15). Large shunts were more common in patients with COPD (26% vs. 6%; P = 0.01). In an expanded COPD cohort, PFO prevalence was similar in 31 hypoxemic (Pao2 ? 7.3 kPa) and 63 less hypoxemic (Pao2 > 8.0 kPa) patients with COPD (39% vs. 52%; P = 0.27). Patients with intrapulmonary shunting had lower Pao2 than both patients with PFO and those with no right-to-left shunt (7.7 vs. 8.6 vs. 9.3 kPa, respectively; P = 0.002). Shunting significantly increased during exercise in patients with COPD with PFO. Endurance time at 60% Vo2max was 574 (178) seconds for patients with PFO and 534 (279) seconds for those without (P = ns). Conclusions: Hypoxemic patients with COPD do not have a higher prevalence of PFO. Patients with COPD with PFO do not perform less well either on a 6-minute walk or submaximal exercise testing despite increased right-to-left shunting during exercise. PMID:24450410

Shaikh, Zarrin F.; Kelly, Julia L.; Shrikrishna, Dinesh; de Villa, Manuel; Mullen, Michael J.; Hopkinson, Nicholas S.; Morrell, Mary J.

2014-01-01

240

Increasing combat realism: the effectiveness of stun belt use on soldiers for the enhancement of live training and testing exercises  

NASA Astrophysics Data System (ADS)

The ability to make correct decisions while operating in a combat zone enables American and Coalition warfighters to better respond to any threats they may encounter due to the minimization of negative training the warfighter encountered during their live, virtual, and constructive (LVC) training exercises. By increasing the physical effects encountered by one's senses during combat scenarios, combat realism is able to be increased, which is a key component in the reduction in negative training. The use of LVC simulations for training and testing augmentation purposes depends on a number of factors, not the least of which is the accurate representation of the training environment. This is particularly true in the realm of tactical engagement training through the use of Tactical Engagement Simulation Systems (TESS). The training environment is perceived through human senses, most notably sight and hearing. As with other haptic devices, the sense of touch is gaining traction as a viable medium through which to express the effects of combat battle damage from the synthetic training environment to participants within a simulated training exercise. New developments in this field are promoting the safe use of an electronic stun device to indicate to a trainee that they have been hit by a projectile, from either direct or indirect fire, through the course of simulated combat. A growing number of examples suggest that this added output medium can greatly enhance the realism of a training exercise and, thus, improve the training value. This paper serves as a literature survey of this concept, beginning with an explanation of TESS. It will then focus on how the electronic stun effect may be employed within a TESS and then detail some of the noted pros and cons of such an approach. The paper will conclude with a description of potential directions and work.

Schricker, Bradley C.; Antalek, Christopher

2006-05-01

241

Quantifying Exertion Level During Exercise Stress Testing Using Percentage of Age-Predicted Maximal Heart Rate, Rate Pressure Product, and Perceived Exertion  

PubMed Central

OBJECTIVE: To determine if the attainment of at least 85% of age-predicted maximal heart rate (APMHR), using the equation 220 – age, and/or at least 25,000 as the product of maximal heart rate and systolic blood pressure (rate pressure product, RPP) is an accurate indicator of exertion level during exercise stress testing. PATIENTS AND METHODS: From May 1, 2009, to February 15, 2010, 238 patients (mean ± SD age, 49.3±11.9 years; 50% male) with symptoms suggestive of myocardial ischemia underwent an exercise stress test with the addition of ventilatory expired gas analysis and a myocardial perfusion study. Ventilatory expired gas analysis determined the peak respiratory exchange ratio (RER), which is considered a valid and reliable variable for quantifying a patient's exertion during exercise. RESULTS: Of the patients, 207 (87%) attained a peak RER of 1.00 or more, and 123 (52%) attained a peak RER of 1.10 or more. An APMHR of 85% or more and peak RPP of 25,000 or more were both ineffective in identifying patients who put forth a maximal exercise effort (ie, peak RER, ?1.10). Perceived exertion was a significant indicator (P=.04) of patient exertion, with a threshold of 15 (6-20 scale) being an optimal cut point. The percentage of equivocal myocardial perfusion study results was significantly higher in patients who demonstrated a submaximal exercise effort by peak RER (P?.007). CONCLUSION: Aerobic exercise testing is an integral component in the assessment of patients with suspected myocardial ischemia. Our findings indicate that the currently used percentage of APMHR and peak RPP thresholds are ineffective in quantifying a patient's level of exertion during exercise stress testing. PMID:21123636

Pinkstaff, Sherry; Peberdy, Mary Ann; Kontos, Michael C.; Finucane, Sheryl; Arena, Ross

2010-01-01

242

Responsiveness of the double limb lowering test and lower abdominal muscle progression to core stabilization exercise programs in healthy adults: a pilot study.  

PubMed

Low back pain (LBP) is one of the most prevalent and expensive health care problems in the United States. Studies suggest that stabilization exercise may be effective in the management of people with LBP. To accurately assess the effect of stabilization programs on muscle performance, clinicians need an objective measure that is both valid and reliable. The purpose of this study was to determine whether the double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) can detect a change in abdominal muscle performance after stabilization exercises. Eleven healthy participants (4 men and 7 women) were randomly assigned to either a specific stabilization exercise (SSE) or general stabilization exercise (GSE) group and were evaluated by the DLLT and LAMP before, during, and at the end of 8 weeks of training. Subjects attended exercise sessions twice per week over 8 weeks. No significant difference in pretest performance existed between the 2 groups. No significant difference was detected with the DLLT for either the SSE or GSE over time or when groups were combined. The LAMP detected a significant difference for the combined groups and GSE but not SSE over time. These data indicate that the LAMP is sensitive to change after a spinal stabilization program, whereas the DLLT does not detect a change after these programs. Furthermore, the GSE was more effective in producing these changes. Additional testing of these assessments is necessary to further validate these tests and to identify specific populations for which these tests may be most appropriate. PMID:24343322

Haladay, Douglas E; Miller, Sayers J; Challis, John H; Denegar, Craig R

2014-07-01

243

Serum thyroid-stimulating hormone levels are not associated with exercise capacity and lung function parameters in two population-based studies  

PubMed Central

Background Thyroid dysfunction has been described to be linked to a variety of cardiovascular morbidities. Through this pathway thyroid function might also be associated with cardiorespiratory function and exercise capacity. So far only few patient-studies with small study populations investigated the association between thyroid dysfunction and exercise capacity. Thus, the aim of our study was to investigate the association of serum thyroid-stimulating hormone (TSH) levels with lung function and cardiopulmonary exercise testing (CPET) in the general population. Methods Data from the two independent cross-sectional population-based studies (Study of Health in Pomerania [SHIP] and SHIP-Trend-0) were pooled. SHIP was conducted between 2002 and 2006 and SHIP-Trend-0 between 2008 and 2012. Participants were randomly selected from population registries. In total, 4206 individuals with complete data were available for the present analysis. Thyroid function was defined based on serum TSH levels. Lung function was evaluated by forced expiratory volume in 1 s and forced vital capacity. CPET was based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. Associations of serum TSH levels with lung function and CPET parameters were analysed by multivariable quantile regression adjusted for age, sex, height, weight, use of beta blockers, smoking status, and physical activity. Results Serum TSH levels, used as continuously distributed variable and categorized according to the clinical cut-offs 0.3 and 3.0 mIU/L or according to quintiles, were not consistently associated with parameters of lung function or CPET. Conclusions Our results suggest that thyroid dysfunction is not associated with lung function and cardiopulmonary exercise capacity in the general population. PMID:25182209

2014-01-01

244

Which exercise test to use for chest pain from an anomalous coronary artery.  

PubMed

Chest pain in children and young people is a frequent cause of contact to general practitioners and outpatient clinics. However, in children, chest pain is typically benign and self-limiting; it is not usually a manifestation of organic disease, and it is very rarely of cardiac origin. The cause of chest pain often remains undiagnosed. There are a number of chronic conditions known to be associated with recurrent chest pain. Symptoms and signs include crushing left-sided precordial pain, pain radiating to the left arm or the jaw, pain onset with exercise and subsiding at rest (with asthma excluded), and an abnormal cardiovascular examination suggests referral for cardiac evaluation. We here report a case of stable angina pectoris in the young. PMID:23448511

Løgstrup, Brian Bridal; Buhl, Jørgen; Nielsen, Agnete Desirée; Smerup, Morten Holdgaard; Nørgaard, Bjarne Linde; Kristensen, Lone Deibjerg

2014-01-01

245

Validation of the accuracy of pretest and exercise test scores in women with a low prevalence of coronary disease: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study  

Microsoft Academic Search

BackgroundRecently revised American College of Cardiology\\/American Heart Association guidelines have suggested that exercise test scores be used in decisions concerning patients with suspected coronary artery disease (CAD). Pretest and exercise test scores derived for use in women without known CAD have not been tested in women with a low prevalence of CAD.

Anthony P Morise; Marian B Olson; C. Noel Bairey Merz; Sunil Mankad; William J Rogers; Carl J Pepine; Steven E Reis; Barry L Sharaf; George Sopko; Karen Smith; Gerald M Pohost; Leslee Shaw

2004-01-01

246

Right ventricular bullet embolectomy without cardiopulmonary bypass.  

PubMed

Victims of gunshot wounds may be noted to have bullets overlying the cardiac silhouette on roentgenogram. Direct cardiac penetration, bullet embolus to the heart, and missile proximity to the heart are all possibilities which must be differentiated. An unusual case of bullet embolism is presented in which thoracotomy was initially performed to rule out direct cardiac penetration. At the time of exploration, an intracardiac bullet embolus was fortuitously palpated and trapped within the apex of the right ventricle. Right ventriculotomy and embolectomy without cardiopulmonary bypass were performed to prevent retrograde or distal migration. PMID:7019584

Graham, J M; Mattox, K L

1981-08-01

247

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

PubMed

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:25230197

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

2014-09-12

248

Reliability and sensitivity of a repeated high-intensity exercise performance test for rugby league and rugby union.  

PubMed

The purpose of this study was to examine the reliability and sensitivity of 3 ecologically valid repeated high-intensity exercise (RHIE) tests for professional rugby league (RL) and rugby union (RU) players. A further purpose was to investigate the relationship between RHIE performance and measures of speed (20-m sprint) and high-intensity intermittent running ability (yo-yo intermittent recovery test). Thirty-six RU and RL players were separated into 3 equal groups based on playing position: backs, RL forwards and RU forwards. Test-retest reliability was assessed by comparing total sprint time over 9 sprints during 2 identical testing sessions. The intraclass correlation coefficients (ICCs) for total sprint time were moderate to high (0.82, 0.97, and 0.94) and coefficient of variation (CV) low (4.2, 1.4, and 0.6%) for the backs, RL forwards, and RU forwards tests, respectively. However, sprint performance decrement scores were poorer, with ICC and CV of 0.78, 0.86, and 0.88 and 49.5, 48.2, and 35.8% for the backs, RL forwards, and RU forwards, respectively. Total sprint times for the backs, RL forwards, and RU forwards decreased over the 3 tests by 0.54, 0.53, and 2.09 seconds, respectively. Changes in RHIE total sprint time were moderately related to changes in 20-m sprint times (T1 to T2, r = 0.63; T2 to T3, r = 0.69; and T1 to T3, r = 0.63; all p < 0.05) but not yo-yo intermittent recovery test performances. This study has shown that the designed RL and RU RHIE tests have moderate to high reliability and produce significant improvements over a training period when total sprint times are compared. PMID:22652919

Austin, Damien J; Gabbett, Tim J; Jenkins, David G

2013-04-01

249

Exercise capacity is not impaired after acute alcohol ingestion: a pilot study.  

PubMed

The usage of alcohol is widespread, but the effects of acute alcohol ingestion on exercise performance and the stress hormone axis are not fully elucidated.We studied 10 healthy white men, nonhabitual drinkers, by Doppler echocardiography at rest, spirometry, and maximal cardiopulmonary exercise test (CPET) in two visits (2-4 days in between), one after administration of 1.5?g/kg ethanol (whisky) diluted at 15% in water, and the other after administration of an equivalent volume of water. Plasma levels of NT-pro-BNP, cortisol, and adrenocorticotropic hormone (ACTH) were also measured 10?min before the test, at maximal effort and at the third minute of recovery. Ethanol concentration was measured from resting blood samples by gas chromatography and it increased from 0.00?±?0.00 to 1.25?±?0.54‰ (P?test. CPET data suggested a trend toward a slight reduction of exercise performance (peak VO2?=?3008?±?638 vs. 2900?±?543?ml/min, ns; peak workload?=?269?±?53 vs. 249?±?40?W, ns; test duration 13.7?±?2.2 vs. 13.3?±?1.7?min, ns; VE/VCO2 22.1?±?1.4 vs. 23.3?±?2.9, ns). Ventilatory equivalent for carbon dioxide at rest was higher after alcohol intake (28?±?2.5 vs. 30.4?±?3.2, P?=?0.039) and maximal respiratory exchange ratio was lower after alcohol intake (1.17?±?0.02 vs. 1.14?±?0.04, P?=?0.04). In conclusion, we showed that acute alcohol intake in healthy white men is associated with a nonsignificant exercise performance reduction and stress hormone stimulation, with an unchanged exercise metabolism. PMID:25083719

Popovic, Dejana; Damjanovic, Svetozar S; Plecas-Solarovic, Bosiljka; Peši?, Vesna; Stojiljkovic, Stanimir; Banovic, Marko; Ristic, Arsen; Mantegazza, Valentina; Agostoni, Piergiuseppe

2014-08-01

250

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

NASA Technical Reports Server (NTRS)

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.

Ivanco, Thomas G.

2013-01-01

251

Intrapulmonary shunt after cardiopulmonary bypass: The use of vital capacity maneuvers versus off-pump coronary artery bypass grafting  

Microsoft Academic Search

Objectives: It has been proved in human subjects and animals that atelectasis is a major cause of intrapulmonary shunting and hypoxemia after cardiopulmonary bypass. Animal studies suggest that shunting can be prevented entirely by a total vital capacity maneuver performed before termination of bypass. This study aimed to test this theory in human subjects and to evaluate possible advantages of

Edda M. Tschernko; Anton Bambazek; Wilfried Wisser; Bernhard Partik; Ursula Jantsch; Klaus Kubin; Marek Ehrlich; Walter Klimscha; Michael Grimm; Franz P. Keznickl

2002-01-01

252

Associates of Cardiopulmonary Arrest in the Perihemodialytic Period  

PubMed Central

Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes). This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases) and 75,538 controls were identified. Cases and controls were 1?:?5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped) were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2?K bath) and to use the lowest effective erythropoietin stimulating agent dose. PMID:25530881

Flythe, Jennifer E.; Li, Nien-Chen; Brunelli, Steven M.; Lacson, Eduardo

2014-01-01

253

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

PubMed Central

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

2013-01-01

254

Application of Computer Simulation Techniques in Military Exercise Control System Development: 1. NETMAN Model Sensitivity Test and Validation. Technical Report 407.  

ERIC Educational Resources Information Center

The methods, procedures, and results of a sensitivity test on NETMAN, a stochastic digital computer model designed to simulate the information collection and scoring control systems used in tactical warfare training exercises, are described. NETMAN enables its users to obtain information such as personnel requirements, training requirements, and…

Siegel, Arthur I.; And Others

255

A new blood pump for cardiopulmonary bypass: the HiFlow centrifugal pump.  

PubMed

Centrifugal blood pumps are considered to be generally superior to the traditionally used roller pumps in cardiopulmonary bypass. In our institute a new lightweight centrifugal sealless blood pump with a unique spherical thrust bearing and with a magnetic coupling was developed, the HiFlow. The small design makes the pump suitable for applications in complex devices or close to a patient. Hemolysis tests were carried out in which the BioMedicus pump BP-80 and a roller pump were used as reference. The centrifugal pump HiFlow showed the least blood trauma within the group of investigated pumps. In summary, the HiFlow pump concept with its low priming volume and limited contact surfaces shows great potential for clinical applications in cardiopulmonary bypass. Also, the possibility of using the pump as a short-term assist device with an option of a pulsatile driving mode was demonstrated. PMID:9212970

Göbel, C; Eilers, R; Reul, H; Schwindke, P; Jörger, M; Rau, G

1997-07-01

256

Effect of altering pathologic right ventricular loading conditions by percutaneous pulmonary valve implantation on exercise capacity.  

PubMed

The data describing the change in exercise capacity after surgical or interventional management of the patient with right ventricular (RV) outflow tract (OT) dysfunction are conflicting. The pathophysiologic consequences of RVOT interventions and the subsequent change in exercise performance are still poorly understood. We sought to assess the effect of percutaneous pulmonary valve implantation (PPVI) on exercise capacity in (1) patients with predominantly pulmonary stenosis (PS) and (2) in patients with predominantly pulmonary regurgitation (PR). A total of 63 patients with either predominantly PS (n = 37) or PR (n = 26) underwent PPVI. Cardiopulmonary exercise testing and magnetic resonance imaging were performed before and within 1 month after PPVI. On magnetic resonance imaging, the at rest effective biventricular stroke volumes improved in both groups after PPVI (p <0.001), but the ejection fraction improved only in the PS group. In the PS group, exercise capacity (peak oxygen uptake, p <0.001), ventilatory efficiency (p <0.001), and peak oxygen pulse (p <0.001) improved after PPVI. In the PR group, none of these parameters changed after PPVI (p = 0.6, p = 0.12, and p = 0.9, respectively). On multivariate analysis, the reduction in RVOT gradient was the only predictor of improved peak oxygen uptake when assessed in the whole patient group (r(part) = -0.59; p <0.001) or in the PS (r(part) = -0.45; p = 0.002) or PR groups alone (r(part) = -0.45; p = 0.02). In conclusion, acutely after PPVI, exercise capacity improves with the relief of stenosis but not regurgitation. A reduction in the RVOT gradient, even small gradients, was the only independent predictor of improved peak oxygen uptake in both patient groups, irrespective of improved pulmonary valve competence. PMID:20185023

Lurz, Philipp; Giardini, Alessandro; Taylor, Andrew M; Nordmeyer, Johannes; Muthurangu, Vivek; Odendaal, Dolf; Mist, Bryan; Khambadkone, Sachin; Schievano, Silvia; Bonhoeffer, Philipp; Derrick, Graham

2010-03-01

257

Effect of Inhaled Iloprost on the Exercise Function of Fontan Patients  

PubMed Central

Background Exercise capacity following Fontan surgery is often depressed. An inability to reduce pulmonary vascular resistance appropriately during exercise may contribute to this phenomenon. The aim of this study was to determine whether administration of iloprost, a selective pulmonary vasodilator, would improve exercise function after Fontan procedure. Methods Double-blind, randomized, placebo controlled, crossover trial. Patients performed two cardiopulmonary exercise tests (CPX) separated by <1 month. A single nebulizer treatment (iloprost or placebo) was administered before each CPX. Results 18 patients aged 12–49 (median 17) yrs were recruited. Mild throat discomfort developed in 10/18 patients during iloprost administration; all but 1 were able to complete treatment. No symptoms developed during placebo treatments (p<0.001). Two additional patients did not complete CPX: one with atrial flutter; another with developmental issues that precluded adequate CPX. In the 15 remaining subjects oxygen pulse (a surrogate for forward stroke volume) at peak exercise was higher following iloprost (median increase 1.2 ml/beat; p<0.001). Peak VO2 also rose (median increase 1.3 ml/kg/min; p<0.04). Nine patients had peak VO2 <30 ml/kg/min; each of these patients had higher peak VO2 following iloprost. Only 3/6 patients with peak VO2 >30 ml/kg/min had higher peak VO2 following iloprost (p<0.04). Conclusions Iloprost improves the peak oxygen pulse and peak VO2 of patients with Fontan physiology and appears to be particularly beneficial among patients with impaired exercise function. Treatment is associated with minor side effects. These findings support the concept of pulmonary vasodilator therapy in Fontan patients with limited functional capacity. PMID:23545150

Rhodes, Jonathan; Ubeda-Tikkanen, Ana; Clair, Mathieu; Fernandes, Susan M.; Graham, Dionne A.; Milliren, Carly E.; Daly, Kevin P.; Mullen, Mary P.; Landzberg, Michael J.

