Sample records for cardiopulmonary exercise tests

  1. Cardiopulmonary exercise testing and its application

    PubMed Central

    Albouaini, K; Egred, M; Alahmar, A

    2007-01-01

    Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance and for objective determination of functional capacity and impairment. This review focuses on the exercise physiology and physiological basis for functional exercise testing and discusses the methodology, indications, contraindications and interpretation of CPET in normal people and in patients with heart failure. PMID:17890705

  2. Cardiopulmonary exercise testing and its application

    PubMed Central

    Albouaini, K; Egred, M; Alahmar, A

    2007-01-01

    Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance and for objective determination of functional capacity and impairment. This review focuses on the exercise physiology and physiological basis for functional exercise testing and discusses the methodology, indications, contraindications and interpretation of CPET in normal people and in patients with heart failure. PMID:17989266

  3. Software for interpreting cardiopulmonary exercise tests

    PubMed Central

    Ross, Robert M; Corry, David B

    2007-01-01

    Background Cardiopulmonary exercise testing (CPET) has become an important modality for the evaluation and management of patients with a diverse array of medical problems. However, interpreting these tests is often difficult and time consuming, requiring significant expertise. Methods We created a computer software program (XINT) that assists in CPET interpretation. The program uses an integrative approach as recommended in the Official Statement of the American Thoracic Society/American College of Chest Physicians (ATS/ACCP) on Cardiopulmonary Exercise Testing. In this paper we discuss the principles behind the software. We also provide the detailed logic in an accompanying file (Additional File 1). The actual program and the open source code are also available free over the Internet at . For convenience, the required download files can also be accessed from this article. Results To test the clinical usefulness of XINT, we present the computer generated interpretations of the case studies discussed in the ATS/ACCP document in another accompanying file (Additional File 2). We believe the interpretations are consistent with the document's criteria and the interpretations given by the expert panel. Conclusion Computers have become an integral part of modern life. Peer-reviewed scientific journals are now able to present not just medical concepts and experimental studies, but actual functioning medical interpretive software. This has enormous potential to improve medical diagnoses and patient care. We believe XINT is such a program that will give clinically useful interpretations when used by the medical community at large. PMID:17953776

  4. Exercise-induced Myocardial Ischemia Detected by Cardiopulmonary Exercise Testing

    PubMed Central

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

    2010-01-01

    Cardiopulmonary exercise testing (CPET) is a well-accepted physiologic evaluation technique in patients diagnosed with heart failure and in individuals presenting with unexplained dyspnea on exertion. Several variables obtained during CPET, including oxygen consumption relative to heart rate (VO2/HR or O2-pulse) and work rate (VO2/Watt) provide consistent, quantitative patterns of abnormal physiologic responses to graded exercise when left ventricular dysfunction is caused by myocardial ischemia. This concept paper describes both the methodology and clinical application of CPET associated with myocardial ischemia. Initial evidence indicates left ventricular dysfunction induced by myocardial ischemia may be accurately detected by an abnormal CPET response. CPET testing may complement current non-invasive testing modalities that elicit inducible ischemia. It provides a physiologic quantification of the work rate, heart rate and O2 uptake at which myocardial ischemia develops. In conclusion, the potential value of adding CPET with gas exchange measurements is likely to be of great value in diagnosing and quantifying both overt and occult myocardial ischemia and its reversibility with treatment. PMID:19231322

  5. Cardiopulmonary exercise testing in the assessment of exertional dyspnea

    PubMed Central

    Datta, Debapriya; Normandin, Edward; ZuWallack, Richard

    2015-01-01

    Dyspnea on exertion is a commonly encountered problem in clinical practice. It is usually investigated by resting tests such as pulmonary function tests and echocardiogram, which may at times can be non-diagnostic. Cardiopulmonary exercise testing (CPET) measures physiologic parameters during exercise which can enable accurate identification of the cause of dyspnea. Though CPET has been around for decades and provides valuable and pertinent physiologic information on the integrated cardiopulmonary responses to exercise, it remains underutilized. The objective of this review is to provide a comprehensible overview of the underlying principles of exercise physiology, indications and contraindications of CPET, methodology and interpretative strategies involved and thereby increase the understanding of the insights that can be gained from the use of CPET.

  6. Cardiopulmonary exercise testing in the assessment of exertional dyspnea.

    PubMed

    Datta, Debapriya; Normandin, Edward; ZuWallack, Richard

    2015-01-01

    Dyspnea on exertion is a commonly encountered problem in clinical practice. It is usually investigated by resting tests such as pulmonary function tests and echocardiogram, which may at times can be non-diagnostic. Cardiopulmonary exercise testing (CPET) measures physiologic parameters during exercise which can enable accurate identification of the cause of dyspnea. Though CPET has been around for decades and provides valuable and pertinent physiologic information on the integrated cardiopulmonary responses to exercise, it remains underutilized. The objective of this review is to provide a comprehensible overview of the underlying principles of exercise physiology, indications and contraindications of CPET, methodology and interpretative strategies involved and thereby increase the understanding of the insights that can be gained from the use of CPET. PMID:25829957

  7. Cardiopulmonary Exercise Testing in Lung Transplantation: A Review

    PubMed Central

    Dudley, Katherine A.; El-Chemaly, Souheil

    2012-01-01

    There has been an increase in lung transplantation in the USA. Lung allocation is guided by the lung allocation score (LAS), which takes into account one measure of exercise capacity, the 6-minute walk test (6MWT). There is a paucity of data regarding the role and value of cardiopulmonary stress test (CPET) in the evaluation of lung transplant recipients while on the transplant waiting list and after lung transplantation. While clearly there is a need for further prospective investigation, the available literature strongly suggests a potential role for CPET in the setting of lung transplant. PMID:22666582

  8. [Cardiopulmonary exercise testing in occupational medical fitness examination and assessment].

    PubMed

    Preisser, A M; Ochmann, U

    2011-11-01

    Medical expert opinion by occupational physicians and pneumologists has two main objectives: making a diagnosis with probability bordering on certainty and clarifying a causal relationship to a present or former occupational exposure to irritant toxic, allergenic or fibrosing dusts, gases, welding fumes or mineral fibres. Especially for conditions that are associated with exertional dyspnea, the diagnosis at rest using spirometry, body plethysmography, pulmonary function test, blood gas analysis, electrocardiogram and echocardiography is of limited use. This paper identifies the indications for cardiopulmonary exercise testing (CPET) in occupational medicine, explains the related measurements and their differential diagnostic value with special consideration of the flow-volume curve under exercise as well as the alveolar-arterial oxygen gradient. Diagnostic statements on the relevance of oxygen uptake measured at continuous and peak load compared to the wattage ascertained on the bicycle ergometer are presented. Characteristic CPET findings are explained in terms of their differential diagnostic significance. Furthermore, the importance of CPET for the assessment of occupational disease-related functional loss (clinical proportions in the reduction of working capacity) is shown. PMID:22083292

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed Central

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

    2010-01-01

    Background Patients with systemic sclerosis (SSc) may develop exercise intolerance due to musculoskeletal involvement, restrictive lung disease, left ventricular dysfunction, or pulmonary vasculopathy (PV). The latter is particularly important since it may lead to lethal pulmonary arterial hypertension (PAH). We hypothesized that abnormalities during cardiopulmonary exercise testing (CPET) in patients with SSc can identify PV leading to overt PAH. Methods Thirty SSc patients from the Harbor-UCLA Rheumatology clinic, not clinically suspected of having significant pulmonary vascular disease, were referred for this prospective study. Resting pulmonary function and exercise gas exchange were assessed, including peakVO2, anaerobic threshold (AT), heart rate- VO2 relationship (O2-pulse), exercise breathing reserve and parameters of ventilation-perfusion mismatching, as evidenced by elevated ventilatory equivalent for CO2 (VE/VCO2) and reduced end-tidal pCO2 (PETCO2) at the AT. Results Gas exchange patterns were abnormal in 16 pts with specific cardiopulmonary disease physiology: Eleven patients had findings consistent with PV, while five had findings consistent with left-ventricular dysfunction (LVD). Although both groups had low peak VO2 and AT, a higher VE/VCO2 at AT and decreasing PETCO2 during early exercise distinguished PV from LVD. Conclusions Previously undiagnosed exercise impairments due to LVD or PV were common in our SSc patients. Cardiopulmonary exercise testing may help to differentiate and detect these disorders early in patients with SSc. PMID:21179195

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

    PubMed Central

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

    2009-01-01

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

  12. [The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing].

    PubMed

    Gläser, S; Ittermann, T; Schäper, C; Obst, A; Dörr, M; Spielhagen, T; Felix, S B; Völzke, H; Bollmann, T; Opitz, C F; Warnke, C; Koch, B; Ewert, R

    2013-01-01

    The interpretation of gas exchange measured by cardiopulmonary exercise testing (CPET) depends on reliable reference values. Within the population based Study of Health in Pomerania (SHIP) CPET was assessed in 1706 volunteers. The assessment based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. CPET was embedded in an extensive examination program. After the exclusion of active smokers and volunteers with evidence of cardiopulmonary and musculoskeletal disorders the reference population comprised 616 healthy subjects (333 women) aged 25 to 85 years. Reference equations including upper and/or lower limits based on quantile regression were assessed. All values were corrected for the most important influencing factors.This study provides reference equations for gas exchange and exercise capacity assessed within a population in Germany. PMID:23247595

  13. Assessment of Survival in Patients With Primary Pulmonary Hypertension Importance of Cardiopulmonary Exercise Testing

    Microsoft Academic Search

    Roland Wensel; Christian F. Opitz; Stefan D. Anker; Jörg Winkler; Gert Höffken; Franz X. Kleber; Rakesh Sharma; Manfred Hummel; Roland Hetzer; Ralf Ewert

    Background—Primary pulmonary hypertension (PPH) is a life-threatening disease. Prognostic assessment is an important factor in determining medical treatment and lung transplantation. Whether cardiopulmonary exercise testing data predict survival has not been reported previously. Methods and Results—We studied 86 patients with PPH (58 female, age 462 years, median NYHA class III) between 1996 and 2001 who were followed up in a

  14. The Utility of Cardiopulmonary Exercise Testing in the Assessment of Suspected Microvascular Ischemia

    PubMed Central

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

    2010-01-01

    Evidence demonstrating the potential value of cardiopulmonary exercise testing (CPET) to accurately detect myocardial ischemia secondary to macro-vascular disease is beginning to emerge. Despite distinct mechanisms mediating ischemia in micro-vascular and macrovascular coronary artery disease (CAD), the net physiologic effect of exercise-induced left ventricular (LV) dysfunction is common to both. The abnormal physiologic response to CPET may, therefore, be similar in patients with macro- and micro-vascular ischemia. The following case report describes the CPET abnormalities in a patient with suspected microvascular CAD and the subsequent improvement in LV function following three weeks of medical therapy with the anti-ischemic drug ranolazine. PMID:19233492

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

    PubMed Central

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

    2013-01-01

    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

  16. The results of cardiopulmonary exercise test in healthy Korean children and adolescents: single center study

    PubMed Central

    Lee, Jun-Sook; Kim, Seong-Ho; Lee, Sang-Yun; Baek, Jae-Suk; Shim, Woo-Sup

    2013-01-01

    Purpose The cardiopulmonary exercise test (CPET) is an important clinical tool for evaluating exercise capacity and is frequently used to evaluate chronic conditions including congenital heart disease. However, data on the normal CPET values for Korean children and adolescents are lacking. The aim of this study was to provide reference data for CPET variables in children and adolescents. Methods From August 2006 to April 2009, 76 healthy children and adolescents underwent the CPET performed using the modified Bruce protocol. Here, we performed a medical record review to obtain data regarding patient' demographics, medical history, and clinical status. Results The peak oxygen uptake (VO2Peak) and metabolic equivalent (METMax) were higher in boys than girls. The respiratory minute volume (VE)/CO2 production (VCO2) slope did not significantly differ between boys and girls. The cardiopulmonary exercise test data did not significantly differ between the boys and girls in younger age group (age, 10 to 14 years). However, in older age group (age, 15 to 19 years), the boys had higher VO2Peak and METMax values and lower VE/VCO2 values than the girls. Conclusion This study provides reference data for CPET variables in case of children and adolescents and will make it easier to use the CPET for clinical decision-making. PMID:23807890

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

    PubMed Central

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

    2015-01-01

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

  18. The Utility of Cardiopulmonary Exercise Testing to Detect and Track Early-Stage Ischemic Heart Disease

    PubMed Central

    Chaudhry, Sundeep; Arena, Ross A.; Hansen, James E.; Lewis, Gregory D.; Myers, Jonathan N.; Sperling, Laurence S.; LaBudde, Brian D.; Wasserman, Karlman

    2010-01-01

    Evidence demonstrating the potential value of noninvasive cardiopulmonary exercise testing (CPET) to accurately detect exercise-induced myocardial ischemia is emerging. This case-based concept report describes CPET abnormalities in an asymptomatic at-risk man with suspected early-stage ischemic heart disease. When CPET was repeated 1 year after baseline assessment, his cardiovascular function had worsened, and an anti-atherosclerotic regimen was initiated. When the patient was retested after 3.3 years, the diminished left ventricular function had reversed with pharmacotherapy directed at decreasing cardiovascular events in patients with coronary artery disease. Thus, in addition to identifying appropriate patients in need of escalating therapy for atherosclerosis, CPET was useful in monitoring progression and reversal of abnormalities of the coronary circulation in a safe and cost-effective manner without the use of radiation. Serial CPET parameters may be useful to track changes marking the progression and/or regression of the underlying global ischemic burden. PMID:20884826

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

    PubMed Central

    Mohammad, Majid Malek; Dadashpour, Shahdak

    2012-01-01

    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

  20. PEAK CARDIOPULMONARY EXERCISE DATA FOR HEALTHY SAUDI MALES

    Microsoft Academic Search

    A. M. Al-Howaikan; H. M. Al-Hazzaa; S. A. Al-Majed

    The use of cardiopulmonary exercise testing as a me asure of functional capacity has increased substantially in recent year s. Yet local normative data are remarkably lacking. Therefore, this study presents normal peak cardiopulmonary exercise values for 94 healthy Saud i males between the ages of 20 and 47 years. Graded exercise testing wa s performed using electronic cycle ergometer

  1. Evaluation of exercise capacity with cardiopulmonary exercise testing and BNP levels in adult patients with single or systemic right ventricles

    PubMed Central

    Gwizda?a, Adrian; Katarzy?ski, S?awomir; Katarzy?ska, Agnieszka; Oko-Sarnowska, Zofia; Br?borowicz, Piotr; Grajek, Stefan

    2010-01-01

    Introduction The aim of the study was to evaluate exercise capacity using cardiopulmonary exercise test (CpET) and serum B-type natriuretic peptide (BNP) levels in patients with single or systemic right ventricles. Material and methods The study group included 40 patients (16 males) – 17 with transposition of the great arteries after Senning operation, 13 with corrected transposition of the great arteries and 10 with single ventricle after Fontan operation, aged 19–55 years (mean 28.8 ±9.5 years). The control group included 22 healthy individuals (10 males) aged 23–49 years (mean 30.6 ±6.1 years). Results The majority of patients reported good exercise tolerance – accordingly 27 were classified in NYHA class I (67.5%), 12 (30%) in class II, and only 1 (0.5%) in class III. Cardiopulmonary exercise test revealed significantly lower exercise capacity in study patients than in control subjects. In the study vs. control group VO2max was 21.7 ±5.9 vs. 34.2 ±7.4 ml/kg/min (p = 0.00001), maximum heart rate at peak exercise (HRmax) 152.5 ±32.3 vs. 187.2 ±15.6 bpm (p = 0.00001), VE/VCO2 slope 34.8 ±7.1 vs. 25.7 ±3.2 (p = 0.00001), forced vital capacity (FVC) 3.7 ±0.9l vs. 4.6 ±0.3 (p = 0.03), forced expiratory volume in 1 s (FEV1) 3.0 ±0.7 vs. 3.7 ±0.9l (p = 0.0002) respectively. Serum BNP concentrations were higher in study patients than in control subjects; 71.8 ±74.4 vs. 10.7 ±8.1 (pg/ml) respectively (p = 0.00001). No significant correlations between BNP levels and CpET parameters were found. Conclusions Patients with a morphological right ventricle serving the systemic circulation and those with common ventricle physiology after Fontan operation show markedly reduced exercise capacity. They are also characterized by higher serum BNP concentrations, which do not however correlate with CpET parameters. PMID:22371746

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

    PubMed

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

    2014-02-01

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

  3. Submaximal cardiopulmonary exercise testing predicts 90-day survival after liver transplantation.

    PubMed

    Prentis, James M; Manas, Derek M D; Trenell, Michael I; Hudson, Mark; Jones, David J; Snowden, Chris P

    2012-02-01

    Liver transplantation has a significant early postoperative mortality rate. An accurate preoperative assessment is essential for minimizing mortality and optimizing limited donor organ resources. This study assessed the feasibility of preoperative submaximal cardiopulmonary exercise testing (CPET) for determining the cardiopulmonary reserve in patients being assessed for liver transplantation and its potential for predicting 90-day posttransplant survival. One hundred eighty-two patients underwent CPET as part of their preoperative assessment for elective liver transplantation. The 90-day mortality rate, critical care length of stay, and hospital length of stay were determined during the prospective posttransplant follow-up. One hundred sixty-five of the 182 patients (91%) successfully completed CPET; this was defined as the ability to determine a submaximal exercise parameter: the anaerobic threshold (AT). Sixty of the 182 patients (33%) underwent liver transplantation, and the mortality rate was 10.0% (6/60). The mean AT value was significantly higher for survivors versus nonsurvivors (12.0 ± 2.4 versus 8.4 ± 1.3 mL/minute/kg, P < 0.001). Logistic regression revealed that AT, donor age, blood transfusions, and fresh frozen plasma transfusions were significant univariate predictors of outcomes. In a multivariate analysis, only AT was retained as a significant predictor of mortality. A receiver operating characteristic curve analysis demonstrated sensitivity and specificity of 90.7% and 83.3%, respectively, with good model accuracy (area under the receiver operating characteristic curve = 0.92, 95% confidence interval = 0.82-0.97, P = 0.001). The optimal AT level for survival was defined to be >9.0 mL/minute/kg. The predictive value was improved when the ideal weight was substituted for the actual body weight of a patient with refractory ascites, even after a correction for the donor's age. In conclusion, the preoperative cardiorespiratory reserve (as defined by CPET) is a sensitive and specific predictor of early survival after liver transplantation. The predictive value of CPET requires further evaluation. PMID:21898768

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed

    Aliannejad, Rasoul; Saburi, Amin; Ghanei, Mostafa

    2013-04-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-04-01

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

  8. Optimizing the exercise protocol for cardiopulmonary assessment.

    PubMed

    Buchfuhrer, M J; Hansen, J E; Robinson, T E; Sue, D Y; Wasserman, K; Whipp, B J

    1983-11-01

    Twelve normal men performed 1-min incremental exercise tests to exhaustion in approximately 10 min on both treadmill and cycle ergometer. The maximal O2 uptake (VO2 max) and anaerobic threshold (AT) were higher (6 and 13%, respectively) on the treadmill than the cycle; the AT was reached at about 50% of VO2 max on both ergometers. Maximal CO2 output, heart rate, and O2 pulse were also slightly, but significantly higher on the treadmill. Maximal ventilation, gas exchange ratio, and ventilatory equivalents for O2 and CO2 for both forms of exercise were not significantly different. To determine the optimum exercise test for both treadmill and cycle, we exercised five of the subjects at various work rate increments on both ergometers in a randomized design. The treadmill increments were 0.8, 1.7, 2.5, and 4.2%/min at a constant speed of 3.4 mph, and 1.7 and 4.2%/min at 4.5 mph. Cycle increments were 15, 30, and 60 W/min. The VO2 max was significantly higher on tests where the increment magnitude was large enough to induce test durations of 8-17 min, but the AT was independent of test duration. Thus, for evaluating cardiopulmonary function with incremental exercise testing by either treadmill or cycle, we suggest selecting a work rate increment to bring the subject to the limit of his tolerance in about 10 min. PMID:6643191

  9. 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

    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

    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

  10. Relationship Between the Oxygen Uptake During Cardiopulmonary Exercise Testing and Left Ventricular Function in Patients with Acute Myocardial Infarction

    PubMed Central

    Imai, Kamon; Kubota, Akihito; Inoue, Kazuhisa; Taguchi, Takayuki; Nishihara, Ken; Hara, Kazuhiko; Fujinawa, Osamu; Uematu, Mitsutoshi; Nakayama, Akikazu; Mizorogi, Tadashi; Ehara, Koukichi; Hosoda, Kazuho

    2003-01-01

    The relationship between exercise capacity and left ventricular function has been evaluated in 35 patients with acute myocardial infarction (34 males and 1 female; mean age 55.5 ± 7.1 years). Single photon emission computed tomography (SPECT) was used to measure left ventricular function in the acute phase (4.9 ± 2.2 days after onset) and the chronic phase (188.5 ± 22.9 days after onset). More than 10% left ventricular dilatation from the acute phase to the chronic phase was defined as remodeling (RM) and the subjects were divided into 2 groups: RM and non-RM. Cardiopulmonary exercise testing was performed at 1 month (1M), 3 months (3M) and 6 months (6M) after onset. In the RM group, anaerobic threshold (AT) and peak oxygen uptake (Peak ) did not change significantly. In the non-RM group, AT was 15 ± 1 (ml/min/Kg) at 1M, 16 ± 2 at 3M and 18 ± 4 at 6M. Peak was 26 ± 3 (ml/min/Kg) at 1M, 30 ± 2 at 3M and 32 ± 3 at 6M. Both parameters in the chronic phase increased significantly compared with those at 1M (p<0.002 and p<0.0001). Thus, change in exercise capacity would correlate with change in left ventricular function.

  11. Predicting the highest workload in cardiopulmonary test

    Microsoft Academic Search

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

    2010-01-01

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

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

    PubMed

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

    2015-02-01

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

  13. Influence of body mass on risk prediction during cardiopulmonary exercise testing in patients with chronic heart failure

    PubMed Central

    Ingle, Lee; Sloan, Rebecca; Carroll, Sean; Goode, Kevin; Cleland, John G; Clark, Andrew L

    2012-01-01

    INTRODUCTION: Peak oxygen uptake (VO2) during a maximal exercise test is used to stratify patients with chronic heart failure (CHF) and is usually corrected for body mass. OBJECTIVE: To explore the influence of body mass on risk prediction during treadmill cardiopulmonary exercise testing (CPET) in patients with CHF. METHODS: A total of 411 patients with suspected CHF (mean [± SD] age 64±12 years; 81% male; mean left ventricular ejection fraction 39±6%) underwent symptom-limited, maximal CPET on a treadmill. Patients were categorized as normal weight, overweight or obese based on body mass index. RESULTS: One hundred fifteen patients died during a median follow-up period of 8.7±2.3 years in survivors. In the univariable analysis, peak VO2 adjusted for body mass (?2=41.4) and unadjusted (?2=40.2) were similar for predicting all-cause mortality. Peak VO2 adjusted for body mass showed marginally higher ?2 values in normal weight, overweight and obese categories than unadjusted values. Anaerobic threshold had similar prognostic power regardless of whether it was corrected for body mass (?2=22.4 and ?2=24.4), with no difference between the two in any of the subgroups separately. In all patients, unadjusted ventilation (VE)/carbon dioxide production (VCO2) slope (?2=40.6) was a stronger predictor of all-cause mortality than body mass adjusted values (?2=32.8), and unadjusted values remained stronger in normal weight, overweight and obese subgroups. CONCLUSION: Correcting peak VO2 for body mass slightly improves risk prediction, especially in obese patients with CHF. The adjustment of other CPET-derived variables including anaerobic threshold and VE/VCO2 slope for body mass appears to provide less prognostic value. PMID:23592931

  14. Aerobic capacity during cardiopulmonary exercise testing and survival with and without liver transplantation for patients with chronic liver disease.

    PubMed

    Bernal, William; Martin-Mateos, Rosa; Lipcsey, Miklós; Tallis, Caroline; Woodsford, Kyne; McPhail, Mark J; Willars, Christopher; Auzinger, Georg; Sizer, Elizabeth; Heneghan, Michael; Cottam, Simon; Heaton, Nigel; Wendon, Julia

    2014-01-01

    Chronic liver disease (CLD) is associated with muscle wasting, reduced exercise tolerance and aerobic capacity (AC). Measures of AC determined with cardiopulmonary exercise testing (CPET) may predict survival after liver transplantation (LT), but the relationship with nontransplant outcomes is uncertain. In patients assessed for LT, we examined the relationship of CPET AC parameters with the severity of liver disease, nutritional state, and survival with and without LT. Patients assessed for elective first LT who underwent CPET and an anthropometric assessment at a single center were studied. CPET-derived measures of AC that were evaluated included the peak oxygen consumption (VO2 peak) and the anaerobic threshold (AT). Three hundred ninety-nine patients underwent CPET, and 223 underwent LT; 45% of the patients had a VO2 peak < 50% of the predicted value, and 31% had an AT < 9 mL/kg/minute. The VO2 peak and AT values correlated with the Model for End-Stage Liver Disease score, but they more closely correlated with serum sodium and albumin levels. The handgrip strength correlated strongly with the VO2 peak. Patients with impaired AC had prolonged hospitalization after LT, and nonsurvivors had lower AT values than survivors 1 year after transplantation (P < 0.05); this was significant in a multivariate analysis. One hundred seventy-six patients did not undergo LT; the 1-year mortality rate was 34.6%. The AT (P < 0.05) and VO2 peak values (P < 0.001) were lower for nonsurvivors. In a multivariate analysis, AT was independently associated with nonsurvival. In conclusion, AC was markedly impaired in many patients with CLD. In patients who did not undergo transplantation, impaired AT was predictive of mortality, and in patients undergoing LT, it was related to postoperative hospitalization and survival. AC should be evaluated as a modifiable factor for improving patient survival whether or not LT is anticipated. PMID:24136710

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

    PubMed Central

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

    2012-01-01

    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

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

    Microsoft Academic Search

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

    2008-01-01

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

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

    PubMed Central

    2010-01-01

    Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p < 0.001), the SPO2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p < 0.001 respectively) and the desaturation index (r = .634, p = 0.001) for the 6MWT; the MRC score and VO2 peak/kg (r = -.731, p < 0.001), SPO2 at peak exercise (r = -. 682, p < 0.001), VE/VCO2 slope (r = .731, p < 0.001), VE/VCO2 at AT (r = .630, p = 0.002) and the Borg scale at peak exercise (r = .50, p = 0.01) for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT. Conclusion In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF. PMID:20509928

  18. Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation

    PubMed Central

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

    2014-01-01

    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

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

    Microsoft Academic Search

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

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

  20. Cardiopulmonary exercise testing in systolic heart failure in 2014: the evolving prognostic role: a position paper from the committee on exercise physiology and training of the heart failure association of the ESC.

    PubMed

    Corrà, Ugo; Piepoli, Massimo F; Adamopoulos, Stamatis; Agostoni, Piergiuseppe; Coats, Andrew J S; Conraads, Viviane; Lambrinou, Ekaterini; Pieske, Burkert; Piotrowicz, Ewa; Schmid, Jean-Paul; Seferovi?, Petar M; Anker, Stefan D; Filippatos, Gerasimos; Ponikowski, Piotr P

    2014-09-01

    The relationship between exercise capacity, as assessed by peak oxygen consumption, and outcome is well established in heart failure (HF), but the predictive value of cardiopulmonary exercise testing (CPET) has been recently questioned, for two main reasons. First, the decisional power of CPET in the selection of heart transplantation candidates has diminished, since newer therapeutic options and the shortage of donor hearts have restricted this curative option to extremely advanced HF patients, frequently not able to perform a symptom-limited CPET. Secondly, the use of CPET has become more complex and sophisticated, with many promising new prognostic indexes proposed each year. Thus, a modern interpretation of CPET calls for selective expertise that is not routinely available in all HF centres. This position paper examines the history of CPET in risk stratification in HF. Throughout five phases of achievements, the journey from a single CPET parameter (i.e. peak oxygen consumption) to a multiparametric approach embracing the full clinical picture in HF-including functional, neurohumoral, and laboratory findings-is illustrated and discussed. An innovative multifactorial model is proposed, with CPET at its core, that helps optimize our understanding and management of HF patients. PMID:25175894

  1. Cardiopulmonary adaptation to exercise in coal miners

    SciTech Connect

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

    1980-11-01

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

  2. [Cardiopulmonary stress test--interpretation and clinical indications].

    PubMed

    Man, Avi; Keren, Gad; Topilsky, Yan

    2014-02-01

    A recent report in Harefuah has introduced cardiopulmonary exercise testing (CPX), presenting its physiological basis and key parameters. Despite the fact that multiple guideline documents and scientific statements have been published in the last few years by the leading European and American societies summarizing the incremental information added by the addition of ventilatory gas exchange measurements, CPX continues to be underutilized by the practicing clinician. One of the main reasons for this is the lack of understanding of the value of CPX by the practicing clinicians. In this review we will describe the current clinical and emerging applications of CPX, and try to simplify interpretation and reporting of CPX test data. We will also review CPX findings in selected clinical populations and the implication of these observations to the clinical evaluation of patients with heart and/ or lung diseases. PMID:24716426

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

    PubMed Central

    2013-01-01

    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

  4. Exercise adherence, cardiopulmonary fitness and anthropometric changes improve exercise self-efficacy and health-related quality of life

    PubMed Central

    Imayama, Ikuyo; Alfano, Catherine M.; Mason, Caitlin E.; Wang, Chiachi; Xiao, Liren; Duggan, Catherine; Campbell, Kristin L.; Foster-Schubert, Karen E.; McTiernan, Anne

    2014-01-01

    Background Regular exercise increases exercise self-efficacy and health-related quality of life (HRQOL); however, the mechanisms are unknown. We examined the associations of exercise adherence and physiological improvements with changes in exercise self-efficacy and HRQOL. Methods Middle-aged adults (N=202) were randomized to 12 months aerobic exercise (360 minutes/week) or control. Weight, waist circumference, percent body fat, cardiopulmonary fitness, HRQOL (SF-36), and exercise self-efficacy were assessed at baseline and 12 months. Adherence was measured in minutes/day from activity logs. Results Exercise adherence was associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (Ptrend?0.05). Increased fitness was associated with improved physical functioning, bodily pain and general health scores (Ptrend?0.04). Reduced weight and percent body fat were associated with improved physical functioning, general health, and bodily pain scores (Ptrend<0.05). Decreased waist circumference was associated with improved bodily pain and general health but with reduced role-emotional scores (Ptrend?0.05). High exercise adherence, increased cardiopulmonary fitness and reduced weight, waist circumference and percent body fat were associated with increased exercise self-efficacy (Ptrend<0.02). Conclusions Monitoring adherence and tailoring exercise programs to induce changes in cardiopulmonary fitness and body composition may lead to greater improvements in HRQOL and self-efficacy that could promote exercise maintenance. PMID:23036856

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

    PubMed Central

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

    2012-01-01

    The aim of this study was to evaluate the prognostic value of renal function in relation to amino-terminal portion of the pro-hormone B-type natriuretic peptide (NT-proBNP) and parameters of cardiopulmonary exercise testing in predicting mortality and morbidity in patients with moderate chronic heart failure (CHF). Sixty-one CHF patients were included in the study. Patients' characteristics were: age 64.3±11.6 years; New York Heart Association class I/II/III: 14/37/10; left ventricular ejection fraction: 0.30±0.13 (%); NT-proBNP: 252.2±348.0 (ng/L); estimated creatinine clearance (e-CC): 73.6±31.4 (mL/min); estimated glomerular filtration rate (e-GFR): 66.1±24.6 (mL/min/1.73 m2); the highest O2 uptake during exercise (VO2-peak): 1.24±0.12 mL/kg/min; VO2/workload: 8.52±1.81 (mL/min/W)]. During follow up (59.5±4.0 months) there were 15 cardiac deaths and 16 patients were hospitalized due to progression of heart failure. NT-proBNP and VO2/workload were independently associated with cardiac death (P=0.007 and P=0.006, respectively). Hospitalization for progressive CHF was only associated with NT-proBNP (P=0.002). The combined cardiac events (cardiac death and hospitalization) were associated with NT-proBNP and VO2/ workload (P=0.007 and P=0.005, respectively). The addition of estimates of renal function (neither serum creatinine nor e-GFR) did not improve the prognostic value for any of the models.In conclusion, in patients with moderate CHF, increased NT-proBNP and reduced VO2/ work-load identify those with increased mortality and morbidity, irrespective of estimates of renal function. PMID:23185680

  6. Exercise stress test

    MedlinePLUS

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

  7. Recommendations on the use of exercise testing in clinical practice

    Microsoft Academic Search

    P. Palange; S. A. Ward; K. H. Carlsen; R. Casaburi; C. G. Gallagher; R. Gosselink; D. E. O'Donnell; L. Puente-Maestu; A. M. Schols; S. Singh; B. J. Whipp

    2006-01-01

    Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A,

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2012-01-01

    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

  10. Usefulness of cardiopulmonary exercise to predict long-term prognosis in adults with repaired tetralogy of Fallot.

    PubMed

    Giardini, Alessandro; Specchia, Salvatore; Tacy, Theresa Ann; Coutsoumbas, Gloria; Gargiulo, Gaetano; Donti, Andrea; Formigari, Roberto; Bonvicini, Marco; Picchio, Fernando Maria

    2007-05-15

    Adults with tetralogy of Fallot (TOF) have increased long-term mortality. The identification of patients at greater risk for death or cardiac-related morbidity is challenging. This study was conducted to assess the prognostic value of cardiopulmonary exercise testing in adults with repaired TOF. One hundred eighteen consecutive adults with repaired TOF (mean age at repair 4.8 +/- 4.2 years) underwent cardiopulmonary exercise testing at a mean age of 24 +/- 8 years (range 16 to 59). The degree of pulmonary regurgitation, right ventricular function, and right ventricular systolic pressure were determined by transthoracic echocardiography. After the exercise tests, patients were regularly followed up for cardiac-related events. During a mean follow-up of 5.8 +/- 2.3 years (range 0.6 to 9.7), 9 patients died and 18 underwent hospitalization. Peak oxygen uptake (hazard ratio 0.974, 95% confidence interval 0.950 to 0.994), the slope of ventilation (VE) per unit of carbon dioxide production (VCO(2)) (hazard ratio 1.076, 95% confidence interval 1.038 to 1.115), and New York Heart Association functional class (hazard ratio 2.118, 95% confidence interval 1.344 to 3.542) were independent predictors of death or hospitalization. Patients with peak oxygen uptake < or =36% of predicted value and those with VE/VCO(2) slopes >39 were at greater risk for cardiac-related death (5-year mortality 48% vs 0%, p <0.0001, and 31% vs 0%, p <0.0001, respectively). In conclusion, the measurement of peak oxygen uptake and VE/VCO(2) slope in adults with repaired TOF can be prognostically important and could become a powerful tool to rationalize decisions regarding the prevention of premature sudden death and the need for reintervention. PMID:17493481

  11. Metabolic Parameters Derived From Cardiopulmonary Stress Testing for Prediction of Prognosis in Patients With Heart Failure: The Ochsner Experience

    PubMed Central

    Crespo, Joaquin; Lavie, Carl J.; Milani, Richard V.; Gilliland, Yvonne E.; Patel, Hamang M.; Ventura, Hector O.

