Science.gov

Sample records for cardiopulmonary exercise tests

  1. Assessing exercise limitation using cardiopulmonary exercise testing.

    PubMed

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

    2012-01-01

    The cardiopulmonary exercise test (CPET) is an important physiological investigation that can aid clinicians in their evaluation of exercise intolerance and dyspnea. Maximal oxygen consumption ([Formula: see text]) is the gold-standard measure of aerobic fitness and is determined by the variables that define oxygen delivery in the Fick equation ([Formula: see text] = cardiac output × arterial-venous O(2) content difference). In healthy subjects, of the variables involved in oxygen delivery, it is the limitations of the cardiovascular system that are most responsible for limiting exercise, as ventilation and gas exchange are sufficient to maintain arterial O(2) content up to peak exercise. Patients with lung disease can develop a pulmonary limitation to exercise which can contribute to exercise intolerance and dyspnea. In these patients, ventilation may be insufficient for metabolic demand, as demonstrated by an inadequate breathing reserve, expiratory flow limitation, dynamic hyperinflation, and/or retention of arterial CO(2). Lung disease patients can also develop gas exchange impairments with exercise as demonstrated by an increased alveolar-to-arterial O(2) pressure difference. CPET testing data, when combined with other clinical/investigation studies, can provide the clinician with an objective method to evaluate cardiopulmonary physiology and determination of exercise intolerance. PMID:23213518

  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:17890705

  3. 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

  4. Cardiopulmonary exercise testing in the MRI environment.

    PubMed

    Lafountain, Richard A; da Silveira, Juliana Serafim; Varghese, Juliet; Mihai, Georgeta; Scandling, Debbie; Craft, Jason; Swain, Carmen B; Franco, Veronica; Raman, Subha V; Devor, Steven T; Simonetti, Orlando P

    2016-04-01

    Maximal oxygen consumption ([Formula: see text]max) measured by cardiopulmonary exercise testing (CPX) is the gold standard for assessment of cardiorespiratory fitness. Likewise, cardiovascular magnetic resonance (CMR) is the gold standard for quantification of cardiac function. The combination of CPX and CMR may offer unique insights into cardiopulmonary pathophysiology; however, the MRI-compatible equipment needed to combine these tests has not been available to date. We sought to determine whether CPX testing in the MRI environment, using equipment modified for MRI yields results equivalent to those obtained in standard exercise physiology (EP) lab. Ten recreationally trained subjects completed [Formula: see text]max tests in different locations; an EP laboratory and an MRI laboratory, using site specific equipment. CMR cine images of the heart were acquired before and immediately after maximal exercise to measure cardiac function. Subjects in all tests met criteria indicating that peak exercise was achieved. Despite equipment modifications for the MRI environment, [Formula: see text]max was nearly identical between tests run in the different labs (95% lower confidence limit (LCL)  =  0.8182). The mean difference in [Formula: see text]max was less than 3.40 ml (kg/min)(-1), within the variability expected for tests performed on different days, in different locations, using different metabolic carts. MRI performed at rest and following peak exercise stress indicated cardiac output increased from 5.1  ±  1.0 l min(-1) to 16.4  ±  5.6 l min(-1), LVEF increased from 65.2  ±  3.3% to 78.4  ±  4.8%, while RVEF increased from 52.8  ±  5.3% to 63.4  ±  5.3%. Regression analysis revealed a significant positive correlation between [Formula: see text]max and stroke volume (R  =  0.788, P  =  0.006), while the correlation with cardiac output did not reach statistical significance (R  =  0.505, P  =  0.137). [Formula: see text]max CPX testing can be effectively performed in the MRI environment, enabling direct combination of physiological data with advanced post-exercise imaging in the same test session. PMID:26987361

  5. 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

  6. Cardiopulmonary exercise testing for risk prediction in major abdominal surgery.

    PubMed

    Levett, Denny Z H; Grocott, Michael P W

    2015-03-01

    Reduced exercise capacity is associated with increased postoperative morbidity. Cardiopulmonary exercise testing variables can be used to risk stratify patients. This information can be used to help guide the choice of surgical procedure and to decide on the most appropriate postoperative care environment. Thus CPET can aid collaborative decision making and improve the process of informed consent. In the future, CPET may be combined with other risk predictors to improve outcome prediction. Furthermore early evidence suggests that CPET can be used to guide prehabilitation training programs, improving fitness and thereby reducing perioperative risk. PMID:25701925

  7. Pulmonary capillary hemangiomatosis: the role of invasive cardiopulmonary exercise testing

    PubMed Central

    Kradin, Richard L.; Rodriguez-Lopez, Josanna M.; Channick, Richard N.

    2015-01-01

    Abstract Pulmonary capillary hemangiomatosis (PCH) is a rare form of pulmonary arterial hypertension (PAH) characterized by pulmonary capillary proliferation and pseudoinvasion of collagenous septal structures. PCH is often accompanied by veno-occlusive changes and pulmonary hypertensive arterial remodeling. The clinical and pathological diagnosis of PCH can be subtle and easily missed. Most reported cases of PCH have been associated with resting PAH. We report the cases of 3 patients who initially presented with exertional dyspnea with normal to mildly elevated resting pulmonary arterial pressures and marked intrapulmonary shunting. In all 3 patients, invasive cardiopulmonary exercise testing was suggestive of pulmonary vascular disease. Owing to abnormalities on invasive exercise testing, lung biopsies were performed; these were diagnostic of PCH, and the patients were referred for lung transplantation. We describe unique features of these 3 cases—including novel pathological findings and the presence of intrapulmonary shunting in all 3 patients—and we discuss the role of cardiopulmonary exercise testing in the evaluation of PCH. PMID:26401260

  8. The Role of Cardiopulmonary Exercise Test in IPF Prognosis

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Aguilaniu, B; Wallaert, B

    2013-06-01

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

  10. Cardiopulmonary exercise testing after laryngectomy: A connection conundrum

    PubMed Central

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

    2015-01-01

    A patient presents with a new bronchogenic carcinoma 5 years after laryngectomy for recurrent laryngeal tumor and 13 years after chemoradiation for concurrent lung cancer with synchronous base-of-tongue tumor. Due to his complex history and perceived limited respiratory reserve, he was felt high risk for the completion pneumonectomy needed for resection of this new tumor. The attending surgeon requested a full cardiopulmonary exercise test for risk assessment prior to surgery. We found that there was no commercially available connector that would allow our CPET equipment to reliably collect respiratory gases from a patient with tracheostomy stoma or tube. We report here a simple coupling devised “in house” that allowed for the performance of an interpretable test leading to a significant change in medical care. PMID:26744642

  11. [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

  12. The spirografic oxygen deficit: its role in cardiopulmonary exercise testing.

    PubMed

    Sperlich, B; Schiffer, T; Hoffmann, U; Strueder, H K; Hollmann, W

    2013-12-01

    The increase in oxygen uptake > 100 ml · min-1 during steady state exercise when elevating the inspired fractional air content (FinO2) from 0.21-1.00 defines the "spirografic oxygen deficit" (SOD). The purpose of this study was 2-fold: 1) determine the SOD at different exercise intensities in healthy participants and 2) investigate if a correlation exists among key variables of cardiopulmonary exercise testing. 12 men (24±2 yrs; 183±4 cm; 83.5±5.3 kg) performed cycle tests to determine maximal power output (Pmax), the power output at the first (PVT1) and the second ventilatory threshold (PVT2), at 4 mmol · l-1 blood lactate (P4) and lactate threshold (PLT). When cycling at 30, 40, 50, 60, 70 and 80% Pmax, the FinO2 was increased from 0.21-1.00 after 5 min to assess the power output at the SOD and at which blood lactate increased > 1 mmol∙L-1 (PLLAC). The SOD occurred at 70% Pmax accompanied by increased blood lactate concentration (p<0.01). The PSOD correlated with PLACC (p=0.05; r=0.61), but not with PVT1, PVT2, P4, or PLT (best p=0.29; highest r=0.39). In conclusion, the SOD may represent a non-invasive tool for evaluating submaximal endurance performance, especially when evaluating the peripheral contribution to performance. PMID:23670361

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-12-01

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

  15. 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

  16. Assessing Late Cardiopulmonary Function in Patients with Repaired Tetralogy of Fallot Using Exercise Cardiopulmonary Function Test and Cardiac Magnetic Resonance

    PubMed Central

    Yang, Ming-Chun; Chen, Chun-An; Chiu, Hsin-Hui; Chen, Ssu-Yuan; Wang, Jou-Kou; Lin, Ming-Tai; Chiu, Shuenn-Nan; Lu, Chun-Wei; Huang, Shu-Chien; Wu, Mei-Hwan

    2015-01-01

    Background Patients with repaired tetralogy of Fallot (TOF) usually experience progressive right ventricle (RV) dysfunction due to pulmonary regurgitation (PR). This could further worsen the cardiopulmonary function. This study aimed to compare the changes in patient exercise cardiopulmonary test and cardiac magnetic resonance imaging, and consider the implication of these changes. Methods Our study examined repaired TOF patients who underwent cardiopulmonary exercise test (CPET) to obtain maximal (peak oxygen consumption, peak VO2) and submaximal parameters (oxygen uptake efficiency plateau, oxygen uptake efficiency plateau (OUEP), and ratio of minute ventilation to carbon dioxide production, VE/VCO2 slope). Additionally, the hemodynamic status was assessed by using cardiac magnetic resonance. Criteria for exclusion included TOF patients with pulmonary atresia, atrioventricular septal defect, or absence of pulmonary valve syndrome. Results We enrolled 158 patients whose mean age at repair was 7.8 ± 9.1 years (range 0.1-49.2 years) and the mean patient age at CPET was 29.5 ± 12.2 years (range 7.0-57.0 years). Severe PR (PR fraction ≥ 40%) in 53 patients, moderate in 55, and mild (PR fraction < 20%) in 50 patients were noted. The mean RV end-diastolic volume index (RVEDVi) was 113 ± 35 ml/m2, with 7 patients observed to have a RVEDVi > 163 ml/m2. The mean left ventricular ejection fraction (LVEF) was 63 ± 8%, left ventricular end-diastolic volume index (LVEDVi) was 65 ± 12 ml/m2, and LVESVi was 25 ± 14 ml/m2. CPET revealed significantly decreased peak VO2 (68.5 ± 14.4% of predicted), and fair OUEP (90.3 ± 14.1% of predicted) and VE/VCO2 slope (27.1 ± 5.3). PR fraction and age at repair were negatively correlated with maximal and submaximal exercise indicators (peak VO2 and OUEP). Left ventricular (LV) function and size were positively correlated with peak VO2 and OUEP. Conclusions The results of CPET showed that patients with repaired TOF had a low maximal exercise capacity (peak VO2), but a fair submaximal exercise capacity (OUEP and VE/VCO2 slope), suggesting limited exercise capability in high intensity circumstances. PR, LV function and age at total repair were the most important determinants of CPET performance. PMID:27122911

  17. Methodological approach to the first and second lactate threshold in incremental cardiopulmonary exercise testing.

    PubMed

    Binder, Ronald K; Wonisch, Manfred; Corra, Ugo; Cohen-Solal, Alain; Vanhees, Luc; Saner, Hugo; Schmid, Jean-Paul

    2008-12-01

    Determination of an 'anaerobic threshold' plays an important role in the appreciation of an incremental cardiopulmonary exercise test and describes prominent changes of blood lactate accumulation with increasing workload. Two lactate thresholds are discerned during cardiopulmonary exercise testing and used for physical fitness estimation or training prescription. A multitude of different terms are, however, found in the literature describing the two thresholds. Furthermore, the term 'anaerobic threshold' is synonymously used for both, the 'first' and the 'second' lactate threshold, bearing a great potential of confusion. The aim of this review is therefore to order terms, present threshold concepts, and describe methods for lactate threshold determination using a three-phase model with reference to the historical and physiological background to facilitate the practical application of the term 'anaerobic threshold'. PMID:19050438

  18. 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

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

    PubMed

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

    2013-02-01

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

  20. Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing

    PubMed Central

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

    2013-01-01

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

  1. [Standardizing clinical performance, data analysis, graphics display, interpretation and report for cardiopulmonary exercise testing].

    PubMed

    Sun, Xing-Guo

    2015-07-01

    The cardiopulmonary exercise testing (CPET) is one important clinical functional testing method, which linked to all functions of respiratory, circulatory, metabolic and neurohumoral etc. The most important parameter of CPET is oxygen uptake which can reflect the core oxygen metabolic information of the human being's holistic integrative physiology. We explain why the CPET interpretation needs new philosophy of holistic integrative physiology and medicine. CPET is a unique holistic, objective, quantitative scientific evaluation skill of human function to distinguish health, sub-health and dieases, It can help us to make optimal recommendations for prevention, diagnosis and differential diagnosis, treatment evaluation, exercise rehabilitation and prognosis of many clinical diseases. However, in order to so, we needs pre-qualified and calibrated stable system, standardized clinical practice, data analysis, display illustration and interpretation principle for CPET. PMID:26775511

  2. Reproducibility of cardiopulmonary parameters during exercise in patients with chronic cardiac failure. The need for a preliminary test.

    PubMed

    Elborn, J S; Stanford, C F; Nicholls, D P

    1990-01-01

    To examine the reproducibility of cardiopulmonary exercise testing in patients with heart failure, three consecutive tests were performed in 30 such patients. The first test underestimated treadmill exercise time by about 20% when compared with the second and third tests, which were not significantly different. Peak achieved VO2, VCO2 and VE were also less during the first test, but blood pressure, heart rate and respiratory rate responses were similar in the three tests. When cardiopulmonary exercise tests are used to assess functional capacity in either individual patients or groups (as in a therapeutic trial), at least two tests should be performed, as a single test is likely to underestimate exercise capacity. PMID:2106439

  3. 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

  4. Cardiopulmonary exercise testing reveals onset of disease and response to treatment in a case of heritable pulmonary arterial hypertension

    PubMed Central

    Trip, Pia; Vonk-Noordegraaf, Anton; Bogaard, Harm Jan

    2012-01-01

    Patients affected by pulmonary arterial hypertension (PAH) show a typical pattern of abnormalities on cardiopulmonary exercise testing (CPET). However, CPET is not routinely used as a screening method. We discuss a patient with hereditary PAH in whom CPET revealed onset of disease. Furthermore, we show that the abnormalities observed can improve in part by PAH-specific treatment. PMID:23130108

  5. Cardiopulmonary exercise testing is a core assessment for patients with heart failure.

    PubMed

    Arena, Ross; Myers, Jonathan; Guazzi, Marco

    2011-01-01

    Despite advances in the treatment of heart failure (HF), which have resulted in improved survival, overall prognosis continues to be poor. Given the high short-term mortality rate, it remains important to utilize assessment techniques with established prognostic value in this patient population. Ideally, a given assessment should also be able to accurately reflect disease severity, a heterogeneous phenomenon in patients with HF, and accurately reflect the magnitude of physiologic/clinical improvement following the implementation or titration of an intervention. Cardiopulmonary exercise testing (CPX) satisfies all of the aforementioned desirable assessment attributes. Peak oxygen consumption and the minute ventilation/carbon dioxide production slope are key CPX variables in assessing prognosis and gauging disease severity. Given the high value of information obtained from this procedure, CPX should be considered a core assessment in the HF population. The current review will concisely define key CPX variables and summarize their clinical applications in patients with HF. PMID:21609384

  6. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing

    PubMed Central

    Lewis, Gregory D.; Opotowsky, Alexander R.; Waxman, Aaron B.; Systrom, David M.

    2016-01-01

    Abstract To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%–64%], Qtmax = 72% predicted [62%–76%]). These were compared to patients with a normal exercise response (normal: n = 28, V̇o2max = 86% predicted [84%–97%], Qtmax = 108% predicted [97%–115%]). Before exercise, all patients received up to 2 L of intravenous normal saline to target an upright pulmonary capillary wedge pressure (PCWP) of ≥5 mmHg. Despite this treatment, biventricular filling pressures at peak exercise were lower in the impaired group than in the normal group (right atrial pressure [RAP]: 6 [IQR: 5–8] vs. 9 [7–10] mmHg, P = 0.004; PCWP: 12 [10–16] vs. 17 [14–19] mmHg, P < 0.001), associated with decreased stroke volume (SV) augmentation with exercise (+13 ± 10 [standard deviation (SD)] vs. +18 ± 10 mL/m2, P = 0.014). A review of hemodynamic data from 23 patients with low RAP on an initial iCPET who underwent a second iCPET after saline infusion (2.0 ± 0.5 L) demonstrated that 16 of 23 patients responded with increases in Qtmax ([+24% predicted [IQR: 14%–34%]), V̇o2max (+10% predicted [7%–12%]), and maximum SV (+26% ± 17% [SD]). These data suggest that inadequate ventricular filling related to low venous pressure is a clinically relevant cause of exercise intolerance. PMID:27162614

  7. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing.

    PubMed

    Oldham, William M; Lewis, Gregory D; Opotowsky, Alexander R; Waxman, Aaron B; Systrom, David M

    2016-03-01

    To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%-64%], Qtmax = 72% predicted [62%-76%]). These were compared to patients with a normal exercise response (normal: n = 28, V̇o2max = 86% predicted [84%-97%], Qtmax = 108% predicted [97%-115%]). Before exercise, all patients received up to 2 L of intravenous normal saline to target an upright pulmonary capillary wedge pressure (PCWP) of ≥5 mmHg. Despite this treatment, biventricular filling pressures at peak exercise were lower in the impaired group than in the normal group (right atrial pressure [RAP]: 6 [IQR: 5-8] vs. 9 [7-10] mmHg, P = 0.004; PCWP: 12 [10-16] vs. 17 [14-19] mmHg, P < 0.001), associated with decreased stroke volume (SV) augmentation with exercise (+13 ± 10 [standard deviation (SD)] vs. +18 ± 10 mL/m(2), P = 0.014). A review of hemodynamic data from 23 patients with low RAP on an initial iCPET who underwent a second iCPET after saline infusion (2.0 ± 0.5 L) demonstrated that 16 of 23 patients responded with increases in Qtmax ([+24% predicted [IQR: 14%-34%]), V̇o2max (+10% predicted [7%-12%]), and maximum SV (+26% ± 17% [SD]). These data suggest that inadequate ventricular filling related to low venous pressure is a clinically relevant cause of exercise intolerance. PMID:27162614

  8. 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

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

    PubMed

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

    2012-04-01

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

  10. Cardiopulmonary exercise testing variables as predictors of long-term outcome in thoracic sarcoidosis

    PubMed Central

    Lopes, A.J.; Menezes, S.L.S.; Dias, C.M.; Oliveira, J.F.; Mainenti, M.R.M.; Guimares, F.S.

    2012-01-01

    Cardiopulmonary exercise testing (CPET) plays an important role in the assessment of functional capacity in patients with interstitial lung disease. The aim of this study was to identify CPET measures that might be helpful in predicting the vital capacity and diffusion capacity outcomes of patients with thoracic sarcoidosis. A longitudinal study was conducted on 42 nonsmoking patients with thoracic sarcoidosis (median age = 46.5 years, 22 females). At the first evaluation, spirometry, the measurement of single-breath carbon monoxide diffusing capacity (DLCOsb) and CPET were performed. Five years later, the patients underwent a second evaluation consisting of spirometry and DLCOsb measurement. After 5 years, forced vital capacity (FVC)% and DLCOsb% had decreased significantly [95.5 (82-105) vs 87.5 (58-103) and 93.5 (79-103) vs 84.5 (44-102), respectively; P < 0.0001 for both]. In CPET, the peak oxygen uptake, maximum respiratory rate, breathing reserve, alveolar-arterial oxygen pressure gradient at peak exercise (P(A-a)O2), and ? SpO2 values showed a strong correlation with the relative differences for FVC% and DLCOsb% (P < 0.0001 for all). P(A-a)O2 ?22?mmHg and breathing reserve ?40% were identified as significant independent variables for the decline in pulmonary function. Patients with thoracic sarcoidosis showed a significant reduction in FVC% and DLCOsb% after 5 years of follow-up. These data show that the outcome measures of CPET are predictors of the decline of pulmonary function. PMID:22331135

  11. Reliability of Maximal Cardiopulmonary Exercise Testing in Men with Prostate Cancer

    PubMed Central

    Scott, Jessica M.; Hornsby, Whitney E.; Lane, Amy; Kenjale, Aarti A.; Eves, Neil D.; Jones, Lee W.

    2014-01-01

    Purpose In order to accurately assess exercise interventions and to evaluate acute and chronic cardiovascular effects in patients with early-stage cancer, consistently reliable functional outcome measures must be obtained. An incremental cardiopulmonary exercise test (CPET) with gas exchange measurement, to assess peak oxygen consumption (peak VO2), provides the gold standard outcome of cardiorespiratory fitness. Methods In the context of a randomized controlled trial, 40 prostate cancer patients (mean age 59±7 years) following radical prostatectomy performed two maximal CPETs within 5.6±5.5 days of each other. Incremental treadmill tests were performed in the morning under identical laboratory conditions. Reliability and within subject variability from test 1 to test 2 for peak and submaximal variables were assessed by correlation coefficients, intraclass correlations (ICC), Bland-Altman plots, coefficient of variation (CV), and paired t-tests. Results There was high reliability between CPETs for peak VO2 (r=0.92, p<0.001, ICC=0.900); ventilatory threshold (VT; r=0.88, p<0.001, ICC=0.927); minute ventilation-carbon dioxide production relationship (VE/VCO2; r=0.86, p < 0.001, ICC=0.850); and peak heart rate (HR; r=0.95, p<0.001, ICC=0.944). However, high within-subject variability was observed for all CPET parameters (mean coefficient of variation: 4.7%). Compared to test 1, significantly higher mean values were observed for peak VO2 (27.0±5.6 vs. 28.1±5.3 mL·kg·−1min−1, p<0.05), VT (1.91±0.5 vs. 1.97±0.4 L.min−1, p<0.05) and VE/VCO2: (31.3±5.8 vs. 32.8±3.4, p<0.05) in test 2. Conclusion These findings indicate the presence of significant, and potentially clinically important, variability in CPET procedures in men with clinically-localized prostate cancer, and have important implications for the application and utility of CPETs to evaluate the efficacy of interventions to improve aerobic capacity in the oncology setting. PMID:24781891

  12. 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

  13. Defining the Optimal Prognostic Window for Cardiopulmonary Exercise Testing in Patients with Heart Failure

    PubMed Central

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

    2010-01-01

    Background Ventilatory efficiency (VE/VCO2 slope) and peak oxygen consumption (VO2) provide robust prognostic information in patients with heart failure (HF) undergoing cardiopulmonary exercise testing (CPX). The purpose of the present study is to assess the change in prognostic characteristics of CPX at different time intervals. Methods and Results Seven hundred and ninety-one subjects (74% male, mean age: 60.7 ±12.9 years, ejection fraction: 34.6 ±15.0%, ischemic etiology: 51%) underwent CPX and were tracked for major cardiac events over a four year period. All event-free subjects were tracked for at least three years. Mean VE/VCO2 slope and peak VO2 were 35.0 ±10.0 and 16.0 ±6 mlO2•kg−1•min−1, respectively. There were a total of 263 major cardiac events (199 deaths/45 transplants/19 left ventricular assist device implantations). Both continuous and dichotomous expressions of the VE/VCO2 slope and peak VO2 were prognostically significant up to 18 months post CPX. Continuous and dichotomous expressions of the VE/VCO2 slope remained prognostically significant up to 36 months post CPX while peak VO2 was not predictive during the third and fourth year of follow-up. In a multivariate analysis, the VE/VCO2 slope was consistently the superior prognostic marker while peak VO2 added predictive value and was retained in the regression up to 18 months post CPX. Conclusions These results indicate that commonly assessed CPX variables retain prognostic value for at least two years. The VE/VCO2 slope is the superior predictor of adverse events throughout follow-up, although peak VO2 provides additive prognostic information during the first two years of follow-up. PMID:20200329

  14. Robot-Assisted End-Effector-Based Stair Climbing for Cardiopulmonary Exercise Testing: Feasibility, Reliability, and Repeatability

    PubMed Central

    Stoller, Oliver; Schindelholz, Matthias; Hunt, Kenneth J.

    2016-01-01

    Background Neurological impairments can limit the implementation of conventional cardiopulmonary exercise testing (CPET) and cardiovascular training strategies. A promising approach to provoke cardiovascular stress while facilitating task-specific exercise in people with disabilities is feedback-controlled robot-assisted end-effector-based stair climbing (RASC). The aim of this study was to evaluate the feasibility, reliability, and repeatability of augmented RASC-based CPET in able-bodied subjects, with a view towards future research and applications in neurologically impaired populations. Methods Twenty able-bodied subjects performed a familiarisation session and 2 consecutive incremental CPETs using augmented RASC. Outcome measures focussed on standard cardiopulmonary performance parameters and on accuracy of work rate tracking (RMSEP−root mean square error). Criteria for feasibility were cardiopulmonary responsiveness and technical implementation. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean differences, limits of agreement, and coefficients of variation (CoV) were estimated to assess repeatability. Results All criteria for feasibility were achieved. Mean V′O2peak was 106±9% of predicted V′O2max and mean HRpeak was 99±3% of predicted HRmax. 95% of the subjects achieved at least 1 criterion for V′O2max, and the detection of the sub-maximal ventilatory thresholds was successful (ventilatory anaerobic threshold 100%, respiratory compensation point 90% of the subjects). Excellent reliability was found for peak cardiopulmonary outcome measures (ICC ≥ 0.890, SEM ≤ 0.60%, MDC ≤ 1.67%). Repeatability for the primary outcomes was good (CoV ≤ 0.12). Conclusions RASC-based CPET with feedback-guided exercise intensity demonstrated comparable or higher peak cardiopulmonary performance variables relative to predicted values, achieved the criteria for V′O2max, and allowed determination of sub-maximal ventilatory thresholds. The reliability and repeatability were found to be high. There is potential for augmented RASC to be used for exercise testing and prescription in populations with neurological impairments who would benefit from repetitive task-specific training. PMID:26849137

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

    PubMed Central

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

    2014-01-01

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

  16. Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery

    PubMed Central

    Pearse, Rupert M; Shulman, Mark A; Abbott, Tom E F; Torres, Elizabeth; Croal, Bernard L; Granton, John T; Thorpe, Kevin E; Grocott, Michael P W; Farrington, Catherine; Myles, Paul S; Cuthbertson, Brian H

    2016-01-01

    Introduction Preoperative functional capacity is considered an important risk factor for cardiovascular and other complications of major non-cardiac surgery. Nonetheless, the usual approach for estimating preoperative functional capacity, namely doctors’ subjective assessment, may not accurately predict postoperative morbidity or mortality. 3 possible alternatives are cardiopulmonary exercise testing; the Duke Activity Status Index, a standardised questionnaire for estimating functional capacity; and the serum concentration of N-terminal pro-B-type natriuretic peptide (NT pro-BNP), a biomarker for heart failure and cardiac ischaemia. Methods and analysis The Measurement of Exercise Tolerance before Surgery (METS) Study is a multicentre prospective cohort study of patients undergoing major elective non-cardiac surgery at 25 participating study sites in Australia, Canada, New Zealand and the UK. We aim to recruit 1723 participants. Prior to surgery, participants undergo symptom-limited cardiopulmonary exercise testing on a cycle ergometer, complete the Duke Activity Status Index questionnaire, undergo blood sampling to measure serum NT pro-BNP concentration and have their functional capacity subjectively assessed by their responsible doctors. Participants are followed for 1 year after surgery to assess vital status, postoperative complications and general health utilities. The primary outcome is all-cause death or non-fatal myocardial infarction within 30 days after surgery, and the secondary outcome is all-cause death within 1 year after surgery. Both receiver-operating-characteristic curve methods and risk reclassification table methods will be used to compare the prognostic accuracy of preoperative subjective assessment, peak oxygen consumption during cardiopulmonary exercise testing, Duke Activity Status Index scores and serum NT pro-BNP concentration. Ethics and dissemination The METS Study has received research ethics board approval at all sites. Participant recruitment began in March 2013, and 1-year follow-up is expected to finish in 2016. Publication of the results of the METS Study is anticipated to occur in 2017. PMID:26969643

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

    PubMed

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

    2015-07-01

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

  18. [Cardiopulmonary exercise test in patients with DDD pacemaker: report of two cases with increased exercise capacity by decreased ventricular tracking limit rate setting].

    PubMed

    Asakuma, S; Nakamura, K; Tateishi, J; Terawaki, K; Nishian, K; Tsumoto, S; Komasa, N; Yasutomi, S; Fujitani, K; Iwasaki, T

    1991-01-01

    We reported 2 patients with complete A-V block with a DDD pacemaker whose exercise capacity was increased by decreased ventricular tracking limit rate setting (VTL) of their pacemakers. Cardiopulmonary exercise test was used for estimating exercise capacity. Case 1: A 15-year-old girl complained of fainting. Her electrocardiogram (ECG) revealed complete A-V block (atrial rates 100/min, ventricular rates 39/min). After implantation of a DDD pacemaker and the VTL setting at 152/min, her bradycardia disappeared, however, she complained of dyspnea after a few minutes' walk. We performed symptom-limited cardiopulmonary exercise test with a motor-driven treadmill. When the pacing rate reached VTL (152/min), ECG suddenly changed to approximately 2:1 pacing (80/min) and the patient complained of dyspnea. Concomitant rapid increases in VE, VCO2 and RQ suggested that dyspnea was caused by the marked change in pacing rates on VTL. With the lowered VTL (110/min), there was no rapid increase in VE, VCO2 and RQ, and dyspnea subsided when the pacing rate reached VTL. At the same time, the peak VO2 and exercise time were increased by 15% and 8%, respectively. Case 2: A 47-year-old man complained of syncope. His ECG revealed complete A-V block (atrial rates 100/min, ventricular rates 33/min). After a DDD pacemaker implantation (VTL: 150/min), he experienced dyspnea while walking up the stairs in his office. Like in Case 1, when the VTL was lowered from 150/min to 110/min, both the peak VO2 and exercise time were increased by 11%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1844429

  19. Cardiopulmonary exercise testing in patients with pulmonary hypertension: clinical recommendations based on a review of the evidence.

    PubMed

    Pinkstaff, Sherry O; Burger, Charles D; Daugherty, John; Bond, Samantha; Arena, Ross

    2016-03-01

    Pulmonary hypertension (PH) remains an ominous diagnosis despite advances in pharmacological and surgical therapy. Early and effective diagnosis is important for clinicians making treatment determinations and patients wishing to understand the prognostic implications of their illness. Cardiopulmonary exercise testing (CPX) has the power to reveal the underlying pathophysiological consequences of the disease process. Research, especially over the last 10-15 years, has demonstrated the utility of this tool. Several CPX variables have been shown to be consistently altered in patients with PH and more so as severity of disease increases. However, to further enhance clinical application, additional research is needed to better define optimal CPX measures and associated cutoff values. This paper gives class-based recommendations with associated levels of evidence for the use of CPX in the PH patient population. PMID:26789612

  20. Changes in Cardiopulmonary Exercise Testing Parameters Following Continuous Flow Left Ventricular Assist Device Implantation and Heart Transplantation

    PubMed Central

    Dunlay, Shannon M.; Allison, Thomas G.; Pereira, Naveen L.

    2014-01-01

    Background Reduced exercise tolerance from impaired cardiac output is an important criterion for left ventricular assist device (LVAD) implantation. However, little is known about how exercise capacity changes following LVAD, and how changes compare with patients undergoing heart transplant. Methods and Results We compared changes in cardiopulmonary exercise testing performed pre- and post-operatively in patients who underwent HeartMate II LVAD implantation (n=25) and heart transplantation (n=74) at the Mayo Clinic in Rochester, Minnesota from 2007–2012. Pre-operatively, patients undergoing LVAD and transplant had markedly reduced exercise time (mean 5.1 minutes [45% predicted] and 5.0 minutes [44% predicted], respectively), low peak VO2 (mean 11.5 ml/kg/min [43% predicted] and 11.9 mL/kg/min [38% predicted]), and abnormal ventilatory gas exchange (VE/VCO2 nadir 39.4 and 37.4). Following LVAD and transplant, there were similar improvements in exercise time (mean Δ +1.2 vs. 1.7 minutes, respectively, p=0.27) and VE/VCO2 nadir (mean Δ −3.7 vs. −4.2, p=0.74). However, peak VO2 increased post-transplant but did not change post-LVAD (mean Δ +5.4 vs. +0.9 mL/kg/min, respectively, p<0.001). Most patients (72%) had a peak VO2<14 mL/kg/min post-LVAD. Conclusions While improvements in exercise capacity and gas exchange are seen following LVAD and heart transplant, peak VO2 doesn’t improve post-LVAD and remains markedly abnormal in most patients. PMID:24893345

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

    PubMed Central

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

    2015-01-01

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

  2. Abnormalities in cardiopulmonary exercise testing ventilatory parameters in heart failure: pathophysiology and clinical usefulness.

    PubMed

    Guazzi, Marco

    2014-03-01

    Heart failure (HF) is a complex syndrome characterized by myocardial dysfunction, derangement of multiple organ systems and poor outcome. Out of several markers of severity, abnormalities in exercise ventilation (VE) offer relevant insights into the pathophysiology of dyspnea, lung gas exchange, and control of ventilation and are now recognized as meaningful indicators of disease severity and prognosis. Ventilation inefficiency, identified as an increased slope of VE vs carbon dioxide production (VCO2) recognizes as major determinants an increased waste ventilation due to enhanced dead space, early occurrence of lactic acidosis, and an abnormal chemoreflex and/or metaboreflex activity. In some cases of HF, especially associated with advanced hemodynamic and neural deregulation, an exercise oscillatory ventilatory (EOV) pattern may occur. According to an increasing number of studies, EOV identifies the 15-30% of higher-risk HF patients requiring aggressive treatment and provides an even more robust prediction of outcome compared to VE/VCO2 slope. Overall, a refined prevalence definition and more comprehensive use of these markers in a clinical environment and in future interventional trials seem challenging for the years to come. PMID:24408786

  3. Reproducibility of Peak Oxygen Uptake and Other Cardiopulmonary Exercise Testing Parameters in Patients with Heart Failure (From the Heart Failure and A Controlled Trial Investigating Outcomes of exercise traiNing)

    PubMed Central

    Bensimhon, Daniel R.; Leifer, Eric S.; Ellis, Stephen J.; Fleg, Jerome L.; Keteyian, Steven J.; Piña, Ileana L.; Kitzman, Dalane W.; McKelvie, Robert S.; Kraus, William E.; Forman, Daniel E.; Kao, Andrew J.; Whellan, David J.; O’Connor, Christopher M.; Russell, Stuart D.

    2008-01-01

    Peak oxygen uptake (pVO2) is an important parameter in assessing the functional capacity and prognosis of patients with heart failure. In heart failure trials, the change in pVO2 is often used to assess the effectiveness of an intervention. However, the within-patient variability of pVO2 on serial testing may limit its usefulness. This study was designed to evaluate the within-patient variability of pVO2 over two baseline cardiopulmonary exercise tests. As a sub study of the HF-ACTION (Heart Failure and A Controlled Trial Investigating Outcomes of exercise traiNing) trial, 398 subjects (73% male, 27% female, mean age 59 years) with HF and left ventricular ejection fraction ≤ 35% underwent two baseline cardiopulmonary exercise tests within 14 days. Mean pVO2 was unchanged from test 1 to test 2 (15.16 ± 4.97 vs. 15.18 ± 4.97 mL/kg/min; p=0.78). However, the mean within-subject absolute change was 1.3 mL/kg/min (10th, 90th percentiles = 0.1, 3.0 mL/kg/min), with 46% of subjects increasing and 48% decreasing on the second test. Other parameters, including the ventilation-to-carbon dioxide production slope and VO2 at ventilatory threshold, also demonstrated significant within-subject variation with minimal mean differences between tests. In conclusion, peak oxygen consumption demonstrates substantial within-subject variability in heart failure subjects and should be taken into account in clinical applications. However, on repeat baseline cardiopulmonary exercise tests, there appears to be no familiarization effect for pVO2 in heart failure subjects and, hence, in multicenter trials there is no need to perform more than one baseline cardiopulmonary exercise test. PMID:18773994

  4. Effects of resistance exercise on cardiopulmonary factors in sedentary individuals.

    PubMed

    Janyacharoen, Taweesak; Thayon, Methiya; Bushong, Wanwisa; Jaikla, Nussamol; Sawanyawisuth, Kittisak

    2016-01-01

    [Purpose] This study investigated the effects of resistance exercise on cardiopulmonary functions in young sedentary subjects. [Subjects] Forty-two young and healthy subjects with a sedentary lifestyle were included in this study. [Methods] The subjects were randomly divided into 2 groups: control and experimental. The control group (n=21) received health education and continued with normal activities of daily living. The experimental group (n=21) underwent resistance training, health education, and continued with normal activities of daily living. The resistance exercise program consisted of 3 postural exercises: chest press, dumbbell pullover, and flat-bench dumbbell fly. The subjects received this intervention 3 times/week for 8 weeks. [Results] The baseline characteristics were comparable between the 2 groups. The 6-minute-walk test score, peak expiratory flow, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation, and chest expansions were significantly improved post-intervention in the experimental group and between the 2 groups. [Conclusion] Cardiopulmonary functions in young sedentary subjects were significantly improved with the 8-week resistance exercise program. PMID:26957760

  5. Effects of resistance exercise on cardiopulmonary factors in sedentary individuals

    PubMed Central

    Janyacharoen, Taweesak; Thayon, Methiya; Bushong, Wanwisa; Jaikla, Nussamol; Sawanyawisuth, Kittisak

    2016-01-01

    [Purpose] This study investigated the effects of resistance exercise on cardiopulmonary functions in young sedentary subjects. [Subjects] Forty-two young and healthy subjects with a sedentary lifestyle were included in this study. [Methods] The subjects were randomly divided into 2 groups: control and experimental. The control group (n=21) received health education and continued with normal activities of daily living. The experimental group (n=21) underwent resistance training, health education, and continued with normal activities of daily living. The resistance exercise program consisted of 3 postural exercises: chest press, dumbbell pullover, and flat-bench dumbbell fly. The subjects received this intervention 3 times/week for 8 weeks. [Results] The baseline characteristics were comparable between the 2 groups. The 6-minute-walk test score, peak expiratory flow, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation, and chest expansions were significantly improved post-intervention in the experimental group and between the 2 groups. [Conclusion] Cardiopulmonary functions in young sedentary subjects were significantly improved with the 8-week resistance exercise program. PMID:26957760

  6. 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; Seferović, 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

  7. 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.

