Note: This page contains sample records for the topic cardiopulmonary exercise tests from Science.gov.
While these samples are representative of the content of Science.gov,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of Science.gov
to obtain the most current and comprehensive results.
Last update: August 15, 2014.
1

Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing  

PubMed Central

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

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

2012-01-01

2

Strategies for Cardiopulmonary Exercise Testing of Pectus Excavatum Patients  

PubMed Central

The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

Malek, Moh H.; Coburn, Jared W.

2008-01-01

3

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

Microsoft Academic Search

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

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

2011-01-01

4

Exercise-induced Myocardial Ischemia Detected by Cardiopulmonary Exercise Testing  

PubMed Central

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.

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

2010-01-01

5

Cardiopulmonary exercise testing in cancer rehabilitation: a systematic review.  

PubMed

This systematic review aims to get insight into the feasibility of cardiopulmonary exercise testing (CPET) in patients with cancer prior to a physical exercise programme. We will focus on quality (defined as the adherence to international guidelines for methods of CPET) and safety of CPET. Furthermore, we compare the peak oxygen uptake (·VO(2peak)) values of patients with cancer with reference values for healthy persons to put these values into a clinical perspective. A computer aided search with 'cardiopulmonary exercise testing' and 'cancer' using MEDLINE, EMBASE, Pedro, CINAHL® and SPORTDiscus™ was carried out. We included studies in which CPET with continuous gas exchange analysis has been performed prior to a physical exercise programme in adults with cancer. Twenty studies describing 1158 patients were eligible. Reported adherence to international recommendations for CPET varied per item. In most studies, the methods of CPET were not reported in detail. Adverse events occurred in 1% of patients. The percentage ·VO(2peak) of reference values for healthy persons varied between 65% and 89% for tests before treatment, between 74% and 96% for tests during treatment and between 52% and 117% for tests after treatment. Our results suggest that CPET is feasible and seems to be safe for patients with cancer prior to a physical exercise programme. We recommend that standard reporting and quality guidelines should be followed for CPET methods. The decreased ·VO(2peak) values of patients with cancer indicate that physical exercise should be implemented in their standard care. PMID:22452663

Steins Bisschop, Charlotte N; Velthuis, Miranda J; Wittink, Harriët; Kuiper, Kees; Takken, Tim; van der Meulen, Wout J T M; Lindeman, Eline; Peeters, Petra H M; May, Anne M

2012-05-01

6

Cardiopulmonary Exercise Testing Before and After Lung and Heart-Lung Transplantation  

Microsoft Academic Search

Heart-lung (HLT) and lung transplantation (LT) have been shown to be effective procedures for pa- tients with end-stage cardiopulmonary disorders. As yet, few data exist on the exercise performance of patients before and after thoracic transplantation except with regard to 6-min walk tests. In this article we report cardiopulmonary exercise test results of lung and heart-lung transplant recipients in comparison

MARTIN SCHWAIBLMAIR; HERMANN REICHENSPURNER; CHRISTIAN MÜLLER; JOSEF BRIEGEL; HEINER FÜRST; JÜRGEN GROH; BRUNO REICHART; CLAUS VOGELMEIER

1999-01-01

7

Improved performance on cardiopulmonary exercise testing following DDDR pacemaker adjustment: a case report.  

PubMed

We report a case of improved cardiopulmonary exercise (CPX) test outcomes measured 48 h after initial CPX testing and immediately after alterations were made to the settings of a dual chamber, dual sensing pacemaker with exercise detection. The changes allowed successful abdominal surgery to be completed. PMID:24638230

Bolsin, S; Colson, M; Ridley, D; Ward, C

2014-06-01

8

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

PubMed Central

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.

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

2010-01-01

9

Theoretical rationale and practical recommendations for cardiopulmonary exercise testing in patients with chronic heart failure  

Microsoft Academic Search

The syndrome of chronic heart failure (CHF) becomes increasingly prevalent in older patients, and while mortality rates are\\u000a declining in most cardiovascular diseases, both prevalence and mortality in CHF remain high. The heart is unable to meet the\\u000a demands of the skeletal musculature, and symptoms manifest as dyspnoea and signs of fatigue during exercise. The cardiopulmonary\\u000a exercise test (CPET) can

Lee Ingle

2007-01-01

10

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

Microsoft Academic Search

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

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

11

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

PubMed Central

BACKGROUND--Essential hyperhidrosis is characterised by an overactivity of the sympathetic fibres passing through the upper dorsal sympathetic ganglia D2-D3. Anatomical interruption at the D2-D3 level is a highly effective treatment for essential hyperhidrosis but also causes (partial) cardiac denervation and, after surgical sympathicolysis, important impairment of cardiopulmonary exercise function has been observed. The purpose of this study was to compare the results of cardiopulmonary exercise testing between patients with essential hyperhidrosis and a normal control population, and to examine the effects of thoracoscopic D2-D3 sympathicolysis on cardiopulmonary exercise capacity in patients with essential hyperhidrosis. METHODS--maximal, symptom limited incremental exercise tests were performed in 26 patients with severe essential hyperhidrosis one week before and one month after D2-D3 thoracoscopic sympathicolysis, and in 14 age and sex matched healthy volunteers. D2-D3 thoracoscopic sympathicolysis was performed using a simplified one stage bilateral procedure. RESULTS--Palmar hyperhidrosis was relieved in every patient, confirming the D2-D3 denervation. A higher peak heart rate (7%) was seen in the patient group than in the normal subjects, but ll other cardiovascular, metabolic, and respiratory parameters were similar. After D2-D3 thoracoscopic sympathicolysis, heart rate at rest (13%) and at peak exercise (7%) were reduced, together with an increase in oxygen pulse. All other parameters remained unchanged. CONCLUSIONS--Sympathetic overactivity relevant to cardiovascular function in essential hyperhidrosis is evident only during sympathetic stimulation. D2-D3 thoracoscopic sympathicolysis causes a small and asymptomatic reduction in maximal and resting heart rate and is not associated with a decrease in exercise capacity, in contrast with the detrimental effects on exercise capacity of open surgical sympathectomy.

Noppen, M.; Herregodts, P.; Dendale, P.; D'Haens, J.; Vincken, W.

1995-01-01

12

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

PubMed Central

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.

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

13

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

PubMed Central

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

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

2013-01-01

14

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

PubMed Central

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

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

2013-01-01

15

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

PubMed Central

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.

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

16

Effect of Treatment by Nasal CPAP onCardiopulmonary Exercise Test in ObstructiveSleep Apnea Syndrome  

Microsoft Academic Search

This study was done to evaluate whether cardiac dysfunction or abnormal measurements on cardiopulmonary exercise testing (CPET) can be improved after 2 months of nasal CPAP treatment. Twenty patients with moderate or severe OSAS received nasal CPAP treatment. All subjects also underwent blood pressure, simple spirometric, and arterial blood gas (ABG) measurements; cardiac evaluation by radionuclide scanning and CPET; and

Ching-Chi Lin; Ching-Kai Lin; Kun-Ming Wu; Chon-Shin Chou

2004-01-01

17

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

PubMed

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

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

2014-02-01

18

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

PubMed

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

Aliannejad, Rasoul; Saburi, Amin; Ghanei, Mostafa

2013-04-01

19

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

PubMed Central

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.

Aliannejad, Rasoul; Saburi, Amin; Ghanei, Mostafa

2013-01-01

20

Cardiopulmonary exercise testing suggests a beneficial response to pulmonary endarterectomy in a patient with chronic thromboembolic obstruction and normal preoperative pulmonary hemodynamics  

PubMed Central

Abstract Pulmonary endarterectomy offers a symptomatic and survival benefit in patients with chronic thromboembolic pulmonary hypertension through sustained improvement in right ventricular function. However, its role in patients with symptom limitation, chronic thrombotic obstruction, and a normal pulmonary hemodynamic profile is less clear. Cardiopulmonary exercise testing (CPET) stresses the cardiopulmonary system and has a characteristic response in pulmonary hypertension. CPET may therefore reveal abnormalities in patients with chronic thrombotic obstruction where hemodynamic investigations conducted at rest are reassuring. Using incremental CPET, we demonstrated improvements in right ventricular performance and ventilatory efficiency following pulmonary endarterecomy in a patient with preoperative exercise limitation and normal pulmonary hemodynamics. Careful evaluation of exercise responses may extend the potential benefit offered by pulmonary endarterectomy in patients with chronic thromboembolic obstruction irrespective of their resting hemodynamic profile.

2014-01-01

21

Predicting the highest workload in cardiopulmonary test  

Microsoft Academic Search

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

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

2010-01-01

22

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

PubMed Central

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

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

2012-01-01

23

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

PubMed

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

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

2014-01-01

24

Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation  

PubMed Central

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

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

2014-01-01

25

Human Investigations into the Arterial and Cardiopulmonary Baroreflexes during Exercise  

PubMed Central

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

Fadel, Paul J.; Raven, Peter B.

2011-01-01

26

Does Obstructive Sleep Apnea Impair the Cardiopulmonary Response to Exercise?  

PubMed Central

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

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

2013-01-01

27

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

Microsoft Academic Search

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

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

28

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

PubMed

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

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

2013-02-20

29

Cardiopulmonary Exercise Testing in Patients with Chronic Heart Failure: Prognostic Comparison from Peak VO2 and VE/VCO2 Slope  

PubMed Central

Background: Cardiopulmonary exercise testing with ventilatory expired gas analysis (CPET) has proven to be a valuable tool for assessing patients with chronic heart failure (CHF). The maximal oxygen uptake (peak V02) is used in risk stratification of patients with CHF. The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) has recently demonstrated prognostic significance in patients with CHF. Methods: Between January 2006 and December 2007 we performed CPET in 184 pts (146 M, 38 F, mean age 59.8 ± 12.9 years), with stable CHF (96 coronary artery disease, 88 dilated cardiomyopathy), in NYHA functional class II (n.107) - III (n.77), with left ventricular ejection fraction (LVEF) ? 45%,. The ability of peak VO2 and VE/VCO2 slope to predict cardiac related mortality and cardiac related hospitalization within 12 months after evaluation was examined. Results: Peak VO2 and VE/VCO2 slope were demonstrated with univariate Cox regression analysis both to be significant predictor of cardiac-related mortality and hospitalization (p < 0.0001, respectively). Non survivors had a lower peak VO2 (10.49 ± 1.70 ml/kg/min vs. 14.41 ± 3.02 ml/kg/min, p < 0.0001), and steeper Ve/VCO2 slope (41.80 ± 8.07 vs. 29.84 ± 6.47, p < 0.0001) than survivors. Multivariate survival analysis revealed that VE/VCO2 slope added additional value to VO2 peak as an independent prognostic factor (?2: 56.48, relative risk: 1.08, 95% CI: 1.03 – 1.13, p = 0.001). The results from Kaplan-Meier analysis revealed a 1-year cardiac-related mortality of 75% in patients with VE/VCO2 slope ? 35.6 and 25% in those with VE/VCO2 slope < 35.6 (log rank ?2: 67.03, p < 0.0001) and 66% in patients with peak VO2 ? 12.2 ml/kg/min and 34% in those with peak VO2 > 12.2 ml/kg/min (log rank ?2: 50.98, p < 0.0001). One-year cardiac-related hospitalization was 77% in patients with VE/VCO2 slope ? 32.5 and 23% in those with VE/VCO2 slope < 32.5 (log rank ?2: 133.80, p < 0.0001) and 63% in patients with peak VO2 ? 12.3 ml/kg/min and 37% in those with peak VO2 > 12.3 ml/kg/min (log rank ?2: 72.86, p < 0.0001). The VE/VCO2 slope was demonstrated with receiver operating characteristic curve analysis to be equivalent to peak VO2 in predicting cardiac-related mortality (0.89 vs. 0.89). Although area under the receiver operating characteristic curve for the VE/VCO2 slope was greater than peak VO2 in predicting cardiac-related hospitalization (0.88 vs 0.82), the difference was no statistically significant (p = 0.13). Conclusion: These results add to the present body of knowledge supporting the use of CPET in CHF patients. The VE/VCO2 slope, as an index of ventilatory response to exercise, is an excellent prognostic parameter and improves the risk stratification of CHF patients. It is easier to obtain than parameters of maximal exercise capacity and is of equivalent prognostic importance than peak VO2.

Sarullo, Filippo Maria; Fazio, Giovanni; Brusca, Ignazio; Fasullo, Sergio; Paterna, Salvatore; Licata, Pamela; Novo, Giuseppina; Novo, Salvatore; Di Pasquale, Pietro

2010-01-01

30

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

PubMed

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(?peak)), 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(?peak) 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

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

2010-12-01

31

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

NASA Technical Reports Server (NTRS)

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

Moore, Alan D.

2011-01-01

32

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

Microsoft Academic Search

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

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

1996-01-01

33

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

PubMed

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

Man, Avi; Keren, Gad; Topilsky, Yan

2014-02-01

34

Exercise stress test  

MedlinePLUS

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

35

Cardiopulmonary response to dynamic exercise after heart and combined heart-lung transplantation.  

PubMed Central

The exercise capacity and cardiopulmonary response to progressive dynamic exercise of eight healthy recipients of heart-lung transplants were compared with those of matched recipients of orthotopic cardiac transplants and normal controls. In both transplant groups the maximum workloads were lower than that in the normal group. The transplant recipients had higher pre-exercise heart rates and lower maximum heart rates than the normal controls. Ventilation during submaximal exercise was similar in the heart transplant group and the controls. The heart-lung group had an increased ventilatory response associated with lower end tidal carbon dioxide concentrations. Exercise capacity after combined heart-lung transplantation is similar to that after cardiac transplantation. Transplant recipients have an abnormal heart rate response during exercise related to cardiac denervation. The altered ventilatory response in heart-lung recipients may be the result of pulmonary denervation.

Banner, N R; Lloyd, M H; Hamilton, R D; Innes, J A; Guz, A; Yacoub, M H

1989-01-01

36

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

PubMed Central

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

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

2010-01-01

37

Metabolic and cardiopulmonary responses to acute progressive resistive exercise in a person with C4 spinal cord injury  

Microsoft Academic Search

Study design: Single-subject (female, 38 years of age) case.Objectives: To describe metabolic and cardiopulmonary responses to progressive resistive exercise in an individual with C4 ASIA A tetraplegia, and to review the relationship between level of spinal cord injury (SCI) and exercise responses.Setting: Large, urban mid-western city rehabilitation hospital in United States of America.Methods: Bilateral shoulder elevation\\/depression (shoulder shrug) exercise with

TJ Birk; E Nieshoff; G Gray; J Steeby; K Jablonski

2001-01-01

38

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

PubMed Central

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

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

1997-01-01

39

Abnormal cardiopulmonary exercise variables in asymptomatic relatives of patients with dilated cardiomyopathy who have left ventricular enlargement  

PubMed Central

BACKGROUND—Left ventricular enlargement with normal systolic function is common in asymptomatic relatives of patients with familial dilated cardiomyopathy, many of whom progress to overt dilated cardiomyopathy at follow up.?OBJECTIVE—To examine maximal and submaximal gas exchange variables of cardiopulmonary exercise testing in asymptomatic relatives with left ventricular enlargement.?DESIGN AND SETTING—Controlled evaluation of metabolic exercise performance of patients with dilated cardiomyopathy and asymptomatic relatives with left ventricular enlargement identified through prospective family screening in a cardiomyopathy outpatient clinic.?METHODS—23 relatives with left ventricular enlargement, 33 normal controls, 29 patients with dilated cardiomyopathy, and 10 elite athletes with echocardiographic criteria of left ventricular enlargement ("physiological" enlargement) underwent symptom limited upright cycle ergometry using a ramp protocol.?RESULTS—Peak oxygen consumption (pVO2; mean (SD)) was significantly reduced in relatives with left ventricular enlargement (78 (16.3)%) v normal controls (96%, p < 0.01) and athletes (152%, p < 0.001), but was higher than in patients with dilated cardiomyopathy (69%, p < 0.01). pVO2 was less than 80% of predicted in 75% of patients, 58% of relatives, 22% of controls, and none of the athletes. Oxygen pulse (pVO2/heart rate) was less than 80% of predicted in 69% of patients, 35% of relatives, 6% of controls, and none of the athletes. The slope of minute ventilation v CO2 production (?VE/?VCO2) was > 30 in 68% of patients, 50% of relatives, and in none of the controls or athletes. Anaerobic threshold, occurring in relatives at 37 (14)% of the predicted VO2, was higher than in the patients (32%, p < 0.01) and lower than in the controls (45%, p < 0.05) or in the athletes (55%, p < 0.001).?CONCLUSIONS—Maximal and submaximal cardiopulmonary exercise test variables are abnormal in asymptomatic relatives with left ventricular enlargement, in spite of normal systolic function. This provides further evidence that left ventricular enlargement represents subclinical disease in relatives of patients with dilated cardiomyopathy. Metabolic exercise testing can complement echocardiography in identifying relatives at risk for the development of dilated cardiomyopathy.???Keywords: cardiomyopathy; exercise; diagnosis

Mahon, N; Sharma, S; Elliott, P; Baig, M; Norman, M; Barbeyto, S; McKenna, W

2000-01-01

40

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

PubMed Central

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

2014-01-01

41

Sample Proficiency Test exercise  

SciTech Connect

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

Alcaraz, A; Gregg, H; Koester, C

2006-02-05

42

Lipid peroxidation and nitric oxide metabolites in sedentary subjects and sportsmen before and after a cardiopulmonary test.  

PubMed

Our aim was to investigate the effects of an exercise test on some indices of oxidative status and endothelial function, in trained and untrained subjects. We examined lipid peroxidation, nitric oxide metabolites (NOx) and their ratio before and after a cardiopulmonary test, using a cycloergometer. We enrolled 60 male subjects who practiced sport unprofessionally, subdivided in two groups (A and B) according to the values of VO2max. Group A included sportsmen with poor or fair aerobic fitness (VO2max <39 ml/Kg/min), group B sportsmen with average to excellent aerobic fitness (VO2max >39 ml/Kg/min). The control group included 19 male sedentary subjects. Lipid peroxidation was evaluated by detection of the thiobarbituric acid-reactive substances (TBARS); the NOx were evaluated employing the Griess reagent. At rest, in comparison with sedentary controls, an increase in TBARS, NOx and TBARS/NOx ratio was found in all sportsmen and partially in the two groups. After the cardiopulmonary test, the increase of TBARS and TBARS/NOx ratio was significantly more evident in sedentary controls than in sportsmen. No variation was observed for NOx in any group. These data suggest that sportsmen are protected against the acute oxidative stress induced by an exercise test, and that protection is not strictly dependent on the aerobic fitness. PMID:22710809

Lo Presti, Rosalia; Canino, Baldassare; Montana, Maria; Caimi, Gregorio

2013-01-01

43

Control of work rate-driven exercise facilitates cardiopulmonary training and assessment during robot-assisted gait in incomplete spinal cord injury  

Microsoft Academic Search

Treadmill training is used for gait rehabilitation in various neurological conditions. Robot-assisted treadmill training automates repetition of the gait cycle and can reduce the load on therapists. Here we investigate the use of robot-assisted treadmill technology in cardiopulmonary rehabilitation and assessment.Using a new approach to exercise work rate estimation and volitional control, we propose cardiopulmonary assessment protocols for robot-assisted gait

K. J. Hunt; L. P. Jack; A. Pennycott; C. Perret; M. Baumberger; T. H. Kakebeeke

2008-01-01

44

Protein carbonyl groups in trained subjects before and after a cardiopulmonary test.  

PubMed

Physical exercise influences the body's oxidative status. The modifications can involve lipids, proteins and nucleic acids, and different effects seem to be induced by regular and acute exercise respectively. We examined protein oxidation, expressed as concentration of protein carbonyl groups (PC), in trained subjects before (time 0), 10 min (time 1) and 24 hours (time 2) after a cardiopulmonary test performed on a cycloergometer. We enrolled 38 trained subjects (26 men and 12 women), subdivided in two groups (A1 and B1) of 19 subjects each, according to the median value of VO2max, and in two groups (A2 and B2) of 19 subjects each, according to the median value of PC at baseline. PC concentration was measured by an enzyme-linked immunosorbent assay (ELISA). The groups A1 and B1 did not differ from each other as regards the basal PC level and groups A2 and B2 were not different as regards the VO2max. At time 1 PC showed a significant increase in comparison with baseline in trained subjects as a whole group, as well as in each subgroup. At time 2, PC were decreased in comparison with both times 0 and 1 in the whole group and in subgroups A1 and B2, whereas in subgroups A2 and B1 the PC value at time 2 was not different compared to time 0. The percentage increase of PC at time 1 vs time 0, as well as the percentage decrease at time 2 vs time 1 and time 0 respectively, were not different between subgroups A1 and B1. On the contrary, the percentage variations observed at each interval were significantly different between subgroups A2 and B2. The results suggest a reaction of antioxidant systems to acute exercise in trained subjects, influenced by basal PC levels more than by aerobic fitness. PMID:23603325

Lo Presti, R; Canino, B; Cilluffo, P; Calandrino, V; Hopps, E; Caimi, G

2013-04-19

45

Exercise testing in pulmonary sarcoidosis  

PubMed Central

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

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

1982-01-01

46

Proprioceptive isokinetic exercise test  

NASA Technical Reports Server (NTRS)

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

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

1993-01-01

47

Development and Safety of an Exercise Testing Protocol for Patients with an Implanted Cardioverter Defibrillator for Primary or Secondary Indication  

PubMed Central

Purpose Performing exercise tests in patients with an implantable cardioverter defibrillator (ICD) presents specific challenges because of susceptibility to ventricular arrhythmias during maximal levels of exertion. The purpose of this paper is to outline the exercise testing protocol from the Anti-Arrhythmic Effects of Exercise after an ICD trial and to report baseline test results and safety outcomes using the protocol. Methods and Results Maximal cardiopulmonary exercise testing was performed to assess levels of physical fitness as part of a randomized trial of walking exercise in patients with ICDs. Subjects were randomized after baseline testing to aerobic exercise plus usual care or usual care alone. A modified Balke treadmill exercise test was used and specific ICD programming procedures were implemented to avoid unnecessary shocks, which included programming off ventricular tachycardia (VT) therapies during testing. To date, 161 baseline tests have been performed. One ventricular fibrillation (VF) cardiac arrest occurred following completion of an exercise test and three tests were stopped by the investigators due to nonsustained ventricular tachycardia. Eleven subjects were not able to achieve maximum exercise, defined as reaching an anaerobic threshold (AT) at baseline testing. There have been no deaths as a result of exercise testing. Conclusions Symptom-limited maximal exercise testing can be performed safely and effectively in patients with ICDs for both primary and secondary prevention indications. Specific strategies for ICD programming and preparation for treating ventricular arrhythmias needs to be in place before exercise testing is performed.

Flo, Gayle L.; Glenny, Robb W.; Kudenchuk, Peter J.; Dougherty, Cynthia M.

2012-01-01

48

Effects of healthy aging on the cardiopulmonary hemodynamic response to exercise.  

PubMed

This study aimed to define the influence of healthy aging on the central hemodynamic response to exercise. Advancing age results in numerous alterations to the cardiovascular system and is a major risk factor to develop heart failure. In patients with suspected heart failure with preserved ejection fraction, there is an increasing interest in the incorporation of stress hemodynamic studies into the diagnostic evaluation pathway. However, many patients with suspected heart failure with preserved ejection fraction are older, and there are few data regarding the effect of aging on the normal central hemodynamic responses to exercise. Therefore, we examined 55 healthy patients using right-sided cardiac catheterization with exercise. Mean age was 49.6 years, with 36% older than 55 years. On exercise, the mean pulmonary artery pressure was higher with advancing age (r = 0.412, p = 0.002). Additionally, age was negatively associated with cardiac index (r = 0.407, p = 0.005). The exercise-induced rise in pulmonary capillary wedge pressure (r = 0.378, p = 0.004) was greater with advancing age. Pulse pressure measured during exercise (r = 0.541, p <0.01) increased with age, as did diastolic dysfunction assessed by E/A ratio (r = 0.569, p <0.001). In conclusion, aging was associated with decreased cardiac output and increased pulmonary artery pressure during exercise, which developed as the consequence of both increased pulmonary vasculature resistance and higher left ventricular filling pressures. PMID:24852914

van Empel, Vanessa P M; Kaye, David M; Borlaug, Barry A

2014-07-01

49

Exercise intolerance, lactic acidosis, and abnormal cardiopulmonary regulation in exercise associated with adult skeletal muscle cytochrome c oxidase deficiency.  

PubMed Central

A 27-yr-old woman with lifelong severe exercise intolerance manifested by muscle fatigue, lactic acidosis, and prominent symptoms of dyspnea and tachycardia induced by trivial exercise was found to have a skeletal muscle respiratory chain defect characterized by low levels of reducible cytochromes a + a3 and b in muscle mitochondria and marked deficiency of cytochrome c oxidase (complex IV) as assessed biochemically and immunologically. Investigation of the pathophysiology of the exercise response in the patient revealed low maximal oxygen uptake (1/3 that of normal sedentary women) in cycle exercise and impaired muscle oxygen extraction as indicated by profoundly low maximal systemic arteriovenous oxygen difference (5.8 ml/dl; controls = 15.4 +/- 1.4, mean +/- SD). The increases in cardiac output and ventilation during exercise, normally closely coupled to muscle metabolic rate, were markedly exaggerated (more than two- to threefold normal) relative to oxygen uptake and carbon dioxide production accounting for prominent tachycardia and dyspnea at low workloads. Symptoms in our patient are similar to those reported in other human skeletal muscle respiratory chain defects involving complexes I and III, and the exaggerated circulatory response resembles that seen during experimental inhibition of the mitochondrial respiratory chain. These results suggest that impaired oxidative phosphorylation in working muscle disrupts the normal regulation of cardiac output and ventilation relative to muscle metabolic rate in exercise.

Haller, R G; Lewis, S F; Estabrook, R W; DiMauro, S; Servidei, S; Foster, D W

1989-01-01

50

Exercise Testing of the Child with Obesity  

Microsoft Academic Search

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

S. Owens; B. Gutin

1999-01-01

51

Environmental Factors for Exercise Testing and Exercise Prescription.  

National Technical Information Service (NTIS)

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

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

2005-01-01

52

Eccentric exercise testing and training  

NASA Technical Reports Server (NTRS)

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

Clarkson, Priscilla M.

1994-01-01

53

Exercise electrocardiogram testing and imaging in women  

Microsoft Academic Search

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

Richard A. Stein; Nieca Goldberg

2007-01-01

54

Exercise thallium testing in ventricular preexcitation  

SciTech Connect

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

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

1987-05-01

55

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

PubMed

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

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

56

Exercise Pathophysiology in Patients With Primary Pulmonary Hypertension  

Microsoft Academic Search

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

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

2008-01-01

57

Repetitive nerve stimulation and exercise testing.  

PubMed

Repetitive nerve stimulation and exercise testing are useful in the evaluation of patients with suspected disorders of the NMJ and muscle membrane excitability when performed with close attention to technical factors. They can be very helpful in the diagnosis of myasthenia gravis. Lambert-Eaton myasthenic syndrome, and botulism, as well as rare disorders of skeletal muscle membrane excitability, including paramyotonia congenita, myotonia congenita, myotonic dystrophy, and the periodic paralyses. PMID:12795512

Shapiro, Barbara E; Preston, David C

2003-05-01

58

Guideline Recommendations for EGFR Mutation Testing in Lung Cancer: Proposal of the Korean Cardiopulmonary Pathology Study Group  

PubMed Central

Mutations of the epidermal growth factor receptor (EGFR) are the strongest predictive factor for response to EGFR tyrosine kinase inhibitors (TKIs), such as gefitinib and erlotinib. EGFR TKIs are approved in Korea as a first-line treatment for lung cancer patients with mutated EGFR. Rapid and accurate EGFR mutation testing is essential for patient selection and establishing targeted therapies with EGFR TKIs. Thus, a standard set of guideline recommendations for EGFR mutation testing suitable for the Korean medical community is necessary. In this article, we propose a set of guideline recommendations for EGFR mutation testing that was discussed and approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.

Shim, Hyo Sup; Chung, Jin-Haeng; Kim, Lucia; Chang, Sunhee; Kim, Wan-Seop; Lee, Geon Kook; Jung, Soon-Hee

2013-01-01

59

Predictive Accuracy of Exercise Stress Testing the Healthy Adult.  

ERIC Educational Resources Information Center

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)

Lamont, Linda S.

1981-01-01

60

Safety of exercise-based cardiac rehabilitation and exercise testing for cardiac patients in Japan.  