    2009-01-01

    Cardiopulmonary parameters, particularly peak oxygen consumption, have proven utility in prognostic stratification for patients with heart failure. These have been typically corrected for total body weight as opposed to lean body mass (LBM). For practical purposes, fat consumes virtually no oxygen and receives minimal perfusion. Based on this rationale and on observations from previous studies, several investigations conducted at the Ochsner Clinic Foundation have assessed the prognostic value of metabolic parameters when corrected for LBM. Three studies reviewed in this discussion consistently found greater prognostic value for LBM-corrected parameters, especially peak oxygen consumption and oxygen pulse. These findings lead to a strong recommendation for LBM correction of cardiopulmonary exercise stress test–derived parameters for more accurate prognostic stratification in patients with heart failure, especially in the obese population. Other centers have studied additional parameters such as the ventilation to carbon dioxide production slope, oxygen uptake efficiency slope, and partial pressure of end-tidal carbon dioxide during exercise and rest. In multiple studies, these ventilation-dependent parameters have shown prognostic superiority compared with the standard peak oxygen consumption even when obtained from submaximal exercise data. However, no study to our knowledge has compared these parameters with LBM-adjusted values as described herein. The prognostic validity of cardiopulmonary exercise stress test–derived parameters requires further investigation in patients treated with ?-blockers. PMID:21603413

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

    PubMed Central

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

    1997-01-01

    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

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

    PubMed Central

    2014-01-01

    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

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

    PubMed

    Pichurko, Bohdan M

    2012-01-01

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

  15. A new method for data presentation in incremental cardiorespiratory exercise testing

    Microsoft Academic Search

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

    1997-01-01

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

  16. Effects of acceleration in the Gz axis on human cardiopulmonary responses to exercise.

    PubMed

    Bonjour, Julien; Bringard, Aurélien; Antonutto, Guglielmo; Capelli, Carlo; Linnarsson, Dag; Pendergast, David R; Ferretti, Guido

    2011-12-01

    The aim of this paper was to develop a model from experimental data allowing a prediction of the cardiopulmonary responses to steady-state submaximal exercise in varying gravitational environments, with acceleration in the G(z) axis (a (g)) ranging from 0 to 3 g. To this aim, we combined data from three different experiments, carried out at Buffalo, at Stockholm and inside the Mir Station. Oxygen consumption, as expected, increased linearly with a (g). In contrast, heart rate increased non-linearly with a (g), whereas stroke volume decreased non-linearly: both were described by quadratic functions. Thus, the relationship between cardiac output and a (g) was described by a fourth power regression equation. Mean arterial pressure increased with a (g) non linearly, a relation that we interpolated again with a quadratic function. Thus, total peripheral resistance varied linearly with a (g). These data led to predict that maximal oxygen consumption would decrease drastically as a (g) is increased. Maximal oxygen consumption would become equal to resting oxygen consumption when a (g) is around 4.5 g, thus indicating the practical impossibility for humans to stay and work on the biggest Planets of the Solar System. PMID:21437604

  17. [Exercise testing in respiratory medicine].

    PubMed

    Meyer, F J; Borst, M M; Buschmann, H C; Ewert, R; Friedmann-Bette, B; Ochmann, U; Petermann, W; Preisser, A M; Rohde, D; Rühle, K-H; Sorichter, S; Stähler, G; Westhoff, M; Worth, H

    2013-01-01

    This document replaces the DGP recommendations published in 1998. Based on recent studies and a consensus conference, the indications, choice and performance of the adequate exercise testing method in its necessary technical and staffing setting are discussed. Detailed recommendations are provided: for arterial blood gas analysis and right heart catherterization during exercise, 6-minute walk test, spiroergometry, and stress echocardiography. The correct use of different exercise tests is discussed for specific situations in respiratory medicine: exercise induced asthma, monitoring of physical training or therapeutical interventions, preoperative risk stratification, and evaluation in occupational medicine. PMID:23325729

  18. Specificity of a Maximal Step Exercise Test

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  19. Exercise stress testing

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1975-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  1. In Vitro Characterization and Performance Testing of the Ension Pediatric Cardiopulmonary Assist System (pCAS)

    PubMed Central

    Pantalos, George M.; Horrell, Tim; Merkley, Tracey; Sahetya, Sarina; Speakman, Jeff; Johnson, Greg; Gartner, Mark

    2009-01-01

    In the last forty years, mechanical circulatory support devices have become an effective option for the treatment of end stage heart failure in adults. Few possibilities, however, are available for pediatric cardiopulmonary support. Ension Inc. (Pittsburgh, PA) is developing a pediatric cardiopulmonary assist system (pCAS) intended to address the limitations of existing devices used for this patient population. The pCAS device is an integrated unit containing an oxygenator and pump within a single casing, significantly reducing the size and blood-contacting surface area in comparison to current devices. Prototype pCAS devices produce appropriate flows and pressures while minimizing priming volume and preparation time. The pCAS was tested on a mock circulation designed to approximate the hemodynamic parameters of a small infant using a 10 Fr. ECMO inflow cannula and an 8 Fr. ECMO outflow cannula. Revision 4 of the device provided a flow rate of 0.42 L/min at 6500 RPM. Revision 5, featuring improved impeller and diffuser designs, provided a flow rate of 0.57 L/min at 5000 RPM. The performance tests indicate that for this cannulae combination, the pCAS pump is capable of delivering sufficient flows for patients less than 5 kg. PMID:19293710

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

    PubMed Central

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

    1977-01-01

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

  3. Eccentric exercise testing and training

    NASA Technical Reports Server (NTRS)

    Clarkson, Priscilla M.

    1994-01-01

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

  4. Exercise thallium testing in ventricular preexcitation

    SciTech Connect

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

    1987-05-01

    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.

  5. Exercise testing in severe emphysema: association with quality of life and lung function.

    PubMed

    Brown, Cynthia D; Benditt, Joshua O; Sciurba, Frank C; Lee, Shing M; Criner, Gerard J; Mosenifar, Zab; Shade, David M; Slivka, William A; Wise, Robert A

    2008-04-01

    Six-minute walk testing (6MWT) and cardiopulmonary exercise testing (CPX) are used to evaluate impairment in emphysema. However, the extent of impairment in these tests as well as the correlation of these tests with each other and lung function in advanced emphysema is not well characterized. During screening for the National Emphysema Treatment Trial, maximum ergometer CPX and 6MWT were performed in 1,218 individuals with severe COPD with an average FEV(1) of 26.9 +/- 7.1 % predicted. Predicted values for 6MWT and CPX were calculated from reference equations. Correlation coefficients and multivariable regression models were used to determine the association between lung function, quality of life (QOL) scores, and exercise measures. The two forms of exercise testing were correlated with each other (r = 0.57, p < 0.0001). However, the impairment of performance on CPX was greater than on the 6MWT (27.6 +/- 16.8 vs. 67.9 +/- 18.9 % predicted). Both exercise tests had similar correlation with measures of QOL, but maximum exercise capacity was better correlated with lung function measures than 6-minute walk distance. After adjustment, 6MWD had a slightly greater association with total SGRQ score than maximal exercise (effect size 0.37 +/- 0.04 vs. 0.25 +/- 0.03 %predicted/unit). Despite advanced emphysema, patients are able to maintain 6MWD to a greater degree than maximum exercise capacity. Moreover, the 6MWT may be a better test of functional capacity given its greater association with QOL measures whereas CPX is a better test of physiologic impairment. PMID:18415810

  6. Exercise Pathophysiology in Patients With Primary Pulmonary Hypertension

    Microsoft Academic Search

    Xing-Guo Sun; James E. Hansen; Ronald J. Oudiz; Karlman Wasserman

    2008-01-01

    Background—Patients with primary pulmonary hypertension (PPH) have a pulmonary vasculopathy that leads to exercise intolerance due to dyspnea and fatigue. To better understand the basis of the exercise limitation in patients with PPH, cardiopulmonary exercise testing (CPET) with gas exchange measurements, New York Heart Association (NYHA) symptom class, and resting pulmonary hemodynamics were studied. Methods and Results—We retrospectively evaluated 53

  7. Better decisions through science: exercise testing scores

    Microsoft Academic Search

    Victor Froelicher; Katerina Shetler; Euan Ashley

    2003-01-01

    Statistical tools can be used to create scores for assisting in the diagnosis of coronary artery disease and assessing prognosis. General practitioners and internists frequently function as gatekeepers, deciding which patients must be referred to the cardiologist. Therefore, they need to use the basic tools they have available (ie, history, physical examination and the exercise test) in an optimal fashion.

  8. Better decisions through science: Exercise testing scores

    Microsoft Academic Search

    Victor Froelicher; Katerina Shetler; Euan Ashley

    2002-01-01

    Statistical tools can be used to create scores for assisting in the diagnosis of coronary artery disease and assessing prognosis. General practitioners and internists frequently function as gatekeepers, deciding which patients must be referred to the cardiologist. Therefore, they need to use the basic tools they have available (ie, history, physical examination and the exercise test) in an optimal fashion.

  9. Exercise Testing for the Symptomatic Athlete

    Microsoft Academic Search

    Karl B. Fields

    Many physicians consider exercise tolerance testing for athletes to be counterintuitive in that these individuals routinely\\u000a perform high-level activity that would stress the cardiovascular system. However, numerous case reports of high-level athletes\\u000a experiencing cardiac death have underscored the importance of identifying the athlete with symptoms that warrant evaluation.\\u000a An additional challenge of deciding who merits testing is the labeling of

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

    PubMed Central

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

    2010-01-01

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

  11. Guideline Recommendations for Testing of ALK Gene Rearrangement in Lung Cancer: A Proposal of the Korean Cardiopulmonary Pathology Study Group

    PubMed Central

    Kim, Hyojin; Shim, Hyo Sup; Kim, Lucia; Kim, Tae-Jung; Kwon, Kun Young

    2014-01-01

    Rearrangement of anaplastic lymphoma kinase (ALK) gene is the best predictor of response to crizotinib, an ALK tyrosine kinase inhibitor. However, the prevalence of the ALK fusion is low, so accurate patient identification is crucial for successful treatment using ALK inhibitors. Furthermore, most patients with lung cancer present with advanced-stage disease at the time of diagnosis, so it is important for pathologists to detect ALK-rearranged patients while effectively maximizing small biopsy or cytology specimens. In this review, we propose a guideline recommendation for ALK testing approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists. PMID:24627688

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

    ERIC Educational Resources Information Center

    Lamont, Linda S.

    1981-01-01

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

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

    PubMed

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

    2014-04-01

    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

  14. Cardiopulmonary performance during exercise in acromegaly, and the effects of acute suppression of growth hormone hypersecretion with octreotide

    Microsoft Academic Search

    Andrea Giustina; Enrico Boni; Giuseppe Romanelli; Vittorio Grossi; Gianni Giustina

    1995-01-01

    We studied 10 adult patients with active acromegaly (4 men and 6 women, mean age 55 ± 5 years and mean body mass index 27.9 ± 1.1 kg\\/m2). Control values for the echocardiographic and exercise studies were obtained from 10 normal subjects matched for sex and age (5 men and 5 women, age 51.1 ± 3.7 years and body mass

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

    Microsoft Academic Search

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

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

  16. Exercise Tolerance Measurements in Pulmonary Vascular Diseases and Chronic Heart Failure

    Microsoft Academic Search

    Massimo F. Piepoli

    2009-01-01

    The hallmark symptoms of heart failure are dyspnoea and fatigue during exercise. In recent years, the physiologic response to progressive exercise using direct measures of ventilation and gas exchange, commonly termed the ‘cardiopulmonary exercise test’ (CPET), has evolved into an important clinical tool in the management of patients with heart failure. CPET provides a global assessment of the integrated response

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

    Microsoft Academic Search

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

    2009-01-01

    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

  18. Paleoecological exercise: Testing competition among Paleozoic brachiopods

    NSDL National Science Digital Library

    David Kendrick

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

  19. Original article Comparison of track and treadmill exercise tests

    E-print Network

    Boyer, Edmond

    Original article Comparison of track and treadmill exercise tests in saddle horses: a preliminary October 1991; accepted 30 April 1992) Summary — Several exercise test procedures were compared by measuring cardiovascular, meta- bolic and locomotor system variables. Six Anglo-arabians and one French

  20. Energy System Contributions During Incremental Exercise Test

    PubMed Central

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

    2013-01-01

    The main purpose of this study was to determine the relative contributions of the aerobic and glycolytic systems during an incremental exercise test (IET). Ten male recreational long-distance runners performed an IET consisting of three-minute incremental stages on a treadmill. The fractions of the contributions of the aerobic and glycolytic systems were calculated for each stage based on the oxygen uptake and the oxygen energy equivalents derived by blood lactate accumulation, respectively. Total metabolic demand (WTOTAL) was considered as the sum of these two energy systems. The aerobic (WAER) and glycolytic (WGLYCOL) system contributions were expressed as a percentage of the WTOTAL. The results indicated that WAER (86-95%) was significantly higher than WGLYCOL (5-14%) throughout the IET (p < 0.05). In addition, there was no evidence of the sudden increase in WGLYCOL that has been previously reported to support to the “anaerobic threshold” concept. These data suggest that the aerobic metabolism is predominant throughout the IET and that energy system contributions undergo a slow transition from low to high intensity. Key Points The aerobic metabolism contribution is the predominant throughout the maximal incremental test. The speed corresponding to the aerobic threshold can be considered the point in which aerobic metabolism reaches its maximal contribution. Glycolytic metabolism did not contribute largely to the energy expenditure at intensities above the anaerobic threshold. PMID:24149151

  1. Exercise Testing and Training in Patients with (Chronic) Pain

    Microsoft Academic Search

    Harriët Wittink; Tim Takken

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

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

    PubMed

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

    2015-01-01

    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 < 0.001; (b) peak ST depression decreased by -0.38 mm (95% CI: -0.66 to -0.10), p < 0.01; and (c) rate-pressure product at 1 mm STD increased by 1.80 × 10(3)mmHg (95% CI: 1.0-2.0), p < 0.001. This is the first meta-analysis to set clinical parameters to assess the benefit of 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

  3. Cardiorespiratory Responses to Exercise After Anatomic Repair of Atrioventricular Discordance with Abnormal Ventriculoarterial Connection

    Microsoft Academic Search

    Kenji Yasuda; Hideo Ohuchi; Yasuo Ono; Toshikatsu Yagihara; Shigeyuki Echigo

    2007-01-01

    We evaluated exercise tolerance and cardiorespiratory responses to exercise in patients with atrioventricular discordance\\u000a (AVD) and abnormal ventriculoarterial connection after anatomic repair. Cardiopulmonary treadmill exercise testing with gas\\u000a measurement was done 62 times in 19 patients with AVD who had undergone anatomic repair at the National Cardiovascular Center.\\u000a Exercise duration, oxygen uptake (\\u000a \\u000a O2) and heart rate at anaerobic threshold

  4. Exercise Training Following Burn Injury: A Survey of Practice

    PubMed Central

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

    2013-01-01

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

  5. Cardiopulmonary resuscitation training revisited.

    PubMed Central

    Goodwin, A P

    1992-01-01

    The cardiopulmonary resuscitation (CPR) skills of 50 junior hospital doctors (22 house officers and 28 senior house officers) were assessed. Theoretical knowledge was measured by a multiple choice questionnaire and practical ability with the Laerdal Skillmeter Resusci Anne. Only 40% of the study group passed both tests. Those doctors who had previously received regular CPR training performed better in the practical test (P<0.05) than those who had not. Theoretical knowledge was unrelated to previous CPR training. It is recommended that junior hospital doctors should undergo regular CPR training every 6 months, in order to maintain their practical CPR skills. PMID:1404190

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

    PubMed

    Elliott, Adrian D; Grace, Fergal

    2010-10-01

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

  7. Effects of a maximal exercise test on neurocognitive function

    Microsoft Academic Search

    Tracey Covassin; Leigh Weiss; John Powell; Christopher Womack; M. R Lovell

    2007-01-01

    Objective: To examine the effects of a maximal exercise test on cognitive function in recreational athletes.Design: A repeated-measures design was used to compare baseline with post-cognitive function and fatigue symptoms after a maximal exercise test.Setting: Division 1 American Midwestern University, (Michigan State University, Michigan, USA).Participants: 102 male and female recreational athletes.Intervention: Participants in the experimental group (n = 54) were

  8. Cardiopulmonary Resuscitation (CPR)

    MedlinePLUS

    MENU Return to Web version Cardiopulmonary Resuscitation (CPR) Cardiopulmonary Resuscitation (CPR) When is CPR important? CPR may be done when a person stops breathing or the heart stops beating (like when ...

  9. Exercise testing and hemodynamic performance in healthy elderly persons

    SciTech Connect

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

    1984-11-01

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

  10. Aerobic exercise physiology in a professional rugby union team

    Microsoft Academic Search

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

    2003-01-01

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

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

    PubMed Central

    Gappmaier, Eduard

    2012-01-01

    Purpose To describe how to perform a Submaximal Clinical Exercise Tolerance Test (SXTT) as part of an exercise evaluation in the physical therapy clinic to determine an appropriate exercise prescription and to establish safety of exercise for physical therapy clients. Summary of Key Points Physical activity is crucial for general health maintenance. An exercise evaluation includes a comprehensive patient history, physical examination, exercise testing, and exercise prescription. The SXTT provides important clinical data that form the foundation for an effective and safe exercise prescription. Observations obtained during the exercise evaluation will identify at-risk patients who should undergo further medical evaluation before starting an exercise program. Two case examples of SXTTs administered to individuals with multiple sclerosis are presented to demonstrate the application of these principles. Statement of Recommendations Due to their unique qualifications, physical therapists shall assume responsibility to design and monitor safe and effective physical activity programs for all clients and especially for individuals with chronic disease and disability. To ensure safety and efficacy of prescribed exercise interventions, physical therapists need to perform an appropriate exercise evaluation including exercise testing before starting their clients on an exercise program. PMID:22833706

  12. The Sunflower Cardiopulmonary Research Project of Children.

    ERIC Educational Resources Information Center

    Greene, Leon

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

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

    Microsoft Academic Search

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

    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,

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

    ERIC Educational Resources Information Center

    Saint Paul Technical Vocational Inst., MN.

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

  15. An Exercise for Illustrating the Logic of Hypothesis Testing

    ERIC Educational Resources Information Center

    Lawton, Leigh

    2009-01-01

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

  16. The prognostic value of post-exercise blood pressure reduction in patients with hypertensive response during exercise stress test

    Microsoft Academic Search

    Chaim Yosefy; Jamal Jafari; Eliezer Klainman; Boris Brodkin; Mark D. Handschumacher; Mordehay Vaturi

    2006-01-01

    BackgroundHypertensive response at peak-exercise and during the recovery phase of exercise stress test (ET) is associated with poor cardiovascular prognosis. We investigated whether decrease in blood pressure (BP) from peak to post-exercise would identify a subgroup at higher cardiovascular risk.

  17. Cardiorespiratory Exercise Tolerance in Asymptomatic Children with Ebstein's Anomaly

    Microsoft Academic Search

    J. M. Lupoglazoff; I. Denjoy; M. Kabaker; K. Benali; B. Riescher; S. Magnier; C. Gaultier; A. Casasoprana

    1999-01-01

    .   The aim of the study was to evaluate cardiorespiratory exercise tolerance in asymptomatic children with Ebstein's anomaly.\\u000a Eleven children with a mean age of 9.6 years were prospectively studied by spirometry, cardiopulmonary exercise testing (bicycle\\u000a ergometer n= 8, treadmill test n= 3), and contrast echocardiography. A right-to-left atrial shunt was detected by contrast echocardiography in 7 children\\u000a (group 1),

  18. A new approach for proficiency test exercise data evaluation

    Microsoft Academic Search

    A. V. Harms

    2009-01-01

    In this paper, a new data evaluation method for proficiency test exercises consisting of a combination of a z-test, a zeta test and an uncertainty outlier test is presented. This new method is compared with eight other evaluation methods\\u000a (both measurement uncertainty using and measurement uncertainty ignoring) in common use and\\/or recommended by ISO 13528. The\\u000a data set used to

  19. Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension.

    PubMed

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

    2013-08-01

    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

  20. Role of exercise in testing and in therapy of COPD.

    PubMed

    Divo, Miguel; Pinto-Plata, Victor

    2012-07-01

    The stair-climbing test, 6MWT, and shuttle test are exercise tests that requires less technical support than the CPET and are more available to any physician. The 6MWT is the simplest and most likely to be cost effective, as it provides useful information regarding prognosis, ADLs, and health care use at a very low cost. In addition, the 6MWT can be used to evaluate response to several interventions, including physical rehabilitation, medications, lung volume reduction interventions, and transplantation. The 6MWT has also been useful in and has become an integral part of the evaluation and response to treatment in other medical conditions, including congestive heart failure, pulmonary hypertension, and pulmonary fibrosis. The stair-climbing test seems to be most useful for preoperative evaluations when a CPET is not available. We have also used it on patients unable to perform a good CPET because of lack of familiarity with bicycle pedaling. The shuttle walk test may be used to better determine a maximal exercise capacity when a CPET is not available and to measure the effects of pulmonary rehabilitation in patients unfamiliar with a CPET. The role of exercise as a therapeutic tool is central to the concept of pulmonary rehabilitation. Exercise training improves not only functional dyspnea and health-related quality of life, but also has been shown to decrease health care resource use. As part of a comprehensive pulmonary rehabilitation initiated after a hospitalization for exacerbation, it has been shown to decrease readmission rates. PMID:22793943

  1. Jogging in place. Evaluation of a simplified exercise test

    SciTech Connect

    Papazoglou, N.; Kolokouri-Dervou, E.; Fanourakis, I.; Natsis, P.; Koutsiouba, P. (Third Hospital of Social Security, Athens (Greece))

    1989-10-01

    The purpose of this study was to evaluate jogging in place as an electrocardiographic exercise test. Jogging in place continuously recorded via an ordinary single-channel electrocardiograph was compared with the Bruce treadmill protocol with a three-channel monitor and recorder in 141 cases with a wide spectrum of chest complaints. Agreement for the presence or absence of electrocardiographic ischemia (ST-segment displacement greater than or equal to 1 mm at 80 ms from the J point, or U-wave inversion) for the two tests was observed in 91 percent of the cases (95 percent confidence intervals: 86 percent to 95.5 percent). One hundred of the previous cases with paired electrocardiographic exercise tests were compared with the presence of reversible defects on exercise myocardial thallium-201 scintigraphy. The electrocardiographic ischemia had a similar correct classification rate in both methods (83 percent with jogging in place and 85 percent with Bruce treadmill protocol; not significant) against the finding of scintigraphic ischemia. This was also true for 52 cases having selective coronary arteriography. The correct classification rate was 54 percent (28/52) with jogging in place and 48 percent (25/52) with Bruce treadmill protocol (not significant). Given the safety and the easy applicability, even in older persons, this simplified test can be recommended as a valid alternative to the established multistage exercise tests.

  2. Post-exercise syncope: Wingate syncope test and effective countermeasure

    PubMed Central

    Lacewell, Alisha N.; Buck, Tahisha M.; Romero, Steven A.; Halliwill, John R.

    2013-01-01

    Altered systemic hemodynamics following exercise can compromise cerebral perfusion and result in syncope. As the Wingate anaerobic test often induces pre-syncope, we hypothesized that a modified Wingate test could form the basis of a novel model for the study of post-exercise syncope and a test-bed for potential countermeasures. Along these lines, breathing through an impedance threshold device has been shown to increase tolerance to hypovolemia, and could prove beneficial in the setting of post-exercise syncope. Therefore, we hypothesized that a modified Wingate test followed by head-up tilt would produce post-exercise syncope, and that breathing through an impedance threshold device (countermeasure) would prevent post-exercise syncope in healthy individuals. Nineteen recreationally active men and women underwent a 60° head-up tilt during recovery from the Wingate test while arterial pressure, heart rate, end-tidal CO2, and cerebral tissue oxygenation were measured on a control and countermeasure day. The duration of tolerable tilt was increased by a median time of 3 min 48 sec with countermeasure compared to control (P < 0.05) and completion of the tilt test increased from 42% to 67% with countermeasure. During the tilt, mean arterial pressure was greater (108.0 ± 4.1 vs.100.4 ± 2.4 mmHg; P < 0.05) with countermeasure compared to control. These data suggest that the Wingate syncope test produces a high incidence of pre-syncope which is sensitive to countermeasures such as inspiratory impedance. PMID:24078670

  3. Samara Dispersal in Boxelder: An Exercise in Hypothesis Testing.

    ERIC Educational Resources Information Center

    Minorsky, Peter V.; Willing, R. Paul

    1999-01-01

    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…

  4. Inflight exercise affects stand test responses after space flight

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

  5. Heart rate-based protocols for exercise challenge testing do not ensure sufficient exercise intensity for inducing exercise-induced bronchial obstruction

    Microsoft Academic Search

    C Trümper; S Mäueler; C Vobejda; E Zimmermann

    2009-01-01

    Objective: To determine if a heart rate-based protocol for bronchial provocation testing ensures sufficient exercise intensity for inducing exercise-induced bronchial obstruction.Participants:100 clinically healthy non-asthmatic sports students.Design:Subjects underwent an exercise challenge test (ECT) on a treadmill ergometer for bronchial provocation according to the guidelines of the American Thoracic Society (ATS). Heart rate (HR), forced expiratory volume in 1 second (FEV1), pH

  6. Simple exercise test for the prediction of relative heat tolerance

    SciTech Connect

    Kenney, W.L.; Lewis, D.A.; Anderson, R.K.; Kamon, E.

    1986-04-01

    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 (140W) 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 physiological limit (+/- approximately 5 min) can be predicted with 95% confidence for the most intense work-heat conditions found in nuclear power stations. In addition, site health and safety personnel can establish qualification criteria for work on hot jobs, based on the test results. The test as developed can be performed in an office environment with the use of a minimum of equipment by personnel with minimal expertise and training. Total maximal test duration is about 20-25 min per person and only heart rate need be monitored (simple pulse palpation will suffice). Test modality is adaptable to any ergometer, the most readily available and least expensive of which is bench-stepping. It is recommended that this test be available for use for those persons who, based upon routine medical examination or past history, are suspected of being relatively heat intolerant.

  7. Radionuclide exercise testing for coronary artery disease

    SciTech Connect

    Beller, G.A.

    1984-08-01

    It is obvious that the indication and clinical applications of radionuclide stress testing have been expanded and that both techniques described in this article are useful for diagnostic and prognostic purposes. The sensitivity and specificity of noninvasive stress testing have been significantly enhanced by the introduction of these radionuclide approaches for detecting ischemia in patients with undiagnosed chest pain. High-risk patients with either stable CAD or recent myocardial infarction can be identified by the severity of the abnormal response elicited. Patients with multiple thallium defects, particularly of the redistribution type, appear to be at the highest risk for subsequent cardiac events. Similarly, patients with a greater than 10 per cent fall in ejection fraction with development of multiple wall motion abnormalities and an increase in end-systolic volume seem to be in a high risk subset. Further developments with single photon emission tomography and computer quantitation of thallium or ventriculographic images should make these tests even more reliable in obtaining useful information in patients with CAD. 34 references.

  8. Development and implementation of treadmill exercise testing protocols in COPD

    PubMed Central

    Cooper, Christopher B; Abrazado, Marlon; Legg, Daniel; Kesten, Steven

    2010-01-01

    Background: Because treadmill exercise testing is more representative of daily activity than cycle testing, we developed treadmill protocols to be used in various clinical settings as part of a two-year, multicenter, chronic obstructive pulmonary disease (COPD) trial evaluating the effect of tiotropium on exercise. Methods: We enrolled 519 COPD patients aged 64.6 ± 8.3 years with a postbronchodilator forced expiratory volume in one second (FEV1) of 1.25 ± 0.42 L, 44.3% ± 11.9% predicted. The patients performed symptom-limited treadmill tests where work rate (?) was increased linearly using speed and grade adjustments every minute. On two subsequent visits, they performed constant ? tests to exhaustion at 90% of maximum ? from the incremental test. Results: Mean incremental test duration was 522 ± 172 seconds (range 20–890), maximum work rate 66 ± 34 watts. For the first and second constant ? tests, both at 61 ± 33 watts, mean endurance times were 317 ± 61 seconds and 341 ± 184 seconds, respectively. The mean of two tests had an intraclass correlation coefficient of 0.85 (P < 0.001). During the second constant ? test, 88.2% of subjects stopped exercise because of breathing discomfort; 87.1% for Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage II, 88.5% for GOLD Stage III, and 90.2% for GOLD Stage IV. Conclusion: The symptom-limited incremental and constant work treadmill protocol was well tolerated and appeared to be representative of the physiologic limitations of COPD. PMID:21103404

  9. Exercises

    MedlinePLUS

    ... Exercises You Can Do at Home These are simple exercises you can do at home to improve ... Find Programs & Services Make a Donation Find a Location View Events Calendar Read the News View Daily ...

  10. Relative Cardiac Efficiency and ST Depression during Progressive Exercise Test

    Microsoft Academic Search

    István Berényi; Géza Ludwig

    1981-01-01

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

  11. Comparison of two exercise testing protocols in patients with chronic fatigue syndrome

    Microsoft Academic Search

    Jo Nijs; Kim Zwinnen; Romain Meeusen; Bas de Geus; Kenny De Meirleir

    2007-01-01

    This study examined whether a linear exercise stress-testing protocol generated different peak exercise per- formance variables than a stepwise exercise testing protocol in patients with chronic fatigue syndrome (CFS). We conducted a comparative study with patients randomly allocated to one of two exercise testing protocols. Twenty-eight women with CFS completed two self-reported measures (the CFS Symptom List and the CFS

  12. Role of exercise stress test in master athletes

    PubMed Central

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

    2005-01-01

    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

  13. [Exercise-induced bronchoconstriction].

    PubMed

    Hildebrand, Katarzyna

    2011-01-01

    Terms exercise-induced asthma (EIA) or exercise-induced bronchoconstriction (EIB) are used to describe transient bronchoconstriction occurring during or immediately after vigorous exercise in some subjects. For the diagnosis of EIB it is necessary to show at least 10% decrease in FEV1 from baseline following physical exercise. The prevalence of EIB has been reported to be 12-15% in general population, 10-20% in summer olympic athletes, affecting up to 50-70% of winter athletes (particularly ski runners and skaters). There are two key theories explaining EIB: thermal and osmotic. Differential diagnosis of EIB should include chronic cardio-pulmonary diseases, vocal cord dysfunction, hyperventilation syndrome and poor physical fitness or overtraining. According to the ATS guidelines from 1999 for the diagnosis of EIB a standardized exercise on a treadmill or cycle ergometer test with stable environmental conditions regarding temperature and humidity of inhaled air, should be employed. Other laboratory tests assessing bronchial hyperresponsiveness to indirect stimuli including eucapnic voluntary hyperpnea (EVH), mannitol, hypertonic saline, AMP or measurement of exhaled nitric oxide (FENO) are also successfully used. In the prevention of EIB include both pharmacologic and non-pharmacologic treatment. In patients with poorly controlled asthma intensification of anti-inflammatory treatment can decrease the frequency and severity of EIB. Short and long acting beta2-agonists, antileukotriene drugs can be used prior to exercise to prevent EIB. PMID:21190152

  14. How well do office and exercise blood pressures predict sustained hypertension? A Dundee Step Test Study

    Microsoft Academic Search

    PO Lim; PT Donnan; TM MacDonald

    2000-01-01

    Exercise systolic blood pressure (BP) appears to be a better predictor of cardiac mortality than casual office BP. We tested whether this could be explained by exercise systolic BP being a better predictor of sustained hypertension than casual office BP. Exercise systolic BP was measured using the lightweight 3-min single stage, submaximal Dundee Step Test in 191 consecutive subjects (102

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

    Microsoft Academic Search

    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

    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

  16. Early exercise testing and coronary angiography after uncomplicated myocardial infarction.

    PubMed Central

    Akhras, F; Upward, J; Stott, R; Jackson, G

    1982-01-01

    In a prospective study 61 patients aged 55 years or less with uncomplicated myocardial infarction underwent treadmill stress testing at two weeks and coronary angiography at six weeks after infarction. Of the 44 patients who had a positive stress test, 43 had additional severe coronary artery disease confirmed by coronary angiography. Of the 17 patients who had a negative stress test for additional disease, coronary angiography identified only single-vessel disease in the infarct area in 15. The sensitivity of the stress test was 95% and the specificity 94%, though the number of patients in the study was small. Thus, exercise testing has considerable potential for the early identification of multiple-vessel disease in patients with uncomplicated myocardial infarction. PMID:6803945

  17. 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.

  18. Cardiopulmonary adaptation to weightlessness

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    SciTech Connect

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

    1988-02-01

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

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

    Microsoft Academic Search

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

    2008-01-01

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

  2. 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 ...