  8. Vitamin D is associated with cardiopulmonary exercise capacity: results of two independent cohorts of healthy adults.

    PubMed

    Kaul, A; Gläser, S; Hannemann, A; Schäper, C; Nauck, M; Felix, S B; Bollmann, T; Ewert, R; Friedrich, N

    2016-02-01

    Vitamin D has an important role in calcium homeostasis and is known to have various health-promoting effects. Moreover, potential interactions between vitamin D and physical activity have been suggested. This study aims to investigate the relationship between 25-hydroxyvitamin D (25(OH)D) and exercise capacity quantified by cardiopulmonary exercise testing (CPET). For this, 1377 participants from the Study of Health in Pomerania (SHIP-1) and 750 participants from the independent SHIP-TREND cohort were investigated. Standardised incremental exercise tests on a cycle ergometer were performed to assess exercise capacity by VO2 at anaerobic threshold, peakVO2, O2 pulse and peak power output. Serum 25(OH)D levels were measured by an automated chemiluminescence immunoassay. In SHIP-1, 25(OH)D levels were positively associated with all considered parameters of cardiopulmonary exercise capacity. Subjects with high 25(OH)D levels (4th quartile) showed an up to 25 % higher exercise capacity compared with subjects with low 25(OH)D levels (1st quartile). All associations were replicated in the independent SHIP-TREND cohort and were independent of age, sex, season and other interfering factors. In conclusion, significant positive associations between 25(OH)D and parameters of CPET were detected in two large cohorts of healthy adults. PMID:26620039

  9. Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine.

    PubMed

    Swaine, I L; Hunter, A M; Carlton, K J; Wiles, J D; Coleman, D

    2010-12-01

    The purpose of this study was to determine the reproducibility of limb power outputs and cardiopulmonary responses, to incremental whole-body exercise using a novel swimming training machine. 8 swimmers with a mean age of 23.7 ± 4.6 (yrs), stature 1.77 ± 0.13 (m) and body mass of 74.7 ± 2.8 (kg) gave informed consent and participated in repeat exercise testing on the machine. All subjects performed 2 incremental exercise tests to exhaustion using front crawl movements. From these tests peak oxygen consumption (VO(₂peak)), peak heart rate (HR(peak)), peak power output (W (peak)) and individual limb power outputs were determined. Results showed there were no significant differences between test 1 and 2 for any variable at exhaustion, and the CV% ranged from 2.8 to 3.4%. The pooled mean values were; VO(₂peak) 3.7 ± 0.65 L.min⁻¹, HR (peak) 178.7 ± 6.6 b.min⁻¹ and W (peak) 349.7 ± 16.5 W. The mean contributions to the total power output from the legs and arms were (37.3 ± 4.1% and 62.7 ± 5.1% respectively). These results show that it is possible to measure individual limb power outputs and cardiopulmonary parameters reproducibly during whole-body exercise using this training machine, at a range of exercise intensities. PMID:20936591

  10. Incremental and independent value of cardiopulmonary exercise test measures and the Seattle Heart Failure Model for prediction of risk in patients with heart failure

    PubMed Central

    Dardas, Todd; Li, Yanhong; Reed, Shelby D.; O’Connor, Christopher M.; Whellan, David J.; Ellis, Stephen J.; Schulman, Kevin A.; Kraus, William E.; Forman, Daniel E.; Levy, Wayne C.

    2016-01-01

    Background Multivariable risk scores and exercise measures are well-validated risk prediction methods. Combining information from a functional evaluation and a risk model may improve accuracy of risk predictions. We analyzed whether adding exercise measures to the Seattle Heart Failure Model (SHFM) improves risk prediction accuracy in systolic heart failure. Methods and Results We used a sample of patients from the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing (HF-ACTION) study to examine the addition of peak VO2, VE/VCO2 slope, 6-minute walk distance (6MWD) or exercise duration (CPXDUR) to the SHFM. Multivariable Cox proportional hazards models were used to test the association between the combined endpoint (death, LVAD or cardiac transplantation) and the addition of exercise variables to the SHFM. 2152 patients were included in the sample. The SHFM and all exercise measures were associated with events (all p-values<0.0001) in proportional hazards models. There was statistically significant improvement in risk estimation when exercise measures were added to the SHFM. However, the improvement in c-index for addition of peak VO2 (+0.01), VE/VCO2 (+0.02), 6MWD (−0.001) and CPXDUR (+0.001) to the SHFM was small or slightly worse than the SHFM alone. Changes in risk assignment with the addition of exercise variables were minimal for patients above or below a15% 1-year mortality. Conclusions Exercise performance measures and the SHFM are independently useful for predicting risk in systolic heart failure. Adding CPET measures and 6MWD to the SHFM offers only minimal improvement in risk reassignment at clinically meaningful cutpoints. PMID:25940075

  11. Are maximal inspiratory breathing exercises or incentive spirometry better than early mobilization after cardiopulmonary bypass?

    PubMed

    Dull, J L; Dull, W L

    1983-05-01

    Forty-nine adults who had undergone cardiopulmonary bypass surgery were randomly assigned to one of three exercise programs to determine if either maximal inspiratory breathing exercises or incentive spirometry offered a therapeutic advantage over early mobilization alone. After extubation, the patients started their assigned exercise programs. A physical examination and pulmonary function tests were performed preoperatively, at the start of the exercise program, and 24 and 48 hours after the start of the program. The results showed a significant decrease (approximately 50%) in lung volumes but no airflow obstruction in patients who had coronary artery bypass graft. In those patients who had valve replacement, lung volumes fell, and in addition, mild airflow obstruction occurred. A majority of patients had postoperative pulmonary complications. There were no significant differences among the exercise programs in improving lung volumes and airflow or in preventing postoperative complications. We conclude that maximal inspiratory breathing exercises or incentive spirometry, when used in addition to early mobilization, offers no therapeutic advantage over early mobilization alone after cardiopulmonary bypass surgery. PMID:6844410

  12. Reproducibility of cardiac power output and other cardiopulmonary exercise indices in patients with chronic heart failure.

    PubMed

    Jakovljevic, Djordje G; Seferovic, Petar M; Nunan, David; Donovan, Gay; Trenell, Michael I; Grocott-Mason, Richard; Brodie, David A

    2012-02-01

    Cardiac power output is a direct measure of overall cardiac function that integrates both flow- and pressure-generating capacities of the heart. The present study assessed the reproducibility of cardiac power output and other more commonly reported cardiopulmonary exercise variables in patients with chronic heart failure. Metabolic, ventilatory and non-invasive (inert gas re-breathing) central haemodynamic measurements were undertaken at rest and near-maximal exercise of the modified Bruce protocol in 19 patients with stable chronic heart failure. The same procedure was repeated 7 days later to assess reproducibility. Cardiac power output was calculated as the product of cardiac output and mean arterial pressure. Resting central haemodynamic variables demonstrate low CV (coefficient of variation) (ranging from 3.4% for cardiac output and 5.6% for heart rate). The CV for resting metabolic and ventilatory measurements ranged from 8.2% for respiratory exchange ratio and 14.2% for absolute values of oxygen consumption. The CV of anaerobic threshold, peak oxygen consumption, carbon dioxide production and respiratory exchange ratio ranged from 3.8% (for anaerobic threshold) to 6.4% (for relative peak oxygen consumption), with minute ventilation having a CV of 11.1%. Near-maximal exercise cardiac power output and cardiac output had CVs of 4.1 and 2.2%, respectively. Cardiac power output demonstrates good reproducibility suggesting that there is no need for performing more than one cardiopulmonary exercise test. As a direct measure of cardiac function (dysfunction) and an excellent prognostic marker, it is strongly advised in the assessment of patients with chronic heart failure undergoing cardiopulmonary exercise testing. PMID:21883095

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

    NASA Technical Reports Server (NTRS)

    Moore, Alan D.

    2011-01-01

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

  14. Exercise Testing: Who, When, and Why?

    PubMed

    Nelson, Nicole; Asplund, Chad A

    2016-03-01

    There are different modalities of exercise testing that can provide valuable information to physicians about patient and athlete fitness and cardiopulmonary status. Cardiopulmonary exercise testing (CPX) is a form of exercise testing that measures ventilatory and gas exchange, heart rate, electrocardiogram, and blood pressures to provide detailed information on the cardiovascular, pulmonary, and muscular systems. This testing allows an accurate quantification of functional capacity/measure of exercise tolerance, diagnosis of cardiopulmonary disease, disease-progression monitoring or response to intervention, and the prescription of exercise and training. CPX directly measures inhaled and exhaled ventilator gases to determine the maximal oxygen uptake, which reflects the body's maximal use of oxygen and defines the limits of the cardiopulmonary system. CPX is the ideal modality to evaluate causes of exertional fatigue and dyspnea, especially in complex cases in which the etiology could be cardiac, pulmonary, or deconditioning. Exercise tolerance has become an important outcome measure in patients with chronic obstructive pulmonary disease and congestive heart failure, as well as other chronic diseases, and is a well-recognized predictor of mortality. Older athletes or those with underlying medical conditions could benefit from exercise testing for risk stratification and clearance to participate, as well as to help set their training zones and determine their functional limitations. PMID:26972264

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

    PubMed

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

    2015-03-01

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

  16. Interaction of the carotid baroreflex, the muscle chemoreflex and the cardiopulmonary baroreflex in man during exercise

    NASA Technical Reports Server (NTRS)

    Eiken, O.; Convertino, V. A.; Doerr, D. F.; Dudley, G. A.; Morariu, G.; Mekjavic, I. B.

    1991-01-01

    The interaction of the muscle chemoreflex and the cardiopulmonary baroreflex with the carotid baroreflex in humans performing exercise was investigated in healthy subjects using specially designed exercise regimen and apparatus. Stimulation of the muscle chemoreflex was achieved by restricting blood flow in the exercising muscles by means of applying a pressure of 50 mm Hg, whereas cardiopulmonary baroreceptors were unloaded by employing LBNP of -20 mm Hg. The carotid baroreceptors were unloaded and stimulated by neck-pressure maneuvers (Sprenkle et al., 1986). Results showed that the cardiodecelerating capacity of the carotid baroreflex remains active during exercise, and may even be sensitized by the chemoreflex-induced increase in arterial pressure; but it is not affected by the cardiopulmonary baroreceptor activity.

  17. The effects of cigarette smoking on cardiopulmonary function and exercise tolerance in teenagers.

    PubMed

    Louie, D

    2001-01-01

    Teenagers who smoke are frequently warned that cigarette smoking will have detrimental effects on the function of their cardiopulmonary system and on their ability to perform exercise. However, there is little published evidence to support this statement. Therefore, in the present study, peak expiratory flow was measured as an indicator of lung function, expired carbon monoxide level was measured as an indicator of current smoking and the associated reduction in the oxygen carrying capacity of the blood, and blood pressure and heart rate were measured as indicators of cardiovascular hemodynamics before and after a one-mile run in 27 teenagers. The results show that, even at a young age, cigarette smoking is associated with significant detrimental effects on cardiopulmonary function and exercise tolerance. Objective evidence of an effect of smoking on cardiopulmonary function and exercise tolerance in this age group may assist educators and health care professionals in convincing teenagers to quit smoking. PMID:11565515

  18. Cardiopulmonary Function, Exercise Capacity, and Echocardiography Finding of Pediatric Patients With Kawasaki Disease

    PubMed Central

    Tuan, Sheng-Hui; Li, Min-Hui; Hsu, Miao-Ju; Tsai, Yun-Jeng; Chen, Yin-Han; Liao, Tin-Yun; Lin, Ko-Long

    2016-01-01

    Abstract Coronary artery (CA) abnormalities influence exercise capacity (EC) of patients with Kawasaki disease (KD), and Z-score of CA is a well established method for detecting CA aneurysm. We studied the influence of KD on cardiopulmonary function and EC; meanwhile we analyzed echocardiographic findings of KD patients. We also assessed the correlation between CA Z-score and EC of KD patients to see if CA Z-score of KD patients could reflect EC during exercise. Sixty-three KD patients were recruited as KD group 1 from children (aged 5–18 y) who received transthoracic echocardiographic examinations and symptom-limited treadmill exercise test for regular follow-up of KD from January 2010 to October 2014 in 1 medical center. We then divided KD group 1 into KD group 2 (<5 y, n = 12) and KD group 3 (≥5 y, n = 51) according to time interval between KD onset to when patients received test. Control groups were matched by age, sex, and body mass index. Max-Z of CA was defined as the maximal Z-score of the proximal LCA or RCA by Dalliarre equation or Fuse calculator. All routine parameters measured during standard exercise test were similar between KD and control groups, except that peak rate pressure products (PRPPs) in KD group 1 to 3 were all lower than corresponding control groups significantly (P = 0.010, 0.020, and 0.049, respectively). PRPPs correlated with Max-Z of CA by both equations modest inversely (by Dallaire, P = 0.017, Spearman rho = −0.301; by Fuse, P = 0.014, Spearman rho = −0.309). Our study recruited larger number of KD patients and provided a newer data of EC of KD patients. Our finding suggests that after acute stage of KD, patients could maintain normal cardiorespiratory fitness. Therefore, we believe that it is important to promote cardiovascular health to KD patients and KD patients should exercise as normal peers. However, since KD patients might still have compromised coronary perfusion during exercise, it remains crucial to assess and monitor cardiovascular risk of KD patients. Max-Z of CA correlates with PRPP modest inversely and might be used as a follow-up indicator of CA reserve during exercise after acute stage of KD. PMID:26765431

  19. Cardiopulmonary Function, Exercise Capacity, and Echocardiography Finding of Pediatric Patients With Kawasaki Disease: An Observational Study.

    PubMed

    Tuan, Sheng-Hui; Li, Min-Hui; Hsu, Miao-Ju; Tsai, Yun-Jeng; Chen, Yin-Han; Liao, Tin-Yun; Lin, Ko-Long

    2016-01-01

    Coronary artery (CA) abnormalities influence exercise capacity (EC) of patients with Kawasaki disease (KD), and Z-score of CA is a well established method for detecting CA aneurysm. We studied the influence of KD on cardiopulmonary function and EC; meanwhile we analyzed echocardiographic findings of KD patients. We also assessed the correlation between CA Z-score and EC of KD patients to see if CA Z-score of KD patients could reflect EC during exercise.Sixty-three KD patients were recruited as KD group 1 from children (aged 5-18 y) who received transthoracic echocardiographic examinations and symptom-limited treadmill exercise test for regular follow-up of KD from January 2010 to October 2014 in 1 medical center. We then divided KD group 1 into KD group 2 (<5 y, n = 12) and KD group 3 (≥5 y, n = 51) according to time interval between KD onset to when patients received test. Control groups were matched by age, sex, and body mass index. Max-Z of CA was defined as the maximal Z-score of the proximal LCA or RCA by Dalliarre equation or Fuse calculator.All routine parameters measured during standard exercise test were similar between KD and control groups, except that peak rate pressure products (PRPPs) in KD group 1 to 3 were all lower than corresponding control groups significantly (P = 0.010, 0.020, and 0.049, respectively). PRPPs correlated with Max-Z of CA by both equations modest inversely (by Dallaire, P = 0.017, Spearman rho = -0.301; by Fuse, P = 0.014, Spearman rho = -0.309).Our study recruited larger number of KD patients and provided a newer data of EC of KD patients. Our finding suggests that after acute stage of KD, patients could maintain normal cardiorespiratory fitness. Therefore, we believe that it is important to promote cardiovascular health to KD patients and KD patients should exercise as normal peers. However, since KD patients might still have compromised coronary perfusion during exercise, it remains crucial to assess and monitor cardiovascular risk of KD patients. Max-Z of CA correlates with PRPP modest inversely and might be used as a follow-up indicator of CA reserve during exercise after acute stage of KD. PMID:26765431

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  2. Cardiopulmonary stress testing in children and adults with congenital heart disease.

    PubMed

    Miliaresis, Christa; Beker, Susan; Gewitz, Michael

    2014-01-01

    Cardiopulmonary exercise stress testing (CPET) is a vital tool used to assess patients with a history of congenital heart disease. There are several tests in the cardiologist's armamentarium that allow for assessment of cardiac anatomy and function. The majority of these tests are only performed with the body at rest and some even require sedation. Exercise stress testing is unique in allowing assessment of the hemodynamic status of a patient in motion. In addition to providing all the information obtained during an exercise stress test, such as heart rate, rhythm, ST-segment analysis, and blood pressure, the CPET provides critical metabolic information. Parameters such as VO2, oxygen pulse, and VE/VCO2 slope help to detail the patient's physiology in a dynamic state. Decisions can then be better made regarding follow-up plans, acceptable exercise recommendations, and future interventions, if necessary. It allows insight into the patient's exercise capacity and quality of life. Norms for both children and adults with many forms of congenital heart disease are now available allowing appropriate comparisons to be made. This review will discuss in detail the CPET and its application in congenital heart disease. PMID:25162333

  3. 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 < 0.01; M vs MEx p < 0.01; MEx vs Ex p = ns). SF-36 highlighted a significant increase in general QoL index in the MEx (58.3 ± 19 vs 77.3 ± 16; p < 0.01) and Ex (62.1 ± 17 vs 73.7 ± 12; p < 0.005) groups. Conclusions We evidenced that 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

  4. Exercise training improves cardiopulmonary and endothelial function in women with breast cancer: findings from the Diana-5 dietary intervention study.

    PubMed

    Giallauria, Francesco; Vitelli, Alessandra; Maresca, Luigi; Santucci De Magistris, Maria; Chiodini, Paolo; Mattiello, Amalia; Gentile, Marco; Mancini, Maria; Grieco, Alessandra; Russo, Angelo; Lucci, Rosa; Torella, Giorgio; Berrino, Franco; Panico, Salvatore; Vigorito, Carlo

    2016-03-01

    To investigate whether exercise training (ET) improves cardiopulmonary and endothelial function in women with breast cancer (BC). Fifty-one female patients (aged between 39 and 72 years) with a history of primary invasive BC within the previous 5 years and enrolled in the Mediterranean diet-based DIANA (diet and androgens)-5 Trial were subdivided into 2 groups: an ET group (n = 25) followed a formal ET program of moderate intensity (3 session/week on a bicycle at 60-70 % VO2peak for 3 months, followed by one session/week until 1-year follow-up), while a control group (n = 26) did not perform any formal ET. At baseline and at 1-year follow-up, all patients underwent cardiopulmonary exercise stress test (CPET) and measurements of vascular endothelial function by peripheral artery tonometry (Reactive Hyperemia Index, RHI). There were no significant differences between the groups in baseline anthropometrical, BC characteristics, and metabolic profile. No differences in baseline CPET and RHI parameters were found. Peak oxygen consumption (VO2peak) significantly increased in ET group (from 12.4 ± 2.9 to 14.3 ± 3.3 mL/kg/min, p < 0.001) compared to the control group (from 12.8 ± 2.5 to 12.6 ± 2.8 mL/kg/min, p = 0.55; p < 0.001 between groups). Compared to the control group (from 2.0 ± 0.4 to 1.9 ± 0.4, p = 0.62), the ET group showed a significant improvement of RHI after 1 year (from 2.1 ± 0.7 to 2.5 ± 0.8, p < 0.001). Changes in VO2peak were correlated with changes in RHI (ΔVO2peak vs. ΔRHI: r = 0.47, p = 0.017). In BC survivors, ET program improves cardiopulmonary functional capacity and vascular endothelial function after 12 months. Whether these changes may favorably modulate some of the pathophysiological mechanisms implied in cancer evolution should be investigated. PMID:26016834

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

  6. Sample Proficiency Test exercise

    SciTech Connect

    Alcaraz, A; Gregg, H; Koester, C

    2006-02-05

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

  7. 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

  8. Heparin sensitivity test for patients requiring cardiopulmonary bypass.

    PubMed

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

    2006-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  10. 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.

  11. Exercise-induced cardiopulmonary arrest in a child with aortic stenosis.

    PubMed

    Saiki, Hirofumi; Sugimoto, Masaya; Senzaki, Hideaki

    2016-06-01

    The beneficial effect of exercise restriction in preventing sudden cardiac death in children with aortic stenosis remains unclear. We report the case of a 15-year-old boy with congenital aortic stenosis who was resuscitated after sudden cardiac arrest during exercise. The case led to the new concept that exercise restriction may prevent not only unpredictable ventricular ischaemic events and associated arrhythmias but also progressive ventricular hypertrophy. PMID:27161031

  12. Exercise stress test

    MedlinePlus

    ... must not eat, smoke, or drink beverages containing caffeine or alcohol for 3 hours (or more) before ... most cases, you will be asked to avoid caffeine for 24 hours before the test. This includes: ...

  13. 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

  14. 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…

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

    PubMed Central

    Fisher-Wellman, Kelsey; Bell, Heather K

    2009-01-01

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

  16. [Preflight assessment by hypoxic inhalation test in cardiopulmonary patients].

    PubMed

    Lebzelter, J; Fink, G; Kleinman, E; Rosenberg, I; Kramer, M R

    2000-04-16

    Flying may expose passengers to hypoxic conditions, which may induce hypoxemia, particularly in those with chronic heart and/or lung disease. Onset of dyspnea, wheezing, chest pain, cyanosis and right heart failure can lead to urgent need for oxygen during flight. The hypoxia inhalation test (HIT) provides a safe and simple means of identifying those who may develop hypoxemia during flight. We report our experience with 48 self-reporting patients who underwent HIT prior to pre-planned air travel. They inhaled for 15-minute periods a reduced oxygen concentration (F1O2 15%) under normobaric conditions, during which O2 saturation was monitored by pulse oximeter; electrocardiogram, blood pressure and symptoms were also monitored. O2 saturation of < 85% (PaO2 50 mm Hg) was considered a positive test. In the 8 cases (17%) with a positive test, 5 had chronic obstructive pulmonary disease and 3 had cardiovascular and/or combined heart-lung disease. We calculated predicted O2 partial pressure in altitude (PaO2ALT) and compared it to actual results in the 8 patients with a positive HIT. In 5, use of the predicted formula would have under-diagnosed the hypoxemia that developed during the HIT. Thus, the results of the HIT changed treatment strategy in these patients. We recommend that patients with positive tests use O2 (2LPM or 4LPM) during flight. HIT is practical and of potential benefit in the objective assessment of patients with various degrees of heart, lung or combined heart-lung disease. Clinicians should be aware of the relative risk of hypoxia during flight in such patients, and of the value of HIT in identifying them, leading to increase in its use. PMID:10883202

  17. Exercise Testing In Health and Disease

    PubMed Central

    Sutton, John R.; Jones, Norman L.

    1974-01-01

    This article outlines areas where exercise testing may be helpful to the clinician, and describes how the various tests can be used to quantify simple cardiac and pulmonary responses to exercise. Exercise testing is also discussed as a diagnostic tool in areas such as ischemic heart disease or asthma. PMID:20469057

  18. In vitro characterization and performance testing of the ension pediatric cardiopulmonary assist system.

    PubMed

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

    2009-01-01

    In the last 40 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. extracorporeal membrane oxygenation inflow cannula and an 8-Fr. extracorporeal membrane oxygenation outflow cannula. Revision 4 of the device provided a flow rate of 0.42 L/min at 6,500 RPM. Revision 5, featuring improved impeller and diffuser designs, provided a flow rate of 0.57 L/min at 5,000 RPM. The performance tests indicate that for this cannulae combination, the pCAS pump is capable of delivering sufficient flows for patients <5 kg. PMID:19293710

  19. [Exercise testing and blood pressure].

    PubMed

    Brenner, R; Allemann, Y

    2011-08-24

    Cardiac monitoring with ECG and blood pressure recording is routinely performed during a stress test and blood pressure response is an important part of its interpretation. Unfortunately, the latter is not straightforward, partly because of the inconsistent definition of a pathologic blood pressure response, the different populations included in the studies and divergent test modalities. An exaggerated blood pressure response in normotensive subjects without coronary heart disease is associated with an increased risk of future arterial hypertension, whereas in patients with known or suspected coronary heart disease, prognosis is not worse than in patients with normal blood pressure response. By contrast, exercise induced hypotension, particularly in patients with coronary artery disease indicates an increased risk for cardiac events and should be investigated further, usually by performing coronary angiography. PMID:21863574

  20. Non-invasive cardiac index monitoring during cardiopulmonary functional testing provides additional prognostic value in patients after acute heart failure.

    PubMed

    Lee, Ming-Feng; Chen, Wei-Siang; Fu, Tieh-Cheng; Liu, Min-Hui; Wang, Jong-Shyan; Hsu, Chih-Chin; Huang, Yu-Yen; Cherng, Wen-Jin; Wang, Chao-Hung

    2012-01-01

    The prognostic value of parameters derived from a cardiopulmonary exercise test (CPET) is well established in patients stabilized after acute heart failure (HF). Under multidisciplinary disease management, this study sought to test whether noninvasive cardiac output (CO) monitoring (NICOM) during the CPET provides additional prognostic value. In total, 131 patients stabilized after acute HF agreed to undergo the CPET with NICOM. Outcome follow-up focused on composite events of death and HF-related rehospitalization. Patients with a peak cardiac index (CI) of ≤ 4.5 L/minute/ m(2) (n = 32), compared to those with a peak CI of > 4.5 L/minute/m(2) (n = 99), had higher incidences of diabetes mellitus (DM) and hypertension, but had lower hemoglobin levels, estimated glomerular filtration rates (eGFR), oxygen uptake efficiency slope (OUES), and peak oxygen uptake (VO(2)). During the 1.2 ± 0.7 years of follow-up, there were 8 (6.1%) deaths, and 16 (12.2%) HF-related rehospitalizations. In a Cox univariable analysis, a lower event-free survival was associated with a history of DM, a higher Ve/VCO(2) slope, lower peak VCO(2) and eGFR, and a peak CI of ≤ 4.5 L/minute/ m(2) (P < 0.05). The Cox multivariable analysis showed that the Ve/VCO(2) slope (hazard ratio (HR) = 1.08, 95% confidence interval (CI): 1.01~1.16, P = 0.02) and peak CI of ≤ 4.5 L/minute/m(2 )(HR = 3.26, 95% CI: 1.18~9.01, P = 0.02) were significant independent predictors. In conclusion, NICOM during the CPET was demonstrated to provide prognostic information in addition to traditional risk factors, biomarkers, and other well-established CPET parameters. PMID:23258137

  1. Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement.

    PubMed

    Puente-Maestu, Luis; Palange, Paolo; Casaburi, Richard; Laveneziana, Pierantonio; Maltais, François; Neder, J Alberto; O'Donnell, Denis E; Onorati, Paolo; Porszasz, Janos; Rabinovich, Roberto; Rossiter, Harry B; Singh, Sally; Troosters, Thierry; Ward, Susan

    2016-02-01

    This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others. PMID:26797036

  2. 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.

  3. Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients

    PubMed Central

    Grosbois, JM; Riquier, C; Chehere, B; Coquart, J; Béhal, H; Bart, F; Wallaert, B; Chenivesse, C

    2016-01-01

    Introduction Exercise tolerance testing is an integral part of the pulmonary rehabilitation (PR) management of patients with chronic obstructive pulmonary disease (COPD). The 6-minute stepper test (6MST) is a new, well-tolerated, reproducible exercise test, which can be performed without any spatial constraints. Objective The aim of this study was to compare the results of the 6MST to those obtained during a 6-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET) in a cohort of COPD patients. Methods Ninety-one COPD patients managed by outpatient PR and assessed by 6MST, 6MWT, and CPET were retrospectively included in this study. Correlations between the number of steps on the 6MST, the distance covered on the 6MWT, oxygen consumption, and power at the ventilatory threshold and at maximum effort during CPET were analyzed before starting PR, and the improvement on the 6MST and 6MWT was compared after PR. Results The number of steps on the 6MST was significantly correlated with the distance covered on the 6MWT (r=0.56; P<0.0001), the power at maximum effort (r=0.46; P<0.0001), and oxygen consumption at maximum effort (r=0.39; P<0.005). Performances on the 6MST and 6MWT were significantly improved after PR (570 vs 488 steps, P=0.001 and 448 vs 406 m, respectively; P<0.0001). Improvements of the 6MST and 6MWT after PR were significantly correlated (r=0.34; P=0.03). Conclusion The results of this study show that the 6MST is a valid test to evaluate exercise tolerance in COPD patients. The use of this test in clinical practice appears to be particularly relevant for the assessment of patients managed by home PR. PMID:27099483

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2011-05-01

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

  6. 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.

  7. 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

  8. Translation of exercise testing to exercise prescription using the talk test.

    PubMed

    Jeanes, Elizabeth M; Jeans, Elizabeth A; Foster, Carl; Porcari, John P; Gibson, Mark; Doberstein, Scott

    2011-03-01

    Traditionally defined in terms of %maximal heart rate (%HRmax) or %maximal metabolic equivalents, the process of exercise prescription is still difficult and individually imprecise. An alternative, and simpler, method is to define exercise intensity in terms of the Talk Test, which may be a surrogate for ventilatory threshold and more consistent with contemporary recommendations for index training intensity in well-trained and athletic individuals. This study was designed to determine how much of a reduction in the absolute exercise intensity from those observed during incremental exercise testing was necessary to allow for comfortable speech during exercise training. Fourteen well-trained (5-7 h·wk(-1)) individuals performed 2 incremental exercise tests (to evaluate reproducibility) and 3 steady-state training bouts (40 minutes), based on the stage before the last positive (LP) stage of the Talk Test (LP-1), the LP stage, and the equivocal (EQ) stage. The LP-1 and LP runs resulted in %HRmax and rating of perceived exertion (RPE) values within the recommended range for exercise training, the EQ run in an unacceptably high %HRmax and RPE. Most subjects could still speak comfortably during the LP-1 and LP stages, and no subject could speak comfortably during the EQ stage. The HR (r = 0.84), RPE (r = 0.81), and Talk Test (r = 0.71) responses during paired incremental tests were well correlated. The results of this test suggest that the absolute exercise intensity during the LP-1 and LP stages of incremental exercise tests with the Talk Test may produce steady-state exercise responses appropriate for training in well-trained and athletic individuals and that the reproducibility of the Talk Test is satisfactory. PMID:21311346

  9. 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

  10. [Cardiopulmonary Comorbidities].

    PubMed

    Seiler, Frederik; von Hardenberg, Albrecht; Böhm, Michael; Bals, Robert; Maack, Christoph

    2016-02-01

    Cardiac and pulmonary diseases are primary causes of global morbidity and mortality. Since the prevalence of both cardiac and pulmonary diseases increases with age, cardiopulmonary comorbidities inflict especially the elderly. Due to the tight physiological connection of the heart and the lung, diseases of both organs affect each other beyond a mere coincidence. At the same time, due to the similarity of their respective symptoms, their differentiation is challenging in clinical practice and therefore, comorbidities can be easily overlooked. This article provides an overview on the characteristics of cardiopulmonary comorbidities and their specific-, but also mutual pathophysiology. PMID:26886042

  11. Heart Rate Recovery Is Impaired After Maximal Exercise Testing in Children with Sickle Cell Anemia

    PubMed Central

    Alvarado, Anthony M.; Ward, Kendra M.; Muntz, Devin S.; Thompson, Alexis A.; Rodeghier, Mark; Fernhall, Bo; Liem, Robert I.

    2014-01-01

    Objective To examine heart rate recovery (HRR) as an indicator of autonomic nervous system (ANS) dysfunction following maximal exercise testing in children and young adults with sickle cell anemia (SCA). Study design Recovery phase heart rate (HR) in the first 5 minutes following maximal exercise testing in 60 subjects with SCA and 30 matched controls without SCA was assessed. The difference between maximal HR and HR at both 1-minute (ΔHR1min) and 2-minute (ΔHR2min) recovery was our primary outcome. Results Compared with controls, subjects with SCA demonstrated significantly smaller mean ΔHR1min (23 bpm, 95% CI [20, 26] vs. 32 bpm, 95% CI [26, 37], p = 0.006) and ΔHR2min (39 bpm, 95% CI [36, 43] vs. 48 bpm, 95% CI [42, 53], p = 0.011). Subjects with SCA also showed smaller mean changes in HR from peak HR to 1 minute, from 1 minute to 2 minutes and from 2 through 5 minutes of recovery by repeated measures testing. In a multivariable regression model, older age was independently associated with smaller ΔHR1min in subjects with SCA. Cardiopulmonary fitness and hydroxyurea use, however, were not independent predictors of ΔHR1min. Conclusions Children with SCA demonstrate impaired HRR following maximal exercise. Reduced post-exercise HRR in SCA suggests impaired parasympathetic function, which may become progressively worse with age, in this population. PMID:25477159

  12. Utility of a Non-Exercise VO2max Prediction Model for Designing Ramp Test Protocols.

    PubMed

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

    2015-10-01

    This study investigated the validity of determining the final work rates of cycling and walking ramp-incremented maximal cardiopulmonary exercise tests (CPETs) using a non-exercise model to predict maximal oxygen uptake VO2max and the American College of Sports Medicine ACSM's metabolic equations. The validity of using this methodology to elicit the recommended test duration of between 8 and 12 min was then evaluated. First, 83 subjects visited the laboratory once to perform a cycling (n=49) or walking (n=34) CPET to investigate the validity of the methodology. Second, 25 subjects (cycling group: n=13; walking group: n=12) performed a CPET on 2 separate days to test the reliability of CPET outcomes. Observed VO2max was 1.0 ml·kg(-1)·min(-1) lower than predicted in the cycling CPET (P=0.001) and 1.4 ml·kg(-1)·min(-1) lower in the walking CPET (P=0.001). Only one of the 133 conducted CPETs was outside the test duration range of 8-12 min. Test-retest reliability was high for all CPET outcomes, with intraclass correlation coefficients of 0.90 to 0.99. In conclusion, the non-exercise model is a valid and reliable method for establishing the final work rate of cycling and walking CPETs for eliciting test durations of between 8 and 12 min. PMID:26038880

  13. Cardiorespiratory endurance evaluation using heart rate analysis during ski simulator exercise and the Harvard step test in elementary school students.