PubMed

Background:The safety of exercise-based cardiac rehabilitation (CR) has not been investigated in Japan, so a nationwide survey was conducted to investigate the incidence of adverse events (AEs) associated with CR and exercise testing.Methods?and?Results:In total, 136 hospitals reported operating recovery-phase CR programs, amounting to 383,096 patient-hours of exercise training. The incidence rates of all AEs and life-threatening AEs (LAE: death, cardiac arrest, acute myocardial infarction, cardiac rupture) during exercise sessions were 12 and 1 event/383,096 patient-hours (3.13 and 0.26 events/100,000patient-hours), respectively. When CR programs were categorized as "Formal" in which an exercise prescription based on exercise testing was issued to individual patients or "Non-formal" without exercise prescription, the incidence of AEs during and within the 24 h after an exercise session was significantly lower in the Formal than the Non-formal CR programs (P<0.001), despite similar hospital size and coronary intervention volumes between the 2 category hospitals. Moreover, LAEs did not occur in 277,721 patient-hours in Formal CR, whereas 2 LAEs occurred in 105,375 patient-hours in Non-formal CR (P<0.05). During 469,215 exercise testing sessions, 3 LAEs (0.64 event/100,000tests) and 31 non-LAEs (6.61 events/100,000tests) occurred.Conclusions:This first nationwide survey in Japan revealed that both exercise-based CR and exercise testing are generally safe, and that Formal CR, in which an individual exercise prescription is determined by exercise testing, is particularly safe. (Circ J 2014; 78: 1646-1653). PMID:24837707

Saito, Masahiko; Ueshima, Kenji; Saito, Muneyasu; Iwasaka, Toshiji; Daida, Hiroyuki; Kohzuki, Masahiro; Makita, Shigeru; Adachi, Hitoshi; Yokoi, Hiroyoshi; Omiya, Kazuto; Mikouchi, Hiroshi; Yokoyama, Hiroyuki; Goto, Yoichi

2014-06-25

61

Consistency of the counting talk test for exercise prescription.  

PubMed

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

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

2012-06-01

62

Exercise Testing and Training in Patients with (Chronic) Pain  

Microsoft Academic Search

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

Harriët Wittink; Tim Takken

63

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

PubMed Central

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

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

2013-01-01

64

Method for combining individual risk variables derived from cardiopulmonary exercise testing into a single variable  

US Patent & Trademark Office Database

A method of pattern recognition for classifying the functional status of patients with chronic disease comprising characterizing the functional status based on a multivariable index (MVI) scoring system wherein the MVI is computed by summing a plurality of individual variable values as individual variable indexes (IVI) and dividing the sum by the number of variables and wherein the plurality of IVI includes rest PetCO.sub.2, .DELTA.PetCO.sub.2, SaO.sub.2, QUES, V.sub.e/VCO.sub.2 slope and P.sub.cap and wherein each IVI is given an equivalent value of <1.00 to >=4.00, the number increasing with increasing severity yielding an MVI value ranging from <1.00 to >=4.00, normal to severe-very severe.

2014-01-14

65

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

PubMed Central

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

Gappmaier, Eduard

2012-01-01

66

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

PubMed Central

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

Ibrahim, Morhaf; Hasan, Reham; Pitonak, Peter

2013-01-01

67

Development of a new disposable pulsatile pump for cardiopulmonary bypass: computational fluid-dynamic design and in vitro tests.  

PubMed

A newly conceived blood pump for pulsatile cardiopulmonary bypass (CPB) is presented. The new device's main design features (fully disposable pumping head with ring shaped valves) were intended to overcome the factors that today limit the use of pulsatile blood pumps, i.e., the complexity and costs of devices. The pump was designed and analyzed by means of three-dimensional computational models, including solid computer assisted design of the pumping head and computational fluid-dynamic (CFD) analyses of the fluid domain and of its interaction with deformable components. A prototype of the device, integrated with the venous reservoir, was built to perform hydraulic in vitro tests with aims of both validating CFD results and verifying the new device's pumping behavior. Functional evaluation of the pump was carried out by using the device in a model circuit made with standard CPB components plus a mock hydraulic bench representing an adult patient's systemic circulation. A roller pump used in pulsatile mode (RP-PM) was used for comparison. At a 5 L/min flow rate, the pulsatile hydraulic power () delivered to the patient was approximately 15 mW for the RP-PM. The new pump proved to be able to deliver up to 40 mW, thus providing a more physiological condition, closer to the delivered by the natural heart (90-140 mW). PMID:12059000

Fiore, Gianfranco B; Redaelli, Alberto; Guadagni, Gualtiero; Inzoli, Fabio; Fumero, Roberto

2002-01-01

68

Exercises  

MedlinePLUS

... PT Physical Therapist View full profile COPD: Lifestyle Management Exercise An exercise program is another very important ... BACK: Nutrition More Exercises Information Back to Lifestyle Management Print Page Email Page Add Page I want ...

69

Aerobic exercise physiology in a professional rugby union team  

Microsoft Academic Search

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

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

2003-01-01

70

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

PubMed

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

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

2014-08-01

71

Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension.  

PubMed

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

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

2013-08-01

72

Jogging in place. Evaluation of a simplified exercise test  

SciTech Connect

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.

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

1989-10-01

73

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

Microsoft Academic Search

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

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

2009-01-01

74

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

Microsoft Academic Search

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

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

2009-01-01

75

Samara Dispersal in Boxelder: An Exercise in Hypothesis Testing.  

ERIC Educational Resources Information Center

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

Minorsky, Peter V.; Willing, R. Paul

1999-01-01

76

Inflight exercise affects stand test responses after space flight  

NASA Technical Reports Server (NTRS)

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.

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

1999-01-01

77

Simple exercise test for the prediction of relative heat tolerance  

SciTech Connect

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.

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

1986-04-01

78

PATTERNING OF PHYSIOLOGICAL AND AFFECTIVE RESPONSES DURING A GRADED EXERCISE TEST IN SEDENTARY MEN AND BOYS  

Microsoft Academic Search

Understanding the impact of acute bouts of exercise on affective valence responses is potentially very important, as the affective response may determine the exercise intensity-adherence relationship. This study examined the relationship between exercise intensity and affective responses in two different sedentary populations via a graded maximal exercise test (GXT). All participants completed two GXTs, set approximately 1 week apart. During

Kate E. Sheppard; Gaynor Parfitt

2008-01-01

79

Evaluation of Cardiopulmonary Resuscitation Techniques in Microgravity.  

National Technical Information Service (NTIS)

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 quanti...

R. Billica J. Gosbee D. T. Krupa

1991-01-01

80

Coincidental changes in ventilation and electromyographic activity during consecutive incremental exercise tests  

Microsoft Academic Search

These experiments examined the effect of metabolic acidosis, induced as a result of dynamic exercise, on ventilation, lactate concentration and electromyographic activity. Seven subjects performed two consecutive incremental exercise tests until volitional exhaustion was achieved. The two tests were identical and were separated by a 7-min period of light exercise. During the tests, ventilation, mixed expired oxygen and carbon dioxide,

Jason H. Mateika; James Duffin

1994-01-01

81

Exercise-induced changes in common laboratory tests.  

PubMed

Examination of 19 serum biochemical and hematologic parameters in a group of white male runners, ranging in age from 23 to 47 years, just prior to and immediately after a 13-mile "mini-marathon," demonstrated a significant increase, by paired Student t-test, in mean values of: K+, BUN, creatinine, CK, LDH, AST (SGOT), alkaline phosphatase, bilirubin, uric acid and leukocyte counts. Prevailing environmental conditions were such as to produce no significant hemoconcentration. Using this group's statistics and this hospital laboratory's upper limits of normal, the percentage of values above two SDs are, for the resting state: K+ 7%, BUN 7%, creatinine 0%, CK 21%, LDH 21%, AST 0%, alkaline phosphatase 0%, bilirubin 7%, uric acid 7%, and leukocyte count 0%. Post-exertional values above normal limits are: K+ 7%, BUN 21%, creatinine 21%, CK 93%, LDH 86%, AST 0%, alkaline phosphatase 0%, bilirubin 14%, uric acid 36%, and leukocyte 71%. Consequently, abnormally high values for K+, BUN, creatinine, CK, LDH, bilirubin, uric acid, and leukocyte counts can often be expected in some patients who exercise heavily. The degree of the abnormality will depend on the level and length of exercise as well as the elapsed time between exercise and testing. PMID:7072633

Priest, J B; Oei, T O; Moorehead, W R

1982-03-01

82

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

Microsoft Academic Search

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

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

83

Exercise  

MedlinePLUS

Exercise - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Search v Make a Donation ... now Download now Publication Stretching for People with MS Illustrated manual showing range of motion, stretching, and ...

84

Cardiopulmonary Syndromes (PDQ®)  

Cancer.gov

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

85

Cardiopulmonary Resuscitation in Trauma  

Microsoft Academic Search

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

Rao R. Ivatury; Kevin R. Ward

86

Cardiopulmonary Bypass and Cardioplegia  

Microsoft Academic Search

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

J. Ernesto Molina

87

Exercise-induced hand tremor: a possible test for beta 2-adrenoceptor selectivity in man?  

PubMed Central

The effects of intravenous doses of propranolol, sotalol, timolol, atenolol and placebo on exercise-induced tachycardia and exercise-induced increases in hand tremor were assessed in four healthy volunteers. All active drugs produced significant reductions in exercise-induced tachycardia. Exercise caused consistent significant increases in hand tremor which were blocked by the three non-cardioselective drugs but not by atenolol or placebo. The blockade of exercise-induced hand tremor is suggested as a possible test for the assessment of the selectivity of beta-adrenoceptor blockade in man.

Abila, B; Wilson, J F; Marshall, R W; Richens, A

1986-01-01

88

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

SciTech Connect

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

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

1986-11-01

89

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

PubMed Central

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

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

2010-01-01

90

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

PubMed Central

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.

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

2005-01-01

91

The minimal important difference of exercise tests in severe COPD.  

PubMed

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

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

2011-04-01

92

Prediction of functional aerobic capacity without exercise testing  

NASA Technical Reports Server (NTRS)

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).

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

1990-01-01

93

Cost and appropriateness of radionuclide exercise stress testing by cardiologists and non-cardiologists  

Microsoft Academic Search

The hypothesis that a diagnostic evaluation performed by a generalist is less expensive than that performed by a specialist is untested. We retrospectively evaluated the indications and financial ramifications of radionuclide exercise stress testing by cardiologists and noncardiologists in 1,902 consecutive adults with normal resting electrocardiograms. Subjects completed radionuclide exercise tests for the diagnosis or management of coronary artery disease

James H. Stein; Eugene F. Uretz; Joseph E. Parrillo; John T. Barron

1996-01-01

94

Acute effects of trimetazidine evaluated by exercise testing  

Microsoft Academic Search

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

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

1987-01-01

95

Exercise Intolerance in Pulmonary Arterial Hypertension  

PubMed Central

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.

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

2012-01-01

96

Cardiopulmonary discipline science plan  

NASA Technical Reports Server (NTRS)

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

1991-01-01

97

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

PubMed Central

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

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

2012-01-01

98

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

ERIC Educational Resources Information Center

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

Petosa, R. Lingyak; Holtz, Brian

2013-01-01

99

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

Microsoft Academic Search

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

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

1986-01-01

100

Prognostic Value of Heart Rate Increase at Onset of Exercise Testing  

Microsoft Academic Search

Background—The initial response of heart rate to dynamic exercise has been proposed as having prognostic value in limited studies that have used modalities other than the treadmill. Our aim was to evaluate the prognostic value of early heart rate parameters in patients referred for routine clinical treadmill testing. Methods and Results—The heart rate rise at the onset of exercise was

Nicholas J. Leeper; Frederick E. Dewey; Euan A. Ashley; Marcus Sandri; Swee Yaw Tan; David Hadley; Jonathan Myers; Victor Froelicher

2010-01-01

101

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

Microsoft Academic Search

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

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

102

Early exercise stress testing is safe after primary percutaneous coronary intervention  

PubMed Central

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

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

2012-01-01

103

Cardiopulmonary Resuscitation: Current Status  

Microsoft Academic Search

n its earliest forms, cardiopulmonary resuscitation (CPR) is most likely as old as human society itself.1 Depictions of mouth-to-mouth ventilation appear in ancient Egyptian hieroglyphics, and descriptions appear in the Bible. Modern CPR techniques emerged in the late 1950s and early 1960s, particularly through the refinements of Kouwenhoven, Jude, and Knicker- bocker, who demonstrated the efficacy of closed-chest compression in

Joseph Varon; George L. Sternbach; Paul E. Marik

104

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

NASA Technical Reports Server (NTRS)

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.

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

1983-01-01

105

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

PubMed Central

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

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

2007-01-01

106

[Effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension].  

PubMed

OBJECTIVE? To investigate the effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension. METHODS? A randomized? double-blind? placebo-controlled prospective study was performed. Sixty patients with diastolic dysfunction ?mitral flow velocity E/A <1? and exercise-induced hypertension ?SBP>200 mm Hg? treated with atorvastatin ?20 mg q.d? or placebo for 1 year. Cardiopulmonary exercise test and exercise blood pressure measurement were performed. Plasma B-natriuretic peptide ?BNP? concentration at rest and at peak exercise? plasma high sensitive-C reaction protein ?hs-CRP? and endothelin ?ET? concentration were determined at baseline and after treatment. RESULTS? After treatment by atorvastatin? the resting SBP? pulse pressure? the peak exercise SBP and BNP were significantly decreased; and the exercise time? metabolic equivalent? maximal oxygen uptake and anaerobic threshold were increased. All of these parameters had significant differences with baseline levels ?P<0.05?? and the rest pulse pressure? the peak exercise SBP and BNP? and the exercise time had significant differences compared with placebo treatment ?P<0.05?. Plasma concentrations of hs-CRP and ET were markedly reduced by atorvastatin treatment compared with baseline and placebo ?P<0.05?. No difference in above parameters was found before and after placebo treatment ?P>0.05?. CONCLUSION? In patients with diastolic dysfunction at rest and exercise-induced hypertension? atorvastatin can effectively reduce plasma hs-CRP and ET level? lower blood pressure and peak exercise SBP? decrease peak exercise plasma BNP concentration? and ultimately improve exercise tolerance? PMID:24998653

Ye, Ping-Xian; Ye, Ping-Zhen; Zhu, Jian-Hua; Chen, Wei; Gao, Dan Chen

2014-05-25

107

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

PubMed Central

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

2013-01-01

108

Cardiopulmonary Resuscitation in the Elderly,  

National Technical Information Service (NTIS)

Contents: The technology of resuscitation; Utilization and outcomes; Costs of cardiopulmonary resuscitation; Orders not to resuscitate; Resuscitation policies; Legal issues in resuscitation decisions.

C. K. Cassel M. D. Silverstein J. LaPuma M. McCally D. Roland

1985-01-01

109

Prediction of morbidity after lung resection with risk factors using treadmill exercise test  

Microsoft Academic Search

Abstract Objective: To predict accurate morbidity after lung resection using treadmill exercise test. Methods: A total of 130 patients (108 men,and 22 women, with mean age 67.1 ^ 11.4 years (range, 34– 78 years)) of 1129 patients underwent standard lobectomy were performed both treadmill exercise test and spirometry preoperatively. We measured,maximum,oxygen,uptake\\/body weight (VO2max\\/BW) and change,in arterial blood oxygen,pressure from rest

Hidehito Matsuoka; Wataru Nishio; Toshihiko Sakamoto; Hiroaki Harada; Noriaki Tsubota

110

Prediction of morbidity after lung resection with risk factors using treadmill exercise test  

Microsoft Academic Search

Objective: To predict accurate morbidity after lung resection using treadmill exercise test. Methods: A total of 130 patients (108 men and 22 women, with mean age 67.1±11.4 years (range, 34–78 years)) of 1129 patients underwent standard lobectomy were performed both treadmill exercise test and spirometry preoperatively. We measured maximum oxygen uptake\\/body weight (VO2max\\/BW) and change in arterial blood oxygen pressure

Hidehito Matsuoka; Wataru Nishio; Toshihiko Sakamoto; Hiroaki Harada; Noriaki Tsubota

2004-01-01

111

Percolation Tests for Septic Systems: A Laboratory Exercise.  

ERIC Educational Resources Information Center

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)

Tinker, John R., Jr.

1978-01-01

112

Compartment Syndrome During an Ischaemic Forearm Exercise Test  

Microsoft Academic Search

THE CASEA 32-year-old man presented with a history of progressive exercise intolerance, exertional myalgia and cramps since childhood. He also complained of shortness of breath on exertion, without any orthopnoea. On examination he had mild proximal upper and lower limb weakness. His facial muscles and neck flexors were normal and there was no scapular winging. His tendon reflexes and sensory

Graham G Niepel; James Lowe; Adrian J Wills

2004-01-01

113

Prognostic value of radionuclide exercise testing after myocardial infarction  

SciTech Connect

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

Schocken, D.D.

1984-08-01

114

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

SciTech Connect

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.

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

1983-06-01

115

Are fixed-rate step tests medically safe for assessing physical fitness?  

Microsoft Academic Search

Maximal oxygen uptake (VO2max) can be predicted by fixed-rate step tests. However, it remains to be analyzed as to what exercise intensities are reached\\u000a during such tests to address medical safety. In this study, we compared the physiological response to a standardized fixed-rate\\u000a step test with maximal cardiopulmonary exercise testing (CPET). One hundred and thirteen healthy adults executed a maximal

Dominique Hansen; Nele Jacobs; Steven Bex; Goedele D’Haene; Paul Dendale; Neree Claes

116

Cardiopulmonary Responses to Supine Cycling during Short-Arm Centrifugation  

NASA Technical Reports Server (NTRS)

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.

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

117

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

SciTech Connect

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

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

1989-04-01

118

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

PubMed

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

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

2014-07-01

119

Bivalirudin Anticoagulation for Cardiopulmonary Bypass  

PubMed Central

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.

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

2007-01-01

120

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

ERIC Educational Resources Information Center

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

Lindwall, Magnus; Palmeira, Antonio

2009-01-01

121

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

ERIC Educational Resources Information Center

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

Zwiren, Linda D.; And Others

1991-01-01

122

Overall increase in heart rate variability after the Square-Wave Endurance Exercise Test training  

Microsoft Academic Search

Objectives. – We studied the influence of the “Square-Wave Endurance Exercise Test” (SWEET) training program on heart rate (HR) variability during supine rest, 60° upright position and submaximal constant exercise.Methods. – Beat-by-beat HR was recorded during 10 min in the three conditions in 14 healthy women. Before and after 6 weeks of training (45 min, three times a week; n = 7) or

L. Mourot; N. Tordi; S. Perrey; M. Bouhaddi; J.-D. Rouillon; J. Regnard

2005-01-01

123

MAXIMAL EXERCISE TESTING USING THE ELLIPTICAL CROSS-TRAINER AND TREADMILL  

Microsoft Academic Search

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

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

124

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

PubMed Central

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

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

2008-01-01

125

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

NASA Technical Reports Server (NTRS)

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

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

2008-01-01

126

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

PubMed

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

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

2014-07-15

127

A test of the catecholamines hypothesis for an acute exercise-cognition interaction.  

PubMed

The purpose of the study was to examine the usage of norepinephrine (NE) and dopamine (DA) in the brain when exercising while simultaneously undertaking cognitive tests. Plasma concentrations of the NE metabolite 3-methoxy 4-hydroxyphenylglycol (MHPG) and the DA metabolite homovanillic acid (HVA) showed a linear increase from rest to exercising at 40% and 80% maximum power output (W.max) while simultaneously undertaking cognitive tasks (random number generation (RNG) and response time). Delta plasma concentrations of MHPG and HVA at each exercise intensity while undertaking cognitive tasks and while exercising without cognitive tasks did not differ. Taking blood samples at 0, 1, 3, and 5 min following cessation of exercise did not affect results. Regression correlations showed that delta MHPG and HVA plasma concentrations at the 1 and 3 min sampling times were strong predictors of delta RNG, response time and movement time. Reaction time at 80% W.max significantly increased, while movement time at 80% W.max significantly decreased. It was concluded that these results provide no support for a direct effect of increased catecholamines concentrations on cognitive performance during exercise. The regression data suggest that there is some relationship between exercise, catecholamines concentrations and cognition. PMID:18164752

McMorris, T; Collard, K; Corbett, J; Dicks, M; Swain, J P

2008-03-01

128

Neonatal cardiopulmonary bypass.  

PubMed

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

Pouard, Philippe; Bojan, Mirela

2013-01-01

129

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

PubMed Central

Growth hormone (GH) was measured before and 10 minutes after a standardised bicycle exercise test (duration 15 minutes) in 37 short children (group 1: mean (SD) age 12.8 (3.5) years; mean (SD) bone age 10.4 (3.6) years; mean (SD) height standard deviation score (SDS) -2.8 (0.7], 16 tall children (group 2: mean age 12.9 (2.8) years; mean bone age 13.9 (1.4) years; mean height SDS 3.0 (0.8], and 30 normal children (group 3: mean age 13.3 (3.2) years; mean bone age 12.8 (3.4) years; mean height SDS -0.4 (0.8]. Results of GH are expressed as mean (SEM). The pre-exercise GH was similar in the three groups (group 1, 8.0 (2.3) mU/l, group 2, 8.5 (2.5) mU/l, and group 3, 8.3 (2.3) mU/l). There was a significant rise in GH after exercise in all three groups. GH after exercise was higher in group 2 (35.1 (2.5) mU/l) compared with groups 1 and 3 (17.8 (3.0) and (20.8 (3.2) mU/l). Post-exercise GH was less than 10 mU/l in 29 children (34% total; 49% group 1, 6% group 2, and 34% group 3). There was a positive relation between post-exercise GH and both bone age and public hair stage. Multiple regression analysis revealed that relevant predictors of a rise in GH with exercise were different for the sexes in these children with varying stature: for boys, bone age and pubic hair stage; for girls, height and height SDS. All the tall girls were in puberty. No statistical relation was observed between post-experience GH and cardiovascular response to exercise, time of day of exercise, time of eating before exercise, and plasma insulin or insulin to glucose ratio at time of exercise. We conclude that the GH response to the physiological stimulus of exercise is higher in puberty compared with childhood. Therefore, although children may be suspected of having GH deficiency after a failure of GH to increase after exercise, a non-response may be a normal finding in prepubertal children, independent of stature.

Greene, S A; Torresani, T; Prader, A

1987-01-01

130

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

PubMed

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

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

2010-05-01

131

The effects of space flight on the cardiopulmonary system  

NASA Technical Reports Server (NTRS)

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

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

1989-01-01

132

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

PubMed

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

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

2013-07-01

133

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

ERIC Educational Resources Information Center

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

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

2006-01-01

134

Daily exercise routines  

NASA Technical Reports Server (NTRS)

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.

Anderson, Patrick L.; Amoroso, Michael T.

1990-01-01

135

[Myocardial infarct following a negative maximal exercise test: apropos of a case].  

PubMed

A 63-year-old patient, with effort angina diagnosed 3 months previously, suffered a myocardial infarction 6 minutes after a maximal exercise stress test which had given a normal result. Intravenous streptokinase, nitrates and calcium-antagonist treatment were performed immediately, but they failed to achieve myocardial re-perfusion. The patient refused coronary arteriography, but one year later underwent a further maximal exercise test, which gave a completely negative result. Here, we discuss hemodynamic mechanism likely to be involved in this rare event, and suggest that coronary arterial spasm might play an important role in inducing delayed myocardial ischemia. PMID:2328861

Baroffio, R; Gasparini, P; Guzzini, F

1990-01-01

136

The validity of predicting maximal oxygen uptake from perceptually regulated graded exercise tests of different durations  

Microsoft Academic Search

The purpose of this study was to assess the validity of predicting maximal oxygen uptake ($$\\\\dot{V}\\\\rm O_2$$max) from sub-maximal $$\\\\dot{V}\\\\rm O_2$$ values elicited during perceptually regulated exercise tests of 2- and 4-min duration. Nineteen physically active men and women (age range 19–23 years) volunteered to participate in two graded exercise tests to volitional exhaustion to measure $$\\\\dot{V}\\\\rm O_2$$max ($$\\\\dot{V}\\\\rm O_2$$maxGXT), at

Roger G. Eston; James A. Faulkner; Elizabeth A. Mason; Gaynor Parfitt

2006-01-01

137

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

PubMed Central

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

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

2009-01-01

138

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

SciTech Connect

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

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

1990-07-01

139

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

Microsoft Academic Search

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

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

2010-01-01

140

The isometric handgrip exercise as a test for unmasking hypertension in the offsprings of hypertensive parents.  

PubMed

Background: A familial history of hypertension increases the risk of hypertension in the offsprings. Aims and objectives: The present study was undertaken to assess the underlying hypertension by using the Isometric Handgrip (IHG) exercise test in the offsprings of hypertensive parents and to compare it with age-matched controls of normotensive parents. Material and Methods: The isometric handgrip test was performed in the study and control groups. The resting blood pressure was recorded before exercise and afterwards the subjects were asked to perform the isometric handgrip exercise with the dominant hand for 2 minutes. Then the blood pressure was recorded in the sitting position during and 5 minutes after the completion of the exercise. Statistical Analysis: The analysis of the results was done by ANOVA with SPSS, version 17.0, by using the unpaired 't' test. Results: The results showed that the Resting Systolic (SBP), Diastolic (DBP) and the Mean (MBP) Blood Pressures were higher (p <0.001) in the offsprings of the hypertensive parents as compared to those in the control subjects of normotensive parents. During the isometric handgrip exercise test, the rise in the systolic, diastolic and the mean blood pressures was significantly higher (p<0.001) in the offsprings of the hypertensive parents. After 5 minutes of exercise, the SBP, DBP and the MBP were found to be significantly higher (p<0.001) in the study group as compared to those in the control group. Conclusions: An early and a regular screening of the children of hypertensive parents is necessary to prevent any future cardiovascular complications. PMID:23905088

Garg, Rinku; Malhotra, Varun; Dhar, Usha; Tripathi, Yogesh

2013-06-01

141

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

NASA Technical Reports Server (NTRS)

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.

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

142

The emerging role of exercise testing and stress echocardiography in valvular heart disease.  

PubMed

Exercise testing has an established role in the evaluation of patients with valvular heart disease and can aid clinical decision making. Because symptoms may develop slowly and indolently in chronic valve diseases and are often not recognized by patients and their physicians, the symptomatic, blood pressure, and electrocardiographic responses to exercise can help identify patients who would benefit from early valve repair or replacement. In addition, stress echocardiography has emerged as an important component of stress testing in patients with valvular heart disease, with relevant established and potential applications. Stress echocardiography has the advantages of its wide availability, low cost, and versatility for the assessment of disease severity. The versatile applications of stress echocardiography can be tailored to the individual patient with aortic or mitral valve disease, both before and after valve replacement or repair. Hence, exercise-induced changes in valve hemodynamics, ventricular function, and pulmonary artery pressure, together with exercise capacity and symptomatic responses to exercise, provide the clinician with diagnostic and prognostic information that can contribute to subsequent clinical decisions. Nevertheless, there is a lack of convincing evidence that the results of stress echocardiography lead to clinical decisions that result in better outcomes, and therefore large-scale prospective randomized studies focusing on patient outcomes are needed in the future. PMID:19958961

Picano, Eugenio; Pibarot, Philippe; Lancellotti, Patrizio; Monin, Jean Luc; Bonow, Robert O

2009-12-01

143

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

PubMed

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

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

1989-12-01

144

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

PubMed

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

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

2014-06-01

145

Cardiac arrhythmias during exercise testing in healthy men.  

NASA Technical Reports Server (NTRS)

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.

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

1973-01-01

146

Illness perceptions predict reassurance following a negative exercise stress testing result  

Microsoft Academic Search

Many patients are not reassured after receiving normal results following cardiac investigations. While previous studies have shown anxiety to be a contributing factor, little research has investigated the influence of patients’ illness perceptions on reassurance. In this study we investigated whether illness perceptions predicted patients’ reassurance following normal exercise stress test results. Sixty-two chest pain patients without prior diagnosed cardiac

Liesje Donkin; Christopher J. Ellis; Rachael Powell; Elizabeth Broadbent; Greg Gamble; Keith J. Petrie

2006-01-01

147

Lactate Accumulation for Runners and Non-Runners during Various Exercise Tests.  

National Technical Information Service (NTIS)

Four runners and six non-runners were studied during various exercise tests in order to compare venous lactate accumulation. Subjects were studied on three occasions while walking on a treadmill with increases in grade at 1, 3 and 5 minute intervals. Base...

W. L. Daniels D. S. Sharp D. Bascik D. M. Kowal

1980-01-01

148

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

NASA Technical Reports Server (NTRS)

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

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

2000-01-01

149

Prognostic value of exercise testing in a cohort of patients followed for 15 years after acute myocardial infarction  

Microsoft Academic Search

Aims To study the long-term prognostic information ob- tained from an exercise test following an acute myocardial infarction. Methods Between 1979 and 1983, 1773 consecutive patients were admitted to Glostrup County Hospital with an acute myocardial infarction. Of 1430 patients who were alive after 3 weeks, 718 performed an exercise test. Survival data were available after 15 years for all

H. Dominguez; C. Torp-Pedersen; L. Koeber; C. Rask-Madsen

150

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

PubMed Central

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

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

2013-01-01

151

Effect of cardiopulmonary bypass on urea cycle intermediates and nitric oxide levels after congenital heart surgery  

Microsoft Academic Search

Objective To test the hypothesis that cardiopulmonary bypass used for repair of ventricular septal defects and atrioventricular septal defects would decrease availability of urea cycle intermediates including arginine and subsequent nitric oxide availability. Study design Consecutive infants (n = 26) undergoing cardiopulmonary bypass for repair of an unrestrictive ventricular septal defect or atrioventricular septal defect were studied. Blood samples were

Frederick E. Barr; Heidi Beverley; Kristin VanHook; Emma Cermak; Karla Christian; Davis Drinkwater; Karrie Dyer; Noel T. Raggio; Jason H. Moore; Brian Christman; Marshall Summar

2003-01-01

152

Comparing fat oxidation in an exercise test with moderate-intensity interval training.  