2014-01-01

258

VOCATIONAL TALENT EXERCISES, PART D.  

ERIC Educational Resources Information Center

THIS WORKBOOK WAS DEVELOPED IN A CURRICULUM PROJECT, DESCRIBED IN VT 004 454, TO HELP YOUNG PEOPLE LEARN BASIC PRINCIPLES AND CONCEPTS OF MECHANICS AND TECHNOLOGY BY MEANS OF A SERIES OF APTITUDE TRAINING EXERCISES. IT IS THE LAST OF FOUR BOOKS WHICH PRESENT 30 EXERCISES DESIGNED FOR 30 CLASS PERIODS. THE EXERCISES ARE SIMILAR TO APTITUDE TEST

George Washington Univ., Washington, DC. School of Education.

259

Longitudinal exercise capacity of patients with repaired tetralogy of fallot.  

PubMed

Patients with repaired tetralogy of Fallot have a reduced percentage of predicted peak oxygen consumption (VO(2)) and percentage of oxygen pulse (O(2)P%) compared to healthy controls. Because data regarding the progression of exercise intolerance in these patients is limited, we sought to analyze the serial exercise data from patients with Tetralogy of Fallot to quantify the changes in their exercise capacity over time and to identify associations with clinical and cardiac magnetic resonance imaging variables. The data from cardiopulmonary exercise tests (CPXs) from 2002 to 2010 for patients with repaired tetralogy of Fallot with ?2 CPXs separated by ?12 months were analyzed. Tests occurring after interventional catheterization or surgery were excluded. A total of 70 patients had 179 CPXs. They had a median age at the initial study of 23.6 years and an interval between the first and last CPX of 2.8 years. At the initial CPX, the peak VO(2) was 27.6 ± 8.8 ml/kg/min (78 ± 19% of predicted), and the peak O(2)P% was 89 ± 22% of predicted. At the most recent study, the peak VO(2) averaged 25.0 ± 7.4 ml/kg/min (73 ± 16% of predicted), and the peak O(2)P% averaged 83 ± 20% (p <0.01) for each versus the initial CPX. The decrease in the peak VO(2) was strongly associated with a decrease in O(2)P% and an increase (worsening) in the slope of the minute ventilation-versus-carbon dioxide production relation. Changes in the peak VO(2) did not correlate with concomitant changes in any other CPX variable. The rate of decrease was not related to a history of shunt palliation, age at CPX, or any other baseline clinical parameter, including cardiac magnetic resonance measurements. In conclusion, the exercise capacity of patients with repaired tetralogy of Fallot tends to decrease over time. This deterioration is variable and unpredictable and is primarily related to a decrease in the forward stroke volume at peak exercise. PMID:21529748

Kipps, Alaina K; Graham, Dionne A; Harrild, David M; Lewis, Erik; Powell, Andrew J; Rhodes, Jonathan

2011-07-01

260

The role of Levosimendan in cardiopulmonary resuscitation.  

PubMed

Although initial resuscitation from cardiac arrest (CA) has increased over the past years, long term survival rates remain dismal. Epinephrine is the vasopressor of choice in the treatment of CA. However, its efficacy has been questioned, as it has no apparent bene?ts for long-term survival or favorable neurologic outcome. Levosimendan is an inodilator with cardioprotective and neuroprotective effects. Several studies suggest that it is associated with increased rates of return of spontaneous circulation as well as improved post-resuscitation myocardial function and neurological outcome. The purpose of this article is to review the properties of Levosimendan during cardiopulmonary resuscitation (CPR) and also to summarize existing evidence regarding the use of Levosimendan in the treatment of CA. PMID:24972240

Varvarousi, Giolanda; Stefaniotou, Antonia; Varvaroussis, Dimitrios; Aroni, Filippia; Xanthos, Theodoros

2014-10-01

261

Pulmonary function and exercise tolerance are related to disease severity in pre-dialytic patients with chronic kidney disease: a cross-sectional study  

PubMed Central

Background Chronic kidney disease (CKD) involves a progressive, irreversible loss of kidney function. While early-stage CKD patients may show changes in pulmonary function and lowered exercise tolerance, the role of the estimated glomerular filtration rate (eGFR) in these patterns remains unknown. The aim of this study was to investigated pulmonary function and exercise tolerance in pre-dialytic CKD patients. Methods A cross-sectional study was carried out with 38 adult volunteers divided into a control group (CG), consisting of 9 healthy adults, and 29 pre-dialytic CKD patients in stages 3 (G3), 4 (G4), and 5 (G5). All participants underwent spirometric and manovacuometric tests, a cardiopulmonary exercise test (CPET), a 6-minute walk test (6MWT), and laboratory tests. Results The significant differences was observed in maximal exercise tolerance, measured as peak oxygen consumption percentage (VO2peak) (mL/kg/min) (CG = 28.9 ± 7.8, G3 = 23.3 ± 5.6, G4 = 21.4 ± 5.2, G5 = 20.2 ± 6.9; p = 0.03), and submaximal exercise tolerance, measured by 6MWT (m) (CG = 627.6 ± 37.8, G3 = 577.4 ± 66.1, G4 = 542.7 ± 57.3, G5 = 531.5 ± 84.2, p = 0.01). The eGFR was associated with pulmonary function-forced expiratory volume in the first second percentage (FEV1) (%) (r = 0.34, p = 0.02) and maximum inspiratory pressure (PImax) (r = 0.41, p = 0.02) - and exercise tolerance - VO2peak (mL/kg/min) (r = 0.43, p = 0.01) and 6MWT distance (m) (r = 0.55, p < 0.01). Conclusion Pre-dialytic CKD patients showed lower maximal and submaximal exercise tolerances than healthy individuals. PMID:24007403

2013-01-01

262

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

ERIC Educational Resources Information Center

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)

Chang, J. C.; And Others

1986-01-01

263

The "Friendly Student" Exercise.  

ERIC Educational Resources Information Center

Uses a class exercise that tests the folk wisdom concerning small-town friendliness. Students are assigned to express random friendliness to strangers so they can determine whether friendlier responses are elicited in small towns or large cities. (KO)

Wright, Richard A.

1989-01-01

264

Exercise Training in Patients with Pulmonary Arterial Hypertension: A Case Report  

PubMed Central

Purpose: To describe the benefits of a feasible, outpatient exercise training program on exercise tolerance and health-related quality of life (HRQL) in individuals with pulmonary arterial hypertension (PAH). Methods: Case report on two subjects recruited from a tertiary care pulmonary hypertension clinic. Subject 1 was a 50-year-old male with idiopathic PAH. Subject 2 was a 54-year-old female with a 20+ year history of scleroderma and 6-year history of PAH. Both subjects underwent exercise training 3 times per week for 6 weeks using a cycle ergometer at workloads progressing from 50% to 80% of peak workload. Outcomes were assessed using cardiopulmonary exercise testing, six-minute walk test (6MWT), and HRQL using the Chronic Respiratory Disease Questionnaire (CRQ) and the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR). Results: Both subjects made substantial improvements in oxygen consumption and workload at anaerobic threshold (improvements of 3.8 and 4.2 mL·kg?1·min,?1 26 and 18 W, respectively) and 6MWT distance (from 496 to 586m and 416 to 517m, respectively). Only Subject 1 made substantial improvements in peak oxygen consumption (from 16.0 to 18.3 mL·kg?1·min?1and from 15.0 to 15.6 mL·kg?1·min,?1 respectively) and peak work rate (from 112 to 130W and 66 to 69W, respectively). Both subjects demonstrated improved HRQL. No adverse events were noted. CONCLUSIONS: A short and practical exercise training program can improve measures of workload, aerobic capacity, and HRQL in individuals with PAH with no adverse effects shown in these two case studies. PMID:20467524

Shoemaker, Michael J.; Wilt, Jeffrey L.; Dasgupta, Rajkumar; Oudiz, Ronald J.

2009-01-01

265

Reliability of 31 P-magnetic resonance spectroscopy during an exhaustive incremental exercise test in children  

Microsoft Academic Search

This study examined the reliability of 31P-magnetic resonance spectroscopy (MRS) to measure parameters of muscle metabolic function in children. On separate days, 14 children (7 boys and 7 girls) completed three knee-extensor incremental tests to exhaustion inside a whole-body scanner (1.5 T, Phillips). The dynamic changes in the ratio of inorganic phosphate to phosphocreatine (Pi\\/PCr) and intracellular muscle pH were resolved

Alan Barker; Joanne Welsman; Deborah Welford; Jonathan Fulford; Craig Williams; Neil Armstrong

2006-01-01

266

Do different mattresses affect the quality of cardiopulmonary resuscitation?  

Microsoft Academic Search

ObjectiveTo determine the effect of different mattresses on cardiopulmonary resuscitation performance and establish whether emergency deflation of an inflatable mattress improves the quality of resuscitation.Design and settingRandomised controlled cross-over trial performed in a general ICUParticipantsCritical care staff from a general ICU.InterventionsCardiopulmonary resuscitation on a manikin on the floor or on a bed with a standard foam mattress and inflated and

Gavin D. Perkins; Robert Benny; Simon Giles; Fang Gao; Michael J. Tweed

2003-01-01

267

Increased Left Ventricular Stiffness Impairs Exercise Capacity in Patients with Heart Failure Symptoms Despite Normal Left Ventricular Ejection Fraction  

PubMed Central

Aims. Several mechanisms can be involved in the development of exercise intolerance in patients with heart failure despite normal left ventricular ejection fraction (HFNEF) and may include impairment of left ventricular (LV) stiffness. We therefore investigated the influence of LV stiffness, determined by pressure-volume loop analysis obtained by conductance catheterization, on exercise capacity in HFNEF. Methods and Results. 27 HFNEF patients who showed LV diastolic dysfunction in pressure-volume (PV) loop analysis performed symptom-limited cardiopulmonary exercise testing (CPET) and were compared with 12 patients who did not show diastolic dysfunction in PV loop analysis. HFNEF patients revealed a lower peak performance (P = .046), breathing reserve (P = .006), and ventilation equivalent for carbon dioxide production at rest (P = .002). LV stiffness correlated with peak oxygen uptake (r = ?0.636, P < .001), peak oxygen uptake at ventilatory threshold (r = ?0.500, P = .009), and ventilation equivalent for carbon dioxide production at ventilatory threshold (r = 0.529, P = .005). Conclusions. CPET parameters such as peak oxygen uptake, peak oxygen uptake at ventilatory threshold, and ventilation equivalent for carbon dioxide production at ventilatory threshold correlate with LV stiffness. Increased LV stiffness impairs exercise capacity in HFNEF. PMID:21403885

Sinning, David; Kasner, Mario; Westermann, Dirk; Schulze, Karsten; Schultheiss, Heinz-Peter; Tschöpe, Carsten

2011-01-01

268

A reliable method for rhythm analysis during cardiopulmonary resuscitation.  

PubMed

Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies. PMID:24895621

Ayala, U; Irusta, U; Ruiz, J; Eftestøl, T; Kramer-Johansen, J; Alonso-Atienza, F; Alonso, E; González-Otero, D

2014-01-01

269

A novel rotary pulsatile flow pump for cardiopulmonary bypass.  

PubMed

It has been suggested that pulsatile blood flow is superior to continuous flow (CF) in cardiopulmonary bypass (CPB). However, adoption of pulsatile flow (PF) technology has been limited because of practicality 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 four piglets (10-12 kg). 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 CF roller pump. Pressure and flow waveforms demonstrated significant pulsatility in the PRVP setup compared with CF at all tested conditions. Measurement of hemodynamic energy data, including the percentage pulsatile energy and the surplus hydraulic energy, also revealed a significant increase in pulsatility with the PRVP (p < 0.001). The 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

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

2014-01-01

270

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

PubMed Central

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

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

2012-01-01

271

Haptic control of a pneumatic muscle actuator to provide resistance for simulated isokinetic exercise; part II: control development and testing.  

PubMed

Pneumatic muscle actuators (PMAs) have a high power to weight ratio and possess unique characteristics which make them ideal actuators for applications involving human interaction. PMAs are difficult to control due to nonlinear dynamics, presenting challenges in system implementation. Despite these challenges, PMAs have great potential as a source of resistance for strength training and rehabilitation. The objective of this work was to control a PMA for use in isokinetic exercise, potentially benefiting anyone in need of optimal strength training through a joint's range of motion. The controller, based on an inverse three-element phenomenological model and adaptive nonlinear control, allows the system to operate as a type of haptic device. A human quadriceps dynamic simulator was developed (as described in Part I of this work) so that control effectiveness and accommodation could be tested prior to human implementation. Tracking error results indicate that the control system is effective at producing PMA displacement and resistance necessary for a scaled, simulated neuromuscular actuator to maintain low-velocity isokinetic movement during simulated concentric and eccentric knee extension. PMID:23495753

Hall, Kara L; Phillips, Chandler A; Reynolds, David B; Mohler, Stanley R; Rogers, Dana B; Neidhard-Doll, Amy T

2015-01-01

272

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

PubMed

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

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

273

Work performance evaluation using the exercising rat model  

SciTech Connect

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.

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

1987-01-01

274

Development and initial testing of functional task exercise on older adults with cognitive impairment at risk of Alzheimer's disease--FcTSim programme--a feasibility study.  

PubMed

The purpose of this study was to illustrate the development of a new functional task-based exercise programme and initially test its feasibility as well as effectiveness for older adults with mild cognitive impairment (MCI). This study used a single-group repeated-measures design. A total of 11 patients (mean age 71.8?years) were recruited to participate in a structured functional task exercise programme for 10?weeks. All outcome measures were undertaken at baseline, post-intervention and post-3-month follow-up using the Neurobehavioral Cognitive Status Examination (NCSE), Verbal Fluency Test (VFT), Chinese Version Verbal Learning Test (CVVLT), Lawton Instrumental Activities of Daily Living Scale (Lawton IADL) and Problems in Everyday Living test (PEDL). Data were analysed using a repeated-measures analysis of variance. Cohen's d effect size was used to assess the practical significant effects. The participants showed significant improvement in NCSE composite score, VFT, CVVLT total free recall, CVVLT 10-minute delayed free recall, Lawton IADL and PEDL. Results of this study demonstrate that the newly designed functional task exercise programme, which uses simulated tasks, is feasible and beneficial to cognitive functions and functional status of older persons with MCI. The findings of the current study further reinforce occupational therapy practitioners' understanding that "occupation" is a "means" and an "end". Further study with a larger population is needed to draw more definitive conclusions. PMID:23761291

Law, Lawla L F; Barnett, Fiona; Yau, Matthew K; Gray, Marion A

2013-12-01

275

A Proximal Change Experiment Testing Two Communication Exercises With Intimate Partner Violent Men  

PubMed Central

This study tests the immediate impact of two interventions for intimate partner violent (IPV) men in affecting behavioral and emotional change during arguments with their partners. Couples with an abusive male partner (N=100) discussed an area of conflict twice, interrupted by a brief intervention. Men were randomly assigned to receive (a) an editing-out-the-negative skills training, (b) an accepting influence skills training, or (c) a time-out. IPV men in both skills-training conditions showed greater decreases in aggressive feelings than IPV men in the time-out condition based on their self-report and observed affective behavior. Women also reported feeling less aggressive when their husbands were assigned to one of the skills-training conditions as compared to the control (time-out) condition. Results suggest that IPV men can learn to adopt new communication skills and that they do appear to have a positive impact on the emotional tone of their arguments. Clinically, communication skills training may be a useful addition to battering intervention programs, although these skills may need to be taught to both men and women involved in violent relationships. PMID:21496517

Babcock, Julia C.; Graham, Katherine; Canady, Brittany; Ross, Jody M.

2013-01-01

276

Reference cardiopulmonary values in normal dogs.  

PubMed

The purpose of this project was to collate canine cardiopulmonary measurements from published and unpublished studies in our laboratory in 97 instrumented, unsedated, normovolemic dogs. Body weight; arterial and mixed-venous pH and blood gases; mean arterial, pulmonary arterial, pulmonary artery occlusion, and central venous blood pressures; cardiac output; heart rate; hemoglobin; and core temperature were measured. Body surface area; bicarbonate concentration; base deficit; cardiac index; stroke volume index, systemic and pulmonary vascular resistance indices; left and right cardiac work indices; alveolar partial pressure of oxygen (pO2) ; alveolar-arterial pO2 gradient (A-apO2); arterial, mixed-venous, and pulmonary capillary oxygen content; oxygen delivery; oxygen consumption; oxygen extraction; venous admixture; arterial and mixed-venous blood CO2 contents; and CO2 production were calculated. In the 97 normal, resting dogs, mean arterial and mixed-venous pH were 7.38 and 7.36, respectively; partial pressure of carbon dioxide (pCO2), 40.2 and 44.1 mm Hg, respectively; base-deficit, -2.1 and -1.9 mEq/liter, respectively; pO2, 99.5 and 49.3 mm Hg, respectively; oxygen content, 17.8 and 14.2 ml/dl, respectively; A-a pO2 was 6.3 mm Hg; and venous admixture was 3.6%. The mean arterial blood pressure (ABPm), mean pulmonary arterial blood pressure (PAPm), pulmonary artery occlusion pressure (PAOP) were 103, 14, and 5.5 mm Hg, respectively; heart rate was 87 beats/min; cardiac index (CI) was 4.42 liters/min/m2; systemic and pulmonary vascular resistances were 1931 and 194 dynes.sec.cm-5, respectively; oxygen delivery, consumption and extraction were 790 and 164 ml/min/m2 and 20.5%, respectively. This study represents a collation of cardiopulmonary values obtained from a large number of dogs (97) from a single laboratory using the same measurement techniques. PMID:15884778

Haskins, Steve; Pascoe, Peter J; Ilkiw, Jan E; Fudge, James; Hopper, Kate; Aldrich, Janet

2005-04-01

277

Cardiac mechanics are impaired during fatiguing exercise and cold pressor test in healthy older adults  

PubMed Central

We sought to determine how the aging left ventricle (LV) responds to sympathetic nervous system (SNS) activation. Three separate echocardiographic experiments were conducted in 11 healthy young (26 ± 1 yr) and 11 healthy older (64 ± 1 yr) adults. Tissue Doppler imaging was used to measure systolic myocardial velocity (Sm), early diastolic myocardial velocity (Em), and late diastolic myocardial velocity (Am) during isometric fatiguing handgrip (IFHG), a 2-min cold pressor test (CPT), and 5 min of normobaric hypoxia. Heart rate (HR) and mean arterial pressure (MAP) were also monitored on a beat-by-beat basis; rate pressure product (RPP) was used as an index of myocardial oxygen demand. At peak IFHG, the groups had similar increases in RPP, but the ?Sm was significantly greater (i.e., larger impairment) in the older subjects (?0.82 ± 0.13 cm/s) compared with the young subjects (0.37 ± 0.30 cm/s). At peak IFHG, the ?Em was similar between older (?1.59 ± 0.68 cm/s) and young subjects (?1.06 ± 0.76 cm/s). In response to the CPT, both Sm and Em were reduced in the older adults but did not change relative to baseline in the young subjects. Normobaric hypoxia elevated HR and RPP in both groups but did not alter Tissue Doppler parameters. These data indicate that Sm and Em are reduced in healthy older adults during IFHG and CPT. We speculate that suboptimal LV adaptations to SNS stress may partly explain why acute heavy exertion can trigger myocardial ischemia. PMID:23154996

Muller, Matthew D.; Mast, Jessica L.; Patel, Hardikkumar

2013-01-01

278

Effects of Exercise Training versus Attention on Plasma B-type Natriuretic Peptide, 6-Minute Walk Test and Quality of Life in Individuals with Heart Failure  

PubMed Central

Purpose The purpose of this study was to compare an Exercise Training Group (EX) with an Attention-Control Group (AT-C) to more specifically assess the impact of exercise training on individuals with heart failure (HF). Methods Forty-two individuals with HF were randomized to AT-C or EX that met with the same frequency and format of investigator interaction. Baseline, 12- and 24-week measurements of B-type naturetic peptide (BNP), 6-minute walk test (6-MWT), and the Kansas City Cardiomyopathy Questionnaire (KCCQ) were obtained. Results BNP tended to increase in the AT-C while remaining stable in the EX over time. A clinically significant increase in 6-MWT was demonstrated by the EX but not the AT-C. The EX achieved a clinically significant change on the KCCQ at 12 weeks, with further improvement by 24 weeks, while the AT-C demonstrated a clinically significant change at 24 weeks. Conclusions Attention alone was inadequate to positively impact BNP levels or 6-MWT distances, but did have a positive impact on quality of life after 24 weeks. Although exercise offers enhanced benefits, individuals with HF unable to participate in an exercise program may still gain quality of life benefits from participation in a peer-support group that discusses topics pertinent to HF. PMID:23304096

Norman, Joseph F.; Pozehl, Bunny J.; Duncan, Kathleen A.; Hertzog, Melody A.; Krueger, Steven K.