    PubMed

    Lee, Hyo Taek; Roh, Hyo Lyun; Kim, Yoon Sang

    2016-01-01

    [Purpose] Efficient management using exercise programs with various benefits should be provided by educational institutions for children in their growth phase. We analyzed the heart rates of children during ski simulator exercise and the Harvard step test to evaluate the cardiopulmonary endurance by calculating their post-exercise recovery rate. [Subjects and Methods] The subjects (n = 77) were categorized into a normal weight and an overweight/obesity group by body mass index. They performed each exercise for 3 minutes. The cardiorespiratory endurance was calculated using the Physical Efficiency Index formula. [Results] The ski simulator and Harvard step test showed that there was a significant difference in the heart rates of the 2 body mass index-based groups at each minute. The normal weight and the ski-simulator group had higher Physical Efficiency Index levels. [Conclusion] This study showed that a simulator exercise can produce a cumulative load even when performed at low intensity, and can be effectively utilized as exercise equipment since it resulted in higher Physical Efficiency Index levels than the Harvard step test. If schools can increase sport durability by stimulating students' interests, the ski simulator exercise can be used in programs designed to improve and strengthen students' physical fitness. PMID:27065556

  14. Cardiorespiratory endurance evaluation using heart rate analysis during ski simulator exercise and the Harvard step test in elementary school students

    PubMed Central

    Lee, Hyo Taek; Roh, Hyo Lyun; Kim, Yoon Sang

    2016-01-01

    [Purpose] Efficient management using exercise programs with various benefits should be provided by educational institutions for children in their growth phase. We analyzed the heart rates of children during ski simulator exercise and the Harvard step test to evaluate the cardiopulmonary endurance by calculating their post-exercise recovery rate. [Subjects and Methods] The subjects (n = 77) were categorized into a normal weight and an overweight/obesity group by body mass index. They performed each exercise for 3 minutes. The cardiorespiratory endurance was calculated using the Physical Efficiency Index formula. [Results] The ski simulator and Harvard step test showed that there was a significant difference in the heart rates of the 2 body mass index-based groups at each minute. The normal weight and the ski-simulator group had higher Physical Efficiency Index levels. [Conclusion] This study showed that a simulator exercise can produce a cumulative load even when performed at low intensity, and can be effectively utilized as exercise equipment since it resulted in higher Physical Efficiency Index levels than the Harvard step test. If schools can increase sport durability by stimulating students’ interests, the ski simulator exercise can be used in programs designed to improve and strengthen students’ physical fitness. PMID:27065556

  15. 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)

  16. Diagnostic value of exercise testing in asbestosis

    SciTech Connect

    Zejda, J. )

    1989-01-01

    The diagnostic value of simple exercise testing was examined in 81 current male asbestos-cement workers, divided into four groups according to the International Labour Office (ILO) category of irregular opacities: 0/0, 25; 1/1, 24; 1/2, 22; and 2/2, 10 men. An increasing X-ray score was accompanied by more severe functional abnormality in keeping with the development of a restrictive defect. Symptom-limited oxygen uptake (VO2SL) did not depend on the X-ray grade and was 76.7, 71.9, 68.7, and 73.5% pv, respectively, for the four groups. Subjects with ILO score 1/1 had significantly higher exercise ventilation at O2 uptake of 1.01.min-1 (VE 1.0) than those with grade 0/0. End-exercise tidal volume (VTSL in 1) decreased with an increasing X-ray score: 2.14, 1.98, 1.85, and 1.62, respectively. VTSL standardized for vital capacity (VTSL/VC) followed the same pattern. Asbestosis was diagnosed in 25 men, in whom VE 1.0 was significantly higher (p less than .02) and VTSL lower (p less than .01) than in the 0/0 group. VO2SL was similar in both groups. The findings suggest that VE 1.0 and VTSL may be early functional indicators of asbestos-related interstitial lung fibrosis. The measurement of both exercise indices may increase the certainty of clinical diagnosis of asbestosis in subjects with less advanced disease.

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

    PubMed

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

    2015-11-01

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

  18. Apical ballooning syndrome following exercise treadmill testing

    PubMed Central

    Irwin, RB; Mamas, MA; El-Omar, M

    2011-01-01

    Transient left ventricular apical ballooning syndrome is an increasingly recognized cause of acute coronary syndrome, particularly in postmenopausal women, and is the subject of increasing interest to both clinicians and researchers. Emotional and physical stressors are often implicated in its development and, while excess sympathetic drive appears to act as a primary trigger, the exact mechanism remains controversial. The clinical presentation is characterized by transient, often severe, left ventricular dysfunction affecting the mid and apical myocardium. By definition, no significant coronary artery lesions are present, although this may not be recognized at initial presentation. While recovery of function with evidence of limited myocardial necrosis is common, significant complications may manifest in the acute phase. A case involving an elderly patient who developed classical features of the syndrome following an exercise treadmill test is presented. To the authors’ knowledge, the present case is the only such report that meets the recently proposed diagnostic criteria. The present case serves to highlight a rare but important complication of exercise testing in an elderly patient. Recent large systematic reviews have provided valuable insights into the clinical features of this condition. The current article examines the data from these studies and others to provide a comprehensive clinical overview. PMID:21747667

  19. Translation of submaximal exercise test responses to exercise prescription using the Talk Test.

    PubMed

    Foster, Carl; Porcari, John P; Gibson, Mark; Wright, Glenn; Greany, John; Talati, Neepa; Recalde, Pedro

    2009-12-01

    The exercise intensity at the Talk Test (TT) has been shown to be highly correlated with objective physiological markers, a useful outcome marker in patients with heart disease, a useful tool for avoiding exertional ischemia, and responsive to both positive and negative changes in exercise capacity. This randomized observational study evaluated the ability of the intensity at the TT during exercise testing to define absolute training workloads. Sedentary adults (n = 14) performed an incremental Balke type exercise test (3.0-3.5 mph at 0% grade, +2% grade every 2 minutes). Heart rate (HR), rating of perceived exertion (RPE), and TT were evaluated at each stage. Subsequently, the subjects performed 3 x 20-minute exercise bouts with the workload over the last 10 minutes of each bout equal to the absolute intensity at the stage preceding the LP (LP-1), at the last positive stage of the TT (LP), and at the first equivocal stage of the TT (EQ). During LP-1, LP, and EQ, HR was 140 +/- 23, 151 +/- 20, and 160 +/- 21 bpm, or 73 +/- 11, 79 +/- 9, and 82 +/- 9 % HRmax; RPE (CR scale) was 3.6 +/- 1.5, 4.4 +/- 1.8, and 6.3 +/- 2.2. The TT Score-ranked as 1 = comfortable speech, 2 = slightly uncomfortable speech, and 3 = speech not comfortable-was 1.4 +/- 0.5, 1.8 +/- 0.4, and 2.6 +/- 0.5 LP-1, LP, and at EQ, LP, respectively. The results suggest that to prescribe absolute training intensity from the TT and to get appropriate HR, RPE, and TT responses in sedentary individuals during training, the workload needs to be based on the intensity approximately 1 stage (approximately 1.0-1.2 metabolic equivalents) below the LP stage observed during an incremental test. PMID:19972627

  20. Exercise testing in Warmblood sport horses under field conditions.

    PubMed

    Munsters, Carolien C B M; van Iwaarden, Alexandra; van Weeren, René; Sloet van Oldruitenborgh-Oosterbaan, Marianne M

    2014-10-01

    Regular exercise testing in Warmblood sport horses may, as in racing, potentially help to characterise fitness indices in different disciplines and at various competition levels and assist in understanding when a horse is 'fit to compete'. In this review an overview is given of the current state of the art of exercise testing in the Olympic disciplines of eventing, show jumping and dressage, and areas for further development are defined. In event horses, a simple four-step incremental exercise test measuring heart rate (HR), lactate concentration (LA) and velocity (V) is most often used. In dressage and riding horses, a wide variety of exercise tests have been developed, including incremental exercise tests, indoor riding tests and lunging tests. In show jumping, the use of a five-step incremental exercise test and exercise tests evaluating technical skills and fatigue of the horse has been reported. The velocity at a plasma LA of 4 mmol/L (VLA4) and HR recovery during submaximal exercise intensity have been shown to be the best parameters in event horses for predicting performance and impending injuries. In riding horses, the fitness level of horses is also an important determinant of injuries. Implementation of regular exercise testing and monitoring of training sessions may have important added value in the assessment of performance ability and potential future injuries in Warmblood sport horses. However, there is an urgent need to standardise methodologies and outcome parameters in order to make results comparable. PMID:25172838

  1. Electrographic Exercise Stress Testing and Coronary Arteriography

    PubMed Central

    Vieweg, W. V. R.; Alpert, J. S.; Johnson, Allen D.; Hagan, A. D.

    1977-01-01

    The electrocardiographic response to exercise stress testing (EST) was compared with coronary arteriographic findings in 114 men referred for evaluation of chest pain. The men were divided into two groups: group A (69 men) in whom the coronary arteriograms showed at least one major vessel with greater than 70 percent reduction in cross sectional area, and group B (45 men) in whom there was no evidence of coronary arterial narrowing. In both groups A and B the description of chest pain was judged to be at least consistent with the diagnosis of angina pectoris if not always representing classical angina pectoris. Only men with a positive finding to EST and those with a negative EST response after achieving at least 90 percent of predicted maximum heart rate were included in the calculations. Our results were strikingly similar to those obtained from an extensive review of the literature and showed the following: sensitivity, 80.4 percent; specificity, 88.6 percent; predictive value of a positive test result, 91.1 percent; predictive value of a negative test result, 75.6 percent, and efficiency of the test 83.7 percent. The maximal EST is a useful predictor of coronary artery disease when a male population is evaluated for chest pain. When a population is selected on some basis other than chest pain (such as elevated lipids or age), EST is a much less useful predictor of coronary artery disease. PMID:906456

  2. Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine.

    PubMed

    De Wijs-Meijler, Daphne P M; Stam, Kelly; van Duin, Richard W B; Verzijl, Annemarie; Reiss, Irwin K; Duncker, Dirk J; Merkus, Daphne

    2016-01-01

    This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early cardiopulmonary dysfunction is difficult to diagnose, particularly in animal models, as cardiopulmonary function is often measured invasively, requiring anesthesia. As many anesthetic agents are cardiodepressive, subtle changes in cardiovascular function may be masked. In contrast, chronic instrumentation allows for measurement of cardiopulmonary function in the awake state, so that measurements can be obtained under quiet resting conditions, without the effects of anesthesia and acute surgical trauma. Furthermore, when animals are properly trained, measurements can also be obtained during graded treadmill exercise. Flow probes are placed around the aorta or pulmonary artery for measurement of cardiac output and around the left anterior descending coronary artery for measurement of coronary blood flow. Fluid-filled catheters are implanted in the aorta, pulmonary artery, left atrium, left ventricle and right ventricle for pressure measurement and blood sampling. In addition, a 20 G catheter is positioned in the anterior interventricular vein to allow coronary venous blood sampling. After a week of recovery, swine are placed on a motor-driven treadmill, the catheters are connected to pressure and flow meters, and swine are subjected to a five-stage progressive exercise protocol, with each stage lasting 3 min. Hemodynamic signals are continuously recorded and blood samples are taken during the last 30 sec of each exercise stage. The major advantage of studying chronically instrumented animals is that it allows serial assessment of cardiopulmonary function, not only at rest but also during physical stress such as exercise. Moreover, cardiopulmonary function can be assessed repeatedly during disease development and during chronic treatment, thereby increasing statistical power and hence limiting the number of animals required for a study. PMID:26889804

  3. Testing a model of post-stroke exercise behavior.

    PubMed

    Shaughnessy, Marianne; Resnick, Barbara M; Macko, Richard F

    2006-01-01

    Stroke is the leading cause of disability in older Americans, and survivors tend to be sedentary, thereby risking loss of functional gains achieved during rehabilitation and increasing cardiovascular risk. Studies of motivation to exercise in older adults suggest that self-efficacy and outcome expectations are key determinants of initiation and adherence to exercise programs. This study tested a theoretical model of physical activity in stroke survivors. A survey of exercise beliefs and patterns was sent to National Stroke Association stroke support groups. Responses from 312 stroke survivors (mean age 63 years, 57% female, 70% White) indicated that only 31% exercised four times weekly. Self-efficacy and outcome expectations for exercise, before exercise history, and physician recommendation all directly and indirectly influenced self-reported exercise behavior and accounted for 33% of the total variance in exercise behavior. Model testing supported the theory and the model fit the data. Interventions to strengthen self-efficacy and outcome expectations for exercise, along with reminders for clinicians to encourage regular exercise programs, may increase the likelihood of initiating and maintaining an exercise program, potentially improving physical function and cardiovascular fitness in this population. PMID:16422040

  4. Energy system contributions during incremental exercise test.

    PubMed

    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 PointsThe 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

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

    PubMed Central

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

    2013-01-01

    Introduction Exercise variables determined in patients with pulmonary arterial hypertension (PAH) at the time of diagnosis, predict survival. It is unknown whether upon treatment, subsequent changes in these exercise variables reflect improvements in survival. The aim of this study was to determine changes in exercise variables in PAH patients and to relate these changes to survival. Methods Baseline cardiopulmonary exercise test (CPET) variables and six-minute-walk-distance (6MWD) were available from 65 idiopathic PAH patients (50 females; mean age 45±2yrs). The same variables were determined after treatment (13months) in a sub group of 43 patients. To estimate the association between changes in exercise variables and changes in cardiac function, right-ventricle ejection fraction (RVEF) was measured by cardiac MRI at baseline and after treatment in 34 patients. Mean follow-up time after the second CPET was 53 (range: 4-111) months. Kaplan-Meier analysis was used to relate survival to baseline and treatment-associated changes in exercise variables. Results Survivors showed a significantly greater change in maximal oxygen uptake than non-survivors and this change in aerobic capacity was significantly related to changes in RVEF. From baseline until the end of the study period, two patients underwent a lung transplantation and 19 patients died. Survival analysis showed that baseline 6MWD (p<0.0001), maximal heart rate (p<0.0001) and the slope relating ventilation with carbon dioxide production (p≤0.05) were significant predictors of survival, whereas baseline oxygen uptake and oxygen pulse held no predictive value. Treatment associated changes in 6MWD (p<0.01), maximal heart rate (p<0.05), oxygen uptake (p<0.001) and oxygen pulse predicted survival (p<0.05), whereas changes in the slope relating ventilation with carbon dioxide production did not. Conclusion Exercise variables with prognostic significance when determined at baseline, retain their prognostic relevance after treatment. However, when changes in exercise variables upon treatment are considered, a different set of variables provides prognostic information. PMID:24039732

  6. Subclinical cardiopulmonary dysfunction in stage 3 chronic kidney disease

    PubMed Central

    Nelson, Alexander; Otto, James; Whittle, John; Stephens, Robert C M; Martin, Daniel S; Prowle, John R

    2016-01-01

    Objective Reduced exercise capacity is well documented in end-stage chronic kidney disease (CKD), preceded by changes in cardiac morphology in CKD stage 3. However, it is unknown whether subclinical cardiopulmonary dysfunction occurs in CKD stage 3 independently of heart failure. Methods Prospective observational cross-sectional study of exercise capacity assessed by cardiopulmonary exercise testing in 993 preoperative patients. Primary outcome was peak oxygen consumption (VO2peak). Anaerobic threshold (AT), oxygen pulse and exercise-evoked measures of autonomic function were analysed, controlling for CKD stage 3, age, gender, diabetes mellitus and hypertension. Results CKD stage 3 was present in 93/993 (9.97%) patients. Diabetes mellitus (RR 2.49 (95% CI 1.59 to 3.89); p<0.001), and hypertension (RR 3.20 (95% CI 2.04 to 5.03); p<0.001)) were more common in CKD stage 3. Cardiac failure (RR 0.83 (95% CI 0.30 to 2.24); p=0.70) and ischaemic heart disease (RR 1.40 (95% CI 0.97 to 2.02); p=0.09) were not more common in CKD stage 3. Patients with CKD stage 3 had lower predicted VO2peak (mean difference: 6% (95% CI 1% to 11%); p=0.02), lower peak heart rate (mean difference:9 bpm (95% CI 3 to 14); p=0.03)), lower AT (mean difference: 1.1 mL/min/kg (95% CI 0.4 to 1.7); p<0.001) and impaired heart rate recovery (mean difference: 4 bpm (95% CI 1 to 7); p<0.001)). Conclusions Subclinical cardiopulmonary dysfunction in CKD stage 3 is common. This study suggests that maladaptive cardiovascular/autonomic dysfunction may be established in CKD stage 3, preceding pathophysiology reported in end-stage CKD. PMID:27127638

  7. Factors Affecting Exercise Test Performance in Patients After Liver Transplantation

    PubMed Central

    Kotarska, Katarzyna; Wunsch, Ewa; Jodko, Lukasz; Raszeja-Wyszomirska, Joanna; Bania, Izabela; Lawniczak, Malgorzata; Bogdanos, Dimitrios; Kornacewicz-Jach, Zdzislawa; Milkiewicz, Piotr

    2016-01-01

    Background Cardiovascular diseases are a leading cause of morbidity and mortality in solid organ transplant recipients. In addition, low physical activity is a risk factor for cardiac and cerebrovascular complications. Objectives This study examined potential relationships between physical activity, health-related quality of life (HRQoL), risk factors for cardiovascular disease, and an exercise test in liver-graft recipients. Patients and Methods A total of 107 participants (62 men/45 women) who had received a liver transplantation (LT) at least 6 months previously were evaluated. Physical activity was assessed using three different questionnaires, while HRQoL was assessed using the medical outcomes study short form (SF)-36 questionnaire, and health behaviors were evaluated using the health behavior inventory (HBI). The exercise test was performed in a standard manner. Results Seven participants (6.5%) had a positive exercise test, and these individuals were older than those who had a negative exercise test (P = 0.04). A significant association between a negative exercise test and a higher level of physical activity was shown by the Seven-day physical activity recall questionnaire. In addition, HRQoL was improved in various domains of the SF-36 in participants who had a negative exercise test. No correlations between physical activity, the exercise test and healthy behaviors, as assessed via the HBI were observed. Conclusions Exercise test performance was affected by lower quality of life and lower physical activity after LT. With the exception of hypertension, well known factors that affect the risk of coronary artery disease had no effect on the exercise test results.

  8. 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,

  9. 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,…

  10. The cardiokymography exercise test compared to the thallium-201 perfusion exercise test in the diagnosis of coronary artery disease

    SciTech Connect

    Burke, J.F.; Morganroth, J.; Soffer, J.; Panidis, I.; Chen, C.C.; David, D.

    1984-04-01

    To determine the usefulness of exercise cardiokymography (CKG) compared to thallium-201 perfusion scanning in the diagnosis of coronary artery disease (CAD), 179 patients with a mean age of 54 +/- 10 years (73% men) were studied. Previously documented CAD was present in 73 patients (41%); 13 (7%) were asymptomatic and 93 (53%) had chest pain syndrome. Exercise stress testing, CKG, and thallium-201 perfusion scanning were independently correlated with coronary angiographic data. Treadmill exercise stress test alone without CKG had a sensitivity of 68% and specificity of 62%. CKG showed a sensitivity of 76% and a specificity of 90%, and easily interpreted cardiokymograms were obtained in 78% of patients studied. Thallium-201 scans had a sensitivity of 79% and a specificity of 88%. However, when the CKG and treadmill exercise test results were concordant (both positive or both negative), the CKG exercise test had a sensitivity of 87% and specificity of 100%. Thus, when the CKG and exercise test results are concordant, the sensitivity and specificity are equal to or better than thallium-201 perfusion scanning for the prediction of CAD. Since CKG is an inexpensive and noninvasive test, its adjunctive use with routine exercise stress testing may be of great value.

  11. [Chronic obstructive pulmonary disease: evaluation of exercise tolerance using three different exercise tests].

    PubMed

    Montes de Oca, M; Ortega Balza, M; Lezama, J; López, J M

    2001-02-01

    The clinical usefulness of simple exercise tests in patients with chronic obstructive pulmonary disease (COPD) continues to give rise to debate. Questions remain about whether these tests assess maximum effort or only exercise tolerance (submaximal effort). To determine the levels of stress reached during the six-minute walking (6MW) test and stair climbing (SC) test and their relation to maximum aerobic capacity, 50 patients with COPD (FEV1 49 +/- 19%) were studied. Data collected included spirometric variables and VO2, heart rate (HR), ventilatory response and dyspnea during the progressive effort ergometric cycle (PEEC) test. Two 6MW and SC tests were completed on two separate days, with distance, number of steps, HR and dyspnea recorded. HR was higher during the PEEC test. Among the simple tests, SC caused a faster HR than did the 6MW test. Likewise, a significant linear relation was observed between VO2/kgpeak during the 6MW test (r2 = 0.27; p < 0.05) and the SC test (r2 = 0.33; p < 0.01). We therefore conclude that exercise tolerance in patients with COPD can be evaluated using simple stress tests. The SC test is probably the best simple way to determine maximum functional capacity, whereas the 6MW test can be reserved for measurement of exercise tolerance. PMID:11181240

  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. The value test: An exercise in futility

    SciTech Connect

    Cordato, R.E.

    1995-09-01

    This exercise has not been to demonstrate that Patricia Herman`s value test is flawed. Indeed, it appears to be a very diligent attempt to get it right. Even a perfect cost/benefit analysis will be fundamentally flawed because all such analysis is an attempt to do something that conceptually cannot be done. Cost/benefit analysis is a non-operational approach for making determinations about social efficiency. Making assumptions to the contrary and then proceeding does not change this fact; it does not change things to argue that this is the best we can do. If we do proceed with the analysis, any conclusion regarding social efficiency is pure speculation. The point is that the problems with the analysis precludes demonstrating that its the best we can do because there is no way to assess the analysis ex post. In order to determine whether the results of a cost/benefit analysis, ex post, moves us in the direction of enhanced social welfare one would have to understand the direction. To know this, the analyst would have to be able to overcome the problems that we have discussed, and this is a catch 22. This analysis also has broader implications for DSM. Support for DSM is based on the assumption that electricity is being overconsumed, but all of the problems that must be overcome to perform cost/benefit analysis must also be overcome to demonstrate that there is an overconsumption problem. It must be shown that existing restrictions on oil drilling/explorations, energy taxes/regulations, and monopoly/cartel influences are not already compensating for the overconsumption. To understand the extent of any overconsumption problem one must overcome the subjective value problem since interpersonal comparisons of costs and benefits have to be made. Combine these problems with the fact that the passage of time changes results and that the science behind some social cost problems is controversial, and it becomes doubtful that DSM as public policy has any economic justification.

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

    PubMed

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

    2011-01-01

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

  15. Caffeine, performance, and metabolism during repeated Wingate exercise tests.

    PubMed

    Greer, F; McLean, C; Graham, T E

    1998-10-01

    Investigations examining the ergogenic and metabolic influence of caffeine during short-term high-intensity exercise are few in number and have produced inconsistent results. This study examined the effects of caffeine on repeated bouts of high-intensity exercise in recreationally active men. Subjects (n = 9) completed four 30-s Wingate (WG) sprints with 4 min of rest between each exercise bout on two separate occasions. One hour before exercise, either placebo (P1; dextrose) or caffeine (Caf; 6 mg/kg) capsules were ingested. Caf ingestion did not have any effect on power output (peak or average) in the first two WG tests and had a negative effect in the latter two exercise bouts. Plasma epinephrine concentration was significantly increased 60 min after Caf ingestion compared with P1; however, this treatment effect disappeared once exercise began. Caf ingestion had no significant effect on blood lactate, O2 consumption, or aerobic contribution at any time during the protocol. After the second Wingate test, plasma NH3 concentration increased significantly from the previous WG test and was significantly higher in the Caf trial compared with P1. These data demonstrate no ergogenic effect of caffeine on power output during repeated bouts of short-term, intense exercise. Furthermore, there was no indication of increased anaerobic metabolism after Caf ingestion with the exception of an increase in NH3 concentration. PMID:9760347

  16. A prognostic scoring system for arm exercise stress testing

    PubMed Central

    Xie, Yan; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Wan, Leping; Martin, Wade H

    2016-01-01

    Objective Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals. Methods In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64.1 (11.1) years. (mean (SD)) between 1997 and 2002. From multivariate Cox models, arm exercise scores were developed for prediction of 5-year and 12-year all-cause and cardiovascular mortality and 5-year cardiovascular mortality or myocardial infarction (MI). Results Arm exercise capacity in resting metabolic equivalents (METs), 1 min heart rate recovery (HRR) and ST segment depression ≥1 mm were the stress test variables independently associated with all-cause and cardiovascular mortality by step-wise Cox analysis (all p<0.01). A score based on the relation HRR (bpm)+7.3×METs−10.5×ST depression (0=no; 1=yes) prognosticated 5-year cardiovascular mortality with a C-statistic of 0.81 before and 0.88 after adjustment for significant demographic and clinical covariates. Arm exercise scores for the other outcome end points yielded C-statistic values of 0.77–0.79 before and 0.82–0.86 after adjustment for significant covariates versus 0.64–0.72 for best fit pharmacological myocardial perfusion imaging models in a cohort of 1730 veterans who were evaluated over the same time period. Conclusions Arm exercise scores, analogous to the Duke Treadmill Score, have good power for prediction of mortality or MI in patients who cannot perform leg exercise. PMID:26835142

  17. 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)/VCO₂slope and the lowest V(E)/VCO₂value, 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

  18. Exercise testing and hemodynamic performance in healthy elderly persons

    SciTech Connect

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

    1984-11-01

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

  19. Predicted maximal heart rate for upper body exercise testing.

    PubMed

    Hill, M; Talbot, C; Price, M

    2016-03-01

    Age-predicted maximal heart rate (HRMAX ) equations are commonly used for the purpose of prescribing exercise regimens, as criteria for achieving maximal exertion and for diagnostic exercise testing. Despite the growing popularity of upper body exercise in both healthy and clinical settings, no recommendations are available for exercise modes using the smaller upper body muscle mass. The purpose of this study was to determine how well commonly used age-adjusted prediction equations for HRMAX estimate actual HRMAX for upper body exercise in healthy young and older adults. A total of 30 young (age: 20 ± 2 years, height: 171·9 ± 32·8 cm, mass: 77·7 ± 12·6 kg) and 20 elderly adults (age: 66 ± 6 years, height: 162 ± 8·1 cm, mass: 65·3 ± 12·3 kg) undertook maximal incremental exercise tests on a conventional arm crank ergometer. Age-adjusted maximal heart rate was calculated using prediction equations based on leg exercise and compared with measured HRMAX data for the arms. Maximal HR for arm exercise was significantly overpredicted compared with age-adjusted prediction equations in both young and older adults. Subtracting 10-20 beats min(-1) from conventional prediction equations provides a reasonable estimate of HRMAX for upper body exercise in healthy older and younger adults. PMID:25319169

  20. Field exercise testing for assessing fitness in French standardbred trotters.

    PubMed

    Couroucé, A

    1999-03-01

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

  1. Methodologic problems in exercise testing research. Are we solving them

    SciTech Connect

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

    1988-06-01

    To evaluate the comparative effects of methodologic factors on the reported accuracies of two standard exercise tests, 56 publications comparing the exercise thallium scintigram with the coronary angiogram were analyzed for conformation to five methodologic standards. Analyzed were adequate definition of study group, avoidance of a limited challenge group, avoidance of workup bias, and blinded analysis of the coronary angiogram and myocardial scintigram. Study group characteristics and technical factors were also reviewed. Better conformation with methodologic standards was found than has been reported previously for treadmill exercise testing. Furthermore, study group characteristics and technical factors were better predictors of sensitivity and specificity than were methodologic deficiencies. Only workup bias and test blinding were significantly associated with test accuracy. The percentage of patients with previous myocardial infarction had the highest correlation and was independently and directly related to sensitivity and inversely related to specificity. 77 references.

  2. Modes of heart rate compensations during exercise ECG test.

    PubMed

    Viik, Jari

    2005-12-01

    Heart rate (HR) compensation of electrocardiographic (ECG) parameters is not an unique concept. However, in the detection of coronary artery disease (CAD) ST-segment plotted as a function HR has been studied extensively during the last 20 years. In clinical practice quantitative methods are evolved for the exercise phase of the exercise test and post-exercise recovery phase has not been studied as extensively. Quantitative parameters, as ST/HR hysteresis, which represents the average difference in ST depressions between the exercise and recovery phases at an identical HR up to three minutes of recovery, has been shown to improve the detection of CAD. Furthermore, the ST/HR parameters have been demonstrated to be very competent in a prediction of mortality. PMID:16330399

  3. 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…

  4. Prevalence of arrhythmias during exercise stress testing in patients with congenital heart disease and severe right ventricular conduit dysfunction.

    PubMed

    Priromprintr, Bryant; Rhodes, Jonathan; Silka, Michael J; Batra, Anjan S

    2014-08-01

    The utility of cardiopulmonary exercise testing (CPET) to define the risks of arrhythmia and sudden death in postoperative patients with congenital heart disease (CHD) remains uncertain. As part of the US Melody valve trial, prospective standardized CPET, along with echocardiography, cardiac magnetic resonance imaging, and cardiac catheterization, were performed in 170 CHD patients with right ventricular outflow tract conduit dysfunction before Melody valve implantation. Ventricular premature complexes (VPC) occurred in 75 patients (44%) and were common during all phases of CPET (13% baseline, 24% exercise, and 23% recovery). Although no subjects had sustained arrhythmias, 2 had nonsustained ventricular tachycardia and 3 had nonsustained supraventricular tachycardia during recovery. There were no statistically significant differences between patients with or without VPCs in echocardiographic, cardiac magnetic resonance imaging, or catheterization measures of cardiac function. However, clinical parameters of age, New York Heart Association functional class ≥II, and ≥3 cardiac surgical procedures were correlated with VPCs. Persistent ventricular ectopy during all exercise stages was present in 11 patients (6.5%), including 3 of the 4 patients who died during follow-up. In conclusion, VPCs were common during CPET, although they were not correlated with various measures of hemodynamic impairment; conversely, increased age, functional class, and number of surgeries were correlated with an increased prevalence of VPCs. CPET appears to be of minimal risk for sustained arrhythmia provocation in CHD patients with right ventricular outflow tract conduits and various degrees of advanced subpulmonary ventricular dysfunction. PMID:24931290

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

    PubMed Central

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

    2013-01-01

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

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

    SciTech Connect

    Papazoglou, N.; Kolokouri-Dervou, E.; Fanourakis, I.; Natsis, P.; Koutsiouba, P. )

    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.

  7. 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

  8. 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…

  9. 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.

  10. Hospital generator sizing, testing, and exercising.

    PubMed

    Nash, H O

    1994-02-01

    With the NFPA 99 and JCAHO requirements for minimum loads on generators during testing, hospital engineers are finding that oversized standby generators can mean operational problems. This document explains the oversized generator problem, including the code changes that gave birth to the problem. Some practical suggestions for sizing generators are then provided. PMID:10132471

  11. 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.

  12. Cardiopulmonary resuscitation update.

    PubMed

    Lipley, Nick

    2014-11-01

    THE ROYAL College of Nursing (RCN), Resuscitation Council (UK) and British Medical Association (BMA) have issued a new edition of their guidance on when to attempt cardiopulmonary resuscitation (CPR). PMID:25369953

  13. Acute Anteroseptal Myocardial Infarction after a Negative Exercise Stress Test

    PubMed Central

    Al-Alawi, Abdullah M.; Janardan, Jyotsna; Peck, Kah Y.; Soward, Alan

    2016-01-01

    A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST segment elevation myocardial infarction was observed on electrocardiography. After thrombolysis, he was transferred to a tertiary hospital where coronary angiography subsequently revealed significant left anterior descending coronary artery stenosis. Thrombus aspiration and a balloon angioplasty were performed. The patient was discharged three days after the surgical procedure in good health. PMID:27226918

  14. More about hospital generator sizing, testing and exercising.

    PubMed

    Nash, H O

    1996-08-01

    The National Fire Protection Agency (NFPA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirements for testing and exercising on-site standby generators are intended to prevent testing with insufficient load. However, engineers grapple with local and state enforcement agencies who require needlessly oversized standby generators, putting the engineer in the difficult position of using supplementary load banks because of insufficient building load for testing. This document examines the latest changes in NFPA codes and the JCAHO policy that aim to resolve testing issues. PMID:10159300

  15. 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.

  16. How many electrocardiographic leads are required for exercise treadmill tests

    SciTech Connect

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

    1987-04-01

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

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

    PubMed

    von Nussbaum, Franz; Li, Volkhart M-J

    2015-10-15

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

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

    MedlinePlus

    ... Resources EKGs and Exercise Stress Tests EKGs and Exercise Stress Tests When you need them—and when ... or electrocardiogram, measures your heart’s activity. In an exercise stress test, you have an EKG while you ...

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

    PubMed

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

    2008-12-01

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

  20. Exercise testing and stress imaging in valvular heart disease.

    PubMed

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

    2014-09-01

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

  1. Exercises

    MedlinePlus

    ... Sack, MS, PT Physical Therapist View full profile COPD: Lifestyle Management Exercise An exercise program is another very important step in managing COPD. It is common for people with lung disease ...

  2. Cancer and the cardiopulmonary system

    SciTech Connect

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

    1984-01-01

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

  3. 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.

  4. 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.

  5. Exerciser

    NASA Technical Reports Server (NTRS)

    Lem, J. D.

    1977-01-01

    The Mark I exerciser which was added for the second and third Skylab missions, was used for a number of arm and leg exercises. This unit is a modified version of a commercial device. This is an iso-kinetic, or constant velocity, exerciser which retards the speed at which the user is allowed to move. The user applies a maximum effort and the device automatically varies the opposing resistance to maintain speed of translation at a constant preselected value.

  6. [Should cardiopulmonary rehabilitation be provided to patients with lung cancer?].

    PubMed

    Frsard, Isabelle; Adler, Ddler; Bhatia, Chetna; Licker, Marc; Triponez, Frdric; Robert, John; Bridevaux, Pierre-Olivier

    2013-04-10

    The exercise capacity has a specific importance in patients with non small cell lung cancer (NSCLC) at all stages of the disease. In the preoperative period for the early stages of the disease, low exercise capacity can be improved and thus allow curative surgery for unfit patients with NSCLC. The body of current literature suggests a beneficial effect of cardiopulmonary rehabilitation on exercise capacity, quality of life and length of hospital stay or rate of post-operative complications. For patients with advanced disease, exercise capacity, which is a predictor of survival, could be maintained at higher level with adapted cardiopulmonary rehabilitation. Ongoing studies will precise the best programs for patients with NSCLC and help to establish guidelines for clinicians. PMID:23659153

  7. Effect of test exercises and mask donning on measured respirator fit.

    PubMed

    Crutchfield, C D; Fairbank, E O; Greenstein, S L

    1999-12-01

    Quantitative respirator fit test protocols are typically defined by a series of fit test exercises. A rationale for the protocols that have been developed is generally not available. There also is little information available that describes the effect or effectiveness of the fit test exercises currently specified in respiratory protection standards. This study was designed to assess the relative impact of fit test exercises and mask donning on respirator fit as measured by a controlled negative pressure and an ambient aerosol fit test system. Multiple donnings of two different sizes of identical respirator models by each of 14 test subjects showed that donning affects respirator fit to a greater degree than fit test exercises. Currently specified fit test protocols emphasize test exercises, and the determination of fit is based on a single mask donning. A rationale for a modified fit test protocol based on fewer, more targeted test exercises and multiple mask donnings is presented. The modified protocol identified inadequately fitting respirators as effectively as the currently specified Occupational Safety and Health Administration (OSHA) quantitative fit test protocol. The controlled negative pressure system measured significantly (p < 0.0001) more respirator leakage than the ambient aerosol fit test system. The bend over fit test exercise was found to be predictive of poor respirator fit by both fit test systems. For the better fitting respirators, only the talking exercise generated aerosol fit factors that were significantly lower (p < 0.0001) than corresponding donning fit factors. PMID:10633954

  8. Blood pressure responses during exercise testing-is up best for prognosis?

    PubMed

    Laukkanen, Jari A; Kurl, Sudhir

    2012-05-01

    Exercise testing is not limited to observation of ischemic electrocardiographic findings during exercise, but also abnormal findings in blood pressure, heart rate, and exercise capacity are valuable. Individuals with exaggerated exercise blood pressure tend to develop future hypertension. Extensive elevation in systolic blood pressure during exercise has been found to increase the risk of left ventricular hypertrophy, myocardial infarction, cerebrovascular stroke, and cardiovascular death. Previous studies have revealed that blood pressure response to exercise is dependent on underlying heart disease and peripheral resistance. Therefore, subjects with documented cardiovascular disease may not be capable of generating a work-load to allow the manifestation of exercise-induced systolic hypertension. Systolic hypotension during exercise is associated with left ventricular dysfunction and inadequate cardiac output, and it is a marker of severe heart disease. Exercise testing with the definition of blood pressure can be performed in a logical way with test results used to decide on therapies and treatment strategies in addition to blood pressure at rest. A modest increment in blood pressure rise corresponding to work-load achieved during the exercise testing is the best sign from the prognostic point of view. The normal limits of exercise blood pressure response could be very helpful for clinicians. PMID:21345155

  9. Short term reproducibility of exercise testing in patients with ST segment elevation and different responses to the dipyridamole test.