PubMed

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 PointsFat oxidation during interval exercise is not com-promised by the undulating exercise intensityPhysiological measures corresponding with the MFO measured during the GXT correlated well to the MIITThe validity of exercise intensity markers derived from a GXT to reflect the physiological responses during MIIT. PMID:24570605

Alkahtani, Shaea

2014-01-01

153

Haemodynamic response to an isometric exercise test in obese patients: Influence of autonomic dysfunction  

Microsoft Academic Search

OBJECTIVE: To investigate blood pressure (BP) and heart rate (HR) responses to an isometric exercise test in obese non diabetic patients and to correlate the results with vagal function and plasma insulin concentration.SUBJECTS: 63 obese patients, 36 of whom had abnormal cardiac parasympathetic control (PS+), and 35 healthy control subjects.METHODS: Analysis of HR variations during three standardized tests: deep-breathing, lying-to-standing

P Valensi; PT Bich Ngoc; S Idriss; J Paries; P Cazes; B Lormeau; JR Attali

1999-01-01

154

Effects of Cardiopulmonary Bypass on Hemostasis.  

National Technical Information Service (NTIS)

The vast majority of cardiac surgical operations are performed with cardiopulmonary bypass. Blood contact with the extracorporeal circuit that is used during cardiopulmonary bypass elicits a wide spectrum of pathophysiological changes that affect a variet...

S. F. Khuri A. D. Michelson C. R. Valeri

1993-01-01

155

Hyperamylasemia following cardiopulmonary bypass.  

PubMed

In order to study the occurrence of postbypass hyperamylasemia, 75 patients undergoing cardiopulmonary bypass (CPB) were studied from March 1989 to January 1990. There were 49 males and 26 females. Among them, 27 had congenital heart disease, 30 had valvular disease, and 18 had coronary artery disease. There were 27 patients with at least one elevated serum amylase sample after operation. Thus, the overall incidence of hyperamylasemia was 36%. As compared with the preoperative data (1.3%), there was a statistically significant difference in the occurrence of hyperamylasemia (p less than 0.05). Three patients had overt clinical pancreatitis postoperatively. There was no positive correlation between the serum amylase level and the occurrence of pancreatitis (p greater than 0.05). Forty-two cases had a significant elevation of the amylase creatinine clearance ratio (ACCR) after CPB. However, there was no significant difference between the groups with pulsatile and nonpulsatile CPB (p greater than 0.05). Three patients (4%) died in our series. The causes of death were heart failure in two and fulminant pancreatitis associated with low cardiac output in one. Although our experience in dealing with pancreatitis improved survival, mortality was still high (33.3%) in our series. Nevertheless, there was no apparent correlation between mortality and postbypass hyperamylasemia (p greater than 0.05). Logistic regression analysis was used to analyze the risk factors of the occurrence of hyperamylasemia, and the analysis revealed that patients with coronary artery disease were susceptible to postbypass hyperamylasemia. Our studies indicate that the use of total serum amylase or ACCR to monitor for the occurrence of pancreatitis in postbypass patients is inadequate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1377742

Chang, H; Chung, Y T; Wu, G J; Hwang, F Y; Chen, K T; Peng, W L; Hung, C R

1992-01-01

156

EXERCISE TESTING AND LEFT MAIN CORONARY ARTERY DISEASE: EXPERIENCE WITH 57 PATIENTS  

PubMed Central

Results of multistage treadmill tests (TMT) of 57 patients with critical stenosis (? 50%) of the left main coronary artery were analyzed. Additional disease was present in the major vessel in three patients (5%), two vessels in 18 patients (32%), and three vessels in 35 patients (61%). The TMT was negative for ischemia in only two patients (4%), positive in 51 (89%), and undetermined in 4 (7%). TMT was strongly positive (? 2 mm ST segment depression) in 40 patients (70%), and in 11 (19%) of these, ST depression was ? 3 mm. Hypotension with exercise was rare and was encountered in only one patient. Arrhythmias were induced with exercise in six patients (10%) and resulted in premature termination of TMT in four. TMT was terminated due to early ST segment depression in 40 patients (70%), in 17 (30%) without chest pain—an unusual finding. Exercise was limited to stage I (Bruce protocol) in 16 (28%), stage II in 26 (46%), stage III in ten (17%), and stage IV in five (9%). Mean exercise tolerance was 298 ± 22 seconds (SEM). Maximum heart rate (HR) achieved was 76 ± 2% of their maximal predicted values. Peak double product (systolic BP × HR) was 20490 ± 830. The data suggest that the TMT is rarely negative in the presence of LM lesions. An early strongly positive response with or without pain should lead one to suspect LM disease. Exercise-induced hypotension is rare. Limited exercise tolerance and/or early ST segment depression in stages I and II of TMT seem to be predictive of the severity of LM lesions.

Salem, Bakr I.; Terasawa, Masahisa; Mathur, Virendra S.; Garcia, Efrain; De Castro, Carlos M.; Hall, Robert J.

1978-01-01

157

Cost and appropriateness of radionuclide exercise stress testing by cardiologists and non-cardiologists.  

PubMed

The hypothesis that a diagnostic evaluation performed by a generalist is less expensive than that performed by a specialist is untested. We retrospectively evaluated the indications and financial ramifications of radionuclide exercise stress testing by cardiologists and noncardiologists in 1,902 consecutive adults with normal resting electrocardiograms. Subjects completed radionuclide exercise tests for the diagnosis or management of coronary artery disease during a 14-month period. Tests were considered "indicated" or "not indicated" based on criteria determined from published reports and established practice guidelines. Savings in costs and charges were determined for a strategy of referral to a cardiologist before ordering tests. Non-cardiologists ordered more tests that were not indicated than cardiologists (69.6% vs 36.2%, chi-square = 209.07, p < 0.00001). Non-cardiologists also ordered tests that were not indicated in patients with (chi-square = 110.02, p < 0.00001) and without (chi-square = 110.02, p < 0.00001) and without (chi-square = 45.44, p < 0.00001) chest pain. Tests that were not indicated resulted in excess costs of $591,384 and excess charges of $1,082,400. Referral to a cardiologist before ordering tests could have saved $63,257 in costs and $169,800 in charges. Both cardiologists and non-cardiologists overutilized radionuclide exercise stress test; however, non-cardiologists were more likely to order tests that were not indicated. A strategy of referral to a cardiologist before ordering tests may be cost-effective in this population. PMID:8546080

Stein, J H; Uretz, E F; Parrillo, J E; Barron, J T

1996-01-15

158

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

PubMed

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

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

2012-08-01

159

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

SciTech Connect

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

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

1987-12-01

160

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

SciTech Connect

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.

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

1987-01-01

161

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

Microsoft Academic Search

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

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

2006-01-01

162

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

NASA Technical Reports Server (NTRS)

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.

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

1989-01-01

163

Perceived speech difficulty during exercise and its relation to exercise intensity and physiological responses.  

PubMed

The aim of this study was to establish how ratings of perceived speech production difficulty (PSPD) during exercise of varying intensities are correlated with various physiological responses, in order to determine whether the PSPD is suitable for prescribing exercise training intensity. An incremental running test was performed to establish the subjects' maximal oxygen consumption (VO(2max)) and ventilatory anaerobic threshold (VAT). During the test, the subjects were asked to read a written text. The subjects graded their PSPD at each stage of the test using a 13-level PSPD scale. Throughout the test, various cardiopulmonary parameters were measured breath-by-breath. Regressions of VO(2), heart rate (HR), and pulmonary ventilation (V(E)), all as percentages of their respective measured maximal values, plotted as a function of PSPD showed that the overall associations among those variables are strong and statistically significant ( P<0.05). However, the individual variability within each relative VO(2), V(E) or HR was found to be rather large. The subjects' distribution in relation to their PSPD at the VAT scattered widely across the PSPD scale. These results indicate that estimating exercise intensity by measuring speech difficulty is not valid. Thus it may be assumed that the "talk test", in its present non-standardized form, is a questionable substitute for the anaerobic threshold, HR, or for any other objective physiological measure for prescribing individual training exercise intensity. PMID:15221401

Rotstein, A; Meckel, Y; Inbar, O

2004-08-01

164

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

PubMed

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

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

2011-01-01

165

Asymptomatic ST segment elevation in the recovery phase of the exercise stress test due to slow coronary flow.  

PubMed

Exercise-induced ST segment elevation without Q wave formation is rarely observed. Frequent causes are significant coronary stenosis, myocardial bridge and coronary vasospasm. Both exercise-induced ST segment elevation due to slow coronary flow and ST segment elevation in the recovery phase of the exercise stress test are very rare. We present a 49-year-old man with asymptomatic inferolateral ST segment elevation in the recovery phase of the exercise stress test due to slow coronary flow, which has not been reported previously. The learning points of the present paper are as follows: a) although significant coronary stenosis, myocardial bridge and coronary vasospasm are frequent causes of exercise-induced ST segment elevation, slow coronary flow might also cause it; b) one should keep in mind that ST segment elevation might also occur in the recovery phase; and c) ST segment elevation might be asymptomatic, as in the present case. PMID:24799931

Sunbul, Murat; Erdogan, Okan; Sari, Ibrahim

2014-01-01

166

Asymptomatic ST segment elevation in the recovery phase of the exercise stress test due to slow coronary flow  

PubMed Central

Exercise-induced ST segment elevation without Q wave formation is rarely observed. Frequent causes are significant coronary stenosis, myocardial bridge and coronary vasospasm. Both exercise-induced ST segment elevation due to slow coronary flow and ST segment elevation in the recovery phase of the exercise stress test are very rare. We present a 49-year-old man with asymptomatic inferolateral ST segment elevation in the recovery phase of the exercise stress test due to slow coronary flow, which has not been reported previously. The learning points of the present paper are as follows: a) although significant coronary stenosis, myocardial bridge and coronary vasospasm are frequent causes of exercise-induced ST segment elevation, slow coronary flow might also cause it; b) one should keep in mind that ST segment elevation might also occur in the recovery phase; and c) ST segment elevation might be asymptomatic, as in the present case.

Erdogan, Okan; Sari, Ibrahim

2014-01-01

167

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

SciTech Connect

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

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

1991-05-01

168

Interval exercise versus continuous exercise in patients with moderate to severe chronic obstructive pulmonary disease - study protocol for a randomised controlled trial [ISRCTN11611768  

PubMed Central

Background Physical exercise has become a cornerstone of management of chronic obstructive pulmonary disease (COPD) because it leads to clinically relevant improvements of exercise capacity and health-related quality of life (HRQL). Despite the scarcity of randomised trials directly comparing exercise protocols, current guidelines recommend high intensity continuous exercise for lower extremities as the probably most effective exercise modality. However, for patients admitted to inpatient respiratory rehabilitation programmes, it is often difficult to initiate such an exercise programme because they are severely limited by dyspnoea and leg fatigue and therefore unable to perform continuous exercise at higher intensities and for periods longer than 30 minutes. Interval exercise may be an attractive alternative for these COPD patients because it allows high intensity exercise with recovery periods. The aim of this study is to assess if interval exercise compared to high intensity continuous exercise is not of inferior effectiveness in terms of HRQL and exercise capacity improvements but associated with better exercise tolerance in patients with moderate to severe COPD at the beginning of a respiratory rehabilitation. Methods/Design We will assign patients with moderately severe to severe COPD to either continuous exercise or interval exercise using a stratified randomisation. Patients will follow 12–15 exercise sessions during a comprehensive inpatient respiratory rehabilitation. Primary end point for effectiveness is HRQL as measured by the Chronic Respiratory Questionnaire (CRQ) two weeks after the end of rehabilitation and secondary endpoints include additional clinical outcomes such as functional exercise capacity, other HRQL measures, patients' experience of physical exercise as well as physiological measures of the effects of physical exercise such as cardiopulmonary exercise testing. Including expected drop-outs, we will need 52 patients per group to show differences corresponding to the minimal clinically important difference of the CRQ. Outcome assessors and investigators involved in data analysis will be blinded to group assignment until analyses have been carried out. Discussion Clinicians and the scientific community need evidence on the benefits and tolerance of exercise protocols available in clinical practice. The proposed trial will provide important and needed data on interval and continuous exercise for decision making in clinical practice.

Puhan, Milo A; Busching, Gilbert; vanOort, Evelien; Zaugg, Christian; Schunemann, Holger J; Frey, Martin

2004-01-01

169

Lung function, maximum and submaximum exercise testing in COPD patients: Reproducibility over a long interval  

Microsoft Academic Search

This study was designed to investigate the reproducibility and clinical relevance of several lung function and exercise test\\u000a indices in a sample of patients with stable severe chronic obstructive pulmonary disease (COPD).\\u000a \\u000a Twenty subjects (ages 67.8±2.0 years, forced expiratory volume in 1s, [FEV1] 39.7±2.8% predicted) receiving conventional medical therapy and pulmonary rehabilitation were tested 4 times at 1 month\\u000a intervals.

André Noseda; Jean-Pierre Carpiaux; Thierry Prigogine; Jacqueline Schmerber

1989-01-01

170

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

PubMed Central

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

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

2013-01-01

171

The perceptually regulated exercise test is sensitive to increases in maximal oxygen uptake.  

PubMed

The aim of this study was to assess the sensitivity of a perceptually regulated exercise test (PRET) to predict maximal oxygen uptake (VO?max) following an aerobic exercise-training programme. Sedentary volunteers were assigned to either a training (TG n = 16) or control (CG n = 10) group. The TG performed 30 min of treadmill exercise, regulated at 13 on the Borg Rating of Perceived Exertion (RPE) Scale, 3× per week for 8 weeks. All participants completed a 12-min PRET to predict VO?max followed by a graded exercise test (GXT) to measure VO?max before and after training. The PRET required participants to control the speed and incline on the treadmill to correspond to RPE intensities of 9, 11, 13 and 15. Predictive accuracy of extrapolation end-points RPE19 and RPE20 from a submaximal RPE range of 9-15 was compared. Measured VO?max increased by 17 % (p < 0.05) from baseline to post-intervention in TG. This was reflected by a similar change in [VO?max predicted from PRET when extrapolated to RPE 19 (baseline VO?max: 31.3 ± 5.5, 30.3 ± 9.5 mL kg(-1) min(-1); post-intervention VO?max: 36.7 ± 6.4, 37.4 ± 7.9 mL kg(-1) min(-1), for measured and predicted values, respectively). There was no change in CG (measured vs. predicted VO?max: 39.3 ± 6.5; 40.3 ± 8.2 and 39.2 ± 7.0; 37.7 ± 6.0 mL kg(-1) min(-1)) at baseline and post-intervention, respectively. The results confirm that PRET is sensitive to increases in VO?max following aerobic training. PMID:23160654

Evans, Harrison J L; Parfitt, Gaynor; Eston, Roger G

2013-05-01

172

Exercise dysfunction in patients seropositive for the human immunodeficiency virus  

SciTech Connect

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

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

1990-03-01

173

Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing.  

PubMed

Increased sympathetic activity and endothelial dysfunction are the proposed mechanisms underlying exaggerated blood pressure response to exercise (EBPR). However, data regarding heart rate behavior in patients with EBPR are lacking. We hypothesized that heart rate recovery (HRR) could be impaired in patients with EBPR. A total of 75 normotensive subjects who were referred for exercise treadmill test examination and experienced EBPR were included to this cross-sectional case-control study. The control group consisted of 75 age- and gender-matched normotensive subjects without EBPR. EBPR was defined as a peak exercise systolic blood pressure (BP) ?210 mmHg in men and ?190 mmHg in women. HRR was defined as the difference in HR from peak exercise to 1 min in recovery; abnormal HRR was defined as ?12 beats/min. These parameters were compared with respect to occurrence of EBPR. Mean values of systolic and diastolic BP at baseline, peak exercise, and the first minute of the recovery were significantly higher in the subjects with EBPR. Mean HRR values were significantly lower (P < 0.001) in subjects with EBPR when compared with those without. Pearson's correlation analysis revealed a significant positive correlation between the decrease in systolic BP during the recovery and degree of HRR in individuals without EBPR (r = 0.42, P < 0.001). Such a correlation was not observed in subjects with EBPR (r = 0.11, P = 0.34). The percentage of abnormal HRR indicating impaired parasympathetic reactivation was higher in subjects with EBPR (29 % vs 13 %, P = 0.02). In logistic regression analyses, HRR and resting systolic BP were the only determinants associated with the occurrence of EBPR (P = 0.001 and P < 0.001, respectively). Decreased HRR was observed in normotensive individuals with EBPR. In subjects with normal BP response to exercise, a linear correlation existed between the degree of HRR and decrease in systolic BP during the recovery period. However, such a correlation was not found in subjects with EBPR. Our data suggest that mechanisms underlying the blunting of the HRR might be associated with the genesis of EBPR. The association between the extent of HRR and adverse cardiovascular outcomes in patients with EBPR needs to be investigated in detail in future research. PMID:23080287

Dogan, Umuttan; Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Gok, Hasan

2013-11-01

174

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

PubMed Central

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

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

2013-01-01

175

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

SciTech Connect

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

Rubler, S.; Fisher, V.J.

1985-12-01

176

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

USGS Publications Warehouse

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

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

2007-01-01

177

Cardiopulmonary resuscitation in the rat.  

PubMed

A standardized method of cardiopulmonary resuscitation in rodents has been developed for anesthetized, mechanically ventilated rats. Ventricular fibrillation was induced and maintained by an alternating current delivered to the right ventricular endocardium. After 4 min of ventricular fibrillation, the chest was compressed with a pneumatic piston device. Eight of 14 animals were successfully resuscitated with DC countershock after 6 min of cardiac arrest. In confirmation of earlier studies from our laboratories in dogs, pigs, and human patients, this rodent model of cardiopulmonary resuscitation demonstrated large venoarterial [H+] and PCO2 gradients associated with reduced pulmonary excretion of CO2 during the low-flow state. Mean aortic pressure, coronary perfusion pressure, and end-tidal CO2 during chest compression were predictive of successful resuscitation. PMID:3145935

von Planta, I; Weil, M H; von Planta, M; Bisera, J; Bruno, S; Gazmuri, R J; Rackow, E C

1988-12-01

178

Gastric perforation after cardiopulmonary resuscitation.  

PubMed

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

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

2012-11-01

179

Desflurane pharmacokinetics during cardiopulmonary bypass  

Microsoft Academic Search

Objective: To describe the washin and washout of desflurane when first administered during cardiopulmonary bypass (CPB) for cardiac surgery. Design: A single-arm prospective study. Setting: University-affiliated hospital operating room. Participants: Ten adult patients presenting for cardiac surgery. Interventions: Consenting patients presenting for cardiac surgery received anesthesia with midazolam and fentanyl. Patients were cooled to 32°C on CPB, then desflurane 6%

Berend Mets; Neil T Reich; Nick Mellas; Jimi Beck; Sang Park

2001-01-01

180

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

NASA Astrophysics Data System (ADS)

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

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

2014-06-01

181

21 CFR 868.6175 - Cardiopulmonary emergency cart.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Cardiopulmonary emergency cart. 868.6175 Section 868.6175 Food... § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and...

2010-04-01

182

21 CFR 868.6175 - Cardiopulmonary emergency cart.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Cardiopulmonary emergency cart. 868.6175 Section 868.6175 Food... § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and...

2009-04-01

183

21 CFR 868.6175 - Cardiopulmonary emergency cart.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Cardiopulmonary emergency cart. 868.6175 Section 868.6175 Food... § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and...

2013-04-01

184

The validity of incremental exercise testing in discriminating of physiological profiles in elite runners.  

PubMed

The goal of this study was to determine whether traditional ergoespirometric incremental exercise testing carried out to the point of exhaustion could be useful in distinguishing the physiological profiles of elite runners that compete in races that lasted about 8 minutes versus those that lasted about 2 hours. Ten male marathon runners (performance time: 2:12:04, coefficient of variation (CV) = 2.33%) and 8 male 3000 m steeplechase runners (performance time: 8:37.83, CV = 2.12%) performed an incremental test on the treadmill (starting speed 10 km·h-1; increments, 2 km·h-1; increment duration, 3 min to exhaustion). Heart rate (HR), VO2, and lactate concentrations were measured at the end of each exercise level. At maximal effort, there were no differences between the groups regarding VO2max and maximal HR; however, the workload time, vVO2max and peak treadmill velocity were significantly higher in the 3000 m steeplechase group (p<0.05). At submaximal effort, there were no significant differences between groups for VO2 (ml·kg-1·min-1), HR, or lactate. Our results show that this type of testing was not sufficient for discriminating the physiological profiles of elite runners who competed in middle-distance versus long-distance events (e.g. in the marathon and the 3000 m steeplechase). PMID:21616773

Legaz-Arrese, Alejandro; Munguía-Izquierdo, D; Carranza-García, L E; Reverter-Masía, J; Torres-Dávila, C G; Medina-Rodríguez, R E

2011-06-01

185

Cerebrovascular responses to submaximal exercise in women with COPD  

PubMed Central

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

2014-01-01

186

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

Microsoft Academic Search

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

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

1996-01-01

187

Can the use of methylprednisolone, vitamin C, or ?-trinositol prevent cold-induced fluid extravasation during cardiopulmonary bypass in piglets?  

Microsoft Academic Search

ObjectiveHypothermic cardiopulmonary bypass is associated with capillary fluid leakage, resulting in edema and occasionally organ dysfunction. Systemic inflammatory activation is considered responsible. In some studies methylprednisolone has reduced the weight gain during cardiopulmonary bypass. Vitamin C and ?-trinositol have been demonstrated to reduce the microvascular fluid and protein leakage in thermal injuries. We therefore tested these three agents for the

M. Farstad; J. K. Heltne; S. E. Rynning; H. Onarheim; A. Mongstad; F. Eliassen; P. Husby

2004-01-01

188

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

PubMed

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 mL·kg(-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

Ortega, Juan Fernando; Hamouti, Nassim; Fernández-Elías, Valentín Emilio; Mora-Rodriguez, Ricardo

2014-07-01

189

Lung function, maximum and submaximum exercise testing in COPD patients: reproducibility over a long interval.  

PubMed

This study was designed to investigate the reproducibility and clinical relevance of several lung function and exercise test indices in a sample of patients with stable severe chronic obstructive pulmonary disease (COPD). Twenty subjects (ages 67.8 +/- 2.0 years, forced expiratory volume in 1s, [FEV1] 39.7 +/- 2.8% predicted) receiving conventional medical therapy and pulmonary rehabilitation were tested 4 times at 1 month intervals. Testing procedures included lung function (inspiratory vital capacity [IVC], FEV1, plethysmographic functional residual capacity [FRC], specific conductance of the airways (sGaw), single breath transfer factor divided by the alveolar volume [TL/VA]); incremental, progressive, symptom-limited, cycle exercise (maximum work load [Wmax], maximum heart rate [HRmax], maximum ventilation [VEmax], maximum oxygen uptake [VO2max]); and 2 modes of submaximum exercise (12 min walking test [12 MWD] and endurance cycle test). The mean of the absolute value of the individual patient, session-to-session, variation was found to be 0.131 for FEV1, 102 ml/min for VO2max. The within-subject variability was the smallest for HRmax and IVC (mean intrasubject coefficient of variation, [CV intra] 5.0 and 6.5%) and the greatest for TL/VA, the work performed during the endurance cycle test (EW) and sGaw (CV intra 16.5, 19.4, and 22.7%), while it was reasonably low (8.1-10.2%) for all the other variables studied. Calculation of the F ratio of the intersubject variance to the residual (total minus intersubject) variance, interpreted as a signal-to-noise, ratio, yielded the following, in decreasing order: TL/VA, EW, VEmax, VO2max, IVC, FEV1, HRmax, Wmax, sGaw, 12 MWD, FRC. If we assume that a useful variable should combine a low within-subject variability (CV intra less than or equal to 10%) with a high signal-to-noise ratio, we conclude that, among all the variables studied, IVC, FEV1, VEmax, and VO2max are those with the greatest clinical potential for functional assessment in patients with COPD. PMID:2512458

Noseda, A; Carpiaux, J P; Prigogine, T; Schmerber, J

1989-01-01

190

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

PubMed

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

Diwakar, Amit; Schmidt, Gregory A

2014-04-01

191

Exercise response  

NASA Technical Reports Server (NTRS)

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.

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

1975-01-01

192

Diagnostic characteristics and prognoses of primary-care patients referred for clinical exercise testing: a prospective observational study  

PubMed Central

Background Evaluation of angina symptoms in primary care often includes clinical exercise testing. We sought to identify clinical characteristics that predicted the outcome of exercise testing and to describe the occurrence of cardiovascular events during follow-up. Methods This study followed patients referred to exercise testing for suspected coronary disease by general practitioners in the County of Jämtland, Sweden (enrolment, 25 months from February 2010). Patient characteristics were registered by pre-test questionnaire. Exercise tests were performed with a bicycle ergometer, a 12-lead electrocardiogram, and validated scales for scoring angina symptoms. Exercise tests were classified as positive (ST-segment depression >1 mm and chest pain indicative of angina), non-conclusive (ST depression or chest pain), or negative. Odds ratios (ORs) for exercise-test outcome were calculated with a bivariate logistic model adjusted for age, sex, systolic blood pressure, and previous cardiovascular events. Cardiovascular events (unstable angina, myocardial infarctions, decisions on revascularization, cardiovascular death, and recurrent angina in primary care) were recorded within six months. A probability cut-off of 10% was used to detect cardiovascular events in relation to the predicted test outcome. Results We enrolled 865 patients (mean age 63.5 years, 50.6% men); 6.4% of patients had a positive test, 75.5% were negative, 16.4% were non-conclusive, and 1.7% were not assessable. Positive or non-conclusive test results were predicted by exertional chest pain (OR 2.46, 95% confidence interval (CI) 1.69-3.59), a pathologic ST-T segment on resting electrocardiogram (OR 2.29, 95% CI 1.44-3.63), angina according to the patient (OR 1.70, 95% CI 1.13-2.55), and medication for dyslipidaemia (OR 1.51, 95% CI 1.02-2.23). During follow-up, cardiovascular events occurred in 8% of all patients and 4% were referred to revascularization. Cardiovascular events occurred in 52.7%, 18.3%, and 2% of patients with positive, non-conclusive, or negative tests, respectively. The model predicted 67/69 patients with a cardiovascular event. Conclusions Clinical characteristics can be used to predict exercise test outcome. Primary care patients with a negative exercise test have a very low risk of cardiovascular events, within six months. A predictive model based on clinical characteristics can be used to refine the identification of low-risk patients.

2014-01-01

193

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

NASA Technical Reports Server (NTRS)

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

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

1998-01-01

194

The Single-Bout Forearm Critical Force Test: A New Method to Establish Forearm Aerobic Metabolic Exercise Intensity and Capacity  

PubMed Central

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

Kellawan, J. Mikhail; Tschakovsky, Michael E.

2014-01-01

195

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

SciTech Connect

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.

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

1991-07-01

196

Functional and hemodynamic cardiac determinants of exercise capacity in patients with systolic heart failure.  

PubMed

Decreased exercise capacity is the main symptom in patients with heart failure (HF). We assessed the association among noninvasively determined maximal cardiac output at exercise, systolic and diastolic cardiac functions at rest, and peak oxygen uptake (pVo(2)) exercise capacity in patients with congestive HF. We studied 102 patients 62 ± 11 years of age with New York Heart Association class II to IV stable HF and left ventricular (LV) ejection fraction <45%. All patients underwent echocardiography and a treadmill cardiopulmonary exercise test for evaluation of pVo(2) corrected for fat-free mass. During the cardiopulmonary exercise test, cardiac output was estimated noninvasively and continuously using Nexfin HD. Fat-free mass-corrected pVo(2) was associated in an univariate linear regression analysis with peak exercise cardiac index (CI) (beta 0.511, p <0.001), LV end-diastolic pressure estimates (peak early diastolic filling velocity/early diastolic tissue velocity [E/e'], beta -0.363, p = 0.001), and right ventricular function (tricuspid annular plane systolic excursion, beta 0.393, p <0.001). In multivariate analysis peak exercise CI (beta 0.380, p = 0.001), but not cardiac output or LV ejection fraction at rest, was an independent predictor of pVo(2). Other independent predictors of pVo(2) were E/e' (beta -0.276, p = 0.009) and tricuspid annular plane systolic excursion (beta 0.392, p <0.001), also when adjusted for age and gender. In conclusion, peak CI is an independent predictor of fat-free mass-corrected pVo(2) in patients with systolic HF. Of all echocardiographic parameters at rest, right ventricular function and E/e' were independently and significantly associated with pVo(2), whereas LV ejection fraction at rest was not. PMID:22818784

Hummel, Yoran M; Bugatti, Silvia; Damman, Kevin; Willemsen, Suzan; Hartog, Jasper W L; Metra, Marco; Sipkens, Johannes S; van Veldhuisen, Dirk J; Voors, Adriaan A

2012-11-01

197

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

Microsoft Academic Search

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

Jemma Edmunds; Nikos Ntoumanis; Joan L Duda

2008-01-01

198

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

PubMed

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

Chen, Shu-Yueh

2004-12-01

199

Diagnosis of important fixed coronary stenosis in patients with variant angina by exercise tests after treatment with calcium antagonists.  