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

    ERIC Educational Resources Information Center

    Wilmore, Jack H.

    1988-01-01

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

  4. Food-dependent exercise-induced anaphylaxis with negative allergy testing.

    PubMed

    Kleiman, Jacob; Ben-Shoshan, Moshe

    2014-01-01

    Food-dependent exercise-induced anaphylaxis (FDEIA) is a disorder where exercise following allergen ingestion triggers anaphylaxis although exercise and allergen exposure are independently tolerated. The diagnosis of FDEIA is based on a characteristic clinical history. The culprit allergen is usually confirmed through the use of skin prick testing (SPT) serum-specific IgE levels and a food-exercise challenge. We present a case of FDEIA suggested by clinical history and open food-exercise challenge with negative specific IgE levels and SPT that highlights the challenges involved in diagnosing and managing this rare disorder. PMID:24503659

  5. Refined Exercise testing can aid DNA-based Diagnosis in Muscle Channelopathies

    PubMed Central

    Tan, S. Veronica; Matthews, Emma; Barber, Melissa; Burge, James A; Rajakulendran, Sanjeev; Fialho, Doreen; Sud, Richa; Haworth, Andrea; Koltzenburg, Martin; Hanna, Michael G

    2010-01-01

    Objective To improve the accuracy of genotype prediction and guide genetic testing in patients with muscle channelopathies we applied and refined specialised electrophysiological exercise test parameters. Methods We studied 56 genetically confirmed patients and 65 controls using needle electromyography, the long exercise test, and short exercise tests at room temperature, after cooling, and rewarming. Results Concordant amplitude-and-area decrements were more reliable than amplitude-only measurements when interpreting patterns of change during the short exercise tests. Concordant amplitude-and-area pattern I and pattern II decrements of >20% were 100% specific for PMC and MC respectively. When decrements at room temperature and after cooling were <20%, a repeat short exercise test after rewarming was useful in patients with myotonia congenita. Area measurements and rewarming distinguished true temperature sensitivity from amplitude reduction due to cold-induced slowing of muscle fibre conduction. In patients with negative short exercise tests, symptomatic eye closure myotonia predicted sodium channel myotonia over myotonia congenita. Distinctive ‘tornado-shaped’ neuromyotonia-like discharges may be seen in patients with paramyotonia congenita. In the long exercise test, area decrements from pre-exercise baseline were more sensitive than amplitude decrements-from-maximum-CMAP in patients with Andersen-Tawil syndrome. Possible ethnic differences in the normative data of the long exercise test argue for the use of appropriate ethnically-matched controls. Interpretation Concordant CMAP amplitude-and-area decrements of >20% allow more reliable interpretation of the short exercise tests and aid accurate DNA-based diagnosis. In patients with negative exercise tests, specific clinical features are helpful in differentiating sodium from chloride channel myotonia. A modified algorithm is suggested.. PMID:21387378

  6. Teaching schoolchildren cardiopulmonary resuscitation

    Microsoft Academic Search

    Carolyn Lester; Peter Donnelly; Clive Weston; Michelle Morgan

    1996-01-01

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

  7. Cardiopulmonary discipline science plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  8. The minimal important difference of exercise tests in severe COPD.

    PubMed

    Puhan, M A; Chandra, D; Mosenifar, Z; Ries, A; Make, B; Hansel, N N; Wise, R A; Sciurba, F

    2011-04-01

    Our aim was to determine the minimal important difference (MID) for 6-min walk distance (6MWD) and maximal cycle exercise capacity (MCEC) in patients with severe chronic obstructive pulmonary disease (COPD). 1,218 patients enrolled in the National Emphysema Treatment Trial completed exercise tests before and after 4-6 weeks of pre-trial rehabilitation, and 6 months after randomisation to surgery or medical care. The St George's Respiratory Questionnaire (domain and total scores) and University of California San Diego Shortness of Breath Questionnaire (total score) served as anchors for anchor-based MID estimates. In order to calculate distribution-based estimates, we used the standard error of measurement, Cohen's effect size and the empirical rule effect size. Anchor-based estimates for the 6MWD were 18.9 m (95% CI 18.1-20.1 m), 24.2 m (95% CI 23.4-25.4 m), 24.6 m (95% CI 23.4-25.7 m) and 26.4 m (95% CI 25.4-27.4 m), which were similar to distribution-based MID estimates of 25.7, 26.8 and 30.6 m. For MCEC, anchor-based estimates for the MID were 2.2 W (95% CI 2.0-2.4 W), 3.2 W (95% CI 3.0-3.4 W), 3.2 W (95% CI 3.0-3.4 W) and 3.3 W (95% CI 3.0-3.5 W), while distribution-based estimates were 5.3 and 5.5 W. We suggest a MID of 26 ± 2 m for 6MWD and 4 ± 1 W for MCEC for patients with severe COPD. PMID:20693247

  9. Prediction of functional aerobic capacity without exercise testing

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  10. Trifascicular block progressing to complete AV block on exercise: a rare presentation demonstrating the usefulness of exercise testing.

    PubMed

    Shetty, Ranjan K; Agarwal, Sumit; Ganiga Sanjeeva, Naveen Chandra; Rao, M Sudhakar

    2015-01-01

    A 41-year-old man presented with dyspnoea and giddiness on exertion for the last 1?month. A resting ECG during showed trifascicular block with complete right bundle branch block, left anterior fascicular block and a prolonged PR interval of >0.24?s. His echocardiography showed no evidence of wall motion abnormality. He was subjected to a treadmill test for exercise-induced ischaemia, which showed complete atrioventricular (AV) block during first stage of Bruce protocol. His symptoms of dyspnoea and giddiness were also reproduced. The test was terminated and ECG returned to trifascicular block, similar to that at his baseline ECG during recovery. Coronary angiogram (CAG) was performed to rule out any ischaemic cause for this exercise-induced AV block, which was normal. In view of his reproducible symptoms and demonstration of complete AV block on exercise, a dual-chamber pacemaker (DDD) was implanted. His symptoms disappeared and he remained asymptomatic on follow-up. PMID:25819829

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

    Microsoft Academic Search

    D. Prabhakar; D. Vaidiyanathan

    2001-01-01

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

  12. Exercise testing scores as an example of better decisions through science

    Microsoft Academic Search

    EUAN ASHLEY; JONATHAN MYERS; VICTOR FROELICHER

    2002-01-01

    ABSTRACT ASHLEY, E., J. MYERS, and V. FROELICHER. Exercise testing scores as an example of better decisions through science. Med. Sci. Sports Exerc., Vol. 34, No. 8, pp. 1391–1398, 2002. Introduction: The application of common statistical techniques to clinical and exercise test data has the potential to become a useful tool for assisting in the diagnosis of coronary artery disease,

  13. Department of Cardiopulmonary Science JUNIOR YEAR

    E-print Network

    Track Cardiovascular Sonography Track Number Course Cr Number Course Cr CPSC 3100 Introduction to the Clinical Cardiopulmonary Sciences 1 CPSC 3100 Introduction to the Clinical Cardiopulmonary Sciences 1 CPSC 3130 Cardiopulmonary Anatomy 5 CPSC 3130 Cardiopulmonary Anatomy 5 CPSC 3220 Cardiopulmonary Physiology

  14. Obesity does not influence the correlation between exercise capacity and serum NT-proBNP levels in chronic heart failure

    Microsoft Academic Search

    António Miguel Ferreira; Miguel Mendes; António Ventosa; Carlos T. Aguiar; Jorge Ferreira; João M. Figueira; José A. Silva

    2008-01-01

    Recent studies have shown that obesity is an independent predictor of lower N-terminal pro-BNP (NT-proBNP) levels and raised concerns about the validity of this biomarker in obese subjects. We evaluated the influence of obesity (body mass index?30 kg\\/m2) on the correlation between exercise capacity and serum NT-proBNP levels in 100 chronic heart failure (CHF) patients referred for cardiopulmonary exercise testing. Circulating

  15. Magnetocardiography and exercise testing: data acquisition and data processing

    Microsoft Academic Search

    K. Brockmeier; S. Comani; S. N. Erne; C. De Gratta; S. Di Luzio; A. Pasquarelli; G. L. Romani

    1991-01-01

    Sixteen healthy male subjects underwent magnetocardiography during physical exercise. A specific signal averaging technique was developed because the quality of the magnetic signals exceeded that of the electrocardiographic signals, particularly regarding baseline shifting. Significant ST segment displacements of the magnetic signal were found during exercise at a heart rate of 120 bpm (p<0.001). No significant ST segment changes were found

  16. Discussing cardiopulmonary resuscitation

    Microsoft Academic Search

    Robert H. Shmerling; Susanna E. Bedell; Armin Lilienfeld; Thomas L. Delbanco

    1988-01-01

    Decisions about when to perform cardiopulmonary resuscitation (CPR) are frequently made without knowing the wishes of the\\u000a patient. To evaluate the feasibility of outpatient discussions about CPR, the authors surveyed 22 male and 53 female, mentally\\u000a competent, ambulatory patients 65 years of age and older. Only 7% of those interviewed had an accurate understanding of what\\u000a CPR meant before hearing

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

    PubMed Central

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

    2014-01-01

    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

  18. Insufficient control of exercise intensity by heart rate monitoring in cardiac patients

    Microsoft Academic Search

    Falko Frese; Philipp Seipp; Susanne Hupfer; Peter Bärtsch; Birgit Friedmann-Bette

    2012-01-01

    Objectives: To test the reliability of heart rate (HR) recommendations for cardiac rehabilitation training obtained from different treadmill tests.Background: For training in cardiac rehabilitation, HR recommendations are derived from cardio-pulmonary tests. Exercise intensity is often controlled through self-monitoring HR by the cardiac patients.Design: Non-randomized clinical trial.Methods: 25 patients of a cardiac sports group (six women, 19 men, age 68.3 ±

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

    ERIC Educational Resources Information Center

    Petosa, R. Lingyak; Holtz, Brian

    2013-01-01

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

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

    Microsoft Academic Search

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

    2002-01-01

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

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

    PubMed Central

    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

    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

  2. Patients with chronic fatigue syndrome performed worse than controls in a controlled repeated exercise study despite a normal oxidative phosphorylation capacity

    Microsoft Academic Search

    Ruud CW Vermeulen; Ruud M Kurk; Frans C Visser; Wim Sluiter; Hans R Scholte

    2010-01-01

    BACKGROUND: The aim of this study was to investigate the possibility that a decreased mitochondrial ATP synthesis causes muscular and mental fatigue and plays a role in the pathophysiology of the chronic fatigue syndrome (CFS\\/ME). METHODS: Female patients (n = 15) and controls (n = 15) performed a cardiopulmonary exercise test (CPET) by cycling at a continuously increased work rate

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

    PubMed Central

    2013-01-01

    Background Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy. Methods Sixty-one HCC patients underwent preoperative cardiopulmonary exercise testing to determine their anaerobic threshold (AT). The AT was defined as the break point between carbon dioxide production and oxygen consumption per unit of time (VO2). Postoperative events including recurrence of HCC, death, liver failure, and complications of cirrhosis were recorded. Univariate and multivariate analyses were performed to evaluate associations between 35 clinical factors and outcomes, and identify independent prognostic indicators of event-free survival and maintenance of Child-Pugh class. Results Multivariate analyses identified preoperative branched-chain amino acid/tyrosine ratio (BTR) <5, alanine aminotransferase level ?42 IU/l, and AT VO2 <11.5 ml/min/kg as independent prognostic indicators of event-free survival. AT VO2 <11.5 ml/min/kg and BTR <5 were identified as independent prognostic indicators of maintenance of Child-Pugh class. Conclusions This study identified preoperative exercise capacity as an independent prognostic indicator of event-free survival and maintenance of Child-Pugh class in HCC patients with chronic liver injury undergoing hepatectomy. PMID:23875788

  4. Physical activity patterns of patients with cardiopulmonary illnesses

    PubMed Central

    Nguyen, Huong Q.; Steele, Bonnie G.; Dougherty, Cynthia M.; Burr, Robert

    2012-01-01

    OBJECTIVES The aims of this paper are to: 1) describe objectively-confirmed physical activity patterns across three chronic cardiopulmonary conditions, and 2) examine the relationship between selected physical activity dimensions with disease severity, self-reported physical and emotional functioning, and exercise performance. INTERVENTIONS Not applicable. DESIGN Cross-sectional study. SETTING Participant’s home environment. PARTICIPANTS Patients with cardiopulmonary illnesses: chronic obstructive pulmonary disease (COPD, n=63), heart failure (HF, n=60), and patients with implantable cardioverter defibrillator (ICD, n=60). MAIN OUTCOME MEASURES Seven ambulatory physical activity dimensions (total steps, percent time active, percent time ambulating at low, medium, and high intensity, maximum cadence for 30 continuous minutes, and peak performance) were measured with an accelerometer. RESULTS Subjects with COPD had the lowest amount of ambulatory physical activity compared to subjects with heart failure and cardiac dysrhythmias (all seven activity dimensions, p<.05); total step counts were: 5319 vs. 7464 vs. 9570, respectively. Six minute walk distance were correlated (r=.44 to .65, p<.01) with all physical activity dimensions in the COPD sample, the strongest correlations being with total steps and peak performance. In subjects with cardiac impairment, maximal oxygen consumption had only small to moderate correlations with five of the physical activity dimensions (r=.22 to .40, p<.05). In contrast, correlations between six minute walk test distance and physical activity were higher (r=.48 to .61, p<.01) albeit in a smaller sample of only patients with heart failure. For all three samples, self-reported physical and mental health functioning, age, body mass index, airflow obstruction, and ejection fraction had either relatively small or non-significant correlations with physical activity. CONCLUSIONS All seven dimensions of ambulatory physical activity discriminated between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, use of one dimension such as total steps may be sufficient. Although physical activity had high correlations with performance on a six minute walk test relative to other variables, accelerometry-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary illness not already captured with existing measures. PMID:22772084

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

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

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

  6. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

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

    1997-10-28

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

  7. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

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

    1997-01-01

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

  8. An agreement approach to predict severe angiographic coronary artery disease with clinical and exercise test data

    Microsoft Academic Search

    Dat Do; Jeffrey A. West; Anthony Morise; J. Edwin Atwood; Victor Froelicher

    1997-01-01

    Objective To demonstrate that an agreement approach to applying equations on the basis of clinical and exercise test variables is an accurate, self-calibrating, and cost-efficient method for predicting severe coronary artery disease in clinical populations.Design Retrospective analysis of consecutive patients with complete data from exercise testing and coronary angiography referred for evaluation of possible coronary artery disease. After developing an

  9. Prognostic value of radionuclide exercise testing after myocardial infarction

    SciTech Connect

    Schocken, D.D.

    1984-08-01

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

  10. Effect of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension on stroke volume response to exercise.

    PubMed

    Surie, Sulaiman; van der Plas, Mart N; Marcus, J Tim; Kind, Taco; Kloek, Jaap J; Vonk-Noordegraaf, Anton; Bresser, Paul

    2014-07-01

    In pulmonary hypertension, exercise is limited by an impaired right ventricular (RV) stroke volume response. We hypothesized that improvement in exercise capacity after pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) is paralleled by an improved RV stroke volume response. We studied the extent of PEA-induced restoration of RV stroke volume index (SVI) response to exercise using cardiac magnetic resonance imaging (cMRI). Patients with CTEPH (n = 18) and 7 healthy volunteers were included. Cardiopulmonary exercise testing and cMRI were performed before and 1 year after PEA. For cMRI studies, pre- and post-operatively, all patients exercised at 40% of their preoperative cardiopulmonary exercise testing-assessed maximal workload. Post-PEA patients (n = 13) also exercised at 40% of their postoperative maximal workload. Control subjects exercised at 40% of their predicted maximal workload. Preoperatively, SVI (n = 18) decreased during exercise from 35.9 ± 7.4 to 33.0 ± 9.0 ml·m(2) (p = 0.023); in the control subjects, SVI increased (46.6 ± 7.6 vs 57.9 ± 11.8 ml·m(-2), p = 0.001). After PEA, the SVI response (?SVI) improved from -2.8 ± 4.6 to 4.0 ± 4.6 ml·m(2) (p <0.001; n = 17). On exercise at 40% of the postoperative maximal workload, SVI did not increase further and was still significantly lower compared with controls. Moreover, 4 patients retained a negative SVI response, despite (near) normalization of their pulmonary hemodynamics. The improvement in SVI response was accompanied by an increased exercise tolerance and restoration of RV remodeling. In conclusion, in CTEPH, exercise is limited by an impaired stroke volume response. PEA induces a restoration of SVI response to exercise that appears, however, incomplete and not evident in all patients. PMID:24819907

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

    NSDL National Science Digital Library

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

    2002-06-01

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

  12. The effects of space flight on the cardiopulmonary system

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

  13. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  14. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  16. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  17. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  18. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  19. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  20. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  1. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  2. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  3. 21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Cardiopulmonary bypass intracardiac suction control. 870.4430 Section 870...Cardiopulmonary bypass intracardiac suction control. (a) Identification. A cardiopulmonary bypass intracardiac suction control is a device which...

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    SciTech Connect

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

    1989-04-01

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

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

    PubMed

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

    2015-01-01

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

  7. Perioperative cardiopulmonary arrest competencies.

    PubMed

    Murdock, Darlene B

    2013-08-01

    Although basic life support skills are not often needed in the surgical setting, it is crucial that surgical team members understand their roles and are ready to intervene swiftly and effectively if necessary. Ongoing education and training are key elements to equip surgical team members with the skills and knowledge they need to handle untimely and unexpected life-threatening scenarios in the perioperative setting. Regular emergency cardiopulmonary arrest skills education, including the use of checklists, and mock codes are ways to validate that team members understand their responsibilities and are competent to help if an arrest occurs in the OR. After a mock drill, a debriefing session can help team members discuss and critique their performances and improve their knowledge and mastery of skills. PMID:23890561

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

    Microsoft Academic Search

    Jean-Louis Mégnien; Alain Simon

    2009-01-01

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

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

    Microsoft Academic Search

    1997-01-01

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

  10. MAXIMAL EXERCISE TESTING USING THE ELLIPTICAL CROSS-TRAINER AND TREADMILL

    Microsoft Academic Search

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

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

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

    ERIC Educational Resources Information Center

    Lindwall, Magnus; Palmeira, Antonio

    2009-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2008-01-01

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

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

    Microsoft Academic Search

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

    2010-01-01

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

  14. Psychometric properties of the Compulsive Exercise Test in an adolescent eating disorder population.

    PubMed

    Formby, Pam; Watson, Hunna J; Hilyard, Anna; Martin, Kate; Egan, Sarah J

    2014-12-01

    The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive pediatric tertiary eating disorder referrals. Adolescents (N=104; 12-17years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly with measures of eating pathology, perfectionism, and frequency of exercise for shape and weight control (r=0.32-0.70, ps<0.05). More research into the multidimensional nature of compulsive exercise in clinical populations is needed. Further, research into compulsive exercise offers promise as an addition to existing cognitive behavioral models and treatments for eating disorders. PMID:25200383

  15. Evaluation of High-Risk Lung Resection Candidates: Pulmonary Haemodynamics versus Exercise Testing

    Microsoft Academic Search

    C. T. Bolliger; M. Solèr; P. Stulz’; E. Grädel; J. Müller-Brand; S. Elsasser; M. Gonon; C. Wyser; A. P. Perruchoud

    1994-01-01

    We compared the value of exercise testing and measurement of pulmonary haemodynamics (PH) in the pre-operative assessment of 5 patients (mean age: 64 years, 3 men) with clinical stage I or II bronchogenic carcinoma and severe chronic obstructive pulmonary disease. They were considered at high risk due to poor pulmonary function tests (PFT); (one or more of the following): (1)

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  17. Initial clinical evaluation of a wheelchair ergometer for diagnostic exercise testing : A technical note

    Microsoft Academic Search

    W. Edwin Langbein; Kevin C. Maki; Lonnie C. Edwards; Ming H. Hwang; Pat Sibley; Linda Fehr

    Abstract—The purpose of this initial study was to evaluate a new wheelchair ergometer (WCE) and exercise test protocol for the detection of coronary artery disease in men with lower limb disabilities. Forty-nine patients (63 ± 9 yr) completed WCE tests without complications. Peak heart rate was 84 ± 15% (mean ± SD) of age-predictedmaximum,and peak double product was 223 ±

  18. Simple Screening Test for Exercise-Induced Bronchospasm in the Middle School Athlete

    ERIC Educational Resources Information Center

    Weiss, Tyler J.; Baker, Rachel H.; Weiss, Jason B.; Weiss, Michelle M.

    2013-01-01

    This article recommends and provides results from a simple screening test that could be incorporated into a standardized school evaluation for all children participating in sports and physical education classes. The test can be employed by physical educators utilizing their own gym to identify children who demonstrate signs of exercise-induced…

  19. The role of exercise testing in the evaluation and management of heart failure

    PubMed Central

    Wright, D; Tan, L

    1999-01-01

    The clinical syndrome of heart failure has been investigated so extensively that it may now almost be regarded as a metabolic disorder. Although an initial insult reduces cardiac pump efficacy, the resultant physiological response culminates in complex neurohormonal dysfunction. This has created confusion and prevented the acceptance of a universal definition of cardiac failure. With much current research concentrating on the pharmacological modification of neuro-endocrine imbalance, it is easy to lose sight of the fundamental principles behind heart failure management, namely, to improve cardiac function. In attempting to achieve this, the issues of morbidity and mortality must be addressed jointly; they are not mutually exclusive entities. Discrepant results between mortality studies and changes in exercise capacity have undermined the value of exercise testing. Because a treatment enhances longevity we should not ignore its effect on symptomatic status, and likewise we should not discard a therapy, which improves function because adverse events result in occasional premature deaths. Informed patient choice must exist.?Historically, exercise testing has been quintessential in our understanding and evaluation of heart failure. Peak oxygen consumption remains the best overall indicator of symptomatic status, exercise capacity, prognosis and hospitalisation. Unfortunately, muddling of surrogate and true end-points has confused many of these issues. Improved comprehension may be gained by applying the concept of cardiac reserve which has been described in a variety of heart conditions and used in cardiac failure patients to provide an indication of prognosis and functional capacity.???Keywords: exercise testing; heart failure PMID:10646020

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

    PubMed

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

    2010-06-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Arnardóttir, Ragnheiður Harpa; Emtner, Margareta; Hedenström, Hans; Larsson, Kjell; Boman, Gunnar

    2006-01-01

    Background In patients with COPD, both laboratory exercise tests and field walking tests are used to assess physical performance. In laboratory tests, peak exercise capacity in watts (W peak) and/or peak oxygen uptake (VO2 peak) are assessed, whereas the performance on walking tests usually is expressed as distance walked. The aim of the study was to investigate the relationship between an incremental shuttle walking test (ISWT) and two laboratory cycle tests in order to assess whether W peak could be estimated from an ISWT. Methods Ninety-three patients with moderate or severe COPD performed an ISWT, an incremental cycle test (ICT) to measure W peak and a semi-steady-state cycle test with breath-by-breath gas exchange analysis (CPET) to measure VO2 peak. Routine equations for conversion between cycle tests were used to estimate W peak from measured VO2 peak (CPET). Conversion equation for estimation of W peak from ISWT was found by univariate regression. Results There was a significant correlation between W peak and distance walked on ISWT × body weight (r = 0.88, p < 0.0001). The agreement between W peak measured by ICT and estimated from ISWT was similar to the agreement between measured W peak (ICT) and W peak estimated from measured VO2 peak by CPET. Conclusion Peak exercise capacity measured by an incremental cycle test could be estimated from an ISWT with similar accuracy as when estimated from peak oxygen uptake in patients with COPD. PMID:17044921

  3. Submaximal Treadmill Exercise Test to Predict VO2max in Fit Adults

    Microsoft Academic Search

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

    2007-01-01

    This study was designed to develop a single-stage submaximal treadmill jogging (TMJ) test to predict VO2max in fit adults. Participants (N?=?400; men?=?250 and women?=?150), ages 18 to 40 years, successfully completed a maximal graded exercise test (GXT) at 1 of 3 laboratories to determine VO2max. The TMJ test was completed during the first 2 stages of the GXT. Following 3

  4. Maximal exercise testing of mentally retarded adolescents and adults: reliability study.

    PubMed

    Fernhall, B; Millar, A L; Tymeson, G T; Burkett, L N

    1990-12-01

    Few data are available regarding maximal exercise testing of mentally retarded individuals. No data are available on the reliability of maximal exercise testing of mentally retarded individuals. The purpose of this study was to determine the reliability of graded exercise testing of mentally retarded adolescents and adults. The testing was conducted at two geographically different centers. At Center A, 14 mentally retarded adolescents (11 boys, three girls) with Down syndrome, who were educable or trainable, were recruited from a nonresidential school. The subjects completed two Balke-Ware treadmill protocols until exhaustion. The treadmill time and heart rate (HR) were recorded. The time between tests was approximately one week. At Center B, 21 mentally retarded adults (14 women, seven men means IQ = 56) were recruited from local workshops and group homes. These subjects completed a treadmill walking protocol, with metabolic measurements, until exhaustion. The time between tests varied from one to four months. At Center A, the subjects achieved a mean treadmill time of 8.72min on test one and 8.84min on test two (means HR = 174 and 175bpm, respectively). The reliability coefficient between the two tests was .94. At Center B, the subjects achieved a mean V0(2)max of 27.2mL.kg-1.min-1 on test one and 26.9mL.kg-1.min-1 on test two. The reliability coefficient was .93. These data show that maximal exercise testing is reliable for these populations of mentally retarded individuals, exhibiting similar values to their nonretarded peers. PMID:2256807

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

    PubMed

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

    2014-06-01

    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

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

    SciTech Connect

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

    1990-07-01

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

  7. Cardiac arrhythmias during exercise testing in healthy men.

    NASA Technical Reports Server (NTRS)

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

    1973-01-01

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

  8. Cardiopulmonary Responses at Various Angles of Cycle Backrest Inclination

    PubMed Central

    Yamada, Sumio; Tanabe, Kazuhiko; Izawa, Kazuhiro; Itoh, Haruki; Murayama, Masahiro

    1999-01-01

    The purpose of this study was to evaluate cardiopulmonary responses during submaximal cycle exercise at various angles of backrest inclination. Ten healthy Japanese men of mean age 25.9 yrs, height 170.6 cm, and body mass 66.1 kg, performed cycle exercises at a constant workload which reached the anaerobic threshold, at 20 degrees, 40 degrees, and 60 degrees of backrest inclination from the vertical plane, but the angle between the seat and back rest was kept at 110 degrees. The results were as follows: 1) Both cardiac output and stroke volume showed a higher value at the resting control state and during exercise as the backrest angle increased. 2) Oxygen consumption, carbon dioxide output, heart rate, gas exchange ratio, and oxygen pulse were not affected by the angle of backrest inclination. 3) Tidal volume at 20 degrees of backrest inclination was higher than at 60 degrees. 4) No significant differences were found in minute ventilation between each backrest angle. These findings suggest that changes in the backrest angle significantly alter cardiopulmonary parameters at rest and during exercise; in particular, an angle difference of 40 degrees may be enough to alter tidal volume, cardiac output and stroke volume, but not the minute ventilation.

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

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  10. Effects of Obstructive Sleep Apnea and Obesity on Exercise Function in Children

    PubMed Central

    Evans, Carla A.; Selvadurai, Hiran; Baur, Louise A.; Waters, Karen A.

    2014-01-01

    Study Objectives: Evaluate the relative contributions of weight status and obstructive sleep apnea (OSA) to cardiopulmonary exercise responses in children. Design: Prospective, cross-sectional study. Participants underwent anthropometric measurements, overnight polysomnography, spirometry, cardiopulmonary exercise function testing on a cycle ergometer, and cardiac doppler imaging. OSA was defined as ? 1 obstructive apnea or hypopnea per hour of sleep (OAHI). The effect of OSA on exercise function was evaluated after the parameters were corrected for body mass index (BMI) z-scores. Similarly, the effect of obesity on exercise function was examined when the variables were adjusted for OAHI. Setting: Tertiary pediatric hospital. Participants: Healthy weight and obese children, aged 7–12 y. Interventions: N/A. Measurements and Results: Seventy-one children were studied. In comparison with weight-matched children without OSA, children with OSA had a lower cardiac output, stroke volume index, heart rate, and oxygen consumption (VO2 peak) at peak exercise capacity. After adjusting for BMI z-score, children with OSA had 1.5 L/min (95% confidence interval -2.3 to -0.6 L/min; P = 0.001) lower cardiac output at peak exercise capacity, but minute ventilation and ventilatory responses to exercise were not affected. Obesity was only associated with physical deconditioning. Cardiac dysfunction was associated with the frequency of respiratory-related arousals, the severity of hypoxia, and heart rate during sleep. Conclusions: Children with OSA are exercise limited due to a reduced cardiac output and VO2 peak at peak exercise capacity, independent of their weight status. Comorbid OSA can further decrease exercise performance in obese children. Citation: Evans CA, Selvadurai H, Baur LA, Waters KA. Effects of obstructive sleep apnea and obesity on exercise function in children. SLEEP 2014;37(6):1103-1110. PMID:24882905

  11. The prevalence of arrhythmias, predictors for arrhythmias, and safety of exercise stress testing in children.

    PubMed

    Ghosh, Reena M; Gates, Gregory J; Walsh, Christine A; Schiller, Myles S; Pass, Robert H; Ceresnak, Scott R

    2015-03-01

    Exercise testing is commonly performed in children for evaluation of cardiac disease. Few data exist, however, on the prevalence, types of arrhythmias, predictors for arrhythmias, and safety of exercise testing in children. A retrospective review of all patients ?21 years undergoing exercise testing at our center from 2008 to 2012 was performed. Patients with clinically relevant arrhythmias were compared to those not experiencing a significant arrhythmia. 1,037 tests were performed in 916 patients. The mean age was 14 ± 4 years, 537 (55 %) were male, 281 (27 %) had congenital heart disease, 178 (17 %) had a history of a prior arrhythmia, and 17 (2 %) had a pacemaker or ICD. 291 (28 %) patients had a rhythm disturbance during the procedure. Clinically important arrhythmias were noted in 34 (3 %) patients and included: 19 (1.8 %) increasing ectopy with exercise, 5 (0.5 %) VT, 5 (0.5 %) second degree AV block, 3 (0.3 %) SVT, and 2 (0.2 %) AFIB. On multivariate logistic regression, variables associated with the development of clinically relevant arrhythmias included severe left ventricular (LV) dysfunction on echo (OR 1.99, CI 1.20-3.30) and prior history of a documented arrhythmia (OR 2.94, CI 1.25-6.88). There were no adverse events related to testing with no patient requiring cardioversion, defibrillation, or acute anti-arrhythmic therapy. A total of 28 % of children developed a rhythm disturbance during exercise testing and 3 % were clinically important. Severe LV dysfunction and a history of documented arrhythmia were associated with the development of a clinically important arrhythmia. PMID:25384613

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

    Microsoft Academic Search

    Louis Abboud; Jamal Hir; Iris Eisen; Walter Markiewicz

    1994-01-01

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

  13. A false-positive ST segment elevation during exercise stress test

    PubMed Central

    Srinivas, Sunil Kumar; Hirapur, Iranna S; Bhairappa, Shivakumar; Manjunath, Cholenahally Nanjappa

    2013-01-01

    A 56-year-old man with multiple risk factors undergoing evaluation for chest pain developed ST elevations in multiple leads during exercise stress test. These ST elevations were not classical of ischaemic pattern. The coronary angiogram showed normal coronaries. The false-positive ST elevation was due to an error in the computer-synthesised averaging algorithm. PMID:23595190

  14. [Prognostic value after 1 year of post-infarction exercise test with measurement of oxygen consumption].

    PubMed

    Borgat, C; Potiron, M; Bouhour, J B; Leroy, A; Helias, J; Bourdon, A; Patra, O; Louvet, S

    1992-03-01

    A symptoms-limited exercise stress test with measurement of myocardial oxygen consumption (VO2) was carried out in 56 patients on the 44th +/- 16 days after infarction and in 48 patients on the 119th +/- 31 days. Analysis of the expired gases was performed by mass spectrography, cycle by cycle. The second test was coupled with an exercise gamma-angiography in 40 cases. The parameters on exercise were analysed in two groups at one year: group 1 asymptomatic and group 2 symptomatic (subgroup 2a with angina but no dyspnoea, subgroup 2b with dyspnoea). At the second test, the peak VO2 was lower in group 2 (19.46 +/- 5.78 ml/mn/kg) than in group 1 (24.2 +/- 6.5 ml/mn/kg) (p less than 0.008) irrespective of the symptom (angina and/or dyspnoea). The oxygen pulse was lower in group 2a with angina at one year (42.4% +/- 14.3%) compared with asymptomatic group 1 patient (58.5 +/- 12.4%) (p = 0.03). The 3 parameters: VO2, blood pressure and ejection fraction on exercise were independent. The lack of physical fitness may partially explain the absence of variation of the peak VO2 at the first test. These preliminary results should be confirmed by a multivariate analysis in a larger patient group. PMID:1575611

  15. Correlations between coronary flow reserve measured with a Doppler guide wire and treadmill exercise testing

    Microsoft Academic Search

    Douglas S. Schulman; David Lasorda; Tony Farah; Peter Soukas; Nathaniel Reichek; James D. Joye

    1997-01-01

    We compared exercise test results to a physiologic depiction of stenosis severity, coronary flow reserve (CFR), measured with a Doppler guide wire in 35 patients with single-vessel coronary disease. Group 1 ( n = 21) had abnormal CFR, and group 2 ( n = 14) had normal CFR. In group 1, 14 of 21 had ST-segment depression versus 3 of

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

    PubMed Central

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

    2015-01-01

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

  17. Prevalence and Predictors of Abnormal Cardiovascular Responses to Exercise Testing Among Individuals With Type 2 Diabetes

    PubMed Central

    Curtis, Jeffrey M.; Horton, Edward S.; Bahnson, Judy; Gregg, Edward W.; Jakicic, John M.; Regensteiner, Judith G.; Ribisl, Paul M.; Soberman, Judith E.; Stewart, Kerry J.; Espeland, Mark A.