    PubMed Central

    Picano, E; Masini, M; Lattanzi, F; Klassen, G A; Distante, A; Levantesi, D; Marraccini, P; L'Abbate, A

    1988-01-01

    The short term reproducibility of exercise testing in 25 patients who had exercise induced ST segment elevation without baseline regional asynergy or a previous myocardial infarction, who had different responses to the dipyridamole test, was assessed. The patients performed a dipyridamole echocardiography test and a second exercise stress test. All underwent coronary arteriography. Seventeen patients had transient regional asynergy after dipyridamole (group 1) and either ST segment elevation (14 patients) or depression (three patients); a second group of eight had no asynergy and no electrocardiographic changes (group 2). The repeated exercise stress test was positive in 16 of the 17 patients of group 1 (11 with ST elevation and five with ST depression) and in two patients of group 2 (both had ST depression and one had coronary artery disease). The dipyridamole echocardiography test was positive in 17 of the 19 patients with coronary artery disease and was negative in all six patients without coronary artery disease. The repeated exercise stress test was positive in 17 of the 19 patients with coronary artery disease and in one patient without. The dipyridamole echocardiography test and a repeated exercise stress test, but not a single exercise stress test, identified coronary artery disease causing exercise induced ST segment elevation. Images Figure PMID:3190956

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

    SciTech Connect

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

    1983-01-01

    Eighty-one patients with diagnostically difficult clinical presentations suggesting coronary disease underwent symptom-limited maximal-exercise treadmill testing (ETT) and exercise radionuclide scanning with /sup 201/Tl. Results of these tests were in agreement in only 47 percent of the cases. Either exercise thallium or ETT was positive in 94 percent of patients with disease. Among a population with a disease prevalence of 67 percent, agreement between exercise thallium an ETT predicted disease in 92 percent of instances or excluded disease in 82 percent of instances. Frequent discordance between these two tests in 53 percent of the cases unfortunately limits this usefulness.

  11. 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).

  12. 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

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

    SciTech Connect

    Vincent, N.R.; Denis, L.

    1986-10-01

    From 1293 patients who underwent thallium stress testing and 1099 patients who had coronary angiography, a consecutive series of 122 who had both studies is evaluated. This group includes suboptimally exercised patients and those receiving one or several cardiovascular drugs that were not discontinued prior to exercise. When compared with the EKG stress test, thallium stress imaging was superior in sensitivity (80% vs 68%), specificity (84% vs 49%), accuracy (81% vs 62%), positive predictive value, (92% vs 75%), and negative predictive value (65% vs 45%) in this group, with 71% prevalence of angiographically significant coronary artery disease.

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

    PubMed Central

    Horwood, Anna; Toor, Sonia

    2014-01-01

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

  15. Prolonged exercise testing in two children with a mild Multiple Acyl-CoA-Dehydrogenase deficiency

    PubMed Central

    Takken, T; Custers, J WH; Visser, G; Dorland, L; Helders, PJM; de Koning, TJ

    2005-01-01

    Background Multiple Acyl-CoA-Dehydrogenase deficiency (MADD) is an inherited metabolic disorder characterized by impaired oxidation of fatty acids and some amino acids. Methods We were interested whether children with MADD could tolerate a prolonged low-intensity exercise test and if this test could have any additional diagnostic value. Therefore, we performed a maximal exercise test and a low-intensity prolonged exercise test in 2 patients with MADD and in 5 control subjects. During a prolonged exercise test the subjects exercised on a cycle ergometer at a constant workload of 30% of their maximum for 90 minutes and heart rate, oxygen uptake, fuel utilization and changes in relevant blood and urinary parameters were monitored. Results The tests were tolerated well. During the prolonged exercise test the fatty acid oxidation (FAO) was quite low compared to 5 control subjects, while characteristic metabolites of MADD appeared in plasma and urine. Conclusion We suggest that the prolonged exercise test could be of diagnostic importance and might replace the fasting test as a diagnostic procedure in some cases, particularly in patients with anamnestic signs of intolerance for prolonged exercise. PMID:15907213

  16. Bivalirudin Anticoagulation for Cardiopulmonary Bypass

    PubMed Central

    Nikolaidis, Nicolas; Velissaris, Theodore; Ohri, Sunil K.

    2007-01-01

    The standard agent used for systemic anticoagulation during cardiopulmonary bypass is heparin. Alternative methods of anticoagulation are required for patients with heparin hypersensitivity. We present the case of a patient with heparin hypersensitivity who was anticoagulated with bivalirudin during cardiopulmonary bypass for coronary artery bypass grafting. This presented unusual challenges surrounding the monitoring of anticoagulation and the method of myocardial protection. PMID:17420808

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

    PubMed

    Lin, R Y; Barnard, M

    1993-06-01

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

  18. Exercise intolerance in pulmonary arterial hypertension.

    PubMed

    Fowler, Robin M; Gain, Kevin R; Gabbay, Eli

    2012-01-01

    Pulmonary arterial hypertension (PAH) is associated with symptoms of dyspnea and fatigue, which contribute to exercise limitation. The origins and significance of dyspnea and fatigue in PAH are not completely understood. This has created uncertainly among healthcare professionals regarding acceptable levels of these symptoms, on exertion, for patients with PAH. Dysfunction of the right ventricle (RV) contributes to functional limitation and mortality in PAH; however, the role of the RV in eliciting dyspnea and fatigue has not been thoroughly examined. This paper explores the contribution of the RV and systemic and peripheral abnormalities to exercise limitation and symptoms in PAH. Further, it explores the relationship between exercise abnormalities and symptoms, the utility of the cardiopulmonary exercise test in identifying RV dysfunction, and offers suggestions for further research. PMID:22737582

  19. Exercise Intolerance in Pulmonary Arterial Hypertension

    PubMed Central

    Fowler, Robin M.; Gain, Kevin R.; Gabbay, Eli

    2012-01-01

    Pulmonary arterial hypertension (PAH) is associated with symptoms of dyspnea and fatigue, which contribute to exercise limitation. The origins and significance of dyspnea and fatigue in PAH are not completely understood. This has created uncertainly among healthcare professionals regarding acceptable levels of these symptoms, on exertion, for patients with PAH. Dysfunction of the right ventricle (RV) contributes to functional limitation and mortality in PAH; however, the role of the RV in eliciting dyspnea and fatigue has not been thoroughly examined. This paper explores the contribution of the RV and systemic and peripheral abnormalities to exercise limitation and symptoms in PAH. Further, it explores the relationship between exercise abnormalities and symptoms, the utility of the cardiopulmonary exercise test in identifying RV dysfunction, and offers suggestions for further research. PMID:22737582

  20. Neonatal cardiopulmonary bypass.

    PubMed

    Pouard, Philippe; Bojan, Mirela

    2013-01-01

    Cardiac surgery with cardiopulmonary bypass is routinely used in neonates who require early repair of congenital heart diseases. However, the bypass temperature and use of deep hypothermic circulatory arrest, the composition of the priming and the acceptable degree of hemodilution, the prophylactic use of antifibrinolytic agents and steroids, the choice of myocardial protection, the best PaO2, and even the pump flow, are still subjects of debate, despite major improvements in neonatal bypass over the last decade. Nevertheless, there are some techniques that have reached a near-consensus and are highly recommended in neonates: the use of minaturized bypass circuits to reduce blood product transfusions and inflammation, ultrafiltration, and the continuous monitoring of mixed venous and regional oxygen saturations to assess adequacy of perfusion. Nevertheless, surprisingly many different techniques may lead to the same results and mortality rate. As operative mortality rates have declined, the comparison endpoints between techniques have moved and focus on morbidity rates, extubation delay, ICU and hospital length of stay; in other words, the cost and (of course) the late functional outcome are certainly the new goals of neonatal cardiopulmonary bypass. PMID:23561819

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

    PubMed Central

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

    2015-01-01

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

  2. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

    Kangas, Lars J.; Keller, Paul E.

    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.

  3. 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.

  4. 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.

  5. Understanding exercise behavior among Korean adults: a test of the transtheoretical model.

    PubMed

    Kim, YoungHo; Cardinal, Bradley J; Lee, JongYoung

    2006-01-01

    The purpose of this study was to examine the theorized association of Transtheoretical Model (TTM) of behavior change constructs by stage of change for exercise behavior among Korean adults. A total of 1,335 Korean adults were recruited and surveyed from the Nowon district, geographically located in northern Seoul. Four Korean-version questionnaires were used to identify the stage of exercise behavior and psychological attributes of adolescents. Data were analyzed by frequency analysis, MANOVA, correlation analysis, and discriminant analysis. Multivariate F tests indicated that behavioral and cognitive processes of change, exercise efficacy, and pros differentiated participants across the stages of exercise behavior. Furthermore, the findings revealed that adults' exercise behavior was significantly correlated with the TTM constructs and that overall classification accuracy across the stages of change was 50.6%. This study supports the internal and external validity of the TTM for explaining exercise behavior. PMID:17228987

  6. 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

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

    ERIC Educational Resources Information Center

    Gronlund, Wayne R.; And Others

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

  8. 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…

  9. 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.

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

    PubMed

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

    2015-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  12. 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.

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

    ERIC Educational Resources Information Center

    Tinker, John R., Jr.

    1978-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

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

  15. Exercise oscillatory ventilation: Mechanisms and prognostic significance.

    PubMed

    Dhakal, Bishnu P; Lewis, Gregory D

    2016-03-26

    Alteration in breathing patterns characterized by cyclic variation of ventilation during rest and during exercise has been recognized in patients with advanced heart failure (HF) for nearly two centuries. Periodic breathing (PB) during exercise is known as exercise oscillatory ventilation (EOV) and is characterized by the periods of hyperpnea and hypopnea without interposed apnea. EOV is a non-invasive parameter detected during submaximal cardiopulmonary exercise testing. Presence of EOV during exercise in HF patients indicates significant impairment in resting and exercise hemodynamic parameters. EOV is also an independent risk factor for poor prognosis in HF patients both with reduced and preserved ejection fraction irrespective of other gas exchange variables. Circulatory delay, increased chemosensitivity, pulmonary congestion and increased ergoreflex signaling have been proposed as the mechanisms underlying the generation of EOV in HF patients. There is no proven treatment of EOV but its reversal has been noted with phosphodiesterase inhibitors, exercise training and acetazolamide in relatively small studies. In this review, we discuss the mechanistic basis of PB during exercise and the clinical implications of recognizing PB patterns in patients with HF. PMID:27022457

  16. Exercise oscillatory ventilation: Mechanisms and prognostic significance

    PubMed Central

    Dhakal, Bishnu P; Lewis, Gregory D

    2016-01-01

    Alteration in breathing patterns characterized by cyclic variation of ventilation during rest and during exercise has been recognized in patients with advanced heart failure (HF) for nearly two centuries. Periodic breathing (PB) during exercise is known as exercise oscillatory ventilation (EOV) and is characterized by the periods of hyperpnea and hypopnea without interposed apnea. EOV is a non-invasive parameter detected during submaximal cardiopulmonary exercise testing. Presence of EOV during exercise in HF patients indicates significant impairment in resting and exercise hemodynamic parameters. EOV is also an independent risk factor for poor prognosis in HF patients both with reduced and preserved ejection fraction irrespective of other gas exchange variables. Circulatory delay, increased chemosensitivity, pulmonary congestion and increased ergoreflex signaling have been proposed as the mechanisms underlying the generation of EOV in HF patients. There is no proven treatment of EOV but its reversal has been noted with phosphodiesterase inhibitors, exercise training and acetazolamide in relatively small studies. In this review, we discuss the mechanistic basis of PB during exercise and the clinical implications of recognizing PB patterns in patients with HF. PMID:27022457

  17. Using squat repetition maximum testing to determine hamstring resistance training exercise loads.

    PubMed

    Ebben, William P; Long, Nicholas J; Pawlowski, Zach D; Chmielewski, Lauren M; Clewien, Rustin W; Jensen, Randall L

    2010-02-01

    The purpose of this study was to determine whether there is a linear relationship between the squat and a variety of hamstring resistance training exercises, and whether this relationship differs on the basis of sex. This study also sought to create prediction equations for the determination of hamstring exercise load based on the squat load. Repetition maximums of the squat, as well as 4 common hamstring resistance training exercises including the seated leg curl, stiff leg dead lift, single leg dead lift, and good morning exercise, were determined for each subject. Subjects included 21 men and 13 women collegiate athletes. Data were evaluated using linear regression analysis to predict hamstring exercise loads from 6 repetition maximum squat data. Results of the analysis of all subjects indicated that squat load was a significant predictor of loads for each of the hamstring exercises. However, separate analysis of women revealed that squat load was not a significant predictor of loads for any of the hamstring exercises. Analysis of the men revealed that squat was a significant predictor of load for the seated leg curl (R = 0.58, p < 0.001), stiff leg dead lift (R = 0.82, p < 0.001), single leg stiff leg dead lift (R = 0.80, p < 0.001), and good morning (R = 0.79, p < 0.001) exercises. On the basis of the analysis of the men, the following prediction equations were devised for each exercise: (1) seated leg curl load = squat load (0.186) + 10.935 kg, (2) stiff leg deadlift load = squat load (1.133) - 86.331 kg, (3) single leg stiff leg deadlift load = squat load (0.443) - 3.425 kg, and (4) good morning load = squat load (0.961) - 105.505 kg. Thus, results from testing core exercises such as the squat can provide useful data for the assignment of loads for assistance exercises. PMID:20072071

  18. Comparison of rest and exercise radionuclide angiocardiography and exercise treadmill testing for diagnosis of anatomically extensive coronary artery disease

    SciTech Connect

    Campos, C.T.; Chu, H.W.; D'Agostino, H.J. Jr.; Jones, R.H.

    1983-06-01

    The accuracy of rest and exercise radionuclide angiocardiography (RNA) and exercise treadmill testing (ETT) for diagnosis of three-vessel or left main coronary artery disease (extensive CAD) was determined in 544 patients. ETT and RNA sensitivities were similar (88% vs 92%, NS), but ETT was more specific than RNA (46% vs 34%, p less than 0.01). The prevalence of extensive CAD in patients with a positive treadmill (41%) increased only 3% when the RNA was also positive. However, in the 292 patients with a negative or indeterminate ETT, a positive RNA increased this prevalence from 16% to 23%, while a negative RNA decreased this prevalence to 5%. These results support the initial use of ETT followed by RNA if the treadmill is negative or indeterminate for diagnosis in a population with a high prevalence of extensive CAD. This approach separates patients into subgroups with a high or low probability of extensive CAD.

  19. Understanding Exercise, Diet and Lung Disease

    MedlinePlus

    ... mucus and beats in a rhythmic fashion to clean the lungs. The airways are also surrounded by ... on a path to better health. Exercise Increases • Energy level • Endurance (Cardiopulmonary) • Muscle strength • Bone density • Ability ...

  20. 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.

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

    ERIC Educational Resources Information Center

    Zwiren, Linda D.; And Others

    1991-01-01

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

  2. 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…

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  5. 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…

  6. 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.

  7. Specialization in home care: a cardiopulmonary model.

    PubMed

    Bartock, B S; Finley-Cottone, D

    1992-01-01

    The Visiting Nurse Service of Rochester and Monroe County, Inc. has developed an innovative method of clinical practice to meet the needs of patients after acute episodes of heart or lung disease. The cardiopulmonary program has a multidisciplinary approach, focusing on disease management through physical assessment, symptom management, diagnostic testing, and rehabilitation via progressive activity tolerance. The program has been successful in either preventing or increasing the length of time between hospital admissions, and has increased the agency's referral base, improved staff job satisfaction, and reduced turnover. PMID:10116686

  8. Exercise Oscillatory Ventilation*

    PubMed Central

    Olson, Lyle J.; Arruda-Olson, Adelaide M.; Somers, Virend K.; Scott, Christopher G.; Johnson, Bruce D.

    2009-01-01

    Background Instability of breathing control due to heart failure (HF) manifests as exercise oscillatory ventilation (EOV). Prior descriptions of patients with EOV have not been controlled and have been limited to subjects with left ventricular ejection fraction (LVEF) of ≤ 0.40. The aim of this study was to compare clinical characteristics including ventilatory responses of subjects with EOV to those of control subjects with HF matched for LVEF. Methods Subjects (n = 47) were retrospectively identified from 1,340 consecutive patients referred for cardiopulmonary exercise testing. Study inclusion required EOV without consideration of LVEF while control subjects (n = 47) were composed of HF patients with no EOV matched for LVEF. Characteristics for each group were summarized and compared. Results For EOV subjects, the mean LVEF was 0.37 (range, 0.11 to 0.70), and 19 subjects (41%) had an LVEF of ≥ 0.40. Compared to control subjects, EOV subjects had increased left atrial dimension, mitral E-wave velocity, and right heart pressures as well as decreased exercise tidal volume response, functional capacity, rest and exercise end-tidal carbon dioxide, and increased ventilatory equivalent for carbon dioxide and dead space ventilation (all p < 0.05). Multivariate analysis demonstrated atrial fibrillation (odds ratio, 6.7; p = 0.006), digitalis therapy (odds ratio, 0.27; p = 0.02), New York Heart Association class (odds ratio, 3.5; p = 0.0006), rest end-tidal carbon dioxide (odds ratio, 0.87; p = 0.005), and peak heart rate (odds ratio, 0.98; p = 0.02) were independently associated with EOV. Conclusions Patients with EOV have clinical characteristics and exercise ventilatory responses consistent with more advanced HF than patients with comparable LV systolic function; EOV may occur in HF patients with an LVEF of ≥ 0.40. PMID:18071013

  9. Acute moderate exercise elicits increased dorsolateral prefrontal activation and improves cognitive performance with Stroop test.

    PubMed

    Yanagisawa, Hiroki; Dan, Ippeita; Tsuzuki, Daisuke; Kato, Morimasa; Okamoto, Masako; Kyutoku, Yasushi; Soya, Hideaki

    2010-05-01

    A growing number of human studies have reported the beneficial influences of acute as well as chronic exercise on cognitive functions. However, neuroimaging investigations into the neural substrates of the effects of acute exercise have yet to be performed. Using multichannel functional near-infrared spectroscopy (fNIRS), we sought cortical activation related to changes in the Stroop interference test, elicited by an acute bout of moderate exercise, in healthy volunteers (N=20). The compactness and portability of fNIRS allowed on-site cortical examination in a laboratory with a cycle ergometer, enabling strict control of the exercise intensity of each subject by assessing their peak oxygen intake (VO2peak). We defined moderate exercise intensity as 50% of a subject's peak oxygen uptake (50%VO2peak). An acute bout of moderate exercise caused significant improvement of cognitive performance reflecting Stroop interference as measured by reaction time. Consistent with previous functional neuroimaging studies, we detected brain activation due to Stroop interference (incongruent minus neutral) in the lateral prefrontal cortices in both hemispheres. This Stroop-interference-related activation was significantly enhanced in the left dorsolateral prefrontal cortex due to the acute bout of moderate exercise. The enhanced activation significantly coincided with the improved cognitive performance. This suggests that the left dorsolateral prefrontal cortex is likely the neural substrate for the improved Stroop performance elicited by an acute bout of moderate exercise. fNIRS, which allows physiological monitoring and functional neuroimaging to be combined, proved to be an effective tool for examining the cognitive effects of exercise. PMID:20006719

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

    PubMed

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

    2015-12-15

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

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

    PubMed Central

    Shim, Wan Joo; Suh, Soon Kyu

    1986-01-01

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

  12. 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

  13. 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…

  14. 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…

  15. Soil Testing as a Classroom Exercise to Determine Soil-forming Processes and Soil Classification.

    ERIC Educational Resources Information Center

    Bencloski, Joseph W.

    1980-01-01

    Describes a learning activity involving correctly matching soils with environments. The activity is intended for use in college level physical geography courses. Information is presented on instructional objectives, outline of preparatory lectures, soil test exercise worksheets, procedures, laboratory setting, testing procedures, collecting and…

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

    PubMed

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

    2013-07-01

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

  17. Cigarette smoking decreases dynamic inspiratory capacity during maximal exercise in patients with type 2 diabetes.

    PubMed

    Kitahara, Yoshihiro; Hattori, Noboru; Yokoyama, Akihito; Yamane, Kiminori; Sekikawa, Kiyokazu; Inamizu, Tsutomu; Kohno, Nobuoki

    2012-06-01

    To investigate the influence of cigarette smoking on exercise capacity, respiratory responses and dynamic changes in lung volume during exercise in patients with type 2 diabetes. Forty-one men with type, 2 diabetes without cardiopulmonary disease were recruited and divided into 28 non-current smokers and 13 current smokers. All subjects received lung function tests and cardiopulmonary exercise testing using tracings of the flow-volume loop. Exercise capacity was compared using the percentage of predicted oxygen uptake at maximal workload (%VO2max). Respiratory variables and inspiratory capacity (IC) were compared between the two groups at rest and at 20%, 40%, 60%, 80% and 100% of maximum workload. Although there was no significant difference in lung function tests between the two groups, venous carboxyhemoglobin (CO-Hb) levels were significantly higher in current smokers. %VO2max was inversely correlated with CO-Hb levels. Changing patterns in respiratory rate, respiratory equivalent and IC were significantly different between the two groups. Current smokers had rapid breathing, a greater respiratory equivalent and a limited increase in IC during exercise. Cigarette smoking diminishes the increase in dynamic IC in patients with type 2 diabetes. As this effect of smoking on dynamic changes in lung volume will exacerbate dynamic hyperinflation in cases complicated by chronic obstructive pulmonary disease, physicians should consider smoking habits and lung function when evaluating exercise capacity in patients with type 2 diabetes. PMID:22916510

  18. Evidence that the talk test can be used to regulate exercise intensity.

    PubMed

    Woltmann, Michaela L; Foster, Carl; Porcari, John P; Camic, Clayton L; Dodge, Christopher; Haible, Stephanie; Mikat, Richard P

    2015-05-01

    The Talk Test (TT) has been shown to be a surrogate of the ventilatory threshold and to be a viable alternative to standard methods of prescribing exercise training intensity. The TT has also been shown to be responsive to manipulations known to change physiologic function including blood donation and training. Whether the TT can be used independently to regulated training intensity is not known. Physically active volunteers (N = 16) performed an incremental exercise test to identify stages of the TT (Last Positive [LP], Equivocal [EQ], and Negative [NEG]). In subsequent, randomly ordered, 30-minute steady-state runs, the running velocity was regulated solely by "clamping" the TT response desired and then monitoring the response of conventional markers of exercise intensity (heart rate, blood lactate, rating of perceived exertion). All subjects were able to complete the LP stage, but only 13 of 16 and 2 of 16 subjects were able to complete the EQ and NEG stages, respectively. Physiologic responses were broadly within those predicted from the incremental exercise test and within the appropriate range of physiologic responses for exercise training. Thus, in addition to correlating with convenient physiological markers, the TT can be used proactively to guide exercise training intensity. The LP stage produced training intensities compatible with appropriate training intensity in healthy adults and with recovery sessions or long duration training sessions in athletes. The EQ and NEG stages produced intensities compatible with higher intensity training in athletes. The results demonstrate that the TT can be used as a primary method to control exercise training intensity. PMID:25536539

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  3. 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.

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

    PubMed Central

    Kim, Youngil

    2015-01-01

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

  5. Impairment on cardiovascular and autonomic adjustments to maximal isometric exercise tests in offspring of hypertensive parents.

    PubMed

    Francica, Juliana V; Heeren, Marcelo V; Tubaldini, Mrcio; Sartori, Michelle; Mostarda, Cristiano; Araujo, Rubens C; Irigoyen, Maria-Cludia; De Angelis, Ktia

    2013-06-01

    The objective of the present study was to compare cardiovascular and autonomic responses to a mental stress test and to a maximal isometric exercise test between offspring of normotensive (ON, n = 10) and hypertensive parents (OH, n = 10). Subjects underwent a 3-min Stroop Color Word Test and a maximal isometric exercise test performed in an isokinetic dynamometer with continuous RR interval monitoring. At rest, arterial pressure and heart rate were similar between groups, but there was a significant reduction in total RR interval variance (ON: 5933 493 vs. OH: 2967 390 ms(2)) and an increase in low-high frequency components ratio of heart rate variability (ON: 2.3 0.4 vs. OH: 4.6 0.8) in OH group. In the first minute of the mental stress test and after both tests, the OH group presented increased heart rate as compared with the ON group. After both tests, only the ON group presented an increase in sympathetic component, thus reaching resting values similar to those of the OH group. Our data demonstrated increased resting cardiac sympathetic modulation in offspring of hypertensive parents at similar levels to that observed in offspring of normotensive parents after a mental stress test or a maximal isometric exercise test. Additionally, the exacerbated heart rate responses to these physiological tests in OH subjects may be associated with resting autonomic dysfunction, thus reinforcing these evaluations as important tools for detecting early dysfunctions in this genetically predisposed population. PMID:22729292

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

    PubMed Central

    Arnardttir, Ragnheiur Harpa; Emtner, Margareta; Hedenstrm, 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

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

    SciTech Connect

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

    1990-07-01

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

  8. [Results of 1000 electrocardiographic exercise tests. Their correlation with previous ischemic cardiopathy and arteriosclerotic risk factors].

    PubMed

    Carrillo López, L; Gómez Lepe, A; Moragrega, J L; Parás Chavero, E

    1976-01-01

    Exercise electrocardiograms were done on one thousand patients referred to the laboratory of exercise tests for: suggestive symptoms of acute heart failure, old miocardial infarction abnormal resting ECG, or evaluation of coronary reserve. The average value of cardiac rate reached for the group, was close to 80%. The maximum exercise loads managed by the men were superior to those of the women, and in general those managed in the negative test were superior in relation to the positive tests. Of the one thousand cases, 20.2% had positive exercise ECG's. There was no difference inthe percentages of positivity between the two sexes, 20.75% and 19.11% for men and women respecitvely. The percentages of positivity are greater in those subjects sent to the laboratory for suspicion of angina pectoris, old MI, or abnormal resting ECG, than in those referred for detection of ischemic heart disease. The groups of patients with diabetes mellitus, arterial hypertension, old MI, and abnormal resting ECG had the highest incidence of positive tests: 41%, 37.5%, 30.6%, and 28.2% respectively. The most frequent localization of the ST segment alterations was the anterior portion, with percentages of 85.1% similar to those mentioned in the literature. The frequency of arrithmias, of 12.4% in this group, is a little less than that described in similar groups, but it corroborates the predominance of non-lethal ventricular arrithmias. The mortality in the tests performed was null. PMID:1023833

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

    PubMed Central

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

    2013-01-01

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

  10. Coronary CT angiography in asymptomatic middle-aged athletes with ST segment anomalies during maximal exercise test.

    PubMed

    Ermolao, A; Roman, F; Gasperetti, A; Varnier, M; Bergamin, M; Zaccaria, M

    2016-01-01

    The clinical significance of ST segment anomalies occurring during exercise test in asymptomatic subjects is still debated. We designed a cross-sectional study to evaluate if the presence of these exercise test abnormalities were related with coronary CT angiography findings. Nine hundred forty athletes (range 30 to 60 years old), performed a maximal exercise test for sport eligibility. Forty-six subjects (4.9%) showing ST abnormalities during exercise and/or the recovery phase were referred to a 64-slice coronary computed tomography (CT) angiography. Among 44 subjects who underwent coronary CT angiography, 23 had an equivocal while 21 had a positive exercise test. Coronary CT angiography found, six and eight subjects with significant and not significant coronary artery disease, respectively. Further, seven patients demonstrated origin and course coronary anomalies. The positive predictive value for significant coronary artery disease of the exercise test was 13.6%. Our data suggest the referral to coronary CT angiography even of patients with equivocal repolarization anomalies during exercise and its recovery phase. Although the positive predictive value of a maximal exercise test in asymptomatic athletes appears lower than what observed in patients at high risk for coronary artery disease, about half of athletes with equivocal or positive exercise test demonstrated some coronary abnormalities. PMID:25623056

  11. 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.

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

    PubMed Central

    Louvaris, Zafeiris

    2015-01-01

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

  13. Multiple-Choice Cloze Exercises: Textual Domain, Science. SPPED Test Development Notebook, Form 81-S [and] Answer Key for Multiple-Choice Cloze Exercises: Textual Domain, Science. SPPED Test Development Notebook, Form 85-S. Revised.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Div. of Research.

    The "Test Development Notebook" is a resource designed for the preparation of tests of literal comprehension for students in grades 1 through 12. This volume contains 200 multiple-choice cloze exercises taken from textbooks in science, and the accompanying answer key. Each exercise carries the code letter of the section to which it belongs. The…

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

    ERIC Educational Resources Information Center

    Sparling, Phillip B.

    1977-01-01

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

  15. 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

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

    PubMed

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

    2011-01-01

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

  17. 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.

  18. Palliative care in cardiopulmonary transplantation.

    PubMed

    McKenna, Maria; Clark, Stephen C

    2015-12-01

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

  19. Daily exercise routines

    NASA Technical Reports Server (NTRS)

    Anderson, Patrick L.; Amoroso, Michael T.

    1990-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  1. A simple exercise test for the prediction of relative heat tolerance.

    PubMed

    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. PMID:3706149

  2. 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

  3. 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

  4. Effects of Age, Exercise Duration, and Test Conditions on Heart Rate Variability in Young Endurance Horses

    PubMed Central

    Younes, Mohamed; Robert, Céline; Barrey, Eric; Cottin, François

    2016-01-01

    Although cardiac recovery is an important criterion for ranking horses in endurance competitions, heart rate variability (HRV) has hardly ever been studied in the context of this equestrian discipline. In the present study, we sought to determine whether HRV is affected by parameters such as age, exercise duration and test site. Accordingly, HRV might be used to select endurance horses with the fastest cardiac recovery. The main objective of the present study was to determine the effects of age, exercise duration, and test site on HRV variables at rest and during exercise and recovery in young Arabian endurance horses. Over a 3-year period, 77 young Arabian horses aged 4–6 years performed one or more exercise tests (consisting of a warm-up, cantering at 22 km.h−1and a final 500 m gallop at full speed) at four different sites. Beat-to-beat RR intervals were continuously recorded and then analyzed (using a time-frequency approach) to determine the instantaneous HRV components before, during and after the test. At rest, the root-mean-square of successive differences in RR intervals (RMSSD) was higher in the 4-year-olds (54.4 ± 14.5 ms) than in the 5-or 6-year-olds (44.9 ± 15.5 and 49.1 ± 11.7 ms, respectively). During the first 15 min of exercise (period T), the heart rate (HR) and RMSSD decreased with age. In 6-year-olds, RMSSD decreased as the exercise duration increased (T: 3.0 ± 1.4 vs. 2T: 3.6 ± 2.2 vs. 3T: 2.8 ± 1.0). During recovery, RMSSD was negatively correlated with the cardiac recovery time (CRT) and the recovery heart rate (RHR; R = −0.56 and −0.53, respectively; p < 0.05). At rest and during exercise and recovery, RMSSD and several HRV variables differed significantly as a function of the test conditions. HRV in endurance horses appears to be strongly influenced by age and environmental factors (such as ambient temperature, ambient humidity, and track quality). Nevertheless, RMSSD can be used to select endurance horses with the fastest cardiac recovery. PMID:27199770

  5. Effects of Age, Exercise Duration, and Test Conditions on Heart Rate Variability in Young Endurance Horses.

    PubMed

    Younes, Mohamed; Robert, Céline; Barrey, Eric; Cottin, François

    2016-01-01

    Although cardiac recovery is an important criterion for ranking horses in endurance competitions, heart rate variability (HRV) has hardly ever been studied in the context of this equestrian discipline. In the present study, we sought to determine whether HRV is affected by parameters such as age, exercise duration and test site. Accordingly, HRV might be used to select endurance horses with the fastest cardiac recovery. The main objective of the present study was to determine the effects of age, exercise duration, and test site on HRV variables at rest and during exercise and recovery in young Arabian endurance horses. Over a 3-year period, 77 young Arabian horses aged 4-6 years performed one or more exercise tests (consisting of a warm-up, cantering at 22 km.h(-1)and a final 500 m gallop at full speed) at four different sites. Beat-to-beat RR intervals were continuously recorded and then analyzed (using a time-frequency approach) to determine the instantaneous HRV components before, during and after the test. At rest, the root-mean-square of successive differences in RR intervals (RMSSD) was higher in the 4-year-olds (54.4 ± 14.5 ms) than in the 5-or 6-year-olds (44.9 ± 15.5 and 49.1 ± 11.7 ms, respectively). During the first 15 min of exercise (period T), the heart rate (HR) and RMSSD decreased with age. In 6-year-olds, RMSSD decreased as the exercise duration increased (T: 3.0 ± 1.4 vs. 2T: 3.6 ± 2.2 vs. 3T: 2.8 ± 1.0). During recovery, RMSSD was negatively correlated with the cardiac recovery time (CRT) and the recovery heart rate (RHR; R = -0.56 and -0.53, respectively; p < 0.05). At rest and during exercise and recovery, RMSSD and several HRV variables differed significantly as a function of the test conditions. HRV in endurance horses appears to be strongly influenced by age and environmental factors (such as ambient temperature, ambient humidity, and track quality). Nevertheless, RMSSD can be used to select endurance horses with the fastest cardiac recovery. PMID:27199770

  6. Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis.

    PubMed

    Augustsson, J; Thomeé, R; Lindén, C; Folkesson, M; Tranberg, R; Karlsson, J

    2006-04-01

    A fatiguing exercise protocol was combined with single-leg hop testing to improve the possibilities of evaluating the effects of training or rehabilitation interventions. In the first test-retest experiment, 11 healthy male subjects performed two trials of single-leg hops under three different test conditions: non-fatigued and following fatiguing exercise, which consisted of unilateral weight machine knee extensions at 80% and 50%, respectively, of 1 repetition maximum (1 RM) strength. Intraclass correlation coefficients ranged from 0.75 to 0.98 for different hop test conditions, indicating that all tests were reliable. For the second experiment, eight healthy male subjects performed the fatiguing exercise protocol to investigate how fatigue influences lower-extremity joint kinematics and kinetics during single-leg hops. Hip, knee and ankle joint angles, moments and powers, as well as ground-reaction forces were recorded with a six-camera, motion-capture system and a force platform. Recovery of hop performance following the fatiguing exercise was also measured. During the take-off for the single-leg hops, hip and knee flexion angles, generated powers for the knee and ankle joints, and ground-reaction forces decreased for the fatigued hop conditions compared with the non-fatigued condition (P<0.05). Compared with landing during the non-fatigued condition, hip moments and ground-reaction forces were lower for the fatigued hop conditions (P<0.05). The negative joint power was two to three times greater for the knee than for the hip and five to 10 times greater for the knee than for the ankle during landing for all test conditions (P<0.05). Most measured variables had recovered three minutes post-exercise. It is concluded that the fatiguing exercise protocol combined with single-leg hop testing was a reliable method for investigating functional performance under fatigued test conditions. Further, subjects utilized an adapted hop strategy, which employed less hip and knee flexion and generated powers for the knee and ankle joints during take-off, and less hip joint moments during landing under fatigued conditions. The large negative power values observed at the knee joint during the landing phase of the single-leg hop, during which the quadriceps muscle activates eccentrically, indicate that not only hop distance but also the ability to perform successful landings should be investigated when assessing dynamic knee function. PMID:16533349

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

    PubMed

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

    2015-12-01

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

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

    PubMed

    Kulagina, T Iu; Stamov, V I; Nikoda, V V; Dobrovol'skaia, T N

    2013-01-01

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

  9. Simulated Cardiopulmonary Arrests in a Hospital Setting.

    ERIC Educational Resources Information Center

    Mishkin, Barbara H.; And Others

    1982-01-01

    Describes a simulated interdisciplinary role rehearsal for cardiopulmonary arrest to prepare nurses to function effectively. Includes needs analysis, program components, and responses of program participants. (Author)

  10. Noninvasive measurement of cardiac performance in recovery from exercise in heart failure patients

    PubMed Central

    Myers, Jonathan N; Gujja, Pradeep; Neelagaru, Suresh; Hsu, Leon; Burkhoff, Daniel

    2011-01-01

    OBJECTIVE: To examine the association between cardiac performance during recovery and the severity of heart failure, as determined by clinical and cardiopulmonary exercise test responses. METHODS: As part of a retrospective cohort study, 46 heart failure patients and 13 normal subjects underwent cardiopulmonary exercise testing while cardiac output was measured using a noninvasive device. Cardiac output in recovery was expressed as the slope of a single exponential relationship between cardiac output and time; the recovery-time constant was assessed in relation to indices of cardiac function, along with clinical, functional, and cardiopulmonary exercise responses. RESULTS: The recovery time constant was delayed in patients with heart failure compared with normal subjects (296.7±238 vs. 110.1±27 seconds, p <0.01), and the slope of the decline of cardiac output in recovery was steeper in normal subjects compared with heart failure patients (p<0.001). The slope of the decline in cardiac output recovery was inversely related to peak VO2 (r = -0.72, p<0.001) and directly related to the VE/VCO2 slope (r = 0.57, p<0.001). Heart failure patients with abnormal recovery time constants had lower peak VO2, lower VO2 at the ventilatory threshold, lower peak cardiac output, and a heightened VE/VCO2 slope during exercise. CONCLUSIONS: Impaired cardiac output recovery kinetics can identify heart failure patients with more severe disease, lower exercise capacity, and inefficient ventilation. Estimating cardiac output in recovery from exercise may provide added insight into the cardiovascular status of patients with heart failure. PMID:21655761

  11. 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. )

    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.