PubMed Central

A 12 lead electrocardiogram was recorded during treadmill exercise in 57 patients with variant angina in whom coronary angiography was performed. Thirty six patients performed exercise tests with and without calcium antagonists, and 21 performed them only with calcium antagonists. In 55 patients calcium antagonists had prevented spontaneous attacks of variant angina for more than two days before the test. The other two patients were given a single dose of diltiazem (90 mg) two hours before the test. Exercise testing without calcium antagonists induced ST segment elevation with chest pain in nine patients, ST segment depression in 10 (nine with chest pain), and no important shift of the ST segment in 17. Five patients had severe coronary stenosis (greater than or equal to 75%) and all of them showed positive response. Thirty one patients had no important coronary stenosis and 14 of them showed positive response. The sensitivity of the exercise test in detecting a coronary stenosis greater than or equal to 75% was 100% without calcium antagonists but the specificity was low (55%). When the exercise test was done in patients taking calcium antagonists, only two (specificity 96%) of 48 patients without severe coronary stenosis showed positive response (elevation of ST segment in one and depression in another) whereas all nine patients with severe coronary stenosis had a positive response (depression of ST segment in six and elevation in three (sensitivity 100%). It is concluded that exercise testing with calcium antagonists may be a useful method for detecting severe coronary stenosis in patients with variant angina. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4

Araki, H; Hayata, N; Matsuguchi, T; Takeshita, A; Nakamura, M

1986-01-01

200

Emergency exercise methodology  

SciTech Connect

Competence for proper response to hazardous materials emergencies is enhanced and effectively measured by exercises which test plans and procedures and validate training. Emergency exercises are most effective when realistic criteria is used and a sequence of events is followed. The scenario is developed from pre-determined exercise objectives based on hazard analyses, actual plans and procedures. The scenario should address findings from previous exercises and actual emergencies. Exercise rules establish the extent of play and address contingencies during the exercise. All exercise personnel are assigned roles as players, controllers or evaluators. These participants should receive specialized training in advance. A methodology for writing an emergency exercise plan will be detailed.

Klimczak, C.A.

1993-03-01

201

Emergency exercise methodology  

SciTech Connect

Competence for proper response to hazardous materials emergencies is enhanced and effectively measured by exercises which test plans and procedures and validate training. Emergency exercises are most effective when realistic criteria is used and a sequence of events is followed. The scenario is developed from pre-determined exercise objectives based on hazard analyses, actual plans and procedures. The scenario should address findings from previous exercises and actual emergencies. Exercise rules establish the extent of play and address contingencies during the exercise. All exercise personnel are assigned roles as players, controllers or evaluators. These participants should receive specialized training in advance. A methodology for writing an emergency exercise plan will be detailed.

Klimczak, C.A.

1993-01-01

202

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

SciTech Connect

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.

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

1986-08-01

203

Influence of training and a maximal exercise test in analytical variability of muscular, hepatic, and cardiovascular biochemical variables.  

PubMed

Abstract Short, middle, and long-term exercise, as well as the relative intensity of the physical effort, may influence a broad array of laboratory results, and it is thereby of pivotal importance to appropriately differentiate the 'physiologic' from the 'pathological' effects of exercise. Therefore, the values of some biomarkers in physically active subjects may be cautiously interpreted since the results may fall outside the conventional reference ranges. It has been demonstrated that middle and long-term endurance and/or strenuous exercise triggers transient elevations of muscular and cardiac biomarkers. However, no data have been published about the effect of short-term maximal exercise test on the most useful muscular, hepatic and cardiovascular biomarkers. The aim of the present study was to assess the baseline concentrations of muscular, hepatic, and cardiovascular makers between trained and untrained subjects, along with changes induced by maximal exercise test. We measured C reactive protein (CRP), procalcitonin (PCT), gamma glutamyltransferase (GGT), creatine kinase-MB isoenzyme (CK-MB), Hs-TnT, NT-proBNP, CK, LDH, AST, and ALT in serum samples of physically active (trained) and physically inactive (sedentary) male collected before, immediately after a maximal exercise test and after a 30-min recovery period. Trained subjects tend to have significantly raised base concentrations of CK, CK-MB, ALT, and LDH compared to sedentary individuals, and this can be clearly interpreted as a mild injury of skeletal muscle. A single maximal exercise was also effective to transiently increase the concentrations of NT-proBNP, but not those of Hs-TnT, thus suggesting that the cardiac involvement is mostly benign in nature. PMID:24484196

Romagnoli, Marco; Alis, Rafael; Aloe, Rosalia; Salvagno, Gian Luca; Basterra, Javier; Pareja-Galeano, Helios; Sanchis-Gomar, Fabian; Lippi, Giuseppe

2014-04-01

204

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

PubMed

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

Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

2014-01-01

205

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

PubMed Central

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

Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

2014-01-01

206

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

SciTech Connect

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

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

1980-04-01

207

Exercise testing without interruption of medication for refining the selection of mildly symptomatic patients for prognostic coronary angiography.  

PubMed Central

OBJECTIVE--To examine how exercise testing on background medical treatment affects the ability of the test to predict prognostically important patterns of coronary anatomy in patients with a high clinical probability of coronary artery disease but who are well controlled on medication. DESIGN--Prospective study. SETTING--Regional cardiothoracic centre and referring district general hospital. PATIENTS--84 patients with a history of typical angina or definite myocardial infarction and mild symptoms who had been placed on the waiting list for prognostic angiography. INTERVENTION--Maximal exercise electrocardiography and radionuclide ventriculography performed off and on medication, followed by angiography within three months. MAIN OUTCOME MEASURE--Prognostically important coronary artery disease for which early surgery might be recommended purely on prognostic grounds, irrespective of symptoms. RESULTS--Coronary artery disease was present in 71/84 (85%) patients; in 28/84 (33%) patients this was prognostically important. When the result was strongly positive, the predictive accuracy for prognostically important disease was 0.46 off and 0.62 on medication for the exercise electrocardiogram and 0.71 off and 0.82 on medication for exercise radionuclide ventriculography. The likelihood ratio was 1.00 off and 1.36 on medication for exercise electrocardiography and 2.54 off and 10.5 on medication for exercise radionuclide ventriculography. In stepwise logistic regression, the test identified as the strongest predictor of prognostically important disease was exercise radionuclide ventriculography on medication for which the improvement chi 2 was 28 (p < 0.0001). With the regression model, the probability of important disease is 92% if exercise radionuclide ventriculography on medication is at least strongly positive, compared with 16% if the result is normal or just positive. CONCLUSION--In patients likely to have coronary disease, exercise testing should be performed without interruption of medication to optimise its ability to identify those with prognostically important disease, and to help to avoid unnecessary or premature angiography in those who are well controlled on medical treatment.

Lim, R.; Kreidieh, I.; Dyke, L.; Thomas, J.; Dymond, D. S.

1994-01-01

208

Exercise performance in thalassemia major: correlation with cardiac iron burden.  

PubMed

Exercise performance is decreased in patients with Thalassemia major (TM), but the relative impact of anemia and iron overload on exercise capacity is unknown. We assessed the cardiopulmonary function of 71, well-transfused TM patients via graded treadmill exercise stress test. All patients underwent MRI of the heart, pancreas, and liver and diagnostic phlebotomy. Patients ranged in age from 13 to 46 years of age. Fifteen patients were excluded from analysis due to submaximal effort. Mean Vo2 max was 83.0% of predicted and was limited by abnormal cardiovascular mechanisms, consisting of a decreased O2 pulse (86.6% of predicted) in men and decreased maximum heart rate (HR) response (85% of predicted) in women. Patients with hemoglobin less than 12 g/dL had lower O2 pulse and Vo2 max, regardless of sex. Cardiac iron was negatively associated with maximum HR response and Vo2 max (r2 = 0.10 and 0.08, respectively, P < 0.05). Vo2 max was correlated with cardiac R2*, hs-CRP, sex and hemoglobin in decreasing strength of association. In thalassemia, exercise performance is limited by impaired stroke-volume reserve in men and blunted HR response in women. Iron toxicity may be mediated through vascular inflammation and direct modulation of HR response to exercise. PMID:23339082

Sohn, Eugene Y; Kato, Roberta; Noetzli, Leila J; Gera, Aakanksha; Coates, Thomas; Harmatz, Paul; Keens, Thomas G; Wood, John C

2013-03-01

209

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

NASA Astrophysics Data System (ADS)

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.

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

2013-04-01

210

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

SciTech Connect

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

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

1988-04-01

211

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

PubMed

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

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

2014-05-16

212

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

ERIC Educational Resources Information Center

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

Pyfer, Howard R.; And Others

213

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

Microsoft Academic Search

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

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

2003-01-01

214

Transient U wave inversion during treadmill exercise testing in patients with left anterior descending coronary artery disease.  

PubMed

The transient U wave inversion during exercise is specific for detecting left anterior descending coronary artery (LAD) disease. In a homogeneous patient group restricted to LAD disease, however, the significance of the electrocardiographic finding has not yet been clarified. Thus, clinical characteristics in patients with angiographically documented one-vessel disease of the LAD and exercise-induced U wave inversion were delineated. Symptom-limited treadmill exercise testing was performed in 60 patients (43 men, 17 women; mean age 64 +/- 8 years) with angina pectoris whose culprit lesion was located only in the LAD. U wave polarity and amplitude were determined before, during, and after exercise with the P-Q segment as the isoelectric line. Exercise-induced transient U wave inversion was defined as positive when there was a discrete negative deflection > or = 0.05 mV within the T-P segment. Of all patients, 16 (27%) had exercise-induced U wave inversion. There were no differences in age, male gender, antianginal medication use, and coronary angiographic data between the two patients groups: patients with and without U wave inversion. Heart rate and double product of heart rate and systemic systolic blood pressure at peak exercise were also similar. Prevalence of abnormal exercise-induced S-T segment shift was 94% (15 of 16 patients) and 61% (27 of 44 patients) of patients with and without U wave inversion, respectively. The difference was statistically significant (p = 0.02). Among patients with exercise-induced S-T segment shift, the proportion of patients with S-T segment elevation to all the patients was larger in patients with U wave inversion than in patients without U wave inversion [3 (20%) of 15 patients vs 0 (0%) of 27 patients, p = 0.03)]. In conclusion, the exercise-induced U wave inversion in patients with one-vessel disease of the LAD indicates the severe degree of myocardial ischemia induced in the territory perfused by the LAD. However, the electrocardiographic finding does not appear to have independent significance since it closely correlates with the presence of S-T segment shift. PMID:10917582

Kodama, K; Hiasa, G; Ohtsuka, T; Ikeda, S; Hashida, H; Kuwahara, T; Hara, Y; Shigematsu, Y; Hamada, M; Hiwada, K

2000-07-01

215

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

SciTech Connect

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

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

1988-04-01

216

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

PubMed Central

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 65±7 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.

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

2014-01-01

217

Massive rhabdomyolysis following cardiopulmonary bypass.  

PubMed

Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed. PMID:24782976

Kim, Young Sam; Yoon, Yong Han; Kim, Joung Taek; Baek, Wan Ki

2014-04-01

218

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

SciTech Connect

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

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

1991-04-01

219

Modified Total-Body Recumbent Stepper Exercise Test for Assessing Peak Oxygen Consumption in People With Chronic Stroke  

PubMed Central

Background: Assessment of peak oxygen consumption (V?o2peak) using traditional modes of testing such as treadmill or cycle ergometer can be difficult in individuals with stroke due to balance deficits, gait impairments, or decreased coordination. Objective: The purpose of this study was to quantitatively assess the validity and feasibility of a modified exercise test using a total-body recumbent stepper (mTBRS-XT) in individuals after stroke. Design: A within-subject design, with a sample of convenience, was used. Participants. Eleven participants (7 male, 4 female) with a mean of 40.1 months (SD=32.7) after stroke, a mean age of 60.9 years (SD=12.0), and mild to severe lower-extremity Fugl-Myer test scores (range=13–34) completed the study. Methods: Participants performed 2 maximal-effort graded exercise tests on separate days using the mTBRS-XT and a cycle ergometer exercise protocol to assess cardiorespiratory fitness. Measurements of V?o2peak and peak heart rate (peak HR) were obtained during both tests. Results: A strong relationship existed between the mTBRS-XT and the cycle ergometer exercise test for V?o2peak and peak HR (r=.91 and .89, respectively). Mean V?O2peak was significantly higher for the mTBRS-XT (16.6 mL×kg?1×min?1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL×kg?1×min?1 [SD=4.5]). All participants performed the mTBRS-XT. One individual with severe stroke was unable to pedal the cycle ergometer. No significant adverse events occurred. Conclusion: The mTBRS-XT may be a safe, feasible, and valid exercise test to obtain measurements of V?o2peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on V?o2peak values for individuals with mild to severe deficits after stroke.

Billinger, Sandra A; Tseng, Benjamin Y; Kluding, Patricia M

2008-01-01

220

Antianginal effects of amlodipine at a single dose on exertional angina patients using treadmill exercise testing—A randomized crossover study in comparison with placebo  

Microsoft Academic Search

With eight cases of stable exertional angina as subjects, the antianginal action and sustained effects of single 10 mg oral doses of new calcium antagonists amlodipine were assessed by treadmill exercise tests in randomized crossover trials with respect to a placebo. Exercise tests were conducted before as well as 4, 8, and 24 hours after administration, and plasma amlodipine concentration

Hiroshi Kishida; Noritake Hata; Toshihiro Kunimi; Hideo Miyagawa; Harumi Nishiyama; Kazuzo Katoh

1992-01-01

221

Exercise, Heart and Health  

PubMed Central

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

2011-01-01

222

Cardio-Pulmonary Response to Shock.  

National Technical Information Service (NTIS)

The general objectives of this laboratory have been to study cardiopulmonary abnormalities associated with shock and trauma, with a focus on the intermediary role of lung and circulating blood cell metabolism. Pressure breathing, pulmonary embolism and ac...

H. B. Hechtman

1983-01-01

223

Wolf Creek VI Conference on Cardiopulmonary Resuscitation.  

National Technical Information Service (NTIS)

The Sixth Wolf-Creek Conference was held at the Ritz Carlton Hotel in Rancho Mirage from June 4, 2001 to June 7, 2001. Approximately 70 internationally renown experts on Cardiopulmonary Resuscitation attended the Conference and presented their most recent...

M. Weil

2001-01-01

224

Teaching Cardiopulmonary Resuscitation in the Schools.  

ERIC Educational Resources Information Center

Cardiopulmonary resuscitation is a key part of emergency cardiac care. It is a basic life support procedure that can be taught in the schools with the assistance of the American Heart Association. (JMF)

Carveth, Stephen W.

1979-01-01

225

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

ERIC Educational Resources Information Center

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

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

2011-01-01

226

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

ERIC Educational Resources Information Center

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)

Treagust, David F.; And Others

1980-01-01

227

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

SciTech Connect

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

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

1987-03-01

228

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

Microsoft Academic Search

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

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

2010-01-01

229

Follow-up with exercise test of effort-induced ventricular arrhythmias linked to ryanodine receptor type 2 gene mutations.  

PubMed

The aim of this study was to assess exercise test results and efficacy of therapy with a ? blocker (acebutolol) in ryanodine receptor type 2 (RyR2) mutation carriers with documented ventricular arrhythmias (VAs) and long-term follow-up. Twenty RyR2 mutation carriers belonging to 8 families and regularly followed at our center were analyzed using a study protocol involving electrocardiography, exercise tests off and on ?-blocker therapy, 2-dimensional echocardiography, and signal-averaged electrocardiography. Off-therapy exercise testing triggered the onset of VAs at different heart rates (mean 132 ± 13 beats/min) with various patterns that worsened while exercising and disappeared immediately after stopping. The most severe VAs detected were nonsustained ventricular tachycardia in 35% and ventricular couplets in 35%. In the remaining subjects single ventricular premature beats were recorded. In 15% of patients single monomorphic ventricular premature beats were detected and identified to be linked to RyR2 mutations owing to the presence of sudden deaths of their family members and subsequent family screening. Acebutolol made the VAs disappear completely in 20% of subjects and decreased their complexity in 50%, whereas it did not change VAs appreciably in 30% of patients with less complex VAs. After 11 ± 8 years of follow-up 2 patients developed syncope. In conclusion, exercise testing was a fundamental tool for assessing the clinical phenotype and efficacy of therapy in RyR2 mutation carriers and therapy with acebutolol led in most subjects to a decreased complexity of the arrhythmic pattern or to complete suppression. PMID:22221940

Steriotis, Alexandros Klavdios; Nava, Andrea; Rampazzo, Alessandra; Basso, Cristina; Thiene, Gaetano; Daliento, Luciano; Folino, Antonio Franco; Rigato, Ilaria; Mazzotti, Elisa; Beffagna, Giorgia; Carturan, Elisa; Corrado, Domenico; Bauce, Barbara

2012-04-01

230

Objective effect manifestation of pectus excavatum on load-stressed pulmonary function testing: a case report  

PubMed Central

Introduction Pectus excavatum is the most common congenital deformity of the anterior chest wall that, under certain conditions, may pose functional problems due to cardiopulmonary compromise and exercise intolerance. Case presentation We present the case of an otherwise physically-adept 21-year-old Chinese sportsman with idiopathic pectus excavatum, whose symptoms manifested only on bearing a loaded body vest and backpack during physical exercise. Corroborative objective evidence was obtained via load-stressed pulmonary function testing, which demonstrated restrictive lung function. Conclusion This report highlights the possible detrimental synergism of thoracic load stress and pectus excavatum on cardiopulmonary function. Thoracic load-stressed pulmonary function testing provides objective evidence in support of such a synergistic relationship.

2011-01-01

231

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

PubMed

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

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

1992-12-01

232

Long-term therapy with policosanol improves treadmill exercise-ECG testing performance of coronary heart disease patients.  

PubMed

This study examined the effects of long-term lipid-lowering therapy with policosanol on the clinical evolution, and exercise-ECG testing responses of 45 coronary heart disease (CHD) patients with myocardial ischemia, documented by exercise 201T1-myocardial perfusion scintigraphy, in an overall randomized, double-blind, placebo-controlled trial, made for different test endpoints. Fifteen patients were treated with 5 mg of policosanol twice daily; another 15 patients were administered the same drug dose plus 125 mg aspirin; and the other 15 patients received placebo plus equal aspirin dose. They were followed for 20 months, previous baseline observations, with treadmill exercise-ECG, besides serum lipid test. Beneficial changes on proportions among the 2 policosanol groups and the placebo group, showed an increment on functional capacity class, a decrement on rest and exercise angina, and a significant decrease in cardiac events, and in ischemic ST segment response, especially in the policosanol plus aspirin group (p = 0.05, X2(2df) = 5.8; p = 0.04, p = 0.02; Fisher). After treatment, sets of mean changes revealed an increase on maximum oxygen uptake, and a decline on double product simultaneously in both policosanol groups (p < or = 0.02, p < or = 0.002; Pillais, Hotellings' T2), while the placebo group was impaired. Aerobic functional capacity percent showed an increment in policosanol groups (p < or = 0.05, paired T). Lipid levels improved as other endpoints already reported. A supposed ergogenic effect of octacosanol, policosanol's main active compound, was not detected with this design. These results show that policosanol-treated CHD patients improved clinical evolution, and exercise-ECG responses, owing to the amelioration of myocardial ischemia, even more when administered with aspirin. PMID:9760006

Stüsser, R; Batista, J; Padrón, R; Sosa, F; Pereztol, O

1998-09-01

233

Cavopulmonary anastomosis without cardiopulmonary bypass†  

PubMed Central

OBJECTIVES There is an increasing trend to perform the bidirectional superior cavopulmonary (Glenn) anastomosis without cardiopulmonary bypass. In this report, we present our results of off-pump bidirectional Glenn operation done without using a venoatrial shunt to decompress the randomized comparative study was superior vena cava during clamping. METHODS A prospective, non-randomized comparative study was conducted in 50 patients with functional single ventricle anomalies who underwent bidirectional Glenn anastomosis without cardiopulmonary bypass. The patients were divided into two groups: Group I (n = 25), where it was done without a veno-atrial shunt, and Group II (n = 25), where it was done with a veno-atrial shunt. Two patients in Group I and 4 patients in Group II had a bilateral bidirectional Glenn shunt. Five patients in Group I and three patients in Group II had a previous left modified Blalock–Taussig shunt. All patients underwent a complete neurological examination both preoperatively as well as postoperatively. RESULTS The early hospital mortality was 4% (2/50), one in each group. The median follow-up was 14 months. The mean internal venous pressure on clamping the superior vena cava was 37.07 ± 7.12 mmHg in Group I and 24 ± 4.4 mmHg in Group II. The mean clamp time was 9.85 ± 3.52 min in Group I and 21.3 ± 4.4 min in Group II. The transcranial pressure gradient was 62.37 ± 15.01 mmHg in Group I, while 65.08 ± 13.89 in Group II. The mean intensive care unit stay was 2.57 ± 75 days in Group I, 3.3 ± 1.09 in Group II. There were no major neurological complications apart from treatable convulsions in one case in Group I (4%), 2 cases in Group II (8%), and delayed recovery in one case (4%) in Group I. CONCLUSIONS Off-pump bidirectional Glenn operation without caval decompression is a safe, simple and more economic procedure.

Mostafa, Ezzeldin A.; El Midany, Ashraf A.H.; Zalat, Mahmoud M.; Helmy, Ahmed

2013-01-01

234

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

PubMed

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

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

2008-05-01

235

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

PubMed

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

Peikert, D; Smolander, J

1991-01-01

236

Recent advances of in vitro tests for the diagnosis of food-dependent exercise-induced anaphylaxis.  

PubMed

Food-dependent exercise-induced anaphylaxis (FDEIA) is a special form of IgE-mediated food allergy and exhibits allergic symptoms in combination of causative food-intake and triggers such as exercise. As the causative foods and the condition of triggers vary among patients, diagnosis of FDEIA is not always easy. Serum food-specific IgE tests, which are widely used in the diagnosis of FDEIA, have rather low sensitivity, because the tests mostly utilize crude extracts of foods. Concept of using defined allergen molecules has been proposed as the term "component-resolved diagnostics" for diagnosis of IgE-mediated allergy. Use of purified allergens such as recombinant omega-5 gliadin turned out to highly improve its sensitivity and specificity of the tests in the diagnosis of wheat-dependent exercise-induced anaphylaxis (WDEIA). Recently, CD203c expression-based basophil activation test (BAT) is reported to be useful in identifying adult patients with WDEIA and predicting causative allergens in WDEIA, when combined with appropriate allergens. Detection of serum allergen levels possibly gives useful information whether food challenge tests have been performed with sufficient strength. PMID:23669019

Morita, Eishin; Chinuki, Yuko; Takahashi, Hitoshi

2013-09-01

237

Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease  

PubMed Central

We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS by electron beam computed tomography (Agatston score), and exercise testing. Decision-making was based on CCS. When CCS?400, coronary angiography (CAG) was recommended. When CCS<10, patients were discharged. Exercise tests were graded as positive, negative or nondiagnostic. The combined endpoint was defined as coronary event or obstructive CAD at CAG. During 12±4 months, CCS?400, 10–399 and <10 were found in 42, 103 and 159 patients and the combined endpoint occurred in 24 (57%), 14 (14%) and 0 patients (0%), respectively. In 22 patients (7%), myocardial perfusion scintigraphy was performed instead of exercise testing due to the inability to perform an exercise test. A positive, nondiagnostic and negative exercise test result was found in 37, 76 and 191 patients, and the combined endpoint occurred in 11 (30%), 15 (20%) and 12 patients (6%), respectively. Receiver-operator characteristics analysis showed that the area under the curve of 0.89 (95% CI: 0.85–0.93) for CCS was superior to 0.69 (95% CI: 0.61–0.78) for exercise testing (P<0.0001). In conclusion, measurement of CCS is an appropriate initial screening test in a well-defined low-risk population with suspected CAD.

Dikkers, Riksta; Perik, Patrick J.; Tio, Rene A.; Gotte, Marco J. W.; Hillege, Hans L.; Vliegenthart, Rozemarijn; Houwers, Janneke B.; Willems, Tineke P.; Oudkerk, Matthijs; Zijlstra, Felix

2007-01-01

238

Knee Exercises  

MedlinePLUS

... and Knee Replacement Rehabilitation News News Multimedia Resources Knee Exercises | If my knee hurts, why exercise? | How do I start exercising? | ... Exercises Print Article Text Size: + | - Next If my knee hurts, why exercise? Having strong, flexible muscles is ...

239

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test  

PubMed Central

Background Exercise test (ET) is the preferred initial noninvasive test for the diagnosis and risk stratification of coronary artery disease (CAD), however, its lower sensitivity may fail to identify patients at greater risk of adverse events. Objective To assess the value of stress echocardiography (SE) for predicting all-cause mortality and major cardiac events (MACE) in patients with intermediate pretest probability of CAD and a normal ET. Methods 397 patients with intermediate CAD pretest probability, estimated by the Morise score, and normal ET who underwent SE were studied. The patients were divided into two groups according to the absence (G1) or presence (G2) of myocardial ischemia on SE .End points evaluated were all-cause mortality and MACE, defined as cardiac death and nonfatal acute myocardial infarction (AMI). Results G1 group was comprised of 329 (82.8%) patients. The mean age of the patients was 57.37 ± 11 years and 44.1% were male. During a mean follow-up of 75.94 ± 17.24 months, 13 patients died, three of them due to cardiac causes, and 13 patients suffered nonfatal AMI. Myocardial ischemia remained an independent predictor of MACE (HR 2.49; [CI] 95% 1.74-3.58). The independent predictors for all-cause mortality were male gender (HR 9.83; [CI] 95% 2.15-44.97) and age over 60 years (HR 4.57; [CI] 95% 1.39-15.23). Conclusion Positive SE for myocardial ischemia is a predictor of MACE in the studied sample, which helps to identify a subgroup of patients at higher risk of events despite having normal ET.

Calasans, Flavia Ricci; Santos, Bruno Fernandes de Oliveira; Silveira, Debora Consuelo Rocha; de Araujo, Ana Carla Pereira; Melo, Luiza Dantas; Barreto-Filho, Jose Augusto; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

2013-01-01

240

Evidence-based risk assessment and recommendations for exercise testing and physical activity clearance in apparently healthy individuals.  

PubMed

Increased physical activity (PA) is associated with improved health and quality of life in the general population. A dose-response effect is evident between increasing levels of PA participation and a lower relative risk for cardiovascular disease and all-cause mortality. However, there is also clear evidence that PA acutely increases the risk of an adverse cardiovascular (CV) event and sudden cardiac death (SCD) significantly above levels expected at rest. Adverse CV events during PA may be triggered acutely by the physiological stress of exercise. This investigation will review the available literature describing the CV risks of exercise testing and PA participation in apparently healthy individuals. A systematic review of the literature was performed using electronic databases, including Medline, CINAHL, SPORT discus, EMBASE, Cochrane DSR, ACP Journal Club, and DARE; additional relevant articles were hand-picked and the final grouping was used for the review using the AGREE process to assess the impact and quality of the selected articles. Six hundred and sixteen relevant articles were reviewed with 51 being identified as describing adverse CV events during exercise and PA. Data suggests the risks of fatal and nonfatal events during maximal exercise testing in apparently healthy individuals rarely occur (approximately <0.8 per 10?000 tests or 1 per 10?000 h of testing). The incidence of adverse CV events is extremely low during PA of varying types and intensities, with data limited almost exclusively to fatal CV events, as nonfatal events are rarely reported. However, this risk is reduced by 25%-50% in those individuals who have prior experience with increased levels of PA, particularly vigorous PA. Throughout a wide age range, the risk of SCD and nonfatal events during PA remain extremely low (well below 0.01 per 10?000 participant hours), but both increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, undetected pre-existing disease is present and SCD is typically the first clinical event. The risks of an adverse CV event during exercise testing and PA are rare and are outweighed by the health benefits. Given this risk-benefit relationship, the PAR-Q is an appropriate method to identify those at higher risk across a wide age span and should be used in conjunction with appropriate clinical guidelines for guiding individuals towards graduated PA. There are not adequate data to describe the risks of PA in those individuals considered to be at higher risk but without cardiovascular disease. PMID:21800940

Goodman, Jack M; Thomas, Scott G; Burr, Jamie

2011-07-01

241

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

NASA Technical Reports Server (NTRS)

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.

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

1973-01-01

242

Evaluation of cardiopulmonary resuscitation techniques in microgravity  

NASA Technical Reports Server (NTRS)

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

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

1991-01-01

243

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

NASA Technical Reports Server (NTRS)

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.

Sandoval, Darleen A.; Matt, Kathleen S.

2003-01-01

244

Exercise tolerance, lung function abnormalities, anemia, and cardiothoracic ratio in sickle cell patients.  