    2010-01-01

    OBJECTIVE We examined maximal graded exercise test (GXT) results in 5,783 overweight/obese men and women, aged 45–76 years, with type 2 diabetes, who were entering the Look AHEAD (Action for Health in Diabetes) study, to determine the prevalence and correlates of exercise-induced cardiac abnormalities. RESEARCH DESIGN AND METHODS Participants underwent symptom-limited maximal GXTs. Questionnaires and physical examinations were used to determine demographic, anthropometric, metabolic, and health status predictors of abnormal GXT results, which were defined as an ST segment depression ?1.0 mm, ventricular arrhythmia, angina pectoris, poor postexercise heart rate recovery (<22 bpm reduction 2 min after exercise), or maximal exercise capacity less than 5.0 METs. Systolic blood pressure response to exercise was examined as a continuous variable, without a threshold to define abnormality. RESULTS Exercise-induced abnormalities were present in 1,303 (22.5%) participants, of which 693 (12.0%) consisted of impaired exercise capacity. ST segment depression occurred in 440 (7.6%), abnormal heart rate recovery in 206 (5.0%), angina in 63 (1.1%), and arrhythmia in 41 (0.7%). Of potential predictors, only greater age was associated with increased prevalence of all abnormalities. Other predictors were associated with some, but not all, abnormalities. Systolic blood pressure response decreased with greater age, duration of diabetes, and history of cardiovascular disease. CONCLUSIONS We found a high rate of abnormal GXT results despite careful screening for cardiovascular disease symptoms. In this cohort of overweight and obese individuals with type 2 diabetes, greater age most consistently predicted abnormal GXT. Long-term follow-up of these participants will show whether these abnormalities are clinically significant. PMID:20056948

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

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

    PubMed Central

    Alkahtani, Shaea

    2014-01-01

    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

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

    PubMed Central

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

    2015-01-01

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

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

    Microsoft Academic Search

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

    2010-01-01

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

  2. Effects of tiotropium on sympathetic activation during exercise in stable chronic obstructive pulmonary disease patients

    PubMed Central

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

    2012-01-01

    Background Tiotropium partially relieves exertional dyspnea and reduces the risk of congestive heart failure in chronic obstructive pulmonary disease (COPD) patients. However, its effect on the sympathetic activation response to exercise is unknown. Aims This study aimed to determine whether tiotropium use results in a sustained reduction in sympathetic activation during exercise. Methods We conducted a 12-week, open-label (treatments: tiotropium 18 ?g or oxitropium 0.2 mg × 3 mg), crossover study in 17 COPD patients. Treatment order was randomized across subjects. The subjects underwent a pulmonary function test and two modes of cardiopulmonary exercise (constant work rate and incremental exercise) testing using a cycle ergometer, with measurement of arterial catecholamines after each treatment period. Results Forced expiratory volume in 1 second and forced vital capacity were significantly larger in the tiotropium treatment group. In constant exercise testing, exercise endurance time was longer, with improvement in dyspnea during exercise and reduction in dynamic hyperinflation in the tiotropium treatment group. Similarly, in incremental exercise testing, exercise time, carbon dioxide production, and minute ventilation at peak exercise were significantly higher in the tiotropium treatment group. Plasma norepinephrine concentrations and dyspnea intensity were also lower during submaximal isotime exercise and throughout the incremental workload exercise in the tiotropium treatment group. Conclusion Tiotropium suppressed the increase of sympathetic activation during exercise at the end of the 6-week treatment, as compared with the effect of oxipropium. This effect might be attributed to improvement in lung function and exercise capacity and reduction in exertional dyspnea, which were associated with decreases in respiratory frequency and heart rate and reduced progression of arterial acidosis. PMID:22615527

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

    SciTech Connect

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

    1991-03-01

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

  4. Treadmill exercise testing of mass screening for coronary risk factors.

    PubMed

    Allen, W H; Aronow, W S; De Cristofaro, D

    1976-01-01

    The prevalence of an abnormal maximal treadmill stress test (MTST) was correlated with coronary risk factors in 1,077 asymptomatic adults (709 men and 368 women) in Long Beach, California. Of 1,077 adults, 113 (10.5%) had a positive MTST. A positive MTST was correlated with sex (p less than 0.001), age (p less than 0.001), a serum cholesterol less than or equal to 200 mg% (p less than 0.02), hypertriglyceridemia (p less than 0.05), cigarette smoking (p less than 0.025), and with the number of coronary risk factors (p less than 0.005) but not with hypertension, cigar or pipe smoking, obesity, or blood sugar. PMID:1260849

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

    SciTech Connect

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

    1987-12-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

  7. Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation

    PubMed Central

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

    2013-01-01

    Cardiopulmonary exercise testing (CPET) is an established method for evaluating dyspnea and ventilatory abnormalities. Ventilatory reserve is typically assessed as the ratio of peak exercise ventilation to maximal voluntary ventilation. Unfortunately, this crude assessment provides limited data on the factors that limit the normal ventilatory response to exercise. Additional measurements can provide a more comprehensive evaluation of respiratory mechanical constraints during CPET (e.g., expiratory flow limitation and operating lung volumes). These measurements are directly dependent on an accurate assessment of inspiratory capacity (IC) throughout rest and exercise. Despite the valuable insight that the IC provides, there are no established recommendations on how to perform the maneuver during exercise and how to analyze and interpret the data. Accordingly, the purpose of this manuscript is to comprehensively examine a number of methodological issues related to the measurement, analysis, and interpretation of the IC. We will also briefly discuss IC responses to exercise in health and disease and will consider how various therapeutic interventions influence the IC, particularly in patients with chronic obstructive pulmonary disease. Our main conclusion is that IC measurements are both reproducible and responsive to therapy and provide important information on the mechanisms of dyspnea and exercise limitation during CPET. PMID:23476765

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

    Microsoft Academic Search

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

    2006-01-01

    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

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

    PubMed

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

    2013-07-01

    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

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

    PubMed Central

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

    2014-01-01

    Background Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all?cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 – 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 – 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia. PMID:25352460

  11. A single exercise test for assessing physiological and performance parameters in elite rowers: the 2-in-1 test.

    PubMed

    Bourdon, Pitre C; David, Adrian Z; Buckley, Jonathan D

    2009-01-01

    Testing to determine blood lactate thresholds for prescription of rowing training is usually conducted separately from performance testing (i.e. 2000m time trial). The purpose of this study was to investigate whether the testing required to determine blood lactate thresholds and performance in elite rowers could be reduced by undertaking a single test combining incremental exercise with a 2000m time trial. Ten elite rowers (age 20.9+/-2.1 years, mean+/-S.D.) performed, on separate occasions and in random order, an incremental seven-step rowing test (INCR), a 2000m time trial (2k), or a combined test involving the performance of six incremental submaximal workloads followed by 15min of recovery and then a 2000m time trial (2-in-1). Physiological and performance parameters (blood lactate thresholds, accumulated oxygen deficit, heart rate, work parameters) determined during 2-in-1 were not significantly different from those determined during INCR or 2k, except for peak oxygen uptake which was higher during 2-in-1 compared with INCR (4.23+/-0.22 versus 4.14+/-0.20lmin(-1), p=0.02), and peak rating of perceived exertion which was lower during 2-in-1 compared with INCR (19.4+/-0.2 versus 19.9+/-0.1, p=0.02). We conclude that physiological and performance parameters that have traditionally been assessed during separate incremental exercise and 2000m time trial testing in elite rowers can be validly determined during a single combined exercise test. PMID:18083633

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

    SciTech Connect

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

    1982-02-01

    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.

  13. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...false Cardiopulmonary bypass bubble detector. 870.4205 Section 870.4205...4205 Cardiopulmonary bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect...

  14. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  19. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870... § 870.4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  20. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870... § 870.4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  1. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870... § 870.4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  2. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  3. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870... § 870.4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  4. 21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Cardiopulmonary bypass accessory equipment. 870.4200 Section...870.4200 Cardiopulmonary bypass accessory equipment. (a) Identification. Cardiopulmonary bypass accessory equipment is a device that...

  5. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Cardiopulmonary bypass pump speed control. (a) Identification...A cardiopulmonary bypass pump speed control is a device used...and is used to control the speed of blood pumps used in cardiopulmonary... (b) Classification. Class II (performance...

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

    PubMed Central

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

    2014-01-01

    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

  7. Gastric perforation after cardiopulmonary resuscitation.

    PubMed

    Jalali, Sayed Mahdi; Emami-Razavi, Hassan; Mansouri, Asieh

    2012-11-01

    Gastric rupture is a rare complication after cardiopulmonary resuscitation (CPR). In most cases, incorrect management of airways during CPR is the main cause. Therefore, a medical emergency becomes a surgical emergency also. We present a case of gastric perforation in a middle-aged patient after CPR performed by his family. He eventually presented with bloody vomitus and a tympanic abdomen. When faced with a patient with abdominal signs post-CPR, surgical complications of CPR should be considered. PMID:22867822

  8. Exercise dysfunction in patients seropositive for the human immunodeficiency virus

    SciTech Connect

    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

    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.

  9. The pacing stress test: thallium-201 myocardial imaging after atrial pacing. Diagnostic value in detecting coronary artery disease compared with exercise testing

    SciTech Connect

    Heller, G.V.; Aroesty, J.M.; Parker, J.A.; McKay, R.G.; Silverman, K.J.; Als, A.V.; Come, P.C.; Kolodny, G.M.; Grossman, W.

    1984-05-01

    Many patients suspected of having coronary artery disease are unable to undergo adequate exercise testing. An alternate stress, pacing tachycardia, has been shown to produce electrocardiographic changes that are as sensitive and specific as those observed during exercise testing. To compare thallium-201 imaging after atrial pacing stress with thallium imaging after exercise stress, 22 patients undergoing cardiac catheterization were studied with both standard exercise thallium imaging and pacing thallium imaging. Positive ischemic electrocardiographic changes (greater than 1 mm ST segment depression) were noted in 11 of 16 patients with coronary artery disease during exercise, and in 15 of the 16 patients during atrial pacing. One of six patients with normal or trivial coronary artery disease had a positive electrocardiogram with each test. Exercise thallium imaging was positive in 13 of 16 patients with coronary artery disease compared with 15 of 16 patients during atrial pacing. Three of six patients without coronary artery disease had a positive scan with exercise testing, and two of these same patients developed a positive scan with atrial pacing. Of those patients with coronary artery disease and an abnormal scan, 85% showed redistribution with exercise testing compared with 87% during atrial pacing. Segment by segment comparison of thallium imaging after either atrial pacing or exercise showed that there was a good correlation of the location and severity of the thallium defects (r . 0.83, p . 0.0001, Spearman rank correlation). It is concluded that the location and presence of both fixed and transient thallium defects after atrial pacing are closely correlated with the findings after exercise testing.

  10. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4380 Cardiopulmonary...of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class II...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4380 Cardiopulmonary...of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class II...

  12. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4380 Cardiopulmonary...of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class II...

  13. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4380 Cardiopulmonary...of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class II...

  14. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4420 Cardiopulmonary...chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class II...

  15. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4420 Cardiopulmonary...chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class II...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    SciTech Connect

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

    1984-07-01

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

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

    SciTech Connect

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

    1984-05-01

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

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

    USGS Publications Warehouse

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

    2007-01-01

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

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

    SciTech Connect

    Rubler, S.; Fisher, V.J.

    1985-12-01

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

  1. Cerebrovascular responses to submaximal exercise in women with COPD

    PubMed Central

    2014-01-01

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

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

    PubMed

    Diwakar, Amit; Schmidt, Gregory A

    2014-04-01

    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

  3. Development and use of a standard treadmill exercise test for the comparison of different conditioning schedules in the horse

    E-print Network

    Pearson, Susan Carol

    1980-01-01

    than duration. With the speeds used in these treatments (92, 123 and 154 m/min) heart rates reached a steady state level at approximately six minutes into the test which was maintained throughout exercise for all durations (10, 15 and 20 min). Four... Rate Variable During Recovery from Exercise (Trial II) 17 Experimental Animals (Trial III) 143 144 145 xi v LIST OF FIGURES Figure Treadmill exercise schedules (Trial I) Pattern of heart rate response to treatments 7, 8, 9 (Trial I). Page...

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

    Microsoft Academic Search

    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

    .   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

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

    SciTech Connect

    Leppo, J.A.

    1984-01-01

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

  6. Alteration of the neonatal pulmonary physiology after total cardiopulmonary bypass

    Microsoft Academic Search

    Alain Serraf; Monica Robotin; Nicolas Bonnet; Hélène Détruit; Bruno Baudet; Michel G. Mazmanian; Philippe Hervé; Claude Planché

    1997-01-01

    Objectives: The purpose of this study was to analyze the mechanisms associated with lung injury after cardiopulmonary bypass and to propose strategies of prevention. Methods: Thirty-two neonatal piglets underwent 90 minutes of hypothermic cardiopulmonary bypass without aortic crossclamping. Five experimental groups were defined: group I had standard cardiopulmonary bypass (control), group II received continuous low-flow lung perfusion during cardiopulmonary bypass,

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

    Microsoft Academic Search

    Adrian D. Elliott; Fergal Grace

    2010-01-01

    Both cycle ergometry and treadmill exercise are commonly employed to examine the cardiopulmonary system under conditions of\\u000a precisely controlled metabolic stress. Although both forms of exercise are effective in elucidating a maximal stress response,\\u000a it is unclear whether breathing strategies or ventilator efficiency differences exist between exercise modes. The present\\u000a study examines breathing strategies, ventilatory efficiency and ventilatory capacity during

  8. The single-bout forearm critical force test: a new method to establish forearm aerobic metabolic exercise intensity and capacity.

    PubMed

    Kellawan, J Mikhail; Tschakovsky, Michael E

    2014-01-01

    No non-invasive test exists for forearm exercise that allows identification of power-time relationship parameters (W', critical power) and thereby identification of the heavy-severe exercise intensity boundary and scaling of aerobic metabolic exercise intensity. The aim of this study was to develop a maximal effort handgrip exercise test to estimate forearm critical force (fCF; force analog of power) and establish its repeatability and validity. Ten healthy males (20-43 years) completed two maximal effort rhythmic handgrip exercise tests (repeated maximal voluntary contractions (MVC); 1 s contraction-2 s relaxation for 600 s) on separate days. Exercise intensity was quantified via peak contraction force and contraction impulse. There was no systematic difference between test 1 and 2 for fCF(peak) force (p = 0.11) or fCF(impulse) (p = 0.76). Typical error was small for both fCF(peak force) (15.3 N, 5.5%) and fCF(impulse) (15.7 N ? s, 6.8%), and test re-test correlations were strong (fCF(peak force), r = 0.91, ICC = 0.94, p<0.01; fCF(impulse), r = 0.92, ICC = 0.95, p<0.01). Seven of ten subjects also completed time-to-exhaustion tests (TTE) at target contraction force equal to 10%fCF(peak force). TTE predicted by W' showed good agreement with actual TTE during the TTE tests (r = 0.97, ICC = 0.97, P<0.01; typical error 0.98 min, 12%; regression fit slope = 0.99 and y intercept not different from 0, p = 0.31). MVC did not predict fCF(peak force) (p = 0.37), fCF(impulse) (p = 0.49) or W' (p = 0.15). In conclusion, the poor relationship between MVC and fCF or W' illustrates the serious limitation of MVC in identifying metabolism-based exercise intensity zones. The maximal effort handgrip exercise test provides repeatable and valid estimates of fCF and should be used to normalize forearm aerobic metabolic exercise intensity instead of MVC. PMID:24699366

  9. Exercise response

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

  10. Mental stress test is an effective inducer of vasospastic angina pectoris: comparison with cold pressor, hyperventilation and master two-step exercise test

    Microsoft Academic Search

    Kazuyo Yoshida; Toshinori Utsunomiya; Toshifumi Morooka; Miyuki Yazawa; Keiko Kido; Toshihiro Ogawa; Toshihiro Ryu; Toru Ogata; Shinsuke Tsuji; Takashi Tokushima; Shuzo Matsuo

    1999-01-01

    Background: Cold pressor, hyperventilation and exercise stress tests were usually used for inducing an angina attack in patients with vasospastic angina pectoris. We induced vasospastic angina attack using the mental calculation stress test, and compared the results with those using other stress tests. Subjects and methods: Subjects were 29 patients with vasospastic angina pectoris. Their ages were 60.8±8.4 years. Coronary

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

    SciTech Connect

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

    1984-05-01

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

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

    PubMed

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

    2014-11-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1998-01-01

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

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

    SciTech Connect

    Sapin, P.M.; Koch, G.; Blauwet, M.B.; McCarthy, J.J.; Hinds, S.W.; Gettes, L.S. (Division of Cardiology, School of Medicine, University of North Carolina, Chapel Hill (USA))

    1991-07-01

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

  15. Talk test as a practical method to estimate exercise intensity in highly trained competitive male cyclists.

    PubMed

    Gillespie, Brent D; McCormick, James J; Mermier, Christine M; Gibson, Ann L

    2015-04-01

    Gillespie, BD, McCormick, JJ, Mermier, CM, and Gibson, AL. Talk Test as a practical method to estimate exercise intensity in highly trained competitive male cyclists. J Strength Cond Res 29(4): 894-898, 2015-The Talk Test (TT) has been used to determine exercise intensity among various population subgroups but not for competitive athletes. This study was designed to compare the ventilatory threshold (VT) with the last positive (+/+), equivocal (+/-), and negative (-/-) stages of the TT for highly trained cyclists. Twelve men (26.5 ± 4.6 years, 71.9 ± 7.6 kg) consented and completed the study, as approved by the university institutional review board. A maximal graded exercise test was used to identify VT, maximal aerobic capacity ((Equation is included in full-text article.)max: 65.9 ± 6.9 ml·kg·min), and maximal heart rate (HRmax: 187.3 ± 11.3 b·min). On a separate visit, the TT was administered using the same protocol. Participants were asked if they could speak comfortably after a standard passage recitation. Response options were: "Yes" (+/+), "I'm not sure" (+/-), or "No" (-/-). Variables at VT were compared with the last (+/+), (+/-), and (-/-) stages of TT through t-test with Bonferroni's adjustment (0.05/3). Differences (p ? 0.017) were found between variables at VT, as compared with (+/+) TT ((Equation is included in full-text article.): 32.9 ± 7.7 ml·kg·min, %(Equation is included in full-text article.): 49.9 ± 9.9, heart rate [HR]: 128.7 ± 18.7 b·min, %HRmax: 68.6 ± 7.9, rating of perceived exertion [RPE]: 11.1 ± 1.1) and (+/-) TT ((Equation is included in full-text article.): 44.4 ± 7.5 ml·kg·min, %(Equation is included in full-text article.): 67.2 ± 7.5). There were no differences between RPE- and HR-based variables at VT, as compared with (+/-) TT (RPE: 13.6 ± 0.63, HR: 147.1 ± 17.2 b·min, %HRmax: 78.5 ± 7.4) or (-/-) TT ((Equation is included in full-text article.): 48.8 ± 7.8 ml·kg·min, %(Equation is included in full-text article.): 73.9 ± 7.1, HR: 155.6 ± 13.6 b·min, %HRmax: 83.1 ± 5.3, RPE: 14.8 ± 0.90). We found that when the athlete could no longer speak comfortably, he was exercising at or near his VT; we concluded that (-/-) TT estimated VT and can therefore provide a practical method to gauge exercise intensity for highly trained competitive cyclists similar to those in our study. PMID:25259472

  16. Swim training does not protect mice from skeletal muscle oxidative damage following a maximum exercise test.

    PubMed

    Barreto, Tatiane Oliveira; Cleto, Lorena Sabino; Gioda, Carolina Rosa; Silva, Renata Sabino; Campi-Azevedo, Ana Carolina; de Sousa-Franco, Junia; de Magalhães, José Carlos; Penaforte, Claudia Lopes; Pinto, Kelerson Mauro de Castro; Cruz, Jader dos Santos; Rocha-Vieira, Etel

    2012-07-01

    We investigated whether swim training protects skeletal muscle from oxidative damage in response to a maximum progressive exercise. First, we investigated the effect of swim training on the activities of the antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), in the gastrocnemius muscle of C57Bl/6 mice, 48 h after the last training session. Mice swam for 90 min, twice a day, for 5 weeks at 31°C (± 1°C). The activities of SOD and CAT were increased in trained mice (P < 0.05) compared to untrained group. However, no effect of training was observed in the activity of GPx. In a second experiment, trained and untrained mice were submitted to a maximum progressive swim test. Compared to control mice (untrained, not acutely exercised), malondialdehyde (MDA) levels were increased in the skeletal muscle of both trained and untrained mice after maximum swim. The activity of GPx was increased in the skeletal muscle of both trained and untrained mice, while SOD activity was increased only in trained mice after maximum swimming. CAT activity was increased only in the untrained compared to the control group. Although the trained mice showed increased activity of citrate synthase in skeletal muscle, swim performance was not different compared to untrained mice. Our results show an imbalance in the activities of SOD, CAT and GPx in response to swim training, which could account for the oxidative damage observed in the skeletal muscle of trained mice in response to maximum swim, resulting in the absence of improved exercise performance. PMID:22075638

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

    PubMed

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

    1996-06-01

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

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

    Microsoft Academic Search

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

    1996-01-01

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

  19. Role of self-reported individual differences in preference for and tolerance of exercise intensity in fitness testing performance.

    PubMed

    Hall, Eric E; Petruzzello, Steven J; Ekkekakis, Panteleimon; Miller, Paul C; Bixby, Walter R

    2014-09-01

    Performance in fitness tests could depend on factors beyond the bioenergetic and skeletomuscular systems, such as individual differences in preference for and tolerance of different levels of exercise-induced somatosensory stimulation. Although such individual-difference variables could play a role in exercise testing and prescription, they have been understudied. The purpose of these studies was to examine the relationships of self-reported preference for and tolerance of exercise intensity with performance in fitness tests. Participants in study I were 516 men and women volunteers from a campus community, and participants in study II were 42 men recruit firefighters undergoing a 6-week training program. Both the Preference and Tolerance scores exhibited significant relationships with performance in several fitness tests and with body composition and physical activity participation. Preference and Tolerance did not change after the training program in study II, despite improvements in objective and perceived fitness, supporting their conceptualization as dispositional traits. Preference and Tolerance scores could be useful not only in ameliorating the current understanding of the determinants of physical performance, but also in personalizing exercise prescriptions and, thus, delivering exercise experiences that are more pleasant, tolerable, and sustainable. PMID:24531429

  20. Inflammatory changes upon a single maximal exercise test in depressed patients and healthy controls

    Microsoft Academic Search

    Silke Boettger; Hans-Josef Müller; Klaus Oswald; Christian Puta; Lars Donath; Holger H. W. Gabriel; Karl-Jürgen Bär

    2010-01-01

    Patients with major depressive disorder (MDD) have repeatedly been described to exhibit both a humoral as well as a cellular pro-inflammatory state. Acute exercise, representing physical stress, can further aggravate such an immune dysbalance. In the light of recommended exercise programmes for depressed patients, we aimed to investigate the inflammatory response to exercise in patients with MDD.Blood cells counts and

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

    PubMed

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

    2013-09-01

    Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake [Formula: see text] provides valuable information about their aerobic power. In the clinical setting, the (VO(2max)) provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, VO(2max) assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [VO(2max) is the most accurate method, it requires a maximal level of exertion, which brings a higher risk of adverse events in individuals with an intermediate to high risk of cardiovascular problems. Estimation of VO(2max) during submaximal exercise testing can offer a precious alternative. Over the past decades, many protocols have been developed for this purpose. The present review gives an overview of these submaximal protocols and aims to facilitate appropriate test selection in sports, clinical, and home settings. Several factors must be considered when selecting a protocol: (i) The population being tested and its specific needs in terms of safety, supervision, and accuracy and repeatability of the VO(2max) estimation. (ii) The parameters upon which the prediction is based (e.g. heart rate, power output, rating of perceived exertion [RPE]), as well as the need for additional clinically relevant parameters (e.g. blood pressure, ECG). (iii) The appropriate test modality that should meet the above-mentioned requirements should also be in line with the functional mobility of the target population, and depends on the available equipment. In the sports setting, high repeatability is crucial to track training-induced seasonal changes. In the clinical setting, special attention must be paid to the test modality, because multiple physiological parameters often need to be measured during test execution. When estimating VO(2max), one has to be aware of the effects of medication on heart rate-based submaximal protocols. In the home setting, the submaximal protocols need to be accessible to users with a broad range of characteristics in terms of age, equipment, time available, and an absence of supervision. In this setting, the smart use of sensors such as accelerometers and heart rate monitors will result in protocol-free VO(2max) assessments. In conclusion, the need for a low-risk, low-cost, low-supervision, and objective evaluation of VO(2max) has brought about the development and the validation of a large number of submaximal exercise tests. It is of paramount importance to use these tests in the right context (sports, clinical, home), to consider the population in which they were developed, and to be aware of their limitations. PMID:23821468

  2. Clinical studies on diabetic myocardial disease using exercise testing with myocardial scintigraphy and endomyocardial biopsy

    SciTech Connect

    Genda, A.; Mizuno, S.; Nunoda, S.; Nakayama, A.; Igarashi, Y.; Sugihara, N.; Namura, M.; Takeda, R.; Bunko, H.; Hisada, K.

    1986-08-01

    Nine diabetics without significant coronary stenosis participated in an exercise testing protocol with thallium-201 myocardial scintigraphy. Endomyocardial biopsy of right ventricle was also obtained. There were 4 patients with abnormal perfusion (positive group) and 5 patients with normal perfusion (negative group). All cases of the positive group were familial diabetics and there was only one case of dietary treatment, whereas in the negative group, there were only 2 cases of familial diabetics and 3 cases receiving dietary treatment. No statistical differences between the positive and negative groups were observed for the data of exercise performance and hemodynamic parameters in cardiac catheterization at rest. However, the mean ejection fraction in the positive group (62 +/- 13%) was significantly lower than in the negative group (77 +/- 4%). In both groups, the mean diameter of myocardial cells and the mean percent fibrosis of biopsy specimens showed significant increases compared with the control group. The mean percent fibrosis in the positive group (24.1 +/- 8.5%) compared with that in the negative group (16.5 +/- 5.9%) showed a tendency to increase. It is suggested that the abnormal perfusion of thallium-201 in the positive group indicates subclinically a pathological change of microcirculation caused by diabetes mellitus.

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

    PubMed Central

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

    2013-01-01

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

  4. MRI Catheterization in Cardiopulmonary Disease

    PubMed Central

    Rogers, Toby; Ratnayaka, Kanishka

    2014-01-01

    Diagnosis and prognostication in patients with complex cardiopulmonary disease can be a clinical challenge. A new procedure, MRI catheterization, involves invasive right-sided heart catheterization performed inside the MRI scanner using MRI instead of traditional radiographic fluoroscopic guidance. MRI catheterization combines simultaneous invasive hemodynamic and MRI functional assessment in a single radiation-free procedure. By combining both modalities, the many individual limitations of invasive catheterization and noninvasive imaging can be overcome, and additional clinical questions can be addressed. Today, MRI catheterization is a clinical reality in specialist centers in the United States and Europe. Advances in medical device design for the MRI environment will enable not only diagnostic but also interventional MRI procedures to be performed within the next few years. PMID:24394821

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    1980-04-01

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

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

    ERIC Educational Resources Information Center

    Pyfer, Howard R.; And Others

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

  8. Arm exercise training for wheelchair users.

    PubMed

    Glaser, R M

    1989-10-01

    Although individuals with lower-limb paralysis typically use their arms for wheelchair locomotion and exercise training, several factors including the relatively small muscle mass available, as well as deficient cardiovascular reflex responses and inactivity of the venous muscle pump (resulting in hypokinetic circulation), can cause the early onset of fatigue during arm activity. Thus, cardiopulmonary (aerobic) fitness is difficult to develop and maintain; this situation can often be exacerbated by a sedentary lifestyle. The purpose of this paper is to present research related to exercise capability of wheelchair users, arm exercise modes, physical fitness training programs using arm exercise, and newly developed exercise techniques which incorporate combinations of voluntary arm exercise and functional neuromuscular stimulation-induced exercise of paralyzed leg muscles. It is evident that exercise training programs utilizing appropriate techniques can markedly improve the physical fitness, functional independence, and rehabilitation outcome of wheelchair users. PMID:2691827

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

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

    SciTech Connect

    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

    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).

  11. An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus

    PubMed Central

    Pereira, Ana C.; Huddleston, Dan E.; Brickman, Adam M.; Sosunov, Alexander A.; Hen, Rene; McKhann, Guy M.; Sloan, Richard; Gage, Fred H.; Brown, Truman R.; Small, Scott A.

    2007-01-01

    With continued debate over the functional significance of adult neurogenesis, identifying an in vivo correlate of neurogenesis has become an important goal. Here we rely on the coupling between neurogenesis and angiogenesis and test whether MRI measurements of cerebral blood volume (CBV) provide an imaging correlate of neurogenesis. First, we used an MRI approach to generate CBV maps over time in the hippocampal formation of exercising mice. Among all hippocampal subregions, exercise was found to have a primary effect on dentate gyrus CBV, the only subregion that supports adult neurogenesis. Moreover, exercise-induced increases in dentate gyrus CBV were found to correlate with postmortem measurements of neurogenesis. Second, using similar MRI technologies, we generated CBV maps over time in the hippocampal formation of exercising humans. As in mice, exercise was found to have a primary effect on dentate gyrus CBV, and the CBV changes were found to selectively correlate with cardiopulmonary and cognitive function. Taken together, these findings show that dentate gyrus CBV provides an imaging correlate of exercise-induced neurogenesis and that exercise differentially targets the dentate gyrus, a hippocampal subregion important for memory and implicated in cognitive aging. PMID:17374720

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

    PubMed

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

    2014-11-27

    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

  13. [Simultaneous test of ventricular function and myocardial perfusion, during exercise, using a new agent labeled with Tc99m].

    PubMed

    Pérez Baliño, N; Sporn, V; Holman, L L; Sosa Liprandi, A; Masoli, O; Mitta, A; Camin, L; Castiglia, S; McKusick, K

    1988-01-01

    One a tribute of a Tc 99m labeled myocardial agent is the possibility to measure both ventricular function and myocardial perfusion with a single injection. To assess this, normal volunteers, 14 patients with coronary artery disease (CAD) and two suffering from cardiomyopathy with normal coronaries, were injected with 8-10 mci carbomethoxy-isopropyl-isonitrile or 20 mci Rp-30 Tc 99m at peak semi-recumbent bicycle exercise and again at rest. Thirty msec per frame first pass data, and 5 min static anterior, 40(0-) and 70(0-) left anterior oblique images were obtained. Standard Thallium 201 stress test were also done, within one month, and were at the same level of exercise. The left ventricular ejection fraction (EF) increased with exercise (69%-76%) in normal patients. All studies showed normal myocardial perfusion on exercise. In CAD patients the EF increased in some patients who had ischemia. Perfusion images with Tc 99m during exercise and at rest had an identical correlation with Thallium 201. The results support the concept of dual ventricular function and perfusion studies using a single Tc 99m labelled myocardial agent, and suggest that this could become the standard radionuclide stress tests in the future. PMID:2967061

  14. Pharmacological and other nonexercise alternatives to exercise testing to evaluate myocardial perfusion and left ventricular function with radionuclides

    SciTech Connect

    DePuey, E.G.; Rozanski, A. (St. Luke's-Roosevelt Hospital Center, New York, NY (USA))

    1991-04-01

    Pharmacological vasodilatation with either dipyridamole or adenosine is a safe and accurate alternative to exercise testing to diagnose coronary artery disease with thallium 201 myocardial perfusion imaging. The technique also provides important prognostic information with regard to future cardiac events in patients undergoing diagnostic testing, in those evaluated preoperatively, and in those with recent myocardial infarctions. Multigated equilibrium and first-pass radionuclide ventriculography also are well suited to evaluate the effects of interventional procedures. Success has been achieved using this methodology in a variety of interventions including conventional exercise testing, pharmacological stress testing, atrial pacing, assessment of myocardial viability with nitroglycerin, mental stress testing, and ambulatory monitoring of left ventricular ejection fraction. 67 references.

  15. Cardiorespiratory exercise tolerance in asymptomatic children with Ebstein's anomaly.

    PubMed

    Lupoglazoff, J M; Denjoy, I; Kabaker, M; Benali, K; Riescher, B; Magnier, S; Gaultier, C; Casasoprana, A

    1999-01-01

    The aim of the study was to evaluate cardiorespiratory exercise tolerance in asymptomatic children with Ebstein's anomaly. Eleven children with a mean age of 9.6 years were prospectively studied by spirometry, cardiopulmonary exercise testing (bicycle ergometer n = 8, treadmill test n = 3), and contrast echocardiography. A right-to-left atrial shunt was detected by contrast echocardiography in 7 children (group 1), whereas no shunt was found in 4 (group 2). VO2 max was decreased [84.5 (SD = 16.8)] and was strongly correlated to oxygen saturation in group 1 (p < 0.0001). Oxygen saturation at peak uptake was significantly decreased compared to baseline [97.4 (SD = 2.0) vs 90% (SD = 9.5%), p = 0.02] and was significantly lower in group 1 than in group 2 [85.7 (2.2) vs 98.2% (SD = 1.2%), p = 0. 03]. Oxygen desaturation was related to a right-to-left atrial shunt (p = 0.01). Decreased VO2 max was also correlated to the small size of the left ventricle (p = 0.05). We concluded that decreased exercise tolerance in children with asymptomatic Ebstein's anomaly is related to a right-to-left atrial shunt and to a small left ventricle. In case of poor exercise tolerance, a contrast echocardiography should be performed to detect an atrial septal defect. PMID:10089242

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    The purpose of this study was to develop an age-generalized regression model to predict maximal oxygen uptake (VO sub 2 max) based on a maximal treadmill graded exercise test (GXT; George, 1996). Participants (N = 100), ages 18-65 years, reached a maximal level of exertion (mean plus or minus standard deviation [SD]; maximal heart rate [HR sub…

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

    MedlinePLUS

    ... better than lifestyle changes and medication—and triggers heart attacks in 1 to 2 percent of patients. They can be a waste of money. An EKG typically costs about $50 and an exercise stress test about $200 to $300, according to ...