  12. Predicting Marathon Time Using Exhaustive Graded Exercise Test in Marathon Runners.

    PubMed

    Till, Eloise S; Armstrong, Stuart A; Harris, Greg; Maloney, Stephen

    2016-02-01

    Till, ES, Armstrong, SA, Harris, G, and Maloney, S. Predicting marathon time using exhaustive graded exercise test in marathon runners. J Strength Cond Res 30(2): 512-517, 2016-The study aimed to investigate the correlation between time on a treadmill test and exhaustion 2 weeks before a road marathon and the subsequent road marathon performance time (MPT). The study recruited 59 runners entered in the Melbourne 2012 marathon, Canberra 2013 marathon, and Gold Coast 2013 marathon. Forty runners completed both the graded exercise treadmill test to exhaustion and the 42.2 km marathon. Nineteen participants dropped out of the study due to illness, injury, or did not begin the treadmill test. A statistically significant correlation was found between treadmill time and MPT (adjusted R = 0.447). Sex, weekly running duration (t = -1.58, p = 0.12), years of running (t = 1.10, p = 0.28), and age (t = 0.94, p = 0.36) did not statistically correlate with MPT. The relationship between the graded exercise test and MPT can be used to predict MPT using y = -3.85x + 351.57, where y is MPT and x is treadmill time. This is a simple, accessible, and cost-effective method to aid athletes in predicting their race time over 42.2 km. Prediction of marathon time in a simple and accessible manner was believed to be useful to the growing population of marathon runners around the world. PMID:26815178

  13. Heart Rate Acceleration and Recovery Indices are Not Related to the Development of Ventricular Premature Beats During Exercise Test

    PubMed Central

    Buyukterzi, Zafer; Ozeke, Ozcan; Ozlu, Mehmet Fatih; Canga, Aytun; Gurel, Ozgul Malcok; Guler, Tumer Erdem; Kaya, Veli; Ozcan, Firat; Cay, Serkan; Topaloglu, Serkan; Aras, Dursun

    2014-01-01

    Background Changes in heart rate (HR) during exercise and recovery from exercise are mediated by the balance between sympathetic and vagal activity. HR acceleration (HRA) and recovery (HRR) are important measures of cardiac autonomic dysfunction and directly correlated with sympathetic and parasympathetic activity. It is not known if the autonomic nervous system related to ventricular arrhythmias during exercise. The purpose was to evaluate the HRA and HRR in patients with and without premature ventricular complex (PVC) during exercise, and to examine the factors that might affect HRA and HRR. Methods The records of consecutive patients undergoing routine exercise test were reviewed. The characteristics and the HRA and HRR were compared between patients with and without PVC during exercise. Results A total of 232 patients (145 men) were recruited; 156 (103 men) developed PVCs during the exercise. Max HR was significantly lower in men with PVCs than in those without, which were not mirrored in women. There was no difference in HRA and HRR between the patients with and without exercise-induced PVCs in both genders. Compared to the men with PVCs, women had higher body mass index, shorter total exercise time, and higher HRA indices after the 3 and 6 minutes exercise. In patients with PVCs, the HRA and HRR indices were similar regardless of the presence of coronary artery disease and the phase of exercise test where PVC developed. Conclusions Although exercise performance may be different between the genders, the HRA or HRR indices were not related to the development of PVC during exercise in both genders. PMID:27122798

  14. Comparison of yearling, two-year-old and adult Thoroughbreds using a standardised exercise test.

    PubMed

    Seeherman, H J; Morris, E A

    1991-05-01

    The purpose of this study was to compare exercise measurements in yearling, two-year-old and adult Thoroughbreds using a standardised treadmill incremental exercise test. Peak oxygen consumption (VO2 peak: 128.0 +/- 2.1, 140.0 +/- 2.1, 163.7 +/- 3.4; ml/kg/min +/- se, P less than 0.05), peak packed cell volume (PCV peak: 0.50 +/- 0.01, 0.58 +/- 0.01, 0.64 +/- 0.01 litres/litre +/- se, P less than 0.05) and the maximum number of steps completed in the exercise test (STEPmax: 7.7 +/- 0.1, 8.1 +/- 0.1, 8.6 +/- 0.1; steps +/- se, P less than 0.05) increased with age and degree of physical activity. Peak venous lactate concentration (LACpeak: 21.3 +/- 1.5, 19.5 +/- 1.7, 14.4 +/- 1.7; mmol/litre +/- se, P less than 0.05) and peak respiratory exchange ratio (Rpeak) were significantly higher in both groups of younger horses compared to the adult racehorses. Peak heart rate (HRpeak: 230 +/- 2, 231 +/- 3, 229 +/- 3; beats/min +/- se) did not change with age or training. The rate of change of VO2 between steps in the exercise test (VO2trans) was significantly lower in the adult racehorses at the highest exercise intensities. The slopes of the linear approximation between R (LinR bx), the natural log transformation of venous lactate concentration (LogLAC bx), and heart rate (HR bx) with velocity were significantly lower in the trained adult racehorses. The slope of venous lactate concentration normalised to per cent VO2peak (LogLAC per cent bx) was significantly lower and R breakpoint (R brkpt) normalised to per cent VO2peak was significantly higher in the trained adult racehorses. There was a more rapid decrease in venous lactate and a more rapid return to initial R values in the adult horses relative to the younger, untrained horses. No significant age or training effects were found in the remainder of the post exercise measurements. These results indicate that aerobic power and exercise capacity increased with age and training. Anaerobic power was already well developed even at a young age. PMID:1909234

  15. Arm exercise-thallium imaging testing for the detection of coronary artery disease

    SciTech Connect

    Balady, G.J.; Weiner, D.A.; Rothendler, J.A.; Ryan, T.J.

    1987-01-01

    Patients with lower limb impairment are often unable to undergo a standard bicycle or treadmill test for the evaluation of coronary artery disease. To establish an alternative method of testing, 50 subjects (aged 56 +/- 10 years) performed arm ergometry testing in conjunction with myocardial thallium scintigraphy. All underwent coronary angiography; significant coronary artery disease (greater than or equal to 70% stenosis) in at least one vessel was present in 41 (82%) of the 50 patients. Thallium scintigraphy was found to have an 83% sensitivity and 78% specificity for detecting coronary disease, compared with a sensitivity and specificity of 54% (p less than 0.01) and 67% (p = NS), respectively, for exercise electrocardiography. In the subgroup of 23 patients who had no prior myocardial infarction or left bundle branch block and were not taking digitalis, thallium scintigraphy had a sensitivity of 80% versus 50% for exercise electrocardiography. Scintigraphy yielded a sensitivity of 84, 74 and 90% for one, two and three vessel disease, respectively. Noninvasive arm ergometry exercise-thallium imaging testing appears to be reliable and useful and should be considered in the evaluation of coronary artery disease in patients with lower limb impairment.

  16. 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.

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

    NASA Technical Reports Server (NTRS)

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

    1973-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  19. 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.

  20. 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

  1. 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

  2. A Descriptive Analysis of Exercise Tolerance Test at Seremban Hospital : An Audit for the Year 2001

    PubMed Central

    Mohamed, Abdul Latiff; Nee, Chan Chee; Azzad, Ahmed

    2004-01-01

    Our purpose is to report on the epidemiological variables and their association with the results of the exercise tolerance test (ETT) in the series of patients referred for standard diagnostic ETT at Seremban Hospital during the year 2001. ETT is widely performed, but, in Malaysia, an analysis of the associations between the epidemiological data and the results of the ETT has not been presented. All patients referred for ETT at Seremban Hospital who underwent exercise treadmill tests for the year 2001 were taken as the study population. Demographic details and patients with established heart disease (i.e. prior coronary bypass surgery, myocardial infarction, or congestive heart failure) were noted. Clinical and ETT variables were collected retrospectively from the hospital records. Testing and data management were performed in a standardized fashion with a computer-assisted protocol. This study showed that there was no significant predictive epidemiological variable on the results of the ETT. However, it was found that there was statistically significant difference between the peak exercise time of males and females undergoing the ETT. PMID:22973128

  3. A descriptive analysis of exercise tolerance test at seremban hospital : an audit for the year 2001.

    PubMed

    Mohamed, Abdul Latiff; Nee, Chan Chee; Azzad, Ahmed

    2004-07-01

    Our purpose is to report on the epidemiological variables and their association with the results of the exercise tolerance test (ETT) in the series of patients referred for standard diagnostic ETT at Seremban Hospital during the year 2001. ETT is widely performed, but, in Malaysia, an analysis of the associations between the epidemiological data and the results of the ETT has not been presented. All patients referred for ETT at Seremban Hospital who underwent exercise treadmill tests for the year 2001 were taken as the study population. Demographic details and patients with established heart disease (i.e. prior coronary bypass surgery, myocardial infarction, or congestive heart failure) were noted. Clinical and ETT variables were collected retrospectively from the hospital records. Testing and data management were performed in a standardized fashion with a computer-assisted protocol. This study showed that there was no significant predictive epidemiological variable on the results of the ETT. However, it was found that there was statistically significant difference between the peak exercise time of males and females undergoing the ETT. PMID:22973128

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

    PubMed

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

    2012-03-01

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

  5. 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

  6. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation.

    PubMed

    Mezzani, Alessandro; Hamm, Larry F; Jones, Andrew M; McBride, Patrick E; Moholdt, Trine; Stone, James A; Urhausen, Axel; Williams, Mark A

    2013-06-01

    Aerobic exercise intensity prescription is a key issue in cardiac rehabilitation, being directly linked to both the amount of improvement in exercise capacity and the risk of adverse events during exercise. This joint position statement aims to provide professionals with up-to-date information regarding the identification of different exercise intensity domains, the methods of direct and indirect determination of exercise intensity for both continuous and interval aerobic training, the effects of the use of different exercise protocols on exercise intensity prescription and the indications for recommended exercise training prescription in specific cardiac patients' groups. The importance of functional evaluation through exercise testing prior to starting an aerobic training program is strongly emphasized, and ramp incremental cardiopulmonary exercise test, when available, is proposed as the gold standard for a physiologically comprehensive exercise intensity assessment and prescription. This may allow a shift from a 'range-based' to a 'threshold-based' aerobic exercise intensity prescription, which, combined with thorough clinical evaluation and exercise-related risk assessment, could maximize the benefits obtainable by the use of aerobic exercise training in cardiac rehabilitation. PMID:23104970

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

    SciTech Connect

    Coyne, E.P.; Belvedere, D.A.; Vande Streek, P.R.; Weiland, F.L.; Evans, R.B.; Spaccavento, L.J. )

    1991-05-01

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

  8. Ischemic preconditioning accelerates muscle deoxygenation dynamics and enhances exercise endurance during the work-to-work test

    PubMed Central

    Kido, Kohei; Suga, Tadashi; Tanaka, Daichi; Honjo, Toyoyuki; Homma, Toshiyuki; Fujita, Satoshi; Hamaoka, Takafumi; Isaka, Tadao

    2015-01-01

    Ischemic preconditioning (IPC) improves maximal exercise performance. However, the potential mechanism(s) underlying the beneficial effects of IPC remain unknown. The dynamics of pulmonary oxygen uptake (VO2) and muscle deoxygenation during exercise is frequently used for assessing O2 supply and extraction. Thus, this study examined the effects of IPC on systemic and local O2 dynamics during the incremental step transitions from low- to moderate- and from moderate- to severe-intensity exercise. Fifteen healthy, male subjects were instructed to perform the work-to-work cycling exercise test, which was preceded by the control (no occlusion) or IPC (3 × 5 min, bilateral leg occlusion at >300 mmHg) treatments. The work-to-work test was performed by gradually increasing the exercise intensity as follows: low intensity at 30 W for 3 min, moderate intensity at 90% of the gas exchange threshold (GET) for 4 min, and severe intensity at 70% of the difference between the GET and VO2 peak until exhaustion. During the exercise test, the breath-by-breath pulmonary VO2 and near-infrared spectroscopy-derived muscle deoxygenation were continuously recorded. Exercise endurance during severe-intensity exercise was significantly enhanced by IPC. There were no significant differences in pulmonary VO2 dynamics between treatments. In contrast, muscle deoxygenation dynamics in the step transition from low- to moderate-intensity was significantly faster in IPC than in CON (27.2 ± 2.9 vs. 19.8 ± 0.9 sec, P < 0.05). The present findings showed that IPC accelerated muscle deoxygenation dynamics in moderate-intensity exercise and enhanced severe-intensity exercise endurance during work-to-work test. The IPC-induced effects may result from mitochondrial activation in skeletal muscle, as indicated by the accelerated O2 extraction. PMID:25952936

  9. INFLUENCE OF EXERCISE TESTING IN GASTROESOPHAGEAL REFLUX IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

    PubMed Central

    MENDES-FILHO, Antonio Moreira; MORAES-FILHO, Joaquim Prado Pinto; NASI, Ary; EISIG, Jaime Natan; RODRIGUES, Tomas Navarro; BARBUTTI, Ricardo Correa; CAMPOS, Josemberg Marins; CHINZON, Dcio

    2014-01-01

    Background Gastroesophageal reflux disease is a worldwide prevalent condition that exhibits a large variety of signs and symptoms of esophageal or extra-esophageal nature and can be related to the esophagic adenocarcinoma. In the last few years, greater importance has been given to the influence of physical exercises on it. Some recent investigations, though showing conflicting results, point to an exacerbation of gastroesophageal reflux during physical exercises. Aim To evaluate the influence of physical activities in patients presenting with erosive and non erosive disease by ergometric stress testing and influence of the lower esophageal sphincter tonus and body mass index during this situation. Methods Twenty-nine patients with erosive disease (group I) and 10 patients with non-erosive disease (group II) were prospectively evaluated. All the patients were submitted to clinical evaluation, followed by upper digestive endoscopy, manometry and 24 h esophageal pH monitoring. An ergometric testing was performed 1 h before removing the esophageal pH probe. During the ergometric stress testing, the following variables were analyzed: test efficacy, maximum oxygen uptake, acid reflux duration, gastroesophageal reflux symptoms, influence of the lower esophageal sphincter tonus and influence of body mass index in the occurrence of gastroesophageal reflux during these physical stress. Results Maximum oxigen consumption or VO 2 max, showed significant correlation when it was 70% or higher only in the erosive disease group, evaluating the patients with or without acid reflux during the ergometric testing (p=0,032). The other considered variables didn't show significant correlations between gastroesophageal reflux and physical activity (p>0,05). Conclusions 1) Highly intensive physical activity can predispose the occurrence of gastroesophageal reflux episodes in gastroesophageal reflux disease patients with erosive disease; 2) light or short sessions of physical activity have no influence on reflux, regardless of body mass index; 3) the lower esophageal sphincter tonus does not influence the occurrence of reflux disease episodes during exercise testing. PMID:24676289

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

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

  11. 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.

  12. Radionuclide observables during the Integrated Field Exercise of the Comprehensive Nuclear-Test-Ban Treaty.

    PubMed

    Burnett, Jonathan L; Miley, Harry S; Milbrath, Brian D

    2016-03-01

    In 2014 the Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) undertook an Integrated Field Exercise (IFE14) in Jordan. The exercise consisted of a simulated 0.5-2 kT underground nuclear explosion triggering an On-site Inspection (OSI) to search for evidence of a Treaty violation. This research paper evaluates two of the OSI techniques used during the IFE14, laboratory-based gamma-spectrometry of soil samples and in-situ gamma-spectrometry, both of which were implemented to search for 17 OSI relevant particulate radionuclides indicative of nuclear explosions. The detection sensitivity is evaluated using real IFE and model data. It indicates that higher sensitivity laboratory measurements are the optimum technique during the IFE and within the Treaty/Protocol-specified OSI timeframes. PMID:26802699

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  14. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  15. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  16. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  17. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  18. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass coronary pressure...

  19. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass coronary pressure...

  20. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass coronary pressure...

  1. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass coronary pressure gauge... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood...

  2. The use of an exponential protocol for bicycle and treadmill exercise testing in patients with chronic cardiac failure.

    PubMed

    Riley, M; Northridge, D B; Henderson, E; Stanford, C F; Nicholls, D P; Dargie, H J

    1992-10-01

    We have studied a standardized exercise protocol suitable for use with a treadmill or bicycle (STEEP protocol) and compared it with a modified Bruce treadmill protocol in a group of patients with chronic cardiac failure. The STEEP protocol has been previously validated in normal subjects. Exercise time (6.79 +/- 2.42 vs 5.34 +/- 1.95 min, P < 0.05) and peak VO2 (16.66 +/- 4.09 vs 15.01 +/- 3.72 ml.min-1.kg-1, P < 0.05) were greater with the STEEP treadmill compared with the bicycle protocol, but VO2 was very similar at equal exercise stages in both modalities. Heart rate and respiratory exchange ratio tended to be greater during bicycle exercise at equal stages. Exercise time was greater with the modified Bruce protocol (9.00 +/- 3.02 min, P < 0.05) than with either STEEP protocol, but peak VO2 (17.13 +/- 4.52 ml.min-1.kg-1) was similar to that obtained with the STEEP treadmill test. We conclude that the STEEP protocol may be used to test patients with chronic cardiac failure, and that exercise times relate well in both treadmill and bicycle. The protocol should prove useful in studies involving a wide range of exercise capacities or both bicycle and treadmill exercise. PMID:1396809

  3. Prediction of peak oxygen pulse (O2Ppeak) without exercise testing in older adults.

    PubMed

    Maranhao Neto, Geraldo A; Oliveira, Ricardo B; Myers, Jonathan N; Farinatti, Paulo T V

    2014-01-01

    Peak oxygen pulse has been considered a surrogate of cardiovascular function and an independent predictor of all cause mortality. However, O2P(peak) depends on maximal volitional effort which may limit its utility in older subjects. The aim of this study was to develop a model to estimate O2P(peak) without exercise in an elderly sample. This cross-sectional study enrolled 67 community-dwelling older adults (69.4±7.1 years; 41 men) for the non-exercise model development and 30 community-dwelling older adults (67.7±6.4 years; n=30; 17 men) for cross-validation. The non-exercise model was derived through hierarchical regression model and cross-validated by means of PRESS statistics and comparison against an independent sample. Classification accuracy of the model for tertiles of estimated and actual O2P(peak) was tested by gamma (γ) nonparametric correlation. The following prediction equation was generated: -3.416+0.137 × weight (kg)+1.226 × Veterans Specific Activity Questionnaire (VSAQ) (metabolic equivalents, METs)+1.987 × gender (0=women, 1=men)-2.045 × β-Blockers use (0=no, 1=yes)-0.044 × resting heart rate (HR) (R(2)=0.83; standard error of estimate (SEE)=1.68 mL beat(-1)). Correlation in cross-validation group was 0.80 (P<0.001). A high probability was observed for the model to rank the values in the same tertile in validation and cross-validation groups (γ=0.98; γ=0.92, respectively, P<0.05). In conclusion, O2P(peak) can be estimated with reasonable precision without exercise testing, providing an alternative for elder subjects not capable to perform maximal effort. PMID:25085231

  4. Exercise induced von Willebrand Factor release -- new model for routine endothelial testing.

    PubMed

    Balen, Sanja; Ruzić, Alen; Mirat, Jure; Persić, Viktor

    2007-01-01

    Endothelial dysfunction (ED) is actively involved in the mechanism of occurrence, development and progression of all the degrees of atherosclerosis. The established impact of ED on the progress and outcome of cardiovascular diseases, together with convincing indications of a possible successful therapeutic modification, necessitate the changeover of ED assessment from experimental to a routine practice. As there is no appropriate method for a clinical practice, scientists anticipate significant research efforts in the further development. Among numerous methods already available, von Willebrand Factor (vWF) stands out significantly. In accordance with the accepted leading diagnostic role of vWF baseline levels in the group of peripheral endothelial markers, and earlier scientific observations on the absence of its expected reactivation during physical exercise, we hypothesised this promising theory. We believe that a constant stronger release of vWF in endothelial cell injury leads to the exhaustion of its stores in Weibel-Palade bodies with the consequent absence of the expected rise of concentration during the exercise. Therefore, we hypothesised that ED could be exhaustible vWF endothelopathy and the exercise induced release of vWF a new, simple, safe and reliable test for the detection of ED and monitoring of the expected therapeutic effect. In order to have a final clinical usability of the proposed diagnostic model, it is necessary to test its reliability in different pathological and risk states, and establish susceptibility in therapeutic procedures. The correlation with invasive functional angiographic tests and the flow mediated dilatation test of peripheral arteries also needs to be validated. We expect the proposed test of vWF inducibility to find its place in clinical practice, i.e. in prevention, prediction and therapy of cardiovascular diseases. PMID:17507174

  5. 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. )

    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.

  6. 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.

  7. 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.

  8. 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

  9. 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…

  10. 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

    Hatchery-reared juvenile, < 25-cm TL (total length), razorback suckers appeared curious and showed no sign of predator avoidance when initially placed with large ( >45-cm TL) flathead catfish. Predator-naive 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-naive fish (p = 0.017). Similar tests exposing predator-savvy and predator-naive 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.

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

    PubMed

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

    2011-01-01

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

  12. 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.

  13. Computer-enhanced thallium scintigrams in asymptomatic men with abnormal exercise tests

    SciTech Connect

    Uhl, G.S.; Kay, T.N.; Hickman, J.R. Jr.

    1981-12-01

    The use of treadmill testing in asymptomatic patients and those with an atypical chest pain syndrome is increasing, yet the proportion of false positive stress electrocardiograms increases as the prevalence of disease decreases. To determine the diagnostic accuracy of computer-enhanced thallium perfusion scintigraphy in this subgroup of patients, multigated thallium scans were obtained after peak exercise and 3 or 4 hours after exercise and the raw images enhanced by a computer before interpretations were made. The patient group consisted of 191 asymptomatic U.S. Air force aircrewmen who had an abnormal exercise electrocardiogram. Of these, 135 had normal coronary angiographic findings, 15 had subcritical coronary stenosis (less than 50 percent diameter narrowing) and 41 had significant coronary artery disease. Use of computer enhancement resulted in only four false positive and two false negative scintigrams. The small subgroup with subcritical coronary disease had equivocal results on thallium scintigraphy, 10 men having abnormal scans and 5 showing no defects. The clinical significance of such subcritical disease in unclear, but it can be detected with thallium scintigraphy. Thallium scintigrams that have been enhanced by readily available computer techniques are an accurate diagnostic tool even in asymptomatic patients with an easily interpretable abnormal maximal stress electrocardiogram. Thallium scans can be effectively used in counseling asymptomatic patients on the likelihood of their having coronary artery disease.

  14. 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.

  15. Graded Maximal Exercise Testing to Assess Mouse Cardio-Metabolic Phenotypes

    PubMed Central

    Petrosino, Jennifer M.; Heiss, Valerie J.; Maurya, Santosh K.; Kalyanasundaram, Anuradha; Periasamy, Muthu; LaFountain, Richard A.; Wilson, Jacob M.; Simonetti, Orlando P.; Ziouzenkova, Ouliana

    2016-01-01

    Functional assessments of cardiovascular fitness (CVF) are needed to establish animal models of dysfunction, test the effects of novel therapeutics, and establish the cardio-metabolic phenotype of mice. In humans, the graded maximal exercise test (GXT) is a standardized diagnostic for assessing CVF and mortality risk. These tests, which consist of concurrent staged increases in running speed and inclination, provide diagnostic cardio-metabolic parameters, such as, VO2max, anaerobic threshold, and metabolic crossover. Unlike the human-GXT, published mouse treadmill tests have set, not staged, increases in inclination as speed progress until exhaustion (PXT). Additionally, they often lack multiple cardio-metabolic parameters. Here, we developed a mouse-GXT with the intent of improving mouse-exercise testing sensitivity and developing translatable parameters to assess CVF in healthy and dysfunctional mice. The mouse-GXT, like the human-GXT, incorporated staged increases in inclination, speed, and intensity; and, was designed by considering imitations of the PXT and differences between human and mouse physiology. The mouse-GXT and PXTs were both tested in healthy mice (C57BL/6J, FVBN/J) to determine their ability to identify cardio-metabolic parameters (anaerobic threshold, VO2max, metabolic crossover) observed in human-GXTs. Next, theses assays were tested on established diet-induced (obese-C57BL/6J) and genetic (cardiac isoform Casq2-/-) models of cardiovascular dysfunction. Results showed that both tests reported VO2max and provided reproducible data about performance. Only the mouse-GXT reproducibly identified anaerobic threshold, metabolic crossover, and detected impaired CVF in dysfunctional models. Our findings demonstrated that the mouse-GXT is a sensitive, non-invasive, and cost-effective method for assessing CVF in mice. This new test can be used as a functional assessment to determine the cardio-metabolic phenotype of various animal models or the effects of novel therapeutics. PMID:26859763

  16. Graded Maximal Exercise Testing to Assess Mouse Cardio-Metabolic Phenotypes.

    PubMed

    Petrosino, Jennifer M; Heiss, Valerie J; Maurya, Santosh K; Kalyanasundaram, Anuradha; Periasamy, Muthu; LaFountain, Richard A; Wilson, Jacob M; Simonetti, Orlando P; Ziouzenkova, Ouliana

    2016-01-01

    Functional assessments of cardiovascular fitness (CVF) are needed to establish animal models of dysfunction, test the effects of novel therapeutics, and establish the cardio-metabolic phenotype of mice. In humans, the graded maximal exercise test (GXT) is a standardized diagnostic for assessing CVF and mortality risk. These tests, which consist of concurrent staged increases in running speed and inclination, provide diagnostic cardio-metabolic parameters, such as, VO2max, anaerobic threshold, and metabolic crossover. Unlike the human-GXT, published mouse treadmill tests have set, not staged, increases in inclination as speed progress until exhaustion (PXT). Additionally, they often lack multiple cardio-metabolic parameters. Here, we developed a mouse-GXT with the intent of improving mouse-exercise testing sensitivity and developing translatable parameters to assess CVF in healthy and dysfunctional mice. The mouse-GXT, like the human-GXT, incorporated staged increases in inclination, speed, and intensity; and, was designed by considering imitations of the PXT and differences between human and mouse physiology. The mouse-GXT and PXTs were both tested in healthy mice (C57BL/6J, FVBN/J) to determine their ability to identify cardio-metabolic parameters (anaerobic threshold, VO2max, metabolic crossover) observed in human-GXTs. Next, theses assays were tested on established diet-induced (obese-C57BL/6J) and genetic (cardiac isoform Casq2-/-) models of cardiovascular dysfunction. Results showed that both tests reported VO2max and provided reproducible data about performance. Only the mouse-GXT reproducibly identified anaerobic threshold, metabolic crossover, and detected impaired CVF in dysfunctional models. Our findings demonstrated that the mouse-GXT is a sensitive, non-invasive, and cost-effective method for assessing CVF in mice. This new test can be used as a functional assessment to determine the cardio-metabolic phenotype of various animal models or the effects of novel therapeutics. PMID:26859763

  17. Maximal exercise testing in patients with spontaneous angina pectoris associated with transiet ST segment elevation. Risks and electrocardiographic findings.

    PubMed Central

    Detry, J M; Mengeot, P; Rousseau, M F; Cosyns, J; Ponlot, R; Brasseur, L A

    1975-01-01

    Six patients with spontaneous angina associated with transient ST segment elevation had a multistate maximal exercise (bicycle) test. In 5 patients, typical electrocardiographic changes were recorded during exercise, namely ST segment elevation often accompanied by an increase in the voltage of the R wave and a widening of the QRS complex. Four of these patients developed severe rhythm disturbances: ventricular tachycardia (2 cases) and ventricular flutter (1 case) were the reason for early interruption of the test in 3 patients, while 1 patient had a short run of ventricular tachycardia after exercise. These rhythm disturbances which spontaneously regressed in all cases were consistently preceded by obvious ST elevation and in 2 patients were attended by slight chest discomfort. Maximal exercise testing of patients suspected of variant angina provides important diagnostic information in many patients, but the risks of potentially lethal arrhythmias should be considered and resuscitation facilities should always be immediately available. Images PMID:1103910

  18. Discussing cardiopulmonary resuscitation with patients.

    PubMed

    Attwood, S; Anderson, K; Mitchell, T

    The British Medical Association and the Royal College of Nursing acknowledge that patients should be involved in the decision-making process regarding cardiopulmonary resuscitation (CPR) in order to gain compliance with any decision made on their behalf. In the past, it was apparent that decisions concerning the eligibility of patients for CPR were being made arbitrarily and older people were being treated unfairly in respect of their consideration for this intervention. This article reviews literature associated with patient involvement in decision-making regarding CPR and 'do not resuscitate' orders and how an assessment and rehabilitation unit promoted this activity as usual practice. In order to enhance partnership with patients and promote best possible practice in respect of CPR decision making the authors suggest a strategy that includes (1) evaluating documentation (2) development of a patient information leaflet and (3) an education programme for healthcare personnel. PMID:11893959

  19. Computer simulation of cardiopulmonary resuscitation.

    PubMed

    Beyar, R; Dinnar, U

    1985-04-01

    Based on recent experiments attributing blood flow in cardiopulmonary resuscitation (CPR) to intra-thoracic pressure variations a computer study of the complete cardiovascular system with an arrested heart is presented. The model is based on a lumped parametric description of the vascular elements subjected to external pressure variations. The blood flow, which is generated in the system, is found to be within the reported experimental findings in similar conditions, and is highly sensitive to valving mechanisms within the heart and the large veins. Optimal conditions for CPR were searched mathematically and found to be consistent with known experimental data. Mechanisms of blood flow in CPR are discussed. The above model thus offers a tool to understand the various mechanisms involved in CPR and the relative importance of different physiological parameters, and may help in the design of an optimal CPR mode. PMID:3999720

  20. The Physiology of Cardiopulmonary Resuscitation.

    PubMed

    Lurie, Keith G; Nemergut, Edward C; Yannopoulos, Demetris; Sweeney, Michael

    2016-03-01

    Outcomes after cardiac arrest remain poor more than a half a century after closed chest cardiopulmonary resuscitation (CPR) was first described. This review article is focused on recent insights into the physiology of blood flow to the heart and brain during CPR. Over the past 20 years, a greater understanding of heart-brain-lung interactions has resulted in novel resuscitation methods and technologies that significantly improve outcomes from cardiac arrest. This article highlights the importance of attention to CPR quality, recent approaches to regulate intrathoracic pressure to improve cerebral and systemic perfusion, and ongoing research related to the ways to mitigate reperfusion injury during CPR. Taken together, these new approaches in adult and pediatric patients provide an innovative, physiologically based road map to increase survival and quality of life after cardiac arrest. PMID:26562060

  1. Cardiopulmonary assessment: is improvement needed?

    PubMed

    Van De Water, Joseph M; Dalton, Martin L; Parish, David C; Vogel, Robert L; Beatty, John C; Adeniyi, Said O

    2005-01-01

    Clinical parameters alone have repeatedly been proven unreliable in assessing cardiopulmonary status, especially in hemodynamically unstable patients. To learn if we had a diagnostic problem in our hospital, we compared physician assessment of cardiac index (CI) and thoracic fluid content (TFC) to values obtained using impedance cardiography (ICG). We selected the newest available ICG monitor, the BioZ, which employs this noninvasive technology. For CI measurements we have shown it to be equivalent to thermodilution and to be more reproducible (variability: 6.3% vs. 24.7%). Physician assessment of CI and TFC (high, normal, or low) was compared to the BioZ monitor's results in 186 patients, considered to be hemodynamically unstable, from the emergency room, the intensive care units, and the floors. Normal values were defined for CI (2.5-4.2 L/min m(2)) and for TFC (males: 30-50 kohm(-1) and females: 21-37 kohm(-1)). The concordance between physician assessment and the BioZ was 51% for CI with Kappa of 0.14 and 58% for TFC with Kappa of 0.19. Attendings did slightly better than the surgical residents with CI (52% vs. 48%) but slightly worse with TFC (57% vs. 61%). The potentially serious conditions of low CI and high TFC were misdiagnosed 42% and 46% of the time, respectively, by all physicians. Analysis of the data revealed that physician use of clinically available objective hemodynamic data, such as heart rate, blood pressure, and pulse pressure index, would not have been helpful. Furthermore, assistance from the pulmonary artery catheter (PAC) is often not available in our hospital, which has experienced a 90% decrease in its utilization over the past six years. Considering the increasing acuity of our aging patient population, accurate assessment of cardiopulmonary status is needed. The use of ICG could be a valuable addition to the physician's armamentarium. PMID:15815820

  2. Longitudinal Influences of Knowledge and Self-efficacy on Exercise Behavior: Tests of a Mutual Reinforcement Model.

    PubMed

    Rimal, R N

    2001-01-01

    The central tenet of social cognitive theory, that individuals' construal processes and behaviors mutually reinforce each other, is tested for exercise behavior. Two longitudinal data sets (year 1 to year 2 and year 1 to year 6) from the Stanford Five-City Project, a field experiment to promote cardiovascular disease prevention in California, are analyzed through structural equation modeling techniques to evaluate the effects of demographics, exercise knowledge, and exercise self-efficacy on exercise behavior. The effects of exercise behavior on subsequent knowledge and self-efficacy are also examined. In both data sets (year 1 to year 2, N = 1254 and year 1 to year 6, N = 939), education, income, age, and sex were significant predictors of exercise behavior. Self-efficacy and knowledge also predicted behavior. Prior exercise behavior predicted subsequent knowledge and self-efficacy. Prior knowledge and self-efficacy, in turn, predicted subsequent exercise behavior. Recommendations are made for enhancing the effectiveness of public health efforts designed to promote healthy behaviors. PMID:22049236

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

    PubMed

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

    2015-01-01

    The present study examined the reliability of the force-velocity relationship during cycling and arm cranking exercises in active males and females. Twenty male and seventeen female physical education students performed three-session tests with legs and three-session tests with arms on a friction-loaded ergometer on six different sessions in a randomized order. The reliability of maximal power (Pmax), maximal pedal rate (V 0), and maximal force (F0) were studied using the coefficient of variation (CV), the intraclass correlation coefficient (ICC) and the test-retest correlation coefficient (r). Reliability indices were better for men (1.74 ≤ CV ≤ 4.36, 0.82 ≤ ICC ≤ 0.97, and 0.81 ≤ r ≤ 0.97) compared with women (2.34 ≤ CV ≤ 7.04, 0.44 ≤ ICC ≤ 0.98, and 0.44 ≤ r ≤ 0.98) and in cycling exercise (1.74 ≤ CV ≤ 3.85, 0.88 ≤ ICC ≤ 0.98, and 0.90 ≤ r ≤ 0.98) compared with arm exercise (2.37 ≤ CV ≤ 7.04, 0.44 ≤ ICC ≤ 0.95, and 0.44 ≤ r ≤ 0.95). Furthermore, the reliability indices were high for Pmax and F0 whatever the expression of the results (raw data or data related to body dimensions). Pmax and F0 could be used in longitudinal physical fitness investigations. However, further studies are needed to judge V 0 reliability. PMID:26539544

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

    PubMed Central

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

    2015-01-01

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

  5. Exercise performance and oxygen uptake efficiency slope in obese children performing standardized exercise.

    PubMed

    Marinov, B; Kostianev, S

    2003-01-01

    Oxygen uptake efficiency slope (OUES) is an index meant to provide an objective measure of cardiopulmonary function at submaximal exercise. The aim was to study the exercise performance and OUES in obese children performing standardized exercise. Sixty children aged 6-17 years performed incremental treadmill exercise test. They were divided into two groups matched by age, sex and height: thirty obese subjects (15 girls/15 boys; BMI = 27.4+/-1.7 m x kg(-2)) and 30 controls (BMI = 18.8+/-1.0 m x kg(-2)). Perceived exertion was assessed by means of CR-10 Borg scale. The duration of the exercise for the obese children was significantly shorter than for controls (p = 0.010) but obese children had greater absolute values for oxygen uptake (VO2 peak mL x min(-1) = 1907+/-249 vs. 1495+/-208; p = 0.013) which, adjusted for body mass, decreased significantly (VO2/kg mL x min(-1) x kg(-1) = 29.2+/-1.4 vs. 33.6+/-1.3; p < 0.001). OUES correlated strongly with VO2 peak (r = 0.91) and oxygen pulse (r = 0.80), as well as with anthropometric variables height (r = 0.88) and age (r = 0.83). Extremely high correlation was found between OUES calculated for 100% of exercise duration and OUES at the anaerobic threshold (r = 0.979; p < 0.001). No significant differences were found between the studied groups concerning the absolute values of OUES. Obese children rated perceived exertion significantly higher than controls (Borg score 6.2+/-0.4 vs. 5.2+/-0.4; p = 0.001). In conclusion, the absolute metabolic cost of exercise and perceived exertion were higher in the obesity group. OUES is an objective measure of cardiopulmonary reserve that doesn't require a maximal effort but it is considerably dependent on anthropometric variables which impedes its interpretation as exercise index in childhood. PMID:14570149

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

    NASA Astrophysics Data System (ADS)

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

    2014-06-01

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

  7. Cardiopulmonary Syndromes (PDQ®)—Patient Version

    Cancer.gov

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

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

    PubMed

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

    2015-12-15

    Cardiorespiratory fitness is a major modifiable risk factor for cardiovascular diseases. People with bipolar disorder have a reduced cardiorespiratory fitness and its assessment within a multidisciplinary treatment therefore is necessary. We investigated the validity of the 6min walk test in people with bipolar disorder. A secondary aim was to assess clinical and demographic characteristics that might interfere with cardiorespiratory fitness performance. 19 (5?) outpatients (47.18.3 years) underwent a 6min walk test and a maximal cardiopulmonary exercise test on a cycle ergometer and completed the Positive-and-Negative-Affect-Schedule (PANAS) and Beck Depression Inventory (BDI). The distance achieved on the 6min walk test correlated moderately with peak oxygen uptake obtained during the maximal cardiopulmonary exercise test. The variance in age, weight and the PANAS negative score explained 70% of the variance in the distance achieved on the 6min walk test. The 6min walk test can be used as a measure-of-proxy to gauge cardiorespiratory fitness in people with bipolar disorder when maximal cardiopulmonary exercise test equipment is not available. Negative mood should be considered when evaluating the cardiorespiratory fitness of this vulnerable population. PMID:26526768

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

    PubMed

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

    2016-01-01

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

  10. Effects of light deprivation in physical performance and psychophysiological responses to a time-to-exhaustion exercise test.