PubMed

Many patients with sickle cell disease (SCD) have a reduced exercise capacity and abnormal lung function. Cardiopulmonary exercise testing (CPET) can identify causes of exercise limitation. Forty-four consecutive SCD patients (27 HbSS, 11 HbSC, and 6 HbS-beta thalassemia) with a median age (interquartile range) of 26 (21-41) years underwent pulmonary function tests, CPET, chest x-ray, and echocardiography to further characterize exercise limitation in SCD. Peak oxygen uptake (V'O2 -peak), expressing maximum exercise capacity, was decreased in 83% of the studied patients. V'O2 -peak correlated with hemoglobin levels (R?=?0.440, P?=?0.005), forced vital capacity (FVC) (R?=?0.717, P?exercise limitation, the patients were limited in exercise capacity due to anemia (n?=?17), cardiovascular dysfunction (n?=?2), musculoskeletal function (n?=?10), pulmonary ventilatory abnormalities (n?=?1), pulmonary vascular exercise limitation (n?=?1), and poor effort (n?=?3). In the present study we demonstrate that anemia is the most important determinant of reduced exercise tolerance observed in SCD patients without signs of pulmonary hypertension. We found a strong correlation between various parameters of lung volume and cardiothoracic ratio and we hypothesize that cardiomegaly and relative small chest size may be important causes of the impairment in pulmonary function, that is, reduced long volumes and diffusion capacity, in SCD. Taking into account anthropomorphic differences between SCD patients and controls could help to interpret lung function studies in SCD better. Am. J. Hematol. 89:819-824, 2014. © 2014 Wiley Periodicals, Inc. PMID:24799296

van Beers, Eduard J; van der Plas, Mart N; Nur, Erfan; Bogaard, Harm-Jan; van Steenwijk, Reindert P; Biemond, Bart J; Bresser, Paul

2014-08-01

245

Diagnostic performance of exercise bicycle testing and single-photon emission computed tomography: comparison with 64-slice computed tomography coronary angiography  

Microsoft Academic Search

To conduct a comparison of the diagnostic performance of exercise bicycle testing and single-photon emission computed tomography\\u000a (SPECT) with computed tomography coronary angiography (CTCA) for the detection of obstructive coronary artery disease (CAD)\\u000a in patients with stable angina. 376 symptomatic patients (254 men, 122 women, mean age 60.4 ± 10.0 years) referred for noninvasive\\u000a stress testing (exercise bicycle test and\\/or SPECT) and invasive

A. C. Weustink; L. A. Neefjes; A. Rossi; W. B. Meijboom; K. Nieman; E. Capuano; E. Boersma; N. R. Mollet; G. P. Krestin; P. J. de Feyter

246

A Maximal Graded Exercise Test to Accurately Predict VO2max in 18–65YearOld Adults  

Microsoft Academic Search

The purpose of this study was to develop an age-generalized regression model to predict maximal oxygen uptake (VO2max) 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?±?standard deviation [SD]; maximal heart rate [HRmax]?=?185.2?±?12.4 beats per minute (bpm); maximal respiratory exchange ratio [RERmax]?=?1.18?±?0.05; maximal rating of perceived

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

2007-01-01

247

Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery.  

PubMed

Over the past decades, major progress in patient selection, surgical techniques and anaesthetic management have largely contributed to improved outcome in lung cancer surgery. The purpose of this study was to identify predictors of post-operative cardiopulmonary morbidity in patients with a forced expiratory volume in 1 s <80% predicted, who underwent cardiopulmonary exercise testing (CPET). In this observational study, 210 consecutive patients with lung cancer underwent CPET with completed data over a 9-yr period (2001-2009). Cardiopulmonary complications occurred in 46 (22%) patients, including four (1.9%) deaths. On logistic regression analysis, peak oxygen uptake (peak V'(O?) and anaesthesia duration were independent risk factors of both cardiovascular and pulmonary complications; age and the extent of lung resection were additional predictors of cardiovascular complications, whereas tidal volume during one-lung ventilation was a predictor of pulmonary complications. Compared with patients with peak V'(O?) >17 mL·kg?¹·min?¹, those with a peak V'(O?) <10 mL·kg?¹·min?¹ had a four-fold higher incidence of cardiac and pulmonary morbidity. Our data support the use of pre-operative CPET and the application of an intra-operative protective ventilation strategy. Further studies should evaluate whether pre-operative physical training can improve post-operative outcome. PMID:20847073

Licker, M; Schnyder, J-M; Frey, J-G; Diaper, J; Cartier, V; Inan, C; Robert, J; Bridevaux, P-O; Tschopp, J-M

2011-05-01

248

21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.  

Code of Federal Regulations, 2010 CFR

...4310 Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used...pressure of the blood perfusing the coronary arteries. (b) Classification....

2010-04-01

249

21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.  

Code of Federal Regulations, 2010 CFR

...4310 Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used...pressure of the blood perfusing the coronary arteries. (b) Classification....

2009-04-01

250

Cardiac arrest\\/cardiopulmonary resuscitation augments cell-mediated immune function and transiently suppresses humoral immune function  

Microsoft Academic Search

Immune system activation has implications for cerebrovascular health, but little is known about the function of the immune system after a major cerebrovascular event, such as cardiac arrest and cardiopulmonary resuscitation (CA\\/CPR). Cardiac arrest and cardiopulmonary resuscitation damages the hippocampus, an important component of the hypothalamic-pituitary-adrenal (HPA) axis, and alterations in HPA axis activity can affect immune function. We tested

Gretchen N Neigh; Erica R Glasper; Staci D Bilbo; Richard J Traystman; A Courtney DeVries

251

Inflammatory response after myocardial revascularization with or without cardiopulmonary bypass  

Microsoft Academic Search

Background. Tumor necrosis factor-? has been implicated in complications seen after cardiac operations with cardiopulmonary bypass. The release of tumor necrosis factor-? and its possible effects were studied in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass.Methods. Twenty patients were studied, 10 with (group 1) and 10 without cardiopulmonary bypass (group 2). Serial blood samples were obtained

Luiz A Brasil; Walter J Gomes; Reinaldo Salomão; Enio Buffolo

1998-01-01

252

The usefulness of submaximal exercise gas exchange to define pulmonary arterial hypertension  

PubMed Central

Background The six-minute walk test is widely utilized to characterize activity tolerance and response to therapy in pulmonary arterial hypertension (PAH), but provides little information about cardiopulmonary pathophysiology. The aim of the present study was to determine whether measures of pulmonary gas exchange during relatively light exercise can be used to differentiate between PAH patients and healthy individuals, and stratify disease severity. Methods 40 PAH patients and 25 matched controls participated in the study. Each individual completed a submaximal exercise test, consisting of 2-min rest, 3-min exercise and 1-min recovery. Ventilation, pulmonary gas exchange, arterial oxygen saturation (SaO2) and heart rate were measured throughout using a simplified gas analysis system. Results A number of gas exchange variables differentiated PAH patients and controls. End-tidal CO2 (PETCO2) and SaO2 were lower in PAH vs. controls (31±7vs.39±3mmHg and 89±5vs95±2%, respectively, p<0.05). By contrast, breathing efficiency (VE/VCO2 ratio) was higher in PAH vs. controls (42±10 vs. 33±5, p<0.05). Additionally, PETCO2 and VE/VCO2 discriminated between different severities of PAH. Conclusions Gas exchange variables obtained during light submaximal exercise differentiated PAH patients from healthy controls and also between different severities of PAH. Submaximal exercise gas exchange may be a useful endpoint measure in a PAH population.

Woods, Paul R; Frantz, Robert P; Taylor, Bryan J; Olson, Thomas P; Johnson, Bruce D

2011-01-01

253

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

ERIC Educational Resources Information Center

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

Flint, Steve; Stewart, Terry

2010-01-01

254

Cardiopulmonary Resuscitation and Older Adults' Expectations.  

ERIC Educational Resources Information Center

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)

Godkin, M. Dianne; Toth, Ellen L.

1994-01-01

255

Cardiopulmonary cerebral resuscitation in neonatal foals  

Microsoft Academic Search

Cardiovascular or pulmonary system failure in neonatal foals requires rapid recognition and initiation of cardiopulmonary cerebral resuscitation (CPCR). Foals may require resuscitation immediately after birth or after arrest from progression of a disease process such as severe sepsis or septic shock. Initial treatment is aimed at establishing an airway and providing ventilation. Circulation is provided by closed-chest compressions. Circulatory access

C. Langdon Fielding; K. Gary Magdesian

2003-01-01

256

Neurological Complications after Cardiopulmonary Bypass: An Update  

Microsoft Academic Search

Introduction: Neurological complications are, at the present time, considered among the most important causes of morbidity and mortality after heart surgery. We evaluated their importance and risk factors. Patients and Methods: We retrospectively reviewed 2,528 consecutive patients who underwent cardiopulmonary bypass in a single center. In each one, we attended to previous vascular risk factors, such as surgical and postoperative

Y. Carrascal; A. L. Guerrero; L. C. Maroto; J. M. Cortina; J. E. Rodríguez; E. Renes; J. J. Rufilanchas

1999-01-01

257

Textile Sensing Interfaces for Cardiopulmonary Signs Monitoring  

Microsoft Academic Search

A wearable system able to monitor cardiopulmonary vital signs is presented. The innovative technological core of the system is based on the use of a textile conformable sensing cloth, where conducting and piezoresistive materials are integrated in form of fibres and yarns, giving rise to fabric sensors, electrodes and connections. Electrocardiogram and impedance pneumography signals are acquired through the same

G. Loriga; N. Taccini; D. De Rossi; R. Paradiso

2005-01-01

258

Reduction of Allogeneic Blood Transfusions After Open Heart Operations by Lowering Cardiopulmonary Bypass Prime Volume  

Microsoft Academic Search

Background. Despite recent advances in blood conservation techniques, up to 30% to 80% of patients undergoing open heart operations require allogeneic blood transfusions. A prospective, randomized study was performed to test the effect of lowering cardiopulmonary bypass prime volume (as an additional component of an integrated blood conservation strategy) on clinical outcome and allogeneic blood transfusion.Methods. One hundred fourteen patients

Oz M Shapira; Gabriel S Aldea; Patrick R Treanor; Robin M Chartrand; Kolleen M DeAndrade; Harold L Lazar; Richard J Shemin

1998-01-01

259

Brain microvascular function during cardiopulmonary bypass  

SciTech Connect

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.

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

1987-11-01

260

Influence of the incremental step size in work rate on exercise response and gas exchange in patients with pulmonary hypertension  

PubMed Central

Background Cardiopulmonary exercise testing (CPET) has become increasingly important as a routine procedure in daily clinical work. So far, it is generally accepted that an individualized exercise protocol with exercise duration of 6 to 12 minutes is preferable to assess maximal exercise performance. The aim of this study was to compare an individualized NYHA adapted exercise protocol with a fixed standard protocol in patients with severe pulmonary arterial hypertension. Methods Twenty-two patients (17 female, 5 male; mean age 49 ± 14 yrs) underwent symptom limited CPET on a bicycle. On two consecutive days each subject performed a stepwise CPET according to a modified Jones protocol (16 Watt per minute stages) as well as an individualized NYHA adapted protocol with 5 or 10 Watt/min stages in a randomized order. Oxygen uptake at peak exercise (peakVO2) and anaerobic threshold (VO2AT), maximal ventilation (VE), breathing reserve (VE/MVV), ventilatory efficiency (VE vs. VCO2 slope), exercise time, maximal power and work rate were assessed and compared between both protocols. Results Comparing both, adapted NYHA protocol and standardized Jones protocol, we found significant differences in maximal power (56.7 ± 19 W vs. 74 ± 18 W; p < 0.001) and exercise time (332 ± 107 sec. vs. 248 ± 72 sec.; p < 0.001). In contrast, no significant differences were obvious comparing both protocols concerning work rate, VE, VE/MVV, peakVO2, VO2AT and VE vs. VCO2 slope. Conclusion Variations of incremental step size during CPET significantly affect exercise time and maximal power, whereas relevant parameters for clinical judgement and prognosis such as oxygen uptake, ventilation and ventilatory efficiency remain unchanged. These findings have practical implications for the exercise evaluation of patients with pulmonary hypertension. To reach maximal results for ventilation, oxygen uptake and gas exchange an individualization of incremental step size appears not to be mandatory.

Glaser, Sven; Lodziewski, Sven; Koch, Beate; Opitz, Christian F; Volzke, Henry; Ewert, Ralf

2008-01-01

261

Responses to training and standardised exercise test in the athlete horse: changes in blood gas profile  

Microsoft Academic Search

In order to assess the relationship between blood gas profile and athletic performance after a specific training programme,\\u000a six clinically healthy Italian saddle horses were used. Each animal was subjected to an adaptation period constituted by horse\\u000a walker exercise, followed by a training programme for 3 months. In the last day of each month, all horses were subjected to\\u000a a standardized

Stefania Casella; Daniela Alberghina; Claudia Giannetto; Giuseppe Piccione

262

Echocardiography during treadmill exercise testing in a patient with mitral stenosis.  

PubMed

Treadmill exercise echocardiography with Doppler during effort has been used for several years in our department. This form of echocardiography is used mainly in evaluation of patients with coronary heart disease and it is being increasingly used in valvular heart disease. We report the case of a 49-year-old woman with moderate mitral stenosis, in which stress echocardiography was important in making correct clinical decisions. PMID:19438154

Almeida, Ana Rita; Cotrim, Carlos; Miranda, Rita; Almeida, Sofia; Lopes, Luís; Loureiro, Maria J; Simões, Otília; Cordeiro, Pedro; Fazendas, Paula; João, Isabel; Carrageta, Manuel

2009-02-01

263

A Test of Self-Determination Theory in the Exercise Domain  

Microsoft Academic Search

In accordance with self-determination theory (SDT; Deci & Ryan, 1985), this study examined the relationship between autonomy support, psychological need satis- faction, motivational regulations, and exercise behavior. Participants (N5369) were recruited from fitness, community, and retail settings. Fulfillment of the 3 basic psychological needs (i.e., competence, autonomy, and relatedness) related to more self-determined motivational regulations. Identified and introjected regula- tions

Jemma Edmunds; Nikos Ntoumanis; Joan L. Duda

2006-01-01

264

Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease.  

PubMed

We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS by electron beam computed tomography (Agatston score), and exercise testing. Decision-making was based on CCS. When CCS>or=400, coronary angiography (CAG) was recommended. When CCS<10, patients were discharged. Exercise tests were graded as positive, negative or nondiagnostic. The combined endpoint was defined as coronary event or obstructive CAD at CAG. During 12+/-4 months, CCS>or=400, 10-399 and <10 were found in 42, 103 and 159 patients and the combined endpoint occurred in 24 (57%), 14 (14%) and 0 patients (0%), respectively. In 22 patients (7%), myocardial perfusion scintigraphy was performed instead of exercise testing due to the inability to perform an exercise test. A positive, nondiagnostic and negative exercise test result was found in 37, 76 and 191 patients, and the combined endpoint occurred in 11 (30%), 15 (20%) and 12 patients (6%), respectively. Receiver-operator characteristics analysis showed that the area under the curve of 0.89 (95% CI: 0.85-0.93) for CCS was superior to 0.69 (95% CI: 0.61-0.78) for exercise testing (P<0.0001). In conclusion, measurement of CCS is an appropriate initial screening test in a well-defined low-risk population with suspected CAD. PMID:17901959

Geluk, Christiane A; Dikkers, Riksta; Perik, Patrick J; Tio, René A; Götte, Marco J W; Hillege, Hans L; Vliegenthart, Rozemarijn; Houwers, Janneke B; Willems, Tineke P; Oudkerk, Matthijs; Zijlstra, Felix

2008-02-01

265

Exercise Interventions in Children with Cancer: A Review  

PubMed Central

The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL) diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.

Huang, Tseng-Tien; Ness, Kirsten K.

2011-01-01

266

Determinants of exercise capacity in cystic fibrosis patients with mild-to-moderate lung disease  

PubMed Central

Background Adult patients with cystic fibrosis (CF) frequently have reduced exercise tolerance, which is multifactorial but mainly due to bronchial obstruction. The aim of this retrospective analysis was to determine the mechanisms responsible for exercise intolerance in patients with mild-to-moderate or severe disease. Methods Cardiopulmonary exercise testing with blood gas analysis at peak exercise was performed in 102 patients aged 28?±?11 years: 48 patients had severe lung disease (FEV1?exercise were independent determinants of exercise capacity (R2?=?0.67). FEV1 was the major significant predictor of VO2 peak impairment in group 1, accounting for 31% of VO2 peak alteration, whereas excessive overall hyperventilation (reduced or absent breathing reserve and VE/VCO2) accounted for 41% of VO2 alteration in group 2. Conclusion Exercise limitation in adult patients with CF is largely dependent on FEV1 in patients with severe lung disease and on the magnitude of the ventilatory response to exercise in patients with mild-to-moderate lung disease.

2014-01-01

267

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

PubMed Central

Background Asymptomatic subjects at intermediate coronary risk may need diagnostic testing for risk stratification. Both measurement of coronary calcium scores and exercise testing are well established tests for this purpose. However, it is not clear which test should be preferred as initial diagnostic test. We evaluated the prevalence of documented coronary artery disease (CAD) according to calcium scores and exercise test results. Methods Asymptomatic subjects with ST-T changes on a rest ECG were selected from the population based PREVEND cohort study and underwent measurement of calcium scores by electron beam tomography and exercise testing. With calcium scores ?10 or a positive exercise test, myocardial perfusion imaging (MPS) or coronary angiography (CAG) was recommended. The primary endpoint was documented obstructive CAD (?50% stenosis). Results Of 153 subjects included, 149 subjects completed the study protocol. Calcium scores ?400, 100–399, 10–99 and <10 were found in 16, 29, 18 and 86 subjects and the primary endpoint was present in 11 (69%), 12 (41%), 0 (0%) and 1 (1%) subjects, respectively. A positive, nondiagnostic and negative exercise test was present in 33, 27 and 89 subjects and the primary endpoint was present in 13 (39%), 5 (19%) and 6 (7%) subjects, respectively. Receiver operator characteristics analysis showed that the area under the curve, as measure of diagnostic yield, of 0.91 (95% CI 0.84–0.97) for calcium scores was superior to 0.74 (95% CI 0.64–0.83) for exercise testing (p = 0.004). Conclusion Measurement of coronary calcium scores is an appropriate initial non-invasive test in asymptomatic subjects at increased coronary risk.

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

2007-01-01

268

Cardiopulmonary function in bicycle racing over mountainous terrain at moderate altitude  

NASA Astrophysics Data System (ADS)

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.

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

1995-09-01

269

A new exercise test for the assessment of heart failure: use of a self powered treadmill.  

PubMed

Time limited exercise on a self powered treadmill was evaluated as a method of assessing functional capacity in patients with mild heart failure. The characteristics of the treadmill were established by exercising 11 controls at three speeds and two inclinations and comparing oxygen consumption with that on a motorised treadmill under the same conditions. Oxygen consumption on the self powered treadmill at an equivalent speed and inclination was significantly higher because of the work needed to overcome the friction of the belt. Unlike a conventional treadmill, increasing the gradient on the self powered treadmill did not increase oxygen consumption. The distance walked in 12 minutes on the self powered treadmill was measured in eight patients with mild heart failure and ten controls. Maximal oxygen consumption was measured in the same group on a conventional treadmill by a mass spectrometer. There was a significant correlation between the distance walked and maximum oxygen consumption. In patients with mild heart failure the distance travelled in 12 minutes on a self powered treadmill provides a practical, inexpensive, and sensitive method of assessing functional capacity. PMID:2736193

Parameshwar, J; Dambrink, J H; Sparrow, J; Wright, C; Park, A; Tweed, J; Poole-Wilson, P A

1989-05-01

270

Exercise induced hypoglycaemic hyperinsulinism  

PubMed Central

BACKGROUND—Hyperinsulinism in childhood is often caused by genetic defects involving the regulation of insulin secretion leading to recurrent episodes of hypoglycaemia. We report two patients with exercise induced hypoglycaemia.?METHODS—Standardised short exercise tests with frequent blood glucose and plasma insulin measurements were performed in the patients and young healthy controls.?RESULTS—Short term exercise resulted in insulin induced hypoglycaemia 15 to 50 minutes after the end of exercise. A massive burst of insulin secretion was observed within a few minutes of the start of exercise in both patients. By contrast glucose and insulin concentrations remained unchanged in healthy controls.?CONCLUSIONS—Hyperinsulinaemic hypoglycaemia after moderate physical exercise represents a rarely described phenotype of hyperinsulinism with an as yet unknown defect in the regulation of insulin secretion. It should be suspected in individuals with recurrent exercise related syncope or disturbance of consciousness.??

Meissner, T; Otonkoski, T; Feneberg, R; Beinbrech, B; Apostolidou, S; Sipila, I; Schaefer, F; Mayatepek, E

2001-01-01

271

Cardiopulmonary changes during clarinet playing.  

PubMed

Since playing wind instrument impedes normal respiratory functions, its effect on expiratory and blood gases as well as on cardiac function was investigated. In 15 skilled clarinettists expiratory PO(2) and PCO(2) were measured in gas drawn from a modified clarinet barrel when playing a composition (Robert Schumann's "Phantasiestücke" Op. 73 for clarinet and piano) with increasing difficulty from movement 1 to movement 3. Blood gases were measured in arterialized ear lobe blood at the end of each movement and the electrocardiogram was recorded continuously. From the expiratory gas pressures one may conclude that the most advanced players adapt their ventilation to the requirements of the composition and sustain expiration during difficult parts of the composition until hypoxic alveolar PO(2) values are reached (minimum 77 mmHg). Less trained clarinettists tend to hyperventilation or shallow breathing. Oxygen saturation in arterialized blood showed a slight step-wise decrease from movement to movement [control 96.6 ± 0.5 (SD)%, end of concert 95.6 ± 1.0%]. SO(2) was significantly higher because of possibly more effective ventilation in instrumentalists with practise time exceeding 2 h daily. Mean heart rate increased to values like during moderate to heavy physical exercise depending on artistic fitness and the difficulty of the movement (maximal individual value 173 beats/min). Additionally, a large variation might be caused through intrathoracic pressure changes, changing exertion, respiratory influences and emotion. The electrocardiogram showed no pathological events. In general, clarinet playing at a professional level imposes strain on ventilation and circulation but usually not on a pathophysiological level. PMID:20734060

Hahnengress, Maria L; Böning, Dieter

2010-12-01

272

Updates on Cardiac Arrest and Cardiopulmonary Resuscitation  

Microsoft Academic Search

Cardiac arrest is a dramatic clinical event that can occur suddenly, often without premonitory signs. The condition is characterized\\u000a by sudden loss of consciousness due to the lack of cerebral blood flow, which occurs when the heart ceases to pump. This phenomenon\\u000a is potentially reversible if cardiopulmonary resuscitation (CPR) procedures are started early, but it becomes irreversible\\u000a without interventions or

G. Ristagno; A. Gullo; W. Tang; M. H. Weil

273

Relationship between exercise behavior, cardiorespiratory fitness, and cognitive function in early breast cancer patients treated with doxorubicin-containing chemotherapy: a pilot study.  

PubMed

The purpose of this study was to examine the relationship between self-reported exercise behavior, cardiorespiratory fitness (CRF), and cognitive function in early breast cancer patients. Thirty-seven breast cancer patients following completion of chemotherapy (median 16 months) and 14 controls were studied. Cognitive function was assessed using the Central Nervous System (CNS) Vital Signs software (CNS Vital Signs, LLC, Morrisville, N.C., USA), a computerized test battery consisting of 9 cognitive subtests. Exercise behavior was evaluated using the Godin Leisure Time Exercise Questionnaire, and CRF was assessed via a cardiopulmonary exercise test to assess peak oxygen consumption. Patients' mean total exercise was 184 ± 141 min·week(-1) compared with 442 ± 315 min·week(-1) in controls (p < 0.001). Significantly fewer patients (32%) were meeting exercise guidelines (i.e., ?150 min of moderate-intensity or vigorous exercise per week) compared with 57% of controls (p = 0.014). Patients' peak oxygen consumption averaged 23.5 ± 6.3 mL·kg(-1)·min(-1) compared with 30.6 ± 7.0 mL·kg(-1)·min(-1) in controls (p < 0.01). Scores on the cognitive subdomains were generally lower in patients compared with controls, although only the difference in verbal memory was significant (unadjusted p = 0.041). In patients, weak to moderate correlations were indicated between exercise, peak oxygen consumption, and the majority of cognitive subdomain scores; however, there was a significant positive correlation between exercise and visual memory (r = 0.47, p = 0.004). In conclusion, breast cancer patients following the completion of primary adjuvant chemotherapy exhibit, in general, worse cognitive performance than healthy women from the general population, and such performance may be related to their level of exercise behavior. PMID:24869976

Crowgey, Theresa; Peters, Katherine B; Hornsby, Whitney E; Lane, Amy; McSherry, Frances; Herndon, James E; West, Miranda J; Williams, Christina L; Jones, Lee W

2014-06-01

274

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

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.

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

275

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

NASA Astrophysics Data System (ADS)

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

Schricker, Bradley C.; Antalek, Christopher

2006-06-01

276

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

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.

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

277

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

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Roller-type cardiopulmonary bypass blood pump. 870.4370...870.4370 Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device...

2010-04-01

278

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

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Roller-type cardiopulmonary bypass blood pump. 870.4370...870.4370 Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device...

2009-04-01

279

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

Code of Federal Regulations, 2010 CFR

... false Nonroller-type cardiopulmonary bypass blood pump. 870.4360...4360 Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device...

2009-04-01

280

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

Code of Federal Regulations, 2010 CFR

... false Nonroller-type cardiopulmonary bypass blood pump. 870.4360...4360 Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device...

2010-04-01

281

Bioavailable transition metals in particulate matter mediate cardiopulmonary injury in healthy and compromised animal models.  

PubMed Central

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.

Costa, D L; Dreher, K L

1997-01-01

282

Validity of COSMED's quark CPET mixing chamber system in evaluating energy metabolism during aerobic exercise in healthy male adults.  

PubMed

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

Nieman, David C; Austin, Melanie D; Dew, Dustin; Utter, Alan C

2013-01-01

283

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

SciTech Connect

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.

Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

1986-10-01

284

A simple and portable paced step test for reproducible measurements of ventilation and oxygen consumption during exercise.  

PubMed

A single work rate paced step test is described. It was designed to allow the measurement of minute ventilation (VI) and oxygen consumption (VO2), under standardised conditions, during exercise in the clinic and lung function laboratory and in field work. The subjects and the operator found the test simple to perform. The values for ventilation at a given oxygen consumption were similar to those from more complex and stressful tests and had a high degree of reproducibility. The ergometer was a 12 inch (30 cm) step with hand rails. The subjects stepped down, once every four seconds in response to a buzzer for 10 minutes. VI and VO2 were measured with a small portable device. In 53 normal subjects of mean weight 69 (range 49-107) kg, mean VO2 measured during the last 5 minutes of the test was 0.89 (range 0.53-1.52) 1/min. Weight and height were independent contributors to the oxygen cost of stepping. The ventilatory equivalent for oxygen (VIO2, which equals VI divided by VO2) increased with age, and was similar to normal values for ventilation at 1.01/min VO2 obtained by workers who used multiple work rate tests on more complex equipment. The within subject variation in VIO2, expressed as the coefficient of variation (cv) and calculated for each age decade, was 14%. This again compared very favourably with the cv for values of ventilation at 1.01/min VO2 from other studies. In 20 normal subjects daily testing showed significant falls in VO2 and V1 over three days of 4% and 5.9% respectively; VIO2 fell by 2%. Testing over four consecutive weeks showed small significant differences between weeks but no clear trend; the within subject weekly variation accounted for less than 3.5% of the total variance for each of the variables. Testing at least four months apart showed a 3.3% fall in the oxygen cost of stepping. No significant diurnal effects on the exercise responses were found. PMID:3433238

Jones, P W; Wakefield, J M; Kontaki, E

1987-02-01

285

Effects of periodic task-specific test feedback on physical performance in older adults undertaking band-based resistance exercise.  

PubMed

The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65-83 years) were assigned to a muscular perfsormance feedback group (MPG, n = 32) or a functional mobility feedback group (FMG, n = 20). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant (P < 0.05) interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities. PMID:24616808

Hasegawa, Ryuichi; Islam, Mohammod Monirul; Watanabe, Ryuji; Tomiyama, Naoki; Taaffe, Dennis R

2014-01-01

286

Effects of Periodic Task-Specific Test Feedback on Physical Performance in Older Adults Undertaking Band-Based Resistance Exercise  

PubMed Central

The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65–83 years) were assigned to a muscular perfsormance feedback group (MPG, n = 32) or a functional mobility feedback group (FMG, n = 20). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant (P < 0.05) interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities.

Islam, Mohammod Monirul; Watanabe, Ryuji; Taaffe, Dennis R.

2014-01-01

287

Exercise and the preservation of bone health.  

PubMed

Exercise is generally accepted as having favorable effects on bone health and, subsequently, a reduction in fracture risk. In the absence of large randomized controlled trials of the potential benefits of exercise on fracture risk, support for this belief comes from cross-sectional studies and interventional studies using surrogate endpoints such as bone mineral density and falls. In this review, we discuss the characteristics of exercise programs that provide an osteogenic stimulus. The goals and benefits of exercise on bone across the age spectrum are discussed. Where there is a paucity of human data, animal studies examining the roles of variables such as exercise intensity, frequency, duration, and mode in shaping the response of bone to exercise are discussed. The effects of disuse and the limited response of bone to remobilization are described. The rapid and dramatic decrease in bone mineral density observed in the early period after heart or lung transplantation is discussed, as are the available data on the benefits of exercise on bone in this population. For cardiopulmonary rehabilitation programs to improve bone health, they should include not just weight-supported activities (eg, cycling) but also weight-bearing activities (eg, walking, resistance exercise). Although the optimal exercise routine for bone health is unknown, components of an osteogenic program are discussed. PMID:18496313

Barry, Daniel W; Kohrt, Wendy M

2008-01-01

288

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

NASA Technical Reports Server (NTRS)

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.

Naifeh, K.