  18. A Negative Finding in an Exercise Test Is Reliable among Elderly People: A Follow-Up Study

    Microsoft Academic Search

    Markku Sumanen; Kari Mattila

    2007-01-01

    Background: Coronary heart disease (CHD) is very common among elderly people. Objective: To specify the diagnostic value of bicycle exercise tests conducted for elderly patients by trained general practitioners in primary health care. Methods: We performed a 2-year follow-up study at the Kangasala Health Centre, Finland. The study population comprised all patients at least 60 years old (n = 311)

  19. Abnormal heart rate recovery immediately after treadmill testing: Correlation with clinical, exercise testing, and myocardial perfusion parameters

    Microsoft Academic Search

    Panagiotis Georgoulias; Alexandros Orfanakis; Nikolaos Demakopoulos; Petros Xaplanteris; Georgios Mortzos; Panos Vardas; Nikolaos Karkavitsas

    2003-01-01

    Background  The increase in heart rate during exercise is considered to be attributed to sympathetic system activation combined with parasympathetic\\u000a withdrawal. The prognostic importance of the chronotropic response to exercise and heart rate recovery 1 minute after exercise\\u000a has already been established. The purpose of this study was to evaluate heart rate recovery as an index of myocardial ischemia,\\u000a by correlating

  20. Evaluation of cardiopulmonary resuscitation techniques in microgravity

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

  1. Exercise, Heart and Health

    PubMed Central

    2011-01-01

    Regular physical activity provides a variety of health benefits, including improvement in cardiopulmonary or metabolic status, reduction of the risk of coronary artery disease or stroke, prevention of cancer, and decrease in total mortality. Exercise-related cardiac events are occasionally reported during highly competitive sports activity or vigorous exercises. However, the risk of sudden death is extremely low during vigorous exercise, and habitual vigorous exercise actually decreases the risk of sudden death during exercise. The cause of sudden death is ischemic in older subjects (?35 years old), while cardiomyopathies or genetic ion channel diseases are important underlying pathology in younger (<35 years old) victims. The subgroup of patients who are particularly at higher risk of exercise-related sudden death may be identified in different ways, such as pre-participation history taking, physical examination and/or supplementary cardiac evaluation. Limitations exist because current diagnostic tools are not sufficient to predict a coronary artery plaque with potential risk of disruption and/or an acute thrombotic occlusion. Proper and cost-effective methods for identification of younger subjects with cardiac structural problems or genetic ion channel diseases are still controversial. PMID:21519508

  2. The role of the bronchial provocation challenge tests in the diagnosis of exercise-induced bronchoconstriction in elite swimmers

    Microsoft Academic Search

    A. Castricum; K. Holzer; P. Brukner; L. Irving

    2010-01-01

    BackgroundThe International Olympic Committee–Medical Commission (IOC-MC) accepts a number of bronchial provocation tests for the diagnosis of exercise-induced bronchoconstriction (EIB) in elite athletes, none of which have been studied in elite swimmers. With the suggestion of a different pathogenesis involved in the development of EIB in swimmers, there is a possibility that the recommended test for EIB in elite athletes,

  3. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  4. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  5. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  6. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  7. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  8. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4230 Cardiopulmonary...with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood....

  9. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4230 Cardiopulmonary...with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood....

  10. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4230 Cardiopulmonary...with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood....

  11. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4230 Cardiopulmonary...with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood....

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

    PubMed Central

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

    2014-01-01

    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

  13. An Experimental Test of Cognitive Dissonance Theory in the Domain of Physical Exercise

    Microsoft Academic Search

    Nikos L. D. Chatzisarantis; Martin S. Hagger; John C. K. Wang

    2008-01-01

    The present study examined cognitive dissonance-related attitude change in the domain of exercise. Experimental participants made a decision to perform a boring exercise task (stepping on a bench\\/chair) under three different conditions: a free-choice condition (n = 33, Male = 17 female = 16, Age = 14.57), under a no-choice\\/control condition (n = 28, Male = 15, Female = 13,

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    SciTech Connect

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

    1987-03-01

    In a recent study of 190 survivors of acute myocardial infarction, the authors sought to determine whether exercise-induced painless ST segments depression indicates residual myocardial ischemia, as defined by /sup 201/Tl scintigraphic criteria. 2 weeks after uncomplicated myocardial infarction, and whether quantitative /sup 201/Tl imaging enhances the prognostic value of such an exercise electrocardiographic response.

  16. Cardiopulmonary responses to arm exercise performed in various ways

    Microsoft Academic Search

    ULF DANIELSSON; STIG GRAMBO; LENNART WENNBERG

    1980-01-01

    Energy expenditure, pulmonary ventilation, and heart rate were studied during arm work when the load, pedalling rate, pedalling direction, and the length of the crank were varied. The same variables were also studied when cranking was performed with both hands on the same side as well as on each side of the crankshaft. The results were compared to the demand

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

    NASA Technical Reports Server (NTRS)

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

    1973-01-01

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

  18. The degree of ST-segment depression on symptom-limited exercise testing: Relation to the myocardial ischemic burden as determined by thallium-201 scintigraphy

    Microsoft Academic Search

    Allen J. Taylor; Matthew C. Sackett; George A. Beller

    1995-01-01

    This study sought to determine the relation between the magnitude of exercise-induced ST depression and the ischemic burden as determined by quantitative thallium-201 scintigraphy. One hundred forty-four consecutive patients were prospectively studied with symptom-limited exercise testing and thallium-201 scintigraphy. Of these patients, 37 had between 1.0 and <2.0 mm (group 1) and 17 had ?2.0 mm (group 2) of exercise-induced

  19. Comparison of ST segment changes on standard and Holter electrocardiogram during exercise testing.

    PubMed

    Pothen, P; Maglio, P; Scanavacca, G; Ronsisvalle, G; Castellani, V; Pigato, R; Pessina, A C; Dal Palù, C

    1992-12-01

    In order to compare the ST segment changes recorded simultaneously on Holter (Del Mar Avionics 445B recorder and DCG VII Scanner) and standard electrocardiogram, 22 patients with chest discomfort and normal resting ECG were evaluated during exercise testing. The conventional ECG was recorded using chest lead V5 and a modified lead II. The Holter recording was done using the bipolar chest lead CM5 and the same modified lead II. Bifurcating electrodes permitted simultaneous recording of electrocardiogram on both systems from the same electrode sites. Seven of the 22 patients had a positive test and 15 had a negative test by both systems. In 7 positive cases the amplitude of ST segment depression was compared. The Holter lead CM5 showed higher amplitude of ST segment depressions in 6 cases compared to the conventional lead V5: 3 cases by 0.5 mm; 2 cases by 1 mm and 1 case by 2.5 mm. In 1 case it was identical. The amplitude of ST segment depression in lead CM5 ranged from 1 to 3.5 mm (mean 2.2 +/- 0.6 mm) and in lead V5 from 1 to 2.5 mm (mean 1.5 +/- 0.6 mm). Thus the amplitude of ST depression was higher in lead CM5 by a mean of 0.7 mm compared to the lead V5. ST segment depression was present only in 6 cases in the modified lead II. ST segment depressions were reproduced faithfully in 3 patients and within the variation of 0.5 mm in other 3 cases by the Holter system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1303304

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

    PubMed Central

    Chandra, Divay; Wise, Robert A.; Kulkarni, Hrishikesh S.; Benzo, Roberto P.; Criner, Gerard; Make, Barry; Slivka, William A.; Ries, Andrew L.; Reilly, John J.; Martinez, Fernando J.

    2012-01-01

    Background: It is uncertain whether the effort and expense of performing a second walk for the 6-min walk test improves test performance. Hence, we attempted to quantify the improvement in 6-min walk distance if an additional walk were to be performed. Methods: We studied patients consecutively enrolled into the National Emphysema Treatment Trial who prior to randomization and after 6 to 10 weeks of pulmonary rehabilitation performed two 6-min walks on consecutive days (N = 396). Patients also performed two 6-min walks at 6-month follow-up after randomization to lung volume reduction surgery (n = 74) or optimal medical therapy (n = 64). We compared change in the first walk distance to change in the second, average-of-two, and best-of-two walk distances. Results: Compared with the change in the first walk distance, change in the average-of-two and best-of-two walk distances had better validity and precision. Specifically, 6 months after randomization to lung volume reduction surgery, changes in the average-of-two (r = 0.66 vs r = 0.58, P = .01) and best-of-two walk distances (r = 0.67 vs r = 0.58, P = .04) better correlated with the change in maximal exercise capacity (ie, better validity). Additionally, the variance of change was 14% to 25% less for the average-of-two walk distances and 14% to 33% less for the best-of-two walk distances than the variance of change in the single walk distance, indicating better precision. Conclusions: Adding a second walk to the 6-min walk test significantly improves its performance in measuring response to a therapeutic intervention, improves the validity of COPD clinical trials, and would result in a 14% to 33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in patients with COPD. PMID:23364913

  1. Vasopressin decreases neuronal apoptosis during cardiopulmonary resuscitation

    PubMed Central

    Ma, Chi; Zhu, Zhe; Wang, Xu; Zhao, Gang; Liu, Xiaoliang; Li, Rui

    2014-01-01

    The American Heart Association and the European Resuscitation Council recently recommended that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopulmonary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, the pathological damage to nerve cells was lessened, and the levels of c-Jun N-terminal kinase and p38 expression were significantly decreased in the hippocampus after treatment with vasopressin alone or the vasopressin and epinephrine combination. No significant difference in resuscitation effects was detected between vasopressin alone and the vasopressin and epinephrine combination. These results suggest that vasopressin alone or the vasopressin and epinephrine combination suppress the activation of mitogen-activated protein kinase and c-Jun N-terminal kinase signaling pathways and reduce neuronal apoptosis during cardiopulmonary resuscitation. PMID:25206865

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

    SciTech Connect

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

    1990-11-15

    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.

  3. The combined effect of the cold pressor test and isometric exercise on heart rate and blood pressure.

    PubMed

    Peikert, D; Smolander, J

    1991-01-01

    The purpose of this study was to determine if the cold pressor test during isometric knee extension [15% of maximal voluntary contraction (MVC)] could have an additive effect on cardiovascular responses. Systolic and diastolic blood pressures, heart rate and pressure rate product were measured in eight healthy male subjects. The subjects performed the cold pressor tests and isometric leg extensions singly and in combination. The increases of systolic and diastolic blood pressure during isometric exercise were of almost the same magnitude as those during the cold pressor test. The responses of arterial blood pressure, and heart rate to a combination of the cold pressor test and isometric knee extension were greater than for each test separately. It is suggested that this additional effect of cold immersion of one hand during isometric exercise may have been due to vasoconstriction effects in the contralateral unstressed limb. In summary, the circulatory effects of the local application of cold during static exercise at 15% MVC were additive. PMID:1893909

  4. A Perceptually-regulated Exercise Test Predicts Peak Oxygen Uptake in Older Active Adults.

    PubMed

    Smith, Ashleigh E; Eston, Roger G; Norton, Belinda; Parfitt, Gaynor

    2015-04-01

    Peak oxygen uptake (VO2peak) is reliably predicted in young and middle-aged adults using a submaximal perceptually-regulated exercise test (PRET). It is unknown whether older adults can use a PRET to accurately predict VO2peak. In this study, the validity of a treadmill-based PRET to predict VO2peak was assessed in 24 participants (65.2 ± 3.9 years, 11 males). The PRET required a change in speed or incline corresponding to ratings of perceived exertion (RPE) 9, 11, 13, and 15. Extrapolation of submaximal VO2 from the PRET to RPE endpoints 19 and 20 and age-predicted HRmax were compared with measured VO2peak. The VO2 extrapolated to both RPE19 and 20 over-predicted VO2peak (p < .001). However, extrapolating VO2 to age-predicted HRmax accurately predicted VO2peak (r = .84). Results indicate older adults can use a PRET to predict VO2peak by extrapolating VO2 from submaximal intensities to an age-predicted HRmax. PMID:24700352

  5. Dynamic pulmonary hyperinflation occurs without expiratory flow limitation in chronic heart failure during exercise.

    PubMed

    Chiari, Stefania; Torregiani, Chiara; Boni, Enrico; Bassini, Sonia; Vizzardi, Enrico; Tantucci, Claudio

    2013-10-01

    To assess the occurrence of tidal expiratory flow limitation (EFL) and/or dynamic pulmonary hyperinflation (DH) in chronic heart failure (CHF) during exercise 15 patients with stable systolic CHF, aged 69 ± 6yr, underwent pulmonary function testing and incremental cardio-pulmonary exercise testing. They subsequently performed constant load exercise testing at 30, 60 and 90% of respective maximum workload. At each step the presence of EFL, by negative expiratory pressure technique, and changes in inspiratory capacity (IC) were assessed. Ejection fraction amounted to 36 ± 6% and VO?, peak (77 ± 19% pred.) was reduced. EFL was absent at any step during constant load exercise. In 6 patients IC decreased more than 10% pred. at highest step. Only in these patients TLC, FRC, RV FEF(25-75%) and DL(CO) were decreased at rest. VO?, peak correlated with DL(CO), TLC and IC at rest and with IC (r(2)=0.59; p<0.001) and decrease in IC (r(2)=0.44; p<0.001) at 90% of maximum workload. During exercise CHF patients do not exhibit EFL, but some of them develop DH that is associated with lower VO?, peak. PMID:23851110

  6. Comparative study of coronary flow reserve, coronary anatomy and results of radionuclide exercise tests in patients with coronary artery disease

    SciTech Connect

    Legrand, V.; Mancini, G.B.; Bates, E.R.; Hodgson, J.M.; Gross, M.D.; Vogel, R.A.

    1986-11-01

    A comparative assessment of regional coronary flow reserve, quantitative percent diameter coronary stenosis and exercise-induced perfusion and wall motion abnormalities was performed in 39 patients with coronary artery disease. Coronary flow reserve was determined by a digital angiographic technique utilizing contrast medium as the hyperemic agent. Percent diameter stenosis was calculated by an automated quantification program applied to orthogonal cineangiograms. Thallium-201 scintigraphy and radionuclide ventriculography were used to assess regional perfusion and wall motion abnormalities, respectively, at rest and during exercise. In Group A, 19 patients without transmural infarction or collateral vessels, coronary flow reserve was inversely related to percent diameter stenosis (r = -0.61, p less than 0.0001), and scintigraphic abnormalities occurred only in vascular distributions with a coronary flow reserve of less than 2.00. There was a strong relation among abnormal regional exercise results, stenoses greater than 50% and reactive hyperemia of less than 2.00. Patients with multivessel disease, however, often had normal exercise scintigrams in regions associated with greater than 50% stenosis and low coronary flow reserve when other regions had a lower coronary flow reserve or higher grade stenosis, or both. In Group B, 20 patients with angiographically visible collateral vessels, 12 of whom had prior myocardial infarction, coronary flow reserve correlated less well with percent diameter stenosis than in Group A (r = -0.47, p less than 0.004). As in Group A patients, there was a significant relation between abnormal exercise test results and stenoses greater than 50%. However, reactive hyperemia values were generally lower than in Group A, and positive exercise stress results were strongly correlated only with highly impaired flow reserves of 1.3 or less.

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

    PubMed

    Sandoval, Darleen A; Matt, Kathleen S

    2003-01-01

    To test whether the oral contraceptive pill cycle affects endocrine and metabolic responses to hypoxic (fraction of inspired oxygen = 13%, P(IO2): 95 mmHg; H) versus normoxic (P(IO2):153 mmHg; N) exercise, we examined eight women (28 +/- 1.2 yr) during the third (PILL) and placebo (PLA) weeks of their monthly oral contraceptive pill cycle. Cardiopulmonary, metabolic, and neuroendocrine measurements were taken before, during, and after three 5-min consecutive workloads at 30%, 45%, and 60% of normoxic V(O2peak) in H and N trials. Heart rate response to exercise was greater in H versus N, but was not different between PILL and PLA. Lactate levels were significantly greater during exercise, and both lactate and glucose levels were significantly greater for 30 min after exercise in H versus N (p < 0.0001). When expressed relative to baseline, lactate levels were lower in PILL versus PLA, but glucose was greater in PILL versus PLA (p < 0.001). Cortisol levels were also significantly greater in PILL versus PLA (p < 0.001). Norepinephrine levels were significantly increased during exercise (p < 0.0001) and in H versus N (p < 0.0001). However, epinephrine levels were not different over time or with trial. Thus, the presence of circulating estradiol and progesterone during the PILL phase reduces glucose and lactate responses to hypoxic exercise. PMID:12713713

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

    NASA Technical Reports Server (NTRS)

    Sandoval, Darleen A.; Matt, Kathleen S.

    2003-01-01

    To test whether the oral contraceptive pill cycle affects endocrine and metabolic responses to hypoxic (fraction of inspired oxygen = 13%, P(IO2): 95 mmHg; H) versus normoxic (P(IO2):153 mmHg; N) exercise, we examined eight women (28 +/- 1.2 yr) during the third (PILL) and placebo (PLA) weeks of their monthly oral contraceptive pill cycle. Cardiopulmonary, metabolic, and neuroendocrine measurements were taken before, during, and after three 5-min consecutive workloads at 30%, 45%, and 60% of normoxic V(O2peak) in H and N trials. Heart rate response to exercise was greater in H versus N, but was not different between PILL and PLA. Lactate levels were significantly greater during exercise, and both lactate and glucose levels were significantly greater for 30 min after exercise in H versus N (p < 0.0001). When expressed relative to baseline, lactate levels were lower in PILL versus PLA, but glucose was greater in PILL versus PLA (p < 0.001). Cortisol levels were also significantly greater in PILL versus PLA (p < 0.001). Norepinephrine levels were significantly increased during exercise (p < 0.0001) and in H versus N (p < 0.0001). However, epinephrine levels were not different over time or with trial. Thus, the presence of circulating estradiol and progesterone during the PILL phase reduces glucose and lactate responses to hypoxic exercise.

  9. Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer

    PubMed Central

    Nugent, A; Steele, I; Carragher, A; McManus, K; McGuigan, J; Gibbons, J; Riley, M; Nicholls, D

    1999-01-01

    BACKGROUND—Resection is the treatment of choice for lung cancer, but may cause impaired cardiopulmonary function with an adverse effect on quality of life. Few studies have considered the effects of thoracotomy alone on lung function, and whether the operation itself can impair subsequent exercise capacity.?METHODS—Patients being considered for lung resection (n = 106) underwent full static and dynamic pulmonary function testing which was repeated 3-6 months after surgery (n =53).?RESULTS—Thoracotomy alone (n = 13) produced a reduction in forced expiratory volume in one second (FEV1; mean (SE) 2.10 (0.16) versus 1.87 (0.15) l; p<0.05). Wedge resection (n = 13) produced a non-significant reduction in total lung capacity (TLC) only. Lobectomy (n = 14) reduced forced vital capacity (FVC), TLC, and carbon monoxide transfer factor but exercise capacity was unchanged. Only pneumonectomy (n = 13) reduced exercise capacity by 28% (PV?O2 23.9 (1.5) versus 17.2 (1.7) ml/min/kg; difference (95% CI) 6.72 (3.15 to 10.28); p<0.01) and three patients changed from a cardiac limitation to exercise before pneumonectomy to pulmonary limitation afterwards.?CONCLUSIONS—Neither thoracotomy alone nor limited lung resection has a significant effect on exercise capacity. Only pneumonectomy is associated with impaired exercise performance, and then perhaps not as much as might be expected.?? PMID:10092695

  10. Exercise testing in asymptomatic or minimally symptomatic aortic regurgitation: relationship of left ventricular ejection fraction to left ventricular filling pressure during exercise

    SciTech Connect

    Boucher, C.A.; Wilson, R.A.; Kanarek, D.J.; Hutter, A.M. Jr.; Okada, R.D.; Liberthson, R.R.; Strauss, H.W.; Pohost, G.M.

    1983-05-01

    Exercise radionuclide angiography is being used to evaluate left ventricular function in patients with aortic regurgitation. Ejection fraction is the most common variable analyzed. To better understand the rest and exercise ejection fraction in this setting, 20 patients with asymptomatic or minimally symptomatic severe aortic regurgitation were studied. All underwent simultaneous supine exercise radionuclide angiography and pulmonary gas exchange measurement and underwent rest and exercise measurement of pulmonary artery wedge pressure (PAWP) during cardiac catheterization. Eight patients had a peak exercise PAWP less than 15 mm Hg (group 1) and 12 had a peak exercise PAWP greater than or equal to 15 mm Hg (group 2). Group 1 patients were younger and more were in New York Heart Association class I. The two groups had similar cardiothoracic ratios, changes in ejection fractions with exercise, and rest and exercise regurgitant indexes. Using multiple regression analysis, the best correlate of the exercise PAWP was peak oxygen uptake (r . -0.78, p less than 0.01). No other measurement added significantly to the regression. When peak oxygen uptake was excluded, rest and exercise ejection fraction also correlated significantly (r . -0.62 and r . -0.60, respectively, p less than 0.01). Patients with asymptomatic or minimally symptomatic severe aortic regurgitation have a wide spectrum of cardiac performance in terms of the PAWP during exercise. The absolute rest and exercise ejection fraction and the level of exercise achieved are noninvasive variables that correlate with exercise PAWP in aortic regurgitation, but the change in ejection fraction with exercise by itself is not.

  11. Statistics for Chemists: Exercises

    NSDL National Science Digital Library

    Wehrens, Ron

    This website contains a group of exercises that allow students to practice basic statistical calculations for descriptive statistics, confidence intervals, hypothesis tests, regression and experimental design. The exercises are interactive and provide feedback for students who submit wrong answers.

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

    SciTech Connect

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

    1989-07-01

    The individual and combined predictive values of dipyridamole-thallium imaging and exercise testing were compared in a prospective study of 70 patients who had abdominal aortic aneurysms or aortoiliac occlusive disease that required surgical repair. All patients were evaluated clinically by the same cardiologist and had exercise stress testing and dipyridamole-thallium imaging before admission for surgery. Ten patients were excluded from the study because they had evidence of severe ischemia when tested (ST segment depression greater than 2 mm on exercise testing, severe multivessel disease on thallium imaging). The remaining 60 patients were operated on (abdominal aortic aneurysm repair, 40; aortobifemoral repair, 17; femorofemoral graft, 3). The test results were withheld from the surgeon, anesthetist, and cardiologist before surgery. A total of 22 patients experienced major cardiac complications postoperatively (acute pulmonary edema, 17; acute myocardial infarction, 5; cardiac death, 2). Thallium imaging showed myocardial ischemia in 31/60 patients. Exercise testing was positive (greater than or equal to 1 mm ST segment depression) in 10/60 patients. Dipyridamole-thallium imaging with a high sensitivity and reasonable specificity is the initial test of choice. Exercise testing is a poor screening test because of its low sensitivity. The combination of the two tests gives the highest positive predictive value and the greatest likelihood ratio. Thus patients assessed initially and found to have positive thallium scan results may be further stratified by exercise testing.

  13. Identification of steady states and quantification of transition periods from beat-by-beat cardiovascular time series: application to incremental exercise test

    Microsoft Academic Search

    P. Castiglioni; G. Merati; M. Di Rienzo

    2004-01-01

    A recently proposed procedure for checking the cardiovascular steady state from beat-by-beat values of blood pressure and heart rate was used for investigating incremental exercise tests. We measured continuous blood pressure in 5 volunteers during rest, incremental exercise until volitional exhaustion, and recovery, and derived a \\

  14. A simplified approach for evaluating multiple test outcomes and multiple disease states in relation to the exercise thallium-201 stress test in suspected coronary artery disease

    SciTech Connect

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

    1989-09-01

    This study describes a simplified approach for the interpretation of electrocardiographic and thallium-201 imaging data derived from the same patient during exercise. The 383 patients in this study had also undergone selective coronary arteriography within 3 months of the exercise test. This matrix approach allows for multiple test outcomes (both tests positive, both negative, 1 test positive and 1 negative) and multiple disease states (no coronary artery disease vs 1-vessel vs multivessel coronary artery disease). Because this approach analyzes the results of 2 test outcomes simultaneously rather than serially, it also negates the lack of test independence, if such an effect is present. It is also demonstrated that ST-segment depression on the electrocardiogram and defects on initial thallium-201 images provide conditionally independent information regarding the presence of coronary artery disease in patients without prior myocardial infarction. In contrast, ST-segment depression on the electrocardiogram and redistribution on the delayed thallium-201 images may not provide totally independent information regarding the presence of exercise-induced ischemia in patients with or without myocardial infarction.

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

    E-print Network

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

    2015-01-01

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

  16. Effect of exercise position during stress testing on cardiac and pulmonary thallium kinetics and accuracy in evaluating coronary artery disease

    SciTech Connect

    Lear, J.L.

    1986-06-01

    We compared the effects of symptom-limited upright and supine exercise on 201Tl distribution and kinetics in the heart and lungs of 100 consecutive patients. Our analysis was based on data obtained with a digital gamma camera in the 45 degrees left anterior oblique position at 5, 40, 240, and 275 min postadministration of (201Tl)chloride. We found significant differences in the results at the 5- and 40-min intervals; viz, higher cardiac and lower pulmonary thallium activity after upright exercise in 94 subjects at both intervals, and greater variability in total and regional cardiac thallium kinetics after supine exercise. With supine exercise, the relatively low initial cardiac activity, relatively high lung activity, and the greater variability in thallium kinetics combined to make interpretation of quantitative data and cardiac images difficult and less accurate with respect to detection of coronary artery disease. These observations have important implications for the interpreting physician when thallium stress tests are performed in the supine position.

  17. 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...

  18. Use of instructional video to prepare parents for learning infant cardiopulmonary resuscitation

    Microsoft Academic Search

    Timothy S. Brannon; Lisa A. White; Julie N. Kilcrease; LaShawn D. Richard; Jana G. Spillers; Cynthia L. Phelps

    2009-01-01

    Parents of premature infants often receive infant cardiopulmonary resuscitation (CPR) training prior to discharge from the hospital, but one study showed that 27.5% of parents could not demonstrate adequate CPR skills after completing an instructor-led class. We hypothesized that parents who viewed an instructional video on infant CPR before attending the class would perform better on a standardized skills test

  19. Cardiopulmonary Resuscitation and Older Adults' Expectations.

    ERIC Educational Resources Information Center

    Godkin, M. Dianne; Toth, Ellen L.

    1994-01-01

    Examined knowledge, attitudes, and opinions of 60 older adults about cardiopulmonary resuscitation (CPR). Most had little or no accurate knowledge of CPR. Knowledge deficits and misconceptions of older adults should be addressed so that they may become informed and active participants in CPR decision-making process. (BF)

  20. TECHNICAL STANDARDS Department of Cardiopulmonary Science

    E-print Network

    below, without unreasonable dependence on technology or intermediaries. Physical Health: A cardiopulmonary science student must possess the physical health and stamina needed to carry out the program of vision, hearing, touch and smell to observe effectively in the classroom, laboratory and clinical setting

  1. Brain microvascular function during cardiopulmonary bypass

    SciTech Connect

    Sorensen, H.R.; Husum, B.; Waaben, J.; Andersen, K.; Andersen, L.I.; Gefke, K.; Kaarsen, A.L.; Gjedde, A.

    1987-11-01

    Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass.

  2. The standardization of results on hair testing for drugs of abuse: An interlaboratory exercise in Lombardy Region, Italy.

    PubMed

    Stramesi, C; Vignali, C; Groppi, A; Caligara, M; Lodi, F; Pichini, S; Jurado, C

    2012-05-10

    Hair testing for drugs of abuse is performed in Lombardy by eleven analytical laboratories accredited for forensic purposes, the most frequent purposes being driving license regranting and workplace drug testing. Individuals undergoing hair testing for these purposes can choose the laboratory in which the analyses have to be carried out. The aim of our study was to perform an interlaboratory exercise in order to verify the level of standardization of hair testing for drugs of abuse in these accredited laboratories; nine out of the eleven laboratories participated in this exercise. Sixteen hair strands coming from different subjects were longitudinally divided in 3-4 aliquots and distributed to participating laboratories, which were requested to apply their routine methods. All the participants analyzed opiates (morphine and 6-acetylmorphine) and cocainics (cocaine and benzoylecgonine) while only six analyzed methadone and amphetamines (amphetamine, methamphetamine, MDMA, MDA and MDEA) and five ?(9)-tetrahydrocannabinol (THC). The majority of the participants (seven labs) performed acidic hydrolysis to extract the drugs from the hair and analysis by GC-MS, while two labs used LC-MS/MS. Eight laboratories performed initial screening tests by Enzyme Multiplied Immunoassay Technique (EMIT), Enzyme-linked Immunosorbent Assay (ELISA) or Cloned Enzyme Donor Immunoassay (CEDIA). Results demonstrated a good qualitative performance for all the participants, since no false positive results were reported by any of them. Quantitative data were quite scattered, but less in samples with low concentrations of analytes than in those with higher concentrations. Results from this first regional interlaboratory exercise show that, on the one hand, individuals undergoing hair testing would have obtained the same qualitative results in any of the nine laboratories. On the other hand, the scatter in quantitative results could cause some inequalities if any interpretation of the data is required. PMID:22018743

  3. Real-time exercise load control using heart rate response during exercise on a stationary bicycle

    Microsoft Academic Search

    Kyungryul Chung; Sayup Kim

    2011-01-01

    The purpose of this study was to develop an algorithm for exercise load control and estimation of energy expenditure during bicycle exercise. In this study, forty-eight healthy volunteers participated and were tested graded exercise test using ramp protocol and four interval training programs. To define the exercise intensity and workload, %HRmax was used for participants exercise prescription. Exercise load of

  4. The influence of brief episodes of aerobic exercise activity, soothing music-nature scenes condition, and suggestion on coping with test-taking anxiety

    Microsoft Academic Search

    Thomas G. Plante; David Marcotte; Gerdenio Manuel; Eleanor Willemsen

    1996-01-01

    This study examines the influence of aerobic exercise activity, soothing musicnature scenes condition, and suggestion on coping with test-taking anxiety. Sixty test anxious subjects were randomly assigned to four treatment groups consisting of 15-min episodes of exercise or soothing music-nature scenes condition with or without verbal suggestion that the treatment task in which they were engaged would be helpful to

  5. Can heart rate values obtained from laboratory and field lactate tests be used interchangeably to prescribe exercise intensity for soccer players?

    Microsoft Academic Search

    Bunak Kunduracioglu; Rustu Guner; Bulent Ulkar; Ali Erdogan

    2007-01-01

    This study was undertaken to investigate the relationship between blood lactate concentration ([La]) and heart rate (HR) values\\u000a obtained during treadmill and field tests at fixed velocities with respect to interchangeability of results to be used in\\u000a exercise prescription. A total of 22 male soccer players participated in the study. Each player performed exercise tests on\\u000a a motorized treadmill and

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

    PubMed Central

    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

    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

  7. Increased Exhaled Nitric Oxide Levels Following Exercise in Patients with Chronic Systolic Heart Failure with Pulmonary Venous Hypertension

    PubMed Central

    Schuster, Andres; Thakur, Akanksha; Wang, Zeneng; Borowski, Allen G.; Thomas, James D.; Wilson Tang, W. H.

    2012-01-01

    Background Fractional exhaled nitric oxide (eNO) is recognized as a marker of pulmonary endothelial function. Oxidative stress is associated to systemic endothelial nitric oxide production but its correlation with eNO in heart failure (HF) patients has not been described. Previous studies have reported increased eNO levels after exercise in symptomatic HF patients but decreased levels in pulmonary arterial hypertension. Our objective is to prospectively examine the potential myocardial and functional determinants of exercise-induced rise of eNO in HF. Methods and Results Thirty-four consecutive ambulatory patients with chronic systolic HF (left ventricular ejection fraction [LVEF] ?45%) underwent symptom-limited cardiopulmonary stress testing and echocardiography. eNO was determined immediately after exercise. Systemic endothelial dysfunction was assessed by asymmetric dimethylarginine (ADMA) and the L-arginine/ADMA ratio. In our study cohort (mean age 53 ±13 years, 76% male, median LVEF 31%, interquartile range [IQR]: 25 to 40), the mean eNO was 23 ±9 ppb. eNO levels were higher in patients with diastolic dysfunction stages 2 or 3 than stage 1 or normal diastology (26.1±9 vs. 19.5±7 ppb, p=0.013). eNO had a positive correlation with estimated systolic pulmonary artery pressure (r= 0.57; p=0.0009) and indexed left atrium volume (r= 0.43; p= 0.014), but did not correlate with cardiopulmonary exercise test parameters, ADMA, or symptom score. Conclusions In contrast to prior reports, the increase in post-exercise eNO observed in stable chronic systolic HF patients may be attributed to the presence of underlying pulmonary venous hypertension probably secondary to advanced diastolic dysfunction. PMID:23040116

  8. Cardiac troponin T levels and exercise stress testing in patients with suspected coronary artery disease: the Akershus Cardiac Examination (ACE) 1 study

    PubMed Central

    Røysland, Ragnhild; Kravdal, Gunnhild; Høiseth, Arne Didrik; Nygård, Ståle; Badr, Pirouz; Hagve, Tor-Arne; Omland, Torbjørn; Røsjø, Helge

    2012-01-01

    Whether reversible ischaemia in patients referred for exercise stress testing and MPI (myocardial perfusion imaging) is associated with changes in circulating cTn (cardiac troponin) levels is controversial. We measured cTnT with a sensitive assay before, immediately after peak exercise and 1.5 and 4.5 h after exercise stress testing in 198 patients referred for MPI. In total, 19 patients were classified as having reversible myocardial ischaemia. cTnT levels were significantly higher in patients with reversible myocardial ischaemia on MPI at baseline, at peak exercise and after 1.5 h, but not at 4.5 h post-exercise. In patients with reversible ischaemia on MPI, cTnT levels did not change significantly after exercise stress testing [11.1 (5.2–14.9) ng/l at baseline compared with 10.5 (7.2–16.3) ng/l at 4.5 h post-exercise, P=0.27; values are medians (interquartile range)]. Conversely, cTnT levels increased significantly during testing in patients without reversible myocardial ischaemia [5.4 (3.0–9.0) ng/l at baseline compared with 7.5 (4.6–12.4) ng/l, P<0.001]. In conclusion, baseline cTnT levels are higher in patients with MPI evidence of reversible myocardial ischaemia than those without reversible ischaemia. However, although cTnT levels increase during exercise stress testing in patients without evidence of reversible ischaemia, this response appears to be blunted in patients with evidence of reversible ischaemia. Mechanisms other than reversible myocardial ischaemia may play a role for acute exercise-induced increases in circulating cTnT levels. PMID:22239123

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

    NASA Astrophysics Data System (ADS)

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

    1995-09-01

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

  10. Clinical Significance of a Spiral Phenomenon in the Plot of CO2 Output Versus O2 Uptake During Exercise in Cardiac Patients.