2012-01-01

279

Utility of the discriminant analysis to categorize untrained Spanish Pure Bred horses on the basis of biochemical and muscle variables before and after a standardized exercise test.  

PubMed

We hypothesized that the information obtained from a discriminant analysis could be used to objectively discriminate horses untrained from early ages, in agreement with certain physiological characteristics. In the biopsies of 24 Spanish Pure Bred horses (1.5-3 years old) before and after a standardized exercise test (SET; 4-7 m/s with a change of velocity of 1m/s every 2 min) muscle enzymes, substrate and metabolites were determined. Also, diverse plasma and blood parameters were considered. Three pre-exercise groups (A1: six horses; A2: seven horses and A3: eleven horses) and two post-exercise groups (B1: sixteen horses; B2: eight horses) were defined from a correspondence analysis. Forward stepwise discriminant analysis selected 11 variables which differentiated the groups between each other both pre- and post-exercise. The results of the present study suggested the utility of a discriminant analysis to categorize horses in agreement with certain physiological variables. It could be used for establishing different types of training in each group by expert trainers. PMID:21458835

Escribano, B M; Agüera, E I; Rubio, M D; Santisteban, R; Vivo, R; Agüera, S; Tovar, P

2011-12-01

280

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

PubMed Central

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

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

2014-01-01

281

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

SciTech Connect

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.

Sutton, J.M.; Topol, E.J. (Univ. of Michigan Medical Center, Ann Arbor (USA))

1991-04-01

282

Rhythm Analysis during Cardiopulmonary Resuscitation: Past, Present, and Future  

PubMed Central

Survival from out-of-hospital cardiac arrest depends largely on two factors: early cardiopulmonary resuscitation (CPR) and early defibrillation. CPR must be interrupted for a reliable automated rhythm analysis because chest compressions induce artifacts in the ECG. Unfortunately, interrupting CPR adversely affects survival. In the last twenty years, research has been focused on designing methods for analysis of ECG during chest compressions. Most approaches are based either on adaptive filters to remove the CPR artifact or on robust algorithms which directly diagnose the corrupted ECG. In general, all the methods report low specificity values when tested on short ECG segments, but how to evaluate the real impact on CPR delivery of continuous rhythm analysis during CPR is still unknown. Recently, researchers have proposed a new methodology to measure this impact. Moreover, new strategies for fast rhythm analysis during ventilation pauses or high-specificity algorithms have been reported. Our objective is to present a thorough review of the field as the starting point for these late developments and to underline the open questions and future lines of research to be explored in the following years. PMID:24527445

Irusta, Unai; Ruiz, Jesus; Ayala, Unai; Aramendi, Elisabete; Eftestøl, Trygve

2014-01-01

283

A pilot study of cerebral tissue oxygenation and postoperative cognitive dysfunction among patients undergoing coronary artery bypass grafting randomised to surgery with or without cardiopulmonary bypass*.  

PubMed

Coronary artery bypass surgery, performed with or without cardiopulmonary bypass, is frequently followed by postoperative cognitive decline. Near-infrared spectroscopy is commonly used to assess cerebral tissue oxygenation, especially during cardiac surgery. Recent studies have suggested an association between cerebral desaturation and postoperative cognitive dysfunction. We therefore studied cerebral oxygen desaturation, defined as area under the cerebral oxygenation curve < 40% of > 10 min.%, with respect to cognitive performance at 4 days (early) and 3 months (late) postoperatively, compared with baseline, using a computerised cognitive test battery. We included 60 patients, of mean (SD) age 62.8 (9.4) years, scheduled for elective coronary artery bypass grafting, who were randomly allocated to surgery with or without cardiopulmonary bypass. Cerebral desaturation occurred in only three patients and there was no difference in cerebral oxygenation between the two groups at any time. Among patients who received cardiopulmonary bypass, 18 (62%) had early cognitive decline, compared with 16 (53%) in the group without cardiopulmonary bypass (p = 0.50). Three months after surgery, 11 patients (39%) in the cardiopulmonary bypass group displayed cognitive dysfunction, compared with four (14%) in the non-cardiopulmonary bypass group (p = 0.03). The use of cardiopulmonary bypass was identified as an independent risk factor for the development of late cognitive dysfunction (OR 6.4 (95% CI 1.2-33.0) p = 0.027. In conclusion, although cerebral oxygen desaturation was rare in our population, postoperative cognitive decline was common in both groups, suggesting that factors other than hypoxic neuronal injury are responsible. PMID:24750013

Kok, W F; van Harten, A E; Koene, B M J A; Mariani, M A; Koerts, J; Tucha, O; Absalom, A R; Scheeren, T W L

2014-06-01

284

Role of Corticosteroids During Cardiopulmonary Bypass  

PubMed Central

Abstract Corticosteroids are commonly used in the peri-operative setting for patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The inflammatory response to CPB is associated with organ dysfunction and increased mortality. Corticosteroids reduce biochemical inflammatory markers associated with CPB, however the impact on clinical outcomes is mixed. The purpose of this article is to evaluate the evidence of changes in clinical outcomes associated with the peri-operative administration of corticosteroids in patients undergoing cardiac surgery with CPB. Randomized, placebo-controlled trials and meta-analyses were reviewed for evidence evaluating the impact of corticosteroids on clinical outcomes including mortality, myocardial infarction, atrial fibrillation (AF), duration of intubation, length of intensive care unit (ICU) or hospital stay, hyperglycemia, and gastrointestinal complications. Most of the relevant studies are underpowered to assess major clinical outcomes. Although corticosteroids likely reduce the risk of AF, this needs to be evaluated when used in addition to or in lieu of other anti-arrhythmic agents. Evidence does not equivocally support the use of corticosteroids to improve clinical outcomes in cardiac surgery patients. PMID:24715740

Kristeller, Judith L.

2014-01-01

285

[Ethics of the cardiopulmonary resuscitation decisions].  

PubMed

Cardiopulmonary Resuscitation (CPR) must be attempted if indicated, not done if it is not indicated or if the patient does not accept or has previously rejected it and withdrawn it if it is ineffective. If CPR is considered futile, a Do-Not-Resuscitate Order (DNR) will be recorded. This should be made known to all physicians and nurses involved in patient care. It may be appropriate to limit life-sustaining-treatments for patients with severe anoxic encephalopathy, if the possibility of clinical evolution to brain death is ruled out. After CPR it is necessary to inform and support families and then review the process in order to make future improvements. After limitation of vital support, certain type of non-heart-beating-organ donation can be proposed. In order to acquire CPR skills, it is necessary to practice with simulators and, sometimes, with recently deceased, always with the consent of the family. Research on CPR is essential and must be conducted according to ethical rules and legal frameworks. PMID:20542599

Monzón, J L; Saralegui, I; Molina, R; Abizanda, R; Cruz Martín, M; Cabré, L; Martínez, K; Arias, J J; López, V; Gràcia, R M; Rodríguez, A; Masnou, N

2010-11-01

286

Hantaviruses and cardiopulmonary syndrome in South America.  

PubMed

Hantavirus (Bunyaviridae) cardiopulmonary syndrome (HCPS) is an emerging health problem in South America due to urban growth and to the expansion of agriculture and cattle-raising areas into ecosystems containing most of the species of Sigmodontinae rodents that act as hantavirus reservoirs. About 4000 HCPS cases have been reported in South America up to 2013, associated with the following hantaviruses: Andes, Anajatuba, Araraquara (ARQV), Paranoá, Bermejo, Castelo dos Sonhos, Juquitiba, Araucária, Laguna Negra, Lechiguanas, Maripa, Oran, Rio Mamore and Tunari. The transmission of hantavirus to man occurs by contact with or through aerosols of excreta and secretions of infected rodents. Person-to-person transmission of hantavirus has also been reported in Argentina and Chile. HCPS courses with a capillary leaking syndrome produced by the hantavirus infecting lung endothelial cells and mostly with a severe inflammatory process associated with a cytokine storm. HCPS starts as a dengue-like acute febrile illness but after about 3 days progresses to respiratory failure and cardiogenic shock, leading to a high fatality rate that reaches 50% for patients infected with ARQV. PMID:24508343

Figueiredo, Luiz Tadeu Moraes; Souza, William Marciel de; Ferrés, Marcela; Enria, Delia Alcira

2014-07-17

287

Cardiopulmonary resuscitation and management of cardiac arrest.  

PubMed

The best chance of survival with a good neurological outcome after cardiac arrest is afforded by early recognition and high-quality cardiopulmonary resuscitation (CPR), early defibrillation of ventricular fibrillation (VF), and subsequent care in a specialist center. Compression-only CPR should be used by responders who are unable or unwilling to perform mouth-to-mouth ventilations. After the first defibrillator shock, further rhythm checks and defibrillation attempts should be performed after 2 min of CPR. The underlying cause of cardiac arrest can be identified and treated during CPR. Drugs have a limited effect on long-term outcomes after cardiac arrest, although epinephrine improves the success of resuscitation, and amiodarone increases the success of defibrillation for refractory VF. Supraglottic airway devices are an alternative to tracheal intubation, which should be attempted only by skilled rescuers. Care after cardiac arrest includes controlled reoxygenation, therapeutic hypothermia for comatose survivors, percutaneous coronary intervention, circulatory support, and control of blood-glucose levels and seizures. Prognostication in comatose survivors of cardiac arrest needs a careful, multimodal approach using clinical and electrophysiological assessments after at least 72 h. PMID:22665327

Nolan, Jerry P; Soar, Jasmeet; Wenzel, Volker; Paal, Peter

2012-09-01

288

[Exercise-induced asthma].  

PubMed

Exercise-induced asthma is characterized by a transient rise of the airways resistances, associated with asthmatic symptoms, 5 to 10 minutes after the end of a submaximal effort. The treatment is based on a pre-effort warming, cover the mouth with a mask (when the weather is cold), the use of beta-mimetic bronchodilators before exercise and, chronic treatment with antiinflammatory drugs. When the patient is not controlled, an evaluation of the lung function is required with a postbronchodilator control or an exercise challenge test. If the patient remains uncontrolled despite the treatment, others diagnostics should be excluded, such as vocal cords dysfunction or left heart failure. PMID:21089401

Michel, O

2010-09-01

289

The effects of aquatic exercise on body composition, physical fitness, and vascular compliance of obese elementary students  

PubMed Central

The purpose of this study was to investigate the effects of aquatic exercise on body composition, physical fitness, and vascular compliance of obese elementary school students. For the purpose of this study, 20 obese elementary students were selected as subjects. The subjects were then divided into two groups: the swimming group (n= 10) and the control group (n= 10). The subjects were asked to exercise for 60 minutes a day, 3 times a week for 12 weeks with an exercise intensity of 50–70% HRmax. The following results were achieved: first, in terms of body composition, both body fat percentage and fat-free mass showed significant differences within the swimming group. There were also significant differences again in the posttest of difference between the two groups. Second, in terms of changes in physical fitness, there were, again, no significant changes in muscular strength between the two groups. However, muscular endurance, flexibility, and cardiopulmonary endurance showed significant differences in the swimming group’s test for difference within groups. Significant differences in both groups for the posttest of differences between groups were also seen. Third, in terms of vascular compliance, there was a significant increase in the right leg for the swimming groups’ test of difference within groups, as well as in the posttest of difference between groups. PMID:25061599

Lee, Bo-Ae; Oh, Deuk-Ja

2014-01-01

290

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

PubMed Central

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

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

2012-01-01

291

Impaired exercise capacity following atrial septal defect closure: an invasive study of the right heart and pulmonary circulation  

PubMed Central

Abstract Patients with early repair of an isolated atrial septal defect (ASD) are expected to have unremarkable right ventricular (RV) and pulmonary circulation physiology. Some studies, however, suggest persistent functional impairment. We aimed to examine the role of abnormal RV and pulmonary vascular response to exercise in patients who had undergone ASD closure. Using a previously published data set, we reviewed invasive exercise cardiopulmonary testing with right-sided hemodynamic data for 12 asymptomatic patients who had undergone ASD closure. The 5 (42%) patients with impaired maximal oxygen uptake () were older and exhibited a lower peak cardiac index (5.6 ± 0.8 vs. 9.0 ± 1.2 L/min/m2; P = .005) because of abnormal stroke volume augmentation (+3.2 ± 3.9 vs. +17.4 ± 10.2 mL/m2; P = .02). While all resting hemodynamic variables were similar, patients with low tended to have abnormal total pulmonary vascular resistance change during exercise (+11% ± 41% vs. ?28% ± 26%; P = .06) and had a steeper relation between mean pulmonary arterial pressure and cardiac index (5.8 ± 0.6 vs. 2.2 ± 0.1 L/min/m2; P = .02). The increase in peak mean RV power during exercise was also significantly lower in the impaired- patients (4.7 ± 1.6 vs. 7.6 ± 2.1 J/s; P = .04). As described in the original study, despite normal resting hemodynamics, a subset of asymptomatic patients with repaired ASD had diminished exercise capacity. Our analysis allows us to conclude that this is due to a combination of abnormal pulmonary vascular response to exercise and impaired RV function. PMID:25610599

Systrom, David; Epstein, Stephen E.; John, Anitha; Ruiz, George; Landzberg, Michael J.; Opotowsky, Alexander R.

2014-01-01

292

Gravity and Development of Cardiopulmonary Reflex  

NASA Astrophysics Data System (ADS)

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.

Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

293

Ambient oxygen concentrations during simulated cardiopulmonary resuscitation.  

PubMed

Oxygen concentrations were measured at 12 points around a cardiopulmonary resuscitation practice mannequin following simulated ventilation with a self-inflating bag, a 'Waters' bag and a ventilator to determine whether increased oxygen concentrations may contribute to the risk of combustion from arcing defibrillator paddles. Ventilation was simulated using either a mask or via a tracheal tube fitted to the airway. The head of the mannequin rested upon a 10-cm-high pillow. Gas sampling took place after 5 min of ventilation with subsequent removal of the ventilatory device and placement on the pillow to the left of the mouth, with the tubing of the device removed to a point 1 m behind the mouth and with the device left connected to the tracheal tube. Gas was sampled after using all devices at oxygen flows of 10l.min-1 and 15l.min-1. Slightly increased oxygen concentrations were noted over the anterior chest after placement of all devices on the pillow at the higher flow. Concentrations of greater than 30% were measured in the left axilla after placement of all devices on the pillow at both flows. No increase in oxygen concentration was seen when the devices were either left connected to the tracheal tube or removed to a distance of 1 m. It would appear that leaving a patient connected to a ventilator poses no increase in risk of fire from ignition of combustible material in an oxygen-enriched atmosphere during defibrillation. Disconnecting any device which continues to discharge oxygen and leaving it on the pillow before defibrillation is dangerous. PMID:9771170

Robertshaw, H; McAnulty, G

1998-07-01

294

Rescuer fatigue during simulated neonatal cardiopulmonary resuscitation.  

PubMed

Objective:To assess development of fatigue during chest compressions (CCs) in simulated neonatal cardiopulmonary resuscitation (CPR).Study design:Prospective randomized manikin crossover study. Thirty neonatal healthcare professionals who successfully completed the Neonatal Resuscitation Program performed CPR using (i) 3:1 compression:ventilation (C:V) ratio, (ii) continuous CC with asynchronous ventilation (CCaV) at a rate of 90 CC per min and (iii) CCaV at 120 CC per min for a duration of 10?min on a neonatal manikin. Changes in peak pressure (a surrogate of fatigue) and CC rate were continuously recorded and fatigue among groups was compared. Participants were blinded to pressure tracings and asked to rate their level of comfort and fatigue for each CPR trial.Result:Compared with baseline, a significant decrease in peak pressure was observed after 72, 96 and 156?s in group CCaV-120, CCaV-90 and 3:1 C:V, respectively. CC depth decreased by 50% within the first 3?min during CCaV-120, 30% during CCaV-90 and 20% during 3:1 C:V. Moreover, 3:1 C:V and CCaV were similarly preferred by healthcare professionals.Conclusion:Similarly, 3:1 C:V and CCaV CPR were also fatiguing. We recommend that rescuers should switch after every second cycle of heart rate assessment during neonatal CPR.Journal of Perinatology advance online publication, 11 September 2014; doi:10.1038/jp.2014.165. PMID:25211285

Li, E S; Cheung, P-Y; O'Reilly, M; Aziz, K; Schmölzer, G M

2014-09-11

295

doi:10.1155/2011/497690 Clinical Study Improved Left Ventricular Diastolic Function with Exercise Training in Hypertension: A Doppler Imaging Study  

E-print Network

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To study the effects of 6 months ’ exercise training on ventricular function in hypertensive patients. Methods. Both groups received routine anti-hypertensive pharmacological therapy and one received a 6 months ’ exercise program in addition. All patients underwent incremental cardiopulmonary exercise test and echocardiography in baseline and after 6 months. Results. (1) In 6 months ’ follow-up, PeakVO2, Powermax (max workload), AT (anaerobic threshold), VO2AT (VO2 at anaerobic threshold), tAT (time from beginning to anaerobic threshold) (P <.05), were increased in the exercise group. HRrest (Heart rate at rest) was decreased (P <.05). LAVI (left atrial volume index), peak mitral filling velocities during early (E) and late (A) diastole E/A ratio, DT(deceleration time of the mitral E wave), IVST(Interventricular septum thickness in diastole), tissue Doppler indice Mean Ea/Aa ratio (P <.05) were also improved. (2) Correlation analysis: 4 variates had significant effect on change of PeakVO2 in the exercise group: age (r =?0.39), change of HRrest (r = 0.59), change of E/A (r = 0.55), change of Mean Ea/Aa (r = 0.58); Through analyzing 2 groups patients ’ baseline values, their age (? = ?0.32), VO2AT (? = 0.29), HRrest (? = ?0.25), LAVI (? = ?0.24), E/A (? = 0.41) were found to be independent predictors of MeanEa/Aa. P-value under.05 was considered statistically significant. Conclusion. 6 months ’ exercise could enhance hypertensive patients ’ aerobic exercise level and diastolic function to a certain extent. 1.