1985-01-01

289

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

PubMed

Haladay, DE, Miller, SJ, Challis, JH, and Denegar, CR. Responsiveness of the double limb lowering test and lower abdominal muscle progression to core stabilization exercise programs in healthy adults: A pilot study. J Strength Cond Res 28(7): 1920-1927, 2014-Low back pain (LBP) is one of the most prevalent and expensive health care problems in the United States. Studies suggest that stabilization exercise may be effective in the management of people with LBP. To accurately assess the effect of stabilization programs on muscle performance, clinicians need an objective measure that is both valid and reliable. The purpose of this study was to determine whether the double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) can detect a change in abdominal muscle performance after stabilization exercises. Eleven healthy participants (4 men and 7 women) were randomly assigned to either a specific stabilization exercise (SSE) or general stabilization exercise (GSE) group and were evaluated by the DLLT and LAMP before, during, and at the end of 8 weeks of training. Subjects attended exercise sessions twice per week over 8 weeks. No significant difference in pretest performance existed between the 2 groups. No significant difference was detected with the DLLT for either the SSE or GSE over time or when groups were combined. The LAMP detected a significant difference for the combined groups and GSE but not SSE over time. These data indicate that the LAMP is sensitive to change after a spinal stabilization program, whereas the DLLT does not detect a change after these programs. Furthermore, the GSE was more effective in producing these changes. Additional testing of these assessments is necessary to further validate these tests and to identify specific populations for which these tests may be most appropriate. PMID:24343322

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

2014-07-01

290

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

PubMed

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

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

2013-04-01

291

Effects of Cardiopulmonary Bypass on Propofol Pharmacokinetics and Bispectral Index During Coronary Surgery  

PubMed Central

PURPOSE Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10) or off-pump coronary artery bypass graft (group, n=10) coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 ?g/mL). Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04). Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01) and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01) half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03), compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

Barbosa, Ricardo Antonio G.; Jorge Santos, Silvia Regina C.; White, Paul F.; Pereira, Valeria A.; Silva Filho, Carlos R.; Malbouisson, Luiz M. S.; Carmona, Maria Jose C.

2009-01-01

292

Cardiopulmonary fitness and respirator clearance: an update.  

PubMed

This review addresses five key questions regarding respirator clearance: What is the efficacy of different methods of respirator clearance? Which diagnostic test is most predictive of cardiac event during respirator use? Is spirometry accurate in predicting respiratory distress/insufficiency during respirator use? Is exercise tolerance testing accurate in predicting cardiac injury during respirator use? Which periodicity of clearance evaluations is most protective against cardiac event during respirator use? The medical literature was searched using PubMed, the Cochrane Library, and Web of Science. Relevant articles were reviewed to assess current recommendations and practices in respirator clearance. Between the years 1970 and 2011, 144 articles were identified, and 21 were included in this review. Current recommendations for respirator clearance are based on consensus rather than outcome studies, and opinions differed between expert sources. Many authors observed the need for cost-effective respirator clearance, but none proposed evidence-based strategies. Prospective studies on respirator clearance that evaluate cardiac and pulmonary outcomes are necessary to establish an evidence base for improving the validity, efficiency, and consistency of respirator clearance testing. PMID:23530599

Belafsky, Sheri; Vlach, Justin; McCurdy, Stephen A

2013-01-01

293

A Simple New Visualization of Exercise Data Discloses Pathophysiology and Severity of Heart Failure  

PubMed Central

Background The complexity of cardiopulmonary exercise testing data and their displays tends to make assessment of patients, including those with heart failure, time consuming. Methods and Results We postulated that a new single display that uses concurrent values of oxygen uptake / ventilation versus carbon dioxide output / ventilation ratios (–versus–), plotted on equal X–Y axes, would better quantify normality and heart failure severity and would clarify pathophysiology. Consecutive –versus– values from rest to recovery were displayed on X–Y axes for patients with Class II and IV heart failure and for healthy subjects without heart failure. The displays revealed distinctive patterns for each group, reflecting sequential changes in cardiac output, arterial and mixed venous O2 and CO2 content differences, and ventilation (). On the basis of exercise tests of 417 healthy subjects, reference formulas for highest and , which normally occur during moderate exercise, are presented. Absolute and percent predicted values of highest and were recorded for 10 individuals from each group: Those of healthy subjects were significantly higher than those of patients with Class II heart failure, and those of patients with Class II heart failure were higher than those of patients with Class IV heart failure. These values differentiated heart failure severity better than peak , anaerobic threshold, peak oxygen pulse, and slopes. Resting –versus– values were strikingly low for patients with Class IV heart failure, and with exercise, increased minimally or even decreased. With regard to the pathophysiology of heart failure, high values during milder exercise, previously attributed to ventilatory inefficiency, seem to be caused primarily by reduced cardiac output rather than increased . Conclusion –versus– measurements and displays, extractable from future or existing exercise data, separate the 3 groups (healthy subjects, patients with Class II heart failure, and patients with Class IV heart failure) well and confirm the dominant role of low cardiac output rather than excessive in heart failure pathophysiology. (J Am Heart Assoc. 2012;1:e001883 doi: 10.1161/JAHA.112.001883.)

Hansen, James E.; Sun, Xing-Guo; Stringer, William W.

2012-01-01

294

Cerebral air embolism in a neonate following cardiopulmonary resuscitation  

Microsoft Academic Search

Sir, We would like to comment on our analysis of the case reported as a Clinical Image titled “Cerebral air embolism in the neonate following cardiopulmonary resuscitation” [1]. It was stated that the patient had a sudden cardiopulmonary arrest and then resuscitation was started but without success; subsequently head CT demonstrated extensive vascular air. The submitted CT scan demonstrated, by

Stuart A. Royal; Arnold C. Merrow Jr

2009-01-01

295

Basics of cardiopulmonary bypass: normal and abnormal postoperative CT appearances.  

PubMed

Cardiothoracic surgical procedures with and without cardiopulmonary bypass are becoming more commonly performed as surgical techniques improve and the population ages. Changes related to cardiopulmonary bypass are often depicted at routine postoperative computed tomographic (CT) studies performed for various reasons. The purpose of this article is to present knowledge critical to the accurate postoperative evaluation of the patient who has undergone cardiopulmonary bypass. This article will review the surgical technique for cardiopulmonary bypass, as well as the associated normal and abnormal postoperative imaging findings. Common cannulation sites used for cardiopulmonary bypass include the ascending aorta, axillary artery, right atrium, superior vena cava, and inferior vena cava. Normal postoperative findings related to cardiopulmonary bypass include (a) felt pledgets, which are used to reinforce cannulation sites; (b) oversewn side grafts; and (c) oversewn graft side branches. These normal postoperative findings can be mistaken for abnormalities. Abnormal postoperative findings related to cardiopulmonary bypass include pseudoaneurysm formation at cannulation sites, aortic dissection, and seroma formation. An awareness of normal and abnormal postoperative CT findings related to cardiopulmonary bypass is critical for all radiologists who interpret chest CT studies, to help prevent unnecessary further evaluation and to help direct prompt treatment when warranted. PMID:23322827

El-Sherief, Ahmed H; Wu, Carol C; Schoenhagen, Paul; Little, Brent P; Cheng, Allen; Abbara, Suhny; Roselli, Eric E

2013-01-01

296

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

NASA Technical Reports Server (NTRS)

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

Ivanco, Thomas G.

2013-01-01

297

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

PubMed Central

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

2013-01-01

298

NONINVASIVE CARDIAC OUTPUT MONITORING DURING EXERCISE TESTING: NEXFIN PULSE CONTOUR ANALYSIS COMPARED TO AN INERT GAS REBREATHING METHOD AND RESPIRED GAS ANALYSIS  

Microsoft Academic Search

Purpose. Exercise testing is often used to assess cardiac function during physical exertion to obtain diagnostic information. However, this procedure is limited to measuring the electrical activity of the heart using electrocardiography and intermittent blood pressure (BP) measurements and does not involve the continuous assessment of heart functioning. In this study, we compared continuous beat-to-beat pulse contour analysis to monitor

S. A. Bartels; W. J. Stok; R. Bezemer; R. J. Boksem; J Goudoever; T. G. V. Cherpanath; Lieshout van J. J; B. E. Westerhof; J. M. Karemaker; C. Ince

2011-01-01

299

The Value of the First Two Minutes of Heart Rate Recovery after Exercise Treadmill Test in Predicting the Presence and Severity of Coronary Artery Disease  

Microsoft Academic Search

Background and Objectives:The recent data has revealed that the first 1 minute and 2 minutes of heart rate re- covery of patients who are being evaluated for chest pain and asymptomatic adults are associated with the overall mortality. However, the clinical significance of the heart rate recovery after exercise testing during the first 2 min- utes for predicting the presence

Soo-Hee Choi; Kwang-Je Lee; Kwang-Ho Lee; Kyung-Hun Lee; Yeo-Won Choi; Ki-Woo Seo; Eun-Young Kim; Wang-Soo Lee; Sang-Wook Kim; Tae-Ho Kim; Chee-Jeong Kim; Wang-Seong Ryu

2007-01-01

300

Coherence between heart rate and dominant frequency of the time-frequency heart rate variability spectrum as ischemic marker in the exercise test  

Microsoft Academic Search

Observation on heart rate (HR) and heart rate variability (HRV) trends in exercise ECGs lead us to hypothesize that some correlation exists between the evolution of HR and the dominant HRV frequency, which may differ in ischemic and healthy subjects. The ECGs recordings from stress test trials were collected and clustered into four groups: ischemic (positive coronary angiography), non-ischemic, volunteers

M. Canales; J. Mateo; R. Bailon; P. Laguna; P. Serrano

2003-01-01

301

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

NASA Astrophysics Data System (ADS)

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

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

2003-06-01

302

Recovery of cardiopulmonary reflexes in monkeys undergoing heart-lung transplantation.  

PubMed

After heart-lung transplantation in primates, cardiopulmonary reflexes were tested and shown to be present. The Hering-Breuer and cough reflexes were tested, as well as responses to an inhaled respiratory stimulant, vasodilator, and an intravenous anticholinesterase and antimuscarinic agent. Recovery of these responses, except to the anticholinesterase agent, suggests that reinervation occurs in autotransplanted organs in primates. The Hering-Breuer reflex was present at 1.9 and 2.2 months after the operation in two animals subjected to autotransplantation. These cardiopulmonary reflex responses were also demonstrated in two allograft recipients studied at 15 and 16.9 months after the operation. Return of protective reflexes such as coughing may be an important mechanism to prevent aspiration pneumonitis and other complications in humans. PMID:2796358

Mihm, F G; Popovic, B K; Noe, C; Hilberman, M; Reitz, B A

1989-10-01

303

VOCATIONAL TALENT EXERCISES, PART D.  

ERIC Educational Resources Information Center

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

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

304

Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test  

PubMed Central

Background Increasing activity levels in adolescents with obesity requires the development of exercise programs that are both attractive to adolescents and easily reproducible. The aim of this study was to develop a modular aerobic training program for adolescents with severe obesity, with a focus on variety, individual targets and acquiring physical skills. We report here the effects on aerobic fitness from a pilot study. Furthermore, we examined the feasibility of the modified shuttle test (MST) as an outcome parameter for aerobic fitness in adolescents with severe obesity. Methods Fifteen adolescents from an inpatient body weight management program participated in the aerobic training study (age 14.7 ± 2.1 yrs, body mass index 37.4 ± 3.5). The subjects trained three days per week for 12 weeks, with each session lasting 30–60 minutes. The modular training program consisted of indoor, outdoor and swimming activities. Feasibility of the MST was studied by assessing construct validity, test-retest reliability and sensitivity to change. Results Comparing pretraining and end of training period showed large clinically relevant and significant improvements for all aerobic indices: e.g. VO2 peak 17.5%, effect size (ES) 2.4; Wmax 8%, ES 0.8. In addition, a significant improvement was found for the efficiency of the cardiovascular system as assessed by the oxygen pulse (15.8%, ES 1.6). Construct validity, test-retest reliability and sensitivity to change of the MST were very good. MST was significantly correlated with VO2 peak (r = 0.79) and Wmax (r = 0.84) but not with anthropometric measures. The MST walking distance improved significantly by 32.5%, ES 2.5. The attendance rate at the exercise sessions was excellent. Conclusion This modular, varied aerobic training program has clinically relevant effects on aerobic performance in adolescents with severe obesity. The added value of our aerobic training program for body weight management programs for adolescents with severe obesity should be studied with a randomized trial. This study further demonstrated that the MST is a reliable, sensitive and easy to administer outcome measure for aerobic fitness in adolescent body weight management trials.

Klijn, Peter HC; van der Baan-Slootweg, Olga H; van Stel, Henk F

2007-01-01

305

Early exercise testing and elective coronary artery bypass surgery after uncomplicated myocardial infarction. Effect on morbidity and mortality  

Microsoft Academic Search

One hundred and nineteen consecutive patients were studied prospectively after uncomplicated myocardial infarction by maximal exercise electrocardiography at two weeks and coronary angiography at six weeks. At angiography 87 patients had a stenosis greater than 70% in one major coronary artery supplying residual viable myocardium outside the infarction zone. In 82 (94%) of these the 12 lead maximal exercise electrocardiogram

F Akhras; J Upward; J Keates; G Jackson

1984-01-01

306

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

EPA Science Inventory

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

307

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

NASA Technical Reports Server (NTRS)

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

Convertino, Victor A.

2003-01-01

308

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

EPA Science Inventory

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

309

Reduction of platelet thrombi and emboli by L-arginine during cardiopulmonary bypass in a pig model  

Microsoft Academic Search

We wanted to test the hypothesis that NO generation by L-arginine (LA) infusion will be beneficial in increasing blood flow to all organs to counteract the process of global ischemia during cardiopulmonary bypass (CPB) and to reduce platelet emboli by platelet inhibition. The effect of LA infusion on NO formation, vasodilation, and reduction of thromboembolic burden in organs and tissues

Mrinal K. Dewanjee; Shu Ming Wu; Mansoor Kapadvanjwala; Dibyendu De; Sumit Dewanjee; Stana Novak; Li-Chien Hsu; Richard A. Perryman; Aldo N. Serafini; George N. Sfakianakis; Robert C. Duncan; W. Dalton Dietrich; Allan F. Horton

1996-01-01

310

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery  

Microsoft Academic Search

BackgroundAcute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hematocrit 22% to 24%) during cardiopulmonary bypass (CPB) has been linked to adverse outcomes after cardiac surgery. Therefore we tested the hypothesis that lowest hematocrit during CPB is independently associated

Madhav Swaminathan; Barbara G Phillips-Bute; Peter J Conlon; Peter K Smith; Mark F Newman; Mark Stafford-Smith

2003-01-01

311

The Association of Lowest Hematocrit During Cardiopulmonary Bypass With Acute Renal Injury After Coronary Artery Bypass Surgery  

Microsoft Academic Search

Background. Acute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hemat- ocrit 22% to 24%) during cardiopulmonary bypass (CPB) has been linked to adverse outcomes after cardiac sur- gery. Therefore we tested the hypothesis that lowest hematocrit during CPB

Madhav Swaminathan; Barbara G. Phillips-Bute; Peter J. Conlon

2010-01-01

312

Can minimized cardiopulmonary bypass systems be safer?  

PubMed

Although a growing body of evidence indicates superiority of minimized cardiopulmonary bypass (mCPB) systems over conventional CPB systems, limited venous return can result in severe fluctuations of venous line pressure which can result in gaseous emboli. In this study, we investigated the influence of sub-atmospheric pressures and volume buffer capacity added to the venous line on the generation of gaseous emboli in the mCPB circuit. Two different mCPB systems (MEC - Maquet, n=7 and ECC.O - Sorin, n=8) and a conventional closed cardiopulmonary bypass (cCPB) system (n=12) were clinically evaluated. In the search for a way to increase volume buffer capacity of mCPB systems, we additionally evaluated the 'Better Bladder' (BB) in a mock circulation by simulating, repeatedly, decreased venous return while measuring pressure and gaseous embolic activity. Arterial gaseous emboli activity during clinical perfusion with a cCPB system was the lowest in comparison to the mCPB systems (312±465 versus 311±421 with MEC and 1,966±1,782 with ECC.O, counts per 10 minute time interval, respectively; p=0.03). The average volume per bubble in the arterial line was the highest in cases with cCPB (12.5±8.3 nL versus 8.0±4.2 nL with MEC and 4.6±4.8 nL with ECC.O; p=0.04 for both). Significant cross-correlation was obtained at various time offsets from 0 to +35 s between sub-atmospheric pressure in the venous line and gaseous emboli activity in both the venous and arterial lines. The in vitro data showed that incorporation of the BB dampens fluctuations of venous line pressure by approximately 30% and decreases gaseous emboli by up to 85%. In conclusion, fluctuations of sub-atmospheric venous line pressure during kinetic-assisted drainage are related to gaseous emboli. Volume buffer capacity added to the venous line can effectively dampen pressure fluctuations resulting from abrupt changes in venous return and, therefore, can help to increase the safety of minimized cardiopulmonary bypass by reducing gaseous microemboli formation resulting from degassing. PMID:22337763

Ganushchak, Y M; Ševerdija, E E; Simons, A P; van Garsse, L; Weerwind, P W

2012-05-01

313

Acute Cardiopulmonary Failure From Sleep-Disordered Breathing  

PubMed Central

Sleep-disordered breathing (SDB) comprises a diverse set of disorders marked by abnormal respiration during sleep. Clinicians should realize that SDB may present as acute cardiopulmonary failure in susceptible patients. In this review, we discuss three clinical phenotypes of acute cardiopulmonary failure from SDB: acute ventilatory failure, acute congestive heart failure, and sudden death. We review the pathophysiologic mechanisms and recommend general principles for management. Timely recognition of, and therapy for, SDB in the setting of acute cardiopulmonary failure may improve short- and long-term outcomes.

Carr, Gordon E.; Mokhlesi, Babak

2012-01-01

314

Submaximal exercise testing in the assessment of interstitial lung disease secondary to systemic sclerosis: reproducibility and correlations of the 6-min walk test  

PubMed Central

Background The 6?min walk test (6MWT) is increasingly used as an outcome measure in interstitial lung disease (ILD). Aim To evaluate the usefulness of the 6MWT in a cohort of patients with ILD secondary to systemic sclerosis (SSc) and to correlate with established physiological parameters. Methods 163 patients with SSc?ILD were recruited for a multicentre, randomised, double?blind clinical trial. Available data at protocol screening included repeated 6MWTs, pulmonary function testing with diffusing capacity, Doppler echocardiography and high?resolution computed tomography of the thorax. Borg Dyspnoea Index was evaluated before and after 6MWT. Results Mean (standard deviation (SD)) distance walked during walk test 1 was 396.6 (84.55)?m compared with 399.5 (86.28)?m at walk test 2. The within?subject, intertest correlation as determined by Pearson's correlation coefficient testing was 0.95 (p<0.001). However, only weak correlations of 6MWT with percentage forced vital capacity and the Borg Dyspnoea Index were observed, and no correlation was observed with percentage diffusing capacity. Conclusion These data confirm the high reproducibility of the 6MWT in patients with SSc?ILD and therefore the validity of the test in this cohort. The lack of correlation of 6MWT with standard physiological parameters of ILD suggests a multifactorial basis for limited exercise capacity in patients with SSc and calls into question the utility of the 6MWT as a measure of outcome in future studies on SSc?ILD.

Buch, M H; Denton, C P; Furst, D E; Guillevin, L; Rubin, L J; Wells, A U; Matucci-Cerinic, M; Riemekasten, G; Emery, P; Chadha-Boreham, H; Charef, P; Roux, S; Black, C M; Seibold, J R

2007-01-01

315

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

PubMed Central

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

2013-01-01

316

Exercise peripheral oxygen saturation (SpO2) accurately reflects arterial oxygen saturation (SaO2) and predicts mortality in systemic sclerosis  

PubMed Central

Background Measures of oxygenation have not been assessed for prognostic significance in systemic sclerosis-related interstitial lung disease (SSc-ILD). Methods 83 subjects with SSc-ILD performed a maximal cardiopulmonary exercise test with an arterial line. The agreement between peripheral oxygen saturation (SpO2) and arterial oxygen saturation (SaO2) was examined and survival differences between subgroups of subjects stratified on SpO2 were analysed. Cox proportional hazards analyses were used to examine the prognostic capabilities of SpO2. Results At maximal exercise the mean (SD) difference between SpO2 and SaO2 was 2.98 (2.98) and only 15 subjects had a difference of >4 points. The survival of subjects with SSc-ILD whose maximum exercise SpO2 (SpO2max) fell below 89% or whose SpO2max fell >4 points from baseline was worse than subjects in comparator groups (log rank p = 0.01 and 0.01, respectively). The hazard of death during the median 7.1 years of follow-up was 2.4 times greater for subjects whose SpO2max fell below 89% (hazard ratio 2.4, 95% CI 1.1 to 4.9, p = 0.02) or whose SpO2max fell >4 points from baseline (hazard ratio 2.4, 95% CI 1.1 to 5.0, p = 0.02). Conclusion In patients with SSc-ILD, SpO2 is an adequate reflection of SaO2 and radial arterial lines need not be inserted during cardiopulmonary exercise tests in these patients. Given the ease of measurement and its prognostic value, SpO2 should be considered as a meaningful clinical and research outcome in patients with SSc-ILD.

Swigris, J J; Zhou, X; Wamboldt, F S; du Bois, R; Keith, R; Fischer, A; Cosgrove, G P; Frankel, S K; Curran-Everett, D; Brown, K K

2013-01-01

317

Validity and reliability of cardiorespiratory measurements recorded by the LifeShirt during exercise tests.  

PubMed

The LifeShirt is a novel ambulatory monitoring system that records cardiorespiratory measurements outside the laboratory. Validity and reliability of cardiorespiratory measurements recorded by the LifeShirt were assessed and two methods of calibrating the LifeShirt were compared. Participants performed an incremental treadmill test and a constant work rate test (65% peak oxygen uptake) on four occasions (>48 h apart) and wore the LifeShirt, COSMED system and Polar Sport Tester simultaneously. The LifeShirt was calibrated using two methods: comparison to a spirometer; and 800 ml fixed-volume bag. Ventilation, respiratory rate, expiratory time and heart rate recorded by the LifeShirt were compared to measurements recorded by laboratory equipment. Sixteen adults participated (6M:10 F); mean (SD) age 23.1 (2.9) years. Agreement between the LifeShirt and laboratory equipment was acceptable. Agreement for ventilation was improved by calibrating the LifeShirt using a spirometer. Reliability was similar for the LifeShirt and the laboratory equipment. This study suggests that the LifeShirt provides a valid and reliable method of ambulatory monitoring. PMID:19505672

Kent, Lisa; O'Neill, Brenda; Davison, Gareth; Nevill, Alan; Elborn, J Stuart; Bradley, Judy M

2009-06-30

318

[Successful cardiopulmonary resuscitation in prone position].  

PubMed

In certain surgical positions standard cardiopulmonary resuscitation (CPR) cannot be carried out. It is sometimes impossible or time-consuming to establish a supine position without increasing the no-flow-time and therefore creating a negative outcome of the patient. The case of CPR in a prone position during an emergency evacuation of a cerebellar hematoma is reported. The resuscitation was initiated in the prone position to decrease the no-flow-time. This was very effective because the return of spontaneous circulation (ROSC) started before turning the patient to the supine position. Resuscitation in the prone position in this case was equally as effective as in the traditional supine position. PMID:20852835

Haffner, E; Sostarich, A M; Fösel, T

2010-12-01

319

Exercise capacity after extremely preterm birth. Development from adolescence to adulthood.  

PubMed

Rationale: Extremely preterm (EP) birth is associated with a series of adverse health outcomes, some of which may be alleviated by improved physical fitness. However, EP-born subjects are reportedly less physically active than term-born peers. Exercise capacity is poorly described in this group, and longitudinal data are needed. Objectives: To compare exercise capacity of adults born EP and at term, and to address developmental patterns from adolescence to adulthood. Methods: An area-based cohort of adults, born in 1982-1985 at gestational age 28 weeks or earlier, or with birth weight of 1,000 g or less, originally examined at 18 years of age, were re-examined at 25 years of age together with individually matched term-born control subjects, using an identical maximal cardiopulmonary treadmill exercise test and validated questionnaires. Measurements and Main Results: A total of 34 (76%) eligible preterm and 33 (85%) term control subjects successfully completed the exercise test at age 25 years. In the two groups, average (95% confidence interval) peak oxygen consumption was 40.7 (37.9-43.5) and 44.2 (41.0-47.4) ml ? kg(-1)?min(-1), respectively, whereas the distance completed on the treadmill was 910 (827-993) m and 1,020 (927-1,113) m. Peak oxygen consumption was unrelated to neonatal factors and current FEV1, but was positively associated with leisure-time physical activity and negatively associated with age at examination. Values obtained at age 18 and 25 years were strongly correlated and within normal range at both examinations. Conclusions: Exercise capacity was modestly reduced in EP-born adults; however, values were within a normal range, positively associated with self-reported physical activity and unrelated to neonatal factors and current airway obstruction. PMID:24502400

Clemm, Hege H; Vollsæter, Maria; Røksund, Ola D; Eide, Geir E; Markestad, Trond; Halvorsen, Thomas

2014-05-01

320

Determination of Best Criteria to Determine Final and Initial Speeds within Ramp Exercise Testing Protocols  

PubMed Central

This study compared strategies to define final and initial speeds for designing ramp protocols. VO2max? was directly assessed in 117 subjects (29 ± 8?yrs) and estimated by three nonexercise models: (1) Veterans Specific Activity Questionnaire (VSAQ); (2) Rating of Perceived Capacity (RPC); (3) Questionnaire of Cardiorespiratory Fitness (CRF). Thirty seven subjects (30 ± 9?yrs) performed three additional tests with initial speeds corresponding to 50% of estimated VO2max? and 50% and 60% of measured VO2max?. Significant differences (P < 0.001) were found between VO2max? measured (41.5 ± 6.6?mL·kg?1·min?1) and estimated by VSAQ (36.6 ± 6.6?mL·kg?1·min?1) and CRF (45.0 ± 5.3?mL·kg?1·min?1), but not RPC (41.3 ± 6.2?mL·kg?1·min?1). The CRF had the highest ICC, the lowest SEE, and better limits of agreement with VO2max? compared to the other instruments. Initial speeds from 50%–60% VO2max? estimated by CRF or measured produced similar VO2max? (40.7 ± 5.9; 40.0 ± 5.6; 40.3 ± 5.5?mL·kg?1·min?1 resp., P = 0.14). The closest relationship to identity line was found in tests beginning at 50% VO2max? estimated by CRF. In conclusion, CRF was the best option to estimate VO2max? and therefore to define the final speed for ramp protocols. The measured VO2max? was independent of initial speeds, but speeds higher than 50% VO2max? produced poorer submaximal relationships between workload and VO2.

da Silva, Sidney C.; Monteiro, Walace D.; Cunha, Felipe A.; Myers, Jonathan; Farinatti, Paulo T. V.

2012-01-01

321

Hypertension. Part 1: How Exercise Helps.  

ERIC Educational Resources Information Center

Reviews possible mechanisms by which exercise lowers blood pressure and discusses research which indicates exercise is an effective therapy for hypertension. The article presents information to help physicians counsel hypertensive patients wanting to start an exercise program and examines the use of exercise testing to predict the onset of…

Tanji, Jeffrey L.

1990-01-01

322

Differential effects of carvedilol and metoprolol succinate on plasma norepinephrine release and peak exercise heart rate in subjects with chronic heart failure.  

PubMed

Dosing equivalency of carvedilol and metoprolol remains a debate. Degree of beta 1-blockade is best assessed by blunting of the exercise-induced heart rate. Accordingly, the authors have investigated dosing equivalency by examining baseline and peak exercise heart rates and norepinephrine levels in subjects with chronic heart failure treated with carvedilol or metoprolol. Thirty-seven subjects treated with carvedilol (32.9 +/- 3.5 mg; n = 23) or metoprolol succinate (XL) (96.4 +/- 15.9 mg; n = 14) referred for cardiopulmonary exercise testing were studied prospectively. Carvedilol versus metoprolol XL subjects did not differ with respect to baseline heart rate (73 +/- 2 vs 70 +/- 3 bpm), or baseline plasma norepinephrine levels (597.5 +/- 78.3 vs 602.1 +/- 69.6 pg/mL), P = NS. However, despite similar peak exercise norepinephrine levels (2735.8 +/- 320.1 vs 2403.1 +/- 371.6 pg/mL), heart rate at peak exercise was higher in subjects receiving carvedilol (135 +/- 4 bpm) than those receiving metoprolol XL (117 +/- 6 bpm), P = 0.02. Similar norepinephrine release and more complete beta 1-blockade is observed in well-matched subjects with chronic heart failure treated with a mean daily dose of metoprolol XL 96.4 mg compared with carvedilol 32.9 mg. PMID:18287590

Vittorio, Timothy J; Zolty, Ronald; Kasper, Michael E; Khandwalla, Raj M; Hirsh, David S; Tseng, Chi-Hong; Jorde, Ulrich P; Ahuja, Kartikya

2008-03-01

323

Correlation of "critical" left coronary artery lesions with positive submaximal exercise tests in patients with chest pain.  