    PubMed

    Nagayama, Osamu; Koike, Akira; Himi, Tomoko; Sakurada, Koji; Kato, Yuko; Suzuki, Shinya; Sato, Akira; Yamashita, Takeshi; Wasserman, Karlman; Aonuma, Kazutaka

    2015-03-01

    A spiral phenomenon is sometimes noted in the plots of CO2 output (VCO2) against O2 uptake (VO2) measured during cardiopulmonary exercise testing (CPX) in patients with heart failure with oscillatory breathing. However, few data are available that elucidate the clinical significance of this phenomenon. Our group studied the prevalence of this phenomenon and its relation to cardiac and cardiopulmonary function. Of 2,263 cardiac patients who underwent CPX, 126 patients with a clear pattern of oscillatory breathing were identified. Cardiopulmonary indexes were compared between patients who showed the spiral phenomenon (n = 49) and those who did not (n = 77). The amplitudes of VO2 and VCO2 oscillations were greater and the phase difference between VO2 and VCO2 oscillations was longer in the patients with the spiral phenomenon than in those without it. Patients with the spiral phenomenon also had a lower left ventricular ejection fraction (43.4 ± 21.4% vs 57.1 ± 16.8%, p <0.001) and a higher level of brain natriuretic peptide (637.2 ± 698.3 vs 228.3 ± 351.4 pg/ml, p = 0.002). The peak VO2 was lower (14.5 ± 5.6 vs 18.1 ± 6.3, p = 0.002), the slope of the increase in ventilation versus VCO2 was higher (39.8 ± 9.5 vs 33.6 ± 6.8, p <0.001), and end-tidal PCO2 both at rest and at peak exercise was lower in the patients with the spiral phenomenon than in those without it. In conclusion, the spiral phenomenon in the VCO2-versus-VO2 plot arising from the phase difference between VCO2 and VO2 oscillations reflects more advanced cardiopulmonary dysfunction in cardiac patients with oscillatory breathing. PMID:25591892

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

    ERIC Educational Resources Information Center

    Flint, Steve; Stewart, Terry

    2010-01-01

    A web-based virtual laboratory exercise in identifying an unknown microorganism was designed for use with a cohort of 3rd-year university food-technology students. They were presented with a food-contamination case, and then walked through a number of diagnostic steps to identify the microorganism. At each step, the students were asked to select 1…

  12. Workplace nutrition and exercise climate: Scale development and preliminary model test

    Microsoft Academic Search

    Joseph J Mazzola

    2010-01-01

    Obesity is a major concern in the United States and has a multitude of negative physical and mental health consequences. Proper nutrition and exercise are important elements to initiating and maintaining a healthy lifestyle. Since most people spend a large amount of their time working, it is important that organizations create an atmosphere that is conducive to employees being able

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

    PubMed

    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

    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

  14. A prospective study of long term prognosis in young myocardial infarction survivors: the prognostic value of angiography and exercise testing

    PubMed Central

    Awad-Elkarim, A A; Bagger, J P; Albers, C J; Skinner, J S; Adams, P C; Hall, R J C

    2003-01-01

    Objectives: To define the ability of early exercise testing and coronary angiography to predict prognosis in young survivors of myocardial infarction (MI). Methods: 255 consecutive patients (210 men) aged 55 years or less (mean 48 years) admitted to hospital (1981–85) were eligible. Of these, 150 patients (130 men) who were able to exercise early after MI and underwent coronary angiography within six months constituted the study group and were followed up for up to 15 years. Survival data up to 18 years was obtained for the whole cohort. Results: Survival at a median of 16 years was 52% for the whole cohort, 62% for the study group, and 48% for the excluded group. From nine years onwards survival deteriorated significantly in the study group compared with an age matched background population. Fifteen years after MI, 121 patients (81%) in the study group had had at least one event (death, MI, revascularisation, cardiac readmission, stroke) leaving 29 (19%) event-free. The number of diseased vessels was the major determinant of time to first event (p = 0.001) and event-free survival (p = 0.04). Exercise duration was also important in the prediction of time to first event (p = 0.003). Death was influenced by a history of prior MI. Conclusion: The favourable initial survival was followed by significant deterioration after nine years. This late attrition is an important treatment target. Furthermore, this study supports risk stratification early after MI combining angiography with non-invasive tools. PMID:12860853

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

    SciTech Connect

    Not Available

    1988-04-01

    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.

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

    PubMed Central

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

    2014-01-01

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

  17. Emergent cardiopulmonary bypass during pectus excavatum repair.

    PubMed

    Craner, Ryan; Weis, Ricardo; Ramakrishna, Harish

    2013-01-01

    Pectus excavatum is a chest wall deformity that produces significant cardiopulmonary disability and is typically seen in younger patients. Minimally invasive repair of pectus excavatum or Nuss procedure has become a widely accepted technique for adult and pediatric patients. Although it is carried out through a thoracoscopic approach, the procedure is associated with a number of potential intraoperative and post-operative complications. We present a case of cardiac perforation requiring emergent cardiopulmonary bypass in a 29-year-old male with Marfan syndrome and previous mitral valve repair undergoing a Nuss procedure for pectus excavatum. This case illustrates the importance of vigilance and preparation by the surgeons, anesthesia providers as well as the institution to be prepared with resources to handle the possible complications. This includes available cardiac surgical backup, perfusionist support and adequate blood product availability. PMID:23816675

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Cardiopulmonary bypass heart-lung machine console. 870.4220... § 870.4220 Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device...

  19. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  20. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  1. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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...

  2. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  3. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...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...

  4. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  5. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...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...

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  7. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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...

  8. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  9. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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...

  10. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  11. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...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...

  13. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...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...

  14. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...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...

  15. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...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...

  16. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  17. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  18. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  19. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  20. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  1. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  2. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  3. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  6. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  7. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  8. 21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  12. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  13. Fluid distribution kinetics during cardiopulmonary bypass

    PubMed Central

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

    2014-01-01

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

  14. Bioavailable transition metals in particulate matter mediate cardiopulmonary injury in healthy and compromised animal models.

    PubMed Central

    Costa, D L; Dreher, K L

    1997-01-01

    Many epidemiologic reports associate ambient levels of particulate matter (PM) with human mortality and morbidity, particularly in people with preexisting cardiopulmonary disease (e.g., chronic obstructive pulmonary disease, infection, asthma). Because much ambient PM is derived from combustion sources, we tested the hypothesis that the health effects of PM arise from anthropogenic PM that contains bioavailable transition metals. The PM samples studied derived from three emission sources (two oil and one coal fly ash) and four ambient airsheds (St. Louis, MO; Washington; Dusseldorf, Germany; and Ottawa, Canada). PM was administered to rats by intratracheal instillation in equimass or equimetal doses to address directly the influence of PM mass versus metal content on acute lung injury and inflammation. Our results indicated that the lung dose of bioavailable transition metal, not instilled PM mass, was the primary determinant of the acute inflammatory response for both the combustion source and ambient PM samples. Residual oil fly ash, a combustion PM rich in bioavailable metal, was evaluated in a rat model of cardiopulmonary disease (pulmonary vasculitis/hypertension) to ascertain whether the disease state augmented sensitivity to that PM. Significant mortality and enhanced airway responsiveness were observed. Analysis of the lavaged lung fluids suggested that the milieu of the inflamed lung amplified metal-mediated oxidant chemistry to jeopardize the compromised cardiopulmonary system. We propose that soluble metals from PM mediate the array of PM-associated injuries to the cardiopulmonary system of the healthy and at-risk compromised host. PMID:9400700

  15. Determinants of exercise capacity in cystic fibrosis patients with mild-to-moderate lung disease

    PubMed Central

    2014-01-01

    Background Adult patients with cystic fibrosis (CF) frequently have reduced exercise tolerance, which is multifactorial but mainly due to bronchial obstruction. The aim of this retrospective analysis was to determine the mechanisms responsible for exercise intolerance in patients with mild-to-moderate or severe disease. Methods Cardiopulmonary exercise testing with blood gas analysis at peak exercise was performed in 102 patients aged 28?±?11 years: 48 patients had severe lung disease (FEV1?exercise were independent determinants of exercise capacity (R2?=?0.67). FEV1 was the major significant predictor of VO2 peak impairment in group 1, accounting for 31% of VO2 peak alteration, whereas excessive overall hyperventilation (reduced or absent breathing reserve and VE/VCO2) accounted for 41% of VO2 alteration in group 2. Conclusion Exercise limitation in adult patients with CF is largely dependent on FEV1 in patients with severe lung disease and on the magnitude of the ventilatory response to exercise in patients with mild-to-moderate lung disease. PMID:24884656

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

    PubMed Central

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

    2014-01-01

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

  17. Exercise testing in late-onset glycogen storage disease type II patients undergoing enzyme replacement therapy

    PubMed Central

    Marzorati, Mauro; Porcelli, Simone; Bellistri, Giuseppe; Morandi, Lucia; Grassi, Bruno

    2012-01-01

    Enzyme replacement therapy (ERT) has recently became available for patients with glycogen storage disease type II. Previous studies have demonstrated clinical efficacy of enzyme replacement therapy, however, data on physiological variables related to exercise tolerance are scarce. Four glycogen storage disease type II late-onset patients (45 ± 6 years) performed an incremental exercise on a cycle ergometer, up to voluntary exhaustion, before (BEFORE) and after 12 months of ERT (AFTER). Peak workload, oxygen uptake, heart rate, cardiac output (by impedance cardiography) and vastus lateralis oxygenation indices (by continuous-wave near-infrared spectroscopy, NIRS) were determined. Peak workload and oxygen uptake values significantly increased during ERT (54 ± 30 vs. 63 ± 31 watt, and 17.2 ± 4.4 vs. 19.7 ± 3.5 ml/kg/min, respectively, in BEFORE vs. AFTER). On the other hand, for both peak cardiac output (12.3 ± 5.3 vs. 14.8 ± 4.5 L/min) and the NIRS-determined peak skeletal muscle fractional O2 extraction, expressed as a percentage of the maximal values during a transient limb ischemia (30 ± 39% vs. 38 ± 28%), the observed increases were not statistically significant. Our findings suggest that in glycogen storage disease type II patients enzyme replacement therapy is associated with a mild improvement of exercise tolerance. The findings need to be validated during a longer follow-up on a larger group of patients. PMID:23182645

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

    PubMed

    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

    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

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

    PubMed Central

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

    2014-01-01

    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

  20. Effects of acetazolamide on aerobic exercise capacity and pulmonary hemodynamics at high altitudes.

    PubMed

    Faoro, Vitalie; Huez, Sandrine; Giltaire, Sébastien; Pavelescu, Adriana; van Osta, Aurélie; Moraine, Jean-Jacques; Guenard, Hervé; Martinot, Jean-Benoît; Naeije, Robert

    2007-10-01

    Aerobic exercise capacity is decreased at altitude because of combined decreases in arterial oxygenation and in cardiac output. Hypoxic pulmonary vasoconstriction could limit cardiac output in hypoxia. We tested the hypothesis that acetazolamide could improve exercise capacity at altitude by an increased arterial oxygenation and an inhibition of hypoxic pulmonary vasoconstriction. Resting and exercise pulmonary artery pressure (Ppa) and flow (Q) (Doppler echocardiography) and exercise capacity (cardiopulmonary exercise test) were determined at sea level, 10 days after arrival on the Bolivian altiplano, at Huayna Potosi (4,700 m), and again after the intake of 250 mg acetazolamide vs. a placebo three times a day for 24 h. Acetazolamide and placebo were administered double-blind and in a random sequence. Altitude shifted Ppa/Q plots to higher pressures and decreased maximum O(2) consumption ((.)Vo(2max)). Acetazolamide had no effect on Ppa/Q plots but increased arterial O(2) saturation at rest from 84 +/- 5 to 90 +/- 3% (P < 0.05) and at exercise from 79 +/- 6 to 83 +/- 4% (P < 0.05), and O(2) consumption at the anaerobic threshold (V-slope method) from 21 +/- 5 to 25 +/- 5 ml.min(-1).kg(-1) (P < 0.01). However, acetazolamide did not affect (.)Vo(2max) (from 31 +/- 6 to 29 +/- 7 ml.kg(-1).min(-1)), and the maximum respiratory exchange ratio decreased from 1.2 +/- 0.06 to 1.05 +/- 0.03 (P < 0.001). We conclude that acetazolamide does not affect maximum exercise capacity or pulmonary hemodynamics at high altitudes. Associated changes in the respiratory exchange ratio may be due to altered CO(2) production kinetics. PMID:17615281

  1. Resistance exercise and growth hormone administration in older men: Effects on insulin sensitivity and secretion during a stable-label intravenous glucose tolerance test

    Microsoft Academic Search

    Jeffrey J. Zachwieja; Gianna Toffolo; Claudio Cobelli; Dennis M. Bier; Kevin E. Yarasheski

    1996-01-01

    To assess the effects of 16 weeks of heavy resistance exercise training (RE) on insulin sensitivity and secretion in healthy older men aged 64 to 75 years (N = 15), stable-label ([6,6,2H2]glucose) intravenous glucose tolerance tests (IVGTTs) were performed before and 7 days after the last bout of exercise. Glucose disappearance rate (Rd) and an index of insulin sensitivity (Si?)

  2. Radiogram No. 1661u Form 24 for 03/01/2013 Hydraulic Loop 1 Coolant Pump Flow Regulator Test. LBNP Exercise

    E-print Network

    Exercise TIME CREW ACTIVITY 06:00-06:10 CDR, FE-5, FE-6 Morning Inspection 06:00-06:10 FE-1 Morning Inspection. SM (Caution & Warning Panel) Test 06:10-06:40 Post-sleep 06:40-07:30 BREAKFAST 07:30-07:50 Work:35-10:05 CDR Physical Exercise (ARED) 08:40-08:50 FE-4 MAI-75. Transmitter Activation and Monitoring 08

  3. The clinical translation gap in child health exercise research: a call for disruptive innovation.

    PubMed

    Ashish, Naveen; Bamman, Marcas M; Cerny, Frank J; Cooper, Dan M; D'Hemecourt, Pierre; Eisenmann, Joey C; Ericson, Dawn; Fahey, John; Falk, Bareket; Gabriel, Davera; Kahn, Michael G; Kemper, Han C G; Leu, Szu-Yun; Liem, Robert I; McMurray, Robert; Nixon, Patricia A; Olin, J Tod; Pianosi, Paolo T; Purucker, Mary; Radom-Aizik, Shlomit; Taylor, Amy

    2015-02-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health. PMID:25109386

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

    PubMed Central

    Nikolaidis, Lazaros; Memon, Nabeel

    2015-01-01

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

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

    PubMed

    Raub, James A

    2002-12-01

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

  6. Exercise and Memory

    NSDL National Science Digital Library

    Twin Cities Public Television, Inc.

    2005-01-01

    This activity (on page 2 of the PDF) is a full inquiry investigation into the effects of exercise on short term memory. Groups of learners will set a baseline score with an initial memory test. Then they split into two teams, one participating in physical exercise while the other remains sedentary. After ten minutes, both teams take another memory test to tabulate and graph score changes. Relates to linked video, DragonflyTV: Exercise and Memory.

  7. Cardiopulmonary resuscitation knowledge among nurses working in Bahrain.

    PubMed

    Marzooq, Hussain; Lyneham, Joy

    2009-08-01

    There is a public expectation that registered nurses are competent in their skills. Nurses need to know cardiopulmonary resuscitation (CPR) to enable them to safely and effectively provide appropriate CPR measures. The objectives of this descriptive study were (i) to investigate nurses' knowledge regarding CPR; and (ii) to identify barriers to appropriate CPR evaluation. One hundred questionnaires were distributed to nurses working in a public government hospital in Bahrain; 82 of these were returned. The results indicated that cognitive knowledge was not adequately retained. Fifty-eight per cent of respondents perceived recalling CPR information as easy or extremely easy. Only 7% of respondents passed the knowledge test. In general, those who had less education and experience did not recall essential CPR knowledge. This study identified a significant problem with the knowledge surrounding CPR. More concerning was the lack of professional responsibility in dealing with this inadequacy. PMID:19703046

  8. Effect of cardiopulmonary C fibre activation on the firing activity of ventral respiratory group neurones in the rat.

    PubMed Central

    Wilson, C G; Bonham, A C

    1997-01-01

    1. Cardiopulmonary C fibre receptor stimulation elicits apnoea and rapid shallow breathing, but the effects on the firing activity of central respiratory neurones are not well understood. This study examined the responses of ventral respiratory group neurones: decrementing expiratory (Edec), augmenting expiratory (Eaug), and inspiratory (I) neurones during cardiopulmonary C fibre receptor-evoked apnoea and rapid shallow breathing. 2. Extracellular neuronal activity, phrenic nerve activity and arterial pressure were recorded in urethane-anaesthetized rats. Cardiopulmonary C fibre receptors were stimulated by right atrial injections of phenylbiguanide. Neurones were tested for antidromic activation from the contra- and ipsilateral ventral respiratory group (VRG), spinal cord and cervical vagus nerve. 3. Edec neurones discharged tonically during cardiopulmonary C fibre-evoked apnoea and rapid shallow breathing, displaying increased burst durations, number of impulses per burst, and mean impulse frequencies. Edec neurones recovered either with the phrenic nerve activity (25 s) or much later (3 min). 4. By contrast, the firing activity of Eaug and most I neurones was decreased, featuring decreased burst durations and number of impulses per burst and increased interburst intervals. Eaug activity recovered in approximately 3 min and inspiratory activity in approximately 1 min. 5. The results indicate that cardiopulmonary C fibre receptor stimulation causes tonic firing of Edec neurones and decreases in Eaug and I neuronal activity coincident with apnoea or rapid shallow breathing. PMID:9365917

  9. Cardiopulmonary data-acquisition system

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  10. 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)

    Schricker, Bradley C.; Antalek, Christopher

    2006-05-01

    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.

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

    PubMed Central

    2014-01-01

    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

  12. Questionable Exercises.

    ERIC Educational Resources Information Center

    Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

    1999-01-01

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

  13. Maximal exercise test is a useful method for physical capacity and oxygen consumption determination in streptozotocin-diabetic rats

    PubMed Central

    Rodrigues, Bruno; Figueroa, Diego M; Mostarda, Cristiano T; Heeren, Marcelo V; Irigoyen, Maria-Cláudia; De Angelis, Kátia

    2007-01-01

    Background The aim of the present study was to investigate the relationship between speed during maximum exercise test (ET) and oxygen consumption (VO2) in control and STZ-diabetic rats, in order to provide a useful method to determine exercise capacity and prescription in researches involving STZ-diabetic rats. Methods Male Wistar rats were divided into two groups: control (CG, n = 10) and diabetic (DG, n = 8). The animals were submitted to ET on treadmill with simultaneous gas analysis through open respirometry system. ET and VO2 were assessed 60 days after diabetes induction (STZ, 50 mg/Kg). Results VO2 maximum was reduced in STZ-diabetic rats (72.5 ± 1 mL/Kg/min-1) compared to CG rats (81.1 ± 1 mL/Kg/min-1). There were positive correlations between ET speed and VO2 (r = 0.87 for CG and r = 0.8 for DG), as well as between ET speed and VO2 reserve (r = 0.77 for CG and r = 0.7 for DG). Positive correlations were also obtained between measured VO2 and VO2 predicted values (r = 0.81 for CG and r = 0.75 for DG) by linear regression equations to CG (VO2 = 1.54 * ET speed + 52.34) and DG (VO2 = 1.16 * ET speed + 51.99). Moreover, we observed that 60% of ET speed corresponded to 72 and 75% of VO2 reserve for CG and DG, respectively. The maximum ET speed was also correlated with VO2 maximum for both groups (CG: r = 0.7 and DG: r = 0.7). Conclusion These results suggest that: a) VO2 and VO2 reserve can be estimated using linear regression equations obtained from correlations with ET speed for each studied group; b) exercise training can be prescribed based on ET in control and diabetic-STZ rats; c) physical capacity can be determined by ET. Therefore, ET, which involves a relatively simple methodology and low cost, can be used as an indicator of cardio-respiratory capacity in future studies that investigate the physiological effect of acute or chronic exercise in control and STZ-diabetic male rats. PMID:18078520

  14. Abolition of exercise induced ST depression after exercise training and its recurrence after beta blockade

    Microsoft Academic Search

    I C Todd; J B McGuinness; D Ballantyne

    1988-01-01

    Exercise training can improve angina. A patient whose exercise tolerance test became normal after a year on an exercise programme nevertheless had a positive exercise test when he was taking a beta blocker. These results suggest that it may be undesirable to use beta blockers in patients with angina who are on exercise programmes.

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

    SciTech Connect

    Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

    1986-10-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate.

  16. Pulmonary hypertension in patients with idiopathic pulmonary fibrosis - the predictive value of exercise capacity and gas exchange efficiency.

    PubMed

    Gläser, Sven; Obst, Anne; Koch, Beate; Henkel, Beate; Grieger, Anita; Felix, Stephan B; Halank, Michael; Bruch, Leonhard; Bollmann, Tom; Warnke, Christian; Schäper, Christoph; Ewert, Ralf

    2013-01-01

    Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 135 patients [82 males; median age of 64 (56; 72 years)] with IPF had pulmonary hypertension as assessed by right heart catheterization [median mean pulmonary arterial pressure 34 (27; 43) mmHg]. The presence of pulmonary hypertension was best predicted by gas exchange efficiency for carbon dioxide (cut off ?152% predicted; area under the curve 0.94) and peak oxygen uptake (?56% predicted; 0.83), followed by diffusing capacity. Resting lung volumes did not predict pulmonary hypertension. Survival was best predicted by the presence of pulmonary hypertension, followed by peak oxygen uptake [HR 0.96 (0.93; 0.98)]. Pulmonary hypertension in IPF patients is best predicted by gas exchange efficiency during exercise and peak oxygen uptake. In addition to invasively measured pulmonary arterial pressure, oxygen uptake at peak exercise predicts survival in this patient population. PMID:23840349

  17. Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis – The Predictive Value of Exercise Capacity and Gas Exchange Efficiency

    PubMed Central

    Gläser, Sven; Obst, Anne; Koch, Beate; Henkel, Beate; Grieger, Anita; Felix, Stephan B.; Halank, Michael; Bruch, Leonhard; Bollmann, Tom; Warnke, Christian; Schäper, Christoph; Ewert, Ralf

    2013-01-01

    Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 135 patients [82 males; median age of 64 (56; 72 years)] with IPF had pulmonary hypertension as assessed by right heart catheterization [median mean pulmonary arterial pressure 34 (27; 43) mmHg]. The presence of pulmonary hypertension was best predicted by gas exchange efficiency for carbon dioxide (cut off ?152% predicted; area under the curve 0.94) and peak oxygen uptake (?56% predicted; 0.83), followed by diffusing capacity. Resting lung volumes did not predict pulmonary hypertension. Survival was best predicted by the presence of pulmonary hypertension, followed by peak oxygen uptake [HR 0.96 (0.93; 0.98)]. Pulmonary hypertension in IPF patients is best predicted by gas exchange efficiency during exercise and peak oxygen uptake. In addition to invasively measured pulmonary arterial pressure, oxygen uptake at peak exercise predicts survival in this patient population. PMID:23840349

  18. Gastroenterology case report of mesalazine-induced cardiopulmonary hypersensitivity

    PubMed Central

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

    2015-01-01

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

  19. Gastroenterology case report of mesalazine-induced cardiopulmonary hypersensitivity.

    PubMed

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

    2015-04-01

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

  20. Pyruvate enhances neurological recovery following cardiopulmonary arrest and resuscitation

    PubMed Central

    Sharma, Arti B.; Barlow, Matthew A.; Yang, Shao-Hua; Simpkins, James W.; Mallet, Robert T.

    2009-01-01

    Purpose Cerebral oxidative stress and metabolic dysfunction impede neurological recovery from cardiac arrest-resuscitation. Pyruvate, a potent antioxidant and energy-yielding fuel, has been shown to protect against oxidant- and ischemia-induced neuronal damage. This study tested whether acute pyruvate treatment during cardiopulmonary resuscitation can prevent neurological dysfunction and cerebral injury following cardiac arrest. Methods Anesthetized, open-chest mongrel dogs underwent 5 min cardiac arrest, 5 min open chest cardiac compression (OCCC), defibrillation and 3 day recovery. Pyruvate (n = 9) or NaCl volume control (n = 8) were administered (0.125 mmol/kg/min iv) throughout OCCC and the first 55 min recovery. Sham dogs (n = 6) underwent surgery and recovery without cardiac arrest-resuscitation. Results Neurological deficit score (NDS), evaluated at 2 day recovery, was sharply increased in NaCl-treated dogs (10.3 ± 3.5) vs. shams (1.2 ± 0.4), but pyruvate treatment mitigated neurological deficit (NDS = 3.3 ± 1.2; P < 0.05 vs. NaCl). Brain samples were taken for histological examination and evaluation of inflammation and cell death at 3 d recovery. Loss of pyramidal neurons in the hippocampal CA1 subregion was greater in the NaCl controls than in pyruvate treated dogs (11.7 ± 2.3% vs. 4.3 ± 1.2%; P < 0.05). Cardiac arrest increased caspase 3 activity, matrix metalloproteinase activity, and DNA fragmentation in the CA1 subregion; pyruvate prevented caspase-3 activation and DNA fragmentation, and suppressed matrix metalloproteinase activity. Conclusion Intravenous pyruvate therapy during cardiopulmonary resuscitation prevents initial oxidative stress and neuronal injury and enhances neurological recovery from cardiac arrest. PMID:17618729

  1. Effects of Periodic Task-Specific Test Feedback on Physical Performance in Older Adults Undertaking Band-Based Resistance Exercise

    PubMed Central

    Islam, Mohammod Monirul; Watanabe, Ryuji; Taaffe, Dennis R.

    2014-01-01

    The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65–83 years) were assigned to a muscular perfsormance feedback group (MPG, n = 32) or a functional mobility feedback group (FMG, n = 20). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant (P < 0.05) interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities. PMID:24616808

  2. 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

    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

    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.

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

    PubMed Central

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

    2014-01-01

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

  4. A Simple New Visualization of Exercise Data Discloses Pathophysiology and Severity of Heart Failure

    PubMed Central

    Hansen, James E.; Sun, Xing-Guo; Stringer, William W.

    2012-01-01

    Background The complexity of cardiopulmonary exercise testing data and their displays tends to make assessment of patients, including those with heart failure, time consuming. Methods and Results We postulated that a new single display that uses concurrent values of oxygen uptake / ventilation versus carbon dioxide output / ventilation ratios (–versus–), plotted on equal X–Y axes, would better quantify normality and heart failure severity and would clarify pathophysiology. Consecutive –versus– values from rest to recovery were displayed on X–Y axes for patients with Class II and IV heart failure and for healthy subjects without heart failure. The displays revealed distinctive patterns for each group, reflecting sequential changes in cardiac output, arterial and mixed venous O2 and CO2 content differences, and ventilation (). On the basis of exercise tests of 417 healthy subjects, reference formulas for highest and , which normally occur during moderate exercise, are presented. Absolute and percent predicted values of highest and were recorded for 10 individuals from each group: Those of healthy subjects were significantly higher than those of patients with Class II heart failure, and those of patients with Class II heart failure were higher than those of patients with Class IV heart failure. These values differentiated heart failure severity better than peak , anaerobic threshold, peak oxygen pulse, and slopes. Resting –versus– values were strikingly low for patients with Class IV heart failure, and with exercise, increased minimally or even decreased. With regard to the pathophysiology of heart failure, high values during milder exercise, previously attributed to ventilatory inefficiency, seem to be caused primarily by reduced cardiac output rather than increased . Conclusion –versus– measurements and displays, extractable from future or existing exercise data, separate the 3 groups (healthy subjects, patients with Class II heart failure, and patients with Class IV heart failure) well and confirm the dominant role of low cardiac output rather than excessive in heart failure pathophysiology. (J Am Heart Assoc. 2012;1:e001883 doi: 10.1161/JAHA.112.001883.) PMID:23130146

  5. Work in progress report - Cardiopulmonary bypass Bicarbonate buffered ultrafiltration leads to a physiologic priming solution in pediatric cardiac surgery

    Microsoft Academic Search

    Wilhelm Alexander Osthaus; Jan Sievers; Thomas Breymann; Robert Suempelmann

    Pediatric cardiopulmonary bypass (CPB) involves a high ratio of priming blood volume to patient blood volume. The composition of packed red blood cells (RBCs) is very unphysiological in terms of acid-base, electrolyte and metabolite values. Therefore, we tested the hypothesis whether ultrafiltration of the prime and replacement with bicarbonate buffered hemofiltration solution (BB-HS) is sufficient for reducing the metabolic load

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

    EPA Science Inventory

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

  7. The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery

    Microsoft Academic Search

    Madhav Swaminathan; Barbara G Phillips-Bute; Peter J Conlon; Peter K Smith; Mark F Newman; Mark Stafford-Smith

    2003-01-01

    BackgroundAcute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hematocrit 22% to 24%) during cardiopulmonary bypass (CPB) has been linked to adverse outcomes after cardiac surgery. Therefore we tested the hypothesis that lowest hematocrit during CPB is independently associated

  8. The Association of Lowest Hematocrit During Cardiopulmonary Bypass With Acute Renal Injury After Coronary Artery Bypass Surgery

    Microsoft Academic Search

    Madhav Swaminathan; Barbara G. Phillips-Bute; Peter J. Conlon

    2010-01-01

    Background. Acute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hemat- ocrit 22% to 24%) during cardiopulmonary bypass (CPB) has been linked to adverse outcomes after cardiac sur- gery. Therefore we tested the hypothesis that lowest hematocrit during CPB

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

    PubMed

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

    2014-08-01

    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

  10. Associates of Cardiopulmonary Arrest in the Perihemodialytic Period

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2010-01-01

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

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

    PubMed Central

    2014-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Ivanco, Thomas G.

    2013-01-01

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

  14. Cardiopulmonary fitness in a sample of Malaysian population.

    PubMed

    Singh, R; Singh, H J; Sirisinghe, R G

    1989-01-01

    Lung capacity and maximum oxygen uptake (VO2max) were measured directly in 167 healthy males, from all the main races in Malaysia. Their ages ranged from 13 to 59 years. They were divided into five age groups (A to E), ranging from the second to the sixth decade. Lung capacities were determined using a dry spirometer and VO2max was taken as the maximum rate of oxygen consumption during exhaustive exercise on a cycle ergometer. Mean forced vital capacity (FVC) was 3.3 +/- 0.5 l and it correlated negatively with age. Mean VO2max was 3.2 +/- 0.2 l.min-1 (56.8 +/- 3.5 ml.kg-1.min-1) in Group A (13-19 years) compared to 1.7 +/- 0.2 l.min-1 (28.9 +/- 2.9 ml.kg-1.min-1) in Group E (50-59 years). Regression analysis revealed an age-related decline in VO2max of 0.77 ml.kg-1.min-1.year-1. Multiple regression of the data gave the following equations for the prediction of an individual's VO2max: VO2max (l.min-1) = 1.99 + 0.035 (weight)-0.04 (age), VO2max (ml.kg-1.min-1) = 67.7-0.77 (age), where age is in years, weight in kg. In terms of VO2max as an index of cardiopulmonary performance. Malaysians have a relatively lower capacity when related to the Swedish norms or even to those of some Chilean workers. Malaysians were, however, within the average norms of the American Heart Association's recommendations. Age-related decline in VO2max was also somewhat higher in the Malaysians. PMID:2601189

  15. Multicenter trial on prognostic value of inducible ischaemia, assessed by dobutamine stress echocardiography and exercise electrocardiography test, in patients with uncomplicated myocardial infarction, treated with thrombolytic therapy

    Microsoft Academic Search

    Alfonso Galati; Riccardo Bigis; Claudio Coletta; Cesare Fiorentini; Roberto Ricci; Giuseppe Occhi; Augusto Sestili; Francesco Rulli; Nadia Aspromonte; Maria Stella Fera; Gabriella Greco; Giuliana Guagnozzi; Vincenzo Ceci

    1998-01-01

    Background. Thrombolysis has reduced early and longterm mortality by about 20%; sometimes, however, there is a re-occlusion of the infarct related artery or an unsuccessful thrombolysis. In these situations, there is a possible increase in detrimental events in the follow-up. Objectives. The aim of the study was to compare the prognostic value of dobutamine echocardiography (DET) and ECG exercise test

  16. The comparative effects of undernutrition, exercise and frequency of ejaculation on the size and tone of the testes and on semen quality in the ram

    Microsoft Academic Search

    C. J. Thwaites

    1995-01-01

    The effects of undernutrition (100% or 10% of maintenance), exercise (walking 0 or 10 km day?1) and frequency of ejaculation (0, 4, 5 or 8 times daily) on the size and tone of the testes and on semen quality were studied in a total of 65 Merino rams in four experiments of 14–36 days duration. Testicular volume was reduced by

  17. Maximal aerobic capacity for repetitive lifting: comparison with three standard exercise testing modes

    Microsoft Academic Search

    M. A. Sharp; E. Harman; J. A. Vogel; J. J. Knapik; S. J. Legg

    1988-01-01

    Summary  A multi-stage, repetitive lifting maximal oxygen uptake (\\u000a$$\\\\dot V_{O_{2max} }$$\\u000a) test was developed to be used as an occupational research tool which would parallel standard ergometric\\u000a$$\\\\dot V_{O_{2max} }$$\\u000a testing procedures. The repetitive lifting\\u000a$$\\\\dot V_{O_{2max} }$$\\u000a test was administered to 18 men using an automatic repetitive lifting device. An intraclass reliability coefficient of 0.91 was obtained with

  18. Miniaturized cardiopulmonary bypass: the Hammersmith technique

    PubMed Central

    2013-01-01

    Background Conventional Cardiopulmonary Bypass (cCPB) is a trigger of systemic inflammatory reactions, hemodilution, coagulopathy, and organ failure. Miniaturised Cardiopulmonary Bypass (mCPB) has the potential to reduce these deleterious effects. Here, we describe our standardised ‘Hammersmith’ mCPB technique, used in all types of adult cardiac operations including major aortic surgery. Methods The use of mCPB remains limited by the diversity of technologies which range from extremely complex, micro systems to ones very similar to cCPB. Our approach is designed around the principle of balancing the benefits of miniaturisation; reducing foreign surface area while maintaining patient safety. Results From January 2010 to March 2011, a single surgeon performed 184 consecutive operations (Euro score Logistic 8.4+/-9.9): 61 aortic valve replacements, 78 CABGs, 25 aortic valve replacement and CABG and 17 other procedures (major aortic surgery, re-do operations or double/triple valve replacements). Our clinical experience suggests that: i. Venous drainage is optimally maintained using kinetic energy. ii. Venous collapse pressure depends on the patient’s anatomy and cannula size, but most importantly on the negative pressure generated by venous drainage. iii. The patient-prime interaction is optimised with antegrade and retrograde autologous priming, which mixes the blood and prime away from the tissues and results in a reduced oncotic destabilization. iv. mCPB is a safe and reproducible technique Conclusion The Hammersmith mCPB is a “next generation” system which uses standard commercially available components. It aims to maintain safety margin and the benefit of miniaturised system whilst reducing the human factor demands. PMID:23731623

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

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.