    PubMed

    Pinheiro, Fabiano A; Santos, Tony M; Ugrinowitsch, Carlos; Noakes, Timothy D; Pires, Flávio O

    2015-11-01

    Studies have shown that there is no effect of light deprivation in closed-loop exercise performance, however less is known about the open-loop exercise performance. Thus, we verified if light deprivation may affect performance and psychophysiological responses to a time-to-exhaustion (TE), constant intensity exercise test. Twelve men performed TE tests (at 80% WPEAK of maximal incremental test) in control and light-deprived condition. Gaseous exchange (VE and VO2), heart rate (HR) and vastus lateralis electromyography (EMG) were continuously assessed, ratings of perceived exertion (RPE) and associative thoughts to exercise (ATE) were obtained every 60s. Responses at absolute time of exercise matched by the shortest time to exhaustion, and responses at exhaustion were compared between conditions (P<0.05). Exhaustion was shortened (5.0 ± 1.6 min vs 6.4 ± 2.4 min) and RPE slope was elevated in light deprivation, when compared to control (P<0.05). Responses of VE, VO2 and RPE were greater at exhaustion in light deprivation TE test than at the equivalent, paired time in control test. However, responses were similar at exhaustion of both TE tests; the exception was the lower EMG when the light was deprived. The light deprivation shortened the exhaustion and increased RPE in TE test, until the attainment of similar maximal psychophysiological responses. PMID:26297803

  11. Aerobic-exercise training improves ventilatory efficiency in overweight children.

    PubMed

    Kaufman, Christopher; Kelly, Aaron S; Kaiser, Dan R; Steinberger, Julia; Dengel, Donald R

    2007-02-01

    The objective of this study was to investigate the effect of an 8-week aerobic-exercise training program on ventilatory threshold and ventilatory efficiency in overweight children. Twenty overweight children (BMI > 85th percentile) performed a graded cycle exercise test at baseline and were then randomly assigned to 8 weeks of stationary cycling (n = 10) or a nonexercising control group (n = 10). Ventilatory variables were examined at ventilatory threshold (VT), which was determined via the Dmax method. After 8 weeks, significant improvements occurred in the exercise group compared with the control group for oxygen uptake at VT (exercise = 1.03 +/- 0.13 to 1.32 +/- 0.12 L/min vs. control = 1.20 +/- 0.10 to 1.11 +/- 0.10 L/min, p < .05) and ventilatory equivalent of carbon dioxide (VE/VCO2) at VT (exercise = 32.8 +/- 0.80 to 31.0 +/- 0.53 vs. control = 30.3 +/- 0.88 to 31.7 +/- 0.91, p < .05). Aerobic-exercise training might help reverse the decrements in cardiopulmonary function observed over time in overweight children. PMID:17554160

  12. 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.

  13. Comparison of glucose tolerance tests to detect the insulin sensitizing effects of a bout of continuous exercise.

    PubMed

    Ortega, Juan Fernando; Hamouti, Nassim; Fernndez-Elas, Valentn Emilio; Mora-Rodriguez, Ricardo

    2014-07-01

    The aim of the present study was to determine which of the available glucose tolerance tests (oral (OGTT) vs. intravenous (IVGTT)) could more readily detect the insulin sensitizing effects of a bout of continuous exercise. Ten healthy moderately fit young men (V?O2peak of 45.4 1.8 mLkg(-1)min(-1); age 27.5 2.7 yr) underwent 4 OGTT and 4 IVGTT on different days following a standardized dinner and overnight fast. One test was performed immediately after 55 min of cycle-ergometer exercise at 60% V?O2peak. Insulin sensitivity index was determined during a 50 min IVGTT according to Tura (CISI) and from a 120 min OGTT using the Matsuda composite index (MISI). After exercise, MISI improved 29 10% without reaching statistical significance (p = 0.182) due to its low reproducibility (coefficient of variation 16 3%; intra-class reliability 0.846). However, CISI significantly improved (50 4%; p < 0.001) after exercise showing better reproducibility (coefficient of variation 13 4%; intra-class reliability 0.955). Power calculation revealed that 6 participants were required for detecting the effects of exercise on insulin sensitivity when using IVGTT, whereas 54 were needed when using OGTT. The superior response of CISI compared with MISI suggests the preferential use of IVGTT to assess the effects of exercise on insulin sensitivity when using a glucose tolerance test. PMID:24971679

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

    PubMed

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

    2006-12-01

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

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

    PubMed

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

    2015-08-01

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

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

    PubMed Central

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

    2015-01-01

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

  17. 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.

  18. 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

  19. Cardiopulmonary Fitness Correlates with Regional Cerebral Grey Matter Perfusion and Density in Men with Coronary Artery Disease

    PubMed Central

    MacIntosh, Bradley J.; Swardfager, Walter; Crane, David E.; Ranepura, Nipuni; Saleem, Mahwesh; Oh, Paul I.; Stefanovic, Bojana; Herrmann, Nathan; Lanctt, Krista L.

    2014-01-01

    Purpose Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD), a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation. Methods CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak) was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM) voxel-based morphometry (VBM). Pseudo-continuous arterial spin labeling (pcASL) was used to produce cerebral blood flow (CBF) images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables. Results In 30 men with CAD (mean age 657 years), VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t?=?9.6, df?=?28, p<0.0001). Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak. Conclusion Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients. PMID:24622163

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

    SciTech Connect

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

    1991-07-01

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

  1. Biomaterial development for cardiopulmonary bypass.

    PubMed

    Gourlay, T

    2001-09-01

    Cardiopulmonary bypass (CPB) is dependent on materials foreign to the patient for its successful application. When blood comes into contact with these so-called biomaterials, an inappropriate inflammatory response, which can be life-threatening in some patients, may develop. The reason for this inappropriate activation of host defence mechanisms is not entirely clear, however a number of strategies have evolved over the years to minimize this unwanted sequelae of CPB. These strategies include surface coating of the materials of the circuit, using new materials thought to improve biocompatibility, and using a number of pharmacological interventions designed to suppress the inflammatory response. Recently, there has been some evidence which indicates that the plasticizer employed in the polyvinyl chloride (PVC) tubing of the CPB circuit may play a part in the development of the inflammatory response. The work described in this paper tends to support this thesis. These studies showed that by washing the plasticizer from the surface of the PVC tubing, the biocompatibility, as reflected in the upregulation of CD11b on the surface of neutrophils, was enhanced. Furthermore, the use of non-plasticized substitutes for PVC had a similar effect. The benefit from removing the plasticizer was similar to that gained from surface coating with heparin, one of the conventional approaches to reducing the inflammatory response to CPB. PMID:11565893

  2. 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

  3. Maximal exercise does not increase ventilation heterogeneity in healthy trained adults.

    PubMed

    Wrobel, Jeremy P; Ellis, Matthew J; Kee, Kirk; Stuart-Andrews, Christopher R; Thompson, Bruce R

    2016-04-01

    The effect of exercise on ventilation heterogeneity has not been investigated. We hypothesized that a maximal exercise bout would increase ventilation heterogeneity. We also hypothesized that increased ventilation heterogeneity would be associated with exercise-induced arterial hypoxemia (EIAH). Healthy trained adult males were prospectively assessed for ventilation heterogeneity using lung clearance index (LCI), Scond, and Sacinat baseline, postexercise and at recovery, using the multiple breath nitrogen washout technique. The maximal exercise bout consisted of a maximal, incremental cardiopulmonary exercise test at 25 watt increments. Eighteen subjects were recruited with mean ± SDage of 35 ± 9 years. There were no significant changes inLCI, Scond, or Sacinfollowing exercise or at recovery. While there was an overall reduction in SpO2with exercise (99.3 ± 1 to 93.7 ± 3%,P < 0.0001), the reduction in SpO2was not associated with changes inLCI, Scondor Sacin Ventilation heterogeneity is not increased following a maximal exercise bout in healthy trained adults. Furthermore,EIAHis not associated with changes in ventilation heterogeneity in healthy trained adults. PMID:27044853

  4. Postexercise hypotension after maximal short-term incremental exercise depends on exercise modality.

    PubMed

    Cunha, Felipe A; Midgley, Adrian W; Soares, Pedro P; Farinatti, Paulo T V

    2015-06-01

    This study investigated postexercise hypotension (PEH) after maximal cardiopulmonary exercise testing (CPET) performed using different exercise modalities. Twenty healthy men (aged 23 ± 3 years) performed 3 maximal CPETs (cycling, walking, and running), separated by 72 h in a randomized, counter-balanced order. Systolic (SBP) and diastolic blood pressure (DBP), heart rate, cardiac output, systemic vascular resistance (SVR), autonomic function (spontaneous baroreflex sensitivity (BRS) and heart rate variability (HRV)), and energy expenditure (EE) were assessed during a 60-min nonexercise control session and for 60 min immediately after each CPET. Total exercise volume (EE during CPET plus 60 min recovery) was significantly higher in running versus cycling and walking CPETs (P ≤ 0.001). Compared with control, only SBP after running CPET was significantly reduced (Δ = -6 ± 8 mm Hg; P < 0.001). Heart rate and cardiac output were significantly increased (P < 0.001) and SVR significantly decreased (P < 0.001) postexercise. BRS and HRV decreased after all CPETs (P < 0.001), whereas sympatho-vagal balance (low- and high-frequency (LF:HF) ratio) increased significantly after all exercise conditions, especially after running CPET (P < 0.001). Changes in SVR, BRS, sympathetic activity (low-frequency component of HRV), and LF:HF ratio were negatively correlated to variations in SBP (range -0.69 to -0.91; P < 0.001) and DBP (range -0.58 to -0.93; P ≤ 0.002). These findings suggest that exercise mode or the total exercise volume are major determinants of PEH magnitude in healthy men. Because of the running CPET, the PEH was primarily related to a decrease in SVR and to an increase in sympatho-vagal balance, which might be a reflex response to peripheral vasodilatation after exercise. PMID:25947649

  5. 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.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. [Influence of cardiopulmonary bypass on lymphocyte function].

    PubMed

    Hamano, K; Ito, H; Shirasawa, B; Gohra, H; Noda, H; Katoh, T; Fujimura, Y; Zempo, N; Esato, K

    1997-11-01

    It is known that lymphocyte function is impaired after cardiopulmonary bypass (CPB). In this study, the lymphocyte stimulation test (LST) with PHA was used before and after CPB in 28 adult patients, and compared with the surgical parameters and serum cytokine (IL-6, IL-8) levels. LST was impaired after CPB in all patients. Although this value usually recovered by the third postoperative day (POD); (normal group, n = 16), some patients showed prolonged duration of the impaired LST (delayed group, n = 12). Therefore, the parameters of surgery, white blood cell (WBC) count, lymphocytes and subsets, and serum cytokine levels were compared between the normal and the delayed groups. There was no significant difference in the number of WBCs or lymphocytes between these two groups. OKT4-positive cells were reduced on the first POD in both groups, and in the normal group, the number of OKT4-positive cells recovered more quickly than in the delayed group. Serum IL-6 and IL-8 levels in the delayed group were elevated after CPB, and were significantly higher in the delayed group than in the normal group. In conclusion, patients who showed prolonged impairment of lymphocyte function may be partly due to prolonged CPB. PMID:9430959

  9. 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.

  10. 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

  11. Performance, ventilation, and oxygen consumption in three different types of exercise test in patients with chronic obstructive lung disease.

    PubMed Central

    Swinburn, C R; Wakefield, J M; Jones, P W

    1985-01-01

    Seventeen patients (six men and 11 women, mean age 66 years) with severe chronic obstructive lung disease (mean FEV1 0.8 (SD 0.3)1) performed three different types of exercise test on four occasions within one week. Three daily doses of placebo tablets were given between the third and fourth attempt at each test. The tests were the 12 minute walking test, a fixed rate and height paced step test, and a cycle ergometer test in which the work rate was increased by 10 watts each minute. Performance increased significantly (p less than 0.01) between the first and fourth attempts in each type of test (12 min walking distance 16% (SD 20%); steps climbed 96% (74%); duration of cycling 29% (41%]. There was a trend for the increase in performance between successive attempts to become progressively smaller but this was not significant. No effect of placebo on exercise performance was detected. The greatest intersubject range of performance was seen in the step test (14-126 steps) and the least in the walking test (438-1014 m). Significant correlations (p less than 0.01) were observed between performance in all three types of exercise test, but the correlations found between the results of the various tests of exercise performance and the FEV1 and the FVC were either weak (p less than 0.05) or non-significant. Ventilation (VE) and oxygen consumption (VO2) were subsequently measured and compared in eight patients during all three types of exercise test. Both the VE and the VO2 that were achieved in the step test were significantly greater than in either the cycle or the walking test. No patient was able to reach and sustain steady state values of VE and VO2 in the step test, whereas a steady state for both VE and VO2 was reached and sustained by all eight patients in the walking test. It is suggested that at least three practice attempts at any exercise test should be made before the introduction of either placebo or specific pharmacological treatment and that even then it may be necessary to allow for the effects of further repeated testing in the assessment of the results of treatment. Images PMID:4035628

  12. Exercise response

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

  13. The acute phase inflammatory response to maximal exercise testing in children and young adults with sickle cell anaemia.

    PubMed

    Liem, Robert I; Onyejekwe, Kasiemobi; Olszewski, Marie; Nchekwube, Chisalu; Zaldivar, Frank P; Radom-Aizik, Shlomit; Rodeghier, Mark J; Thompson, Alexis A

    2015-12-01

    Although individuals with sickle cell anaemia (SCA) have elevated baseline inflammation and endothelial activation, the acute phase response to maximal exercise has not been evaluated among children with SCA. We measured the acute phase response to maximal exercise testing for soluble vascular cell adhesion molecule (sVCAM) as well as interleukin 6 (IL6), total white blood cell (WBC) count, C-reactive protein (CRP) and D-dimer in a cohort of children with SCA and matched controls at baseline, immediately after, and 30, 60 and 120min following exercise. Despite higher baseline levels of all biomarkers except CRP, the acute phase response from baseline to immediately after exercise was significantly greater in subjects versus controls for CRP (21 vs. 02mg/l, P=002) and D-dimer (160 vs. 10?g/l, P<001) only. Similar between-group trends were observed over time for all biomarkers, including sVCAM, IL6, total WBC, CRP and D-dimer. Lower fitness, defined by peak oxygen consumption (VO2 ), was independently associated with greater acute phase responses to exercise for sVCAM. Our results suggest maximal exercise may not be associated with any greater escalation of endothelial activation or inflammation in SCA and provide preliminary biomarker evidence for the safety of brief, high-intensity physical exertion in children with SCA. PMID:26456230

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

    PubMed

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

    2010-07-01

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

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

    PubMed

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

    2015-08-01

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

  16. Validity of the 3-Minute All-Out Exercise Test on the CompuTrainer.

    PubMed

    Clark, Ida E; Gartner, Hannah E; Williams, Jade L; Pettitt, Robert W

    2016-03-01

    Clark, IE, Gartner, HE, Williams, JL, and Pettitt, RW. Validity of the 3-minute all-out exercise test on the CompuTrainer. J Strength Cond Res 30(3): 825-829, 2016-The 3-minute all-out exercise test (3MT) has emerged as a useful procedure for identifying critical power (CP) and the finite work capacity above CP (W') within a single visit. The CP concept enables for the prediction of exhaustive time limits (TLIMs) for a wide range of severe intensity power outputs and is a method for prescribing high-intensity interval training (HIIT). Road cyclists often use the CompuTrainer for indoor HIIT. The purpose of this study was to validate the 3MT for use on the CompuTrainer. On 4 separate visits, 10 competitive cyclists performed a 3MT, and three separate constant-load bouts projected to yield exhaustive TLIMs of 3, 6, and 9 minutes, respectively, using the Computrainer. Actual CP and W' were calculated using the linear work-time (W-t) and power-inverse time (1/t) models. The results for CP (W) from the 3MT (215 ± 40), the W-t model (212 ± 36), and the 1/t model (213 ± 36) did not differ (F = 2.96, p = 0.11, (Equation is included in full-text article.)= 0.43). Similarly, the results for W' (kJ) for the 3MT (11.2 ± 4.0), the W-t model (12.1 ± 6.5), and the 1/s model (11.7 ± 6.3) did not differ (F = 2.40, p = 0.15, (Equation is included in full-text article.)= 0.375). We conclude that use of the 3MT and the CP concept for performance assessment and HIIT prescription on the CompuTrainer is a valid procedure. PMID:26340469

  17. Using squat testing to predict training loads for the deadlift, lunge, step-up, and leg extension exercises.

    PubMed

    Ebben, William P; Feldmann, Christina R; Dayne, Andrea; Mitsche, Diana; Chmielewski, Lauren M; Alexander, Paul; Knetgzer, Kenneth J

    2008-11-01

    The purpose of this study was to determine whether there is a linear relationship between the squat and a variety of quadriceps resistance training exercises for the purpose of creating prediction equations for the determination of quadriceps exercise loads based on the squat load. Six-repetition maximums (RMs) of the squat, as well as four common resistance training exercises that activate the quadriceps including the deadlift, lunge, step-up, and leg extension, were determined for each subject. Subjects included 21 college students. Data were evaluated using linear regression analysis to predict quadriceps exercise loads from 6RM squat data and were cross-validated with the prediction of sum of squares statistic. Analysis of the data revealed that the squat is a significant predictor of loads for the dead lift (R2 = 0.81, standard error of the estimate [SEE] = 12.50 kg), lunge (R2 = 0.62, SEE = 12.57 kg), step-up (R2 = 0.71, SEE = 9.58 kg), and leg extension (R2=0.67, SEE = 10.26 kg) exercises. Based on the analysis of the data, the following 6RM prediction equations were devised for each exercise: (a) deadlift load = squat load (0.83) + 14.92 kg, (b) lunge load = squat load (0.52) + 14.82 kg, (c) step-up load = squat load (0.50) + 3.32 kg, and (d) leg extension load = squat load (0.48) + 9.58 kg. Results from testing core exercises such as the squat can provide useful data for the assignment of loads for other exercises. PMID:18978614

  18. Exercise-Induced Systemic Venous Hypertension in the Fontan Circulation.

    PubMed

    Navaratnam, Devaraj; Fitzsimmons, Samantha; Grocott, Michael; Rossiter, Harry B; Emmanuel, Yaso; Diller, Gerard-Paul; Gordon-Walker, Timothy; Jack, Sandy; Sheron, Nick; Pappachan, John; Pratap, Jayant Nick; Vettukattil, Joseph J; Veldtman, Gruschen

    2016-05-15

    Increasingly end-organ injury is being demonstrated late after institution of the Fontan circulation, particularly liver fibrosis and cirrhosis. The exact mechanisms for these late phenomena remain largely elusive. Hypothesizing that exercise induces precipitous systemic venous hypertension and insufficient cardiac output for the exercise demand, that is, a possible mechanism for end-organ injury, we sought to demonstrate the dynamic exercise responses in systemic venous perfusion (SVP) and concurrent end-organ perfusion. Ten stable Fontan patients and 9 control subjects underwent incremental cycle ergometry-based cardiopulmonary exercise testing. SVP was monitored in the right upper limb, and regional tissue oxygen saturation was monitored in the brain and kidney using near-infrared spectroscopy. SVP rose profoundly in concert with workload in the Fontan group, described by the regression equation 15.97 + 0.073 watts per mm Hg. In contrast, SVP did not change in healthy controls. Regional renal (p <0.01) and cerebral tissue saturations (p <0.001) were significantly lower and decrease more rapidly in Fontan patients. We conclude that in a stable group of adult patients with Fontan circulation, high-intensity exercise was associated with systemic venous hypertension and reduced systemic oxygen delivery. This physiological substrate has the potential to contribute to end-organ injury. PMID:27032711

  19. 21 CFR 868.6175 - Cardiopulmonary emergency cart.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and transport... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary emergency cart. 868.6175...

  20. 21 CFR 868.6175 - Cardiopulmonary emergency cart.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and transport... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary emergency cart. 868.6175...

  1. 21 CFR 868.6175 - Cardiopulmonary emergency cart.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and transport... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary emergency cart. 868.6175...

  2. 21 CFR 868.6175 - Cardiopulmonary emergency cart.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and transport... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary emergency cart. 868.6175...

  3. 21 CFR 868.6175 - Cardiopulmonary emergency cart.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and transport... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary emergency cart. 868.6175...

  4. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  5. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  6. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  7. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  8. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  9. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  10. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  11. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  12. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  13. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood. (b... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass defoamer. 870.4230...

  14. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass bubble detector. 870.4205... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect bubbles in the arterial return line of the cardiopulmonary bypass circuit. (b)...

  15. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass bubble detector. 870.4205... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect bubbles in the arterial return line of the cardiopulmonary bypass circuit. (b)...

  16. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass bubble detector. 870.4205... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect bubbles in the arterial return line of the cardiopulmonary bypass circuit. (b)...

  17. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass oxygenator. 870.4350... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange... the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”...

  18. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass oxygenator. 870.4350... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange... the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”...

  19. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass oxygenator. 870.4350... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange... the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”...

  20. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass oxygenator. 870.4350... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange... the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”...

  1. Potential neurobiological benefits of exercise in chronic pain and posttraumatic stress disorder: Pilot study.

    PubMed

    Scioli-Salter, Erica; Forman, Daniel E; Otis, John D; Tun, Carlos; Allsup, Kelly; Marx, Christine E; Hauger, Richard L; Shipherd, Jillian C; Higgins, Diana; Tyzik, Anna; Rasmusson, Ann M

    2016-01-01

    This pilot study assessed the effects of cardiopulmonary exercise testing and cardiorespiratory fitness on plasma neuropeptide Y (NPY), allopregnanolone and pregnanolone (ALLO), cortisol, and dehydroepiandrosterone (DHEA), and their association with pain sensitivity. Medication-free trauma-exposed participants were either healthy (n = 7) or experiencing comorbid chronic pain/posttraumatic stress disorder (PTSD) (n = 5). Peak oxygen consumption (VO2) during exercise testing was used to characterize cardiorespiratory fitness. Peak VO2 correlated with baseline and peak NPY levels (r = 0.66, p < 0.05 and r = 0.69, p < 0.05, respectively), as well as exercise-induced changes in ALLO (r = 0.89, p < 0.001) and peak ALLO levels (r = 0.71, p < 0.01). NPY levels at the peak of exercise correlated with pain threshold 30 min after exercise (r = 0.65, p < 0.05), while exercise-induced increases in ALLO correlated with pain tolerance 30 min after exercise (r = 0.64, p < 0.05). In contrast, exercise-induced changes in cortisol and DHEA levels were inversely correlated with pain tolerance after exercise (r = -0.69, p < 0.05 and r = -0.58, p < 0.05, respectively). These data suggest that cardiorespiratory fitness is associated with higher plasma NPY levels and increased ALLO responses to exercise, which in turn relate to pain sensitivity. Future work will examine whether progressive exercise training increases cardiorespiratory fitness in association with increases in NPY and ALLO and reductions in pain sensitivity in chronic pain patients with PTSD. PMID:27006290

  2. 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…

  3. 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).

  4. 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.

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

    PubMed Central

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

    2010-01-01

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

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

    SciTech Connect

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

    1988-04-01

    Technical and methodological factors might affect the reported accuracies of diagnostic tests. To assess their influence on the accuracy of exercise thallium scintigraphy, the medical literature (1977 to 1986) was non-selectively searched and meta-analysis was applied to the 56 publications thus retrieved. These were analyzed for year of publication, sex and mean age of patients, percentage of patients with angina pectoris, percentage of patients with prior myocardial infarction, percentage of patients taking beta-blocking medications, and for angiographic referral (workup) bias, blinding of tests, and technical factors. The percentage of patients with myocardial infarction had the highest correlation with sensitivity (0.45, p = 0.0007). Only the inclusion of subjects with prior infarction and the percentage of men in the study group were independently and significantly (p less than 0.05) related to test sensitivity. Both the presence of workup bias and publication year adversely affected specificity (p less than 0.05). Of these two factors, publication year had the strongest association by stepwise linear regression. This analysis suggests that the reported sensitivity of thallium scintigraphy is higher and the specificity lower than that expected in clinical practice because of the presence of workup bias and the inappropriate inclusion of post-infarct patients.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  9. 4-Second Exercise Test: Reference Values for Ages 18–81 Years

    PubMed Central

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

    2015-01-01

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

  10. Dysregulated arginine metabolism and cardiopulmonary dysfunction in patients with thalassaemia.

    PubMed

    Morris, Claudia R; Kim, Hae-Young; Klings, Elizabeth S; Wood, John; Porter, John B; Trachtenberg, Felicia; Sweeters, Nancy; Olivieri, Nancy F; Kwiatkowski, Janet L; Virzi, Lisa; Hassell, Kathryn; Taher, Ali; Neufeld, Ellis J; Thompson, Alexis A; Larkin, Sandra; Suh, Jung H; Vichinsky, Elliott P; Kuypers, Frans A

    2015-06-01

    Pulmonary hypertension (PH) commonly develops in thalassaemia syndromes, but is poorly characterized. The goal of this study was to provide a comprehensive description of the cardiopulmonary and biological profile of patients with thalassaemia at risk for PH. A case-control study of thalassaemia patients at high versus low PH-risk was performed. A single cross-sectional measurement for variables reflecting cardiopulmonary status and biological pathophysiology were obtained, including Doppler-echocardiography, 6-min-walk-test, Borg Dyspnoea Score, New York Heart Association functional class, cardiac magnetic resonance imaging (MRI), chest-computerized tomography, pulmonary function testing and laboratory analyses targeting mechanisms of coagulation, inflammation, haemolysis, adhesion and the arginine-nitric oxide pathway. Twenty-seven thalassaemia patients were evaluated, 14 with an elevated tricuspid-regurgitant-jet-velocity (TRV) ≥ 2·5 m/s. Patients with increased TRV had a higher frequency of splenectomy, and significantly larger right atrial size, left atrial volume and left septal-wall thickness on echocardiography and/or MRI, with elevated biomarkers of abnormal coagulation, lactate dehydrogenase (LDH) levels and arginase concentration, and lower arginine-bioavailability compared to low-risk patients. Arginase concentration correlated significantly to several echocardiography/MRI parameters of cardiovascular function in addition to global-arginine-bioavailability and biomarkers of haemolytic rate, including LDH, haemoglobin and bilirubin. Thalassaemia patients with a TRV ≥ 2·5 m/s have additional echocardiography and cardiac-MRI parameters suggestive of right and left-sided cardiac dysfunction. In addition, low arginine bioavailability may contribute to cardiopulmonary dysfunction in β-thalassaemia. PMID:25907665

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

    ERIC Educational Resources Information Center

    Krampen, Gunter

    2010-01-01

    The effects of relaxation exercises on orthography performance in language arts education of fifth to seventh graders were experimentally tested. Participants were 399 basic secondary school students and their language arts teachers from the Hauptschule, a German type of secondary education covering grades five to nine that leads to a basic…

  12. 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…

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

    ERIC Educational Resources Information Center

    Heaman, Doris J.; Estes, Jenny

    1997-01-01

    This study documented the prevalence of exercise-induced asthma (EIA) in rural elementary schools, examining the use of a free-running asthma screening test and peak expiratory flow-rate measurement for school screening. Results indicated that 5.7% of the students had EIA. Absenteeism and poverty were related to EIA. (SM)

  14. 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

  15. Safety and exercise tolerance of acute high altitude exposure (3454 m) among patients with coronary artery disease

    PubMed Central

    Schmid, J‐P; Noveanu, M; Gaillet, R; Hellige, G; Wahl, A; Saner, H

    2006-01-01

    Objectives To assess the safety and cardiopulmonary adaptation to high altitude exposure among patients with coronary artery disease. Methods 22 patients (20 men and 2 women), mean age 57 (SD 7) years, underwent a maximal, symptom limited exercise stress test in Bern, Switzerland (540 m) and after a rapid ascent to the Jungfraujoch (3454 m). The study population comprised 15 patients after ST elevation myocardial infarction and 7 after a non‐ST elevation myocardial infarction 12 (SD 4) months after the acute event. All patients were revascularised either by percutaneous coronary angioplasty (n  =  15) or by coronary artery bypass surgery (n  =  7). Ejection fraction was 60 (SD 8)%. β blocking agents were withheld for five days before exercise testing. Results At 3454 m, peak oxygen uptake decreased by 19% (p < 0.001), maximum work capacity by 15% (p < 0.001) and exercise time by 16% (p < 0.001); heart rate, ventilation and lactate were significantly higher at every level of exercise, except at maximum exertion. No ECG signs of myocardial ischaemia or significant arrhythmias were noted. Conclusions Although oxygen demand and lactate concentrations are higher during exercise at high altitude, a rapid ascent and submaximal exercise can be considered safe at an altitude of 3454 m for low risk patients six months after revascularisation for an acute coronary event and a normal exercise stress test at low altitude. PMID:16339809

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

    ERIC Educational Resources Information Center

    Treagust, David F.; And Others

    1980-01-01

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

  17. 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.

  18. 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…

  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. Quantification of the Impaired Cardiac Output Response to Exercise in Heart Failure: Application of a Non-Invasive Device

    PubMed Central

    Myers, Jonathan; Gujja, Pradeep; Neelagaru, Suresh; Hsu, Leon; Burkhoff, Daniel

    2009-01-01

    An impaired cardiac output (CO) response to exercise is a hallmark of chronic heart failure (CHF), and the degree to which CO is impaired is related to the severity of CHF and prognosis. However, practical methods for obtaining cardiac output during exercise are lacking, and what constitutes and impaired response is unclear. Forty six CHF patients and 13 normal subjects underwent cardiopulmonary exercise testing (CPX) while CO and other hemodynamic measurements at rest and during exercise were obtained using a novel, non-invasive, bioreactance device based on assessment of relative phase shifts of electric currents injected across the thorax, heart rate and ventricular ejection time. An abnormal cardiac output response to exercise was defined as achieving ≤ 95% of the confidence limits of the slope of the relationship between CO and oxygen uptake (VO2). An impaired CO slope identified patients with more severe CHF as evidenced by a lower peak VO2, lower peak CO, heightened VE/VCO2 slope, and lower oxygen uptake efficiency slope. CO can be estimated during exercise using a novel bioreactance technique; patients with an impaired response to exercise exhibit reduced exercise capacity and inefficient ventilation typical of more severe CHF. Non- invasive measurement of cardiac performance in response to exercise provides a simple method of identifying patients with more severe CHF and may complement the CPX in identifying CHF patients at high risk. Key points Non-invasive measurement of cardiac output during exercise is feasible in patients with heart failure. Impairment in the CO response to exercise identifies heart failure patients with more severe disease, lower exercise capacity and inefficient ventilation. Non-invasive measurement of cardiac performance during exercise has potentially important applications for the functional and prognostic assessment of patients with heart failure. PMID:24149996

  1. Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study

    PubMed Central

    2011-01-01

    Background Neurologic deficits after cardiac surgery are common complications. Aim of this prospective observational pilot study was to investigate the incidence of postoperative cognitive deficit (POCD) after cardiac surgery, provided that relevant decrease of cerebral oxygen saturation (cSO2) is avoided during cardiopulmonary bypass. Methods cSO2 was measured by near infrared spectroscopy in 35 patients during cardiopulmonary bypass. cSO2 was kept above 80% of baseline and above 55% during anesthesia including cardiopulmonary bypass. POCD was tested by trail making test, digit symbol substitution test, Ray's auditorial verbal learning test, digit span test and verbal fluency test the day before and 5 days after surgery. POCD was defined as a decline in test performance that exceeded - 20% from baseline in two tests or more. Correlation of POCD with lowest cSO2 and cSO2 - threshold were determined explorative. Results POCD was observed in 43% of patients. Lowest cSO2 during cardiopulmonary bypass was significantly correlated with POCD (p = 0.015, r2 = 0.44, without Bonferroni correction). A threshold of 65% for cSO2 was able to predict POCD with a sensitivity of 86.7% and a specificity of 65.0% (p = 0.03, without Bonferroni correction). Conclusions Despite a relevant decrease of cerebral oxygen saturation was avoided in our pilot study during cardiopulmonary bypass, incidence of POCD was comparable to that reported in patients without monitoring. A higher threshold for cSO2 may be needed to reduce the incidence of POCD. PMID:21401948

  2. Exercise: Benefits of Exercise

    MedlinePlus Videos and Cool Tools

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

  3. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children

    PubMed Central

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

    2015-01-01

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

  4. 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.

  5. 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

  6. CARDIORESPIRATORY FUNCTION BEFORE AND AFTER AEROBIC EXERCISE TRAINING IN PATIETNS WITH INTERSTITIAL LUNG DISEASE

    PubMed Central

    Keyser, Randall E.; Woolstenhulme, Joshua G.; Chin, Lisa M.K.; Nathan, Steven D.; Weir, Nargues A.; Connors, Gerilynn; Drinkard, Bart; Lamberti, James; Chan, Leighton

    2014-01-01

    PURPOSE To characterize the cardiorespiratory response to exercise before and after aerobic exercise training in patients with interstitial lung disease (ILD). METHODS We performed a clinical study, examining 13 patients (New York Heart Association/World Health Organization Functional Class II or III) before and after 10-weeks of supervised treadmill exercise walking, at 70–80% of heart rate reserve, 30–45 minutes per session, 3 times per week. Outcome variables included measures of cardiorespiratory function during a treadmill cardiopulmonary exercise test (tCPET), with additional near infrared spectroscopy measurements of peripheral oxygen extraction and bioimpedance cardiography measurements of cardiac output. 6-minute walk test distance (6MWD) was also measured. RESULTS All subjects participated in at least 24 of their 30, scheduled exercise sessions with no significant adverse events. After training, the mean 6MWD increased by 52±48 meters (P=.001), peak tCPET time increased by 163±130 seconds (P=.001), and time to achieve gas exchange threshold increased by 145±37 seconds (P<.001). Despite a negligible increase in peak oxygen uptake (VO2) with no changes to cardiac output, the overall work rate/VO2 relationship was enhanced after training. Muscle oxygen extraction increased by 16% (P=.049) after training. CONCLUSION Clinically significant improvements in cardiorespiratory function were observed after aerobic exercise training in this group of subjects with ILD. These improvements appear to have been mediated by increases in the peripheral extraction of oxygen rather than changes in oxygen delivery. PMID:25313451

  7. 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...

  8. Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

    PubMed Central

    Vaz, Humberto Andres; Vanz, Ana Paula; Castro, Iran

    2016-01-01

    Background The kinetics of high-sensitivity troponin T (hscTnT) release should be studied in different situations, including functional tests with transient ischemic abnormalities. Objective To evaluate the release of hscTnT by serial measurements after exercise testing (ET), and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Methods Patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h), 2 (TnT2h), 5 (TnT5h), and 8 hours (TnT8h) after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC) for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance). Results This study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h). After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002), 59% (p = 0.003) and 45% (p = 0.003) higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Conclusion Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI. PMID:26959404

  9. 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

  10. 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

  11. Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial

    PubMed Central

    Román, Eva; García-Galcerán, Cristina; Torrades, Teresa; Herrera, Silvia; Marín, Ana; Doñate, Maite; Alvarado-Tapias, Edilmar; Malouf, Jorge; Nácher, Laura; Serra-Grima, Ricard; Guarner, Carlos; Soriano, German

    2016-01-01

    Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time. Trial Registration: ClinicalTrials.gov NCT01447537 PMID:27011355

  12. [Basic mechanisms of QRS voltage changes on ECG of healthy subjects during the exercise test].