PubMed

This study correlates the anatomic pathologic coronary anatomy found by arteriography in each of three groups of symptomatic patients, all with coronary artery disease, divided according to the magnitude of ST-segment depression after an adequate submaximal treadmill exercise test. Group I consists of 45 patients with ST-segement depression of 2 mm. or more, Group II of 31 patients with ST-segment depression between 1.0 and 1.9 mm., and Group III, 30 patients with 0 to 0.9 mm. ST-segment depression. Seventy-five per cent of the patients in Group I had critical lesions defined as (1) 75 per cent or greater narrowing of left main coronary artery (LMCA), (2) 75 per cent or greater obstructive left anterior descending and left circumflex coronary artery both proximal to any major branching, the so-called left main equivalent (LME) lesions, and (3) 90 per cent or more obstruction of the left anterior descending coronary proximal to any major branches. Of patients in Group I, 24 PER CENT Had LMCA lesions, 29 per cent had LAD lesions. Eight-two per cent of Group I patients had two- or three-vessel disease. All patients with LMCA lesions had 2 mm. or more ST-segment depression. Over 95 per cent of patients with "critical" lesions is less than 5 per cent in the presence of an adequate aubmaximal treadmill test that shows less than 1 mm. of ST-segment depression, it is concluded that in such patients with medically controllable angina, coronary arteriography is not necessary. PMID:1114960

Cheitlin, M D; Davia, J E; de Castro, C M; Barrow, E A; Anderson, W T

1975-03-01

324

Delivery of Cardiopulmonary Resuscitation in the Microgravity Environment.  

National Technical Information Service (NTIS)

The microgravity environment presents several challenges for delivering effective cardiopulmonary resuscitation (CPR). Chest compressions must be driven by muscular force rather than by the weight of the rescuer's upper torso. Airway stabilization is infl...

M. R. Barratt R. D. Billica

1992-01-01

325

Aortic luminal thrombus and intramural hematoma after cardiopulmonary resuscitation  

PubMed Central

We describe the case of a patient with an intramural hematoma and floating thrombus after cardiopulmonary resuscitation. The 92-year old man had a cardiac arrest due to ventricular fibrillation and witnesses immediately initiated manual cardiopulmonary resuscitation. Transesophageal echocardiography was performed immediately on hospital admission because the patient was in cardiogenic shock. In addition to an akinetic anterior wall, examination of the descending thoracic aorta demonstrated an intramural hematoma and a floating intra-aortic thrombus at a distance of 40cm from the dental arch. There was no aortic dissection. The thrombus was attributed to aortic compression during cardiopulmonary resuscitation. Although the aortic thrombus and intramural hematoma were not associated with any complications in this patient, insertion of an intra-aortic balloon may have led to aortic rupture or embolic events. Transesophageal echocardiography should be performed, when available, prior to insertion of an intra-aortic balloon for counterpulsation in patients who have undergone cardiopulmonary resuscitation.

Fagnoul, David; Herpain, Antoine; Vincent, Jean-Louis; De Backer, Daniel

2013-01-01

326

A Comfortability Level Scale for Performance of Cardiopulmonary Resuscitation.  

ERIC Educational Resources Information Center

This article discusses the development of an instrument to appraise the comfortability level of college students in performing cardiopulmonary resuscitation. Methodology and findings of data collection are given. (Author/DF)

Otten, Robert Drew

1984-01-01

327

Cardiopulmonary Efficiency in Former and Active Champion Scullers.  

National Technical Information Service (NTIS)

Cardiopulmonary efficiency was determined in 12 active and 12 former championship scullers grouped according to age, and the results were compared. None of the older subjects had any severe systemic diseases, especially of the lungs or the heart. Circulat...

F. Dorschner A. A. Buehlmann

1974-01-01

328

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

PubMed Central

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

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

2013-01-01

329

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

PubMed

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

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

2013-12-01

330

Excess ventilation and ventilatory constraints during exercise in patients with chronic obstructive pulmonary disease.  

PubMed

We assessed the relationship between minute ventilation/carbon dioxide output (VE/VCO2) and ventilatory constraints during an incremental cardiopulmonary exercise testing (CPET) in patients with chronic obstructive pulmonary disease (COPD). Slope and intercept of the VE/VCO2 linear relationship, the ratios of inspiratory capacity/total lung capacity (IC/TLC) and of tidal volume (VT) over vital capacity (VTpeak/VC) and IC (VTpeak/IC) and over forced expiratory volume at 1st second (VTpeak/FEV1) at peak of exercise were measured in 52 COPD patients during a CPET. The difference peak-rest in end-tidal pressure of CO2 (PETCO2) was also measured. VE/VCO2 intercept showed a negative correlation with IC/TLC peak (p<0.01) and a positive one with VTpeak/FEV1 (p<0.01) and with PETCO2 peak-rest (p<0.01). VE/VCO2 slope was negatively related to VTpeak/VC, VTpeak/IC and VTpeak/FEV1 (all correlations p<0.05) and to PETCO2 peak-rest (p<0.01). In COPD, VE/VCO2 slope and intercept provide complementary information on the ventilatory limitation to exercise, as assessed by changes in the end-expiratory lung volume and in tidal volume excursion. PMID:24657545

Teopompi, Elisabetta; Tzani, Panagiota; Aiello, Marina; Gioia, Maria Rosaria; Marangio, Emilio; Chetta, Alfredo

2014-06-15

331

Exercise at Home  

MedlinePLUS

... Health Information > Healthy Lifestyle > Exercise > Exercise at Home Exercise at Home Exercise and staying active are an ... plans to begin exercising with your doctor. Posture Exercises Better posture means better breathing and movement. Axial ...

332

Idiopathic Ventricular Arrhythmias Detected by an Implantable Loop Recorder in a Child with Exercise-Induced Syncope  

PubMed Central

Syncope is common in the general population. Despite extensive evaluation, including tilt-table testing and electrophysiologic studies, approximately 30% of cases of recurrent syncope remain unexplained. An implantable loop recorder can be used for diagnosis when recurrent syncope has an idiopathic cause. We present the case of a 9-year-old boy who had a history of recurrent, exercise-induced syncope. Results of physical examination and noninvasive diagnostic testing were inconclusive, and an electrophysiologic study revealed no inducible supraventricular or ventricular arrhythmias. Sixteen months after an implantable loop recorder was placed, the patient had a syncopal episode while swimming in a pool. Cardiopulmonary resuscitation was performed, and data from the loop recorder revealed polymorphic ventricular tachycardia and ventricular fibrillation. A cardioverter-defibrillator was subsequently implanted. Implantable loop recorders can play an important role in the diagnosis of life-threatening arrhythmias in children whose syncope is otherwise unexplained.

Akdeniz, Celal; Ozyilmaz, Isa; Saygi, Murat; Ergul, Yakup; Tuzcu, Volkan

2013-01-01

333

General surgical complications can be predicted after cardiopulmonary bypass.  

PubMed Central

OBJECTIVE: The authors review the general surgical complications of cardiopulmonary bypass, including newer procedures such as heart and lung transplantation, to identify patients at higher risk. SUMMARY BACKGROUND DATA: Although rare, the general surgical complications of cardiopulmonary bypass are associated with high mortality. The early identification of patients at increased risk for these complications may allow for earlier detection and treatment of these problems to reduce mortality. METHODS: A retrospective review was performed of 1831 patients undergoing cardiopulmonary bypass from 1991 to 1993. This was done to identify factors that significantly contributed to an increased risk of general surgical complications. RESULTS: Factors associated with an increased risk of general surgical complications included prolonged cardiopulmonary bypass (p < 0.005) and intensive care unit stay (p < 0.002), occurrence of arrhythmias (p < 0.001), use of inotropic agents (preoperatively or postoperatively p < 0.001), insertion of the intra-aortic balloon pump (preoperatively p < 0.005, postoperatively p < 0.001), use of steroids (p < 0.001), and prolonged ventilator support (p < 0.001). Multivariate analysis identified use of the intra-aortic balloon pump (p < 0.001) as the strongest predictor of the general surgical complications of cardiopulmonary bypass. A variety of factors not contributing significantly to an increased risk also were identified. CONCLUSIONS: Factors indicative of or contributing to periods of decreased end-organ perfusion appear to be significantly related to general surgical complications after cardiopulmonary bypass.

Spotnitz, W D; Sanders, R P; Hanks, J B; Nolan, S P; Tribble, C G; Bergin, J D; Zacour, R K; Abbott, R D; Kron, I L

1995-01-01

334

Cardiac autonomic functions derived from short-term heart rate variability recordings associated with heart rate recovery after treadmill exercise test in young individuals  

Microsoft Academic Search

Analysis of short-term heart rate variability (HRV) may provide useful information about autonomic nervous control of heart\\u000a rate recovery. We studied 495 individuals (273 men), age range 19–85 years, submitted to treadmill exercise tests and short-term\\u000a HRV evaluations over time (standard deviation of the normal-to-normal interval [SDNN], the square root of the mean squared\\u000a differences of successive normal-to-normal intervals [RMSSD],

Ju-Yi Chen; Yungling Leo Lee; Wei-Chuan Tsai; Cheng-Han Lee; Po-Sheng Chen; Yi-Heng Li; Liang-Miin Tsai; Jyh-Hong Chen; Li-Jen Lin

2011-01-01

335

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

SciTech Connect

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

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

1991-04-01

336

Acute administration of bronchodilators on exercise tolerance in treated COPD patients.  

PubMed

Exercise intolerance is a major feature in patients with Chronic Obstructive Pulmonary Disease (COPD). Bronchodilators increase endurance time (ET) and reduce dynamic hyperinflation (DH). We evaluated whether a single-dose of salbutamol/ipratropium + flunisolide (BD+ICS), added on top of the regular treatment, may improve ET in COPD patients. In a single-blind randomized crossover pilot trial, nebulised BD+ICS or placebo (PL) was administered 30 min before a constant load cardiopulmonary test, in 22 moderate-to-severe COPD patients (FEV?: 53.9% pred). ET was the primary outcome measured. BD+ICS did not improve ET or VO? peak with respect to PL. BD+ICS increased pre-test FEV? and pre-test Inspiratory Capacity but did not modify DH. In a retrospective analysis, patients were divided in Improvers (N=11) and Non-Improvers (N=11) according to the difference in ET between BD+ICS and PL (> 25 s). Improvers had a worst BODE index, a higher static hyperinflation and poorer Vd/Vt ratio at peak of exercise with respect to Non-Improvers. Improvers only had a significant increase from BD+ICS on pre-test FEV? and IC. In conclusion, although a single-dose BD+ICS did not improve ET in COPD patients under regular treatment, a subgroup of more severe patients may have some benefit from that. PMID:20970517

Vagaggini, Barbara; Nieri, Dario; Malagrinò, Laura; Antonelli, Sandra; De Cusatis, Giovanna; De Simone, Claudia; Costa, Francesco; Paggiaro, Pier Luigi

2011-02-01

337

Evaluation of a cardiopulmonary-resuscitation training manual for pharmacists.  

PubMed

The development and evaluation of a training manual for pharmacists participating in cardiopulmonary resuscitation (CPR) efforts at an institution encompassing ambulatory-care, acute-care, and emergency-trauma facilities are described. The manual was developed to familiarize pharmacists who had little or no experience in CPR procedures with the equipment and medications used and the pharmacist's role on the CPR team. To evaluate the effectiveness of the manual, a 29-question multiple-choice test was administered to 35 staff pharmacists who were randomly assigned to study and control groups. Training manuals were issued to members of the study group, who were asked to document time spent studying them. Three weeks after the pretest, the same test was administered to all subjects. There was no control on the number of CPR events attended during the three-week period. The study group spent less than two hours (mean +/- S.D. = 97.5 +/- 34.22 min) using the manual. For the study group, posttest scores were significantly higher than pretest scores. The difference in pretest scores for the study and control groups was not significant, but for the posttest the study group scores were significantly higher. Because use of the manual appeared to improve knowledge of drug therapy and procedures used in CPR, the pharmacy department incorporated it into its orientation procedure. PMID:6846346

Smolarek, R T; Solomon, D K; Powell, M F; Roffe, B D

1983-03-01

338

A novel rotary pulsatile flow pump for cardiopulmonary bypass.  

PubMed

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

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

2014-01-01

339

A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation  

PubMed Central

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

Ayala, U.; Irusta, U.; Ruiz, J.; Eftest?l, T.; Kramer-Johansen, J.; Alonso-Atienza, F.; Alonso, E.; Gonzalez-Otero, D.

2014-01-01

340

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

PubMed Central

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

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

2014-01-01

341

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

PubMed Central

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

2014-01-01

342

Cardiac autonomic functions derived from short-term heart rate variability recordings associated with heart rate recovery after treadmill exercise test in young individuals.  

PubMed

Analysis of short-term heart rate variability (HRV) may provide useful information about autonomic nervous control of heart rate recovery. We studied 495 individuals (273 men), age range 19-85 years, submitted to treadmill exercise tests and short-term HRV evaluations over time (standard deviation of the normal-to-normal interval [SDNN], the square root of the mean squared differences of successive normal-to-normal intervals [RMSSD], the number of interval differences of successive normal-to-normal intervals greater than 50 ms [NN50 count], the proportion derived by dividing NN50 count by the total number of normal-to-normal intervals [pNN50]) and frequency (low-frequency power [LF], high-frequency power [HF], total power) domains. Among 495 patients, 106 patients (68 men) were elderly (age ? 65 years). Male gender and hypertension were significantly higher in elderly patients. The young patients had higher HRR after exercise. HRR at 4 min (54 ± 13 vs 60 ± 12 beats/min; P = 0.003) was the most significant predictor for positive exercise test result. In the young group, both time domain measures (SDNN: correlation coefficient 0.34, P < 0.001; RMSSD: correlation coefficient 0.37, P < 0.001) and frequency domain measures (LF: correlation coefficient 0.21, P < 0.001; HF: correlation coefficient 0.13, P = 0.01; total power: correlation coefficient 0.22, P < 0.001) were significantly associated with HRR at 4 min. HRR at 4 min was significantly associated with short-term HRV of time and frequency domains in young individuals, but not elderly ones, receiving treadmill exercise test. PMID:21052688

Chen, Ju-Yi; Lee, Yungling Leo; Tsai, Wei-Chuan; Lee, Cheng-Han; Chen, Po-Sheng; Li, Yi-Heng; Tsai, Liang-Miin; Chen, Jyh-Hong; Lin, Li-Jen

2011-05-01

343

Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass  

SciTech Connect

We tested the hypothesis that insulin-dependent diabetic patients with coronary artery bypass graft surgery experience altered coupling of cerebral blood flow and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age-matched controls), cerebral blood flow was measured using 133Xe clearance during nonpulsatile, alpha-stat blood gas managed cardiopulmonary bypass at the conditions of hypothermia and normothermia. In diabetic patients, the cerebral blood flow at 26.6 +/- 2.42 degrees C was 25.3 +/- 14.34 ml/100 g/min and at 36.9 +/- 0.58 degrees C it was 27.3 +/- 7.40 ml/100 g/min (p = NS). The control patients increased cerebral blood flow from 20.7 +/- 6.78 ml/100 g/min at 28.4 +/- 2.81 degrees C to 37.6 +/- 8.81 ml/100 g/min at 36.5 +/- 0.45 degrees C (p less than or equal to 0.005). The oxygen consumption was calculated from jugular bulb effluent and increased from hypothermic values of 0.52 +/- 0.20 ml/100 g/min in diabetics to 1.26 +/- 0.28 ml/100 g/min (p = 0.001) at normothermia and rose from 0.60 +/- 0.27 to 1.49 +/- 0.35 ml/100 g/min (p = 0.0005) in the controls. Thus, despite temperature-mediated changes in oxygen consumption, diabetic patients did not increase cerebral blood flow as metabolism increased. Arteriovenous oxygen saturation gradients and oxygen extraction across the brain were calculated from arterial and jugular bulb blood samples. The increase in arteriovenous oxygen difference between temperature conditions in diabetic patients and controls was significantly different (p = 0.01). These data reveal that diabetic patients lose cerebral autoregulation during cardiopulmonary bypass and compensate for an imbalance in adequate oxygen delivery by increasing oxygen extraction.

Croughwell, N.; Lyth, M.; Quill, T.J.; Newman, M.; Greeley, W.J.; Smith, L.R.; Reves, J.G. (Duke Univ. Medical Center, Durham, NC (USA))

1990-11-01

344

Hantaviruses and cardiopulmonary syndrome in South America.  

PubMed

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

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

2014-07-17

345

[Initial pediatric trauma care and cardiopulmonary resuscitation].  

PubMed

Accidents are a frequent cause of death in children older than 1 year. The most frequent causes of death by accident are traffic accidents, drowning, intentional injuries, burns, and falls. Cardiopulmonary resuscitation is one component of the set of actions needed to obtain initial stabilization of a child with serious trauma. In the first few minutes after the accident, cardiorespiratory arrest can occur due to airway obstruction or inadequate ventilation, massive blood loss or severe brain damage; cardiorespiratory arrest in this setting has a dismal outcome. When arrest occurs hours after trauma, it is usually caused by hypoxia, hypovolemia, hypothermia, intracranial hypertension, or electrolyte disturbances. The first response to trauma should include three objectives: to protect (scenario assessment and implementation of safety measures), to alert (activation of the emergency medical system) and to help (initial trauma care). Initial trauma care includes primary and secondary surveys. The primary survey involves several consecutive steps: A. airway and cervical spine stabilization, B. breathing, C. circulation and hemorrhage control, D. neurological dysfunction, and E. exposure. The secondary survey consists of assessment of the victim by means of anamnesis, sequential physical examination (from head to limbs) and complementary investigations. During emergency trauma care, specific procedures such as extrication and mobilization maneuvers, cervical spine control by means of bimanual immobilization, and cervical collar placement or helmet removal. If a cardiorespiratory arrest occurs during initial trauma care, resuscitation maneuvers must be immediately started with the specific adaptations indicated in children with trauma. PMID:17340788

Domínguez Sampedro, P; Cañadas Palazón, S; de Lucas García, N; Balcells Ramírez, J; Martínez Ibáñez, V

2006-12-01

346

[Ethics of the cardiopulmonary resuscitation decisions].  

PubMed

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

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

2010-11-01

347

Histamine release during adult cardiopulmonary bypass.  

PubMed

Histamine, an inflammatory mediator in its own right, may also be a marker for a more widespread systemic inflammatory process. In this study we have examined variations in plasma histamine concentrations produced during the course of cardiac surgery involving cardiopulmonary bypass, the relationship between these variations and intra-operative events. By assays of serum tryptase and CD-63 expression we have also attempted to identify the source of histamine. Histamine concentrations that were significantly raised from baseline level were demonstrated. These were elevated from the time of aortic cross-clamping and continued to be raised for 24 h postoperatively (p < 0.00625). This was associated with an increase in CD-63 expression (p < 0.025) (but not an increase in tryptase concentration) following aortic cross-clamping and protamine administration, suggesting that basophils are the source of histamine. 41% of patients had arrhythmias in the post bypass period. The rise in histamine levels was not related to the incidence of cardiac arrhythmias. PMID:16288615

Fayaz, K M; Pugh, S; Balachandran, S; Sudheer, P S; Hall, J E

2005-12-01

348

Pulmonary function and exercise-associated changes with chronic low-level paraquat exposure.  

PubMed

The present study was undertaken to test the hypothesis that chronic, low-level paraquat exposure causes restrictive lung function with gas transfer impairment. Three hundred thirty-eight Costa Rican farm workers from banana, coffee, and palm oil farms completed a questionnaire, spirometry, and a test of single-breath carbon monoxide diffusing capacity. Subjects 40 years of age or older, without other medical risk factors, completed maximal cardiopulmonary exercise tests. Most (66.6%) were paraquat handlers; 24.8% of handlers and 27.3% of nonhandlers reported current cigarette smoking. In linear regression models, cumulative paraquat exposure was not an independent predictor of VA, carbon monoxide diffusing capacity, peak oxygen uptake, FVC, or oxygen pulse peak. However, the ventilatory equivalent for CO(2), although within normal range, was significantly higher with increased cumulative paraquat exposure. Oxygen desaturation greater than 5% from rest to peak exercise had an odds ratio of 1.7 (95% confidence interval = 0.9-3.0) with the cumulative paraquat exposure index in models adjusted for age, weight, and smoking status. The association of paraquat exposure with ventilatory equivalent and oxygen desaturation suggests that paraquat may be associated with subclinical gas exchange abnormalities, but overall these findings are consistent with no clinically significant increases in interstitial thickening or restrictive lung disease among this population. PMID:15229097

Schenker, Marc B; Stoecklin, Maria; Lee, Kiyoung; Lupercio, Rafael; Zeballos, R Jorge; Enright, Paul; Hennessy, Tamara; Beckett, Laurel A

2004-10-01

349

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

NASA Technical Reports Server (NTRS)

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

1979-01-01

350

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

PubMed Central

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

Lee, Bo-Ae; Oh, Deuk-Ja

2014-01-01

351

CT coronary angiography and exercise ECG in a population with chest pain and low-to-intermediate pre-test likelihood of coronary artery disease  

Microsoft Academic Search

ObjectiveTo evaluate diagnostic accuracy of exercise ECG (ex-ECG) versus 64-slice CT coronary angiography (CT-CA) for the detection of significant coronary artery stenosis in a population with low-to-intermediate pre-test likelihood of coronary artery disease (CAD).DesignRetrospective single centre.SettingTertiary academic hospital.Patients177 consecutive patients (88 men, 89 women, mean age 53.5±7.6 years) with chest pain and low-to-intermediate pre-test likelihood of CAD were retrospectively enrolled.InterventionsAll

Erica Maffei; Sara Seitun; Chiara Martini; Alessandro Palumbo; Giuseppe Tarantini; Elena Berti; Roberto Grilli; Carlo Tedeschi; Giancarlo Messalli; Andrea Guaricci; Annick C Weustink; Nico RA Mollet; Filippo Cademartiri

2010-01-01

352

Changes in Cardiopulmonary Reserve and Peripheral Arterial Function Concomitantly with Subclinical Inflammation and Oxidative Stress in Patients with Heart Failure with Preserved Ejection Fraction  

PubMed Central

Background. Changes in cardiopulmonary reserve and biomarkers related to wall stress, inflammation, and oxidative stress concomitantly with the evaluation of peripheral arterial blood flow have not been investigated in patients with heart failure with preserved ejection fraction (HFpEF) compared with healthy subjects (CTL). Methods and Results. Eighteen HFpEF patients and 14 CTL were recruited. Plasma levels of inflammatory and oxidative stress biomarkers were measured at rest. Brain natriuretic peptide (BNP) was measured at rest and peak exercise. Cardiopulmonary reserve was assessed using an exercise protocol with gas exchange analyses. Peripheral arterial blood flow was determined by strain gauge plethysmography. Peak VO2 (12.0 ± 0.4 versus 19.1 ± 1.1?mL/min/kg, P < 0.001) and oxygen uptake efficiency slope (1.55 ± 0.12 versus 2.06 ± 0.14, P < 0.05) were significantly decreased in HFpEF patients compared with CTL. BNP at rest and following stress, C-reactive-protein, interleukin-6, and TBARS were significantly elevated in HFpEF. Both basal and posthyperemic arterial blood flow were not significantly different between the HFpEF patients and CTL. Conclusions. HFpEF exhibits a severe reduction in cardiopulmonary reserve and oxygen uptake efficiency concomitantly with an elevation in a broad spectrum of biomarkers confirming an inflammatory and prooxidative status in patients with HFpEF.

Vitiello, Damien; Harel, Francois; Touyz, Rhian M.; Sirois, Martin G.; Lavoie, Joel; Myers, Jonathan; Ducharme, Anique; Racine, Normand; O'Meara, Eileen; Gayda, Mathieu; Rouleau, Jean Lucien; de Denus, Simon

2014-01-01

353

[The Japanese guidelines for cardiopulmonary bypass and recommendations concerning safety devices for cardiopulmonary bypass].  

PubMed

In March 2007, under the guidance of the Ministry of Health, Labour and Welfare, a committee released Japanese guidelines for cardiopulmonary bypass (CPB) with the purpose to standardize CPB hardware and software for patient's safety and education of medical personnel. In April 2007, the Japanese Society of Extra Corporeal Technology in Medicine (JaSECT) released recommendations concerning safety devices for cardiopulmonary bypass. An on-site training session for CPB troubles was held at the 38th annual meeting of Japanese Society for Cardiovascular Surgery in February 2008 as a measure to ensure safety of CPB. Young heart surgeons and perfusionists were taught the basic CPB operations, recovering procedures after an incident, and the use of safety devices. A questionnaire survey was conducted at the end of the training session. Eight heart surgeons and 7 perfusionists (3 certified and 4 without certification) participated in the session None of the 8 heart surgeons who participated had read the guidelines or made an effort to accomplish the recommendations. Of the 7 certified or uncertified perfusionists who participated, only one certified perfusionist made an effort to accomplish the recommendation. CPB accidents are rare, but as a medical team, tragedies such as death and life-threatening complication due to CPB accident should be prevented at all costs. We believe that the 1st step to prevent CPB incident is to read and understand the CPB guidelines thoroughly, and to accomplish the "required" items listed in the recommendations. PMID:19670778

Anno, Makoto; Yoshida, K; Momose, Naoki; Matayoshi, Toru; Minami, Shigeru; Tomizawa, Yasuko

2009-08-01

354

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

PubMed

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

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

2014-06-01

355

Volcanological Exercises  

NSDL National Science Digital Library

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

Nelson, Stephen

356

Pediatric Cardiopulmonary Resuscitation: Advances in Science, Techniques, and Outcomes  

PubMed Central

More than 25% of children survive to hospital discharge after in-hospital cardiac arrests, and 5% to 10% survive after out-of-hospital cardiac arrests. This review of pediatric cardiopulmonary resuscitation addresses the epidemiology of pediatric cardiac arrests, mechanisms of coronary blood flow during cardiopulmonary resuscitation, the 4 phases of cardiac arrest resuscitation, appropriate interventions during each phase, special resuscitation circumstances, extracorporeal membrane oxygenation cardiopulmonary resuscitation, and quality of cardiopulmonary resuscitation. The key elements of pathophysiology that impact and match the timing, intensity, duration, and variability of the hypoxic-ischemic insult to evidence-based interventions are reviewed. Exciting discoveries in basic and applied-science laboratories are now relevant for specific subpopulations of pediatric cardiac arrest victims and circumstances (eg, ventricular fibrillation, neonates, congenital heart disease, extracorporeal cardiopulmonary resuscitation). Improving the quality of interventions is increasingly recognized as a key factor for improving outcomes. Evolving training strategies include simulation training, just-in-time and just-in-place training, and crisis-team training. The difficult issue of when to discontinue resuscitative efforts is addressed. Outcomes from pediatric cardiac arrests are improving. Advances in resuscitation science and state-of-the-art implementation techniques provide the opportunity for further improvement in outcomes among children after cardiac arrest.

Topjian, Alexis A.; Berg, Robert A.; Nadkarni, Vinay M.

2009-01-01

357

Characteristics and outcome of cardiopulmonary resuscitation in hospitalised African children?  

PubMed Central

Objective To review the characteristics and outcome of cardiopulmonary resuscitation in children at a rural hospital in Kenya. Patients and method All children aged 0–14 years who experienced ?1 episode of respiratory or cardiopulmonary arrest during April 2002–2004 were prospectively identified. Demographic variables, cause of hospitalisation, type and duration of arrest, resuscitation measures taken and outcomes were determined. Results 114 children experienced at least one episode of respiratory arrest (RA) or cardiopulmonary arrest (CPA). Cardiopulmonary resuscitation (CPR) was performed on all children. “Do not resuscitate order” (DNR) was given in 15 patients after initial resuscitation. Eighty two patients (72%) had RA and 32 (28%) had CPA. 25/82 (30%) patients with RA survived initial CPR compared to 5/32 (16%) with CPA. Survival at discharge was 22% (18/82) in children who had RA while no one with CPA survived at discharge. The leading underlying diseases were severe malaria, septicaemia and severe malnutrition. Prolonged resuscitation beyond 15 min and receiving adrenaline [epinephrine] (at least one dose of 10 ?g/kg IV) were predictive of poor final outcome. Conclusion Cardiopulmonary arrest after admission has a very poor prognosis in our hospital. Infectious diseases are the main underlying causes of arrest. If a child fails to respond to the basic tenements of PALS within 15 min then it is unlikely that further efforts to sustain life will be fruitful in hospitals where ventilation facilities are not present.

Olotu, A.; Ndiritu, M.; Ismael, M.; Mohammed, S.; Mithwani, S.; Maitland, K.; Newton, C.R.J.C.

2009-01-01

358

The effects of dexmedetomidine on inflammatory mediators after cardiopulmonary bypass.  