Huan Zheng; Ming Luo; Yi Shen; Hong Fang

296

Effects of peripheral neuropathy on exercise capacity and quality of life in patients with chronic obstructive pulmonary diseases  

PubMed Central

Introduction Chronic obstructive pulmonary diseases (COPD) have some systemic effects including systemic inflammation, nutritional abnormalities, skeletal muscle dysfunction, and cardiovascular, skeletal and neurological disorders. Some studies have reported the presence of peripheral neuropathy (PNP) at an incidence of 28-94% in patients with COPD. Our study aimed to identify whether PNP affects exercise performance and quality of life in COPD patients. Material and methods Thirty mild-very severe patients with COPD (male/female = 29/1, mean age = 64 ±10 years) and 14 normal subjects (male/female = 11/5, mean age = 61 ±8 years) were included in the present study. All subjects underwent pulmonary function testing (PFT), cardiopulmonary exercise testing, electroneuromyography and short form 36 (SF-36). Results Peak oxygen uptake (PeakVO2) was lower in COPD patients (1.15 ±0.53 l/min) than healthy subjects (2.02 ±0.46 l/min) (p = 0.0001). There was no PNP in healthy subjects while 16 (53%) of the COPD patients had PNP. Forced expiratory volume in 1 s (FEV1) and PeakVO2 were significantly different between patients with PNP and those without (p = 0.009, p = 0.03 respectively). Quality of life of patients with PNP was lower than that of patients without PNP (p < 0.05). Conclusions The present study demonstrates the exercise limitation in COPD patients with PNP. Thus, presence of PNP has a poor effect on exercise capacity and quality of life in patients with COPD. Furthermore, treatment modalities for PNP can be recommended to these patients in order to improve exercise capacity and quality of life. PMID:22662003

Ulubay, Gaye; Ulasli, Sevinc Sarinc; Ozdemirel, Tugce; Karatas, Metin

2012-01-01

297

Feasibility of absolute cerebral tissue oxygen saturation during cardiopulmonary resuscitation  

PubMed Central

Introduction Current monitoring during cardiopulmonary resuscitation (CPR) is limited to clinical observation of consciousness, breathing pattern and presence of a pulse. At the same time, the adequacy of cerebral oxygenation during CPR is critical for neurological outcome and thus survival. Cerebral oximetry, based on near-infrared spectroscopy (NIRS), provides a measure of brain oxygen saturation. Therefore, we examined the feasibility of using NIRS during CPR. Methods Recent technologies (FORE-SIGHT™ and EQUANOX™) enable the monitoring of absolute cerebral tissue oxygen saturation (SctO2) values without the need for pre-calibration. We tested both FORE-SIGHT™ (five patients) and EQUANOX Advance™ (nine patients) technologies in the in-hospital as well as the out-of-hospital CPR setting. In this observational study, values were not utilized in any treatment protocol or therapeutic decision. An independent t-test was used for statistical analysis. Results Our data demonstrate the feasibility of both technologies to measure cerebral oxygen saturation during CPR. With the continuous, pulseless near-infrared wave analysis of both FORE-SIGHT™ and EQUANOX™ technology, we obtained SctO2 values in the absence of spontaneous circulation. Both technologies were able to assess the efficacy of CPR efforts: improved resuscitation efforts (improved quality of chest compressions with switch of caregivers) resulted in higher SctO2 values. Until now, the ability of CPR to provide adequate tissue oxygenation was difficult to quantify or to assess clinically due to a lack of specific technology. With both technologies, any change in hemodynamics (for example, ventricular fibrillation) results in a reciprocal change in SctO2. In some patients, a sudden drop in SctO2 was the first warning sign of reoccurring ventricular fibrillation. Conclusions Both the FORE-SIGHT™ and EQUANOX™ technology allow non-invasive monitoring of the cerebral oxygen saturation during CPR. Moreover, changes in SctO2 values might be used to monitor the efficacy of CPR efforts. PMID:23448653

2013-01-01

298

Normoxic and Hyperoxic Cardiopulmonary Bypass in Congenital Heart Disease  

PubMed Central

Cyanotic congenital heart disease comprises a diverse spectrum of anatomical pathologies. Common to all, however, is chronic hypoxia before these lesions are operated upon when cardiopulmonary bypass is initiated. A range of functional and structural adaptations take place in the chronically hypoxic heart, which, whilst protective in the hypoxic state, are deleterious when the availability of oxygen to the myocardium is suddenly improved. Conventional cardiopulmonary bypass delivers hyperoxic perfusion to the myocardium and is associated with cardiac injury and systemic stress, whilst a normoxic perfusate protects against these insults. PMID:25328889

Mokhtari, Amir

2014-01-01

299

Volcanological Exercises  

NSDL National Science Digital Library

This homework exercise, which builds on knowledge gained in previous homework exercises located at the same site, asks students in an undergraduate class at Tulane University to answer some basic questions about volcanoes, and to determine the volcanic hazards associated with Mt. Rainier, Washington; Montserrat, West Indies; and Long Valley Caldera, California by searching the World Wide Web.

Nelson, Stephen

300

Budget Exercise.  

ERIC Educational Resources Information Center

Following a discussion of the factors to be considered in constructing feasible college budgets, an exercise in budget development is presented involving a hypothetical community college with 2,500 full-time equivalent (FTE) students, 500 in developmental education, 750 each in transfer and technical programs, and 500 undecided. Exercise

Clowes, Darrel A.

301

A pilot study indicating that bradykinin B2 receptor antagonism attenuates protamine-related hypotension after cardiopulmonary bypass  

Microsoft Academic Search

Background: The administration of protamine to patients who received heparin during cardiopulmonary bypass (CPB) induces hypotension. Protamine inhibits the carboxypeptidase N–mediated degradation of bradykinin, a peptide that causes vasodilation and tissue-type plasminogen activator (t-PA) release. This study tests the primary hypothesis that blocking the bradykinin B2 receptor would attenuate protamine-related hypotension.Methods: We conducted a prospective, double-blind, randomized study in 16

Mias Pretorius; Frank G. Scholl; Julie A. McFarlane; Laine J. Murphey; Nancy J. Brown

2005-01-01

302

Preventive effect of gastrodin on cognitive decline after cardiac surgery with cardiopulmonary bypass: A double-blind, randomized controlled study  

Microsoft Academic Search

Summary  Cognitive decline is a common complication after cardiac surgery with cardiopulmonary bypass (CPB), but as such no pharmacological\\u000a therapy has been shown to be efficacious in preventing the decline. However, gastrodin has been shown to have multi-pharmacological\\u000a effects on neurological functions. We undertook this study to test the hypothesis that gastrodin would potentially prevent\\u000a CPB-associated neurocognitive decline. We randomly assigned

Zhao Zhang; Pu Ma; Younian Xu; Meijun Zhan; Yunjian Zhang; Shanglong Yao; Shihai Zhang

2011-01-01

303

Baroreflex regulation of blood pressure during dynamic exercise  

NASA Technical Reports Server (NTRS)

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.

Raven, P. B.; Potts, J. T.; Shi, X.; Blomqvist, C. G. (Principal Investigator)

1997-01-01

304

Limited influence of aspirin intake on mast cell activation in patients with food-dependent exercise-induced anaphylaxis: comparison using skin prick and histamine release tests.  

PubMed

Food-dependent exercise-induced anaphylaxis (FDEIA) is a severe systemic syndrome induced by physical exercise after ingesting causative food. Aspirin is a well-known trigger for anaphylaxis in patients with FDEIA. Possible mechanisms by which symptoms are aggravated by aspirin include enhanced antigen absorption and mast cell activation. The aim of this study was to determine whether aspirin intake has an influence on mast cell/basophil activation in patients with FDEIA. Provocation tests revealed that adding aspirin to the causative food challenge in 7 of 9 (77.8%) patients with FDEIA provoked symptoms. In most cases, pretreatment with aspirin did not enhance skin tests (71.4%) or histamine release tests (88.9%) with food allergen challenges. The study confirms that histamine release and skin prick tests can be adjunctive tools for diagnosing FDEIA. In addition, our results suggest that exacerbation of FDEIA symptoms by aspirin is not mediated by direct effects of aspirin on mast cell/basophil activation. PMID:22068206

Fukunaga, Atsushi; Shimizu, Hideki; Tanaka, Mami; Kikuzawa, Ayuko; Tsujimoto, Mariko; Sekimukai, Akiko; Yamashita, Junji; Horikawa, Tatsuya; Nishigori, Chikako

2012-09-01

305

Application of a new parameter in the 6-minute walk test for manifold analysis of exercise capacity in patients with COPD  

PubMed Central

Background New parameters in the 6-minute walk test (6MWT) are required for comprehensive analysis of exercise capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to apply a novel index, the desaturation distance ratio (DDR), to clinical research on COPD as an estimate of exercise capacity and to examine whether DDR is a potential parameter for manifold analysis of exercise capacity in patients with COPD. Methods A total of 41 patients with COPD (median age [interquartile range] =75 [68–79] years; and body mass index [BMI] =22.3 [19.4–23.8] kg/m2) participated in the study. The 6MWT was performed along with anthropometric measurements and a pulmonary function test. The “desaturation area” was measured as the total area above the curve created using peripheral oxygen saturation (SpO2) values observed at each minute during the 6MWT. Then the DDR was calculated as the ratio of the desaturation area to the 6-minute walk distance (6MWD). Results The 6MWD was 370 (328–445) m, and the decline in SpO2 values (?SpO2) was ?5.0% (?8.0% to ?1.5%). The DDR correlated modestly with baseline pulmonary function in patients with COPD (forced expiratory volume in 1 second [% of predicted value]: r=?0.658, P<0.001; and diffusing capacity of the lung for carbon monoxide [DLCO]: r=?0.470, P=0.002), comparable with the findings of the 6MWD. The DDR correlated well with ?SpO2 (r=?0.656, P<0.001) and with the increase in subjective sense of dyspnea during the 6MWT, as assessed by Borg scale scores (?Borg) (r=0.486, P=0.001), in contrast with the 6MWD, which was not significantly correlated with ?SpO2 and ?Borg scale scores. Conclusion The DDR is more informative for manifold analysis of exercise capacity associated with oxygen desaturation and subsequent sense of dyspnea by exercise in patients with COPD. PMID:25395845

Ijiri, Naoki; Kanazawa, Hiroshi; Yoshikawa, Takahiro; Hirata, Kazuto

2014-01-01

306

Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children  

PubMed Central

Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5th edition). Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF) patients scored significantly higher than the low-dose fentanyl (LDF) + dexmedetomidine (DEX) (LDF + DEX) group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046). The bispectral index (BIS) value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011). For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ) score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027). Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental outcome. PMID:25558192

Naguib, Aymen N.; Winch, Peter D.; Tobias, Joseph D.; Yeates, Keith O.; Miao, Yongjie; Galantowicz, Mark; Hoffman, Timothy M.

2015-01-01

307

Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds.  

PubMed

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

Cunha, F A; Montenegro, R A; Midgley, A W; Vasconcellos, F; Soares, P P; Farinatti, P

2014-08-01

308

Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds  

PubMed Central

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

Cunha, F.A.; Montenegro, R.A.; Midgley, A.W.; Vasconcellos, F.; Soares, P.P.; Farinatti, P.

2014-01-01

309

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

SciTech Connect

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.

Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan [Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States)

2009-11-15

310

Phenylephrine-Modulated Cardiopulmonary Blood Flow Measured with Use of X-ray Digital Subtraction Angiography  

PubMed Central

Introduction Cardiopulmonary blood flow is an important indicator of organ function. Limitations in measuring blood flow in live rodents suggest that rapid physiological changes may be overlooked. For instance, relative measurements limit imaging to whole organs or large sections without adequately visualizing vasculature. Additionally, current methods use small samples and invasive techniques that often require killing animals, limiting sampling speed, or both. A recently developed high spatial- and temporal-resolution x-ray digital subtraction angiography (DSA) system visualizes vasculature and measures blood flow in rodents. This study was the first to use this system to measure changes in cardiopulmonary blood flow in rats after administering the vasoconstrictor phenylephrine. Methods Cardiopulmonary blood flow and vascular anatomy was assessed in 11 rats before, during, and after recovery from phenylephrine. After acquiring DSA images at 12 time points, a calibrated non-parametric deconvolution technique using singular value decomposition (SVD) was applied to calculate quantitative aortic blood flow in absolute metrics (mL/min). Trans-pulmonary transit time was calculated as the time interval between maximum signal enhancement in the pulmonary trunk and aorta. Pulmonary blood volume was calculated based on the central volume principle. Statistical analysis compared differences in trans-pulmonary blood volume and pressure, and aortic diameter using paired t-tests on baseline, peak, and late-recovery time points. Results Phenylephrine had dramatic qualitative and quantitative effects on vascular anatomy and blood flow. Major vessels distended significantly (aorta, ~1.2-times baseline) and mean arterial blood pressure increased ~2 times. Pulmonary blood volume, flow, pressure, and aortic diameter were not significantly different between baseline and late recovery, but differences were significant between baseline and peak, as well as peak and recovery time points. Discussion The DSA system with calibrated SVD technique acquired blood flow measurements every 30 seconds with a high level of regional specificity, thus providing a new option for in vivo functional assessment in small animals. PMID:21846505

Lin, MingDe; Qi, Yi; Chen, Antonia F.; Badea, Cristian T.; Johnson, G. Allan

2011-01-01

311

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

PubMed Central

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 (100×100 ?m2). 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 18.90×CODSA=COFick. 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. PMID:19994543

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

2009-01-01

312

Oxygen consumption in hemodialysis patients undergoing cardiopulmonary bypass  

Microsoft Academic Search

Objectives: Cardiopulmonary bypass (CPB) can be successfully performed in patients on hemodialysis. However, ischemic complications occur more often in these patients. This could partly be because of shunting through the arteriovenous (AV) fistula during CPB, resulting in reduced peripheral flow and oxygen (O2) delivery. Inadequate oxygen delivery during CPB should be reflected in a lower oxygen consumption (VO2) compared with

Waheedullah Karzai; Hans-Joachim Priebe

1998-01-01

313

Family presence during cardiopulmonary resuscitation and invasive procedures in children  

PubMed Central

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

Ferreira, Cristiana Araújo G.; Balbino, Flávia Simphronio; Balieiro, Maria Magda F. G.; Mandetta, Myriam Aparecida

2014-01-01

314

Retention of Cardiopulmonary Resuscitation Skills by Medical Students.  

ERIC Educational Resources Information Center

A study of preclinical medical students' cardiopulmonary resuscitation (CPR) skills showed students had a very recent CPR course had a significantly lower failure rate than those with courses one or two years previously. The most frequent errors were in chest compression rate and inability to adhere to the single-rescuer compression-to-ventilation…

Fossel, Michael; And Others

1983-01-01

315

Minimally invasive cardiopulmonary bypass: does it really change the outcome?  

Microsoft Academic Search

INTRODUCTION: Many innovative cardiopulmonary bypass (CPB) systems have recently been proposed by the industry. With few differences, they all share a philosophy based on priming volume reduction, closed circuit with separation of the surgical field suction, centrifugal pump, and biocompatible circuit and oxygenator. These minimally invasive CPB (MICPB) systems are intended to limit the deleterious effects of a conventional CPB.

Marco Ranucci; Giuseppe Isgrò

2007-01-01

316

Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 2. Pulmonary Rehabilitation Review  

Microsoft Academic Search

Alba AS, Kim H, Whiteson JH, Bartels MN. Cardiopulmonary rehabilitation and cancer rehabilitation. 2. Pulmonary rehabilitation review.Pulmonary rehabilitation includes the rehabilitation of not only patients with respiratory failure in need of ventilatory support but also patients with primary pulmonary disease. New advances in medical management now offer treatment to patients with end-stage emphysema, pulmonary hypertension, and interstitial disease, and the

Augusta S. Alba; Heakyung Kim; Jonathan H. Whiteson; Matthew N. Bartels

2006-01-01

317

Transthoracic echocardiography for cardiopulmonary monitoring in intensive care  

Microsoft Academic Search

Summary Background and objective: To evaluate the feasibility of an abbreviated focus assessed transthoracic echocardio- graphic protocol, consisting of four standardized acoustic views for cardiopulmonary screening and monitoring. Methods: The protocol was applied in 210 patients in a 20-bed multidisciplinary intensive care unit in a univer- sity hospital. When inconclusive, an additional transoesophageal echocardiographic examination was performed. Diagnosis, indication, acoustic

M. B. Jensen; E. Sloth; K. M. Larsen; M. B. Schmidt

2004-01-01

318

Exercise stress testing and an electromechanical S wave of the electrocardiogram. Does the S-wave voltage change with increasing work rate?  

PubMed

A new view of the electrocardiogram, first proposed by Posel and arising from Craib's travelling dipole concept, predicts an electromechanical relationship between S-wave amplitude changes and cardiac mechanical function changes. In an attempt to determine whether the S-wave voltage changes with increasing work rate, 10 male subjects were tested at rest and at maximum exercise. A statistically significant increase in the S wave occurred with increased mechanical work. The theoretical prediction of an electromechanical S wave is thus validated and a request is extended to other workers to verify or refute its existence. PMID:1154158

Katzeff, I E; Edwards, H

1975-06-28

319

Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial  

PubMed Central

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

2013-01-01

320

Humanized animal exercise model for clinical implication.  

PubMed

Exercise and physical activity function as a patho-physiological process that can prevent, manage, and regulate numerous chronic conditions, including metabolic syndrome and age-related sarcopenia. Because of research ethics and technical difficulties in humans, exercise models using animals are requisite for the future development of exercise mimetics to treat such abnormalities. Moreover, the beneficial or adverse outcomes of a new regime or exercise intervention in the treatment of a specific condition should be tested prior to implementation in a clinical setting. In rodents, treadmill running (or swimming) and ladder climbing are widely used as aerobic and anaerobic exercise models, respectively. However, exercise models are not limited to these types. Indeed, there are no golden standard exercise modes or protocols for managing or improving health status since the types (aerobic vs. anaerobic), time (morning vs. evening), and duration (continuous vs. acute bouts) of exercise are the critical determinants for achieving expected beneficial effects. To provide insight into the understanding of exercise and exercise physiology, we have summarized current animal exercise models largely based on aerobic and anaerobic criteria. Additionally, specialized exercise models that have been developed for testing the effect of exercise on specific physiological conditions are presented. Finally, we provide suggestions and/or considerations for developing a new regime for an exercise model. PMID:24647666

Seo, Dae Yun; Lee, Sung Ryul; Kim, Nari; Ko, Kyung Soo; Rhee, Byoung Doo; Han, Jin

2014-09-01

321

Exercise Habit  

MedlinePLUS

... bicycle the next. Consider activities like dancing and racquet sports, and even chores like vacuuming or mowing the ... on a regular basis. How can I prevent injuries? To avoid injuring yourself during exercise, don’t ...

322

Seismological Exercises  

NSDL National Science Digital Library

This homework exercise, which was designed for an undergraduate level geology class at Tulane University, asks the student to make evaluations about the Loma Prieta Earthquake and other earthquakes using seismograms, time travel curves, maps and other information.

Nelson, Stephen

323

Exercise and fatigue in rheumatoid arthritis.  

PubMed

Fatigue, the enduring sensation of weakness, lack of energy, tiredness or exhaustion, is described by 40%-80% of patients with rheumatoid arthritis as their most disabling symptom with wide-ranging consequences for quality of life. Little attention has been paid to its multidimensional nature or to its reliability as a measure to evaluate progression of the disease. Low impact aerobic exercise affects the level of fatigue, and this same level of fatigue influences the exercise itself. We searched Medline, Cochrane Collaboration Register of Controlled Trials (CCRCT), Lilacs, PubMed and Scopus databases for randomized controlled trials (with appropriate description of methods, materials and results) on the assessment of fatigue and exercise. Review articles, case reports, letters to the editor and editorials were excluded. Of 121 references initially identified, 4 randomized controlled trials met the inclusion criteria. Two studies used the MAF scale (Multidimensional Assessment of Fatigue), one used the MAC (Mental Adjustment to Cancer) fatigue scale, and all trials used POMS (Profile of Mood States) to assess fatigue. All four trials conducted a 12 week program of two to three times/ week and different periods of follow-up. Two studies used low impact aerobic exercise, one used dance-based exercise, and another study followed a home cardiopulmonary conditioning program using a stationary bicycle. While fatigue appears to be a reliable outcome measure in the clinical management of RA, especially when related to exercise prescription, further research is needed to evaluate the correlation between exercise, fatigue and quality of life, using fatigue scales validated to explore the different components of fatigue and its wide-ranging consequences. PMID:24575509

Balsamo, Sandor; Diniz, Leonardo R; dos Santos-Neto, Leopoldo L; da Mota, Licia M H

2014-01-01

324

Arthritis and Aerobic Exercise: A Review.  

ERIC Educational Resources Information Center

Arthritic patients who regularly do aerobic exercise make significant gains in aerobic and functional status, and in subjective areas like pain tolerance and mood. Still, they are often advised to curtail physical activity. Guidelines are presented for physicians prescribing aerobic exercise. An exercise tolerance test is recommended. (SM)

Ike, Robert W.; And Others

1989-01-01

325

Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction  

SciTech Connect

Thrombolytic therapy has become the treatment of choice for patients with acute myocardial infarction. Researchers are not yet able to identify patients with salvage of myocardium who are at risk for recurrent coronary events. Thus, a prospective trial was performed in 46 patients with myocardial infarction (28 anterior and 18 inferior) who received thrombolytic therapy to determine if early thallium tomography (4.7 days) using oral dipyridamole would identify more patients with residual ischemia than early symptom-limited exercise treadmill tests (5.5 days). There were no complications during the exercise treadmill tests or oral dipyridamole thallium tomography. Mean duration of exercise was 11 +/- 3 minutes and the peak heart rate was 126 beats/min. Thirteen patients had positive test results. After oral dipyridamole all patients had abnormal thallium uptake on the early images. Positive scans with partial filling in of the initial perfusion defects were evident in 34 patients. Angina developed in 13 patients and was easily reversed with intravenous aminophylline. Both symptom-limited exercise treadmill tests and thallium tomography using oral dipyridamole were safely performed early after myocardial infarction in patients receiving thrombolytic therapy. Thallium tomography identified more patients with residual ischemia than exercise treadmill tests (74 vs 28%). Further studies are required to determine whether the results of thallium tomography after oral dipyridamole can be used to optimize patient management and eliminate the need for coronary angiography in some patients.

Jain, A.; Hicks, R.R.; Frantz, D.M.; Myers, G.H.; Rowe, M.W. (Univ. of North Carolina Hospitals, Chapel Hill (USA))

1990-09-01

326

Cardiopulmonary Fitness and Heart Rate Recovery as Predictors of Mortality in a Referral Population  

PubMed Central

Background Exercise testing provides valuable information in addition to ST?segment changes. The present study evaluated the associations among exercise test parameters and all?cause mortality in a referral population. Methods and Results We examined conventional cardiovascular risk factors and exercise test parameters in 6546 individuals (mean age 49 years, 58% men) with no known cardiovascular disease who were referred to our clinic for exercise stress testing between 1993 and 2003. The association of exercise parameters with mortality was assessed during a follow?up of 8.1±3.7 years. A total of 285 patients died during the follow?up period. Adjusting for age and sex, the variables associated with mortality were: smoking, diabetes, functional aerobic capacity (FAC), heart rate recovery (HRR), chronotropic incompetence, and angina during the exercise. Adjusting for cardiovascular risk factors (diabetes, smoking, body mass index, blood pressure, serum total, HDL, LDL cholesterol, and triglycerides) and other exercise variables in a multivariable model, the only exercise parameters independently associated with mortality were lower FAC (adjusted hazard ratio [HR] per 10% decrease in FAC, 1.21; 95% confidence interval [CI], 1.13 to 1.29; P<0.001), and abnormal HRR, defined as failure to decrease heart rate by 12 beats at 1 minute recovery (adjusted HR per 1?beat decrease, 1.05; 95% CI, 1.03 to 1.07; P<0.001). The additive effects of FAC and HRR on mortality were also highly significant when considered as categorical variables. Conclusion In this cohort of patients with no known cardiovascular disease who were referred for exercise electrocardiography, FAC and HRR were independently associated with all?cause mortality. PMID:24663334

Dhoble, Abhijeet; Lahr, Brian D.; Allison, Thomas G.; Kopecky, Stephen L.

2014-01-01

327

Out-of-hospital cardiac arrest: determinant factors for immediate survival after cardiopulmonary resuscitation1  

PubMed Central

OBJECTIVE: to analyze determinant factors for the immediate survival of persons who receive cardiopulmonary resuscitation from the advanced support units of the Mobile Emergency Medical Services (SAMU) of Belo Horizonte. METHOD: this is a retrospective, epidemiological study which analyzed 1,165 assistance forms, from the period 2008 - 2010. The collected data followed the Utstein style, being submitted to descriptive and analytical statistics with tests with levels of significance of 5%. RESULTS: the majority were male, the median age was 64 years, and the ambulance response time, nine minutes. Immediate survival was observed in 239 persons. An association was ascertained of this outcome with "cardiac arrest witnessed by persons trained in basic life support" (OR=3.49; p<0.05; CI 95%), "cardiac arrest witnessed by Mobile Emergency Medical Services teams" (OR=2.99; p<0.05; CI95%), "only the carry out of basic life support" (OR=0.142; p<0.05; CI95%), and "initial cardiac rhythm of asystole" (OR=0.33; p<0.05; CI 95%). CONCLUSION: early access to cardiopulmonary resuscitation was related to a favorable outcome, and the non-undertaking of advanced support, and asystole, were associated with worse outcomes. Basic and advanced life support techniques can alter survival in the event of cardiac arrest. PMID:25296138

Morais, Daniela Aparecida; Carvalho, Daclé Vilma; Correa, Allana dos Reis

2014-01-01

328

Non-thyroidal illness syndrome and cardiopulmonary bypass in children with congenital heart disease  

PubMed Central

Background: The thyroid hormones influence on all metabolic pathways. After heart surgery using cardiopulmonary bypass (CPB), serum T3 decreases and remains low for at least 24 hours. Several studies on pediatric have reported reduction of thyroid hormones after heart surgery. This study aimed to investigate the status of thyroid function tests in children with CPB surgery. Methods: This study was carried out based on the available data on 132 children aged less than 15 years suffering from CHD. The patients underwent open heart surgery in Rajaie Center in Iran from January to November 2010. The thyroid hormone levels were measured shortly after admission, and postoperatively in Intensive Care Unit (ICU) and thereafter at 12, 24 and 48-hour intervals. The patients’ gender, age, weight, body mass index, heart disease details, previous cardiac surgeries, and cardiac surgery-related data such as pump time, aortic clamping time, hypothermia duration, postoperative hemodynamic status and postoperative use of inotropic drugs were recorded and analyzed Results: All patients showed a decrease in T3, T4 and TSH and an increase in T3-resin uptake after surgery. Eventually, 3 (3.2%) patients died. Preoperatively, there was a significant association between the reduction in the thyroid hormone levels and inotropic drugs as well as the type of the heart disease (p<0.05). Conclusion: There is an association between post-operative inotropic drugs administration and reduction thyroid hormones levels in patients undergoing congenital heart disease cardiopulmonary bypass surgery. PMID:25489437

Babazadeh, Kazem; Tabib, Avisa; Eshraghi, Peyman; Bakhshandeh, Hooman; Zamani, Hassan

2014-01-01

329

Biotechnological traps for the reduction of inflammation due to cardiopulmonary bypass operations.  

PubMed

Cardiopulmonary bypass induces a systemic inflammatory response (SIR), characterized by the activation of cellular and humoral elements, with concomitant release of neutrophil elastase and matrix-metallo proteinases. In the present study, the protease release during extracorporeal circulation in 28 patients undergoing cardiac surgical operations was monitored using casein zymography. A peak in protease activity was found in all patients at the end of cardiopulmonary bypass. Plasma samples of patients were allowed to interact with different traps obtained by immobilizing different protease inhibitors on specific carriers. alpha1-Antitrypsin, Bovine Pancreatic Trypsin Inhibitor, Elastatinal or Leupeptin were used as inhibitors and were covalently immobilized by diazotization or by condensation. A reduction in the proteolytic activity of the plasma samples was observed after interaction with the different traps. The most efficient traps, i.e. the ones displaying greatest power to inhibit protease activity, were those obtained by immobilizing Bovine Pancreatic Trypsin Inhibitor and Leupeptin. The biocompatibility of traps was also tested. Results show that protease activity in blood can be decreased by our protease traps. PMID:16533521

Grano, Valentina; Salamino, Franca; Melloni, Edon; Minafra, Roberto; Regola, Eliana; Diano, Nadia; Nicolucci, Carla; Attanasio, Angelina; Nappi, Gianantonio; Cotrufo, Maurizio; Maresca, Lucio; De Santo, Natale Gaspare; Mita, Damiano Gustavo

2006-07-01

330

Noncontact accurate measurement of cardiopulmonary activity using a compact quadrature Doppler radar sensor.  

PubMed

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

Hu, Wei; Zhao, Zhangyan; Wang, Yunfeng; Zhang, Haiying; Lin, Fujiang

2014-03-01

331

Safety and feasibility of maximal physical testing in rheumatic diseases: a cross-sectional study with 5,910 assessments.  

PubMed

The purpose of the study was to report on the safety and feasibility of the application of maximal physical tests in a heterogeneous cohort of rheumatic patients. This is a 5-year retrospective descriptive report on the incidence of events associated with maximal physical testing from 536 patients, totalizing 5,910 tests. Tests were classified as cardiopulmonary, muscle strength, and physical functioning tests. Any adverse events during the tests and limiting factors incurring in tests cancellation were reported. Eighteen out of 641 cardiopulmonary exercise tests had an adverse occurrence, with cardiac disturbance (1.4 % of total tests) being the most prevalent. Moreover, 14 out of 641 tests were not feasible. Out of 3,478 tests comprising leg press, bench press, knee extension, and handgrip tests, 15 tests had an adverse event. The most common occurrence was joint pain (0.4 % of total tests), which was also the most frequent factor precluding testing (0.5 % of total tests). Forty-five out of 3,478 (1.3 %) of the tests were not feasible. There was a very low incidence of events (0.2 %) during the physical functioning tests. Joint pain was the only adverse event during the tests, whereas physical limitations were the most important barriers for the execution of the tests (1.1 % of total tests). The incidence of limiting events in this test was 1.6 % (n = 29). This report brings new data on the safety and feasibility of maximal physical testing in rheumatic patients. The physical tests described in this study may be applied for testing rheumatic patients both in research and clinical setting. PMID:25373541

Ferraz, Rodrigo Branco; Gualano, Bruno; Filho, Carlos Merege; Almeida, Murilo Groschitz; Perandini, Luiz Augusto; Dassouki, Thalita; Sá-Pinto, Ana Lúcia; Lima, Fernanda Rodrigues; Roschel, Hamilton

2014-11-01

332

Mineral Classification Exercise  

NSDL National Science Digital Library

This exercise is designed to help students think about the properties of minerals that are most useful for mineral classification and identification. Students are given a set of minerals and asked to come up with a hierarchical classification scheme (a "key") that can be used to identify different mineral species. They compare their results with the products of other groups. They test the various schemes by applying them to unknown samples. While doing this exercise, the students develop observational and interpretational skill. They also begin to think about the nature of classification systems.

Perkins, Dexter

333

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

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

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

334

The effect of muscle phospholipid fatty acid composition on exercise performance: a direct test in the migratory white-throated sparrow (Zonotrichia albicollis).  

PubMed

Dietary polyunsaturated fatty acids (PUFA) can have various effects on animal physiology through their roles as energy, structural, regulatory, and signaling molecules. Of recent interest has been the incorporation of dietary PUFA into muscle membranes as phospholipids, thereby potentially affecting exercise performance by mechanisms such as altered mitochondrial proton leak and membrane-bound protein activity. We first studied the effects of a high-omega6 PUFA diet vs. a high-omega3 PUFA diet on peak metabolic rate (PMR) in white-throated sparrows, and additionally measured mRNA expression of fatty acid transporters and the activity of major oxidative enzymes. Our experiment, thus, allowed a test of the "natural doping" hypothesis. With a simple diet manipulation, the two groups of sparrows diverged significantly in both muscle phospholipid composition and adipose triacylglycerol composition. The high-omega6 sparrows achieved higher PMR without a change in enzyme activity or transporter expression. We then fed sparrows the 2 diets, followed by a food restriction (H omega3RI and H omega6RI treatments). When their adipose stores were exhausted, we fed both groups a common diet of intermediate fatty acid composition. This protocol resulted in the H omega6RI and H omega3RI groups diverging significantly in muscle phospholipid composition, but they had substantially similar adipose stores. PMR did not differ between the H omega6RI and H omega3RI groups. We conclude that muscle phospholipids do not play a major role in affecting exercise performance. The fatty acid composition of stored triacylglycerol may instead affect exercise via the preferential use of particular fatty acids by muscles. PMID:19587112

Price, Edwin R; Guglielmo, Christopher G

2009-09-01

335

Norepinephrine and atrial natriuretic peptide responses to exercise testing in rehabilitated and nonrehabilitated men with ischemic cardiomyopathy after healing of anterior wall acute myocardial infarction  

Microsoft Academic Search

In conclusion, a long-term cardiac rehabilitation program can improve exercise performance in patients with ischemic cardiomyopathy, and resting plasma levels of ANP and NE are sensitive indexes of exercise performance.

Joseph Shemesh; Ehud Grossman; Edna Peleg; Adam Steinmetz; Talma Rosenthal; Michael Motro

1995-01-01

336

Gradual versus continuous increase of load in ergometric tests: are the results comparable?  

PubMed

Standard exercise testing (ET) comprises progressive exercise provocation with cardiovascular monitoring. Exercise tolerance is estimated by workload. Cardiopulmonary exercise testing (CPX) is a non-invasive measurement of ventilatory gas exchange which provides more accurate quantifications of cardiorespiratory fitness (CRF). Workload is usually increased stepwise in ET and continuously (ramp) in CPX. Our aim was to examine the comparability of the results. Thirty two healthy volunteers (17 females/15 males, age 26.8?±?6.1 years, BMI 24.5?±?3.0) underwent exercise testing on a bicycle ergometer up to maximum physical exhaustion; under ramp protocol (CPX) and 2-7 days later with a stepwise increase of workload (ET). We compared the physical work capacity under both methods at maximum workload, at heart rate of 150 and 170 beats/min (PWC150 and PWC170), and the exercise duration. We found that there were no statistically significant differences in the maximum heart rate (CPX: 177.1?±?11.7/min vs. ET: 178.5?±?11.2/min) or maximal workload (CPX: 219.8?±?50.6 vs. ET: 209.4?±?42.5). PWC150 and PWC150/kg were higher with CPX than those with ET (156.6?±?51 vs. 146.4?±?42.3, p?Exercise duration was almost equal (12.1 vs. 11.3 min). We conclude that overall physical performance was higher with CPX. Since the results are similar, we recommend the CPX: wattage and other parameters in performance assessment are to be determined directly, interpolations are obsolete. PMID:25256339

Preisser, A M; Velasco Garrido, M; Bittner, C; Hampel, E; Harth, V

2015-01-01

337

[Metabolic intolerance to exercise].  

PubMed

Exercise intolerance (EI) is a frequent cause of medical attention, although it is sometimes difficult to come to a final diagnosis. However, there is a group of patients in whom EI is due to a metabolic dysfunction. McArdle's disease (type V glucogenosis) is due to myophosphorylase (MPL) deficiency. The ischemic exercise test shows a flat lactate curve. The most frequent mutations in the PYGM gene (MPL gene) in Spanish patients with MPL deficiency are R49X and W797R. Carnitine palmitoyltransferase (CPT) II deficiency is invariably associated to repetitive episodes of myoglobinuria triggered by exercise, cold, fever or fasting. The diagnosis depends on the demonstration of CPT II deficiency in muscle. The most frequent mutation in the CPT2 gene is the S113L. Patients with muscle adenylate deaminase deficiency usually show either a mild myopathy or no symptom. The diagnosis is based on the absence of enzyme activity in muscle and the lack of rise of ammonia in the forearm ischemic exercise test. The mutation Q12X in the AMPD1 gene is strongly associated with the disease. Exercise intolerance is a common complaint in patients with mitochondrial respiratory chain (MRC) deficiencies, although it is often overshadowed by other symptoms and signs. Only recently we have come to appreciate that exercise intolerance can be the sole presentation of defects in the mtDNA, particularly in complex I, complex III, complex IV, or in some tRNAs. In addition, myoglobinuria can be observed in patients under statin treatment, particularly if associated with fibrates, due to an alteration in the assembly of the complex IV of the MRC. PMID:12838448

Arenas, J; Martín, M A

2003-01-01

338

Biocompatibility of silicone-coated oxygenator in cardiopulmonary bypass  

Microsoft Academic Search

Background. This study was designed to analyze the biocompatibility of silicone-coated oxygenators using inflammatory response as the outcome measure, and to investigate whether the silicone-coated oxygenators perform better in terms of postoperative organ dysfunction.Methods. The 32 patients who underwent cardiopulmonary bypass (CPB) were divided into 3 groups: group A (n = 10), heparin-coated circuit with silicone-coated oxygenator; group B (n

Akira Shimamoto; Shinji Kanemitsu; Kazuya Fujinaga; Motoshi Takao; Koji Onoda; Takatsugu Shimono; Kuniyoshi Tanaka; Hideto Shimpo; Isao Yada

2000-01-01

339

Cerebral Hypoxia During Cardiopulmonary Bypass: A Magnetic Resonance Imaging Study  

Microsoft Academic Search

Background. Neurocognitive deficits after open heart operations have been correlated to jugular venous oxygen desaturation on rewarming from hypothermic cardiopulmonary bypass (CPB). Using a porcine model, we looked for evidence of cerebral hypoxia by magnetic resonance imaging during CPB. Brain oxygenation was assessed by T2?-weighted imaging, based on the blood oxygenation level-dependent effect (decreased T2?-weighted signal intensity with increased tissue

W. Alan C Mutch; Lawrence N Ryner; Piotr Kozlowski; Gordon Scarth; R. Keith Warrian; Gerald R Lefevre; Ted G Wong; Darren B Thiessen; Linda G Girling; Leonard Doiron; Chris McCudden; John K Saunders

1997-01-01

340

Traditional games resulted in post-exercise hypotension and a lower cardiovascular response to the cold pressor test in healthy children  

PubMed Central

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

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

341

Traditional games resulted in post-exercise hypotension and a lower cardiovascular response to the cold pressor test in healthy children.  

PubMed

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

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

342

Video-assisted minimally invasive coronary operations without cardiopulmonary bypass: A multicenter study  

Microsoft Academic Search

Objective: The need to avoid the risks associated with cardiopulmonary bypass has led to the interest in coronary operations without cardiopulmonary bypass. Patients and methods: From April 1994 to September 1995, 44 patients (mean age 63.3 ± 10.0 years, range 43 to 83 years) were selected for video-assisted coronary artery bypass grafting without cardiopulmonary bypass through a small anterior thoracotomy.

Federico Benetti; Massimo A. Mariani; Guido Sani; Piet W. Boonstra; Jan G. Grandjean; Pierpaolo Giomarelli; Michele Toscano

1996-01-01

343

Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial  

PubMed Central

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

2012-01-01

344

Reliability and clinical correlates of the Astrand-Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder.  

PubMed

Cardiovascular fitness is reduced in people with schizophrenia and is related to an increased morbidity and mortality. There is mounting interest in the accurate measurement of cardiovascular fitness in schizophrenia, yet existing measures used in the general population have not been tested on validity and reliability in this high-risk group. Therefore, we examined the reproducibility and feasibility of the Astrand-Rhyming sub-maximal exercise test in patients with schizophrenia or schizoaffective disorder. Secondary aims were to assess minimal detectable changes, practice effects and the presence of clinical symptoms that are associated with cardio-respiratory fitness (expressed as estimated oxygen uptake). From 47 patients with schizophrenia or schizoaffective disorder two trials of the Astrand-Rhyming test, administered within three days, were analysed. The intraclass correlation coefficient for the estimated oxygen uptake between the two tests was 0.92 (95% confidence interval: 0.85-0.95). The minimal detectable change was 6.5mlO2/min/kg. No practice effect could be detected. A backward regression analysis demonstrated that illness duration, negative symptoms and level of physical activity explained 63.0% of the variance in estimated oxygen uptake. The current study demonstrates that the Astrand-Rhyming test can be recommended for evaluating the aerobic fitness in patients with schizophrenia or schizoaffective disorder. PMID:25246409

Vancampfort, Davy; Guelinckx, Hannes; De Hert, Marc; Stubbs, Brendon; Soundy, Andrew; Rosenbaum, Simon; De Schepper, Els; Probst, Michel

2014-12-30

345

Reliability of the Swedish version of the Exercise Self-Efficacy Scale (S-ESES): a test-retest study in adults with neurological disease.  

PubMed

Abstract Objective: To examine the test-retest reliability of the Swedish translated version of the Exercise Self-Efficacy Scale (S-ESES) in people with neurological disease and to examine internal consistency. Design: Test-retest study. Subjects: A total of 30 adults with neurological diseases including: Parkinson's disease; Multiple Sclerosis; Cervical Dystonia; and Charcot Marie Tooth disease. Method: The S-ESES was sent twice by surface mail. Completion interval mean was 16 days apart. Weighted kappa, intraclass correlation coefficient 2,1 [ICC (2,1)], standard error of measurement (SEM), also expressed as a percentage value (SEM%), and Cronbach's alpha were calculated. Results: The relative reliability of the test-retest results showed substantial agreement measured using weighted kappa (MD?=?0.62) and a very high-reliability ICC (2,1) (0.92). Absolute reliability measured using SEM was 5.3 and SEM% was 20.7. Excellent internal consistency was shown, with an alpha coefficient of 0.91 (test 1) and 0.93 (test 2). Conclusion: The S-ESES is recommended for use in research and in clinical work for people with neurological diseases. The low-absolute reliability, however, indicates a limited ability to measure changes on an individual level. PMID:25418018

Ahlström, Isabell; Hellström, Karin; Emtner, Margareta; Anens, Elisabeth

2014-11-24

346

21 CFR 870.4290 - Cardiopulmonary bypass adaptor, stopcock, manifold, or fitting.  

Code of Federal Regulations, 2014 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4290 Cardiopulmonary...manifold, or fitting is a device used in cardiovascular diagnostic, surgical, and...

2014-04-01

347

21 CFR 870.4290 - Cardiopulmonary bypass adaptor, stopcock, manifold, or fitting.  

Code of Federal Regulations, 2013 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4290 Cardiopulmonary...manifold, or fitting is a device used in cardiovascular diagnostic, surgical, and...

2013-04-01

348

21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing....

2013-04-01

349

Modulation of skin sensitivity by dynamic and isometric exercise in man  

Microsoft Academic Search

Summary  The effect of dynamic cycle ergometer exercise and isometric leg exercise on skin sensitivity was studied in man. Exercise was performed at different loads. Cutaneous sensitivity to innocuous and noxious thermal stimuli was tested using a contact thermostimulator and sensitivity to tactile stimuli was tested using electrical stimuli. During isometric exercise a segmental (the exercising limb), but not a multisegmental,

Pekka Paalasmaa; Pentti Kemppainen; Antti Pertovaara

1991-01-01

350

Determinants of exercise peak arterial blood pressure, circulatory power, and exercise cardiac power in a population based sample of Finnish male and female aged 30 to 47 years: the Cardiovascular Risk in Young Finns Study  

PubMed Central

Background Novel parameters derived from peak maximal oxygen uptake (VO2) and exercise arterial blood pressure, such as peak circulatory power (CP) and exercise cardiac power (ECP), can be used in the risk assessment of cardiovascular disease and stroke. However, the determinants of these factors are poorly characterized in the general population. Methods We assessed peak arterial blood pressure, CP and ECP with standardized cardiopulmonary exercise test (CPET) on 281 female and 257 male participants of the Cardiovascular Risk in Young Finns Study. The subjects were aged 30–47 years. Peak VO2 as well as systolic and diastolic arterial blood pressures were measured to calculate peak mean arterial pressure, CP and ECP. These parameters were assessed for correlation with sex, age, height, weight, waist-to-hip ratio, smoking, physical activity index (PAI), fasting insulin and glucose levels as well as the use of antihypertensive treatment. Results Sex, age and weight explained 36% of the variation in peak systolic blood pressure, and these factors in combination with height and the use of antihypertensive treatment explained 13% of the variation in peak diastolic blood pressure. Sex, height, weight, waist-to-hip ratio, PAI and smoking explained 49%???52% of the variation in peak CP. Sex, age, height, weight, waist-to-hip ratio, PAI, smoking and insulin levels explained 21%???49% of variation in ECP. Conclusions Subject demographics and lifestyle-related factors should be taken into account when exercise blood pressure response, CP and ECP are used to evaluate patients’ cardiac function in CPET. PMID:24621399

2014-01-01

351

Flooding Exercises  

NSDL National Science Digital Library

This homework exercise, developed for an undergraduate geology course at Tulane University, leads students through the steps involved in determining the probability that a flood of a given discharge will occur in any given year. Students retrieve discharge data from U.S. Geological Services Internet sites for Dry Creek, LA, Rapid Creek, SD and Red River, ND to make their calculations.

Nelson, Stephen

352

Exercise apparatus  

NASA Technical Reports Server (NTRS)

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.

Schaffner, Grant (Inventor); Bentley, Jason R. (Inventor); Loehr, James A. (Inventor); Gundo, Daniel P. (Inventor)

2006-01-01

353

PBMCs express a transcriptome signature predictor of oxygen uptake responsiveness to endurance exercise training in men.  

PubMed

Peripheral blood cells are an accessible environment in which to visualize exercise-induced alterations in global gene expression patterns. We aimed to identify a peripheral blood mononuclear cell (PBMC) signature represented by alterations in gene expression, in response to a standardized endurance exercise training protocol. In addition, we searched for molecular classifiers of the variability in oxygen uptake (V?o2). Healthy untrained policemen recruits (n = 13, 25 ± 3 yr) were selected. Peak V?o2 (measured by cardiopulmonary exercise testing) and total RNA from PBMCs were obtained before and after 18 wk of running endurance training (3 times/wk, 60 min). Total RNA was used for whole genome expression analysis using Affymetrix GeneChip Human Gene 1.0 ST. Data were normalized by the robust multiarray average algorithm. Principal component analysis was used to perform correlations between baseline gene expression and V?o2peak. A set of 211 transcripts was differentially expressed (ANOVA, P < 0.05 and fold change > 1.3). Functional enrichment analysis revealed that transcripts were mainly related to immune function, cell cycle processes, development, and growth. Baseline expression of 98 and 53 transcripts was associated with the absolute and relative V?o2peak response, respectively, with a strong correlation (r > 0.75, P < 0.01), and this panel was able to classify the 13 individuals according to their potential to improve oxygen uptake. A subset of 10 transcripts represented these signatures to a similar extent. PBMCs reveal a transcriptional signature responsive to endurance training. Additionally, a baseline transcriptional signature was associated with changes in V?o2peak. Results might illustrate the possibility of obtaining molecular classifiers of endurance capacity changes through a minimally invasive blood sampling procedure. PMID:25465030

Dias, Rodrigo Gonçalves; Silva, Michelle Sabrina Moreira; Duarte, Nubia Esteban; Bolani, Wladimir; Alves, Cleber Renê; Junior, José Ribeiro Lemos; da Silva, Jeferson Luis; de Oliveira, Patrícia Alves; Alves, Guilherme Barreto; de Oliveira, Edilamar Menezes; Rocha, Cristiane Souza; Marsiglia, Julia Daher Carneiro; Negrao, Carlos Eduardo; Krieger, Eduardo Moacyr; Krieger, José Eduardo; Pereira, Alexandre Costa

2015-02-01

354

Predicting short and long-term exercise intentions and behaviour in patients with coronary artery disease: A test of protection motivation theory.  

PubMed

The purpose of this study was to examine the utility of protection motivation theory (PMT) in the prediction of exercise intentions and behaviour in the year following hospitalisation for coronary artery disease (CAD). Patients with documented CAD (n = 787), recruited at hospital discharge, completed questionnaires measuring PMT's threat (i.e. perceived severity and vulnerability) and coping (i.e. self-efficacy, response efficacy) appraisal constructs at baseline, 2 and 6 months, and exercise behaviour at baseline, 6 and 12 months post-hospitalisation. Structural equation modelling showed that the PMT model of exercise at 6 months had a good fit with the empirical data. Self-efficacy, response efficacy, and perceived severity predicted exercise intentions, which, in turn predicted exercise behaviour. Overall, the PMT variables accounted for a moderate amount of variance in exercise intentions (23%) and behaviour (20%). In contrast, the PMT model was not reliable for predicting exercise behaviour at 12 months post-hospitalisation. The data provided support for PMT applied to short-term, but not long-term, exercise behaviour among patients with CAD. Health education should concentrate on providing positive coping messages to enhance patients' confidence regarding exercise and their belief that exercise provides health benefits, as well as realistic information about disease severity. PMID:20204992

Tulloch, Heather; Reida, Robert; D'Angeloa, Monika Slovinec; Plotnikoff, Ronald C; Morrina, Louise; Beatona, Louise; Papadakisa, Sophia; Pipe, Andrew

2009-03-01

355

Increase in N-terminus-pro-B-type natriuretic peptide during exercise of patients with univentricular heart after a total cavopulmonary connection.  

PubMed

An increase in N-terminus pro-B-type natriuretic peptide (NT-proBNP) during exercise is related to myocardial ischemia, myocardial dysfunction, and inflammatory stress. Its value for patients with a univentricular heart after total cavopulmonary connection (TCPC) is unknown. For 66 patients with TCPC, a cardiopulmonary exercise test was performed. Venous NT-proBNP samples were drawn with the patient at rest and then 2-3 min after peak exercise. The median NT-proBNP during rest was 82 ng/l (range, 11-2,554 ng/l), with 22 patients above the upper reference limit. A higher NT-proBNP during rest was related to a worse peak oxygen uptake (peak [Formula: see text]), a higher ventilatory equivalent (VE/VCO(2) slope), and a need for diuretics administration. A small but significant increase in NT-proBNP during exercise at 6 ng/l (range, 0-314 ng/l) was related mainly to its resting value. The relative increase was solely related to a higher body mass and not to any of the investigated functional parameters. Usually, NT-proBNP during rest is not elevated in TCPC patients. If so, it is a valuable predictor of cardiac function. During exercise, only a minor increase in NT-proBNP occurs. Its extent is not related to any of the investigated functional parameters. Maybe the filling restriction from the lungs prevents atrial and ventricular overload as well as BNP secretion in TCPC patients. PMID:22374379

Hager, Alfred; Christov, Florian; Hess, John

2012-06-01

356

Detection of water-to-blood leakages in heat exchangers for cardiopulmonary bypass.  

PubMed

In the construction of heat exchangers, it is of great importance that when they are in use it shall be impossible for water to leak into the blood, as this might lead to hemolysis, intoxications, air emboli, or infection by microorganisms. In an investigation the aim of which was to discover water-to-blood leakages in the heat exchangers that are generally used during cardiopulmonary bypass, tests were carried out on 17 heat exchangers that are used all over the world and are supplied by five different makers. They included both disposable and nondisposable models. In six stainless steel heat exchangers, water leakages to the blood compartment were detected with the aid of helium. Some of these heat exchangers were brand new and had never been used. The size of the leakages was found to be sufficient to enable them to act as channels for the passage of foreign microorganisms. PMID:1177489

de Jong, D S; Meindersma, T E; Lindemans, J; Nauta, J

1975-10-01

357

Usefulness of isometric hand grip exercise in detecting coronary artery disease during dobutamine atropine stress echocardiography in patients with either stable angina pectoris or another type of positive stress test  

Microsoft Academic Search

Dobutamine atropine stress echocardiography (DASE) detects coronary artery disease (CAD) by increasing myocardial oxygen demand causing ischemia. The sensitivity of the test for detection of CAD is reduced in patients with submaximal stress. We hypothesized that increasing cardiac work load by adding isometric exercise would improve the detection of ischemia during DASE. We studied 31 patients, mean age 57±11 years,

Imran Afridi; Michael L Main; David L Parrish; Ali Kizilbash; Benjamin D Levine; Paul A Grayburn

1998-01-01

358

The 1998–1999 collaborative exercises and proficiency testing program on DNA typing of the Spanish and Portuguese Working Group of the International Society for Forensic Genetics (GEP-ISFG)  

Microsoft Academic Search

A total of 28 laboratories (labs) submitted results for the 1998 collaborative exercise and the proficiency testing program of the Spanish and Portuguese Working Group of the International Society for Forensic Genetics (GEP-ISFG) group. This number increased to 46 labs in 1999. Six bloodstains were submitted, each one with 200?l soaked in cotton except the sample no. 6 submitted for

Josefina Gómez; Angel Carracedo

2000-01-01

359

The nature of undergraduates' conceptual understanding of oxygen transport and utilization in humans: Can cardiopulmonary simulation software enhance learning of propositional knowledge and/or diagnose alternative conceptions in novices and intermediates?  

NASA Astrophysics Data System (ADS)

The purpose of the this research was to explore undergraduates' conceptual development for oxygen transport and utilization, as a component of a cardiopulmonary physiology and advanced respiratory care course in the allied health program. This exploration focused on the student's development of knowledge and the presence of alternative conceptions, prior to, during, and after completing cardiopulmonary physiology and advanced respiratory care courses. Using the simulation program, SimBioSysTM (Samsel, 1994), student-participants completed a series of laboratory exercises focusing on cardiopulmonary disease states. This study examined data gathered from: (1) a novice group receiving the simulation program prior to instruction, (2) a novice group that experienced the simulation program following course completion in cardiopulmonary physiology, and (3) an intermediate group who experienced the simulation program following completion of formal education in Respiratory Care. This research was based on the theory of Human Constructivism as described by Mintzes, Wandersee, and Novak (1997). Data-gathering techniques were based on theories supported by Novak (1984), Wandersee (1997), and Chi (1997). Data were generated by exams, interviews, verbal analysis (Chi, 1997), and concept mapping. Results suggest that simulation may be an effective instructional method for assessing conceptual development and diagnosing alternative conceptions in undergraduates enrolled in a cardiopulmonary science program. Use of simulation in conjunction with clinical interview and concept mapping may assist in verifying gaps in learning and conceptual knowledge. This study found only limited evidence to support the use of computer simulation prior to lecture to augment learning. However, it was demonstrated that students' prelecture experience with the computer simulation helped the instructor assess what the learner knew so he or she could be taught accordingly. In addition, use of computer simulation after formal instruction was shown to be useful in aiding students identified by the instructor as needing remediation.

Wissing, Dennis Robert

360

Use of the Lund University Cardiopulmonary Assist System in the MD902: a fire safety assessment  

Microsoft Academic Search

Background: The Lund University Cardiopulmonary Assist System (LUCAS) is a gas-driven mechanical cardiopulmonary resuscitation device. If oxygen is used as the driving gas in a confined environment, there is a potential fire hazard. 24% oxygen is considered the threshold for increased risk.Objective and methods: Three trials were conducted using different cabin ventilation settings to determine the rise in oxygen concentration

J S Farmery; M Carter

2007-01-01

361

Avoiding cardiopulmonary bypass in multivessel CABG reduces cytokine response and myocardial injury  

Microsoft Academic Search

Background. Proinflammatory cytokines play a key role in the inflammatory cascade after cardiopulmonary bypass and may induce cardiac dysfunction. We compared the production of cytokines and the degree of postoperative myocardial injury in patients with multivessel coronary artery disease undergoing coronary artery bypass grafting through median sternotomy with or without cardiopulmonary bypass.Methods. Forty-four consecutive patients were studied. Patients were selected

Song Wan; Mohammad Bashar Izzat; Tak Wai Lee; Innes Y. P Wan; Nelson L. S Tang; Anthony P. C Yim

1999-01-01

362

Effect of chronic cardiopulmonary disease on survival after resection for stage Ia lung cancer  

Microsoft Academic Search

The role of chronic cardiopulmonary disease as a risk factor for immediate and late mortality was evaluated retrospectively in a consecutive series of 116 patients who had had resections for stage Ia non-oat-cell lung cancers. The presence of chronic cardiopulmonary disease was diagnosed on the clinical history and preoperative assessment of lung and heart function by traditional means. Patients with

U Pastorino; M Valente; V Bedini; A Pagnoni; G Ravasi

1982-01-01

363

Bacterial translocation secondary to small intestinal mucosal ischemia during cardiopulmonary bypass. Measurement by diamine oxidase and peptidoglycanq  

Microsoft Academic Search

Objective: To demonstrate that small intestinal mucosal ischemia occurs during cardiopulmonary bypass by measuring serum diamine oxidase activity, an index of small intestinal mucosal ischemia, in perioerative patients undergoing cardiovascular surgery with and without cardiopulmonary bypass. Methods: Twelve successive patients who underwent coronary artery bypass grafting with cardiopulmonary bypass (Group I) were compared to 10 patients who underwent off-pump coronary

Nobuo Tsunooka; Kazutaka Maeyama; Yoshihiro Hamada; Hiroshi Imagawa; Shinji Takano; Yuji Watanabe; Kanji Kawachi

2010-01-01

364

Bacterial translocation secondary to small intestinal mucosal ischemia during cardiopulmonary bypass. Measurement by diamine oxidase and peptidoglycan  

Microsoft Academic Search

Objective: To demonstrate that small intestinal mucosal ischemia occurs during cardiopulmonary bypass by measuring serum diamine oxidase activity, an index of small intestinal mucosal ischemia, in perioerative patients undergoing cardiovascular surgery with and without cardiopulmonary bypass. Methods: Twelve successive patients who underwent coronary artery bypass grafting with cardiopulmonary bypass (Group I) were compared to 10 patients who underwent off-pump coronary

Nobuo Tsunooka; Kazutaka Maeyama; Yoshihiro Hamada; Hiroshi Imagawa; Shinji Takano; Yuji Watanabe; Kanji Kawachi

2004-01-01

365

Delayed stenosis of the small intestine after cardiopulmonary arrest.  

PubMed

A man in his 70s experienced cardiopulmonary arrest (CPA) due to acute myocardial infarction. He was resuscitated and treated with a multimodal approach, and he fortunately survived CPA without neurological damage. However, abdominal pain and vomiting occurred 45 days after the CPA. Small intestinal endoscopy showed pinhole-like stenosis of the ileum. Although balloon dilation was performed through the scope, his symptoms did not improve. Partial small bowel resection was eventually performed 139 days after the CPA. Pathological findings revealed ischemic changes in the mucosa at two spots. We speculate that an ischemic event occurred in the small bowel during CPA. PMID:25482908

Adachi, Seiji; Okuno, Mitsuru; Horibe, Yohei; Ono, Tomohiko; Goto, Naoe; Nakamura, Noriaki; Iwama, Midori; Yamauchi, Osamu; Saito, Koshiro

2014-12-01

366

Microprocessor-based cardiopulmonary monitoring system  

NASA Technical Reports Server (NTRS)

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.

1978-01-01

367

Orthostasis: exercise and exercise training  

NASA Technical Reports Server (NTRS)

There are two major problems here that are not independent. One is the more practically oriented problem of determining the effect of various modes of exercise training on gravitational tolerances, i.e., the point of syncope (unconsciousness) usually estimated from the time of appearance of presyncopal signs and symptoms. The other is more theoretical and concerns the mechanism of blood pressure failure that results in syncope. In many experimental designs these two problems or purposes have been intermingled, with equivocal results.

Geelen, G.; Greenleaf, J. E.

1993-01-01

368

Influence of a custom made maxillary mouthguardguard guard on gas exchange parameters during incremental exercise in amateur road cyclists.  

PubMed

Mouthguards are frequently used for protection purposes, particularly by athletes competing in contact sports. However, there is increasing evidence supporting their use for improving performance. Studies have focused their use in athletes who do not traditionally use mouthguards and who may be looking for a performance edge. The aim of the current study was to evaluate the influence of a custom made mouthguard (PM) on maximal and submaximal physiological parameters related to performance in road cycling.Ten well-trained amateur road cyclists (34 ± 6 years) performed an incremental cardiopulmonary exercise test to exhaustion on a frictional braked cycle ergometer. Work rate (WR), heart rate, oxygen consumption (VO2), carbon dioxide production, and ventilation at the lactate threshold, at the respiratory compensation point (RCP), and at maximal exercise (MAX) were determined in normal conditions (C) and wearing PM. Cycling economy was also evaluated by analyzing the slope of the VO2/WR (?VO2/?WR, mL/watt/min) relationship during the test.Wearing the PM compared to C resulted in significant increases in WR at RCP (281 ± 32 vs 266 ± 19 watts, P=0.04) and at MAX (353 ± 44 vs 339 ± 38 watts, P=0.004). The PM also resulted in an average 8% lower ?VO2/?WR (9.5 ± 1.1 vs 10.3 ± 1.1 mL/watt/min, P=0.06) but did not significantly modify any of the other measured parameters at LT, RCP and MAX.To the best of our knowledge this study is the first to evaluate the effects of a dentistry-designed mouthguard on physical performance of road cyclists. These results provide support for cyclists to correct jaw posture which may improve their exercise performance. PMID:25226314

Piero, Malpezzi; Simone, Uliari; Jonathan, Myers; Maria, Spiridonova; Giulio, Grossi; Francesco, Terranova; Gabriella, Collini; Laura, Amabile; Eva, Bernardi; Gianni, Mazzoni; Francesco, Conconi; Giovanni, Grazzi

2014-09-15

369

Exercise and Compulsive Behavior.  

ERIC Educational Resources Information Center

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…

Polivy, Janet; Clendenen, Vanessa

370

The effects of aerobic exercise and strengthening exercise on pain pressure thresholds.  

PubMed

[Purpose] We assessed the effects of aerobic exercise and strengthening exercise on pain pressure thresholds (PPTs) over time. [Subjects and Methods] Fifteen healthy participants were recruited and randomly divided into 3 groups: aerobic exercise, strengthening exercise, and control. The subjects in the aerobic group walked on a treadmill for 40?min at 6.5?km/h. The subjects in the strength group performed circuit training that included bench press, lat pull down, biceps curl, triceps extension, and shoulder press based on the perceived exertion for 40?min. The subjects in the control group rested without any exercise in a quiet room for 40?min. The PPTs of 5 potential muscle trigger points before exercise, and immediately after 10 and 40?min of exercise or rest were measured using an electronic algometer (JTECH Medical, USA). The Friedman's, Kruskal-Wallis, and Mann-Whitney tests were performed using SPSS 18.0 (IBM, Korea). [Results] The PPTs of all subjects decreased after 10?min of exercise, but the difference was not statistically significant. The PPTs of the control group decreased after 40?min. Furthermore, the PPTs of 3 muscles increased after 40?min of aerobic exercise and of 6 muscles after 40?min of strengthening exercise. No significant difference in PPTs was noted among the groups. [Conclusion] The results show that 40?min is a more appropriate exercise time, although the efficacy of controlling pain did not differ between strengthening exercise and aerobic exercise. PMID:25140106

Lee, Han Suk

2014-07-01

371

77 FR 10542 - Revision of the National Preparedness for Response Exercise Program (PREP) Guidelines  

Federal Register 2010, 2011, 2012, 2013, 2014

...the National Preparedness for Response Exercise Program (PREP) Guidelines AGENCY...The National Preparedness for Response Exercise Program (PREP) is designed to facilitate...among other things, that periodic exercises take place to test oil spill...

2012-02-22

372

NEAMTWS-ECTE1: The First Enlarged Communication Test Exercise of the Tsunami Early Warning and Mitigation System in the North-eastern Atlantic, the Mediterranean and connected seas  

NASA Astrophysics Data System (ADS)

During the seventh session of the Intergovernmental Coordination Group for the Tsunami Early Warning and Mitigation System in the North-eastern Atlantic, the Mediterranean and connected seas (ICG/NEAMTWS) held in Paris, France, from 23 to 25 November 2010, a task team on Communication Test and Tsunami Exercises (TT-CT&TE) was established. The task team was responsible for the preparation and conduct of the First Enlarged Communication Test Exercise (NEAMTWS-ECTE1) and the organization of its assessment. The aim of the test exercise was to refine procedures for testing the communication of tsunami alert messages between National Tsunami Warning Centres and all Tsunami Warning Focal Points (TWFPs), including speed and availability within NEAM region. Earlier small size tests, conducted during the previous intersessional period, highlighted the importance of having other communication method like Global Telecommunication System (GTS), and therefore the utilization of GTS during the NEAMTWS-ECTE1 was another aim of the exercise. NEAMTWS-ECTE1 was conducted on 10 August 2011 with the participation of 139 end-users belonging to 42 agencies in 31 countries. A methodical and detailed analysis of the ECTE1 has been provided to ICG/NEAMTWS as a report, where 27 new recommendations were provided in order to improve all aspects of a Communication Test Exercise (CTE), ranging from the manual to the interaction with the media, but especially focusing on the technical and procedural improvements. Some technical problems during the NEAMTWS-ECTE1 have helped to clearly identify certain operational and procedural issues on which NEAMTWS should conclude some guidelines. A Small Scale Communication Test (SSCT-1) focusing on the problem areas of NEAMTWS-ECTE1 was conducted on 26 October 2011 as a follow-up exercise to consolidate the lessons learnt from NEAMTWS-ECTE1. Both NEAMTWS-ECTE-1 and SSCT-1 clearly indicates that message dissemination using fax is the least effective communication method utilized and subject to deficiencies beyond the control of the message provider and/or recipient. GTS dissemination should be considered as very effective, yet more testing needs to be done to obtain a sufficient maturity of the use of GTS within NEAM region.

Necmioglu, O.; Rudloff, A.; Matias, L. M.; Schindele, F.; Comoglu, M.; Meral Ozel, N.

2012-04-01

373

Cardiopulmonary Circuit Models for Predicting Injury to the Heart  

NASA Astrophysics Data System (ADS)

Circuit models have been used extensively in physiology to describe cardiopulmonary function. Such models are being used in the DARPA Virtual Soldier (VS) Project* to predict the response to injury or physiological stress. The most complex model consists of systemic circulation, pulmonary circulation, and a four-chamber heart sub-model. This model also includes baroreceptor feedback, airway mechanics, gas exchange, and pleural pressure influence on the circulation. As part of the VS Project, Oak Ridge National Laboratory has been evaluating various cardiopulmonary circuit models for predicting the effects of injury to the heart. We describe, from a physicist's perspective, the concept of building circuit models, discuss both unstressed and stressed models, and show how the stressed models are used to predict effects of specific wounds. *This work was supported by a grant from the DARPA, executed by the U.S. Army Medical Research and Materiel Command/TATRC Cooperative Agreement, Contract # W81XWH-04-2-0012. The submitted manuscript has been authored by the U.S. Department of Energy, Office of Science of the Oak Ridge National Laboratory, managed for the U.S. DOE by UT-Battelle, LLC, under contract No. DE-AC05-00OR22725. Accordingly, the U.S. Government retains a non-exclusive, royalty-free license to publish or reproduce the published form of this contribution, or allow others to do so, for U.S. Government purpose.

Ward, Richard; Wing, Sarah; Bassingthwaighte, James; Neal, Maxwell

2004-11-01

374

Evaluation of closed cardiopulmonary bypass circuit for aortic valve replacement.  

PubMed

Since 2005, we have used a novel technique based on the closed cardiopulmonary bypass system without cardiotomy suction (minimal cardiopulmonary bypass [mini-CPB]) for aortic valve replacement (AVR). In this study, we investigated the clinical advantages of this approach. We prospectively studied 32 patients who underwent isolated AVR using the mini-CPB (group M, n = 13) or conventional CPB (group C, n = 19). We compared the hemodilution ratio, serum interleukin (IL)-6 and IL-8 levels, and blood transfusion volume between the two groups. The characteristics, duration of CPB, and aortic cross-clamping time did not differ between the two groups. The hemodilution ratio was significantly lower in group M just after starting CPB (M vs. C: 14% +/- 2% vs. 25% +/- 3%, p = 0.0009). IL-6 levels increased significantly after surgery in both groups, but the postoperative levels were significantly lower in group M at 6 (84.9 +/- 24.9 pg/ml vs. 152 +/- 78 pg/ml, p = 0.042) and 12 (72.7 +/- 36.1 pg/ml vs. 123 +/- 49.6 pg/ml, p = 0.029) hours after CPB. There were no differences in IL-8 or blood transfusion volume after CPB. Mini-CPB offers an alternative to conventional CPB for AVR and has some advantages regarding hemodilution and serum IL-6 levels. However, it is unlikely to become the standard approach for AVR because there are no marked clinical advantages of mini-CPB. PMID:20559134

Kobayashi, Yasuhiko; Mitsuno, Masataka; Yamamura, Mitsuhiro; Tanaka, Hiroe; Ryomoto, Masaaki; Fukui, Shinya; Tsujiya, Noriko; Kajiyama, Tetsuya; Miyamoto, Yuji

2010-01-01

375

Gravity and the Evolution of Cardiopulmonary Morphology in Snakes  

PubMed Central

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

Lillywhite, Harvey B.; Albert, James S.; Sheehy, Coleman M.; Seymour, Roger S.

2011-01-01

376

Retinal hemorrhage after cardiopulmonary resuscitation with chest compressions.  

PubMed

Retinal hemorrhages in children in the absence of risk factors are regarded to be pathognomonic of shaken baby syndrome or other nonaccidental injuries. The physician must decide whether the retinal hemorrhages in children without risk factors are due to abuse or cardiopulmonary resuscitation with chest compression (CPR-CC). The objective of this study was to determine if CPR-CC can lead to retinal hemorrhages in children. Twenty-two patients who received in-hospital CPR-CC between February 15, 1990, and June 15, 1990, were enrolled. Pediatric ophthalmology fellows carried a code beeper and responded to calls for cardiopulmonary arrest situations. At the scene of CPR-CC, an indirect funduscopic examination was conducted for presence of retinal hemorrhages in the posterior pole. Follow-up examinations were performed at 24 and 72 hours. Of the 22 patients, 6 (27%) had retinal hemorrhages at the time of CPR-CC. Of these 6 patients, 5 had risk factors for retinal hemorrhages. The sixth patient had no risk factors and may have represented the only true case of retinal hemorrhages due to CPR-CC. Retinal hemorrhages are uncommon findings after CPR-CC. Retinal hemorrhages that are found after CPR-CC usually occur in the presence of other risk factors for hemorrhage with a mild hemorrhagic retinopathy in the posterior pole. PMID:23629401

Pham, Hang; Enzenauer, Robert W; Elder, James E; Levin, Alex V

2013-06-01

377

An Exercise to Introduce Power  

ERIC Educational Resources Information Center

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.)

Seier, Edith; Liu, Yali

2013-01-01

378

Investigation of an Exercise-Induced State of Hypofrontality.  

E-print Network

?? The reticular-activating hypofrontality model of acute exercise (RAH) predicts exercise-induced hypoactivity in frontal cortex which mediates executive function. Connors Continuous Performance Test (CCPT) was… (more)

Wohlwend, Martin

2012-01-01

379

Exercising with Osteoarthritis  

MedlinePLUS

... everyone. In fact, studies show that people with osteoarthritis benefit from regular exercise and physical activity. For people with osteoarthritis, regular exercise can help: l Maintain healthy and ...

380

Gender differences in myocardial function and arterio-ventricular coupling in response to maximal exercise in adolescent floor-ball players  

PubMed Central

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

2014-01-01

381

Relationship between delta power and the electrocardiogram-derived cardiopulmonary spectrogram: possible implications for assessing the effectiveness of sleep  

PubMed Central

Objectives The physiologic relationship between slow-wave activity (SWA) (0–4 Hz) on the electroencephalogram (EEG) and high-frequency (0.1–0.4 Hz) cardiopulmonary coupling (CPC) derived from electrocardiogram (ECG) sleep spectrograms is not known. Because high-frequency CPC appears to be a biomarker of stable sleep, we tested the hypothesis that that slow-wave EEG power would show a relatively fixed-time relationship to periods of high-frequency CPC. Furthermore, we speculated that this correlation would be independent of conventional nonrapid eye movement (NREM) sleep stages. Methods We analyzed selected datasets from an archived polysomnography (PSG) database, the Sleep Heart Health Study I (SHHS-I). We employed the cross-correlation technique to measure the degree of which 2 signals are correlated as a function of a time lag between them. Correlation analyses between high-frequency CPC and delta power (computed both as absolute and normalized values) from 3150 subjects with an apnea-hypopnea index (AHI) of ?5 events per hour of sleep were performed. Results The overall correlation (r) between delta power and high-frequency coupling (HFC) power was 0.40 ± 0.18 (P = .001). Normalized delta power provided improved correlation relative to absolute delta power. Correlations were somewhat reduced in the second half relative to the first half of the night (r = 0.45 ± 0.20 vs r = 0.34 ± 0.23). Correlations were only affected by age in the eighth decade. There were no sex differences and only small racial or ethnic differences were noted. Conclusions These results support a tight temporal relationship between slow wave power, both within and outside conventional slow wave sleep periods, and high frequency cardiopulmonary coupling, an ECG-derived biomarker of “stable” sleep. These findings raise mechanistic questions regarding the cross-system integration of neural and cardiopulmonary control during sleep. PMID:24269134

Thomas, Robert Joseph; Mietus, Joseph E.; Peng, Chung-Kang; Guo, Dan; Gozal, David; Montgomery-Downs, Hawley; Gottlieb, Daniel J.; Wang, Cheng-Yen; Goldberger, Ary L.

2014-01-01

382

Potential effect of 6 vs 12-weeks of physical training on cardiac autonomic function and exercise capacity in chronic obstructive pulmonary disease.  

PubMed

Background: Exercise is an important part of COPD treatment. However, it is not know about the minimum effective time of physical training that could beneficially modify the cardiac autonomic modulation (CAM) and exercise capacity in these patients. Aim: To contrast the potential effects of a physical training program (PTP), for 6 versus 12 weeks, on CAM by linear and nonlinear heart rate variability (HRV) indices and exercise capacity in COPD patients. Design: Prospective randomized controlled trial. Setting: Outpatient pulmonary rehabilitation. Population: Twenty moderatetosevere COPD patients were assigned randomly to either a training group (n=10) or a control group (n=10). Methods: HRV at rest and during submaximal test was determined by linear (rMSSD and SDNN) and nonlinear indices [SD1, SD2 and sample entropy (SE)]. In addition, key responses were obtained during cardiopulmonary exercise testing (CPET), the walking distance (WD) during the six minute walking test and submaximal constant speed testing (CST). PTP consisted of 30 minutes of aerobic exercise training on a treadmill, 3 times per week at 70% of CPET peak speed rate. Patients were evaluated on baseline, 6 and 12 weeks. Results: Significant improvements in HRV indices, WD, as well as, other physiological responses were observed after 6 weeks of the PTP and maintained until 12 weeks (P<0.05). However, after 12 weeks, the SD1 index demonstrated an additional improvement compared with 6 weeks (P<0.05). Peak oxygen uptake and dioxide carbon production improved only after 12 weeks (p<0.05). Interestingly, the 6th weekbaseline delta (6th weekbaseline) of WD, SDNN and SE were significantly higher than 12th week6th week delta (P<0.05). Conclusion: These results indicate that beneficial changes on cardiac autonomic modulation in conjunction with improvement in submaximal functional capacity occur in the first 6 weeks of PTP in moderate to severe COPD. Clinical Rehabilitation Impact: Shortterm rehabilitation (6 weeks) is an effective sufficient time to beneficially modify important outcomes as cardiac modulation and exercise capacity in COPD patients. PMID:24594853

Borghi-Silva, A; Mendes, R G; Trimer, R; Oliveira, C R; Fregonezi, G A; Resqueti, V R; Arena, R; Sampaio-Jorge, L M

2014-03-01

383

Vitamin D status and V[combining dot above]O2peak during a skate treadmill graded exercise test in competitive ice hockey players.  

PubMed

Vitamin D status has been associated with cardiorespiratory fitness (CRF) in cross-sectional investigations in the general population. Data characterizing the association between 25-hydroxyvitamin D (25(OH)D) concentration and CRF in athletes are lacking. Junior and collegiate ice hockey players were recruited from the Minneapolis, MN (44.9° N), area during the off-season period (May 16-June 28). The purpose of this study was to examine the cross-sectional association between 25(OH)D concentration and CRF in a sample population of competitive ice hockey players. Circulating 25(OH)D level was assessed from a capillary blood sample analyzed using liquid chromatography-tandem mass spectrometry. V[Combining Dot Above]O2peak during a skate treadmill graded exercise test (GXT) was used to assess CRF. Data on both 25(OH)D concentration and V[Combining Dot Above]O2peak were available for 52 athletes. Insufficient 25(OH)D concentrations were found in 37.7% of the athletes (<32 ng·ml). Vitamin D status was not significantly associated with any physiological or physical parameter during the skate treadmill GXT. PMID:24832977

Fitzgerald, John S; Peterson, Ben J; Warpeha, Joseph M; Wilson, Patrick B; Rhodes, Greg S; Ingraham, Stacy J

2014-11-01

384

Resistance Versus Aerobic Exercise  

PubMed Central

OBJECTIVE In type 1 diabetes, small studies have found that resistance exercise (weight lifting) reduces HbA1c. In the current study, we examined the acute impacts of resistance exercise on glycemia during exercise and in the subsequent 24 h compared with aerobic exercise and no exercise. RESEARCH DESIGN AND METHODS Twelve physically active individuals with type 1 diabetes (HbA1c 7.1 ± 1.0%) performed 45 min of resistance exercise (three sets of seven exercises at eight repetitions maximum), 45 min of aerobic exercise (running at 60% of Vo2max), or no exercise on separate days. Plasma glucose was measured during and for 60 min after exercise. Interstitial glucose was measured by continuous glucose monitoring 24 h before, during, and 24 h after exercise. RESULTS Treatment-by-time interactions (P < 0.001) were found for changes in plasma glucose during and after exercise. Plasma glucose decreased from 8.4 ± 2.7 to 6.8 ± 2.3 mmol/L (P = 0.008) during resistance exercise and from 9.2 ± 3.4 to 5.8 ± 2.0 mmol/L (P = 0.001) during aerobic exercise. No significant changes were seen during the no-exercise control session. During recovery, glucose levels did not change significantly after resistance exercise but increased by 2.2 ± 0.6 mmol/L (P = 0.023) after aerobic exercise. Mean interstitial glucose from 4.5 to 6.0 h postexercise was significantly lower after resistance exercise versus aerobic exercise. CONCLUSIONS Resistance exercise causes less initial decline in blood glucose during the activity but is associated with more prolonged reductions in postexercise glycemia than aerobic exercise. This might account for HbA1c reductions found in studies of resistance exercise but not aerobic exercise in type 1 diabetes. PMID:23172972

Yardley, Jane E.; Kenny, Glen P.; Perkins, Bruce A.; Riddell, Michael C.; Balaa, Nadia; Malcolm, Janine; Boulay, Pierre; Khandwala, Farah; Sigal, Ronald J.

2013-01-01

385

Predicted values of exercise capacity in heart failure: where we are, where to go.  

PubMed

Cardiopulmonary exercise testing (CPET) is a procedure widely used in daily clinical activity to investigate cardiac and pulmonary disorders. Peak oxygen consumption (VO2 peak) is the most validated and clinically accepted parameter used to report aerobic capacity in healthy individuals and in different clinical settings. However, peak VO2 is influenced by several factors, whose variability is nowadays particularly evident due to the extensive use of CPET even in very young and very old subgroups of patients. Thus, its diagnostic and prognostic significance may be improved by the use of % of predicted VO2. At present, many sets of normal values are available, making the identification of the most proper max VO2 predicted value a challenging problem. In fact, normal value sets have been obtained from studies whose accuracy was reduced by important limitations, such as small sample size, low grade of heterogeneity of the population enrolled, poor rigorousness of methods, or difficulty in interpreting results. Accordingly, the aim of the present review is threefold: (A) to report some illustrative cases to show how the choice of the normal value set can influence the report of CPET; (B) to describe the most known and used reference value sets, highlighting the main characteristics of sample population, the most important methodological aspects, and the major limitations of the studies; (C) to suggest which equation should be used, if any, and to underline its weakness. PMID:23942790

Gargiulo, Paola; Olla, Sergio; Boiti, Costanza; Contini, Mauro; Perrone-Filardi, Pasquale; Agostoni, Piergiuseppe

2014-09-01

386

Work, exercise, and space flight. 3: Exercise devices and protocols  

NASA Technical Reports Server (NTRS)

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.

Thornton, William

1989-01-01

387

Humanoid Assessing Rehabilitative Exercises.  

PubMed

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". Background: The article presents the approach in which the rehabilitative exercise prepared by healthcare professional is encoded as formal knowledge and used by humanoid robot to assist patients without involving other care actors. Objectives: The main objective is the use of humanoids in rehabilitative care. An example is pulmonary rehabilitation in COPD patients. Another goal is the automated judgment functionality to determine how the rehabilitation exercise matches the pre-programmed correct sequence. Methods: We use the Aldebaran Robotics' NAO humanoid to set up artificial cognitive application. Pre-programmed NAO induces elderly patient to undertake humanoid-driven rehabilitation exercise, but needs to evaluate the human actions against the correct template. Patient is observed using NAO's eyes. We use the Microsoft Kinect SDK to extract motion path from the humanoid's recorded video. We compare human- and humanoid-operated process sequences by using the Dynamic Time Warping (DTW) and test the prototype. Results: This artificial cognitive software showcases the use of DTW algorithm to enable humanoids to judge in near real-time about the correctness of rehabilitative exercises performed by patients following the robot's indications. Conclusion: One could enable better sustainable rehabilitative care services in remote residential settings by combining intelligent applications piloting humanoids with the DTW pattern matching algorithm applied at run time to compare humanoid- and human-operated process sequences. In turn, it will lower the need of human care. PMID:24986076

Simonov, M; Delconte, G

2014-07-01

388

Brachiopod exercise for FossilPlot  

NSDL National Science Digital Library

Students are taught how to use FossilPlot software in the lab prior to this exercise. Students work individual to work through the short exercise, handing in a copy of the diversity graphs for the brachiopod orders (which will be tested in the following midterm) and a completed worksheet. The exercise reinforces the main functions of FossilPlot and addresses basic concepts on diversity and biostratigraphy. Once the assignments are collected and graded, we discuss the outcomes of the exercise in class.

Leif Tapanila

389

Minimizing systemic inflammation during cardiopulmonary bypass in the pediatric population.  

PubMed

Cardiopulmonary bypass (CPB) is known to cause a systemic inflammatory response. Inflammation includes several cascade activations: complement, cytokine, and coagulation. The early phase is triggered by blood contact with the synthetic bypass circuit and the late phase by ischemia-reperfusion and endotoxemia. Systemic inflammatory response syndrome (SIRS) is constant following cardiac surgery; however, a compensatory anti-inflammatory response is also constant and the clinical manifestations (varying from uncomplicated SIRS to shock and multiple organ dysfunction) depend on the balance between the two responses. When overexpressed, the inflammatory response may significantly increase a patient's risk. Minimization of systemic inflammation is a major concern and several strategies aiming to inhibit the inflammatory response are described. None of them is satisfactory, but the "control" of the inflammatory response extent is likely to require a multimodal approach. This review aims to describe the strategies proposed to reduce CPB-related systemic inflammation. PMID:24392866

Durandy, Yves

2014-01-01

390

Severe hyperkalemia during cardiopulmonary bypass: etiology and effective therapy.  

PubMed

Hyperkalemia is considered a medical emergency as it can result in severe disturbances in cardiac rhythm and death. Although many causes of hyperkalemia exist, exogenous red blood cell transfusions are being recognized as the primary perioperative etiology. The authors report a case of severe intraoperative hyperkalemia associated with the use of allogeneic blood products (packed red blood cells), during a surgical mission to a developing country. The patient was undergoing repeat mitral valve replacement with cardiopulmonary bypass (CPB) and developed significant hyperkalemia with a serum potassium value of 9.9 mEq/L. Successful intraoperative therapies were instituted with a gradual reduction in the serum potassium value to 4.8 mEq, which allowed the patient to be weaned from CPB. The authors review the etiology of hyperkalemia in children including its relationship with allogeneic red blood cell transfusions and treatment modalities including specific therapies which can be instituted during CPB. PMID:23799735

Martin, David P; Gomez, Daniel; Tobias, Joseph D; Schechter, William; Cusi, Carlos; Michler, Robert

2013-04-01

391

Coronary blood flow during cardiopulmonary resuscitation in swine  

SciTech Connect

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.

Bellamy, R.F.; DeGuzman, L.R.; Pedersen, D.C.

1984-01-01

392

Exercise Is Medicine.  

ERIC Educational Resources Information Center

Suggests that exercise should be the first-line therapy for preventing and treating many common diseases; however, physicians need more training in how best to use exercise therapy. The paper explains the power of exercise and discusses how to motivate individuals to start safe, enjoyable, and life-saving exercise routines. (SM)

Elrick, Harold

1996-01-01

393

Musk as a Pheromone? Didactic Exercise.  

ERIC Educational Resources Information Center

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…

Bersted, Chris T.

394

Potato Types and Characteristics: Laboratory Exercises.  

ERIC Educational Resources Information Center

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)

Pavlista, Alexander D.

1997-01-01

395

Exercise Versus +Gz Acceleration Training  

NASA Technical Reports Server (NTRS)

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.

Greenleaf, John E.; Simonson, S. R.; Stocks, J. M.; Evans, J. M.; Knapp, C. F.; Dalton, Bonnie P. (Technical Monitor)

2002-01-01

396

Benefits, Consequences, and Uncertainties of Conventional (Exercise) Countermeasure Approaches  

NASA Technical Reports Server (NTRS)

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.

Ploutz-Snyder, Lori

2013-01-01

397

Testing the effectiveness of a self-efficacy based exercise intervention for adults with venous leg ulcers: protocol of a randomised controlled trial  

PubMed Central

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

2014-01-01

398

Cardiopulmonary Toxicity of Size-Fractionated Particulate Matter Obtained at Different Distances from a Highway  

EPA Science Inventory

This study was initiated to determine the effect of size fractionated particulate matter (PM) obtained at different distances from a highway on acute cardiopulmonary toxicity in mice. PM was collected for 2 weeks using a three-stage (ultrafine: ...

399

21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.  

Code of Federal Regulations, 2014 CFR

...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....

2014-04-01

400

Leptin deficiency is involved in the cognitive impairment of streptozocin-induced diabetic rats undergoing cardiopulmonary bypass  

PubMed Central

Several lines of evidence have demonstrated that leptin is probably involved in the cognitive impairment which induced by a single injection of streptozocin (STZ). However, there is little literature reporting the relationship between cognitive impairment and cardiopulmonary bypass (CPB). This study aimed to investigate the role of leptin in the cognitive impairment of STZ-induced diabetic rats undergoing CPB. Wistar rats received 2 h of CPB exposure 1 month after a single intraperitoneal injection of 60 mg/kg of STZ or the vehicle. Behavioral results of rats in Morris water maze were recorded. After that, rat hippocampi were harvested for measuring leptin, tumor necrosis factor-? (TNF-?) and interleukin-1? (IL-1?). Besides, we observed intracerebroventricular injection of leptin on the cognitive impairment of diabetic-rats undergoing CPB and measured behavioral performance and hippocampal TNF-? and IL-1? levels. Rats undergoing CPB significantly aggravates STZ-induced an increase of the latency to the platform and a decrease of the proportion of time spent in the target quadrant of rats in Morris water maze test. Additionally, the expression of leptin significantly decreased, while TNF-? and IL-1? levels significantly increased. Moreover, intracerebroventricular injection of leptin has a therapeutic effect for cognitive impairment of diabetic rats undergoing CPB. Leptin deficiency in hippocampus is probably involved in the cognitive impairment of streptozocin-induced diabetic rats undergoing cardiopulmonary bypass. PMID:25356111

Yang, Chun; Zhu, Bin; Hua, Fei

2014-01-01

401

Does impaired O2 delivery during exercise accentuate central and peripheral fatigue in patients with coexistent COPD-CHF?  

PubMed Central

Impairment in oxygen (O2) delivery to the central nervous system (“brain”) and skeletal locomotor muscle during exercise has been associated with central and peripheral neuromuscular fatigue in healthy humans. From a clinical perspective, impaired tissue O2 transport is a key pathophysiological mechanism shared by cardiopulmonary diseases, such as chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). In addition to arterial hypoxemic conditions in COPD, there is growing evidence that cerebral and muscle blood flow and oxygenation can be reduced during exercise in both isolated COPD and CHF. Compromised cardiac output due to impaired cardiopulmonary function/interactions and blood flow redistribution to the overloaded respiratory muscles (i.e., ?work of breathing) may underpin these abnormalities. Unfortunately, COPD and CHF coexist in almost a third of elderly patients making these mechanisms potentially more relevant to exercise intolerance. In this context, it remains unknown whether decreased O2 delivery accentuates neuromuscular manifestations of central and peripheral fatigue in coexistent COPD-CHF. If this holds true, it is conceivable that delivering a low-density gas mixture (heliox) through non-invasive positive pressure ventilation could ameliorate cardiopulmonary function/interactions and reduce the work of breathing during exercise in these patients. The major consequence would be increased O2 delivery to the brain and active muscles with potential benefits to exercise capacity (i.e., ?central and peripheral neuromuscular fatigue, respectively). We therefore hypothesize that patients with coexistent COPD-CHF stop exercising prematurely due to impaired central motor drive and muscle contractility as the cardiorespiratory system fails to deliver sufficient O2 to simultaneously attend the metabolic demands of the brain and the active limb muscles. PMID:25610401

Oliveira, Mayron F.; Zelt, Joel T. J.; Jones, Joshua H.; Hirai, Daniel M.; O'Donnell, Denis E.; Verges, Samuel; Neder, J. Alberto

2014-01-01

402

Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution  

Microsoft Academic Search

Context Associations have been found between day-to-day particulate air pollution and increased risk of various adverse health outcomes, including cardiopulmonary mor- tality. However, studies of health effects of long-term particulate air pollution have been less conclusive. Objective To assess the relationship between long-term exposure to fine particu- late air pollution and all-cause, lung cancer, and cardiopulmonary mortality. Design, Setting, and

C. Arden Pope III; Richard T. Burnett; Michael J. Thun; Eugenia E. Calle; Daniel Krewski; Kazuhiko Ito; George D. Thurston

2002-01-01

403

Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results  

Microsoft Academic Search

OBJECTIVE--To determine the circumstances, incidence, and outcome of cardiopulmonary resuscitation in British hospitals. DESIGN--Hospitals registered all cardiopulmonary resuscitation attempts for 12 months or longer and followed survival to one year. SETTING--12 metropolitan, provincial, teaching, and non-teaching hospitals across Britain. SUBJECTS--3765 patients in whom a resuscitation attempt was performed, including 927 in whom the onset of arrest was outside the hospital.

H. Tunstall-Pedoe; L. Bailey; D. A. Chamberlain; A. K. Marsden; M. E. Ward; D. A. Zideman

1992-01-01

404

Value of exercise thallium-201 imaging in patients with diagnostic and nondiagnostic exercise electrocardiograms  

SciTech Connect

The role of exercise imaging with thallium-201 in the evaluation of patients suspected of having coronary artery disease was studied in 194 patients undergoing diagnostic coronary arteriography. Ninety-eight patients had 70 percent or more narrowing of one or more coronary vessels and 96 patients had either no or insignificant coronary artery disease. One hundren twenty-three of the 194 patients had conclusive treadmill exercise electrocardiograms (either positive or negative), and 71 had inconclusive exercise electrocardiograms. The specificity of exercise imaging (97 percent) was higher than that of exercise electrocardiograms (86 percent, p less than 0.02). The specificity of both tests combined was not significantly different from that of exercise electrocardiograms alone. The sensitivity (79 percent) and specificity (95 percent) of exercise imaging were not significantly different in patients with inconclusive exercise electrocardiograms when compared with those in patients whose exercise electrocardiograms were conclusive. These data indicate that exercise imaging is sensitive and specific in diagnosing coronary artery disease in the presence of diagnostic as well as nondiagnostic exercise electrocardiograms and that propranolol therapy does not affect the results.

Iskandrian, A.S.; Segal, B.L.

1981-08-01

405

Enhanced muscle pump during mild dynamic leg exercise inhibits sympathetic vasomotor outflow.  

PubMed

Muscle sympathetic nerve activity (MSNA) is not increased during leg cycling at light and mild intensities, despite activation of central command and the exercise pressor reflex. We determined whether increasing central blood volume and loading the cardiopulmonary baroreceptors modulate sympathetic vasomotor outflow during leg cycling. To this end, we changed the pedaling frequency to enhance skeletal muscle pump. Subjects performed two leg cycle exercises at differential pedal rates of 60 and 80 rpm (60EX and 80EX trials) for two conditions (with and without MSNA measurement). In each trial, subjects completed leg cycling with a differential workload to maintain constant oxygen consumption (VO2). MSNA was recorded via microneurography at the right median nerve of the elbow. Without MSNA measurement, thoracic impedance, stroke volume (SV), and cardiac output (CO) were measured non-invasively using impedance cardiography. Heart rate and VO2 during exercise did not differ between the 60EX and 80EX trials. Changes in thoracic impedance, SV, and CO during the 80EX trial were greater than during the 60EX trial. MSNA during the 60EX trial was unchanged compared with that at rest (25.8 ± 3.1 [rest] to 28.3 ± 3.4 [exercise] bursts/min), whereas a significant decrease in MSNA was observed during the 80EX trial (25.8 ± 2.8 [rest] to 19.7 ± 2.0 [exercise] bursts/min). These results suggest that a muscle pump-induced increase in central blood volume, and thereby loading of cardiopulmonary baroreceptors, could inhibit sympathetic vasomotor outflow during mild dynamic leg exercise, despite activation of central command and the exercise pressor reflex. PMID:25347854

Katayama, Keisho; Ishida, Koji; Saito, Mitsuru; Koike, Teruhiko; Hirasawa, Ai; Ogoh, Shigehiko

2014-01-01

406

Exercise caution: over-exercise is associated with suicidality among individuals with disordered eating.  

PubMed

We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3-4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations. PMID:23219104

Smith, April R; Fink, Erin L; Anestis, Michael D; Ribeiro, Jessica D; Gordon, Kathryn H; Davis, Heather; Keel, Pamela K; Bardone-Cone, Anna M; Peterson, Carol B; Klein, Marjorie H; Crow, Scott; Mitchell, James E; Crosby, Ross D; Wonderlich, Stephen A; le Grange, Daniel; Joiner, Thomas E

2013-04-30

407

Device specific analysis of neonatal aortic outflow cannula jet flows for improved cardiopulmonary bypass hemodynamics  

NASA Astrophysics Data System (ADS)

Hemodynamically efficient aortic outflow cannulae can provide high blood volume flow rates at low exit force during extracorporeal circulation in pediatric or neonatal cardiopulmonary bypass repairs. Furthermore, optimal hemolytic aortic insertion configurations can significantly reduce risk of post-surgical neurological complications and developmental defects in the young patient. The methodology and results presented in this study serve as a baseline for design of superior aortic outflow cannulae based on a novel paradigm of characterizing jet-flows at different flow regimes. In-silico evaluations of multiple cannula tips were used to delineate baseline hemodynamic performance of the popular pediatric cannula tips in an experimental cuboidal test-rig, using PIV. High resolution CFD jet-flow simulations performed for various cannula tips in the cuboidal test-rig as well as in-vivo insertion configurations have suggested the existence of optimal surgically relevant characteristics such as cannula outflow angle and insertion depth for improved hemodynamic performance during surgery. Improved cannula tips were designed with internal flow-control features for decreased blood damage and increased permissible flow rates.

Menon, Prahlad; Sotiropoulos, Fotis; Undar, Akif; Pekkan, Kerem

2011-11-01