    PubMed

    Saltykova, M M

    2015-01-01

    Electrocardiography is the most commonly used technique for detection stress-induced myocardial ischemia. However, the sensitivity of ECG-criteria is not high. One of the major problem is the difficulty in differentiating ECG changes caused by various factors. The aim of this study was to evaluate the dependence of the QRS voltage changes during exercise on parameters of central hemodynamics, gender particularities and to reveal mechanisms causing these changes. To eliminate the effect of changes in cardiomyocytes transmembrane potentials under the influence of the neurotransmitters of the autonomic nervous system during stepwise increasing exercises and/or due to a lack of ATP results from inadequate myocardial blood flow only healthy subjects not older than 35 years were included in the study (7 men and 7 women) and only periods of ventricular depolarization (QRS complex on the ECG) were included in the analysis. We compared the changes of QRS waves during exercise sessions with two upper and one lower limbs in both men and women. The exercise load was twice bigger in exercise with one leg relative to exercise with two arms. Responses of heart rate and systolic arterial pressure were similar. Amplitude of S-wave in left chest leads significantly increased in both sessions without significant difference between augmentations in the sessions and in groups of men and women. Significant relationship between the S wave augmentation and the peak systolic arterial pressure were revealed. Furthermore, the QRS changes during the exercise with vertical and a horizontal torso position were compared to assess the impact of diastolic arterial pressure and displacement of the diaphragm and heart rotation due to increase of abdominal pressure during the last steps of exercise. The obtained results allow us to exclude the impact of the heart position and size changes, as well as the exercise load on S-wave changes and make a conclusion about the dependence of this parameter on the value of systolic blood pressure. PMID:25857180

  13. Italian mitochondrial DNA database: results of a collaborative exercise and proficiency testing.

    PubMed

    Turchi, Chiara; Buscemi, Loredana; Previderè, Carlo; Grignani, Pierangela; Brandstätter, Anita; Achilli, Alessandro; Parson, Walther; Tagliabracci, Adriano

    2008-05-01

    This work is a review of a collaborative exercise on mtDNA analysis undertaken by the Italian working group (Ge.F.I.). A total of 593 samples from 11 forensic genetic laboratories were subjected to hypervariable region (HVS-I/HVS-II) sequence analysis. The raw lane data were sent to MtDNA Population Database (EMPOP) for an independent evaluation. For the inclusion of data for the Italian database, quality assurance procedures were applied to the control region profiles. Only eight laboratories with a final population sample of 395 subjects passed the quality conformance test. Control region haplogroup (hg) assignments were confirmed by restriction fragment length polymorphism (RFLP) typing of the most common European hg-diagnostic sites. A total of 306 unique haplotypes derived from the combined analysis of control and coding region polymorphisms were found; the most common haplotype--CRS, 263, 309.1C, 315.1C/ not7025 AluI--was shared by 20 subjects. The majority of mtDNAs detected in the Italian population fell into the most common west Eurasian hgs: R0a (0.76%), HV (4.81%), H (38.99%), HV0 (3.55%), J (7.85%), T (13.42%), U (11.65%), K (10.13%), I (1.52%), X (2.78%), and W (1.01%). PMID:17952451

  14. Exercise physiology and testing in adult patients with congenital heart disease.

    PubMed

    Buber, Jonathan; Rhodes, Jonathan

    2014-01-01

    As the longevity of patients with congenital heart disease improves, the number surviving to adulthood will continue to rise. Consequently, practicing physicians can expect to encounter an increasing number of adult patients with various congenital cardiac conditions. Impaired exercise tolerance in this patient population is exceptionally common; adult patients with congenital heart disease have reduced exercise capacity compared with healthy, age-matched counterparts. The different methods of evaluating exercise capacity, the characteristic physiologic abnormalities encountered in patients with various congenital cardiac conditions, the pathophysiologic mechanisms that may account for these abnormalities, and the clinical implications of these findings are discussed. PMID:24275292

  15. 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.

  16. 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. )

    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.

  17. Exercise behavior in older adults: a test of the transtheoretical model.

    PubMed

    Cheung, Corjena; Wyman, Jean; Gross, Cynthia; Peters, Jennifer; Findorff, Mary; Stock, Holly

    2007-01-01

    The transtheoretical model (TTM) was developed as a guide for understanding behavior change. Little attention has been given, however, to the appropriateness of the TTM for explaining the adoption of exercise behavior in older adults. The purposes of this study were to determine the reliability of the TTM instruments and validate TTM predictions in 86 community-dwelling older adults (mean age 75.1 +/- 7.0 years, 87% women) who were participants in a 16-week walking program. TTM construct scales--self-efficacy, decisional balance (pros and cons), and processes of change (behavioral and cognitive)--were generally reliable (all>.78). Behavioral processes of change increased from baseline to follow-up, but pros, cons, and cognitive processes did not change among participants who became regular exercisers. Stage of change did not predict exercise adoption, but baseline self-efficacy predicted walking behavior. These results lend partial support to the TTM in predicting exercise behavior. PMID:17387232

  18. Exercise physiology, testing, and training in patients supported by a left ventricular assist device.

    PubMed

    Loyaga-Rendon, Renzo Y; Plaisance, Eric P; Arena, Ross; Shah, Keyur

    2015-08-01

    The left ventricular assist device (LVAD) is an accepted treatment alternative for the management of end-stage heart failure. As we move toward implantation of LVADs in less severe cases of HF, scrutiny of functional capacity and quality of life becomes more important. Patients demonstrate improvements in exercise capacity after LVAD implantation, but the effect is less than predicted. Exercise training produces multiple beneficial effects in heart failure patients, which would be expected to improve quality of life. In this review, we describe factors that are thought to participate in the persistent exercise impairment in LVAD-supported patients, summarize current knowledge about the effect of exercise training in LVAD-supported patients, and suggest areas for future research. PMID:25682553

  19. The future of aerobic exercise testing in clinical practice: is it the ultimate vital sign?

    PubMed

    Arena, Ross; Myers, Jonathan; Guazzi, Marco

    2010-05-01

    The four traditional vital signs: resting heart rate, blood pressure, respiratory rate and body temperature, serve as the cornerstone of a physical examination. Other assessments such as pain have been proposed as additional vital signs. To this point however, there has been limited consideration for aerobic exercise assessment as a vital sign. A wealth of literature demonstrating the prognostic, diagnostic and interventional value of the aerobic exercise assessment now exists, supporting its use in numerous clinical scenarios. Moreover, the assessment of the aerobic exercise response allows for the manifestation of physiologic abnormalities that are not readily apparent during the collection of resting data. This review will provide evidence supporting the assertion that the aerobic exercise assessment may be afforded vital sign status in future clinical practice. PMID:20462339

  20. [Detection of multivessel lesions after myocardial infarction. Improvement of the predictive value of early exercise stress test by discriminant analysis].

    PubMed

    Leroy, F; Langlois-Minet, P; Fievet, P; Agraou, B; Dujardin, J J

    1996-02-01

    The aim of this study was to assess, by a discriminant analysis, the different parameters of exercise stress testing associated with multivessel disease after uncomplicated myocardial infarction and to determine whether their combination improved the diagnostic value of ST depression alone, the usual diagnostic criterion. One hundred and seventeen out of 240 consecutive pts admitted for acute myocardial infarction between october 1992 and may 1994 underwent early exercise stress testing and coronary angiography 8.5 +/- 3 days and 13 +/- 8 days respectively after infarction. The population was divided into two groups: a "study" group (pts recruited between october 1992 and october 1993) for whom a diagnostic equation had been established based on a discriminant analysis, and "a control" group (pts recruited between november 1993 and may 1994) allowing validation of the diagnostic equation. Of the 9 clinical and 14 exercise stress test variables, only 3 remained statistically significant after discriminant analysis in this study group: the number of METS achieved (p < 0.0005), maximal ST depression in V5 (p < 0.005) and maximal heart rate (p < 0.01). Using these three parameters, a discriminating equation was established in the study group and then validated in the control group. Using this equation, the percentage of pts correctly identified as having multivessel disease was 75% in the study group and 79% in the control group, whereas ST depression, the most commonly used criterion, only classified 68% of the study group and 60% of the control group correctly. This study confirmed the good tolerance of early maximal exercise stress testing after uncomplicated myo-cardial infarction. The combination of three easily discernable parameters improved the diagnostic performance of the stress test in identifying multivessel disease after myocardial infarction. PMID:8678750

  1. 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. )

    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.

  2. A pilot study to assess the feasibility of a submaximal exercise test to measure individual response to cardiac medication in dogs with acquired heart failure.

    PubMed

    Ferasin, L; Marcora, S

    2007-08-01

    Exercise testing is not commonly used in canine medicine because of several limitations. The aim of this study was to investigate the suitability of a treadmill test to measure the exercise capacity of untrained canine cardiac patients and to measure some biological parameters that might reflect the tolerance of dogs with heart failure to submaximal exercise. The exercise capacity of seven dogs with naturally occurring heart failure was evaluated before the institution of cardiac medication and 7 days after the beginning of the study. An additional re-examination was requested after 28 days. The exercise test was performed on a motorized treadmill at three different speeds (0.5 m/s, 1.0 m/s and 1.5 m/s). The following parameters were measured at the end of each stage and after 20 min recovery: heart rate, rectal temperature, glucose, lactate, aspartate aminotransferase, creatine kinase, PvO(2), PvCO(2), pH, haematocrit, bicarbonate, sodium, potassium and chloride. Serum cardiac troponin-I was also measured at the beginning of the test and at the end of the recovery period. Owners' perception reflected the ability of their dogs to exercise on the treadmill. Lactate level increased noticeably with the intensity of the exercise test, and its variation coincided with different exercise tolerance observed by the owners. Heart rate seemed to follow a similar trend in the few dogs presented in sinus rhythm. None of the remaining parameters appeared to be sensitive indicators of activity level in the dogs used in this study. The treadmill exercise test in dogs with acquired heart failure is feasible and might provide useful information for assessing individual response to cardiac medication. Lactate and heart rate seemed to reflect individual levels of exercise tolerance, although further studies are necessary to confirm the reliability and repeatability of this test. PMID:17253114

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

    PubMed

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

    2015-10-01

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

  4. 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.

  5. 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.

  6. Novelties in pharmacological management of cardiopulmonary resuscitation

    PubMed Central

    Bartos, Jason A.; Yannopoulos, Demetris

    2014-01-01

    Purpose of review The ultimate goal of cardiopulmonary resuscitation is long-term neurologically intact survival. Despite numerous well designed studies, the medications currently used in advanced cardiac life support have not demonstrated success in this regard. This review describes the novel therapeutics under investigation to improve functional recovery and survival. Recent findings Whereas current medications focus on achieving return of spontaneous circulation and improved hemodynamics, novel therapies currently in development are focused on improving cellular survival and function by preventing metabolic derangement, protecting mitochondria, and preventing cell death caused by cardiac arrest. Improved cardiac and neurologic function and survival benefits have been observed using animal models of cardiopulmonary arrest. Summary Although substantial data have shown benefits using robust animal models, further human studies are necessary to investigate the potential long-term benefits of these therapies. PMID:23995130

  7. 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.

  8. Exercise improves visual deficits tested by visual evoked potentials in streptozotocin-induced diabetic rats.

    PubMed

    Ozkaya, Y Gül; Ağar, Aysel; Hacioğlu, Gülay; Yargiçoğlu, Piraye

    2007-12-01

    Visual evoked potentials (VEP) can be used as an objective non-invasive method to study the electrical activity of the visual system. Latency and amplitude measurements of VEP demonstrated that diabetes mellitus has been associated with increases in the latencies whereas the amplitude measurements revealed contradictory results. Although physical exercise has been reported to reduce the complications of diabetes mellitus, the effect of exercise on the visual system remains unknown. We investigated the effects of long-term moderate physical exercise on VEP in streptozotocin (STZ)-diabetic rats. We also measured brain thiobarbituric acid-reactive substances (TBARS) to explore the possible contribution of lipid peroxidation on the visual system. Animals were divided into four groups: control (C), control exercise (CE), diabetic (D) and diabetic exercise (DE) groups. Diabetes was induced by a single intraperitoneal injection of STZ (60 mg/kg). Three days after the confirmation of diabetes, DE and CE groups were trained by running on a motor-driven treadmill with a progressive eight-week programme. The animals began running at 10 m/min, 0 degrees slope, 10 min/day and reached a level of 28 m/min, 6 degrees slope, 60 min/day by week 8. TBARS were elevated and VEP latencies were delayed in diabetic rats, indicating diabetes-induced defects in the optic pathway. These prolonged latencies were restored by exercise training. VEP amplitudes of the DE group were found unaltered with the exception of a decrement in P(2)N(2) which represents an early component of VEP, suggesting that exercise improves visual system defects in diabetic animals at different levels of the optic pathway. PMID:18075235

  9. Alternative method of ultrafiltration after cardiopulmonary bypass.

    PubMed

    Groom, R C; Akl, B F; Albus, R A; Hill, A; Munoz, R; Lefrak, E A

    1994-08-01

    A revised circuit design for modified ultrafiltration is presented rendering the technique more convenient for use after cardiopulmonary bypass when blood cardioplegia is used. The procedure employs a hollow-fiber ultrafiltration device attached to the cardioplegia circuit. A bubble trap, heat exchanger, and a pressure monitor are incorporated as safety features. The technique has been used in 80 patients (30 pediatric and 50 adult) and has been associated with relevant increases in colloid osmotic pressure and hematocrit. PMID:8067874

  10. Prediction of VO[subscript 2]max in Children and Adolescents Using Exercise Testing and Physical Activity Questionnaire Data

    ERIC Educational Resources Information Center

    Black, Nate E.; Vehrs, Pat R.; Fellingham, Gilbert W.; George, James D.; Hager, Ron

    2016-01-01

    Purpose: The purpose of this study was to evaluate the use of a treadmill walk-jog-run exercise test previously validated in adults and physical activity questionnaire data to estimate maximum oxygen consumption (VO[subscript 2]max) in boys (n = 62) and girls (n = 66) aged 12 to 17 years old. Methods: Data were collected from Physical Activity…

  11. What Exercise of the Source Inversion Validation BlindTest I didn't Tell You?

    NASA Astrophysics Data System (ADS)

    Ji, C.; Shao, G.

    2010-12-01

    Uncertainties of the finite fault inversions based upon strong motion data are investigated using the BlindTest I exercise of the SPICE earthquake source inversion validation project, motivated by previous counterintuitive results (Mai et al., 2007). The distributions of slip and the shapes of asymmetric cosine slip rate functions (Ji et al., 2003) on the fault surface are simultaneously inverted by matching 10 or 33 broadband 3-component velocity waveforms within the period ranging from DC to 2 Hz, using the finite fault method that carries waveform inversions in wavelet domain. The effects of subfault size, data noise, and the number of stations have been explored. Our results suggest that: 1) Although there are inevitable discrepancies between the inverted model and the target because of ignoring the spatial slip variations within individual subfaults, with precise velocity structure, precise fault geometry and good station coverage, the fault slip and rise time distribution can be well constrained even the data includes very large Gaussian noise. 2) It is crucial for source studies to develop new inversion schedule that can properly honor the frequency/temporal dependent energy distribution of seismic radiation and 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) Though the relative value of the objective function inside the model space is used to guide the inversion, the absolute value of the objective function cannot be used to evaluate the quality of the inverted model. 4) As the inversion based on the observations only on the surface, the spatiotemporal resolution of the source inversion is affected not only by the data quality but also the earthquake itself. For strike slip faulting on a vertical fault, the along-strike resolution is better than that along the down-dip direction.

  12. Exercise testing and thallium-201 myocardial imaging in relation to coronary artery disease in patients with severe aortic valve disease.

    PubMed

    Taylor, R R; Mews, G C; Van der Schaaf, A; Dickie, G; Surveyor, I

    1980-12-01

    Thirty-three patients with aortic valve disease, fifteen with regurgitation, eleven with stenosis and seven with mixed disease, undergoing assessment for valve replacement which included adequate coronary angiography, were studied. A symptom limited graded treadmill exercise test was undertaken with administration of 40-70 MBq of 201Tl. Myocardial imaging was started within 15 minutes and repeated after four hours using a 37 PM tube Searle gamma camera. Myocardial images were read independently by three observed. Of the 33 sets of images, 21 were -ve, 5 +ve, 2 I (Indeterminate) and 5 D (Difference of opinion). Eight of the 33 patients had significant coronary artery disease (CAD) and of these three were scored +ve (all triple vessel). Two patients without CAD were scored +ve. Eight subjects developed angina during exercise testing, of whom four had CAD, and four with CAD did no develop angina. Historically, 13 of the 33 subjects had typical angina, six having CAD; an additional eight had other significant chest pain, two having CAD. In these subjects with severe aortic valve disease, exercise testing and myocardial imaging with 201 TI was of little value in detecting CAD. All patients with CAD gave a history of significant chest pain. PMID:6938184

  13. Value of measuring end tidal partial pressure of carbon dioxide as an adjunct to treadmill exercise testing

    PubMed Central

    Chambers, John B; Kiff, Peter J; Gardner, William N; Jackson, Graham; Bass, Christopher

    1988-01-01

    The end tidal partial pressure of carbon dioxide (Pco2) was measured during treadmill exercise in 30 normal controls and 113 patients referred for assessment of chest pain. Among the 92 patients without significant ST depression hypocapnia occurred more often in those reporting typical than atypical chest pain (17 of 22 patients compared with 29 of 70; p<001). Hypocapnia was uncommon in patients with significant ST depression whether reporting typical or atypical chest pain (one of 10 patients and two of 11, respectively). Hypocapnia at rest (Pco2 <4 kPa) occurred in 16 (14%) patients but in only one control. Hypocapnia occurred during or after exercise in only one control and three of the 21 patients with significant ST depression on exercise (group 1). The remaining 92 patients were divided into those with a history suggestive of hyperventilation (group 2; n=30) and those without (group 3; n=62). Hypocapnia developed significantly more often in both these groups (21 and 25 patients respectively) than in controls or patients with significant ST depression. An abnormal response of the Pco2 to exercise provided objective data to support a clinical suspicion of chest pain induced by hyperventilation in 24 cases, suggested a cause for equivocal ST depression other than coronary stenosis in five patients, and led to the diagnosis of previously unsuspected respiratory disease in 14 patients. Measurement of end tidal Pco2 gives additional valuable diagnostic information during the conventional treadmill exercise test in patients with both typical and atypical chest pain. PMID:3133051

  14. Using squat testing to predict training loads for lower-body exercises in elite karate athletes.

    PubMed

    Wong, Del P; Tan, Erik C H; Chaouachi, Anis; Carling, Christopher; Castagna, Carlo; Bloomfield, Jonathan; Behm, David G

    2010-11-01

    The purpose of this study was to determine the relationship between squat loads and 2 bilateral and 2 unilateral stepping lower-body exercises in predominantly unilateral movement elite athletes (Karate). Equations to predict loads for lower-body exercises based on the squat load were also determined. Fourteen male elite Karate athletes (age = 22.6 ± 1.2 years) performed 6 repetition maximum (RM) of the following free-weight bilateral exercises: back half squat, deadlift, leg press and unilateral stepping exercises, lunge; and step-up. Results showed that 6RM squat load was significantly (p < 0.001) correlated with deadlift (r = 0.86), leg press (r = 0.76), lunge (r = 0.86), and step-up (r = 0.92). Linear regression showed that the 6RM squat load was a significant predictor for deadlift, leg press, lunge, and step-up (R2 range from 0.57 to 0.85, p < 0.001). The following 6RM prediction equations were determined: (a) Deadlift = squat load (1.12)-16.60 kg, (b) Leg press = squat load (1.66) + 16.10 kg, (c) Lunge = squat load (0.61) + 9.39 kg, and (d) step-up = squat load (0.85)-10.36 kg. Coaches and fitness professionals can use the 6RM squat load as a time effective and accurate method to predict training loads for both bilateral and unilateral lower-body exercises with quadriceps as the prime mover. Load prescriptions for unilateral exercises should take into account the type of athletic population. PMID:20838250

  15. Lack of Efficacy of Ulinastatin Therapy During Cardiopulmonary Bypass Surgery

    PubMed Central

    Qiu, Yan; Lin, Jing; Yang, Yang; Zhou, Jing; Gong, Li-Na; Qin, Zhen; Du, Lei

    2015-01-01

    Background: It was believed that inflammatory response induced by cardiopulmonary bypass (CPB) was blamed for complications after cardiac surgery. To improve the outcome, many pharmacological interventions have been applied to attenuate inflammatory response during CPB. The objective of this study was to investigate the effect of ulinastatin (urinary trypsin inhibitor [UTI]) on outcome after CPB surgery. Methods: Totally, 208 patients undergoing elective valves replacement between November 2013 and September 2014 were divided into Group U (n = 70) and Group C (n = 138) based on they received UTI or not. Categorical variables were compared between groups using Fisher's exact test, and continuous variables using unpaired Student's t-test or Mann–Whitney U-test. One-way analysis of variance and Dunnett's or Tukey's tests were used to compare values at different time points within the same group. The risk of outcomes was estimated and adjusted by multivariable logistic regression, propensity scoring, and mixed-effect models for all measured variables. Results: Both the serious complications in total, including death, acute lung injury, acute respiratory distress syndrome and acute kidney injury, and the other complications, including hemodialysis, infection, re-incubation, and tracheotomy were similar between the two groups (P > 0.05). After adjusted by multivariable logistic regression and the propensity score, UTI still cannot be found any benefit to improve any outcomes after cardiac surgery. Also, no statistical differences with regard to duration of postoperative mechanical ventilation, the length of Intensive Care Unit and hospital stays (P > 0.05). Conclusion: UTI did not improve postoperative outcomes in our patients after cardiopulmonary bypass surgery. PMID:26612285

  16. 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

  17. 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 Δ(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

  18. Design and testing of an MRI-compatible cycle ergometer for non-invasive cardiac assessments during exercise

    PubMed Central

    2012-01-01

    Background Magnetic resonance imaging (MRI) is an important tool for cardiac research, and it is frequently used for resting cardiac assessments. However, research into non-pharmacological stress cardiac evaluation is limited. Methods We aimed to design a portable and relatively inexpensive MRI cycle ergometer capable of continuously measuring pedalling workload while patients exercise to maintain target heart rates. Results We constructed and tested an MRI-compatible cycle ergometer for a 1.5 T MRI scanner. Resting and sub-maximal exercise images (at 110 beats per minute) were successfully obtained in 8 healthy adults. Conclusions The MRI-compatible cycle ergometer constructed by our research group enabled cardiac assessments at fixed heart rates, while continuously recording power output by directly measuring pedal force and crank rotation. PMID:22423637

  19. 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…

  20. 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

  1. 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.

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

    NASA Technical Reports Server (NTRS)

    Naifeh, K.

    1985-01-01

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

  3. Effects of eight weeks of exercise training and orlistat therapy on body composition and maximal exercise capacity in obese females.

    PubMed

    Ozcelik, O; Dogan, H; Kelestimur, H

    2006-01-01

    A comparative assessment was made of the short-term effects of orlistat therapy and exercise training on body composition and aerobic fitness in obese females. A total of 24 obese patients were enrolled in to the study; 12 received orlistat therapy (DO) and 12 participated in a regular aerobic exercise-training programme (DE). All patients were on hypocaloric diets. Each patient performed three incremental ramp exercise tests (one at Week 0, one at the end of Week 4 and one at the end of Week 8) to exhaustion using an electromagnetically braked cycle ergometer to determine their anaerobic threshold and maximal exercise (Wmax) capacity. Patients in the DE group performed continuous exercise at a work rate that corresponded to the anaerobic threshold. Weight loss and loss of fat mass after 8 weeks were -6.4% (P=0.002) and -13.4% (DE) vs -5.8% (P=0.002) and -6.4% (P=0.008) (DO), respectively. Wmax capacity was 90.8+/-5 W (basal) vs 92.9+/-5 W (Week 4, P=0.1) and 100.4+/-6 W (Week 8, 10.5%, P=0.04) in the DO group, and 96.2+/-6 W (basal) vs 129.1+/-4 W (Week 4, 34.1%, P=0.002) and 137.5+/-5 W(Week 8, 42.9%, P=0.002) in the DE group. Despite similar decreases in body weight in both groups, patients in the DE group achieved a markedly higher level of Wmax, reflecting a better improvement in cardiopulmonary fitness, compared with patients in the DO group. Considering the improvement of aerobic fitness in the short term, an aerobic exercise-training programme should be considered for sedentary obese patients to improve their aerobic fitness and thereby reduce the negative outcomes of obesity. PMID:16198382

  4. Sex-Based Effects on Immune Changes Induced by a Maximal Incremental Exercise Test in Well-Trained Swimmers

    PubMed Central

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

    2014-01-01

    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 Points Maximal 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

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

    PubMed

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

    2015-04-01

    Exercise intolerance due to impaired oxidative metabolism is a prominent symptom in patients with mitochondrial myopathy (MM), but it is still uncertain whether L-carnitine supplementation is beneficial for patients with MM. The aim of our study was to investigate the effects of L-carnitine on exercise performance in MM. Twelve MM subjects (mean ageSD=35.410.8 years) with chronic progressive external ophthalmoplegia (CPEO) were first compared to 10 healthy controls (mean ageSD=297.8 years) before they were randomly assigned to receive L-carnitine supplementation (3 g/daily) or placebo in a double-blind crossover design. Clinical status, body composition, respiratory function tests, peripheral muscle strength (isokinetic and isometric torque) and cardiopulmonary exercise tests (incremental to peak exercise and at 70% of maximal), constant work rate (CWR) exercise test, to the limit of tolerance [Tlim]) were assessed after 2 months of L-carnitine/placebo administration. Patients with MM presented with lower mean height, total body weight, fat-free mass, and peripheral muscle strength compared to controls in the pre-test evaluation. After L-carnitine supplementation, the patients with MM significantly improved their Tlim (141.9 vs 111.4 min) and oxygen consumption ( V ? O 2 ) at CWR exercise, both at isotime (1151115 vs 1049104 mL/min) and at Tlim (1223114 vs 1060108 mL/min). These results indicate that L-carnitine supplementation may improve aerobic capacity and exercise tolerance during high-intensity CWRs in MM patients with CPEO. PMID:25714882

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

    PubMed Central

    Coats, Valrie; Maltais, Franois; Simard, Sbastien; Frchette, ric; Tremblay, Lise; Ribeiro, Fernanda; Saey, Didier

    2013-01-01

    BACKGROUND: Patients with lung cancer often experience a reduction in exercise tolerance, muscle weakness and decreased quality of life. Although the effectiveness of pulmonary rehabilitation programs is well recognized in other forms of cancers and in many pulmonary diseases, few researchers have studied its impact in patients with lung cancer, particularly in those awaiting lung resection surgery (LRS). OBJECTIVES: To investigate the feasibility of a short, home-based exercise training program (HBETP) with patients under investigation for non-small cell lung cancer and potential candidates for LRS, and to determine the effectiveness of this program on exercise tolerance, skeletal muscle strength and quality of life. METHODS: Sixteen patients with lung cancer awaiting LRS participated in a four-week HBETP including moderate aerobic activities (walking and cycling) and muscle training performed three times weekly. Before and after the intervention, a cardiopulmonary exercise test, a 6 min walk test and the assessment of muscle strength and quality of life were performed. RESULTS: Thirteen patients completed the four-week HBETP and all the patients completed >75% of the prescribed exercise sessions. The duration of the cycle endurance test (26479 s versus 421241 s; P<0.05) and the 6 min walk test distance (54098 m versus 568101 m; P<0.05) were significantly improved. Moreover, the strength of the deltoid, triceps and hamstrings were significantly improved (? post-pre training 1.822.83 kg, 1.321.75 kg and 3.413.7 kg; P<0.05, respectively). CONCLUSION: In patients with lung cancer awaiting LRS, HBETP was feasible and improved exercise tolerance and muscle strength. This may be clinically relevant because poor exercise capacity and muscle weakness are predictors of postoperative complications. PMID:23616972

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

    PubMed Central

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

    2015-01-01

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

  8. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4350 Cardiopulmonary bypass oxygenator. (a) Identification....

  9. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4420 Cardiopulmonary bypass cardiotomy...

  10. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  11. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  12. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  13. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  14. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass bubble detector. 870.4205 Section 870.4205 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used...

  15. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass bubble detector. 870.4205 Section 870.4205 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used...

  16. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  17. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870.4240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary bypass heat exchanger....

  18. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  19. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  20. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  1. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass temperature controller. 870.4250 Section 870.4250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4250 Cardiopulmonary bypass temperature controller....

  2. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass coronary pressure gauge. 870.4310 Section 870.4310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4310 Cardiopulmonary bypass coronary pressure...

  4. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  5. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the...

  6. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the...

  7. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  8. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the...

  9. MEASUREMENT OF CARDIOPULMONARY FUNCTION BY REBREATHING METHODOLOGY IN PIGLETS

    EPA Science Inventory

    The use of a multiple gas rebreathing method for the measurement of cardiopulmonary function in mechanically ventilated neonates was evaluated. The following indices of cardiopulmonary function were assessed in 20 piglets (mean weight, 2.3 kg): (1) pulmonary capillary blood flow ...

  10. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  11. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  12. Sarcoidosis of the cardio-pulmonary systems.

    PubMed

    Dubrey, Simon; Sharma, Rakesh; Underwood, Richard; Mittal, Tarun; Wells, Athol

    2016-02-01

    Sarcoidosis is a multi-system disease with a wide range of phenotypes. Pulmonary involvement is the most frequently identified target for sarcoidosis and is responsible for the majority of deaths. Cardiac sarcoid is less commonly identified, may be occult, is significantly influenced by race, and can portend an unpredictable and sometimes fatal outcome. Sarcoidosis remains an enigmatic disease spectrum of unknown aetiology, frequently difficult to diagnose and with a variable disease course. This article summarises current views on the diagnosis and management of cardiopulmonary involvement. PMID:26833512

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

    PubMed

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

    2015-06-01

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

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

    PubMed

    Stuckless, Troy J R; Pyke, Kyra E

    2015-10-01

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

  15. Perspective: Does Laboratory-Based Maximal Incremental Exercise Testing Elicit Maximum Physiological Responses in Highly-Trained Athletes with Cervical Spinal Cord Injury?

    PubMed Central

    West, Christopher R.; Leicht, Christof A.; Goosey-Tolfrey, Victoria L.; Romer, Lee M.

    2016-01-01

    The physiological assessment of highly-trained athletes is a cornerstone of many scientific support programs. In the present article, we provide original data followed by our perspective on the topic of laboratory-based incremental exercise testing in elite athletes with cervical spinal cord injury. We retrospectively reviewed our data on Great Britain Wheelchair Rugby athletes collected during the last two Paralympic cycles. We extracted and compared peak cardiometabolic (heart rate and blood lactate) responses between a standard laboratory-based incremental exercise test on a treadmill and two different maximal field tests (4 min and 40 min maximal push). In the nine athletes studied, both field tests elicited higher peak responses than the laboratory-based test. The present data imply that laboratory-based incremental protocols preclude the attainment of true peak cardiometabolic responses. This may be due to the different locomotor patterns required to sustain wheelchair propulsion during treadmill exercise or that maximal incremental treadmill protocols only require individuals to exercise at or near maximal exhaustion for a relatively short period of time. We acknowledge that both field- and laboratory-based testing have respective merits and pitfalls and suggest that the choice of test be dictated by the question at hand: if true peak responses are required then field-based testing is warranted, whereas laboratory-based testing may be more appropriate for obtaining cardiometabolic responses across a range of standardized exercise intensities. PMID:26834642

  16. Cardiac Dysfunction during Exercise in Uncomplicated Type 2 Diabetes

    PubMed Central

    REGENSTEINER, JUDITH G.; BAUER, TIMOTHY A.; REUSCH, JANE E. B.; QUAIFE, ROBERT A.; CHEN, MARCUS Y.; SMITH, SUSAN C.; MILLER, TYLER M.; GROVES, BERTRON M.; WOLFEL, EUGENE E.

    2010-01-01

    Purpose Type 2 diabetes mellitus (T2DM) has been associated with reduced peak exercise capacity (V̇O2peak). The causes of this impairment are not clearly established, but evidence suggests that abnormalities in cardiac function play a significant role. We hypothesized that exercise would be associated with impaired cardiac function and hemodynamics in recently diagnosed T2DM, even in the absence of clinically evident cardiovascular complications. Methods After baseline normal echocardiography screening, 10 premenopausal women with uncomplicated T2DM (average duration of diagnosed T2DM, 3.6 yr) and 10 healthy nondiabetic women of similar age, weight, and activity levels performed a peak cardiopulmonary exercise test while instrumented with an indwelling pulmonary artery catheter for assessing cardiac function. On separate days, technetium-99m sestamibi (cardolite) imaging was performed to assess myocardial perfusion at rest and peak exercise in seven T2DM and seven control patients. Results Resting measures of cardiac hemodynamics were similar in T2DM and control subjects. Absolute V̇O2peak (mL·min−1) and peak cardiac output (L·min−1) tended to be lower in T2DM than in control subjects but did not reach statistical significance. However, pulmonary capillary wedge pressure (PCWP) rose significantly more during exercise in T2DM than in controls (148% vs 109% increase at peak exercise, P < 0.01). Normalized myocardial perfusion index was lower in persons with diabetes than in controls (11.0 ± 3.5 × e−9 vs 17.5 ± 8.1 × e−9, respectively, P < 0.05) and inversely related to peak exercise PCWP (R = −0.56, P < 0.05). Conclusions Cardiac hemodynamics during graded exercise are altered in women with recently diagnosed T2DM as demonstrated by the disproportionate increase in PCWP at peak exercise compared with controls subjects. Cardiac abnormalities observed are potentially early signs of subclinical cardiac dysfunction associated with T2DM, which may precede the more greatly impaired cardiac function at rest and with exercise observed in longer established T2DM. PMID:19346991

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

    PubMed Central

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

    2015-01-01

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

  18. Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease.

    PubMed

    Long, Lili; Xu, Lin; Xiao, Zhenghui; Hu, Shixiong; Luo, Ruping; Wang, Hua; Lu, Xiulan; Xu, Zhiyue; Yao, Xu; Zhou, Luo; Long, Hongyu; Gong, Jiaoe; Song, Yanmin; Zhao, Li; Luo, Kaiwei; Zhang, Mengqi; Feng, Li; Yang, Liming; Sheng, Xiaoqi; Fan, Xuegong; Xiao, Bo

    2016-01-01

    From 2010 to 2012, large outbreaks of EV-A71-related- hand foot and mouth disease (HFMD) occurred annually in China. Some cases had neurological complications and were closely associated with fatal cardiopulmonary collapse, but not all children with central nervous system (CNS) involvement demonstrated a poor prognosis. To identify which patients and which neurological complications are more likely to progress to cardiopulmonary failure, we retrospectively studied 1,125 paediatric inpatients diagnosed with EV-A71-related HFMD in Hunan province, including 1,017 cases with CNS involvement. These patients were divided into cardiopulmonary failure (976 people) group and group without cardiopulmonary failure (149 people). A logistic regression analysis was used to compare the clinical symptoms, laboratory test results, and neurological complications between these two groups. The most significant risk factors included young age, fever duration ≥3 days, coma, limb weakness, drowsiness and ANS involvement. Patients with brainstem encephalitis and more CNS-involved regions were more likely to progress to cardiopulmonary failure. These findings can help front-line clinicians rapidly and accurately determine patient prognosis, thus rationally distributing the limited medical resources and implementing interventions as early as possible. PMID:27001010

  19. Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease

    PubMed Central

    Long, Lili; Xu, Lin; Xiao, Zhenghui; Hu, Shixiong; Luo, Ruping; Wang, Hua; Lu, Xiulan; Xu, Zhiyue; Yao, Xu; Zhou, Luo; Long, Hongyu; Gong, Jiaoe; Song, Yanmin; Zhao, Li; Luo, Kaiwei; Zhang, Mengqi; Feng, Li; Yang, Liming; Sheng, Xiaoqi; Fan, Xuegong; Xiao, Bo

    2016-01-01

    From 2010 to 2012, large outbreaks of EV-A71-related- hand foot and mouth disease (HFMD) occurred annually in China. Some cases had neurological complications and were closely associated with fatal cardiopulmonary collapse, but not all children with central nervous system (CNS) involvement demonstrated a poor prognosis. To identify which patients and which neurological complications are more likely to progress to cardiopulmonary failure, we retrospectively studied 1,125 paediatric inpatients diagnosed with EV-A71-related HFMD in Hunan province, including 1,017 cases with CNS involvement. These patients were divided into cardiopulmonary failure (976 people) group and group without cardiopulmonary failure (149 people). A logistic regression analysis was used to compare the clinical symptoms, laboratory test results, and neurological complications between these two groups. The most significant risk factors included young age, fever duration ≥3 days, coma, limb weakness, drowsiness and ANS involvement. Patients with brainstem encephalitis and more CNS-involved regions were more likely to progress to cardiopulmonary failure. These findings can help front-line clinicians rapidly and accurately determine patient prognosis, thus rationally distributing the limited medical resources and implementing interventions as early as possible. PMID:27001010

  20. Restrictive lung disease is an independent predictor of exercise intolerance in the adult with congenital heart disease

    PubMed Central

    Ginde, Salil; Bartz, Peter J.; Hill, Garick D.; Danduran, Michael J.; Biller, Julie; Sowinski, Jane; Tweddell, James S.; Earing, Michael G.

    2016-01-01

    Background/Objectives Following repair of congenital heart disease (CHD), adult patients are at risk for reduced exercise capacity. Restrictive lung disease (RLD) may contribute to reduced exercise capacity in this population. The aim of this study was to determine the prevalence of RLD and its impact on exercise tolerance in the adult with congenital heart disease. Methods One hundred consecutive adult patients with CHD, who underwent routine cardiopulmonary exercise testing with spirometry, were evaluated. Clinical data was obtained by retrospective chart review. Results Patients from 10 major diagnostic groups were identified. The median age for the cohort was 31 years (range 18–63) and included 43 males and 57 females. Most patients, 79%, had at least one previous surgical procedure. Based on spirometry and flow/volume loops, 50 patients were classified as normal pulmonary function, 44 patients had patterns suggestive of RLD, 4 suggestive of mixed (obstructive and restrictive), and 2 indeterminate. Risk factors associated with RLD include history of multiple thoracotomies (odds ratio=9.01, p=0.05) and history of atrial arrhythmias (odd ratio=4.25, p=0.05). Overall, 56% of the patients had abnormal exercise capacity. Spirometry suggestive of RLD was a significant risk factor for decreased exercise capacity (odds ratio=3.65, p=0.03). Patients with spirometry suggesting RLD also had lower exercise duration (p=0.004) and a higher New York Heart Association Functional Class (p=0.02). History of previous surgery and decreased heart rate reserve were also significant risk factors for decreased exercise capacity. Conclusion Abnormal spirometry suggestive of RLD is common in the adult with CHD and is a significant risk factor for decreased exercise tolerance in this population. Further studies, are needed to evaluate the relationship between RLD and exercise intolerance and its relationship to mortality in the adult with CHD. PMID:23075089

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

    PubMed Central

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

    2012-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-07-01

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

  3. 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

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

    PubMed

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

    2015-12-01

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

  5. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass vascular catheter,...

  6. Racial Differences in the Prognostic Value of Cardiorespiratory Fitness (Results from the Henry Ford Exercise Testing Project).

    PubMed

    Al-Mallah, Mouaz H; Qureshi, Waqas T; Keteyian, Steven J; Brawner, Clinton A; Alam, Mohsin; Dardari, Zeina; Nasir, Khurram; Blaha, Michael J

    2016-05-01

    The aim of this analysis was to determine whether racial differences exist in the prognostic value of cardiorespiratory fitness (CRF) in black and white patients undergoing stress testing. We included 53,876 patients (mean age 53 ± 13, 49% women) from the Henry Ford Exercise Testing project free of established coronary disease or heart failure who completed a maximal exercise test from 1991 to 2009. Patients were followed for a mean duration of 11.5 years for all-cause mortality, ascertained by linkage with the Death Master File. Follow-up over mean 6.2 years was also available for incident myocardial infarction. Multivariate Cox proportional hazards regression models were used adjusting for demographic variables, risk factors, medications, and reason for stress test referral, including formal interaction testing by race (black vs white). Black patients (n = 16,725) were younger (54 ± 13 vs 52 ± 13, p <0.001) but had higher prevalence of hypertension (73% vs 57%, p <0.001) and obesity (28% vs 21%, p <0.001). On average, black patients achieved a lower CRF compared with whites (8.4 vs 9.5 metabolic equivalents, p <0.0001). A graded increase in mortality risk was noted with decreasing CRF for both black and white patients. In multivariate Cox regression, CRF was a predictor of both myocardial infarction and mortality, with no significant interaction between race, fitness, and outcomes (all interaction terms p >0.10). CRF is a strong predictor of all-cause mortality in both white and black patients, with no significant interaction observed between race, fitness, and outcomes. PMID:26976790

  7. Positive exercise thallium-201 test responses in patients with less than 50% maximal coronary stenosis: angiographic and clinical predictors

    SciTech Connect

    Brown, K.A.; Osbakken, M.; Boucher, C.A.; Strauss, H.W.; Pohost, G.M.; Okada, R.D.

    1985-01-01

    The incidence and causes of abnormal thallium-201 (TI-201) myocardial perfusion studies in the absence of significant coronary artery disease were examined. The study group consisted of 100 consecutive patients undergoing exercise TI-201 testing and coronary angiography who were found to have maximal coronary artery diameter narrowing of less than 50%. Maximal coronary stenosis ranged from 0 to 40%. The independent and relative influences of patient clinical, exercise and angiographic data were assessed by logistic regression analysis. Significant predictors of a positive stress TI-201 test result were: (1) percent maximal coronary stenosis (p less than 0.0005), (2) propranolol use (p less than 0.01), (3) interaction of propranolol use and percent maximal stenosis (p less than 0.005), and (4) stress-induced chest pain (p . 0.05). No other patient variable had a significant influence. Positive TI-201 test results were more common in patients with 21 to 40% maximal stenosis (59%) than in patients with 0 to 20% maximal stenosis (27%) (p less than 0.01). Among patients with 21 to 40% stenosis, a positive test response was more common when 85% of maximal predicted heart rate was achieved (75%) than when it was not (40%) (p less than 0.05). Of 16 nonapical perfusion defects seen in patients with 21 to 40% maximal stenosis, 14 were in the territory that corresponded with such a coronary stenosis. Patients taking propranolol were more likely to have a positive TI-201 test result (45%) than patients not taking propranolol (22%) (p less than 0.05).

  8. 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

  9. 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

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

    PubMed Central

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

    2015-01-01

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

  11. THE CLINICAL TRANSLATION GAP IN CHILD HEALTH EXERCISE RESEARCH: A CALL FOR DISRUPTIVE INNOVATION

    PubMed Central

    2014-01-01

    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

  12. Comprehensive Nuclear-Test-Ban Treaty (CTBT) Monitoring in the Context of the National Data Centre Preparedness Exercise (NPE)

    NASA Astrophysics Data System (ADS)

    Coyne, John; Kitov, Ivan; Krysta, Monika; Becker, Andreas; Brachet, Nicolas; Mialle, Pierrick

    2010-05-01

    The Comprehensive Nuclear Test Ban Treaty Organization (CTBTO) is tasked with monitoring compliance with the CTBT. In order to fulfill this mission, the CTBTO is building the International Monitoring System (IMS), which consists of 337 seismic, hydroacoustic, infrasound, and radionuclide monitoring facilities. Data from the IMS are collected, processed and reviewed by the International Data Centre (IDC). Event listings are formed and subsequently communicated to authorized users designated by States Signatories, which are ultimately responsible of characterizing the CTBT relevance of each event. To be better prepared for this some States Signatories have established National Data Centers (NDCs). In coordination with the CTBTO, NDCs have agreed to organize and conduct annual preparedness exercises to provide for an opportunity for staff from CTBTO and the NDCs to collaborate to gain a better understanding of how IDC data and products may fulfill verification needs. In doing so an in-depth examination of a selected seismo-acoustic event, automatically formed at the IDC, is made. The NDC leading the exercise chooses the event that best mimics a realistic CTBT relevant event. For the related analysis it may also add data from other sources. The NPE 2009 was to-date the most comprehensive exercise as for the first time the event was chosen from an IDC list comprising, three types of observations: Seismic, infrasound and virtual radionuclide. The latter is inferred from atmospheric transport modeling calculations for a hypothetical release from the event location. The presentation will describe the sequence of coordinated actions at NDCs and IDC from seismo-acoustic observation and event formation down to event selection and joint analysis.

  13. Exercise-induced desaturation in patients with chronic obstructive pulmonary disease on six-minute walk test

    PubMed Central

    Dogra, Archana Chauhan; Gupta, Urmil; Sarkar, Malay; Padam, Anita

    2015-01-01

    Background and Objectives: Exercise-induced desaturation (EID) is associated with increased mortality in chronic obstructive pulmonary disease (COPD). However, the relationship of EID with anthropometric and clinical parameters of resting pulmonary function test and six-minute walk test (6MWT) in COPD remains unclear. The study was designed to assess the correlate of EID and to identify various possible predictors of EID in stable normoxemic patients of COPD. Materials and Methods: Sixty patients with stable COPD diagnosed and staged as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underwent 6MWT. A drop in standard pulse oximetry (SpO2) of ≥4% or nadir up to ≤88% was defined as EID. Based on EID during 6MWT, two groups were formed: desaturators (DS) and nondesaturators (NDS). DS and NDS were compared for baseline and clinical characters by the Student's t-test while Pearson and Spearman rho correlation coefficient assessed strength of the association of anthropometric and clinical variables with EID. The predictors of EID were identified by logistic regression and receiver operator curve analysis. Result: Out of 60 patients with stable COPD, 33 patients desaturated on exercise (n = 33/60). DS had significantly lower values of FEV1 (P < 0.001), FVC (P < 0.01) FEV1/FVC (P < 0.01) compared to NDS. EID had significant negative correlation with FEV1 (r = 0.31, P < 0.01), resting oxygen saturation (r = 0.549, P < 0.001) and 6MWD (r = 0.511, P < 0.001). Resting SpO2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively. Interpretation and Conclusion: The 6MWT is a safe and sensitive test to recognize EID in normoxic stable COPD patients. Resting oxygen saturation is a good predictor of EID. PMID:26180379

  14. ["Topless" cardiopulmonary resuscitation. Fashion or science?].

    PubMed

    Markstaller, K; Eberle, B; Dick, W F

    2004-10-01

    A decade after the onset of a discussion whether ventilation could be omitted from bystander basic life support (BLS) algorithms, the state of the evidence is reevaluated. Initial animal studies and a prospective randomized patient trial had suggested that omission of ventilation during the first minutes of lay cardiopulmonary resuscitation (CPR) did not impair patient outcomes. More recent studies demonstrate, however, that this may hold true only in very specific scenarios, and that the chest compression-only technique was never superior to standard BLS. Instead of calling basics of BLS training and practice into question, more and better training of lay persons and professionals appears mandatory, and targeted use of dispatcher-guided telephone CPR should be evaluated and, if it improves outcome, it should be encouraged. Future studies should focus much less on the omission but on the optimization of ventilation under the specific conditions of CPR. PMID:15340728

  15. Trilinolein improves erythrocyte deformability during cardiopulmonary bypass.

    PubMed Central

    Tsai, S K; Chan, P; Lee, T Y; Yung, J M; Hong, C Y

    1994-01-01

    The in vitro effect of trilinolein, a triglyceride with linoleic acid as the major fatty acid residue in the esterified positions of glycerol, on erythrocyte deformability was studied in blood samples collected from 12 patients before and after cardiopulmonary bypass (CPB). Erythrocyte deformability was measured with a filtration method and expressed as red cell filtration rate (RFR). RFR was reduced after CPB and the reduction was time dependent. Trilinolein at a concentration of 10(-7) M significantly reversed the CPB-induced reduction of RFR when it was mixed with blood samples collected 30, 60 and 90 min from the start of CPB. This study confirmed the effect of CPB on erythrocyte deformability and showed that this damage could be significantly improved by mixing blood with trilinolein. PMID:8054252

  16. Automated cardiopulmonary resuscitation: a case study.

    PubMed

    Spiro, Jon; Theodosiou, Maria; Doshi, Sagar

    2014-02-01

    Rates of survival after cardiac arrest are low and correlate with the quality of cardiopulmonary resuscitation (CPR). Devices that deliver automated CPR (A-CPR) can provide sustained and effective chest compressions, which are especially useful during patient transfer and while simultaneous invasive procedures are being performed. The use of such devices can also release members of resuscitation teams for other work. This article presents a case study involving a man with acute myocardial infarction complicated by cardiogenic shock and pulmonary oedema. It describes how ED nursing and medical teams worked together to deliver A-CPR, discusses the use of A-CPR devices in a tertiary cardiac centre, and highlights the advantages of using such devices. PMID:24494769

  17. [Bidirectional Glenn shunt without cardiopulmonary bypass].

    PubMed

    Maeba, S; Nemoto, S; Hamdan, L; Okada, T; Azhari, M

    2006-11-01

    From April 2002 to March 2005, 18 patients having undergone bidirectional Glenn shunt (BDG) without cardiopulmonary bypass (CPB) [off-pump BDG] were retrospectively reviewed. During BDG anastomosis, a temporary bypass was established between superior vena cava (15) or innominate vein (3) and main pulmonary artery (16) or right atrium (2). Hemodynamics and oxygenation were maintained well throughout the temporary bypass time. There was no emergent use of CPB. Mean transpulmonary pressure gradient immediately after and 24 hours after the BDG were 6.7 and 5.6 mmHg, respectively. Echocardiography showed mild flow turbulence at the anastomosis in 1 case. This simple and inexpensive technique provided good surgical view with stable hemodynamics enabling satisfactory BDG in selected cases. Furthermore, it could avoid adverse effects of CPB such as lung injury and possible blood transfusion. This experience would encourage off-pump BDG combined with more challenging procedures. PMID:17094543

  18. Lessons learned from the first U.S./Russian Federation joint tabletop exercise to prepare for conducting on-site inspections under the Comprehensive Nuclear Test Ban Treaty

    SciTech Connect

    Filarowski, C; Gough, R; Hawkins, W; Knowles, S; Kreek, S; MacLeod, G; Rockett, P; Smith, A; Sweeney, J; Wild, J; Wohletz, K

    1999-03-24

    A U.S./Russian Federation Joint Tabletop Exercise took place in Snezhinsk, Russia, from 19 to 24 October 1998, whose objectives were the following: (1) To simulate the actions of the Inspection Team (IT), including interactions with the inspected State Party (ISP), in order to examine different ways the United States and Russian Federation (RF) approach inspections and develop appropriate recommendations for the international community. (2) To identify ambiguities and contradictions in the interpretation of Treaty and Protocol provisions that might become apparent in the course of an inspection and that need clarification in connection with the development of Operational Manuals and on-site inspection (OSI) infrastructure. (3) To confirm the efficacy of using bilateral tabletop exercises to assist in developing an effective Comprehensive Test Ban Treaty (CTBT) verification regime. (4) To identify strong and weak points in the preparation and implementation methods of such exercises for the purpose of further improving possible future exercises.

  19. The Diagnostic Yield of Exercise Stress Testing as a Screening Tool for Subclinical Coronary Artery Disease in Patients with Moderate to Severe Obstructive Sleep Apnea

    PubMed Central

    Cilli, Aykut; Batmaz, Fulsen; Demir, Ibrahim; Boz, Adil; Toprak, Evren; Ozdemir, Tülay; Peker, Yüksel

    2011-01-01

    Study Objective: To address the yield of routine exercise stress testing as a screening tool for subclinical coronary artery disease (CAD) in patients with moderate to severe obstructive sleep apnea (OSA). Design and Setting: A cross-sectional study in a university hospital. Participants: Of 380 consecutive patients with OSA, data from 206 subjects (mean apnea-hypopnea index [AHI] 41 ± 21 events/h) were studied; data from 78 with a history of CAD and 96 with mild OSA (AHI 5-15 events/h) were excluded. Measurements: Routine exercise stress testing. Results: Six subjects could not reach maximal exercise capacity. Of the remaining 200 patients, the results of exercise stress testing were normal in 189. Three had a positive stress test, with coronary angiography confirming the diagnosis of CAD. Eight patients had suspected positive findings on the stress test, but the results of the myocardial perfusion study were negative. Conclusion: The prevalence of subclinical CAD in this selected population with OSA was 1.5%, which is not higher than that in a general population. Our results do not support the routine use of exercise stress testing in patients with moderate to severe OSA who do not have symptoms of CAD. Citation: Cilli A; Batmaz F; Demir I; Boz A; Toprak E; Ozdemir T; Peker Y. The diagnostic yield of exercise stress testing as a screening tool for subclinical coronary artery disease in patients with moderate to severe obstructive sleep apnea. J Clin Sleep Med 2011;7(1):25-29. PMID:21344047

  20. Lessons learned from the first US/Russian Federation joint tabletop exercise to prepare for conducting on-site inspections under the Comprehensive Nuclear Test Ban Treaty

    SciTech Connect

    Filarowski, C; Kreek, S; Smith, A; Sweeney, J; Wild, J; Gough, R; Rockett, P; MacLeod, G; Hawkins, W; Wohletz, K; Knowles, S

    1999-03-24

    A U.S./Russian Federation Joint Tabletop Exercise took place in Snezhinsk, Russia, from 19 to 24 October 1998 whose objectives were to examine the functioning of an Inspection Team (IT) in a given scenario, to evaluate the strategies and techniques employed by the IT, to identify ambiguous interpretations of treaty provisions that needed clarification, and to confirm the overall utility of tabletop exercises to assist in developing an effective Comprehensive Test Ban Treaty (CTBT) verification regime. To achieve these objectives, the United States and Russian Federation (RF) agreed that two exercises would be conducted. The first would be developed by the RF, who would act as controller and as the inspected State Party (ISP), while the United States would play the role of the IT. The roles would be reversed in the second exercise; the United States would develop the scenario and play the ISP, while the RF would play the IT. A joint control team, comprised of members of both the U.S. and RF control teams, agreed on a number of ground rules for the two exercises and established a joint Evaluation Team to evaluate both of the exercises against the stated objectives. To meet time limitations, the scope of this joint exercise needed to be limited. The joint control team decided that each of the two exercises would not go beyond the first 25 days of an on-site inspection (OSI) and that the focus would be on examining the decision-making of the IT as it utilized the various technologies to clarify whether a nuclear test explosion had taken place. Hence, issues such as logistics, restricted access, and activities prior to Point of Entry (POE) would be played only to the extent needed to provide for a realistic context for the exercises' focus on inspection procedures, sensor deployments, and data interpretation. Each of the exercises began at the POE and proceeded with several iterations of negotiations between the IT and ISP, instrument deployments, and data evaluation by the IT. By the end of each of the exercises, each IT had located the site of the underground nuclear explosion (UNE). While this validated the methods employed by each of the ITS, the Evaluation Team noted that each IT employed different search strategies and that each strategy had both advantages and disadvantages. The exercises also highlighted ambiguities in interpretation of certain treaty provisions related to overflights and seismic monitoring. Likewise, a substantial number of lessons were learned relating to radionuclide monitoring and the impact of logistical constraints on successful OSI execution. These lessons are discussed more fully in the body of this report. Notwithstanding the overall positive assessment by the U.S. and RF participants, as well as by the Evaluation Team, that the exercise had met its objectives, there were a variety of areas identified that could be improved in subsequent OSI exercises. Some of these included reexamination of the methods used to convey visual observation data in an exercise; the amount of time compression employed; and the need for better verification of agreements pertaining to the structure, format, and other rules of the exercise. This report summarizes the lessons learned pertaining to both the technical and operational aspects of an OSI as well as to those pertaining to the planning and execution of an OSI exercise. It concludes with comments from the Evaluation Team and proposed next steps for future U.S./RF interactions on CTBT OSIs.

  1. Validity of COSMED's quark CPET mixing chamber system in evaluating energy metabolism during aerobic exercise in healthy male adults.

    PubMed

    Nieman, David C; Austin, Melanie D; Dew, Dustin; Utter, Alan C

    2013-01-01

    This study validated the accuracy of COSMED's Quark cardiopulmonary exercise testing (CPET) metabolic mixing chamber system in measuring metabolic factors during maximal, graded exercise testing. Subjects included 32 physically active men between the ages of 18 and 34 years. During the first test session, subjects were measured for maximal oxygen consumption twice (15 min separation) with the CPET and Douglas bag systems (random order). During the second test session, subjects exercised through four stages of the Bruce treadmill protocol with measurement by the CPET and Douglas bag systems (random order) during steady state at the end of each 3-minute stage. Statistical analysis using a 2 (systems) x 5 (time) repeated measures ANOVA showed that the pattern of change in VO2, VCO2, VE, FeO2, FeCO2, and RER did not differ significantly between CPET and Douglas bag systems. This validation study indicates that the CPET mixing chamber system provides valid metabolic measurements that compare closely with the Douglas bag system during aerobic exercise. PMID:23541100

  2. 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.

  3. 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

  4. Exercise after breast cancer treatment: current perspectives.

    PubMed

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

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

  5. Exercise after breast cancer treatment: current perspectives

    PubMed Central

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  7. [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

  8. Cardiopulmonary Syndromes (PDQ®)—Health Professional Version

    Cancer.gov

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

  9. The association of clinical indication for exercise stress testing with all-cause mortality: the FIT Project

    PubMed Central

    Kim, Joonseok; Al-Mallah, Mouaz; Juraschek, Stephen P.; Brawner, Clinton; Keteyian, Steve J.; Nasir, Khurram; Dardari, Zeina A.; Blumenthal, Roger S.

    2016-01-01

    Introduction We hypothesized that the indication for stress testing provided by the referring physician would be an independent predictor of all-cause mortality. Material and methods We studied 48,914 patients from The Henry Ford Exercise Testing Project (The FIT Project) without known congestive heart failure who were referred for a clinical treadmill stress test and followed for 11 ±4.7 years. The reason for stress test referral was abstracted from the clinical test order, and should be considered the primary concerning symptom or indication as stated by the ordering clinician. Hierarchical multivariable Cox proportional hazards regression was performed, after controlling for potential confounders including demographics, risk factors, and medication use as well as additional adjustment for exercise capacity in the final model. Results A total of 67% of the patients were referred for chest pain, 12% for shortness of breath (SOB), 4% for palpitations, 3% for pre-operative evaluation, 6% for abnormal prior testing, and 7% for risk factors only. There were 6,211 total deaths during follow-up. Compared to chest pain, those referred for palpitations (HR = 0.72, 95% CI: 0.60–0.86) and risk factors only (HR = 0.72, 95% CI: 0.63–0.82) had a lower risk of all-cause mortality, whereas those referred for SOB (HR = 1.15, 95% CI: 1.07–1.23) and pre-operative evaluation (HR = 2.11, 95% CI: 1.94–2.30) had an increased risk. In subgroup analysis, referral for palpitations was protective only in those without coronary artery disease (CAD) (HR = 0.75, 95% CI: 0.62–0.90), while SOB increased mortality risk only in those with established CAD (HR = 1.25, 95% CI: 1.10–1.44). Conclusions The indication for stress testing is an independent predictor of mortality, showing an interaction with CAD status. Importantly, SOB may be associated with higher mortality risk than chest pain, particularly in patients with CAD. PMID:27186173

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

    PubMed Central

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

    2015-01-01

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

  11. Anesthetic Management for Cardiopulmonary Bypass: Update for 2014.

    PubMed

    Bechtel, Allison; Huffmyer, Julie

    2014-04-10

    Cardiopulmonary bypass has revolutionized the practice of cardiac surgery and allows safe conduct of increasingly complex cardiac surgery. A brief review of the bypass circuit is undertaken in this review. A more thorough review of the anesthetic management is accomplished including choice of anesthetic medications and their effects. The inflammatory response to cardiopulmonary bypass is reviewed along with interventions that may help ameliorate the inflammation. PMID:24728883

  12. Ventilatory efficiency during exercise in healthy subjects.

    PubMed

    Sun, Xing-Guo; Hansen, James E; Garatachea, Nuria; Storer, Thomas W; Wasserman, Karlman

    2002-12-01

    When evaluating dyspnea in patients with heart or lung disease it is useful to measure the quantity of ventilation needed to eliminate metabolically produced CO2 (i.e., the ventilatory efficiency). Mathematically, the relationship between ventilation (VE) and CO2 output is determined by the arterial CO2 pressure and the physiologic dead space-tidal volume ratio. We decided to determine how age, sex, size, fitness, and the type of ergometer influenced ventilatory efficiency in normal subjects. Three methods were compared for expressing this relationship: (1) the VE versus CO2 output slope below the ventilatory compensation point, commonly used by cardiologists for estimating the severity of heart failure; (2) the VE/CO2 output ratio at the anaerobic threshold, commonly used by pulmonologists; and (3) the lowest VE/CO2 output ratio during exercise, the latter parameter not previously reported. We studied 474 healthy adults, between 17 and 78 years of age during incremental cycle and treadmill cardiopulmonary exercise tests at three test sites, correcting the total VE for the equipment dead space. The lowest VE/CO2 output ratio was insignificantly different from the ratio at the anaerobic threshold, less variable than that for the slope relationship, and unaffected by the site, ergometer, and gas exchange measurement systems. The regression equation for the lowest VE/CO2 output ratio was 27.94 + 0.108 x age + (0.97 = F, 0.0 = M) - 0.0376 x height, where age is in years and height is in centimeters. We conclude that the lowest VE/CO2 output ratio is the preferred noninvasive method to estimate ventilatory inefficiency. PMID:12450934

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

    PubMed

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

    2013-04-01

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

  14. 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…

  15. Analysis on the Effect of Individualized Aerobic Exercise Intervention for Teenagers with Type 2 Diabetes

    PubMed Central

    Chun-qi, Zhao

    2015-01-01

    Objective: To investigate the intervention effect of individualized aerobic exercise on type 2 diabetes in teenagers. Method: To select 60 cases of teenager with type 2 diabetes in Zhoukou Hospital of Traditional Medicine in February 2013 to February 2014 as the research object, test all enrolled patients’ maximal oxygen and blood glucose fluctuation, and then give individualized aerobic exercise intervention, after 6 months intervention, compare the changes of patients’ indexes and evaluate the effect of individualized aerobic exercise intervention. Result: After the intervention, the patients’ plasma triglyceride and cholesterol content are significantly lower than before (P < 0.05); there’s no significant difference between high and low-density lipoprotein (P > 0.05). Moreover, the patients’ insulin and C-peptide level are significantly higher than those before intervention (P < 0.05); before intervention, their blood glucose and glycated hemogiobin level are higher than normal, after intervention, they are weakened, but there’s no significant difference (P > 0.05). The maximal oxygen uptake and different intensity of metabolic equivalents are higher than before, but there’s no significant difference (P > 0.05). Conclusion: For teenagers with type 2 diabetes, the implementation of individualized aerobic exercise intervention can effectively improve the patients’ lipid metabolism and cardio-pulmonary function, and effectively promote the insulin and C-peptide secretion, to provide scientific basis for effective control of blood glucose. PMID:26981161

  16. What are the electrical stimulation design parameters for maximum VO2 aimed at cardio-pulmonary rehabilitation?

    PubMed

    Minogue, Conor M; Caulfield, Brian M; Reilly, Richard B

    2007-01-01

    Electrical Stimulation (ES) is increasingly being considered as a means to improve cardio-pulmonary performance in patients with reduced exercise capacity. This short review considers the ES signal parameters and protocols used in studies that have included a measurement of oxygen uptake during the session. It suggests that the tetanic signal parameters normally used for muscle strengthening are not suitable for producing a sustained increase in oxygen uptake. Instead, very low frequencies are preferred, perhaps because there is less fatigue of the type 1 muscle fibers. PMID:18002484

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

    PubMed Central

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

    2015-01-01

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

  18. Value of standardised exercise tests and blood biochemistry in the selection and training of breeding stallions.

    PubMed

    Sloet van Oldruitenborgh-Oosterbaan, M M; Wensing, T; Barneveld, A; Breukink, H J

    1991-10-19

    Stallions selected by the Royal Dutch Warmblood Society were submitted to a standardised lungeing test at the beginning and at the end of a 100-day test of performance and ability. The heart rate, haematology and biochemistry values obtained in the first lungeing test showed no significant differences between the 15 stallions which were rejected by the Royal Dutch Warmblood Society during the first month of the 100-day test, the 15 stallions rejected during the last month and the 11 stallions which were approved for registration in the studbook. The 26 stallions submitted to the second lungeing test had significantly lower heart rates and blood lactate concentrations than in the first test. The standardised lungeing test had no value in predicting the rejection or approval of the stallions, and the fitness of a stallion at the beginning of the 100-day test did not influence its chance of being approved as a breeding stallion. The differences between the results of the first and the second tests suggest that the fitness of the stallions improved during the 100-day test. PMID:1759338

  19. Exercise Hypertension

    PubMed Central

    Schultz, Martin G.; Sharman, James E.

    2014-01-01

    Irrespective of apparent ‘normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥210 mm Hg in men or ≥190 mm Hg in women or diastolic BP ≥110 mm Hg in men or women), a condition termed exercise hypertension or a ‘hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory ‘masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE. PMID:26587435

  20. Exercise Hypertension.

    PubMed

    Schultz, Martin G; Sharman, James E

    2014-05-01

    Irrespective of apparent 'normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ?210 mm Hg in men or ?190 mm Hg in women or diastolic BP ?110 mm Hg in men or women), a condition termed exercise hypertension or a 'hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory 'masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE. PMID:26587435

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

    PubMed Central

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

    2014-01-01

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

  2. 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.

  3. A novel rotary pulsatile flow pump for cardiopulmonary bypass.

    PubMed

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

    2014-01-01

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

  4. A Novel Rotary Pulsatile Flow Pump for Cardiopulmonary Bypass

    PubMed Central

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

    2014-01-01

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

  5. Effect of flunixin meglumine on selected physiologic and performance parameters of athletically conditioned thoroughbred horses subjected to an incremental exercise stress test.

    PubMed

    Colahan, Patrick T; Bailey, James E; Chou, Chi-Chung; Johnson, Martha; Rice, Brett L; Jones, Galin L; Cheeks, Joseph P

    2002-01-01

    Twelve clinically sound, healthy, athletically conditioned Thoroughbred horses were subjected to an incremental exercise stress test to determine the effects and period of detection of a single dose of flunixin meglumine (1.1 mg/kg by intravenous injection) in serum and urine by ELISA. Flunixin concentrations, performance, and hematologic and clinical chemical parameters were measured. All horses were rotated through four treatment groups of a Latin-square design providing for each horse to serve as its own control. Flunixin meglumine reduced prostaglandin F(1alpha) and thromboxane concentrations that had been increased by intense exercise. Performance parameters did not improve and prostaglandin concentrations did not significantly correlate with total run time. Exercise did not change the flunixin elimination profile in either serum or urine, and concentrations were found to be below the detection limit of the ELISA test within 36 hours in serum and 120 hours in urine. PMID:12050827

  6. Testing in Groups: A "Real" Exercise in Small Group Problem-Solving.

    ERIC Educational Resources Information Center

    Millar, Dan Pyle

    Students in a small group discussion class offered as part of a speech communication curriculum found that testing their knowledge of the theory of the course in small groups was a positive learning experience. Each self-selected test group was made up of three students and was formed at least two class periods prior to the exam. Time was given in…

  7. Alternative ventilation strategies in cardiopulmonary resuscitation.

    PubMed

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

    2002-06-01

    The introduction of the 2000 Guidelines for Cardiopulmonary Resuscitation emphasizes a new, evidence-based approach to the science of ventilation during cardiopulmonary resuscitation (CPR). New laboratory and clinical science underemphasizes the role of ventilation immediately after a dysrhythmic cardiac arrest (arrest primarily resulting from a cardiovascular event, such as ventricular defibrillation or asystole). However, the classic airway patency, breathing, and circulation (ABC) CPR sequence remains a fundamental factor for the immediate survival and neurologic outcome of patients after asphyxial cardiac arrest (cardiac arrest primarily resulting from respiratory arrest). The hidden danger of ventilation of the unprotected airway during cardiac arrest either by mouth-to-mouth or by mask can be minimized by applying ventilation techniques that decrease stomach gas insufflation. This goal can be achieved by decreasing peak inspiratory flow rate, increasing inspiratory time, and decreasing tidal volume to approximately 5 to 7 mL/kg, if oxygen is available. Laboratory and clinical evidence recently supported the important role of alternative airway devices to mask ventilation and endotracheal intubation in the chain of survival. In particular, the laryngeal mask airway and esophageal Combitube proved to be effective alternatives in providing oxygenation and ventilation to the patient in cardiac arrest in the prehospital arena in North America. Prompt recognition of supraglottic obstruction of the airway is fundamental for the management of patients in cardiac arrest when ventilation and oxygenation cannot be provided by conventional methods. "Minimally invasive" cricothyroidotomy devices are now available for the professional health care provider who is not proficient or comfortable with performing an emergency surgical tracheotomy or cricothyroidotomy. Finally, a recent device that affects the relative influence of positive pressure ventilation on the hemodynamics during cardiac arrest has been introduced, the inspiratory impedance threshold valve, with the goal of maximizing coronary and cerebral perfusion while performing CPR. Although the role of this alternative ventilatory methodology in CPR is rapidly being established, we cannot overemphasize the need for proper training to minimize complications and maximize the efficacy of these new devices. PMID:12386498

  8. Posture Exercises

    MedlinePlus

    ... Search You are here Home » Posture Exercises Posture Exercises When a person develops kyphosis, the posture becomes ... and strengthen the back. Try the following two exercises to keep your spine more limber and flexible. ...

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

    PubMed Central

    2014-01-01

    Background Previous studies on type 2 diabetes have shown an association between exercise capacity and insulin resistance. In patients with coronary artery disease (CAD) exercise capacity is often reduced due to exercise-induced ischemia. We have investigated the association between glucometabolic control, including the homeostatic model assessment (HOMA) of insulin resistance, and exercise capacity in patients with type 2 diabetes and CAD with and without exercise-induced ischemia. Methods In 137 patients (age 63.1 ± 7.9) cardiopulmonary exercise testing on treadmill was performed using a modified Balke protocol. The highest oxygen uptake (VO2peak) was reported as 30-s average. Fasting blood samples were drawn for determination of glucose, insulin and HbA1c. Insulin resistance (IR) was assessed by the HOMA2-IR computer model. Exercise-induced ischemia was defined as angina and/ or ST-depression in ECG ≥ 0.1 mV during the exercise test. Results HOMA2-IR was inversely correlated to VO2peak (r = -0.328, p < 0.001), still significant after adjusting for age, gender, smoking and BMI. Patients with HOMA2-IR above the median value (1.3) had an adjusted odds ratio of 3.26 (95 % CI 1.35 to 7.83, p = 0.008) for having VO2peak below median (23.8 mL/kg/min). Insulin levels were inversely correlated to VO2peak (r = -0.245, p = 0.010), also after adjusting for age and gender, but not after additional adjustment for BMI. The correlation between HOMA2-IR and VO2peak was also significant in the subgroups with (n = 51) and without exercise-induced ischemia (n = 86), being numerically stronger in the group with ischemia (r = -0.430, p = 0.003 and r = -0.276, p = 0.014, respectively). Fasting glucose and HbA1c were not correlated with VO2peak or AT. Conclusions Insulin resistance, as estimated by fasting insulin and the HOMA index, was inversely associated with exercise capacity in patients with type 2 diabetes and CAD, the association being more pronounced in the subgroup with exercise-induced ischemia. These results indicate that insulin resistance is related to exercise capacity in type 2 diabetic patients with CAD, possibly even more so in patients with exercise-induced ischemia compared to those without. PMID:24612649

  10. Assessment of Speckle-Tracking Echocardiography-Derived Global Deformation Parameters During Supine Exercise in Children.

    PubMed

    Liu, Michael Y; Tacy, Theresa; Chin, Clifford; Obayashi, Derek Y; Punn, Rajesh

    2016-03-01

    Exercise echocardiography is an underutilized tool in pediatrics with current applications including detecting segmental wall abnormalities, assessing the utility of global ventricular function, and measuring pulmonary hemodynamics. No prior study has applied speckle-tracking echocardiography (STE) during exercise echocardiography in children. The aim of this study was to determine the feasibility of measuring speckle-tracking-derived peak systolic velocities, global longitudinal and circumferential strain, and global strain rates at various phases of exercise. Ninety-seven healthy children underwent cardiopulmonary exercise testing using supine cycle ergometry. The exercise stress test consisted of baseline pulmonary function testing, monitoring of blood pressure and heart rate responses, electrocardiographic recordings, and oxygen saturations while subjects pedaled against a ramp protocol based on body weight. Echocardiographic measurements and specifically speckle-tracking analysis were performed during exercise at baseline, at a heart rate of 160 beats per minute and at 10 min after exercise. Peak systolic velocity, peak systolic strain, and peak systolic strain rate at these three phases were compared in the