    2003-01-01

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

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

    PubMed

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

    2015-03-01

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

  1. Keeping cool: a case for hypothermia after cardiopulmonary resuscitation.

    PubMed

    Bader, Mary Kay; Rovzar, Michael; Baumgartner, Laurie; Winokur, Robert; Cline, Jon; Schiffman, George

    2007-11-01

    Cessation of circulation during cardiac arrest causes critical end-organ ischemia. Although the neurological consequences of cardiopulmonary arrest can be catastrophic, an aggressive "push fast and push hard" resuscitation technique maintains blood flow until the return of spontaneous circulation. However, reperfusion to the cerebrum leads to cellular chaos and further neurological injury. Use of moderate hypothermia after cardiac arrest mediates these cellular and chemical processes, reducing the impact of the arrest and reperfusion phenomena. A 43-year-old man had 2 asystolic arrests with 20 minutes of cardiopulmonary resuscitation as a result of massive, multiple pulmonary emboli. After the cardiac arrest, the patient was comatose and posturing. The 2005 American Heart Association guidelines for cardiopulmonary resuscitation were used along with moderate hypothermia in an attempt to minimize the neurological consequences of the cardiopulmonary arrest and to optimize the patient's outcome. PMID:17962509

  2. [Asymptomatic severe aortic stenosis with preserved left ventricular ejection fraction. Evaluation during exercise test: Which results and which decision?].

    PubMed

    Bensahi, I; Elfhal, A; Magne, J; Dulgheru, R; Lancellotti, P; Pierard, L

    2015-04-01

    Aortic stenosis is the most common valvular heart disease in Europe and North America and it is a real public health problem. Its prevalence increases with population aging. Symptomatic patients require surgery (class I, level of evidence B). In asymptomatic patients, a stress test with or without imaging is recommended to unmask the false asymptomatic patients and refine risk stratification of occurrence of major events. This support remains difficult and makes the optimal timing for surgery controversial in the absence of prospective data on the determinants of aortic stenosis progression, multicenter studies on risk stratification or randomized studies on patient management. The complexity of care arises from the balance between the spontaneous disease risk (risk of sudden death and irreversible left ventricular dysfunction) and the risk of surgery and prosthetic complications. It is therefore crucial to identify subgroups of patients at risk of pejorative progression in whom prophylactic surgery may be considered. This article focuses on evaluating during exercise asymptomatic patients with severe aortic stenosis and preserved left ventricular ejection fraction. We will explain how to perform the test, determine which echocardiographic measurements should be obtained, focusing on the diagnostic and prognostic value of these measurements and discuss indications for surgery according to new practice guidelines. PMID:25661422

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

    PubMed Central

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

    2004-01-01

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

  4. Cardiopulmonary Impairment in Young Women with Polycystic Ovary Syndrome

    Microsoft Academic Search

    Francesco Orio; Francesco Giallauria; Stefano Palomba; Teresa Cascella; Francesco Manguso; Laura Vuolo; Tiziana Russo; Achille Tolino; Gaetano Lombardi; Annamaria Colao; Carlo Vigorito

    Context: Insulin resistance is a feature of polycystic ovary syndrome (PCOS), and it is related to mitochondrial function, particularly with maximal oxygen consumption (VO2max). At the moment, no evalua- tion of cardiopulmonary functional capacity in young patients with PCOS has been performed. Objective: Our objective was to assess cardiopulmonary functional capacity in young PCOS overweight patients. DesignandSetting:Weconductedaprospectivebaseline-controlled clinicalstudyatUniversity\\

  5. Physical Activity is Associated with Improved Aerobic Exercise Capacity over Time in Adults with Congenital Heart Disease

    PubMed Central

    Bhatt, Ami B; Landzberg, Michael J; Rhodes, Jonathan

    2013-01-01

    Background Impaired exercise capacity is common in adults with congenital heart disease (ACHD). This impairment is progressive and is associated with increased morbidity and mortality. We studied the influence of the frequency of at least moderately strenuous physical activity (PhysAct) on changes in exercise capacity of ACHD patients over time. Methods We studied ACHD patients ?21 years old who had repeated maximal (RER?1.09) cardiopulmonary exercise tests within 6 to 24 months. On the basis of data extracted from each patient’s clinical records, PhysAct frequency was classified as (1) Low: minimal PhysAct, (2) Occasional: moderate PhysAct <2 times/week, or (3) Frequent: moderate PhysAct ?2 times/week. Results PhysAct frequency could be classified for 146 patients. Those who participated in frequent exercise tended to have improved pVO2 (?pVO2=+1.63±2.67 ml/kg/min) compared to those who had low or occasional activity frequency (?pVO2=+0.06±2.13 ml/kg/min, p=0.003) over a median follow-up of 13.2 months. This difference was independent of baseline clinical characteristics, time between tests, medication changes, or weight change. Those who engaged in frequent PhysAct were more likely to have an increase of pVO2 of ?1SD between tests as compared with sedentary patients (multivariable OR=7.4, 95%CI 1.5-35.7). Aerobic exercise capacity also increased for patients who increased activity frequency from baseline to follow-up; 27.3% of those who increased their frequency of moderately strenuous physical activity had a clinically significant (at least +1SD) increase in pVO2 compared to only 11% of those who maintained or decreased activity frequency. Conclusions ACHD patients who engage in frequent physical activity tend to have improved exercise capacity over time. PMID:23962775

  6. Effect of moderate physical exercise on noninvasive cardiac autonomic tests in healthy volunteers

    Microsoft Academic Search

    Xiao Hua Guo; Gang Yi; Velislav Batchvarov; Mark M Gallagher; Marek Malik

    1999-01-01

    Background: In addition to the assessment of extreme cardiovascular reserve, new methodology is needed which is sensitive enough to detect subtle improvement in cardiovascular fitness in cardiac patients. Aim: This study modelled subtle clinical improvement by a moderate physical activity programme in healthy volunteers and investigated whether the improved fitness is detectable by non-invasive tests of cardiac autonomic status. Methods:

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

    EPA Science Inventory

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

  8. A reliable method for rhythm analysis during cardiopulmonary resuscitation.

    PubMed

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

    2014-01-01

    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

  9. Submaximal exercise testing in the assessment of interstitial lung disease secondary to systemic sclerosis: reproducibility and correlations of the 6?min walk test

    PubMed Central

    Buch, M H; Denton, C P; Furst, D E; Guillevin, L; Rubin, L J; Wells, A U; Matucci?Cerinic, M; Riemekasten, G; Emery, P; Chadha?Boreham, H; Charef, P; Roux, S; Black, C M; Seibold, J R

    2007-01-01

    Background The 6?min walk test (6MWT) is increasingly used as an outcome measure in interstitial lung disease (ILD). Aim To evaluate the usefulness of the 6MWT in a cohort of patients with ILD secondary to systemic sclerosis (SSc) and to correlate with established physiological parameters. Methods 163 patients with SSc?ILD were recruited for a multicentre, randomised, double?blind clinical trial. Available data at protocol screening included repeated 6MWTs, pulmonary function testing with diffusing capacity, Doppler echocardiography and high?resolution computed tomography of the thorax. Borg Dyspnoea Index was evaluated before and after 6MWT. Results Mean (standard deviation (SD)) distance walked during walk test 1 was 396.6 (84.55)?m compared with 399.5 (86.28)?m at walk test 2. The within?subject, intertest correlation as determined by Pearson's correlation coefficient testing was 0.95 (p<0.001). However, only weak correlations of 6MWT with percentage forced vital capacity and the Borg Dyspnoea Index were observed, and no correlation was observed with percentage diffusing capacity. Conclusion These data confirm the high reproducibility of the 6MWT in patients with SSc?ILD and therefore the validity of the test in this cohort. The lack of correlation of 6MWT with standard physiological parameters of ILD suggests a multifactorial basis for limited exercise capacity in patients with SSc and calls into question the utility of the 6MWT as a measure of outcome in future studies on SSc?ILD. PMID:16868020

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

    PubMed Central

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

    2011-01-01

    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

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

    NASA Technical Reports Server (NTRS)

    1979-01-01

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

  12. Work performance evaluation using the exercising rat model

    SciTech Connect

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

    1987-01-01

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

  13. Compulsive Exercise

    MedlinePLUS

    ... exercise, especially when it is combined with an eating disorder, can cause serious and permanent health problems, and in extreme cases, death. Because compulsive exercise is closely related to eating disorders, help can be found at community agencies specifically ...

  14. 004. Dynamics of QT interval from rest to peak exercise among chronic obstructive pulmonary disease (COPD) patients

    PubMed Central

    Boutou, Afroditi; Franks, Russell; Mohan, Divya; Mantziari, Lilian; Wong, Tom; Hopkinson, Nicholas; Polkey, Michael

    2015-01-01

    Background Cardiovascular involvement is frequent in chronic obstructive pulmonary disease (COPD), with autonomic dysfunction a recognized feature. However, the dynamics of QT interval, a known marker of autonomic dysfunction, from rest to peak exercise in COPD patients has not yet been investigated. The aim of this study was to examine the changes in QT, heart-rate corrected QT (QTc), PR, QRS and RR intervals from rest to peak exercise in a population of stable COPD outpatients and of healthy controls. Methods Prospectively collected data on COPD patients and healthy controls who underwent spirometry and maximum cardiopulmonary exercise testing with a continuous 12- lead ECG recording, were retrospectively analyzed. Distribution of variables was assessed with Shapiro-Wilk test and group comparisons were conducted utilizing the paired samples t-test or Wilcoxon rank test, as appropriate. Level of P<0.05 was considered significant. Results The study population consisted of 143 patients (63.6% male; 62.8±7.4 years old; FEV1%=32.3±14) and 18 age and gender-matched controls. Among controls, QT, PR and RR intervals were shortened while QTc was prolonged from rest to peak exercise. Among COPD patients, QTc interval did not change. QT, PR and RR intervals were shortened, but absolute changes were smaller, compared to the ones of controls. Patients under drugs which are known to prolong QT had similar QT, compared to the ones under no such drugs. Conclusions COPD patients demonstrate a different exercise response; QTc interval is not prolonged, while the shortening of QT is about 30% of what expected when compared to healthy controls.

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

    PubMed Central

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

    2014-01-01

    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

  16. 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

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

    2013-12-01

    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

  17. Effects of thiamine supplementation on exercise-induced fatigue.

    PubMed

    Suzuki, M; Itokawa, Y

    1996-03-01

    High-dose thiamine (vitamin B1) supplementation (100 mg/day) may be helpful in preventing or accelerating recovery from exercise-induced fatigue. Sixteen volunteer male athletes volunteer, 8 with a blood thiamine level of 40 ng/ml or more (normal thiamine group) and 8 with levels below that level (low thiamine group) were selected as subjects. They exercised on a bicycle ergometer and the effects of thiamine supplementation were compared with placebo. Blood thiamine level markedly increased following supplementation of thiamine for 3 days before exercise. Exercise-induced changes in hemodynamic parameters and cardiopulmonary function indicated the onset of fatigue. Thiamine supplementation significantly suppressed the increase in blood glucose in the normal thiamine group and significantly decreased the number of complaints shortly after exercise in the subjective fatigue assessment of 30 items. PMID:8815395

  18. Testing of a biomechanical model of the lumbar muscle force distribution using quasi-static loading exercises.

    PubMed

    Ladin, Z; Neff, K M

    1992-11-01

    The study of lumbar muscle force distribution in response to externally applied loads is based on the introduction of biomechanical models of the lumbar region. The evaluation of such models requires the execution of loading exercises while monitoring the EMG activity of certain lumbar muscles. This work uses muscle activity maps as the major design tool of such exercises, provided that the subject is constrained to an upright erect posture. The maps describe the predicted muscle force for a given combination of externally applied bending moments. A series of shoulder adduction exercises were designed and the EMG signals of eight lumbar muscles were measured while subjects performed the exercises. The results show good agreement between the model predictions and the EMG measurements, especially when the load and the muscle were contralateral to one another. PMID:1487895

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

    PubMed Central

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

    2013-01-01

    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

  20. Hypertension. Part 1: How Exercise Helps.

    ERIC Educational Resources Information Center

    Tanji, Jeffrey L.

    1990-01-01

    Reviews possible mechanisms by which exercise lowers blood pressure and discusses research which indicates exercise is an effective therapy for hypertension. The article presents information to help physicians counsel hypertensive patients wanting to start an exercise program and examines the use of exercise testing to predict the onset of…

  1. Lung function of healthy boys and girls in Jamaica in relation to ethnic composition, test exercise performance, and habitual physical activity

    PubMed Central

    Miller, G. J.; Saunders, M. J.; Gilson, R. J. C.; Ashcroft, M. T.

    1977-01-01

    Miller, G. J., Saunders, M. J., Gilson, R. J. C., and Ashcroft, M. T. (1977).Thorax, 32, 486-496. Lung function of healthy boys and girls in Jamaica in relation to ethnic composition, test exercise performance, and habitual physical activity. The relationships of forced expiratory volume and forced vital capacity on height, age, sex, area of residence, and ethnic composition were assessed in 622 children in Jamaica. Rural children in hill-farming communities were judged to have a higher habitual physical activity than urban children. Allowing for differences in body size, forced vital capacity averaged 3% greater in rural children than in urban children, 7% less in girls than in boys, and 16% greater in children of European origin than in children of African descent. Lung volumes, indices of gas transfer, and submaximal-exercise responses were measured in a subgroup of 108 children of African descent believed to be of common genetic stock. Total lung capacity and vital capacity averaged respectively 6% greater and 7% greater in rural than in urban children of equal height but residual volume and transfer factor did not differ significantly between localities. Rural children had a lower average cardiac frequency during test exercise than did urban children. Sex differences and locality differences in vital capacity and total lung capacity disappeared when allowance was made for standardised exercise cardiac frequency. At standard body size and age transfer factor increased with decreasing cardiac frequency for standard work. The results suggest an harmonious development of the cardiac and respiratory components of the oxygen transport system, consonant with the demand for muscular work. Increased habitual physical activity and improved exercise performance appear to be associated with increases in vital capacity, total lung capacity, and transfer factor. PMID:929491

  2. Hantaviruses and cardiopulmonary syndrome in South America.

    PubMed

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

    2014-07-17

    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

  3. Iron overload in paediatrics undergoing cardiopulmonary bypass.

    PubMed

    Mumby, S; Chaturvedi, R R; Brierley, J; Lincoln, C; Petros, A; Redington, A N; Gutteridge, J M

    2000-03-17

    Pathological changes in iron status are known to occur during bypass and will be superimposed upon physiological abnormalities in iron distribution, characteristic of the neonatal period. We have sought to define the severity of iron overload in these patients. Plasma samples from 65 paediatric patients undergoing cardiopulmonary bypass (CPB) were analysed for non-haem iron, total iron binding capacity, transferrin and bleomycin-detectable iron. Patients were divided into four age groups for analysis. Within each age group, patients who were in iron overload at any time point were statistically compared to those who were not. The most significant changes in iron chemistry were seen in the plasma of neonates, with 25% in a state of plasma iron overload. 18.5% of infants and 14.3% of children at 1-5 years were also in iron overload at some time point during CPB. No children over 5 years, however, went into iron overload. Increased iron saturation of transferrin eliminates its ability to bind reactive forms of iron and to act as an antioxidant. When transferrin is fully saturated with iron, reactive forms of iron are present in the plasma which can stimulate iron-driven oxidative reactions. Our data suggest that paediatric patients are at greater risk of iron overload during CPB, and that some form of iron chelation therapy may be advantageous to decrease oxidative stress. PMID:10699376

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

    PubMed Central

    2014-01-01

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

  5. Pulmonary circulation and gas exchange at exercise in Sherpas at high altitude.

    PubMed

    Faoro, Vitalie; Huez, Sandrine; Vanderpool, Rebecca; Groepenhoff, Herman; de Bisschop, Claire; Martinot, Jean-Benot; Lamotte, Michel; Pavelescu, Adriana; Guénard, Hervé; Naeije, Robert

    2014-04-01

    Tibetans have been reported to present with a unique phenotypic adaptation to high altitude characterized by higher resting ventilation and arterial oxygen saturation, no excessive polycythemia, and lower pulmonary arterial pressures (Ppa) compared with other high-altitude populations. How this affects exercise capacity is not exactly known. We measured aerobic exercise capacity during an incremental cardiopulmonary exercise test, lung diffusing capacity for carbon monoxide (DL(CO)) and nitric oxide (DL(NO)) at rest, and mean Ppa (mPpa) and cardiac output by echocardiography at rest and at exercise in 13 Sherpas and in 13 acclimatized lowlander controls at the altitude of 5,050 m in Nepal. In Sherpas vs. lowlanders, arterial oxygen saturation was 86 ± 1 vs. 83 ± 2% (mean ± SE; P = nonsignificant), mPpa at rest 19 ± 1 vs. 23 ± 1 mmHg (P < 0.05), DL(CO) corrected for hemoglobin 61 ± 4 vs. 37 ± 2 ml · min(-1) · mmHg(-1) (P < 0.001), DL(NO) 226 ± 18 vs. 153 ± 9 ml · min(-1) · mmHg(-1) (P < 0.001), maximum oxygen uptake 32 ± 3 vs. 28 ± 1 ml · kg(-1) · min(-1) (P = nonsignificant), and ventilatory equivalent for carbon dioxide at anaerobic threshold 40 ± 2 vs. 48 ± 2 (P < 0.001). Maximum oxygen uptake was correlated directly to DL(CO) and inversely to the slope of mPpa-cardiac index relationships in both Sherpas and acclimatized lowlanders. We conclude that Sherpas compared with acclimatized lowlanders have an unremarkable aerobic exercise capacity, but with less pronounced pulmonary hypertension, lower ventilatory responses, and higher lung diffusing capacity. PMID:23869067

  6. Cardiopulmonary arrest owing to oesophageal achalasia recovered completely with cardiopulmonary resuscitation followed by therapeutic hypothermia

    PubMed Central

    Hifumi, Toru; Okada, Ichiro; Inoue, Junichi; Koido, Yuichi

    2013-01-01

    We report the first case of cardiopulmonary arrest (CPA), caused by oesophageal achalasia, which recovered completely with cardiopulmonary resuscitation (CPR) followed by therapeutic hypothermia. A 53-year-old woman arrived at our hospital with recovery of spontaneous circulation (ROSC) after cardiac arrest. Dysphagia, vomiting and general fatigue had progressed for a week before. After an ambulance was called for severe dyspnoea, she collapsed in CPA. Emergency medical technicians arrived and CPR was started immediately. She experienced CPA and ROSC twice during transport to the hospital. On arrival, the patient was in respiratory distress prompting immediate intubation to eliminate airway obstruction. A CT scan revealed a transformed, occluded trachea owing to a dilated oesophagus. A large amount of food, air and saliva was suctioned with a nasogastric tube, and the patient was admitted to the intensive care unit for therapeutic hypothermia. Neurological recovery was evident. On the 11th day, pneumatic dilatation was performed and she was discharged on the 33rd day. PMID:23355594

  7. Cardiopulmonary arrest owing to oesophageal achalasia recovered completely with cardiopulmonary resuscitation followed by therapeutic hypothermia.

    PubMed

    Hifumi, Toru; Okada, Ichiro; Inoue, Junichi; Koido, Yuichi

    2013-01-01

    We report the first case of cardiopulmonary arrest (CPA), caused by oesophageal achalasia, which recovered completely with cardiopulmonary resuscitation (CPR) followed by therapeutic hypothermia. A 53-year-old woman arrived at our hospital with recovery of spontaneous circulation (ROSC) after cardiac arrest. Dysphagia, vomiting and general fatigue had progressed for a week before. After an ambulance was called for severe dyspnoea, she collapsed in CPA. Emergency medical technicians arrived and CPR was started immediately. She experienced CPA and ROSC twice during transport to the hospital. On arrival, the patient was in respiratory distress prompting immediate intubation to eliminate airway obstruction. A CT scan revealed a transformed, occluded trachea owing to a dilated oesophagus. A large amount of food, air and saliva was suctioned with a nasogastric tube, and the patient was admitted to the intensive care unit for therapeutic hypothermia. Neurological recovery was evident. On the 11th day, pneumatic dilatation was performed and she was discharged on the 33rd day. PMID:23355594

  8. Ischemia monitoring with on-line vectorcardiography compared with results from a predischarge exercise test in patients with acute ischemic heart disease

    Microsoft Academic Search

    Peter Lundin; Jens Jensen; Nina Rehnqvist; Sven V. Eriksson

    1995-01-01

    Information from 24-hour monitoring with on-line vectorcardiography, starting immediately after admission, was compared with results from a predischarge exercise test 3–13 days after admission. A total of 169 patients with acute myocardial infarction and 73 patients with unstable angina pectoris were investigated. Patients were followed for 487 ± 135 days. During the follow-up period, 19 patients (8%) died from cardiac

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

    SciTech Connect

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

    1991-04-01

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

  10. The effects of dexmedetomidine on inflammatory mediators after cardiopulmonary bypass.

    PubMed

    Ueki, M; Kawasaki, T; Habe, K; Hamada, K; Kawasaki, C; Sata, T

    2014-07-01

    Cardiac surgery with cardiopulmonary bypass is associated with the development of a systemic inflammatory response that can often lead to dysfunction of major organs. We hypothesised that the highly selective ?2-adrenergic agonist, dexmedetomidine, attenuates the systemic inflammatory response. Forty-two patients were randomly assigned to receive dexmedetomidine or saline after aortic cross-clamping). The mean (SD) levels of the nuclear protein plasma high-mobility group box 1 increased significantly from 5.1 (2.2) ng ml(-1) during (16.6 (7.3) ng ml(-1) ) and after (14.3 (8.2) ng ml(-1) ) cardiopulmonary bypass in the saline group. In the dexmedetomidine group, the levels increased significantly only during cardiopulmonary bypass (4.0 (1.9) ng ml(-1) baseline vs. 10.8 (2.7) ng ml(-1) ) but not after (7.4 (3.8) ng ml(-1) ). Dexmedetomidine infusion also suppressed the rise in mean (SD) interleukin-6 levels after cardiopulmonary bypass (a rise of 124.5 (72.0) pg ml(-1) vs. 65.3 (30.9) pg ml(-1)). These suppressive effects of dexmedetomidine might be due to the inhibition of nuclear factor kappa B activation and suggest that intra-operative dexmedetomidine may beneficially inhibit inflammatory responses associated with ischaemia-reperfusion injury during cardiopulmonary bypass. PMID:24773263

  11. European ring exercise on water toxicity using different bioluminescence inhibition tests based on Vibrio fischeri, in support to the implementation of the water framework directive.

    PubMed

    Farré, Marinella; Martínez, Elena; Hernando, M-D; Fernández-Alba, Amadeo; Fritz, Johann; Unruh, Eckehardt; Mihail, Otilia; Sakkas, Vasilis; Morbey, Ana; Albanis, Triantafyllos; Brito, Fatima; Hansen, Peter D; Barceló, Damià

    2006-04-15

    An inter-laboratory comparison exercise was conducted under the European Union funded project entitled: Screening Methods for Water Data Information in Support of the Implementation of the Water Framework Directive (SWIFT-WFD) and coordinated by the Consejo Superior de Investigaciones Científicas (CSIC), in order to evaluate the reproducibility of different toxicity tests based on the bioluminescence inhibition of Vibrio fischeri, for the rapid water toxicity assessment. For the first time, this type of exercise has been organized in Europe, and using different tests based on the same principle. In this exercise, 10 laboratories from 8 countries (Austria, Cyprus, Germany, Greece, Italy, Portugal, Romania, and Spain) took place, and a total number of 360 samples were distributed. During the exercise, six series of six samples were analyzed along 5 months. Every batch of samples was composed by three real samples and three standard solutions. The real samples were: a raw influent and the effluent of a wastewater treatment plant (WWTP), and a sample from a first settlement of the WWTP spiked with a mixture of toxicant standards. A final number of 330 (91.7%) samples was analyzed, 3300 values in duplicate were collected, and the results for each sample were expressed as the 50% effective concentration (EC(50)) values calculated through five points of dilution inhibition curves, after 5 and 15min of incubation times. A statistical study was initiated using 660 results. The mean values, standard deviations (sigma), variances (sigma(2)), and upper and lower warning limits (UWL and LWL) were obtained, using the EC(50) values calculated with the result from the participating laboratories. The main objectives of this toxicity ring study were to evaluate the repeatability (r) and reproducibility (R) when different laboratories conduct the test, the influence of complex matrix samples, the variability between different tests based on the same principle, and to determine the rate at which participating laboratories successfully completed tests initiated. In this exercise, the 3.93% toxicity values were outliers according with the Z-score values and the Dixon test. The samples with the greater number of outliers were those with the smallest variability coefficient, corresponding to the greater and the smaller toxicity level. No relation was found through the cluster analysis, between the final results and the different commercial devices involved. Testing by multiple commercial devices did not appear to reduce the precision of the results, and the variability coefficient for the exercise was nearby to the average value for past editions carried out at national level, where the different participants used the same commercial device. Stability of samples was also followed during the exercise. While statistical significance differences were not found for the greater part of samples, for the sample from the WWTP influent, a significant decrease of the toxicity value was found along this study. Nevertheless, this was a type of sample with a high toxicity level during all the exercise. On the other hand, in order to obtain the chemical characterization of real samples, those were analyzed by chromatographic techniques, using different sequential solid phase extraction (SSPE) procedures, followed by liquid chromatography coupled with mass spectrometry (LC-MS), and gas chromatography-mass spectrometry (GC-MS). Good agreement was found between the chemical analysis results and the toxicity level of the samples. PMID:18970570

  12. Delivery of cardiopulmonary resuscitation in the microgravity environment

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  13. Exercise addiction.

    PubMed

    Landolfi, Emilio

    2013-02-01

    This article examines the nature of exercise addiction. It presents a broad, congruent and discerning narrative literature review with the aim of providing a deeper understanding of the condition 'exercise addiction', including symptoms and options for treatment. In addition, guidelines are provided with respect to 'healthy' levels of exercise. Criteria used for determining the eligibility of studies evaluated in the review included the provision of relevant information in studies identified using pertinent search terms. The review highlights some of the key distinctions between healthy levels of exercise and exercise addiction. The findings suggest that an individual who is addicted to exercise will continue exercising regardless of physical injury, personal inconvenience or disruption to other areas of life including marital strain, interference with work and lack of time for other activities. 'Addicted' exercisers are more likely to exercise for intrinsic rewards and experience disturbing deprivation sensations when unable to exercise. In contrast, 'committed' exercisers engage in physical activity for extrinsic rewards and do not suffer severe withdrawal symptoms when they cannot exercise. Exercisers must acquire a sense of life-balance while embracing an attitude conducive to sustainable long-term physical, psychological and social health outcomes. Implementation of recommendations by the Canadian Society for Exercise Physiology, which states that all apparently healthy adults between 18 and 64 years of age should accumulate at least 150 minutes of moderate (5 or 6 on a scale of 0-10) to vigorous (7 or 8 on a scale of 0-10) intensity aerobic physical activity per week in bouts of 10 minutes or more, also expressed as 30 minutes per day distributed over 5 days per week, would be a good start. PMID:23329605

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

    PubMed

    Lee, Bo-Ae; Oh, Deuk-Ja

    2014-06-01

    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

  15. What the exercise of the SPICE source inversion validation BlindTest 1 did not tell you

    NASA Astrophysics Data System (ADS)

    Shao, Guangfu; Ji, Chen

    2012-04-01

    Uncertainties of earthquake finite-fault inversions based upon strong motion data are investigated using the source inversion validation BlindTest 1 exercise of the SPICE (Seismic Wave Propagation and Imaging in Complex Media: A European Network) project, motivated by previous counterintuitive results. The distribution of slip and the shapes of asymmetric slip rate functions are simultaneously inverted by matching 10 or 33 broad-band three-component velocity waveforms within the period ranging from 0.02 to 2 Hz, using a finite-fault method that carries out the waveform inversion in the wavelet domain. The effects of subfault size, data noise and the number of stations have been explored. Our results suggest: (1) Although there are inevitable discrepancies between the inverted model and the target model because of ignoring the spatial slip variations within individual subfaults, the fault slip and rise-time distributions can be well constrained even with the data including large Gaussian noise. (2) It is crucial for source studies to develop new inversion schemes that can properly honour the frequency- and time-dependent energy distribution of seismic radiation and data noise. For instance, inversions using the variance reduction function of velocity waveforms as the objective function have low sensitivities to the total seismic moment and peak slip. (3) Although the relative value of the objective function is guided in the inversion, the absolute value of the objective function cannot be used to evaluate the quality of an inverted model. (4) Because the source inversion is based on surface observations, the spatiotemporal resolution of source inversion is affected not only by the data quality but also by the earthquake itself. For vertical strike-slip faults, the along-strike resolution is better than that along the downdip direction.

  16. Regional distribution of lung perfusion and ventilation at rest and during steady-state exercise after unilateral lung transplantation.

    PubMed

    Ross, D J; Waters, P F; Waxman, A D; Koerner, S K; Mohsenifar, Z

    1993-07-01

    Cardiopulmonary exercise testing has previously demonstrated a reduced maximum oxygen uptake and anaerobic threshold, as well as abnormal wasted ventilation fraction and gas exchange after unilateral lung transplantation. To further explain the mechanisms of these abnormalities, we assessed the regional distribution of pulmonary blood flow and ventilation at rest and during steady-state exercise in nine recipients of unilateral lung transplants. Krypton-81 (81mKr) aerosol and technetium-99m (99mTc) were utilized to assess lung ventilation (V) and perfusion (Q), respectively. The digitalized images were trisected to analyze apical, mid-, and basilar lung perfusion and ventilation in both the transplanted and native lung, both at rest and steady-state upright exercise. Results were compared with previously reported data obtained in normal subjects in our laboratory using the identical technique. At rest, 75 +/- 13 percent of perfusion was directed to the transplanted lung; however, the corresponding fractional ventilation was only 67 +/- 14 percent. During exercise, there was no significant change in fractional perfusion or ventilation. Resting apical perfusion in the transplanted lung was higher than normal in four patients and comparable to normal in five patients. In contrast to the augmentation of apical perfusion observed in normal subjects during upright exercise, none of our patients increased the regional perfusion to the apices during exercise in either transplanted or native lungs. These unexpected responses suggest either more maximal allograft apical recruitment at rest due to the increased allograft perfusion or an abnormality in the apical pulmonary vasculature after transplantation. Furthermore, the relative mismatch in ventilation and perfusion in transplanted and native lungs suggests regions of high V/Q in the native, and low V/Q in the transplanted lung. This mismatch is most pronounced in recipients of single lung transplants for pulmonary vascular disease. PMID:8325055

  17. Acute posthypoxic myoclonus after cardiopulmonary resuscitation

    PubMed Central

    2012-01-01

    Background Acute posthypoxic myoclonus (PHM) can occur in patients admitted after cardiopulmonary resuscitation (CPR) and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP) and electroencephalogram (EEG). Methods Patients with acute PHM (focal myoclonus or status myoclonus) within 72 hours after CPR were retrospectively selected from a multicenter cohort study. All patients were treated with hypothermia. Criteria for cortical origin of the myoclonus were: giant SEP potentials; or epileptic activity, status epilepticus, or generalized periodic discharges on the EEG (no back-averaging was used). Good outcome was defined as good recovery or moderate disability after 6?months. Results Acute PHM was reported in 79/391 patients (20%). SEPs were available in 51/79 patients and in 27 of them (53%) N20 potentials were present. Giant potentials were seen in 3 patients. EEGs were available in 36/79 patients with 23/36 (64%) patients fulfilling criteria for a cortical origin. Nine patients (12%) had a good outcome. A broad variety of drugs was used for treatment. Conclusions The results of this study show that acute PHM originates from subcortical, as well as cortical structures. Outcome of patients admitted after CPR who develop acute PHM in this cohort was better than previously reported in literature. The broad variety of drugs used for treatment shows the existing uncertainty about optimal treatment. PMID:22853736

  18. Normoxic and Hyperoxic Cardiopulmonary Bypass in Congenital Heart Disease

    PubMed Central

    Mokhtari, Amir

    2014-01-01

    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

  19. Particulate Air Pollution and Risk of ST-Segment Depression During Repeated Submaximal Exercise Tests Among Subjects With Coronary Heart Disease The Exposure and Risk Assessment for Fine and Ultrafine Particles in Ambient Air (ULTRA) Study

    Microsoft Academic Search

    Juha Pekkanen; Annette Peters; Gerard Hoek; Pekka Tiittanen; Bert Brunekreef; Jeroen de Hartog; Joachim Heinrich; Angela Ibald-Mulli; Wolfgang G. Kreyling; Timo Lanki; Kirsi L. Timonen; Esko Vanninen

    Background—Daily variations in ambient particulate air pollution have been associated with cardiovascular mortality and morbidity. We therefore assessed the associations between levels of the 3 main modes of urban aerosol distribution and the occurrence of ST-segment depressions during repeated exercise tests. Methods and Results—Repeated biweekly submaximal exercise tests were performed during 6 months among adult subjects with stable coronary heart

  20. Determination of a sedative dose and influence of midazolam on cardiopulmonary function in Canada geese.

    PubMed

    Valverde, A; Honeyman, V L; Dyson, D H; Valliant, A E

    1990-07-01

    Midazolam HCl (1.0 or 2.0 mg/kg of body weight) was administered IM to 6 Canada geese to determine a sedative dose that would allow positioning for radiologic examination. The effects of both test doses on cardiopulmonary function were evaluated at 5, 10, 15, 20, 30, and 40 minutes after drug administration and were compared with 2 end-tidal isoflurane concentrations (1.5 and 2.5%). The 2.0 mg/kg dosage induced moderate sedation at 15 and 20 minutes; sedation was adequate for positioning the geese. Sedation induced by the 1.0 mg/kg dosage was inadequate. The effects of both test doses on blood pressure, heart rate, and temperature were not significantly different from each other and from baseline data. Respiratory rate increased significantly (P less than 0.05) at 10, 15, 20, and 30 minutes with the 2.0 mg/kg dosage, and at 15 and 20 minutes with the 1.0 mg/kg dosage. Blood pressure and respiratory rate were significantly (P less than 0.05) decreased with isoflurane when compared with baseline data and the midazolam test doses. The results of this study indicate that midazolam at a dosage of 2.0 mg/kg induces adequate sedation with minimal cardiopulmonary changes, and, as an alternative to general anesthesia with isoflurane, provides a satisfactory level of restraint for radiography. PMID:2389885

  1. 33 CFR 104.230 - Drill and exercise requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Drill and exercise requirements. 104.230...Vessel Security Requirements § 104.230 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the...

  2. 33 CFR 106.225 - Drill and exercise requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Drill and exercise requirements. 106.225...Facility Security Requirements § 106.225 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the...

  3. 33 CFR 105.220 - Drill and exercise requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Drill and exercise requirements. 105.220...Facility Security Requirements § 105.220 Drill and exercise requirements. (a) General. (1) Drills and exercises must test the...

  4. Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test

    Microsoft Academic Search

    Peter HC Klijn; Olga H van der Baan-Slootweg; Henk F van Stel

    2007-01-01

    BACKGROUND: Increasing activity levels in adolescents with obesity requires the development of exercise programs that are both attractive to adolescents and easily reproducible. The aim of this study was to develop a modular aerobic training program for adolescents with severe obesity, with a focus on variety, individual targets and acquiring physical skills. We report here the effects on aerobic fitness

  5. Comparative study of coronary flow reserve, coronary anatomy and results of radionuclide exercise tests in patients with coronary artery disease

    Microsoft Academic Search

    Victor Legrand; G. B. John Mancini; Eric R. Bates; John Mc B. Hodgson; Milton D. Gross; Robert A. Vogel

    1986-01-01

    A comparative assessment of regional coronary flow reserve, quantitative percent diameter coronary stenosis and exercise-induced perfusion and wall motion abnormalities was performed in 39 patients with coronary artery disease. Coronary flow reserve was determined by a digital angiographic technique utilizing contrast medium as the hyperemic agent. Percent diameter stenosis was calculated by an automated quantification program applied to orthogonal cineangiograms.

  6. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

    PubMed Central

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

    2015-01-01

    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

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

    SciTech Connect

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

    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.

  8. Family presence during cardiopulmonary resuscitation and invasive procedures in children

    PubMed Central

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

    2014-01-01

    Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes. PMID:24676198

  9. Impedance-Based Ventilation Detection During Cardiopulmonary Resuscitation

    Microsoft Academic Search

    Martin Risdal; Sven Ole Aase; Mette Stavland; T. Eftestl

    2007-01-01

    It has been suggested to develop automated external defibrillators with the ability to monitor cardiopulmonary resuscitation (CPR) performance online and give corrective feedback in order to improve the resuscitation quality. Thoracic impedance changes are closely correlated to lung volume changes and can be used to monitor the ventilatory activity. We developed a pattern-recognition-based detection system that uses thoracic impedance to

  10. Development/Plasticity/Repair Cardiopulmonary Arrest and Resuscitation Disrupts

    E-print Network

    Wenk, Gary

    Development/Plasticity/Repair Cardiopulmonary Arrest and Resuscitation Disrupts Cholinergic Anti Research, North Shore-LIJ Health System, Manhasset, NY 11030 Cardiac arrest is a leading cause of death worldwide. While survival rates following sudden cardiac arrest remain relatively low, recent advancements

  11. Laparoscopic insufflation of the abdomen depresses cardiopulmonary function

    Microsoft Academic Search

    Mark D. Williams; Peter C. Murr

    1993-01-01

    Recently we have used the laparoscope to remove the gallbladder in critically ill patients in order to spare them the operative trauma of laparotomy. However, increased intraperitoneal pressure may have deleterious cardiopulmonary effects. This was investigated in a dog model. Insufflation of the abdomen with carbon dioxide decreased the mean cardiac output to less than 80% of baseline (PPCO2 and

  12. Doppler measurement of cardiac output during cardiopulmonary resuscitation

    Microsoft Academic Search

    D I Fodden; A C Crosby; K S Channer

    1996-01-01

    OBJECTIVE: To estimate the cardiac output produced by external cardiac compression during standard cardiopulmonary resuscitation performed by two groups of operators with different levels of experience and training. METHODS: Cardiac output was measured by Doppler aortovelography. All patients included in the study had necropsy examinations. Only patients without evidence of pulmonary embolism, myocardial rupture, aortic valve disease, or acute depletion

  13. Cardiac surgery with cardiopulmonary bypass: does aprotinin affect outcome?

    Microsoft Academic Search

    P. J. Van der Linden; J.-F. Hardy; A. Trenchant; Ph. Van Der Linden; S. G. De Hert

    2007-01-01

    Background. Aprotinin, a non-specific serine protease inhibitor, has been used for two decades to reduce perioperative blood loss and the risk for allogeneic transfusion in cardiac surgery. This study evaluated the effects of aprotinin on outcome (mortality, cardiac events, renal failure, and cerebrovascular events) in such patients undergoing cardiac surgery with cardiopulmonary bypass. Methods. Data were obtained in patients who

  14. Inflammatory response after coronary revascularization with or without cardiopulmonary bypass

    Microsoft Academic Search

    Raimondo Ascione; Clinton T Lloyd; Malcolm J Underwood; Attilio A Lotto; Antonis A Pitsis; Gianni D Angelini

    2000-01-01

    Background. We sought to investigate the effect of multiple coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (CPB) on the perioperative inflammatory response.Methods. Sixty patients undergoing CABG were randomly assigned to one of two groups: (A) on pump with conventional CPB and cardioplegic arrest, and (B) off pump on the beating heart. Serum samples were collected for estimation

  15. Inflammatory Response After Coronary Revascularization With or Without Cardiopulmonary Bypass

    Microsoft Academic Search

    Raimondo Ascione; Clinton T. Lloyd; Malcolm J. Underwood; Attilio A. Lotto; Antonis A. Pitsis; Gianni D. Angelini

    2010-01-01

    Background. We sought to investigate the effect of multiple coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (CPB) on the perioper- ative inflammatory response. Methods. Sixty patients undergoing CABG were ran- domly assigned to one of two groups: (A) on pump with conventional CPB and cardioplegic arrest, and (B) off pump on the beating heart. Serum samples were

  16. Periventricular closure of ventricular septal defects without cardiopulmonary bypass

    Microsoft Academic Search

    Zahid Amin; Xiaoping Gu; James M Berry; Jack L Titus; Samuel S Gidding; Albert P Rocchini

    1999-01-01

    Background. Minimally invasive techniques are currently in use to close atrial and ventricular septal defects (VSD). Cardiopulmonary bypass (CPB) is instituted via the femoral vessels, which may cause injury to these vessels, especially in younger patients. The objectives of this study were to demonstrate the feasibility of periventricular closure of muscular VSD (MVSD) and paramembranous VSD (PVSD) without CPB, using

  17. Retention of Cardiopulmonary Resuscitation Skills by Medical Students.

    ERIC Educational Resources Information Center

    Fossel, Michael; And Others

    1983-01-01

    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…

  18. Compulsive Exercise

    MedlinePLUS

    ... often result in long-term damage. Instead of building muscle, too much exercise actually destroys muscle mass, especially if the body isn't getting enough nutrition, forcing it to break down muscle for energy. Girls who exercise compulsively may disrupt the balance ...

  19. Volcanological Exercises

    NSDL National Science Digital Library

    Stephen Nelson

    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.

  20. Baroreflex regulation of blood pressure during dynamic exercise

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

    From the work of Potts et al. Papelier et al. and Shi et al. it is readily apparent that the arterial (aortic and carotid) baroreflexes are reset to function at the prevailing ABP of exercise. The blood pressure of exercise is the result of the hemodynamic (cardiac output and TPR) responses, which appear to be regulated by two redundant neural control systems, "Central Command" and the "exercise pressor reflex". Central Command is a feed-forward neural control system that operates in parallel with the neural regulation of the locomotor system and appears to establish the hemodynamic response to exercise. Within the central nervous system it appears that the HLR may be the operational site for Central Command. Specific neural sites within the HLR have been demonstrated in animals to be active during exercise. With the advent of positron emission tomography (PET) and single-photon emission computed tomography (SPECT), the anatomical areas of the human brain related to Central Command are being mapped. It also appears that the Nucleus Tractus Solitarius and the ventrolateral medulla may serve as an integrating site as they receive neural information from the working muscles via the group III/IV muscle afferents as well as from higher brain centers. This anatomical site within the CNS is now the focus of many investigations in which arterial baroreflex function, Central Command and the "exercise pressor reflex" appear to demonstrate inhibitory or facilitatory interaction. The concept of whether Central Command is the prime mover in the resetting of the arterial baroreceptors to function at the exercising ABP or whether the resetting is an integration of the "exercise pressor reflex" information with that of Central Command is now under intense investigation. However, it would be justified to conclude, from the data of Bevegard and Shepherd, Dicarlo and Bishop, Potts et al., and Papelier et al. that the act of exercise results in the resetting of the arterial baroreflex. In addition, if, as we have proposed, the cardiopulmonary baroreceptors primarily monitors and reflexly regulates cardiac filling volume, it would seem from the data of Mack et al. and Potts et al. that the cardiopulmonary baroreceptor is also reset at the beginning of exercise. Therefore, investigations of the neural mechanisms of regulation involving Central Command and cardiopulmonary afferents, similar to those being undertaken for the arterial baroreflex, need to be established.

  1. Hereditary spherocytosis in a patient undergoing coronary artery bypass grafting with cardiopulmonary bypass--a case report.

    PubMed

    Spegar, J; Riha, H; Kotulak, T; Vanek, T

    2015-01-01

    Hereditary spherocytosis is a genetically determined abnormality of red blood cells. It is the most common cause of inherited haemolysis in Europe and North America within the Caucasian population. We document a patient who underwent an aortocoronary bypass procedure on cardiopulmonary bypass. In view of the uncertain tolerance of the abnormal red cells in hereditary spherocytosis to cardiopulmonary bypass, we reviewed the patient's chart and analyzed recorded values of these parameters: free plasma haemoglobin, renal parameters, cystatin C, bilirubin, liver tests, urine samples. From the results, we can see that slight haemolysis-elevated bilirubin in the blood sample and elevated bilirubin and urobilinogen in the urine sample occurred on the first postoperative day. The levels of these parameters slowly decreased during the next postoperative days. There was no real clinical effect of this haemolysis on renal functions. PMID:24714521

  2. Importance of enjoyment when promoting physical exercise.

    PubMed

    Hagberg, L A; Lindahl, B; Nyberg, L; Hellénius, M-L

    2009-10-01

    The purpose of this study was to investigate the importance of enjoyment of exercise in a health care-based intervention aimed at promoting physical exercise in primary health care patients. In a controlled study design, the intervention group was offered a wide range of group exercises over 3 months, followed by support in designing their own exercise program. The control group received usual care. Enjoyment of exercise and exercise level were measured. Associations between enjoyment and exercise level were analyzed using Spearman's rank correlation coefficients. Changes in enjoyment between and within study groups were analyzed by the independent and paired t-test. Associations were found between enjoyment and exercise level (r=0.36, P<0.01), as well as between changes in enjoyment and changes in exercise level (r=0.34, P<0.01). At the 12-month follow-up, enjoyment of exercise was 25% higher in the intervention group than in the control group (P<0.01). In this group of primary health care patients, enjoyment of exercise was associated with exercise level. Enjoyment of exercise seems to be a mediator of exercise level. Furthermore, health care-based interventions seem to be able to affect enjoyment of exercise. Enjoyment of exercise may be important for the long-term effectiveness, of health care-based interventions. PMID:18694433

  3. Corrected End-Tidal PCO2 Accurately Estimates PaCO2 at Rest and During Exercise in Morbidly Obese Adults

    PubMed Central

    Bernhardt, Vipa; Lorenzo, Santiago; Zavorsky, Gerald S.

    2013-01-01

    Background: Obesity affects lung function and gas exchange and imposes mechanical ventilatory limitations during exercise that could disrupt the predictability of PaCO2 from end-tidal PCO2 (PETCO2), an important clinical tool for assessing gas exchange efficiency during exercise testing. PaCO2 has been estimated during exercise with good accuracy in normal-weight individuals by using a correction equation developed by Jones and colleagues (PJCO2 = 5.5 + 0.9 × PETCO2 – 2.1 × tidal volume). The purpose of this project was to determine the accuracy of PaCO2 estimations from PETCO2 and PJCO2 values at rest and at submaximal and peak exercise in morbidly obese adults. Methods: PaCO2 and PETCO2 values from 37 obese adults (22 women, 15 men; age, 39 ± 9 y; BMI, 49 ± 7; [mean ± SD]) were evaluated. Subjects underwent ramped cardiopulmonary exercise testing to volitional exhaustion. PETCO2 was determined from expired gases simultaneously with temperature-corrected arterial blood gases (radial arterial catheter) at rest, every minute during exercise, and at peak exercise. Data were analyzed using paired t tests. Results: PETCO2 was not significantly different from PaCO2 at rest (PETCO2 = 37 ± 3 mm Hg vs PaCO2 = 38 ± 3 mm Hg, P = .14). However, during exercise, PETCO2 was significantly higher than PaCO2 (submaximal: 42 ± 4 vs 40 ± 3, P < .001; peak: 40 ± 4 vs 37 ± 4, P < .001, respectively). Jones’ equation successfully corrected PETCO2, such that PJCO2 was not significantly different from PaCO2 (submax: PJCO2 = 40 ± 3, P = .650; peak: 37 ± 4, P = .065). Conclusion: PJCO2 provides a better estimate of PaCO2 than PETCO2 during submaximal exercise and at peak exercise, whereas at rest both yield reasonable estimates in morbidly obese individuals. Clinicians and physiologists can obtain accurate estimations of PaCO2 in morbidly obese individuals by using P jco 2 . PMID:22878275

  4. Effect of Sildenafil on Ventilatory Efficiency and Exercise Tolerance in Pulmonary Hypertension

    PubMed Central

    Oudiz, Ronald J.; Roveran, Giorgio; Hansen, James E.; Sun, Xing-Guo; Wasserman, Karlman

    2007-01-01

    Background The pulmonary vasculopathy in pulmonary arterial hypertension (PAH) results in increased resistance to pulmonary blood flow, limiting the cardiac output required for the increased O2 demands of exercise. Aims We sought to determine the physiologic basis for clinical improvement in PAH patients receiving sildenafil, hypothesizing that the key mechanisms of improvement are improved blood flow and ventilatory efficiency, leading to improved exercise capacity and O2 pulse over time. Methods We studied 28 PAH patients with (n=14) and without (n=14) sildenafil treatment. All received warfarin and diuretic therapy, and 13/14 sildenafil-treated patients were already receiving specific PAH drugs. Cardiopulmonary exercise testing was performed before and after sildenafil. Results Peak V?O2, peak O2 pulse, V?E/V?CO2 and PetCO2, were 0.84 ± 0.1 L/min, 6.1 ± 0.7 ml • beat?1, 49 ± 2 and 26 ± 1.5 mmHg, and improved after adding sildenafil to 0.91 ± 0.1 L/min, 6.8 ± 0.8 ml • beat?1, 43 ± 2, and 30 ± 1.9, respectively, whereas control patients worsened (p = 0.012, 0.008, 0.008 and 0.0002, treated vs. controls, respectively). Conclusions Sildenafil improves PetCO2, V?E/V?CO2, peak O2 pulse and peak V?O2 during exercise compared to controls. A prospective, placebo-controlled study is needed to validate these findings. PMID:17707133

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

    PubMed Central

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

    2014-01-01

    The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve (%V?O2?R) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and V?O2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL·kg-1·min-1 (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and %V?O2?R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and %V?O2?R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise. PMID:25003546

  6. Pulmonary vascular reserve and exercise capacity at sea level and at high altitude.

    PubMed

    Pavelescu, Adriana; Faoro, Vitalie; Guenard, Hervé; de Bisschop, Claire; Martinot, Jean-Benoit; Mélot, Christian; Naeije, Robert

    2013-03-01

    It has been suggested that increased pulmonary vascular reserve, as defined by reduced pulmonary vascular resistance (PVR) and increased pulmonary transit of agitated contrast measured by echocardiography, might be associated with increased exercise capacity. Thus, at altitude, where PVR is increased because of hypoxic vasoconstriction, a reduced pulmonary vascular reserve could contribute to reduced exercise capacity. Furthermore, a lower PVR could be associated with higher capillary blood volume and an increased lung diffusing capacity. We reviewed echocardiographic estimates of PVR and measurements of lung diffusing capacity for nitric oxide (DL(NO)) and for carbon monoxide (DL(CO)) at rest, and incremental cardiopulmonary exercise tests in 64 healthy subjects at sea level and during 4 different medical expeditions at altitudes around 5000 m. Altitude exposure was associated with a decrease in maximum oxygen uptake (VO2max), from 42±10 to 32±8 mL/min/kg and increases in PVR, ventilatory equivalents for CO2 (V(E)/VCO2), DL(NO), and DL(CO). By univariate linear regression VO2max at sea level and at altitude was associated with V(E)/VCO2 (p<0.001), mean pulmonary artery pressure (mPpa, p<0.05), stroke volume index (SVI, p<0.05), DL(NO) (p<0.02), and DL(CO) (p=0.05). By multivariable analysis, VO2max at sea level and at altitude was associated with V(E)/VCO2, mPpa, SVI, and DL(NO). The multivariable analysis also showed that the altitude-related decrease in VO2max was associated with increased PVR and V(E)/VCO2. These results suggest that pulmonary vascular reserve, defined by a combination of decreased PVR and increased DL(NO), allows for superior aerobic exercise capacity at a lower ventilatory cost, at sea level and at high altitude. PMID:23537256

  7. [Case of food-dependent exercise-induced anaphylaxis diagnosed by the provocation test with cuttlefish after the pretreatment with 1.5 g of aspirin].

    PubMed

    Nakamura, Kazuko; Inomata, Naoko; Okawa, Tomoko; Maeda, Nobuko; Kirino, Mio; Shiomi, Kazuo; Ikezawa, Zenro

    2010-12-01

    A 29-year-old woman had an episode of urticaria at the age of 17 while exercising after eating fried cuttlefish. For years thereafter, she experienced several episodes of urticaria after eating seafood. At the age of 29, she ate grilled seafood, including cuttlefish for supper after taking loxoprofen for lumbago. One hour later, she developed generalized urticaria accompanied by nausea, abdominal pain, swelling of the lips, and dyspnea while walking; she was taken to a hospital. She was then referred to us for further examination of the etiology of her anaphylactic reactions. The level of specific IgE measured using Immuno CAP was negative for all kinds of foods, including cuttlefish. However, a skin prick test was positive for raw and cooked cuttlefish. Provocation tests were performed on admission by combining the intake of cuttlefish and aspirin under the suspicion of cuttlefish allergy enhanced by nonsteroidal anti-inflammatory drugs and exercise. As a result, she developed no symptoms except for slight itching of the oral mucosa after eating 20 g or 100 g of cuttlefish with or without concomitant administration of 0.5 g of aspirin. Finally, generalized urticaria appeared after challenge with cuttlefish and 1.5 g of aspirin. She was diagnosed with food-dependent exercise-induced anaphylaxis (FDEIA) caused by cuttlefish. She has not developed urticaria since she started to avoid eating cuttlefish. Our results indicated that in provocation tests for the diagnosis of FDEIA, allergic reactions could not only be induced by food intake but could also be enhanced by aspirin in a dose-dependent manner. PMID:21212730

  8. New ideas - Cardiopulmonary bypass The Jena universal perfusion system: a universal cardiopulmonary bypass circuit for cardiac surgery

    Microsoft Academic Search

    Alexander Lauten; Kai Liebing; Ulrich Franke; Thorsten Wahlers

    Cardiopulmonary bypass (CPB) is a standard technique in cardiac surgery, which itself contributes to postoperative morbidity. Neurologic sequelae after CPB is caused by air embolism or systemic inflammatory response due to artificial surface and is closely related to the characteristics of the extracorporeal circuit. Minimized systems without a venous reservoir take these factors into account. They require a differentiated volume

  9. Comparison of end-tidal carbon dioxide levels with cardiopulmonary resuscitation success presented to emergency department with cardiopulmonary arrest.

    PubMed Central

    Akinci, Emine; Ramadan, Hayri; Yuzbasioglu, Yucel; Coskun, Figen

    2014-01-01

    Objective: To measure end-tidal carbon dioxide pressure (PetCO2) in preset interval in order to evaluate the efficiency of cardiopulmonary resuscitation (CPR) performed on patients in cardiopulmonary arrest, evaluate the validity of PetCO2 in predicting the mortality and finally assess the PetCO2 levels of the patients in cardiopulmonary arrest based on the initial presenting rhythm. Methods: This prospective study was conducted at the Ankara Training and Research Hospital on patients who presented with cardiopulmonary arrest. Standard ACLS (Advanced Cardiac Life Support) protocols were performed. Patients were categorized in two groups based on their rhythms as Ventricular Fibrillation and Asystole. Patients’ PetCO2 values were recorded. Results: PetCO2 levels of the Return of Spontaneous Circulation (ROSC) group in the 5th, 10th, 15th and 20th minutes were significantly higher compared to the exitus group (p<0.001). In distinguishing ROSC and exitus, PetCO2 measurements within 5-20 minute intervals showed highest performance on the 20th and lowest on the 5th minutes. Conclusion: PetCO2 values are higher in the ROSC group. During the CPR, the most reliable time for ROSC estimation according to PetCO2 values is 20th minute. None of the patients who had PetCO2 levels less than 14 mmHg survived. PMID:24639823

  10. Effect of the exercise test on albuminuria, blood pressure and blood glucose in type I (insulin-dependent) diabetic patients

    Microsoft Academic Search

    Peter Pon?uch; Juraj Vozár; Helena Kratochvíl’ová

    1988-01-01

    Summary  Twenty-nine male type I diabetic patients (age range 16–46 years) and thirteen healthy men (age range 18–43 years) were exercised\\u000a on a cycling ergometer at 75 W and 100 W after having achieved a steady state of water diuresis. Diabetic patients were subdivided\\u000a into Group A (n=19, resting urinary albumin excretion rate — UAER ? 16 µg\\/min) and Group B

  11. Automatic evaluations and exercise setting preference in frequent exercisers.

    PubMed

    Antoniewicz, Franziska; Brand, Ralf

    2014-12-01

    The goals of this study were to test whether exercise-related stimuli can elicit automatic evaluative responses and whether automatic evaluations reflect exercise setting preference in highly active exercisers. An adapted version of the Affect Misattribution Procedure was employed. Seventy-two highly active exercisers (26 years ± 9.03; 43% female) were subliminally primed (7 ms) with pictures depicting typical fitness center scenarios or gray rectangles (control primes). After each prime, participants consciously evaluated the "pleasantness" of a Chinese symbol. Controlled evaluations were measured with a questionnaire and were more positive in participants who regularly visited fitness centers than in those who reported avoiding this exercise setting. Only center exercisers gave automatic positive evaluations of the fitness center setting (partial eta squared = .08). It is proposed that a subliminal Affect Misattribution Procedure paradigm can elicit automatic evaluations to exercising and that, in highly active exercisers, these evaluations play a role in decisions about the exercise setting rather than the amounts of physical exercise. Findings are interpreted in terms of a dual systems theory of social information processing and behavior. PMID:25602145

  12. Metabolic and cardiorespiratory responses in young oarsmen during prolonged exercise tests on a rowing ergometer at power outputs corresponding to two concepts of anaerobic threshold

    Microsoft Academic Search

    J. Bourgois; J. Vrijens

    1997-01-01

    A group of ten young experienced oarsmen [mean age 17.5 (SD 1.7) years, height 182.5 (SD 5.9) cm, body mass 77.0 (SEM 10.6)\\u000a kg] exercised in a progressive incremental test (PIE: 50W?·?3?min?1) on a rowing ergometer to determine the power output corresponding to the 4?mmol lactate?·?l?1 anaerobic threshold (AT4) and the individual anaerobic threshold (IAT). Within 10 days they performed

  13. Clinical value of vectorcardiography, Holter monitoring and quantitative electrocardiology. Belgian Society of Cardiology. Working Group on Electrocardiology, Exercise Testing and Cardiac Rehabilitation.

    PubMed

    2000-06-01

    This a position paper of the Working Group on Electrocardiology, Exercise Testing and Cardiac rehabilitation of the Belgian Society of Cardiology (BSC), aimed at reassessing the value for the clinical practice of cardiology of some electrocardiological techniques such as vectorcardiography and Holter monitoring in the frame of what has been called "quantitative electrocardiology". This official statement issued on behalf of the BSC was deemed necessary because of several consecutive attempts to discredit the clinical merits of these electrocardiological techniques currently in use in our country. This paper will also reassess the role of quantitative electrocardiology amidst non-invasive diagnostic methods used for cardiac imaging. PMID:10902039

  14. Cerebral Blood Flow and Oxygenation at Maximal Exercise: The Effect of Clamping Carbon Dioxide

    PubMed Central

    Olin, J. Tod; Dimmen, Andrew C.; Subudhi, Andrew W.; Roach, Robert C.

    2010-01-01

    During exercise, as end-tidal carbon dioxide (PETCO2) drops after the respiratory compensation point (RCP), so does cerebral blood flow velocity (CBFv) and cerebral oxygenation. This low-flow, low-oxygenation state may limit work capacity. We hypothesized that by preventing the fall in PETCO2 at peak work capacity (Wmax) with a newly-designed high-flow, low-resistance rebreathing circuit, we would improve CBFv, cerebral oxygenation, and Wmax. Ten cyclists performed two incremental exercise tests, one as control and one with PETCO2 constant (clamped) after the RCP. We analyzed PETCO2, middle cerebral artery CBFv, cerebral oxygenation, and cardiopulmonary measures. At Wmax, when we clamped PETCO2 (39.7 ± 5.2 vs. 29.6 ± 4.7 mmHg, P<0.001), CBFv increased (92.6 ± 15.9 vs. 73.6 ± 12.5 cm/s, P<0.001). However, cerebral oxygenation was unchanged (?TSI -21.3 ± 13.1% vs. -24.3 ± 8.1%, P=0.33), and Wmax decreased (380.9 ± 20.4 vs. 405.7 ± 26.8 Watts, P<0.001). At Wmax, clamping PETCO2 increases CBFv, but this does not appear to improve Wmax. PMID:20884383

  15. Gender differences in the endocrine and metabolic responses to hypoxic exercise.

    PubMed

    Sandoval, Darleen A; Matt, Kathleen S

    2002-02-01

    This study tested the hypothesis that women would have blunted physiological responses to acute hypoxic exercise compared with men. Fourteen women taking oral contraceptives (28 +/- 0.9 yr of age) and 15 men (30 +/- 1.0 yr of age) with similar peak O(2) consumption (VO(2 peak)) values (56 +/- 1.1 vs. 57 +/- 0.8 ml x kg fat-free mass(-1) x min(-1)) were studied under hypoxic (H; fraction of inspired oxygen = 13%) vs. normoxic (fraction of inspired oxygen = 20.93%) conditions. Cardiopulmonary, metabolic, and neuroendocrine measures were taken before, during, and 30 min after three 5-min consecutive workloads at 30, 45, and 60% VO(2 peak). In women compared with men, glucose levels were greater during recovery from H (P < 0.05) and lactate levels were lower at 45% VO(2 peak), 60% VO(2 peak), and up to 20 min of recovery (P < 0.05), regardless of trial (P < 0.0001). Although the women had greater baseline levels of cortisol and growth hormone (P < 0.0001), gender did not affect these hormones during H or exercise. Catecholamine responses to H were also similar between genders. Thus the endocrine response to hypoxia per se was not blunted in women as we had hypothesized. Other mechanisms must be at play to cause the gender differences in metabolic substrates in response to hypoxia. PMID:11796657

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

    PubMed Central

    2013-01-01

    Background After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. Methods/Design This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (?20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject’s inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Discussion Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics-assisted treadmill exercise is a relatively recent intervention method and might be used to train and evaluate aerobic capacity in this population. The present pilot trial is expected to provide new insights into the implementation of early cardiovascular exercise for individuals with severe motor impairment. The findings of this study may guide future research to explore the effects of early cardiovascular activation after severe neurological events. Trial registration This trial is registered with the Clinical Trials.gov Registry (NCT01679600). PMID:24053609

  17. PULMONARY CIRCULATION AT EXERCISE

    PubMed Central

    NAEIJE, R; CHESLER, N

    2012-01-01

    The pulmonary circulation is a high flow and low pressure circuit, with an average resistance of 1 mmHg.min.L?1 in young adults, increasing to 2.5 mmHg.min.L?1 over 4–6 decades of life. Pulmonary vascular mechanics at exercise are best described by distensible models. Exercise does not appear to affect the time constant of the pulmonary circulation or the longitudinal distribution of resistances. Very high flows are associated with high capillary pressures, up to a 20–25 mmHg threshold associated with interstitial lung edema and altered ventilation/perfusion relationships. Pulmonary artery pressures of 40–50 mmHg, which can be achieved at maximal exercise, may correspond to the extreme of tolerable right ventricular afterload. Distension of capillaries that decrease resistance may be of adaptative value during exercise, but this is limited by hypoxemia from altered diffusion/perfusion relationships. Exercise in hypoxia is associated with higher pulmonary vascular pressures and lower maximal cardiac output, with increased likelihood of right ventricular function limitation and altered gas exchange by interstitial lung edema. Pharmacological interventions aimed at the reduction of pulmonary vascular tone have little effect on pulmonary vascular pressure-flow relationships in normoxia, but may decrease resistance in hypoxia, unloading the right ventricle and thereby improving exercise capacity. Exercise in patients with pulmonary hypertension is associated with sharp increases in pulmonary artery pressure and a right ventricular limitation of aerobic capacity. Exercise stress testing to determine multipoint pulmonary vascular pressures-flow relationships may uncover early stage pulmonary vascular disease. PMID:23105961

  18. Evaluation of an Exercise Field Test Using Heart Rate Monitors to Assess Cardiorespiratory Fitness and Heart Rate Recovery in an Asymptomatic Population

    PubMed Central

    Coolbaugh, Crystal L.; Anderson, Ivan B.; Wilson, Machelle D.; Hawkins, David A.; Amsterdam, Ezra A.

    2014-01-01

    Purpose Measures of cardiorespiratory fitness (CRF) and heart rate recovery (HRR) can improve risk stratification for cardiovascular disease, but these measurements are rarely made in asymptomatic individuals due to cost. An exercise field test (EFT) to assess CRF and HRR would be an inexpensive method for cardiovascular disease risk assessment in large populations. This study assessed 1) the predictive accuracy of a 12-minute run/walk EFT for estimating CRF () and 2) the accuracy of HRR measured after an EFT using a heart rate monitor (HRM) in an asymptomatic population. Methods Fifty subjects (48% women) ages 18–45 years completed a symptom-limited exercise tolerance test (ETT) (Bruce protocol) and an EFT on separate days. During the ETT, was measured by a metabolic cart, and heart rate was measured continuously by a HRM and a metabolic cart. Results EFT distance and sex independently predicted. The average absolute difference between observed and predicted was 0.26±3.27 ml·kg?1·min?1 for our model compared to 7.55±3.64 ml·kg?1·min?1 for the Cooper model. HRM HRR data were equivalent to respective metabolic cart values during the ETT. HRR at 1 minute post-exercise during ETT compared to the EFT had a moderate correlation (r?=?0.75, p<0.001). Conclusion A more accurate model to estimate CRF from a 12-minute run/walk EFT was developed, and HRR can be measured using a HRM in an asymptomatic population outside of clinical settings. PMID:24848378

  19. Climate change. A global threat to cardiopulmonary health.

    PubMed

    Rice, Mary B; Thurston, George D; Balmes, John R; Pinkerton, Kent E

    2014-03-01

    Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies. PMID:24400619

  20. Climate Change. A Global Threat to Cardiopulmonary Health

    PubMed Central

    Thurston, George D.; Balmes, John R.; Pinkerton, Kent E.

    2014-01-01

    Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies. PMID:24400619