PubMed

Cardiac surgery with cardiopulmonary bypass is associated with the development of a systemic inflammatory response that can often lead to dysfunction of major organs. We hypothesised that the highly selective ?2 -adrenergic agonist, dexmedetomidine, attenuates the systemic inflammatory response. Forty-two patients were randomly assigned to receive dexmedetomidine or saline after aortic cross-clamping). The mean (SD) levels of the nuclear protein plasma high-mobility group box 1 increased significantly from 5.1 (2.2) ng.ml(-1) during (16.6 (7.3) ng.ml(-1) ) and after (14.3 (8.2) ng.ml(-1) ) cardiopulmonary bypass in the saline group. In the dexmedetomidine group, the levels increased significantly only during cardiopulmonary bypass (4.0 (1.9) ng.ml(-1) baseline vs 10.8 (2.7) ng.ml(-1) ) but not after (7.4 (3.8) ng.ml(-1) ). Dexmedetomidine infusion also suppressed the rise in mean (SD) interleukin-6 levels after cardiopulmonary bypass (a rise of 124.5 (72.0) pg.ml(-1) vs 65.3 (30.9) pg.ml(-1) ). These suppressive effects of dexmedetomidine might be due to the inhibition of nuclear factor kappa B activation and suggest that intra-operative dexmedetomidine may beneficially inhibit inflammatory responses associated with ischaemia-reperfusion injury during cardiopulmonary bypass. PMID:24773263

Ueki, M; Kawasaki, T; Habe, K; Hamada, K; Kawasaki, C; Sata, T

2014-07-01

359

Delivery of cardiopulmonary resuscitation in the microgravity environment  

NASA Technical Reports Server (NTRS)

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

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

1992-01-01

360

Acute posthypoxic myoclonus after cardiopulmonary resuscitation  

PubMed Central

Background Acute posthypoxic myoclonus (PHM) can occur in patients admitted after cardiopulmonary resuscitation (CPR) and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP) and electroencephalogram (EEG). Methods Patients with acute PHM (focal myoclonus or status myoclonus) within 72 hours after CPR were retrospectively selected from a multicenter cohort study. All patients were treated with hypothermia. Criteria for cortical origin of the myoclonus were: giant SEP potentials; or epileptic activity, status epilepticus, or generalized periodic discharges on the EEG (no back-averaging was used). Good outcome was defined as good recovery or moderate disability after 6?months. Results Acute PHM was reported in 79/391 patients (20%). SEPs were available in 51/79 patients and in 27 of them (53%) N20 potentials were present. Giant potentials were seen in 3 patients. EEGs were available in 36/79 patients with 23/36 (64%) patients fulfilling criteria for a cortical origin. Nine patients (12%) had a good outcome. A broad variety of drugs was used for treatment. Conclusions The results of this study show that acute PHM originates from subcortical, as well as cortical structures. Outcome of patients admitted after CPR who develop acute PHM in this cohort was better than previously reported in literature. The broad variety of drugs used for treatment shows the existing uncertainty about optimal treatment.

2012-01-01

361

Gravity and Development of Cardiopulmonary Reflex  

NASA Astrophysics Data System (ADS)

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

Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

362

Obstructive sleep apnea, inflammation, and cardiopulmonary disease.  

PubMed

Obstructive sleep apnea (OSA) occurs commonly in the U.S. population and is seen in both obese as well as non-obese individuals. OSA is a disease characterized by periodic upper airway collapse during sleep, which then results in either apnea, hypopnea, or both. The disorder leads to a variety of medical complications. Neuropsychiatric complications include daytime somnolence, cognitive dysfunction, and depression. Increased incidence of motor vehicle accidents has been documented in these patients and probably reflects disordered reflex mechanisms or excessive somnolence. More importantly, vascular disorders such as hypertension, stroke, congestive cardiac failure, arrhythmias, and atherosclerosis occur frequently in these patients. The lungs may be affected by pulmonary hypertension and worsening of asthma. Recent data from several laboratories demonstrate that obstructive sleep apnea is characterized by an inflammatory response. Cytokines are elaborated during the hypoxemic episodes leading to inflammatory responses as marked clinically by elevated C-reactive protein (CRP). As elevated CRP levels are considered markers of the acute phase response and characterize progression of vascular injury in coronary artery disease, it is likely that obstructive sleep apnea could lead to worsening of vasculopathy. Moreover, as inflammatory mechanisms regulate bronchial asthma, it is also likely that cytokines and superoxide radicals generated during hypoxemic episodes could exacerbate reactive airway disease. Patients with Cough, Obstructive sleep apnea, Rhinosinusitis, and Esophageal reflux clustered together can be categorized by the acronym, "CORE", syndrome. The purpose of this manuscript is to review the inflammatory responses that occur in patients with obstructive sleep apnea and relate them to the occurrence of cardiopulmonary disease. PMID:15353323

Arter, Jim L; Chi, David S; M, Girish; Fitzgerald, S Matthew; Guha, Bhuvana; Krishnaswamy, Guha

2004-09-01

363

Blood transfusion therapy for traumatic cardiopulmonary arrest  

PubMed Central

Background: Blood transfusion therapy (BTT), which represents transplantation of living cells, poses several risks. Although BTT is necessary for trauma victims with hemorrhagic shock, it may be futile for patients with blunt traumatic cardiopulmonary arrest (BT-CPA). Materials and Methods: We retrospectively examined the medical records of consecutive patients with T-CPA. The study period was divided into two periods: The first from 1995-1998, when we used packed red cells (PRC) regardless of the return of spontaneous circulation (ROSC), and the second from 1999-2004, when we did not use PRC before ROSC. The rates of ROSC, admission to the ICU, and survival-to-discharge were compared between these two periods. Results: We studied the records of 464 patients with BT-CPA (175 in the first period and 289 in the second period). Although the rates of ROSC and admission to the ICU were statistically higher in the first period, there was no statistical difference in the rate of survival-to-discharge between these two periods. In the first period, the rate of ROSC was statistically higher in the non-BTT group than the BTT group. However, for cases in which ROSC was performed and was successful, there were no statistical differences in the rate of admission and survival-to-discharge between the first and second group, and between the BTT and non-BTT group. Conclusion: Our retrospective consecutive study shows the possibility that BTT before ROSC for BT-CPA and a treatment strategy that includes this treatment improves the success rate of ROSC, but not the survival rate. BTT is thought to be futile as a treatment for BT-CPA before ROSC.

Moriwaki, Yoshihiro; Sugiyama, Mitsugi; Tahara, Yoshio; Iwashita, Masayuki; Kosuge, Takayuki; Toyoda, Hiroshi; Arata, Shinju; Suzuki, Noriyuki

2013-01-01

364

Exercise and age  

MedlinePLUS

Age and exercise ... It's never too late to start exercising. Exercise has benefits at any age. Don't worry if you've never exercised, or if you stopped exercising for some reason. Being physically ...

365

Vagal Reflexes Following an Exercise Stress Test: a Simple Clinical Tool for Gene-Specific Risk Stratification in the Long QT Syndrome  

PubMed Central

Objectives To assess whether heart rate (HR) reduction following an exercise stress test (ExStrT), an easily quantifiable marker of vagal reflexes, might identify high and low risk long QT syndrome (LQTS) type 1 (LQT1) patients. Background Identification of LQTS patients more likely to be symptomatic remains elusive. We have previously shown that depressed baroreflex sensitivity (BRS), an established marker of reduced vagal reflexes, predicts low probability of symptoms among LQT1. Methods We studied 169 LQTS genotype-positive patients below age 50 who performed an ExStrT with the same protocol, on and off ?-blockers including 47 South African LQT1 patients all harboring the KCNQ1-A341V mutation and 122 Italian LQTS patients with impaired (IKs?, LQT1, n=66) or normal (IKs+, 50 LQT2 and 6 LQT3) IKs current. Results Despite similar maximal HR and workload, by the first minute after cessation of exercise the symptomatic patients in both IKs? groups had a greater HR reduction compared to the asymptomatic (19±7 vs 13±5 and 27±10 vs 20±8 bpm, both p=0.009). By contrast, there was no difference between the IKs+ symptomatic and asymptomatic patients (23±9 vs 26±9 bpm, p=0.47). LQT1 patients in the upper tertile for HR reduction had a higher risk of being symptomatic (OR 3.28, 95% CI 1.3–8.3, p=0.012). Conclusions HR reduction following exercise identifies LQT1 patients at high or low arrhythmic risk, independently of ?-blocker therapy, and contributes to risk stratification. Exercise training, which potentiates vagal reflexes, should be avoided by LQT1 patients.

Crotti, Lia; Spazzolini, Carla; Porretta, Alessandra P.; Dagradi, Federica; Taravelli, Erika; Petracci, Barbara; Vicentini, Alessandro; Pedrazzini, Matteo; Rovere, Maria Teresa La; Vanoli, Emilio; Goosen, Althea; Heradien, Marshall; Brink, Paul A.; George, Alfred L.; Schwartz, Peter J.

2012-01-01

366

Effect of ventilation on cerebral oxygenation during exercise: Insights from canonical correlation  

PubMed Central

We tested hypothesis that cerebral deoxygenation near maximal exercise intensity is mediated by hyperventilation, via hypocapnia-induced reductions in cerebral blood flow, by utilizing canonical correlation analysis (CCA) to determine the relative influence of cardiopulmonary changes on cerebral oxygenation, as assessed by near infrared spectroscopy (NIRS). Twenty-three subjects performed incremental exercise tests under normoxic and hypoxic conditions. Changes in ventilation (V?E) were strongly correlated with end-tidal CO2 (PET CO2) and NIRS after the respiratory compensation point (RCP) (r2 >0.97). However, in contrast to our expectations, CBF velocity (CBFv) shared the least amount of variance with NIRS measurements (r2 < 0.56) and the reduction in CBFv was not accompanied by a reduction in cerebral blood volume. These results demonstrate that while cerebral deoxygenation was associated with hyperventilation, it was not solely explained by hypocapnia-induced reductions in CBFv. CCA revealed that a relative increase in the venous contribution to NIRS explained a larger amount of variation in cerebral oxygenation than reductions CBFv.

Heine, Martin; Subudhi, Andrew W.; Roach, Robert C.

2009-01-01

367

Baroreflex regulation of blood pressure during dynamic exercise  

NASA Technical Reports Server (NTRS)

From the work of Potts et al. Papelier et al. and Shi et al. it is readily apparent that the arterial (aortic and carotid) baroreflexes are reset to function at the prevailing ABP of exercise. The blood pressure of exercise is the result of the hemodynamic (cardiac output and TPR) responses, which appear to be regulated by two redundant neural control systems, "Central Command" and the "exercise pressor reflex". Central Command is a feed-forward neural control system that operates in parallel with the neural regulation of the locomotor system and appears to establish the hemodynamic response to exercise. Within the central nervous system it appears that the HLR may be the operational site for Central Command. Specific neural sites within the HLR have been demonstrated in animals to be active during exercise. With the advent of positron emission tomography (PET) and single-photon emission computed tomography (SPECT), the anatomical areas of the human brain related to Central Command are being mapped. It also appears that the Nucleus Tractus Solitarius and the ventrolateral medulla may serve as an integrating site as they receive neural information from the working muscles via the group III/IV muscle afferents as well as from higher brain centers. This anatomical site within the CNS is now the focus of many investigations in which arterial baroreflex function, Central Command and the "exercise pressor reflex" appear to demonstrate inhibitory or facilitatory interaction. The concept of whether Central Command is the prime mover in the resetting of the arterial baroreceptors to function at the exercising ABP or whether the resetting is an integration of the "exercise pressor reflex" information with that of Central Command is now under intense investigation. However, it would be justified to conclude, from the data of Bevegard and Shepherd, Dicarlo and Bishop, Potts et al., and Papelier et al. that the act of exercise results in the resetting of the arterial baroreflex. In addition, if, as we have proposed, the cardiopulmonary baroreceptors primarily monitors and reflexly regulates cardiac filling volume, it would seem from the data of Mack et al. and Potts et al. that the cardiopulmonary baroreceptor is also reset at the beginning of exercise. Therefore, investigations of the neural mechanisms of regulation involving Central Command and cardiopulmonary afferents, similar to those being undertaken for the arterial baroreflex, need to be established.

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

1997-01-01

368

Respiratory rate predicts cardiopulmonary arrest for internal medicine inpatients  

Microsoft Academic Search

Objective: To assess whether vital sign measurements could identify internal medicine patients at risk for cardiopulmonary arrest.\\u000a \\u000a \\u000a Design: Retrospective case-control study comparing 72 hours of pre-arrest vital sign measurements with 72 hours of vital sign measurements\\u000a for patients from the same units who did not experience cardiopulmonary arrest.\\u000a \\u000a \\u000a \\u000a \\u000a Setting: Twelve non — intensive care internal medicine units at a large

John F. Fieselmann; Michael S. Hendryx; Charles M. Helms; Douglas S. Wakefield

1993-01-01

369

Post-exercise palpation of pulse rates: its applicability to habitual exercisers.  

PubMed

Despite the increased popularity of heart rate (HR) monitors, endurance-trained adults as well as habitual exercisers often use pulse rate palpation to periodically monitor exercise intensity. However, due to the rapid recovery of HR following exercise bouts, post-exercise palpation of pulse rates may underestimate exercise HR. To test this hypothesis, we studied 20 young physically active adults performing two sets of exercise for 5 min at 70% and 85% of maximal HR on the treadmill; one with carotid and another with radial pulse count. Post-exercise palpation of pulse rate was lower (P < 0.01) than the actual HR during exercise, underestimating exercise HR by 20-27 bpm (beats per min). Even when ECG tracings of HR were analyzed immediately after exercise (0-15 s), a significant underestimation of exercise HR (7-9 bpm) still persisted (P < 0.05). Following exercise, pulse rate obtained by carotid palpation at both intensities and radial palpation at the lower intensity was no different from the corresponding HR measured with ECG. In the radial artery trial at the higher exercise intensity, pulse rate following exercise was lower (10 bpm; P < 0.05) than ECG-derived HR. Arterial stiffness, which is closely associated with arterial baroreflex sensitivity, was not significantly related to the changes in HR with carotid palpation. We concluded that post-exercise pulse palpations may not be appropriate as an indicator of exercise intensity in habitual exercisers. PMID:15885039

Devan, Allison E; Lacy, Barbara K; Cortez-Cooper, Miriam Y; Tanaka, Hirofumi

2005-06-01

370

Depressed Adolescents Treated with Exercise (DATE): A pilot randomized controlled trial to test feasibility and establish preliminary effect sizes  

PubMed Central

The Depressed Adolescents Treated with Exercise (DATE) study evaluated a standardized aerobic exercise protocol to treat nonmedicated adolescents that met DSM-IV-TR criteria for major depressive disorder. From an initial screen of 90 individuals, 30 adolescents aged 12-18 years were randomized to either vigorous exercise (EXER) (>12 kg/kcal/week [KKW]) or a control stretching (STRETCH) activity (< 4 KKW) for 12 weeks. The primary outcome measure was the blinded clinician rating of the Children's Depression Rating Scale – Revised (CDRS-R) to assess depression severity and Actical (KKW) accelerometry 24hr/7days a week to assess energy expenditure and adherence. Follow-up evaluations occurred at weeks 26 and 52. The EXER group averaged 77% adherence and the STRETCH group 81% for meeting weekly target goals for the 12 week intervention based on weekly sessions completed and meeting KKW requirements. There was a significant increase in overall weekly KKW expenditures (p < .001) for both groups with the EXER group doubling the STRETCH group in weekly energy expenditure. Depressive symptoms were significantly reduced from baseline for both groups with the EXER group improving more rapidly than STRETCH after six weeks (p < .016) and nine weeks (p < .001). Both groups continued to improve such that there were no group differences after 12 weeks (p = .07). By week 12, the exercise group had a 100% response rate (86% remission), whereas the stretch group response rate was 67% (50% remission) (p = .02). Both groups had improvements in multiple areas of psychosocial functioning related to school and relationships with parents and peers. Anthropometry reflected decreased waist, hip and thigh measurements (p = .02), more so for females than males (p = .05), but there were no weight changes for either gender. The EXER group sustained 100% remission at week 26 and 52. The STRETCH group had 80% response and 70% remission rates at week 26 and by week 52 only one had not fully responded. The study provides support for the use of exercise as a non-medication intervention for adolescents with major depressive disorders when good adherence and energy expenditure (KKW) are achieved.

Hughes, Carroll W.; Barnes, Shauna; Barnes, Conrad; DeFina, Laura F.; Nakonezny, Paul; Emslie, Graham J.

2013-01-01

371

Corrected End-Tidal PCO2 Accurately Estimates PaCO2 at Rest and During Exercise in Morbidly Obese Adults  

PubMed Central

Background: Obesity affects lung function and gas exchange and imposes mechanical ventilatory limitations during exercise that could disrupt the predictability of PaCO2 from end-tidal PCO2 (PETCO2), an important clinical tool for assessing gas exchange efficiency during exercise testing. PaCO2 has been estimated during exercise with good accuracy in normal-weight individuals by using a correction equation developed by Jones and colleagues (PJCO2 = 5.5 + 0.9 × PETCO2 – 2.1 × tidal volume). The purpose of this project was to determine the accuracy of PaCO2 estimations from PETCO2 and PJCO2 values at rest and at submaximal and peak exercise in morbidly obese adults. Methods: PaCO2 and PETCO2 values from 37 obese adults (22 women, 15 men; age, 39 ± 9 y; BMI, 49 ± 7; [mean ± SD]) were evaluated. Subjects underwent ramped cardiopulmonary exercise testing to volitional exhaustion. PETCO2 was determined from expired gases simultaneously with temperature-corrected arterial blood gases (radial arterial catheter) at rest, every minute during exercise, and at peak exercise. Data were analyzed using paired t tests. Results: PETCO2 was not significantly different from PaCO2 at rest (PETCO2 = 37 ± 3 mm Hg vs PaCO2 = 38 ± 3 mm Hg, P = .14). However, during exercise, PETCO2 was significantly higher than PaCO2 (submaximal: 42 ± 4 vs 40 ± 3, P < .001; peak: 40 ± 4 vs 37 ± 4, P < .001, respectively). Jones’ equation successfully corrected PETCO2, such that PJCO2 was not significantly different from PaCO2 (submax: PJCO2 = 40 ± 3, P = .650; peak: 37 ± 4, P = .065). Conclusion: PJCO2 provides a better estimate of PaCO2 than PETCO2 during submaximal exercise and at peak exercise, whereas at rest both yield reasonable estimates in morbidly obese individuals. Clinicians and physiologists can obtain accurate estimations of PaCO2 in morbidly obese individuals by using P jco 2 .

Bernhardt, Vipa; Lorenzo, Santiago; Zavorsky, Gerald S.

2013-01-01

372

Exercise Prescription.  

ERIC Educational Resources Information Center

Practical guidelines for physical education teachers concerning the right amount of exercise to develop and maintain health-related fitness among students are outlined, along with some techniques for developing student motivation. (JMF)

Pollock, Michael L.; Blair, Steven N.

1981-01-01

373

Exercise Habit  

MedlinePLUS

... distance faster now? Are you at your target heart rate? Think about joining a health club or community ... thing when you're done exercising until your heart rate returns to normal. Pay attention to your body. ...

374

Seismological Exercises  

NSDL National Science Digital Library

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

Nelson, Stephen

375

Effect of Sildenafil on Ventilatory Efficiency and Exercise Tolerance in Pulmonary Hypertension  

PubMed Central

Background The pulmonary vasculopathy in pulmonary arterial hypertension (PAH) results in increased resistance to pulmonary blood flow, limiting the cardiac output required for the increased O2 demands of exercise. Aims We sought to determine the physiologic basis for clinical improvement in PAH patients receiving sildenafil, hypothesizing that the key mechanisms of improvement are improved blood flow and ventilatory efficiency, leading to improved exercise capacity and O2 pulse over time. Methods We studied 28 PAH patients with (n=14) and without (n=14) sildenafil treatment. All received warfarin and diuretic therapy, and 13/14 sildenafil-treated patients were already receiving specific PAH drugs. Cardiopulmonary exercise testing was performed before and after sildenafil. Results Peak V?O2, peak O2 pulse, V?E/V?CO2 and PetCO2, were 0.84 ± 0.1 L/min, 6.1 ± 0.7 ml • beat?1, 49 ± 2 and 26 ± 1.5 mmHg, and improved after adding sildenafil to 0.91 ± 0.1 L/min, 6.8 ± 0.8 ml • beat?1, 43 ± 2, and 30 ± 1.9, respectively, whereas control patients worsened (p = 0.012, 0.008, 0.008 and 0.0002, treated vs. controls, respectively). Conclusions Sildenafil improves PetCO2, V?E/V?CO2, peak O2 pulse and peak V?O2 during exercise compared to controls. A prospective, placebo-controlled study is needed to validate these findings.

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

2007-01-01

376

An Elementary Organic Review Exercise.  

ERIC Educational Resources Information Center

An elementary organic review exercise is described which can be given to a secondary school student who has completed an elementary unit on the chemistry of carbon. This is recommended as an exercise, not a test, but can be utilized for evaluative purposes. The format includes both multiple-choice and essay questions. (DS)

Beach, Darrell H.

1980-01-01

377

Advanced Exercises  

NSDL National Science Digital Library

These exercises help students understand how the code of the Insertion Sort and the Selection Sort work. It also compares how efficient several different algorithms are. Advanced Exercise 1 - Understanding the Insertion Sort code Remember that the Insertion Sort sort works by making sure everything to the left of the pointer is sorted. The variable j of the for loop represents this pointer, and therefore it starts at 1 and continues to the end of the ...

Watts, Mrs.

2007-10-15

378

Using Electromyography to Detect the Weightings of the Local Muscle Factors to the Increase of Perceived Exertion During Stepping Exercise  

Microsoft Academic Search

Rate of perceived exertion (RPE) is a clinically co nvenient indicator for monitoring exercise intensity in cardiopulmonary re habilitation. It might not be sensitive enough for clinicians to determine the patients' ph ysiological status because its association with the cardiovascular system and local muscle fac tors is unknown. This study used the electromyographic sensor to detect the local muscle fatigue

Ya-Ju Chang; Chin-Chih Liu; Cheng-Hsiang Lin; Peih-Ling Tsaih; Miao-Ju Hsu

2008-01-01

379

Association of SNPs from 17 Candidate Genes with Baseline Symptom-Limited Exercise Test Duration and Decrease in Duration over 20 Years: The CARDIA Fitness Study  

PubMed Central

Background It is not known if the genes involved with endurance performance during young adulthood are also involved with changes in performance. We examined the associations of gene variants with symptom-limited exercise test duration at baseline and decrease in duration over 20 years. Methods and Results 3,783 (1,835 Blacks 1,948 Whites) and 2,335 (1,035 Blacks 1,300 Whites) participants from CARDIA were included in the baseline and 20 year models, respectively. 217 SNPs in Blacks and 171 SNPs in Whites from 17 genes were genotyped. In Blacks, five SNPs in the ATP1A2, HIF1A, NOS3, and PPARGC1A loci tended to be associated (p<0.05) with baseline duration in a multivariate regression model. Blacks (n=99) with at least four of the most-favorable genotypes at these loci had approximately two minutes longer baseline duration than those with only two such genotypes (P<0.0001). In Whites, the HIF1A rs1957757 and PPARGC1A rs3774909 markers tended to be associated with baseline duration, but the association of a multimarker construct of the most-favorable genotypes at both SNPs with baseline duration was not statistically significant. In Whites, four SNPs in the AGT, AMPD1, ANG, and PPARGC1A loci tended to be associated with decrease in exercise duration over 20 years, and those (n=40) with all four favorable genotypes had 0.8 min less decline in duration compared to those with none or one (n=232) (P<0.0001). Conclusion In multimarker constructs, alleles at genes related to skeletal muscle Na+/K+ transport, hypoxia, and mitochondrial metabolism are associated with symptom-limited exercise test duration over time in adults.

Sarzynski, Mark A.; Rankinen, Tuomo; Sternfeld, Barbara; Grove, Megan L.; Fornage, Myriam; Jacobs, David R.; Sidney, Stephen; Bouchard, Claude

2011-01-01

380

Evaluation of an Exercise Field Test Using Heart Rate Monitors to Assess Cardiorespiratory Fitness and Heart Rate Recovery in an Asymptomatic Population  

PubMed Central

Purpose Measures of cardiorespiratory fitness (CRF) and heart rate recovery (HRR) can improve risk stratification for cardiovascular disease, but these measurements are rarely made in asymptomatic individuals due to cost. An exercise field test (EFT) to assess CRF and HRR would be an inexpensive method for cardiovascular disease risk assessment in large populations. This study assessed 1) the predictive accuracy of a 12-minute run/walk EFT for estimating CRF () and 2) the accuracy of HRR measured after an EFT using a heart rate monitor (HRM) in an asymptomatic population. Methods Fifty subjects (48% women) ages 18–45 years completed a symptom-limited exercise tolerance test (ETT) (Bruce protocol) and an EFT on separate days. During the ETT, was measured by a metabolic cart, and heart rate was measured continuously by a HRM and a metabolic cart. Results EFT distance and sex independently predicted. The average absolute difference between observed and predicted was 0.26±3.27 ml·kg?1·min?1 for our model compared to 7.55±3.64 ml·kg?1·min?1 for the Cooper model. HRM HRR data were equivalent to respective metabolic cart values during the ETT. HRR at 1 minute post-exercise during ETT compared to the EFT had a moderate correlation (r?=?0.75, p<0.001). Conclusion A more accurate model to estimate CRF from a 12-minute run/walk EFT was developed, and HRR can be measured using a HRM in an asymptomatic population outside of clinical settings.

Coolbaugh, Crystal L.; Anderson, Ivan B.; Wilson, Machelle D.; Hawkins, David A.; Amsterdam, Ezra A.

2014-01-01

381

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

PubMed Central

Background After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. Methods/Design This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (?20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject’s inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Discussion Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics-assisted treadmill exercise is a relatively recent intervention method and might be used to train and evaluate aerobic capacity in this population. The present pilot trial is expected to provide new insights into the implementation of early cardiovascular exercise for individuals with severe motor impairment. The findings of this study may guide future research to explore the effects of early cardiovascular activation after severe neurological events. Trial registration This trial is registered with the Clinical Trials.gov Registry (NCT01679600).

2013-01-01

382

The preventative role of growth hormone on acute liver injury induced by cardiopulmonary bypass in a rat model  

Microsoft Academic Search

Objective: Cardiopulmonary bypass (CPB)-induced acute liver injury is a life-threatening complication after cardiac surgery and is thought to be associated with inflammatory response and acute-phase response (APR). Recombinant human growth hormone (rhGH) can modulate the APR and inflammatory response. Here, we tested the protective effect of GH on CPB-induced liver injury in the rat. Methods: Adult male Sprague— Dawley rats

Yong An; Ying-Bin Xiao

2010-01-01

383

The preventative role of growth hormone on acute liver injury induced by cardiopulmonary bypass in a rat model  

Microsoft Academic Search

Objective: Cardiopulmonary bypass (CPB)-induced acute liver injury is a life-threatening complication after cardiac surgery and is thought to be associated with inflammatory response and acute-phase response (APR). Recombinant human growth hormone (rhGH) can modulate the APR and inflammatory response. Here, we tested the protective effect of GH on CPB-induced liver injury in the rat. Methods: Adult male Sprague–Dawley rats (group

Yong An; Ying-Bin Xiao

2007-01-01

384

Cardiopulmonary limited ultrasound examination for "quick-look" bedside application.  

PubMed

Although taking a "quick look" at the heart using a small ultrasound device is now feasible, a formal ultrasound imaging protocol to augment the bedside physical examination has not been developed. Therefore, we sought to evaluate the diagnostic accuracy and prognostic value of a cardiopulmonary limited ultrasound examination (CLUE) using 4 simplified diagnostic criteria that would screen for left ventricular dysfunction (LV), left atrial (LA) enlargement, inferior vena cava plethora (IVC+), and ultrasound lung comet-tail artifacts (ULC+) in patients referred for echocardiography. The CLUE was tested by interpretation of only the parasternal LV long-axis, subcostal IVC, and 2 lung apical views in each of 1,016 consecutive echocardiograms performed with apical lung imaging. For inpatients, univariate and multivariate logistic regression analyses were performed to assess the relations between mortality, CLUE findings, age, and gender. In this echocardiographic referral series, 78% (n = 792) were inpatient and 22% (n = 224) were outpatient. The CLUE criteria demonstrated a sensitivity, specificity, and accuracy for a LV ejection fraction of ?40% of 69%, 91%, and 89% and for LA enlargement of 75%, 72%, and 73%, respectively. CLUE findings of LV dysfunction, LA enlargement, IVC+, and ULC+ were seen in 16%, 53%, 34%, and 28% of inpatients. The best multivariate logistic model contained 3 predictors of in-hospital mortality: ULC+, IVC+ and male gender, with adjusted odds ratios (95% confidence intervals) of 3.5 (1.4 to 8.8), 5.8 (2.1 to 16.4), and 2.3 (0.9 to 5.8), respectively. In conclusion, a CLUE consisting of 4 quick-look "signs" has reasonable diagnostic accuracy for bedside use and contains prognostic information. PMID:21641569

Kimura, Bruce J; Yogo, Norihiro; O'Connell, Charles W; Phan, James N; Showalter, Brian K; Wolfson, Tanya

2011-08-15

385

Near-death experiences in patients undergoing cardiopulmonary resuscitation  

Microsoft Academic Search

The purposes of this two-phase descriptive study were to document the frequency of near-death experiences (NDEs) in a nonprobability convenience sample of patients undergoing cardiopulmonary resuscitation (CPR), to describe the types of NDE experienced most commonly during CPR, and to describe patients' views of helpful nursing responses to reports of NDEs. In Phase I a nurse read to subjects Greyson's

Susan Boykoff Schoenbeck; Gerald D. Hocutt

1991-01-01

386

Transthoracic echocardiography for cardiopulmonary monitoring in intensive care  

Microsoft Academic Search

Summary Background and objective: To evaluate the feasibility of an abbreviated focus assessed transthoracic echocardio- graphic protocol, consisting of four standardized acoustic views for cardiopulmonary screening and monitoring. Methods: