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1

Cardiopulmonary exercise testing: current applications.  

PubMed

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

Stringer, William W

2010-04-01

2

Software for interpreting cardiopulmonary exercise tests  

PubMed Central

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

Ross, Robert M; Corry, David B

2007-01-01

3

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. PMID:19231322

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

2010-01-01

4

Cardiopulmonary exercise testing following hay exposure challenge in farmer's lung  

Microsoft Academic Search

ABSTRACT: In patients experiencing an acute ,episode of hypersensitivity pneu- monitis (HP), the alveoli and interstitium show a marked inflammation. The effects ofthis infiltration with effector cells on gas ,exchange and the cardiopulmonary system are not well characterized, and there are no data regarding cardiopul- monary,exercise testing during hypersensitivitypneumonitis. The aim of this study was to gain new insights into

M. Schwaiblmair; T. Beinert; C. Vogelmeier; G. Fruhmann

1997-01-01

5

Serial Cardiopulmonary Exercise Testing in Patients with Previous Fontan Surgery  

PubMed Central

Patients with previous Fontan surgery have reduced peak oxygen consumption (VO2), and data regarding progression of exercise intolerance is limited. The purpose of this study was to assess the evolution of exercise tolerance in patients with previous Fontan surgery. We performed a retrospective cohort study of patients with previous Fontan surgery who underwent cardiopulmonary exercise testing between November 2002 and January 2009. Patients were required to have completed at least two tests, with adequate levels of effort, ?6 months apart. We identified 78 patients (55% male) who had undergone a total of 215 cardiopulmonary exercise tests. Age at initial study was 19.7 ± 10.2 years; time interval since previous Fontan surgery 13.3 ± 5.7 years; and time interval between the initial and the most recent exercise test was 3.0 ± 1.4 years. Morphologic left ventricle was present in 58 (74.4%) patients. At baseline, peak VO2 averaged 24.7 ± 7.0 ml/kg/min (63.7% ± 15.8% predicted). At most recent study, peak VO2 averaged 23.2 ± 7.2 ml/kg/min, (60.4% ± 13.9% predicted). Percent predicted peak VO2 declined slowly, with a mean rate of decline of 1.25 ± 0.36 percentage points/y (p < 0.001). Most of the decline occurred in patients < 18 years of age (mean rate of decline 1.78 ± 0.46 percentage points/y; p = 0.0004). Thereafter, the rate of decline was less marked (mean rate of decline 0.54 ± 0.57 percentage points/y; p = not significant). Ventricular morphology, type of Fontan procedure, and cardiac medications were not predictive of progressive exercise intolerance. In conclusion, although the exercise function of previous Fontan patients tends to decline during late adolescence, it appears to stabilize during early adulthood. PMID:19915891

Fernandes, Susan M.; McElhinney, Doff B.; Khairy, Paul; Graham, Dionne A.; Landzberg, Michael J.; Rhodes, Jonathan

2014-01-01

6

Cardiopulmonary Exercise Testing in Lung Transplantation: A Review  

PubMed Central

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

Dudley, Katherine A.; El-Chemaly, Souheil

2012-01-01

7

Cardiopulmonary exercise testing: arm crank vs cycle ergometry.  

PubMed

This pilot study compared oxygen consumption during arm crank and cycle ergometer tests in 15 women. The mean (SD) peak oxygen consumption was less with arm cranking (25 (5) ml.kg(-1) .min(-1)) than with cycling (40 (7) ml.kg(-1) .min(-1)), p < 0.0001. The mean (SD) anaerobic threshold was less with arm cranking (13 (2) ml.kg(-1) .min(-1)) than with cycling (20 (4) ml.kg(-1) .min(-1)), p < 0.0001. There was moderate correlation, r(2) = 0.60, between the anaerobic thresholds determined by arm and leg exercise, p = 0.0007. This study suggests that arm crank cardiopulmonary exercise testing could be used for pre-operative assessment in those unable to cycle. PMID:23573845

Orr, J L; Williamson, P; Anderson, W; Ross, R; McCafferty, S; Fettes, P

2013-05-01

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. PMID:21179195

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

2010-01-01

9

Revisiting cardiopulmonary exercise testing applications in heart failure: aligning evidence with clinical practice.  

PubMed

American Heart Association/American College of Cardiology class recommendations and associated level of evidence for cardiopulmonary exercise testing (CPX) have been put forth. A new paradigm is proposed for CPX use and interpretation in heart failure (HF). Evidence for this new paradigm will be provided, showing that clinical utilization, class recommendations, and the associated level of evidence for CPX in the HF population can be expanded significantly. PMID:25061999

Arena, Ross; Guazzi, Marco; Cahalin, Lawrence P; Myers, Jonathan

2014-10-01

10

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. PMID:19233492

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

11

Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing  

PubMed Central

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

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

2013-01-01

12

Cardiopulmonary exercise testing prior to myeloablative allo-SCT: a feasibility study.  

PubMed

The feasibility of symptom-limited cardiopulmonary exercise testing (CPET) prior to allo-SCT was assessed in addition to the prognostic value of CPET-derived measures. CPET was performed prospectively on 21 patients with hematologic malignancies, with assessments of peak (for example, peak oxygen consumption, VO2peak) and submaximal (for example, ventilatory threshold (VT)) measures of cardiopulmonary function. No serious adverse events were observed during CPET procedures, with 95% of patients achieving criteria for a peak test. Mean VO2peak was 24.7±6.4?mL?kg(-1?)min(-1) (range: 10.9-35.5), equivalent to 29%±17% below that of age-matched healthy controls. All patients proceeded with the conditioning regimen followed by allo-SCT. Median follow-up was 25 months. During this period, 11 (52.4%) patients died (n=6, relapsed disease; n=5, non-relapse mortality (NRM)); 9 patients (43%) developed pulmonary toxicity. In univariate analyses, both peak and submaximal markers of cardiopulmonary function were predictors of OS, pulmonary toxicity and NRM. For OS, the HR for VO2peak and VT were 0.89 (95% CI, 0.8-0.99, P=0.04) and 0.84 (95% CI, 0.71-0.98, P=0.03), respectively. In conclusion, CPET is safe and feasible prior to allo-SCT. Patients have marked impairments in cardiopulmonary function prior to allo-SCT. CPET-derived metrics may complement conventional measures to improve risk stratification. PMID:25068429

Kelsey, C R; Scott, J M; Lane, A; Schwitzer, E; West, M J; Thomas, S; Herndon Ii, J E; Michalski, M G; Horwitz, M E; Hennig, T; Jones, L W

2014-10-01

13

The utility of cardiopulmonary exercise testing to detect and track early-stage ischemic heart disease.  

PubMed

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

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

2010-10-01

14

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. PMID:20884826

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

15

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

PubMed Central

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

Mohammad, Majid Malek; Dadashpour, Shahdak

2012-01-01

16

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

17

Oxygen pulse kinetics in Fontan patients during treadmill ramp protocol cardiopulmonary exercise testing.  

PubMed

After single-ventricle palliation, patients have variable long-term functional outcomes. Cardiopulmonary exercise testing (CPET) is an assessment tool used to quantify functional outcome. Oxygen pulse kinetics during CPET, which can be an important indicator of dynamic changes in stroke volume reserve, has not been systematically studied in this population. This study aimed to analyze oxygen pulse kinetics during a treadmill ramp protocol among patients with Fontan physiology compared with that of normal subjects and to explore the ability of oxygen pulse kinetics to define functional status further. Peak oxygen pulse and change in oxygen pulse during ramp treadmill CPET were retrospectively collected and compared between 44 Fontan patients and 85 age- and sex-matched control subjects. The peak oxygen pulse was significantly lower in the Fontan group (9.80 ± 4.11 ml/beat) than in the control group (13.62 ± 4.7 ml/beat) (p ? 0.001). The resting oxygen pulse did not differ between the two groups (3.13 ± 1.23 vs. 3.09 ± 1.33 ml/beat; p = 0.88). The oxygen pulse was higher in the patients with chronotropic insufficiency, but the difference was not statistically significant (11.11 ± 4.97 vs. 9.25 ± 3.63 ml/beat; p = 0.17). Regression analysis showed a significant difference in the slope of the oxygen pulse-to-workload relationship. The Fontan group showed no relation between degree of reduction in the oxygen pulse from peak to end of exercise and the underlying defect, peak heart rate, peak oxygen consumption, ventilatory anaerobic threshold (VAT), expired volume (VE)/carbon dioxide output (VCO(2)) at the VAT, maximum heart rate, or minimum oxygen saturation. Analysis of oxygen pulse kinetics in Fontan patients suggests that there is an early and progressive limitation in stroke volume compared with control subjects. This limitation may be partially masked by increased oxygen extraction. In patients with chronotropic insufficiency, absolute or body surface area-indexed oxygen pulse may be higher than in those with a normal heart rate response. A composite assessment of the oxygen pulse and oxygen pulse kinetics, including the oxygen pulse slope and the percentage of reduction in oxygen pulse from peak to end of exercise, may allow a more comprehensive assessment of the degree of cardiac limitation in this group of patients. PMID:22466709

Bansal, Manish; Fiutem, Justin J; Hill, James A; O'Riordan, Mary Ann; Zahka, Kenneth G

2012-12-01

18

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. PMID:24015343

Aliannejad, Rasoul; Saburi, Amin; Ghanei, Mostafa

2013-01-01

19

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

PubMed Central

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

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

2014-01-01

20

Cardiopulmonary stress during exercise training in patients with COPD.  

PubMed

Exercise training is an essential component of pulmonary rehabilitation. However, the cardiopulmonary stress imposed during different modalities of exercise training is not yet known. In the present study, the cardiopulmonary stress of a 12-week exercise training programme in 11 chronic obstructive pulmonary disease (COPD) patients (forced expiratory volume in one second 42+/-12%pred, age 69+/-6 yrs) was measured. Pulmonary gas exchange and cardiac frequency (f(C)) of three training sessions were measured with a portable metabolic system at the beginning, mid-term and end of the programme. Symptoms were assessed with Borg scores. The exercise intensity was compared with the recommendations for exercise training by the American College of Sports Medicine (ACSM). Training effects were significant (maximum change in work: 14+/-11 Watts, 6-min walk test: 44+/-36 m). Whole body exercises (cycling, walking and stair climbing) consistently resulted in higher cardiopulmonary stress (oxygen uptake (V'(O(2))), minute ventilation and f(C)) than arm cranking and resistance training. Dyspnoea was higher during cycling than resistance training. Patients exercised for >70% (>20 min) of the total exercise time at >40% of the V'(O(2)) reserve and f(C) reserve ("moderate" intensity according to the ACSM) throughout the programme. The cardiopulmonary stress resistance training is lower than during whole-body exercise and results in fewer symptoms. In addition, exercise testing based on guidelines using a fixed percentage of baseline peak performance and symptom scores achieves and sustains training intensities recommended according to the American College of Sports Medicine. PMID:16540501

Probst, V S; Troosters, T; Pitta, F; Decramer, M; Gosselink, R

2006-06-01

21

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

PubMed Central

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

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

2012-01-01

22

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

PubMed

Cardiopulmonary exercise testing for peak oxygen uptake (Vo(2peak)) can evaluate prognosis in chronic heart failure (CHF) patients, with the peak respiratory exchange ratio (RER(peak)) commonly used to confirm maximal effort and maximal oxygen uptake (Vo(2max)). We determined the precision of RER(peak) in confirming Vo(2max), and whether a novel ramp-incremental (RI) step-exercise (SE) (RISE) test could better determine Vo(2max) in CHF. Male CHF patients (n = 24; NYHA class I-III) performed a symptom-limited RISE-95 cycle ergometer test in the format: RI (4-18 W/min; ?10 min); 5 min recovery (10 W); SE (95% peak RI work rate). Patients (n = 18) then performed RISE-95 tests using slow (3-8 W/min; ?15 min) and fast (10-30 W/min; ?6 min) ramp rates. Pulmonary gas exchange was measured breath-by-breath. Vo(2peak) was compared within patients by unpaired t-test of the highest 12 breaths during RI and SE phases to confirm Vo(2max) and its 95% confidence limits (CI(95)). RER(peak) was significantly influenced by ramp rate (fast, medium, slow: 1.21 ± 0.1 vs. 1.15 ± 0.1 vs. 1.09 ± 0.1; P = 0.001), unlike Vo(2peak) (mean n = 18; 14.4 ± 2.6 ml·kg(-1)·min(-1); P = 0.476). Group Vo(2peak) was similar between RI and SE (n = 24; 14.5 ± 3.0 vs. 14.7 ± 3.1 ml·kg(-1)·min(-1); P = 0.407); however, within-subject comparisons confirmed Vo(2max) in only 14 of 24 patients (CI(95) for Vo(2max) estimation averaged 1.4 ± 0.8 ml·kg(-1)·min(-1)). The RER(peak) in CHF was significantly influenced by ramp rate, suggesting its use to determine maximal effort and Vo(2max) be abandoned. In contrast, the RISE-95 test had high precision for Vo(2max) confirmation with patient-specific CI(95) (without secondary criteria), and showed that Vo(2max) is commonly underestimated in CHF. The RISE-95 test was well tolerated by CHF patients, supporting its use for Vo(2max) confirmation. PMID:22653993

Bowen, T Scott; Cannon, Daniel T; Begg, Gordon; Baliga, Vivek; Witte, Klaus K; Rossiter, Harry B

2012-08-01

23

Cardiopulmonary Exercise Testing Identifies Low Risk Patients With Heart Failure and Severely Impaired Exercise Capacity Considered for Heart Transplantation  

Microsoft Academic Search

Objectives. The 3-year survival rates of 500 patients with congestive heart failure (CHF) referred for heart transplantation were assessed to evaluate the clinical and exercise variables most useful for estimating prognostic risk.Background. Detailed prognostic risk stratification of patients with a peak exercise oxygen consumption (Vo2) 14 ml\\/min per kg to identify lower risk patient subsets has been limited in earlier

Naohiko Osada; Bernard R Chaitman; Leslie W Miller; Daniel Yip; Mary Beth Cishek; Thomas L Wolford; Thomas J Donohue

1998-01-01

24

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. PMID:22002871

Fadel, Paul J.; Raven, Peter B.

2011-01-01

25

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

PubMed

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

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

2014-11-01

26

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

27

Cardiopulmonary responses to exercise in patients with hypertrophic cardiomyopathy  

PubMed Central

Objective—To examine the submaximal and maximal indices of the exercise response of patients with hypertrophic cardiomyopathy.?Design and setting—Prospective examination of cardiopulmonary responses to ramp exercise test of a consecutive group of patients with hypertrophic cardiomyopathy attending a cardiomyopathy outpatient clinic.?Methods—50 patients aged 12 to 76 years (mean (SD) 35 (14)) with diagnosis of hypertrophic cardiomyopathy performed incremental cycle ergometry; 22 sedentary volunteers (seven female, 15 male) aged 14 to 58 years (mean (SD) 31 (12)) served as controls. Respiratory gas was continuously sampled from the mouthpiece, and its concentration profile phase aligned to the respired air flow signals. Following analogue to digital conversion, gas exchange variables were computed breath by breath and the data were averaged every 30 seconds for graphic display. A 12 lead ECG was monitored continuously and recorded every three minutes during the exercise.?Results—Both the peak oxygen uptake attained on the test (V?O2 peak) and anaerobic threshold were reduced in patients with hypertrophic cardiomyopathy compared with the control group (p < 0.0001). In 29 patients (59%) the V?O2 peak was less than 60% and only two patients achieved a peak above 80% of their predicted values. The anaerobic threshold was below 60% of the predicted value in 31 patients and above 80% in only three patients. The slope of oxygen uptake/work rate relation (?V?O2/?WR) was decreased in 16 patients (32%). The maximum oxygen pulse (V?O2/HR) was reduced as a percentage of the predicted value, and became flat at high work rates in 32 patients. There was a significant correlation between anaerobic threshold and V?O2 peak (p < 0.0001), work efficiency (p < 0.0001), and maximum oxygen pulse (p < 0.0001). The slope of change in ventilation against change in carbon dioxide output (?V?E/?V?CO2) for the subanaerobic threshold range was increased in 36 patients (72%) and was inversely correlated with anaerobic threshold (p < 0.0002).?Conclusions—There were severe abnormalities in maximal and submaximal indices of pulmonary gas exchange in a cohort of hypertrophic cardiomyopathy patients attending a referral cardiovascular clinic. The pattern of the abnormalities suggests that a reduced stroke volume response, ventilation/perfusion mismatch, and abnormal peripheral oxygen utilisation are the possible mechanisms of exercise intolerance.?? Keywords: exercise tolerance;  work efficiency;  oxygen pulse;  hypertrophic cardiomyopathy PMID:9764062

Jones, S; Elliott, P; Sharma, S; McKenna, W; Whipp, B

1998-01-01

28

Anemia of Chronic Disease in Chronic Obstructive Pulmonary Disease: A Case-Control Study of Cardiopulmonary Exercise Responses  

Microsoft Academic Search

Background: Anemia may be present in patients with chronic obstructive pulmonary disease (COPD) and further impair their functional capacity. Objectives: This study investigated the prevalence of anemia of chronic disease (ACD) in COPD patients and its impact on dyspnea and exercise capacity, utilizing cardiopulmonary exercise testing (CPET). Methods: ACD prevalence was assessed in 283 consecutive patients with stable COPD (263

Afroditi K. Boutou; Ioannis Stanopoulos; Georgia G. Pitsiou; Theodoros Kontakiotis; George Kyriazis; Lazaros Sichletidis; Paraskevi Argyropoulou

2011-01-01

29

Cardiopulmonary adaptation to exercise in coal miners  

SciTech Connect

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

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

1980-11-01

30

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

31

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

NASA Technical Reports Server (NTRS)

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

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

1991-01-01

32

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, ...

33

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

PubMed

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

Miliaresis, Christa; Beker, Susan; Gewitz, Michael

2014-01-01

34

Amelioration of Depressed Cardiopulmonary Reflex Control of Sympathetic Nerve Activity by Short-Term Exercise Training in Male Rabbits with Heart Failure  

Microsoft Academic Search

Abstract The reflex regulation of sympathetic nerve activity has been demonstrated,to be impaired in the chronic heart failure (CHF) state compared,to the normal condition. Exercise training (EX) appears to be beneficial to patients with CHF and has been shown to reduce sympathetic outflow in this disease state. We tested the hypothesis that EX corrects the reduced cardiopulmonary,(CP) reflex response to

R. U. Pliquett; K. G. Cornish; K. P. Patel; H. D. Schultz; J. D. Peuler; I. H. Zucker

2003-01-01

35

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

PubMed Central

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

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

1997-01-01

36

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 PMID:10768898

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

2000-01-01

37

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

PubMed Central

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

2014-01-01

38

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

39

Heparin sensitivity test for patients requiring cardiopulmonary bypass.  

PubMed

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

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

2006-12-01

40

Utility of metabolic exercise testing in distinguishing hypertrophic cardiomyopathy from physiologic left ventricular hypertrophy in athletes  

Microsoft Academic Search

OBJECTIVESThis study evaluated the role of metabolic (cardiopulmonary gas exchange) exercise testing in differentiating physiologic LVH in athletes from HCM.BACKGROUNDRegular intensive training may cause mild increases in left ventricular wall thickness (LVWT). Although the degree of left ventricular hypertrophy (LVH) is typically less than that seen in hypertrophic cardiomyopathy (HCM), genetic studies have shown that a substantial minority of patients

Sanjay Sharma; Perry M Elliott; Greg Whyte; Niall Mahon; Mohan S Virdee; Brian Mist; William J McKenna

2000-01-01

41

Cardiopulmonary Rehabilitation, Exercise Training, and Preventive Cardiology: An Overview of a Decade of Research at the Ochsner Heart and Vascular Institute: Presented in part at Grand Rounds, Research Series, Ochsner Medical Institutions, May 17, 1999  

PubMed Central

A decade of research from the Ochsner Heart and Vascular Institute's cardiopulmonary rehabilitation and exercise training programs demonstrates the benefits of this therapy on coronary risk factors, exercise capacity, cardiopulmonary parameters, behavioral characteristics, and quality of life in various subgroups of patients, including the elderly, women, obese patients, and groups with dyslipidemia and psychological distress, as well as in patients with congestive heart failure or severe lung disease. Substantial data from our program support the idea that cardiopulmonary rehabilitation and exercise training programs are underemphasized and underutilized for the secondary prevention of coronary artery disease. PMID:21845136

Lavie, Carl J.; Milani, Richard V.; Cassidy, Mark M.; Gilliland, Yvonne E.; Bernal, J. Alberto

1999-01-01

42

Exercise stress testing  

NASA Technical Reports Server (NTRS)

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

Schuster, B.

1975-01-01

43

Specificity of a Maximal Step Exercise Test  

ERIC Educational Resources Information Center

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

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

2007-01-01

44

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

45

Different ventilatory responses to progressive maximal exercise test performed with either the arms or legs  

PubMed Central

OBJECTIVE: This study aimed to compare respiratory responses, focusing on the time-domain variability of ventilatory components during progressive cardiopulmonary exercise tests performed on cycle or arm ergometers. METHODS: The cardiopulmonary exercise tests were conducted on twelve healthy volunteers on either a cycle ergometer or an arm ergometer following a ramp protocol. The time-domain variabilities (the standard deviations and root mean squares of the successive differences) of the minute ventilation, tidal volume and respiratory rate were calculated and normalized to the number of breaths. RESULTS: There were no significant differences in the timing of breathing throughout the exercise when the cycle and arm ergometer measurements were compared. However, the arm exercise time-domain variabilities for the minute ventilation, tidal volume and respiratory rate were significantly greater than the equivalent values obtained during leg exercise. CONCLUSION: Although the type of exercise does not influence the timing of breathing when dynamic arm and leg exercises are compared, it does influence time-domain ventilatory variability of young, healthy individuals. The mechanisms that influence ventilatory variability during exercise remain to be studied. PMID:21876964

Castro, Renata R T; Pedrosa, Sabrina; Nobrega, Antonio C L

2011-01-01

46

Oxygen Pulse as a Predictor of Cardiopulmonary Events in Lung Resection  

Microsoft Academic Search

Traditional algorithms suggest a stepwise approach to the functional evaluation of candidates for lung resection. A cardiopulmonary exercise test is incorporated as a supplementary test for patients with borderline pulmonary predicted values, and sometimes as a first screening test for cardiac risk evaluation. To assess the predictive weight of exercise tests in noncardiac thoracic surgery, we retrospectively analyzed 99 patients

Andrea Campione; Alberto Terzi; Marco Bobbio; Gian Luca Rosso; Angela Beatrice Scardovi; Mauro Feola

2010-01-01

47

Effect of low altitude at the Dead Sea on exercise capacity and cardiopulmonary response to exercise in cystic fibrosis patients with moderate to severe lung disease.  

PubMed

Oxygen supplementation may improve exercise tolerance and the physiological response to exercise in cystic fibrosis (CF) patients. Elevated barometric pressure at low altitude is a simple means of increasing the quantity of inspired oxygen. Our objectives were to examine the effect of natural oxygen enrichment (at the Dead Sea, 396 m below sea level) on exercise capacity, and the physiological responses to maximal and submaximal exercise in CF patients. Patients were tested twice: at sea level (barometric pressure, 754 +/- 6 mmHg, mean +/- SD), and at the Dead Sea (barometric pressure, 791 +/- 3 mmHg), in a randomized crossover design. We studied 14 CF patients (6 females, 8 males), aged 15-45 years, with moderate to severe lung disease (mean forced expired volume in 1 sec = 50.0 +/- 11.2% predicted). Tests at each site included resting spirometry, anthropometry, a graded submaximal exercise test, a maximal exercise test on a treadmill, and a 6-min walk test. Tests were performed in identical order at both sites. Tests at the Dead Sea were performed 72 hr after arrival. No differences between sites were observed in lung function at rest. Peak oxygen consumption was significantly improved at the Dead Sea compared with sea level (1.68 +/- 0.73 vs. 1.57 +/- 0.74 l/min, respectively, P = 0.05), along with an improvement in the ventilatory equivalent for oxygen (41.2 +/- 6.3 vs. 46.1 +/- 7.1, respectively, P < 0.05). During submaximal exercise, blood oxygen saturation improved at the Dead Sea compared with sea level at all exercise intensities (P < 0.05). In conclusion, these results suggest that even a brief stay at the Dead Sea area may have physiological benefits for CF patients with moderate to severe lung disease. PMID:16429430

Falk, Bareket; Nini, Asaph; Zigel, Levana; Yahav, Yaacov; Aviram, Micha; Rivlin, Joseph; Bentur, Lea; Avital, Avraham; Dotan, Raffy; Blau, Hannah

2006-03-01

48

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

PubMed Central

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

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

1977-01-01

49

Patterns of cardiovascular and ventilatory response to maximal cardiopulmonary test in elite basketball players  

Microsoft Academic Search

Material and methods. Materials of the study were collected during a ramp exercise test of 33 professional athletes using an electronically braked bike ERGOLINE 9000. Power output and heart rate samples were collected. Ventilation and gas exchange indices were measured during the tests using VMAX229 metabolic card and Sensor Medics gas flow analyzer. Scattergrams of power, oxygen uptake, heart rate

Audrius Gocentas; Algirdas Juozulynas; Vytautas Obelenis; Arturas Andziulis; Anatoli Landõr

50

Activated clotting time tests with heparinase in the management of pediatric patients on cardiopulmonary bypass.  

PubMed

Routine ACT tests cannot distinguish between prolonged blood clotting due to heparin effect or acquired abnormalities of the coagulation system after a loading dose of heparin. The purpose of this study was to examine an ACT test that inactivates heparin with Heparinase allowing for ACT assessment with and without heparin effect (HR-ACT with/without Heparinase, HemoTec, Inc.). The HR-ACT values were compared with the standard OR procedure that employed the Hemochron ACT. Twenty pediatric patients undergoing cardiopulmonary bypass for repair of cardiac defects were examined. All comparative ACT values were obtained from the same blood sample. Five sampling times were examined: 1) A baseline ACT was obtained before heparin had been administered; 2) A pre bypass ACT after a single heparin dose; 3) On bypass; 4) A post protamine ACT at the conclusion of surgery; and 5) In the Intensive Care Unit (PICU), 1 hour post protamine. The HemoTec HR-ACT with Heparinase and HR-ACT tests differentiated clotting time results that reflected coagulation status without the heparin effect. It identified those patients on bypass who were less than 5 kg, with prolonged ACTs that were due in part to hemodilution despite efforts at hemoconcentration. PMID:8123932

Kriesmer, P; Payne, N R; Tessmer, J; Uden, D L

1993-01-01

51

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

52

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

PubMed

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

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

2011-05-01

53

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

54

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

PubMed

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

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

2011-03-01

55

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

PubMed Central

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

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

2014-01-01

56

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

PubMed

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

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

2014-11-01

57

Biological quality control for exercise testing  

Microsoft Academic Search

BACKGROUNDA study was undertaken to evaluate the use of a biological quality control programme for a computer controlled, breath-by-breath exercise test system over a 2.5 year period.METHODSOne healthy volunteer performed a regular progressive treadmill test with breath-by-breath measurements of oxygen uptake (V?o2), carbon dioxide output (V?co2), ventilation (V?e), and the ECG heart rate (HR). Following a familiarisation period, five consecutive

S M Revill; M D L Morgan

2000-01-01

58

Reliability of Peak Exercise Testing in Patients with Heart Failure with Preserved Ejection Fraction  

PubMed Central

Exercise intolerance is the primary symptom among heart failure patients with preserved ejection fraction (HFpEF), is a major determinant of their reduced quality of life, and an important outcome in clinical trials. Although cardiopulmonary exercise testing (CPET) provides peak and submaximal diagnostic indices, the reliability of peak treadmill CPET in patients ? 55 years of age with HFpEF has not been examined. Two CPETs were performed in 52 HFpEF patients (age 70 ± 7 years). The two tests were separated by an average of 23 ± 13 days (median: 22 days) and performed under identical conditions, with no intervention or change in status between visits except for initiation of a placebo run-in. A multi-step protocol for patient screening, education, and quality control was utilized. Mean peak VO2 was similar on test 1 and test 2 (14.4 ± 2.4 vs. 14.3 ± 2.3 ml/kg/min). The correlation coefficients and intraclass correlations (ICC) from the testing days were as follows: VO2 r = 0.85, p < 0.001, ICC = 0.855; ventilatory anaerobic threshold r= 0.79, p < 0.001, ICC= 0.790; VE/VCO2 slope r = 0.87, p < 0.001, ICC = 0.864; HR r = 0.94, p < 0.001, ICC = 0.938. These results challenge conventional wisdom that serial baseline testing is required in clinical trials with exercise capacity outcomes. In conclusion, in women and men with HFpEF and severe physical dysfunction, key submaximal and peak exercise testing variables exhibited good reliability and were not significantly altered by a learning effect or placebo administration. PMID:22981266

Scott, Jessica M.; Haykowsky, Mark J.; Eggebeen, Joel; Morgan, Timothy M.; Brubaker, Peter H.; Kitzman, Dalane W.

2012-01-01

59

Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?  

PubMed Central

In patients with fibrotic idiopathic interstitial pneumonia (f-IIP), the diffusing capacity for carbon monoxide (DLCO) has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-a)O2 at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT). Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF, n = 88) and fibrotic nonspecific interstitial pneumonias (NSIP, n = 33). All but 3 patients (97.5%) had low DLCO values (35?mmHg) and 100 (83%) demonstrated significant oxygen desaturation during 6MWT (>4%). Interestingly 27 patients had low DLCO and normal P(A-a)O2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-a)O2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-a)O2, peak, or 6MWT SpO2. PMID:22900170

Wallaert, Benoit; Wemeau-Stervinou, Lidwine; Salleron, Julia; Tillie-Leblond, Isabelle; Perez, Thierry

2012-01-01

60

Exercise testing and training with the young cystic fibrosis patient.  

PubMed

The purpose of the article is to review the literature related to exercise and Cystic fibrosis (CF), with particular focus on the young CF patient. Exercise intolerance is a characteristic of CF, however, recent studies in adults have advanced our understanding of how exercise can be used effectively as a prognostic marker and for rehabilitation purposes. New analyses from exercise testing have shown to have prognostic value, and different methods of exercise training have been reported to improve the functional capacity and quality of life of the young CF patient. There is a growing awareness and belief among clinicians of the benefits of exercise testing and training, however, recent work suggests that exercise is being underused in the healthcare management of the CF patient. More research is needed to identity which exercise tests and training programmes would be most feasible to incorporate into CF centres routine clinical procedures. Key pointsNew methods of health assessment from exercise testing in the young CF patient have shown to have prognostic value.The introduction of new training methods into exercise programmes can improve the functional capacity and quality of life of young patients with CF.Exercise is still being underused in the healthcare management of the CF patient. PMID:24149414

Stevens, Daniel; Williams, Craig A

2007-01-01

61

Is it Necessary to Weight Exercises in Standard Tests?  

Microsoft Academic Search

This is an examination into the advisability of weighting separate exercises or questions that make up a standard test. Many standard tests are composed of exercises of unequal difficulty and the cumulative method employed in scoring these tests involves the weighting of unit problems. The weights are usually expressed in terms of PE or SD recalculated with reference to an

Peter L. Spencer; Harl R. Douglass

1923-01-01

62

Energy System Contributions During Incremental Exercise Test  

PubMed Central

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

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

2013-01-01

63

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

64

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

65

Methodologic problems in exercise testing research. Are we solving them  

Microsoft Academic Search

To evaluate the comparative effects of methodologic factors on the reported accuracies of two standard exercise tests, 56 publications comparing the exercise thallium scintigram with the coronary angiogram were analyzed for conformation to five methodologic standards. Analyzed were adequate definition of study group, avoidance of a limited challenge group, avoidance of workup bias, and blinded analysis of the coronary angiogram

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

1988-01-01

66

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

SciTech Connect

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

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

1984-04-01

67

Exercise training after burn injury: a survey of practice.  

PubMed

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

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

2013-01-01

68

The value test: An exercise in futility  

SciTech Connect

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

Cordato, R.E.

1995-09-01

69

Effects of air ventilation during stationary exercise testing.  

PubMed

The impact of air ventilation on performance and physiological responses during stationary exercise in the laboratory was studied. Fourteen well-trained cyclists performed three exercise tests on a cycle ergometer, each separated by a 1-week interval. The first test was a graded test to determine the power output corresponding with the 4-mmol l(-1) lactate level. Tests 2 and 3 were 30-min constant-load tests at a power output corresponding with this 4-mmol l(-1) lactate threshold. One constant-load test was performed in the absence (NAV), whilst the other was performed in the presence (AV) of air ventilation (3 m s(-1)). During the constant-load tests, heart rate, tympanic temperature, blood lactate concentration and oxygen uptake (VO2) were measured at 10-min intervals and at the end of the test. Differences between the two test conditions were evaluated using paired t-tests. During NAV, 12 subjects interrupted the test due to premature exhaustion (exercise duration <30 min), versus only seven in AV ( P<0.05). At the end of the test tympanic temperature was 35.9 (0.2) degrees C in AV and was higher in NAV [36.7 (0.2) degrees C, P<0.05]. Exercise heart rate increased at a faster rate during NAV [+2.2 (0.3) beats min(-1)] than during AV [+1.5 (0.2) beats min(-1), P<0.05]. Blood lactate concentration and VO2 were similar between conditions. Air ventilation is essential to prevent an upward shift in the lactate:heart rate as well as the power output:heart rate relationship during laboratory exercise testing and indoor exercise training. PMID:15083366

Van Schuylenbergh, R; Vanden Eynde, B; Hespel, P

2004-07-01

70

Statistical Lessons Learned From Exercise Testing Research and Scores  

Microsoft Academic Search

\\u000a Four major mistakes have been made when evaluating the exercise test’s diagnostic characteristics that explain much of the\\u000a differences in the studies. They are: 1) choosing subjects for test evaluation that represent a limited challenge to the diagnostic\\u000a performance of the test, 2) not limiting the amount of work up bias in identifying patients for test evaluation, 3) applying\\u000a age-predicted

Vic Froelicher

71

Use of transcutaneous oxygen and carbon dioxide tensions for assessing indices of gas exchange during exercise testing.  

PubMed

The slow response characteristics of the combined transcutaneous electrode have been viewed as a major disadvantage when compared with other types of non-invasive assessment of gas exchange during exercise testing. We have previously shown that by using the highest recommended temperature of 45 degrees C to reduce response times, and combining this with an exercise protocol of gradual work load increments, that this allows changes in arterial blood gases to be closely followed by transcutaneous values. In the present study we have validated the use of a transcutaneous electrode for estimation of alveolar-arterial oxygen gradient (AaO2) and dead space to tidal volume ratio (V(D)/V(T)) during exercise, against values calculated from direct arterial blood gas analysis. One hundred measurements were made in 20 patients with various cardiopulmonary disorders who underwent exercise testing. Exercise testing was performed by bicycle ergometry with a specific protocol involving gradual work load increments at 2 min intervals. Transcutaneous gas tensions were measured by a heated combined O2 and CO2 electrode. Arterial blood was sampled at the midpoint of each stage of exercise and transcutaneous tensions noted at the end of each stage. The mean difference of the AaO2 gradient calculated from blood gas tensions obtained by the two methods was 0.14 kPa. The limits of agreement were -0.26 and 0.63 kPa. The same values for V(D)/V(T) calculated from gas tensions measured by the two methods were: mean difference 0001; limits of agreement -0.0242 and 0.0252. For both these parameters there was an even scatter around the mean value on Bland and Altman analysis. The findings of this study suggest that estimation of parameters of gas exchange using transcutaneous values during exercise testing is reliable, provided the electrode is heated to a slightly higher temperature than usual and the work load increments are gradual, allowing for the latency in the response time of the system. This system allows the assessment of the contribution of ventilation/perfusion inequality to breathlessness on exertion in patients, provided an initial arterial or ear lobe capillary sample is obtained for calibration purposes. This technique is particularly valuable in patients undergoing repeat exercise tests as it circumvents the need for arterial cannulation. PMID:10845433

Carter, R; Banham, S W

2000-04-01

72

An Exercise for Illustrating the Logic of Hypothesis Testing  

ERIC Educational Resources Information Center

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

Lawton, Leigh

2009-01-01

73

Treadmill exercise testing in an epidemiologic study of elderly subjects.  

PubMed

We sought to characterize the physical performance of older subjects in a community-based study of aging and fitness and to establish norms of oxygen consumption during exercise in this group. A community-based census identified 3057 age-eligible individuals of whom 2092 individuals (68.4%) agreed to participate in the overall study. Of these, 1101 subjects between 55 and 94 years of age who were free of known heart disease and able to perform treadmill exercise were tested using the Cornell protocol. Of these 1101 subjects, 73.8% of women and 89.5% of men (p < .001) exceeded what was considered a minimal threshold workload [i.e., > or =2 min of exercise and a respiratory exchange ratio (RER) > or = 1.00]. Moreover, 32.9% of women and 52.7% of men achieved a RER > or = 1.10 and were considered to have achieved maximal exercise. For all subjects who exceeded the minimal exercise workload, the mean exercise duration was 10.0 +/- 4.0 min for women and 13.2 +/- 4.6 min for men. Peak VO2/kg x min(-1) decreased linearly with age for both women (y = 38.33 - 0.27 x age + 1.12 H) and men (y = 41.78 - 0.26 x age + 12.65 H - 0.15 H x age), (p < .001 for sex difference), where H is defined as presence (=1) or absence (=0) of a disease condition. However, this sex-related difference disappeared when VO2/kg x min(-1) was adjusted for lean body mass. Thus, from a community-based sample of older persons, we have provided data (by 5-year age groups) for rates of participation in treadmill exercise testing and the success rate for achieving maximal exercise. Oxygen consumption and other exercise data are presented for older, healthy subjects as well as for those with various chronic diseases associated with aging (excluding those with cardiac or cerebrovascular disease). Exercise duration, peak VO2/kg x min(-1) (normalized for total and lean body mass), and peak exercise heart rate declined with age. Most of the sex difference in peak VO2/kg x min(-1) could be explained by the greater percent of body fat in women. PMID:18314555

Hollenberg, M; Ngo, L H; Turner, D; Tager, I B

1998-07-01

74

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

75

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.

76

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

Microsoft Academic Search

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

C Trümper; S Mäueler; C Vobejda; E Zimmermann

2009-01-01

77

Treadmill exercise testing with increasing inclination as exercise protocol for wheelchair athletes  

Microsoft Academic Search

Study design: Treadmill testing on a progressive incline of 11 wheelchair athletes.Objective: To determine if a novel treadmill exercise protocol which uses increments in inclination, rather than the standard increments in velocity, can be used to effectively determine maximum oxygen uptake VO2max for elite wheelchair athletes.Setting: Nottwil, Switzerland.Methods: Eleven elite wheelchair basketball players (29.3±6.3 years, 72.7±16.9 kg and 177±9.6 cm)

B Knechtle; W Köpfli

2001-01-01

78

Cardiopulmonary adaptation to weightlessness  

NASA Technical Reports Server (NTRS)

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

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

1994-01-01

79

[Interpretation of exercise stress testing by primary care physicians].  

PubMed

Considering that angina is an important symptom of coronary heart disease, exercise stress testing has proven its usefulness and remains a reference exam. Indeed, it is reasonably reliable and accessible, even for non cardiologist physicians, and provides both diagnostic as well as prognostic information. In this article, we review the key points to know about stress testing, in particular patient selection and interpretation of it results. A good comprehension of these different aspects is likely to improve patient care and to help avoid, additional tests that may be unnecessary. PMID:19852420

Graz, Y; Perrenoud, J-J; Gaspoz, J-M

2009-09-23

80

Blood lactate diagnostics in exercise testing and training.  

PubMed

A link between lactate and muscular exercise was seen already more than 200 years ago. The blood lactate concentration (BLC) is sensitive to changes in exercise intensity and duration. Multiple BLC threshold concepts define different points on the BLC power curve during various tests with increasing power (INCP). The INCP test results are affected by the increase in power over time. The maximal lactate steady state (MLSS) is measured during a series of prolonged constant power (CP) tests. It detects the highest aerobic power without metabolic energy from continuing net lactate production, which is usually sustainable for 30 to 60 min. BLC threshold and MLSS power are highly correlated with the maximum aerobic power and athletic endurance performance. The idea that training at threshold intensity is particularly effective has no evidence. Three BLC-orientated intensity domains have been established: (1) training up to an intensity at which the BLC clearly exceeds resting BLC, light- and moderate-intensity training focusing on active regeneration or high-volume endurance training (Intensity < Threshold); (2) heavy endurance training at work rates up to MLSS intensity (Threshold ? Intensity ? MLSS); and (3) severe exercise intensity training between MLSS and maximum oxygen uptake intensity mostly organized as interval and tempo work (Intensity > MLSS). High-performance endurance athletes combining very high training volume with high aerobic power dedicate 70 to 90% of their training to intensity domain 1 (Intensity < Threshold) in order to keep glycogen homeostasis within sustainable limits. PMID:21487146

Beneke, Ralph; Leithäuser, Renate M; Ochentel, Oliver

2011-03-01

81

Use of electrocardiographic-thallium exercise testing in clinical practice  

SciTech Connect

Although there is a great deal of data on the accuracy of combined electrocardiographic-thallium exercise testing, little is known about the use of these tests in clinical practice. A quantitative likelihood system was employed to characterize referral patterns for such testing, and the impact of test results on the likelihood of coronary artery disease was examined. Two hundred thirteen subjects consecutively referred for the purpose of establishing or excluding the presence of coronary artery disease were studied. No subject had a history of a prior myocardial infarction. By historical evaluation, 96 had a low likelihood of coronary disease (less than or equal to 0.20), 88 an intermediate likelihood (0.21 to 0.80) and 29 a high likelihood (greater than 0.80). As anticipated from theoretical analyses, testing produced the greatest shifts in disease likelihood in subjects with an intermediate pretest disease likelihood, and confirmed the historical evaluation in patients at the extremes of pretest disease likelihood. Therefore, although electrocardiographic-thallium stress testing is best suited for subjects with intermediate pretest disease likelihood, the majority of referrals had either a high or low likelihood. Clinicians appear to value confirmatory results in patients at the extremes of pretest disease likelihood. Electrocardiographic exercise testing would serve a similar purpose.

Gitler, B.; Fishbach, M.; Steingart, R.M.

1984-02-01

82

Cancer and the cardiopulmonary system  

SciTech Connect

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

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

1984-01-01

83

Effects of bilateral T2-sympathectomy on static and dynamic heart rate responses to exercise in hyperhidrosis patients  

Microsoft Academic Search

The static\\/dynamic changes of gas exchange, heart rate (HR) and blood pressure in terms of work rate (WR) and WR changes in ramp exercise were investigated by cardio-pulmonary exercise tests (CPETs) in hyperhidrosis patients before (W0), one week (W1) and four weeks (W4) after bilateral T2-sympathectomy. Accompanied by constant oxygen consumption and WR at peak exercise and similar oxygen debt

Hua Ting; Shin-Da Lee; Ai-Hui Chung; Ming-Lung Chuang; Gin-Den Chen; Jiuan-Miaw Liao; Chen-Lurng Chang; Thomas S. M. Chiou; Tzer-Bin Lin

2005-01-01

84

Estimation of the exercise ventilatory compensation point by the analysis of the relationship between minute ventilation and heart rate  

Microsoft Academic Search

Cardiopulmonary exercise test is the gold standard for the identification of the ventilatory compensation point (VCP), an\\u000a important threshold for exercise training prescription. We hypothesized that changes in the slope of increment in minute ventilation\\u000a (V’E) over heart rate (HR) during incremental exercise can be utilized, as alternative to the ventilatory equivalents method,\\u000a for VCP detection. In 14 healthy subjects

Paolo Onorati; Dario Martolini; Josuel Ora; Gabriele Valli; Alexia Fedeli; Paolo Palange

2008-01-01

85

Exercise testing and stress imaging in valvular heart disease.  

PubMed

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

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

2014-09-01

86

Heart rate deceleration after exercise predicts patients most likely to respond to cardiac resynchronisation therapy  

Microsoft Academic Search

ObjectiveThis study examines the relationship between heart rate recovery following exercise and subsequent response to cardiac resynchronisation therapy (CRT).BackgroundBlunted heart rate recovery is an adverse prognostic marker in heart failure and has been shown to correlate with disease severity.Methods37 patients receiving biventricular pacemakers for conventional indications underwent functional assessments; cardiopulmonary exercise test, 6-min walk test and quality-of-life assessment, together with

D. E. Thomas; S. A. Exton; Z. R. Yousef

2010-01-01

87

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

88

Reduced Cardiopulmonary Baroreflex Sensitivity in Patients With Hypertrophic Cardiomyopathy  

Microsoft Academic Search

Objectives. We sought to assess baroreflex function in patients with hypertrophic cardiomyopathy (HCM). Background. We have previously demonstrated a specific ab- normality in the afferent limb of the cardiopulmonary baroreflex in patients with vasovagal syncope. Patients with HCM exhibit abnormal control of their vasculature during exercise and upright tilt; we therefore hypothesize a similar abnormality in the afferent limb of

HELEN L. THOMSON; JAYNE MORRIS-THURGOOD; JOHN ATHERTON; MICHAEL FRENNEAUX

2010-01-01

89

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

Microsoft Academic Search

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

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

2008-01-01

90

Pyridostigmine reduces QTc interval during recovery from maximal exercise in ischemic heart disease  

Microsoft Academic Search

Following a randomized, cross-over, and double-blind design, 14 patients with coronary heart disease were submitted, to maximal cardiopulmonary exercise tests on a treadmill, 2 h after the oral administration of either placebo or pyridostigmine bromide (45 mg), a reversible cholinesterase inhibitor. One observer, who was blind to the experimental condition, measured RR and QT intervals over the 12 electrocardiographic leads

Renata R. T. Castro; Salvador M. Serra; Graciema Porphirio; Fernanda S. N. S. Mendes; Leonardo P. J. Oliveira; Antonio C. L. Nóbrega

2006-01-01

91

Self -Exercising Self Testing k-orderComparators X. Kavousianos & D. Nikolos  

E-print Network

, which usually differs from application to application. In [1] it was shown that Self-Exercising (SESelf - Exercising Self Testing k-orderComparators X. Kavousianos & D. Nikolos Department@ceid.upatras.gr, nikolosd@cti.gr Abstract In this paper we give a systematic method to design Self - Exercising (SE) [11self

Kavousianos, Xrysovalantis

92

Exercise Testing, Training, and Beta-Adrenergic Blockade.  

ERIC Educational Resources Information Center

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

Wilmore, Jack H.

1988-01-01

93

[Predictors of cardiac arrhythmias in patients with arterial hypertension during exercise stress testing].  

PubMed

Arterial hypertension is an important risk factor for atrial and ventricular arrhythmias. 203 male patients were examined in order to identify predictors of cardiac arrhythmias in patients with arterial hypertension during exercise stress testing. All participants were studied by 24-hour ambulatory blood pressure monitoring, transthoracic echocardiography, an ultrasound scan of the carotid arteries and treadmill test. 47,3% of patients presented cardiac arrhythmias during exercise stress testing. The left ventricular mass, diastolic function and carotid intima-media thickness were found to be independent predictors of exercise-induced arrhythmias. The use of the exercise stress testing may be reasonable for additional risk stratification in hypertensive patients. PMID:24632645

2014-02-01

94

Late cardiopulmonary toxicity after treatment for Hodgkin's disease.  

PubMed Central

Cardiac and pulmonary functions were evaluated in 75 patients aged 50 years or under, treated for Hodgkin's disease by mantle radiotherapy at least 3 years earlier; all received the same mantle field radiotherapy: radiotherapy alone, MOPP chemotherapy plus radiotherapy, MOPP and ABVD chemotherapy plus radiotherapy. No patient had any symptom of heart disease. Only borderline abnormalities of ECG or echocardiogram were observed in 12 patients. One of them showed a moderate aortic stenosis which was known before the treatment; apical or septum hypokinesia were present in four patients and one patient had a slightly right ventricular dilatation. Twelve (16%) chest radiographs showed moderate or severe abnormalities, but there was no significant correlation between the results of pulmonary function tests and Xenon ventilation/perfusion scintigraphy, the clinical examination and the intensity of the radiological sequelae. Twenty-nine (64%) Xenon scintigraphies showed a reduction of lung perfusion in the irradiated areas without any symptom. The resting mean pulmonary function test was significantly lower for the patients than for the control group with regard to Total Capacity and Vital Capacity. The exercise tolerance, as indicated by analysis of blood gases, was below the one expected for only two patients who were dyspneic during the low level of exercise. We did not find any significant difference between the three treatment groups. We conclude that the treatment with mantle field under good technical conditions (high energy photons, moderate doses...) can result in minimal cardiopulmonary dysfunction. PMID:1616862

Allavena, C.; Conroy, T.; Aletti, P.; Bey, P.; Lederlin, P.

1992-01-01

95

Predictors of Older Primary Care Patients' Participation in a Submaximal Exercise Test and a Supervised, Low-Impact Exercise Class  

Microsoft Academic Search

Objectives. This study is an investigation of physical activity promotion among a nonvolunteer sample of community-dwelling, older, urban primary care patients. Our primary interest was in the rates of exercise test and class participation. Of secondary interest were the medical record and baseline survey predictors of test and class participation.Methods. The first 500 nonterminally ill women ages 50 years or

Teresa M. Damush; Timothy E. Stump; AnnMarie Saporito; Daniel O. Clark

2001-01-01

96

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

97

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

98

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

PubMed Central

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

Horwood, Anna; Toor, Sonia

2014-01-01

99

Measuring behavioral outcomes in cardiopulmonary rehabilitation: AN AACVPR STATEMENT.  

PubMed

Outcome measurement in cardiopulmonary rehabilitation is required for optimal assessment of program quality, effectiveness of treatments, and evaluation of patient progress. Recent position statements from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Cardiology, American Heart Association, American Thoracic Society, and American College of Chest Physicians have provided state-of-the-art information on the importance of assessing performance and outcome measures for optimal program effectiveness. Such measures are also required for AACVPR program certification. To meet current standards of practice, the AACVPR developed an Outcomes Matrix that includes 4 domains: Health, Clinical, Behavioral, and Service. Although the Clinical and Health domains have been most commonly used in outcome reporting (eg, 6-minute walk test, quality-of-life survey scores), behavioral measures have received less attention, primarily because they have been perceived as being more difficult to measure and quantify over time. This statement describes 5 common behavioral outcome measures: smoking cessation, medication use, supplemental oxygen use, exercise habits, and nutritional behaviors. Sample questions and calculations for each of these behavioral measures are also provided. By using these measures at program entry and completion, cardiac and pulmonary rehabilitation practitioners can effectively track and document behavioral changes over time for physicians, third-party insurance providers, or hospital administrators and thus demonstrate the effectiveness of exercise and educational interventions on patient overall health and well-being. PMID:19471140

Verrill, David; Graham, Helen; Vitcenda, Mark; Peno-Green, Laura; Kramer, Valerie; Corbisiero, Teresa

2009-01-01

100

The stage one Turing test as an artificial intelligence class exercise  

Microsoft Academic Search

This paper describes an implementation of the man-woman Turing test as a class exercise in an artificial intelligence course. The exercise helps students to understand more clearly the difficulties and challenges involved in designing an artificially intelligent computer to pass the more famous person-computer Turing test.

Nancy Lynn Tinkham; Darren F. Provine

1994-01-01

101

The stage one Turing test as an artificial intelligence class exercise  

Microsoft Academic Search

This paper describes an implementation of the man-woman Turing test as a class exercise in an artificial intelligence course. The exercise helps students to understand more clearly the difficulties and challenges involved in designing an artificially intelligent computer to pass the more famous person-computer Turing test.

Nancy Lynn Tinkham; Darren F. Provine

1995-01-01

102

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

103

Muscle anaerobic response to a maximal treadmill exercise test in Standardbred trotters.  

PubMed

The purpose of this study was to develop a standardised maximal treadmill exercise test performed until fatigue in order to find reproducible markers for anaerobic metabolism, specifically adenine nucleotide degradation. Six Standardbred trotters performed an incremental maximal treadmill exercise test in 1 min steps (starting with 7 m/s) until they could no longer keep pace with the treadmill. The test was performed twice with at least one week between the tests. Heart rate was recorded and venous blood samples were obtained during the test and in the recovery period for determination of plasma lactate, hypoxanthine, xanthine and uric acid. Muscle biopsy samples (m. gluteus) were collected at rest, immediately post exercise, and after 15 min recovery and analysed for their concentrations of glycogen, creatine phosphate (CP), adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), inosine monophosphate (IMP) and muscle lactate (MLa). Significant decreases in glycogen, CP and ATP and significant increases in IMP and MLa were seen immediately post exercise. None of these metabolites had returned to resting levels after 15 min of recovery. A marked increase in plasma lactate (PLa) occurred during exercise and the peak concentration (mean value = 27.2 mmol/l) was reached within 5 min of recovery. Plasma uric acid concentration did not increase during exercise but rose markedly immediately post exercise, reaching the highest level (mean value = 121.5 micromol/l) at 20-30 min recovery. The duration of the maximal test was related to peak PLa and the uric acid concentration at 30 min of recovery. A correlation was also found between the ATP and IMP concentrations immediately post exercise and the plasma uric acid concentration at 30 min of recovery. The results show that this treadmill test triggered anaerobic metabolism and also that uric acid concentration post exercise seems to be a marker for the adenine nucleotide degradation that occurs during intense exercise. No significant differences were seen in metabolic response between the 2 test occasions. PMID:9844969

Schuback, K; Essén-Gustavsson, B

1998-11-01

104

Importance of Treadmill Exercise Time as an Initial Prognostic Screening Tool in Patients with Systolic Left Ventricular Dysfunction  

PubMed Central

Background We sought to determine if treadmill exercise time may be of value as an initial prognostic screening tool in ambulatory patients with impaired systolic function referred for cardiopulmonary exercise testing. Methods and Results We studied 2,231 adult systolic heart failure patients (27% women) who underwent cardiopulmonary stress testing using a modified Naughton protocol. We assessed the value of treadmill exercise time for prediction of all-cause death and a composite of death or UNOS status 1 heart transplantation. During a mean follow up of 5 years, 742 (33%) patients died. There were 249 (11%) UNOS status 1 heart transplants. Treadmill exercise time was predictive of death and the composite outcome in both women and men, even after accounting for peak oxygen consumption and other clinical covariates (adjusted hazard ratio of lowest versus high sex-specific quartile for prediction of death 1.70, 95% CI 1.05–2.75, P=0.03, and for prediction of the composite outcome 1.75, 95% CI 1.15–2.66, P=0.009). For a one minute change in exercise time there was a 7% increased hazard of death (e.g. comparing 480 to 540 seconds HR 1.07, 95% CI 1.02–1.12, P=0.004). Conclusions Since cardiopulmonary stress testing is not available in every hospital, treadmill exercise time using a modified Naughton protocol may be of value as an initial prognostic screening tool. PMID:19528334

Hsich, Eileen; Gorodeski, Eiran Z.; Starling, Randall C.; Blackstone, Eugene H.; Ishwaran, Hemant; Lauer, Michael S.

2014-01-01

105

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

PubMed Central

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

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

2014-01-01

106

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

107

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

108

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

PubMed Central

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

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

2014-01-01

109

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. PMID:23875788

2013-01-01

110

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

Microsoft Academic Search

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

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

2002-01-01

111

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

MedlinePLUS

... EKGs and exercise stress tests EKGs and exercise stress tests When you need them for heart disease—and when you don't Download PDF If you ... of heart disease, an electrocardiogram (EKG) or exercise stress test can be lifesaving. The same is true ...

112

Comparison of Adenosine and Exercise Stress Test for Quantitative Perfusion Imaging in Patients on Beta-Blocker Therapy  

Microsoft Academic Search

Beta-blocker therapy is used to decrease myocardial ischemia during exercise but may cause suboptimal diagnostic performance in exercise stress testing. The aim of the present study was to compare results of quantitative technetium-99-sestamibi single photon emission tomography (SPECT), following exercise stress test or pharmacological stress test with adenosine. We chose adenosine as comparison, since betablockers may not interfere with adenosine

Roland Müller-Suur; Sven V. Eriksson; Lars Erik Strandberg; Laszlo Mesko

2001-01-01

113

Studies with the USF/NASA toxicity screening test method - Exercise wheels and oxygen replenishment  

NASA Technical Reports Server (NTRS)

Continuing efforts to improve the University of San Francisco/NASA toxicity screening test method have included the addition of exercise wheels to provide a different measure of incapacitation, and oxygen replenishment to offset any effect of oxygen depletion by the test animals. The addition of exercise wheels limited the number of animals in each test and doubled the required number of tests without any significant improvement in reproducibility. Oxygen replenishment appears to have an effect on survival in the last 5 minutes of the 30-minute test, but the effect is expected to be similar for most materials.

Hilado, C. J.; Cumming, H. J.

1977-01-01

114

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

115

Clinical and Exercise Test Predictors of All-Cause Mortality* Results From > 6,000 Consecutive Referred Male Patients  

Microsoft Academic Search

Objective: To report the prevalence of abnormal treadmill test responses and their association with mortality in a large consecutive series of patients referred for standard exercise tests, with testing performed and reported in a standardized fashion. Background: Exercise testing is widely performed, but few databases exist of large numbers of consecutive tests performed on patients referred for routine clinical purposes

Manish Prakash; Jonathan Myers; Victor F. Froelicher; Rachel Marcus; Dat Do; Damayanthi Kalisetti; J. Edwin Atwood

116

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

ERIC Educational Resources Information Center

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

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

2007-01-01

117

Prevalence of False-Positive Exercise Tests in Apparently Normal Women.  

ERIC Educational Resources Information Center

The results of exercise testing in 192 apparently healthy women were examined to assess the false-positive rate in cardiovascular response. Findings are presented. It is suggested that varying methods of testing and interpretation may account for the high rate of false positivity in some testing centers. (Author/MT)

Murray, Paul M.; Cantwell, John D.

1988-01-01

118

Different effects of exercise tests on the antioxidant enzyme activities in lymphocytes and neutrophils  

Microsoft Academic Search

We have determined the effects of maximal and submaximal cycloergometer tests on the antioxidant enzyme defences of neutrophils and lymphocytes. We also compared the neutrophil and lymphocyte basal enzyme antioxidant activities. A total of 17 well-trained amateur athletes, runners, and cyclists participated in this study. Two tests were performed on an electromagnetic reduction cycloergometer: the maximal exercise test, and the

Pedro Tauler; Antoni Aguiló; Isabel Gimeno; Pilar Guix; Josep A Tur; Antoni Pons

2004-01-01

119

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

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

Arm-cranking exercise assisted by Functional Electrical Stimulation in C6 tetraplegia: a pilot study.  

PubMed

Tetraplegic volunteers undertook progressive exercise training, using novel systems for arm-cranking exercise assisted by Functional Electrical Stimulation (FES). The main aim was to determine potential training effects of FES-assisted arm-crank ergometry (FES-ACE) on upper limb strength and cardiopulmonary (fitness) in tetraplegia. Surface FES was applied to the biceps and triceps during exercise on an instrumented ergometer. Two tetraplegic volunteers with C6 Spinal Cord Injury (SCI) went through muscle strengthening, baseline exercise testing and three months of progressive FES-ACE training. Repeat exercise tests were carried out every four weeks during training, and post-training, to monitor upper-limb strength and cardiopulmonary fitness. At each test point, an incremental test was carried out to determine peak work rate, peak oxygen uptake, gas exchange threshold and oxygen uptake-work rate relationship during FES-ACE. Peak oxygen uptake for Subject A increased from 0.7 l/min to 1.1 l/min, and peak power output increased from 7 W to 38 W after FES-ACE training. For Subject B, peak oxygen uptake was unchanged, but peak power output increased from 3 W to 8 W. These case studies illustrate potential benefits of FES-ACE in tetraplegia, but also the differences in exercise responses between individuals. PMID:19212037

Coupaud, S; Gollee, H; Hunt, K J; Fraser, M H; Allan, D B; McLean, A N

2008-01-01

122

Exercise test in pediatric renal transplant recipients and its relationship with their cardiac function.  

PubMed

Pediatric kidney transplant recipients are at increased risk of CVD. Exercise test is a good method to evaluate exercise capacity, cardiorespiratory fitness, and risk of potential CVDs. The aim of this study was to assess the exercise capacity in this population and determine its relationship with their cardiac function using conventional and tissue Doppler echocardiography. Exercise test, conventional and tissue Doppler echocardiography were performed on 44 kidney transplant children (age ranging 11-20, 59% male) with acceptable renal function, and the results were compared with their normal healthy counterparts. Our transplant patients achieved significantly lower maximal heart rate, maximal heart rate ratio, total energy expenditure during the exercise, and maximal O2 consumption (Max VO2 ) than the normal group (p < 0.05). No correlation was found between hemoglobin (Hb) level, dialysis duration, kidney function, and the exercise test parameters. Kidney transplant patients had preserved systolic despite diminished diastolic cardiac function compared to the normal children. Our pediatric renal transplant recipients had severely impaired diastolic dysfunction and significantly reduced MaxVO2 compared with their healthy counterparts. No correlation was found between MaxVO2 and measured indices of systolic and diastolic cardiac function. PMID:24483258

Derakhshan, Ali; Derakhshan, Dorna; Amoozgar, Hamid; Shakiba, Mohammad Ali; Basiratnia, Mitra; Fallahzadeh, Mohammad Hossein

2014-05-01

123

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

124

Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder  

ERIC Educational Resources Information Center

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

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

2010-01-01

125

Assessment of the Talk Test and Rating of Perceived Exertion for Exercise Intensity Prescription in Persons With Paraplegia  

PubMed Central

Background: Physical activity recommendations require accurate estimations of exercise intensity. Rating of Perceived Exertion (RPE) and talk test (TT) are 2 commonly recommended techniques to gauge intensity. It is not known whether these are valid to select an exercise intensity that would elicit a training effect for persons with spinal cord injury (SCI). Objective: To define the exercise intensity of each TT stage and RPE exercise intensity category and assess whether persons with paraplegia are able to use the TT to select a “comfortable” exercise workload they could maintain for 15 minutes. Methods: Twelve participants with paraplegia completed 2 arm crank exercise tests on nonconsecutive days within 14 days. Test 1 was an incremental peak effort assessment. Test 2 was a 15-minute simulated exercise session at a participant-selected fixed workload. During each test, participants reported their RPE and performed a TT at 2-minute intervals. Results: The intensity of the first negative TT stage was vigorous (75 ± 15 %VO2R); at low and moderate intensities, perceived effort was greater than measured intensity; at vigorous and maximal intensities, perceived effort matched measured intensity. Individuals successfully used the TT to select an exercise workload they could maintain for 15 minutes. RPE, but not exercise intensity, increased during the 15-minute session. Conclusions: During arm crank exercise when speaking is not comfortable (ie, first negative TT), persons with paraplegia are exercising at vigorous intensity, which is sufficient to elicit training effects. During incremental peak exercise testing, RPE does not appear to accurately index low-moderate exercise intensities. During the simulated exercise session, RPE appeared to index peripheral fatigue. PMID:23459216

Cowan, Rachel E.; Ginnity, Kelly L.; Kressler, Jochen; Nash, Mark S.; Nash, Mark S.

2012-01-01

126

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

127

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

128

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

PubMed Central

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

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

2013-01-01

129

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

130

Multiple-Choice Cloze Exercises: Consumer Domain. SPPED Test Development Notebook, Form 81-C [and] Answer Key for Multiple-Choice Cloze Exercises: Consumer Domain. SPPED Test Development Notebook, Form 85-C. Revised.  

ERIC Educational Resources Information Center

The "Test Development Notebook" is a resource designed for the preparation of tests of literal comprehension for students in grades 1 through 12. This volume contains 100 multiple-choice cloze exercises taken from consumer magazines, catalogs, instructions, advertisements, and contracts; and the accompanying answer key. Each exercise carries the…

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

131

Predicting Maximal Oxygen Uptake Via a Perceptually Regulated Exercise Test (PRET)  

Microsoft Academic Search

Recent research has yielded encouraging, yet inconsistent findings concerning the validity and reliability of predicting maximal oxygen uptake (V. O2max) from a graded perceptually regulated exercise test (PRET). Accordingly, the purpose of the present study was to revisit the validity and reliability of this application of ratings of perceived exertion (RPE) using a modified PRET protocol. Twenty-three volunteers (mean age,

Michael Morris; Kevin Lamb; David Cotterrell; John Buckley

2009-01-01

132

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

133

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

ERIC Educational Resources Information Center

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

Sparling, Phillip B.

1977-01-01

134

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

135

Factor XII deficiency and cardiopulmonary bypass.  

PubMed

Factor XII initiates the intrinsic coagulation cascade and may affect the fibrinolytic system. Routine coagulation tests used during cardiopulmonary bypass (CPB) are abnormal in factor-XII-deficient patients and are useless for monitoring anticoagulation in these patients. A factor-XII-deficient patient requiring CPB is described. The baseline celite activated clotting time (ACT) was greater than 1400 seconds and the thrombin time was 12.4 seconds (control, 11.9 seconds). Two units of plasma were given resulting in an ACT of 173 seconds. Following 300 units/kg of heparin and during CPB, the ACT ranged from 670-596 seconds with the thrombin time greater than 200 seconds. Plasma provides exogenous factor XII allowing an endpoint on the ACT test and may protect against possible postoperative hypofibrinolytic complications. A commercially available modified thrombin time may also be useful and provide an endpoint during high-dose heparinization. PMID:7795307

Wallock, M; Arentzen, C; Perkins, J

1995-01-01

136

21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

137

21 CFR 870.4230 - Cardiopulmonary bypass defoamer.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section 870.4230...870.4230 Cardiopulmonary bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction...

2012-04-01

138

21 CFR 870.4230 - Cardiopulmonary bypass defoamer.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section 870.4230...870.4230 Cardiopulmonary bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction...

2013-04-01

139

21 CFR 870.4230 - Cardiopulmonary bypass defoamer.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section 870.4230...870.4230 Cardiopulmonary bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction...

2011-04-01

140

21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.  

Code of Federal Regulations, 2011 CFR

... false Cardiopulmonary bypass pump speed control. 870.4380 Section 870...870.4380 Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a device used that...

2011-04-01

141

21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.  

Code of Federal Regulations, 2010 CFR

... false Cardiopulmonary bypass pump speed control. 870.4380 Section 870...870.4380 Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a device used that...

2010-04-01

142

Methods for “Indirect” challenge tests including exercise, eucapnic voluntary hyperpnea, and hypertonic aerosols  

Microsoft Academic Search

Bronchial provocation tests that use stimuli that act indirectly to cause airway narrowing have a high specificity for identifying\\u000a people with active asthma who have the potential to respond to treatment with antiinflammatory drugs. The first test to be\\u000a developed was exercise and it was used to assess the efficacy of drugs such as sodium cromoglycate. Eucapnic voluntary hyperpnea\\u000a was

Sandra D. Anderson; John D. Brannan

2003-01-01

143

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

PubMed

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

Wright, D J; Tan, L B

1999-08-01

144

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

PubMed Central

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

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

2012-01-01

145

Cardiopulmonary bypass assisted resection of mediastinal masses.  

PubMed

We report a recurrent solitary fibrous tumor of the mediastinum that was encircling the right pulmonary artery. The resection of the tumor with the involved right pulmonary artery segment and sequential graft reconstruction of the vessel was facilitated by the use of cardiopulmonary bypass. We review the indications, management, and outcomes of cardiopulmonary bypass for the resection of mediastinal masses. PMID:22500568

Agathos, E Andreas; Lachanas, Elias; Karagkiouzis, Grigorios; Spartalis, Eleftherios; Tomos, Periklis

2012-05-01

146

A Cart for Cardiopulmonary Resuscitation  

PubMed Central

The authors have devised a cart for use during cardiopulmonary resuscitation, the prime purpose of which is to bring every essential piece of equipment, and all the drugs generally required, to the immediate area to revive a pulseless and/or apneic patient with the least effort and confusion. The strategically placed contents of the cart are described. The regular use of such a cart, following appropriate formal staff training and instruction in resuscitation procedures, and frequent reading of an appropriate instruction poster, as well as the reporting of all these events on an appropriate protocol, will increase the effectiveness of acute resuscitation in hospital. ImagesFig. 1Fig. 2 PMID:14098894

Israel, Jacob S.; McCulla, Kathleen; Dobkin, Allen B.

1963-01-01

147

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

148

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

149

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

150

Surface-bound heparin fails to reduce thrombin formation during clinical cardiopulmonary bypass  

Microsoft Academic Search

The hypothesis that heparin-coated perfusion circuits reduce thrombin formation and activity; fibrinolysis; and platelet, complement, and neutrophil activation was tested in 20 consecutive, randomized adults who had cardiopulmonary bypass. Twenty identical perfusion systems were used; in 10, all blood-contacting surfaces were coated with partially degraded heparin (Carmeda process; Medtronic Cardiopulmonary, Anaheim, Calif.). All patients received a 300 U\\/kg dose of

Robert C. Gorman; Nicholas P. Ziats; A. Koneti Rao; Nicolas Gikakis; Ling Sun; Mohammed M. H. Khan; Nina Stenach; Suneeti Sapatnekar; Vibhuti Chouhan; Joseph H. Gorman; Stefan Niewiarowski; Robert W. Colman; James M. Anderson; L. Henry Edmunds

1996-01-01

151

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

NASA Technical Reports Server (NTRS)

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

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

1973-01-01

152

Use of transcutaneous oxygen and carbon dioxide tensions for assessing indices of gas exchange during exercise testing  

Microsoft Academic Search

The slow response characteristics of the combined transcutaneous electrode have been viewed as a major disadvantage when compared with other types of non-invasive assessment of gas exchange during exercise testing. We have previously shown that by using the highest recommended temperature of 45°C to reduce response times, and combining this with an exercise protocol of gradual work load increments, that

R CARTER; S. W BANHAM

2000-01-01

153

Non-invasive haemodynamic assessments using Innocor™ during standard graded exercise tests  

Microsoft Academic Search

Cardiac output (Q) and stroke volume (V\\u000a S) represent primary determinants of cardiovascular performance and should therefore be determined for performance diagnostics\\u000a purposes. Since it is unknown, whether measurements of Q and V\\u000a S can be performed by means of Innocor™ during standard graded exercise tests (GXTs), and whether current GXT stages are sufficiently\\u000a long for the measurements to take

Piero Fontana; Urs Boutellier; Marco Toigo

2010-01-01

154

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

155

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

Microsoft Academic Search

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

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

2002-01-01

156

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

SciTech Connect

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

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

1982-02-01

157

Role of exercise stress testing in healthy subjects and patients with coronary heart disease. Controversies in cardiology--I.  

PubMed

The value of the exercise stress test in the evaluation of clinically healthy subjects and patients with coronary heart disease is not limited to the isolated interpretation of abnormalities of the S-T segment. Other measurable parameters which are of diagnostic and prognostic importance include: (1) a decrease in systolic blood pressure during exercise; (2) the appearance of complex ventricular arrhythmias of low exercise heart rates; (3) the appearance of inverted U waves during or after exercise; (4) the patient's maximal exercise capacity; and (5) new auscultatory findings postexercise. The reliability of the exercise test as a diagnostic tool is futher enhanced by proper patient selection and careful attention to exercise techniques. Subjects with labile ST-T wave changes during standing hyperventilation, fixed ST-T changes at rest, and intraventricular conduction defects are not ideal candidates for "diagnostic" stress testing and the examining physician must rely more heavily on nonelectrocardiographic findings. The criteria used to define an abnormal S-T response will vary according to the lead system used. However, in both symptomatic and asymptomatic subjects the appearance of marked degrees of S-T depression at low exercise heart rates significantly increases the probability of finding advanced coronary disease, particularly if the S-T depression is seen in multiple monitoring leads and is of prolonged duration postexercise. PMID:358820

Morris, S N; McHenry, P L

1978-10-01

158

Comparison of oxygen consumption in rats during uphill (concentric) and downhill (eccentric) treadmill exercise tests.  

PubMed

The study of the physiological adaptations of skeletal muscle in response to eccentric (ECC) contraction is based on protocols in which exercise intensities are determined relative to the concentric (CON) reference exercise (as percentage of the CON maximal oxygen consumption, or VO2max). In order to use similar exercise protocols in rats, we compared the VO2 values during uphill (CON) and downhill (ECC) running tests. VO2 was measured in 15 Wistar rats during incremental treadmill running exercises with different slopes: level (0%), positive (+15% incline: CON+15%) and negative (i15% incline: ECC-15%; and 130% incline: ECC-30%). Similar VO2 values were obtained in the ECC-30% and CON+15% running conditions at the three target speeds (15, 25 and 35 cm/sec). Conversely, VO2 values were lower (p < 0.05) in the ECC-15% than in the CON+15% condition (CON+15% VO2/ECC-15% VO2 ratios ranging from 1.86 to 2.05 at the three target speeds). Thus, doubling the downhill slope gradient in ECC condition leads to an oxygen consumption level that is not significantly different as in CON condition. These findings can be useful for designing animal research protocols to study the effects of ECC and CON exercise in ageing population or subjects suffering from cardiovascular diseases. Key PointsVO2 in rats during treadmill race in eccentric and concentric conditions were measured.A novel breath-by-breath device allowing direct access to the animal was used.THREE DIFFERENT SLOPES: +15%, -15% and -30% were used.VO2 values obtained in the -30% eccentric and the +15% concentric conditions were not significantly different. PMID:25177200

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

2014-09-01

159

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

PubMed Central

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

2012-01-01

160

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

PubMed Central

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

Chavanelle, Vivien; Sirvent, Pascal; Ennequin, Gael; Caillaud, Kevin; Montaurier, Christophe; Morio, Beatrice; Boisseau, Nathalie; Richard, Ruddy

2014-01-01

161

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

162

Alteration of the neonatal pulmonary physiology after total cardiopulmonary bypass  

Microsoft Academic Search

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

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

1997-01-01

163

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

SciTech Connect

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

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

1984-05-01

164

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

165

Cost Benefit Analysis of Installing a Recovery Exercise Module (REM) in a Cruise Missile for an Operational Test Launch.  

National Technical Information Service (NTIS)

This thesis provides a cost benefit analysis of installing a Recovery Exercise Module (REM) in a Cruise Missile for an Operational Test Launch. Topics considered include: Should the Cruise Missile Project Office (CMPO) continue development of a new redesi...

H. E. Glassman

1987-01-01

166

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

E-print Network

DEVELOPMENT AND USE OF A STANDARD TREADMILL EXERCISE TEST FOR THE COMPARISON OF DIFFERENT CONDITIONING SCHEDULES IN THE HORSE A thesis by SUSAN CAROL PEARSON Submitted to the Graduate College of Texas A1IM Ur, iversity in partial fulfillment... of the requirement for the degree of MASTER OF SCIENCE May 1980 Major Subject: Animal Science DEVELOPMENT AND USE OF A STANDARD TREADMILL EXERCISE TEST FOR THE COMPARISON OF DIFFERENT CONDITIONING SCHEDULES IN THE HORSE A thesis by SUSAN CAROL PEARSON...

Pearson, Susan Carol

2012-06-07

167

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

SciTech Connect

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

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

1984-07-01

168

What are the electrical stimulation design parameters for maximum VO2 aimed at CardioPulmonary rehabilitation?  

Microsoft Academic Search

Electrical stimulation (ES) is increasingly being considered as a means to improve cardio-pulmonary performance in patients with reduced exercise capacity. This short review considers the ES signal parameters and protocols used in studies that have included a measurement of oxygen uptake during the session. It suggests that the tetanic signal parameters normally used for muscle strengthening are not suitable for

Conor M. Minogue; Brian M. Caulfield; Richard B. Reilly

2007-01-01

169

Mini cardiopulmonary bypass: Anesthetic considerations  

PubMed Central

This review article is going to elaborate on the description, components, and advantages of mini-cardiopulmonary bypass (mini-CPB), with special reference to the anesthetic management and fast track anesthesia with mini-CPB. There are several clinical advantages of mini-CPB like, reduced inflammatory reaction to the pump, reduced need for allogenic blood transfusion and lower incidence of postoperative neurological complications. There are certainly important points that have to be considered by anesthesiologists to avoid sever perturbation in the cardiac output and blood pressure during mini-CPB. Fast-track anesthesia provides advantages regarding fast postoperative recovery from anesthesia, and reduction of postoperative ventilation time. Mini bypass offers a sound alternative to conventional CPB, and has definite advantages. It has its limitations, but even with that it has a definite place in the current practice of cardiac surgery.

Alsatli, Raed A.

2012-01-01

170

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. PMID:15310394

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

2004-01-01

171

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

ERIC Educational Resources Information Center

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

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

2011-01-01

172

Walking tests during the exercise training: specific use for the cardiac rehabilitation.  

PubMed

Walk tests, principally the six-minute walk test (6mWT), constitute a safe, useful submaximal tool for exercise tolerance testing in cardiac rehabilitation (CR). The 6mWT result reflects functional status, walking autonomy and efficacy of CR on walking endurance, which is more pronounced in patients with low functional capacity (heart failure - cardiac surgery). The 6mWT result is a strong predictor of mortality. However, clinically significant changes and reliability are still subject to debate - probably because of the ambiguity in terms of the target speed (either comfortable or brisk walking). Of the other time-based walk tests, the 2-minute-walk test is the only one applicable during CR, reserved for patients with severe disabilities by its psychometric properties. Fixed-distance tests (principally the 200m fast walk test) and incremental shuttle walking, tests explore higher levels of effort and may represent a safe and inexpensive alternative to laboratory-based tests during CR. These walking tests may be useful for personalizing prescription of training programs. However, the minimum clinically significant difference has not yet been determined. Lastly, walking tests appear to be potential useful tools in promoting physical activity and behavioural changes at home. Thus, validation of other walk tests with better psychometric properties will be necessary. PMID:24126080

Casillas, J-M; Hannequin, A; Besson, D; Benaïm, S; Krawcow, C; Laurent, Y; Gremeaux, V

2013-10-01

173

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

174

Exercise stress tests for detecting myocardial ischemia in asymptomatic patients with diabetes mellitus.  

PubMed

The predominant cause of death in diabetes mellitus (DM) is coronary artery disease (CAD). Little is known about prevalence of silent ischemia in developing nations. We compared prevalence of silent ischemia in DM to a control group by exercise myocardial perfusion imaging (MPI) and electrocardiogram (ECG) in developing nations. The prospective multinational Ischemia Assessment with Exercise imaging in Asymptomatic Diabetes study recruited participants at 12 sites in Asia, Africa, and Latin America. DM participants were age- and gender-matched 2:1 to non-DM individuals with ?1 CAD risk factor. Subjects underwent exercise tests that were interpreted in core labs in blinded fashion. The study included 392 DM and 205 control participants. Among participants with diagnostic ECGs, a similar proportion of DM and controls had ischemic ECG (15% vs 12%, p = 0.5). A significantly higher proportion of DM group had MPI abnormalities compared with controls (26% vs 14%, p <0.001). In participants with ischemia on MPI, only 17% had ischemic ECG, whereas in those without ischemia on MPI, 10% had ischemic ECG. In a multivariable model, DM was independently associated with abnormal MPI (odds ratio 2.1, 95% confidence interval 1.3-3.5, p = 0.004). Women were less likely to have ischemia by MPI than men (10% vs 30%, p <0.001) and concordance between ECG and MPI was much worse in women. In conclusion, in this large prospective study, asymptomatic DM participants had (1) more ischemia by exercise MPI than ECG, (2) more ischemia by MPI but not ECG than control group, and (3) ischemia by MPI was less in women than men. PMID:23578350

Hage, Fadi G; Lusa, Lara; Dondi, Maurizio; Giubbini, Raffaele; Iskandrian, Ami E

2013-07-01

175

Cold sensitivity test for individuals with non-freezing cold injury: the effect of prior exercise  

PubMed Central

Background One of the chronic symptoms of non-freezing cold injury (NFCI) is cold sensitivity. This study examined the effects of prior exercise on the response to a cold sensitivity test (CST) in NFCI patients with the aim of improving diagnostic accuracy. Methods Twenty three participants, previously diagnosed with NFCI by a Cold Injuries Clinic, undertook two CSTs. Participants either rested (air temperature 31°C) for approximately 80 min (prior rest condition (REST)) or rested for 30 min before exercising gently for 12 min (prior exercise condition (EX)). Following REST and EX, the participants placed their injured foot, covered in a plastic bag, into 15°C water for 2 min; this was followed by spontaneous rewarming in 31°C air for 10 min. Results The great toe skin temperature (Tsk) before immersion averaged 32.5 (3.4)°C in both conditions. Following immersion, the rate of rewarming of the great toe Tsk was faster in EX compared to REST and was higher 5 min (31.7 (3.4)°C vs. 29.8 (3.4)°C) and 10 min (33.8 (4.0)°C vs. 32.0 (4.0)°C) post-immersion. Over the first 5 min of rewarming, changes in the great toe Tsk correlated with the changes in skin blood flow (SkBF) in EX but not the REST condition. No relationship was observed between Tsk in either CST and the severity of NFCI as independently clinically assessed. Conclusions Exercise prior to the CST increased the rate of the toe Tsk rewarming, and this correlated with the changes in SkBF. However, the CST cannot be used in isolation in the diagnosis of NFCI, although the EX CST may prove useful in assessing the severity of post-injury cold sensitivity for prognostic and medico-legal purposes. PMID:23849038

2013-01-01

176

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

Microsoft Academic Search

AbstractObjective: To examine the competence of a cohort trained in cardiopulmonary resuscitation by the BBC's 999 training roadshows.Design: Descriptive cohort study applying an innovative testing procedure to a nationwide systematic sample. The test sample received an unsolicited home visit and without warning were required to perform cardiopulmonary resuscitation on a manikin while being videoed. The videos were then analysed for

C Ll Morgan; P D Donnelly; C A Lester; D H Assar

1996-01-01

177

Cardiopulmonary Arrest Caused by Craniometaphyseal Dysplasia  

Microsoft Academic Search

Craniometaphyseal dysplasia is a rare congenital disorder that can cause craniofacial skeleton and tubular bone anomalies.\\u000a A 7-month-old girl, with congenital facial palsy, mouth breathing, and nasal obstruction, was brought to the hospital because\\u000a she suffered sudden cardiopulmonary arrest. Computed tomography showed bony narrowing of the choanae. The diagnosis was cardiopulmonary\\u000a arrest triggered by asphyxia caused by severe choanal stenosis.

Ayako Chida; Youichi Yanagawa; Hiroshi Matsumoto; Shigeaki Nonoyama

178

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

179

STS-34 Mission Specialist (MS) Chang-Diaz tests CCA prior to WETF exercises  

NASA Technical Reports Server (NTRS)

STS-34 Atlantis, Orbiter Vehicle (OV) 104, Mission Specialist (MS) Franklin R. Chang-Diaz, wearing extravehicular mobility unit (EMU), tests his communications carrier assembly (CCA) with the help of Rockwell Space Operations (RSO) technician Pam S. Peters (right) prior to donning his EMU helmet. These procedures are necessary for an extravehicular activity (EVA) contingency exercise (underwater simulation) in JSC's Weightless Environment Training Facility (WETF) Bldg 29. Chang-Diaz stands on a platform that will lower him into the WETF's 25 ft deep pool.

1989-01-01

180

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. PMID:24898136

2014-01-01

181

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

SciTech Connect

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

Leppo, J.A.

1984-01-01

182

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. PMID:23335651

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

2013-01-01

183

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

184

Cardiopulmonary involvement in Puumala hantavirus infection  

PubMed Central

Background Hantavirus infections cause potentially life-threatening disease in humans world-wide. Infections with American hantaviruses may lead to hantavirus pulmonary syndrome characterised by severe cardiopulmonary distress with high mortality. Pulmonary involvement in European Puumala hantavirus (PUUV) infection has been reported, whereas knowledge of potential cardiac manifestations is limited. We aimed to comprehensively investigate cardiopulmonary involvement in patients with PUUV-infection. Methods Twenty-seven hospitalised patients with PUUV-infection were examined with lung function tests, chest high-resolution CT (HRCT), echocardiography including speckle tracking strain rate analysis, ECG and measurements of cardiac biomarkers N-terminal pro-B-type natriuretic peptide (NT-ProBNP) and troponin T. Patients were re-evaluated after 3 months. Twenty-five age and sex-matched volunteers acted as controls for echocardiography data. Results Two-thirds of the patients experienced respiratory symptoms as dry cough or dyspnoea. Gas diffusing capacity was impaired in most patients, significantly improving at follow-up but still subnormal in 38%. HRCT showed thoracic effusions or pulmonary oedema in 46% of the patients. Compared to controls, the main echocardiographic findings in patients during the acute phase were significantly higher pulmonary vascular resistance, higher systolic pulmonary artery pressure, lower left ventricular ejection fraction and impaired left atrial myocardial motion. Pathological ECG, atrial fibrillation or T-wave changes, was demonstrated in 26% of patients. NT-ProBNP concentrations were markedly increased and were inversely associated with gas diffusing capacity but positively correlated to pulmonary vascular resistance. Furthermore, patients experiencing impaired general condition at follow-up had significantly lower gas diffusing capacity and higher pulmonary vascular resistance, compared to those feeling fully recovered. Conclusions In a majority of patients with PUUV-infection, both cardiac and pulmonary involvement was demonstrated with implications on patients’ recovery. The results demonstrate vascular leakage in the lungs that most likely is responsible for impaired gas diffusing capacity and increased pulmonary vascular resistance with secondary pulmonary hypertension and right heart distress. Interestingly, NT-ProBNP was markedly elevated even in the absence of overt ventricular heart failure. The method of simultaneous investigations of important cardiac and respiratory measurements improves the interpretation of the underlying pathophysiologic mechanisms. PMID:24160911

2013-01-01

185

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. PMID:24622163

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

186

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. PMID:24699366

Kellawan, J. Mikhail; Tschakovsky, Michael E.

2014-01-01

187

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

188

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

Microsoft Academic Search

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

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

1999-01-01

189

Type of exercise alters VE/VCO2slope in CAD patients.  

PubMed

The exercise carbon dioxide equivalent slope predicts prognosis in coronary artery disease patients. However, no study examined whether the carbon dioxide equivalent slope in coronary artery disease patients is dependent on the type of exercise. Twenty-nine coronary artery disease patients performed maximal cardiopulmonary exercise tests on bike, treadmill and arm cycle, with assessment of oxygen uptake, carbon dioxide output, and expiratory volume. The carbon dioxide equivalent slope was calculated from rest till peak exercise. The carbon dioxide equivalent slope was significantly different between walking, cycling, and arm cranking exercises (P<0.05), i.e. the carbon dioxide equivalent slope was the lowest during walking and the highest during arm cranking. Bland-Altman plots revealed that the difference of the carbon dioxide equivalent slope between exercises was greater in the case of a higher averaged carbon dioxide equivalent slope and overall peak oxygen uptake. In conclusion, the carbon dioxide equivalent slope is significantly dependent on the type of exercise in coronary artery disease patients. Additionally, the averaged carbon dioxide equivalent slope and peak oxygen uptake affect the difference of the carbon dioxide equivalent slopes between exercises. PMID:19288392

Hansen, D; Dendale, P; Berger, J

2009-04-01

190

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

PubMed

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

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

2013-01-01

191

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

192

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

193

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

Microsoft Academic Search

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

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

2010-01-01

194

A single electromyographic testing point is valid to monitor neuromuscular fatigue during continuous exercise.  

PubMed

Two different protocols for estimating the electromyographic fatigue threshold (EMGFT) have been proposed in the literature. These protocols are distinguished by the number of visits required to determine the EMGFT. The purpose of this study, therefore, was to statistically compare the estimated EMGFT from the single-visit incremental test and the multiple-visit constant workload tests for single-leg knee-extensor exercise. Seven healthy college-aged men [mean ± SEM; age = 25.0 ± 0.7 years] performed the incremental test and on separate occasions also performed 4 constant workload tests to voluntary exhaustion. The EMG amplitude was recorded from the rectus femoris muscle during all the testing sessions. For the single-visit test, the EMG amplitude vs. time relationship for each power output was examined using linear regression. For the multiple-visit tests, the EMG amplitude vs. time relationship was calculated for each constant power output. Thereafter, the power outputs were plotted as a function of the slope coefficient for the EMG amplitude vs. time relationships, and linear regression was performed. The EMGFT was defined as the intersection of the regression line with the y-intercept of the power output vs. slope coefficient plot. The results indicated that the estimated EMGFT from the single-visit test was significantly (p = 0.012) lower than the estimate from the multiple-visit tests. Because this test is performed during a single visit and concludes within 20 minutes, it may also have application in clinical rehabilitation settings and not merely for an athletic population. PMID:25029004

Galen, Sujay S; Malek, Moh H

2014-10-01

195

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

PubMed

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

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

2014-09-01

196

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

PubMed

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

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

2013-09-01

197

Aortic Outflow Cannula Tip Design and Orientation Impacts Cerebral Perfusion During Pediatric Cardiopulmonary Bypass Procedures  

E-print Network

-operative neurological complications associated with cardiopulmonary bypass (CPB). High-speed jets from 8 to 10FR emphasize the importance of cannulation strategy and hypothesize engineering better CPB perfusion through of the cannula tip to include a diffuser cone angle (tested up to 7°) eliminated BCA backflow for any tested

Pekkan, Kerem

198

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

199

Cerebrovascular responses to cold pressor test during static exercise in humans.  

PubMed

The purpose of this study was to determine whether exercise modulates the responses of middle cerebral artery blood velocity (MCA V(mean)) and cerebrovascular conductance to sympathetic stimulation (i.e. cold pressor test--CPT). To accomplish this, MCA V(mean) responses were assessed during CPT, static handgrip exercise (HG) at 30% of maximum voluntary contraction and combined condition (HG + CPT), assigned in a counterbalanced order, in eight healthy subjects. Blood pressure (BP), cardiac output (CO) and end-tidal partial pressure of carbon dioxide (PETCO(2)) were also measured non-invasively, and an index of vascular conductance was calculated for MCA (CVCi). BP increased from rest (P < 0·05) during CPT and HG and was additionally augmented during HG + CPT (P < 0·05 versus rest, CPT and HG). Despite the greater augmentation in BP during HG + CPT, MCA V(mean) was similarly increased during both HG (18·5 ± 2%, P < 0·05 versus rest) and combined condition (19·6 ± 2%, P < 0·05 versus rest). MCA V(mean) remained unchanged from rest during CPT only. CVCi was slightly reduced (P < 0·05) from rest during HG but was greatly reduced by CPT (P < 0·05 versus rest). The reduction in CVCi evoked by CPT at rest (-15 ± 2%, P < 0·05 versus rest) was significantly attenuated during HG (-8 ± 2%, P < 0·05 versus CPT). Increases in CO were similar in all trials, and PETCO(2) was unchanged from rest throughout the experiments. In summary, the cerebral conductance index decreases during the cold pressure test while that reduction is smaller when the CPT is conducted during the HG. This was critical for the maintenance of MCA V(mean) during combined condition. PMID:22152080

Vianna, Lauro C; Sales, Allan Robson Kluser; da Nóbrega, Antonio Claudio Lucas

2012-01-01

200

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

PubMed Central

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

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

2014-01-01

201

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

202

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. PMID:22188608

2011-01-01

203

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

204

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

205

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

206

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

207

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

PubMed

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

Péronnet, F; Aguilaniu, B

2014-06-01

208

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

209

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

ERIC Educational Resources Information Center

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

Heaman, Doris J.; Estes, Jenny

1997-01-01

210

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

ERIC Educational Resources Information Center

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

Krampen, Gunter

2010-01-01

211

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

ERIC Educational Resources Information Center

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

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

2007-01-01

212

Skill mastery in cardiopulmonary resuscitation training classes  

Microsoft Academic Search

The authors evaluated skill levels of trainees (n = 48) who were taught cardiopulmonary resuscitation (CPR) in “American Red Cross: Adult CPR” classes offered at a work site. The evaluation used a validated skill checklist and a Lærdal Skillmeter mannequin to assess trainee competence. Only 1 in 10 of the trainees could correctly perform all 12 CPR skills assessed by

Robert T Brennan; Allan Braslow

1995-01-01

213

Pulmonary aspiration during unsuccessful cardiopulmonary resuscitation  

Microsoft Academic Search

The incidence of pulmonary aspiration in a group of patients who did not respond to cardiopulmonary resuscitation (CPR) was assessed at autopsy and found to be 29%. This figure is undoubtedly an underestimate of the total problem, and some indication of the potential for aspiration during CPR is revealed by the fact that 46% of the patients studied had full

E. G. Lawes; P. J. F. Baskett

1987-01-01

214

What did We Learn from the Exercise of the Source Inversion Validation Blind Test I?  

NASA Astrophysics Data System (ADS)

We participated in the Blind Test I exercise of the Source Inversion Validation project (http://www.seismo.ethz.ch/staff/martin/BlindTest.html), in which researchers are asked to invert the rupture process of a pseudo source using noise-free synthetic seismic waveforms at an ideally distributed near-fault strong motion network. Previously, nine groups had participated in this exercise, but “4 out of 9 inversion results are, statistically speaking, not better than a random model with somehow correlated slip!" (Mai et al., 2007). Since the earth structure and fault plane geometry were given in the test, the discrepancies between the inverted models and the target may reflect the errors in source representations or the intrinsic non-uniqueness of the finite fault inverse methods. Here we attempt to verify this counterintuitive result, investigate the causes, and explore the potential ways to improve the inversion. We have used as many as 41 crustal layers to precisely approximate the given continuous velocity model in calculating reflectivity synthetics (<2 Hz). The slip pattern of our preliminary inversion result looks similar to the target, but its slip amplitude and total seismic moment are roughly a factor of two larger. The later analysis reveals that the amplitudes of waveform data posted online are twice of what they should be, likely caused by a mistake in applying the target model. Furthermore, the velocity data had been contaminated by constant offsets, which have been corrected as well in our computation. Our forward calculations, based on the target model, are matching the corrected synthetic data with a 99.91% average variance reduction. We divide the fault plane into 1 km by 1 km subfaults. We invert the slip and the shape of the asymmetric cosine slip rate function simultaneously (Ji et al., 2003) by matching the broadband velocity waveforms (<2 Hz) at all 33 stations. Our inversion results indicate: 1) the target model could be well retrieved by matching the broadband seismic data 2) By just matching the bandpass filtered strong motion waveforms from 0.1 Hz to 1 Hz, as typically applied in the previous studies, however, cannot guarantee that the inverted model closely reproduce the target model. 3) The fault-plane spatial resolution and ground-motion temporal resolution are correlated. Using a larger subfault reduces not only the spatial resolution but also the reliability of the high frequency temporal variation.

Li, X.; Shao, G.; Ji, C.; Lavallee, D.

2009-12-01

215

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

PubMed Central

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

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

2014-01-01

216

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

217

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

218

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

EPA Science Inventory

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

219

Denervation of vagal cardiopulmonary receptors by injection of kainic acid into the nodose ganglia in dogs  

Microsoft Academic Search

We determined if kainic acid, a neuroexcitotoxin, could be used to denervate the cell bodies of cardiopulmonary vagal sensory neurons. Kainic acid (5 ?g) was injected into the nodose ganglion of five dogs. Ten to fourteen days following this procedure, these kainic acid-injected dogs were anesthetized and tested for the extent of the deafferentation. Five additional dogs were used as

Don W Wallick; Mark E Dunlap; Sherry S Stuesse; Marc D Thames

2002-01-01

220

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

SciTech Connect

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

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

1990-11-15

221

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

SciTech Connect

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

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

1986-11-01

222

Cardiopulmonary effects of internal cardioverter/defibrillator implantation.  

PubMed

Cardiopulmonary effects of electrophysiological testing of internal cardioverter/defibrillator (ICD) devices were studied in ten patients undergoing general anaesthesia. In the control-phase, haemodynamic performance and oxygenation were slightly impaired. After completion of the electrophysiological procedures (ICD-phase), cardiopulmonary function had deteriorated significantly. Cardiac index declined by 16%, whereas left ventricular filling pressure and pulmonary vascular resistance increased (P less than or equal to 0.01). Oxygenation, but not CO2-elimination deteriorated (P less than or equal to 0.01) and venous admixture increased by 72% (P less than or equal to 0.01). Alveolo-arterial PO2-difference (PA-aO2) increased by 43% (P less than or equal to 0.01), indicating ventilation-perfusion (VA/Q) mismatching. Repeated inductions of ventricular tachycardia and/or fibrillation subject the myocardium to transient global ischaemia, leading to acute congestive heart failure, and positive inotropic intervention was necessary in 40% of the patients. Partial pulmonary insufficiency resulted possibly from interstitial oedema and VA/Q-inhomogeneities. ICD implantation has detrimental effects on haemodynamics and gas exchange in patients with impaired left ventricular function. PMID:1785242

Hachenberg, T; Hammel, D; Möllhoff, T; Brüssel, T; Block, M; Borggrefe, M; Haberecht, H; Scheld, H H; Wendt, M

1991-10-01

223

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. PMID:23765384

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

224

Affective responses of inactive women to a maximal incremental exercise test: A test of the dual-mode model  

Microsoft Academic Search

ObjectiveThe link between exercise intensity and affect has been a popular topic of investigation for many years but has drawn few universally accepted conclusions. Recently, Ekkekakis [(2003). Pleasure and displeasure from the body: Perspectives from exercise. Cognition and Emotion, 7, 213–239] proposed a ‘dual-mode model’ to explain the nature of this relationship by employing individual metabolic markers (such as the

Amy S. Welch; Angie Hulley; Carrie Ferguson; Mark R. Beauchamp

2007-01-01

225

Role of alpha-tocopherol in cardiopulmonary fitness in endurance athletes, cyclists.  

PubMed

Exercise increases oxygen consumption and causes a disturbance of intracellular pro-oxidant-antioxidant homeostasis. Athletes are exposed to acute and chronic stress that may lead to increased generation of oxidative species. Hence oxidative stress increases in athletes. Administration of antioxidant like alpha-tocopherol as supplementation may reduce the cell damage caused due to oxidative stress. In the present study, our aim was to study the effects of alpha-tocopherol supplementation on the cardiopulmonary fitness in endurance athletes (cyclists) and non-athletes. Our study included 40 cyclists who were trained under District Youth Service & Sports Office. 40 controls were randomly selected from student group of B.L.D.E.A's Medical College. Alpha-tocopherol (Vitamin E) 200 mg/day for 21 days wasgiven to study group and placebo was given to placebo group. Various physiological parameters like heart rate, blood pressure, respiratory rate were recorded, for assessing cardiopulmonary fitness: Physical Fitness Index (PFI) and VO2 max ml/min/kg were recorded before and after supplementation of vitamin E in athletes, and were compared with placebo group before and after supplementation of placebo and also with non-athletes. The results obtained from present study indicate that antioxidant like alpha-tocopherol supplementation did not contribute significantly to improve the cardiopulmonary fitness of endurance athletes. PMID:20509332

Patil, Sumangala M; Chaudhuri, Dipayan; Dhanakshirur, Gopal B

2009-01-01

226

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

227

Effect of a short-term exercise program on glycemic control measured by fructosamine test in type 2 diabetes patients  

PubMed Central

Background Glycated hemoglobin (A1C) and Fasting Plasma Glucose (FPG) are the two monitoring blood glucose tests most frequently used. However, both methods are shown to be insensitive to detect glycemic variations in short duration periods. Therefore, we aimed to assess the effect of a short-term exercise program on glycemic levels measured by fructosamine concentrations in type 2 diabetes patients. Methods Eight volunteers (51.1?±?8.2 years) underwent a supervised exercise program during eight weeks (3 d.wk-1, 50-60% of VO2 peak for 30–60 minutes). The body composition, VO2 peak, A1C, FPG, fructosamine and capillary blood glucose (CBG) were evaluated. We used ANOVA - One Way for repeated measures followed by Tukey post-hoc test and paired t test. P values <0.05 were considered significant. Results We found statistical differences on the concentrations of fructosamine, VO2 peak and CBG. However, A1C and FPG showed no statistical difference. Fructosamine declined by 15% (57 ?mol/L) between the beginning and the end of the study. Individually, 50% of the sample reached the reference values for the normality in fructosamine test. VO2 peak increased by 14.8% (3.8 ml.kg-1.min-1) and CBG decreased on an average of 34.4% (69.3 mg/dL). Conclusions Fructosamine test is effective in the evaluation of glucose with type 2 diabetes patients when undergoing a short exercise program, alternatively to the traditional A1C and FPG assessment. Our results are relevant in clinical practice, because the significant improvement in glycemic status can help to evaluate the inclusion of exercise as adjunct therapy to replace the prescription of additional drugs in poorly controlled patients. PMID:24512719

2014-01-01

228

Cardiopulmonary bypass system-mountable anesthetic machine  

Microsoft Academic Search

Miniaturization of the cardiopulmonary bypass (CPB) system may provide several benefits, such as decreasing the manpower,\\u000a cost, and amount of homologous blood required and improving patient care. We have proposed a portable CPB system-mountable\\u000a anesthetic machine. Our portable CPB system consists of a bypass circuit, a hard shell reservoir, a membrane oxygenator, and\\u000a two pumps. The reservoir has three chambers,

Tsuguo Igari; Shunichi Hoshino; Fumio Iwaya; Hitoshi Hikichi; Yoshitaka Inagaki

2000-01-01

229

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

230

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

PubMed

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

Sandoval, Darleen A; Matt, Kathleen S

2003-01-01

231

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

SciTech Connect

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

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

1989-07-01

232

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

SciTech Connect

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

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

1989-09-01

233

Modeling mechanical cardiopulmonary interactions for virtual environments.  

PubMed Central

We have developed a computer system for modeling mechanical cardiopulmonary behavior in an interactive, 3D virtual environment. The system consists of a compact, scalar description of cardiopulmonary mechanics, with an emphasis on respiratory mechanics, that drives deformable 3D anatomy to simulate mechanical behaviors of and interactions between physiological systems. Such an environment can be used to facilitate exploration of cardiopulmonary physiology, particularly in situations that are difficult to reproduce clinically. We integrate 3D deformable body dynamics with new, formal models of (scalar) cardiorespiratory physiology, associating the scalar physiological variables and parameters with corresponding 3D anatomy. Our approach is amenable to modeling patient-specific circumstances in two ways. First, using CT scan data, we apply semi-automatic methods for extracting and reconstructing the anatomy to use in our simulations. Second, our scalar models are defined in terms of clinically-measurable, patient-specific parameters. This paper describes our approach and presents a sample of results showing normal breathing and acute effects of pneumothoraces. Images Figure 2 Figure 3 Figure 4 PMID:9357669

Kaye, J. M.

1997-01-01

234

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. 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

235

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

SciTech Connect

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

Lear, J.L.

1986-06-01

236

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

PubMed Central

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

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

2012-01-01

237

Effect of betaxolol hydrochloride on heart rate variability indices during exercise stress testing in patients with hypertension  

Microsoft Academic Search

Betaxolol hydrochloride is a ?1-selective antagonist that produces vasodilation in patients with hypertension and ischemic heart disease. The goal of the present study was to characterize the effect of betaxolol on heart rate variability indices (HRV), a well-established prognostic marker. Symptom limited-treadmill exercise testing was performed in 17 hypertensive patients (60.9 ± 14.8 years-old) before and immediately a 3 weeks

B. Takase; Y. Abe; M. Nagata; T. Matsui; H. Hattori; F. Ohsuzu; M. Ishihara; A. Kurita

2005-01-01

238

Statistics for Chemists: Exercises  

NSDL National Science Digital Library

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

Wehrens, Ron

2011-03-25

239

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

NASA Astrophysics Data System (ADS)

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

Ji, C.; Shao, G.

2010-12-01

240

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

Code of Federal Regulations, 2010 CFR

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

2010-04-01

241

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

Code of Federal Regulations, 2010 CFR

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

2010-04-01

242

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

Code of Federal Regulations, 2010 CFR

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

2010-04-01

243

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

Code of Federal Regulations, 2010 CFR

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

2010-04-01

244

21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

245

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

...Cardiopulmonary bypass heart-lung machine console. 870.4220 Section 870...Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

2014-04-01

246

Quantitative Electrocardiographic Measures and Long-Term Mortality in Exercise Test Patients With Clinically Normal Resting Electrocardiograms  

PubMed Central

Background Currently the only function of the resting electrocardiogram (ECG) in patients referred for exercise testing is to determine whether imaging is mandated. It is unknown if subtle ECG findings in those patients with clinically normal resting ECGs have prognostic significance. Methods We performed a single-center cohort study of 18,964 patients without known CVD, who had a clinically normal resting ECG and who underwent treadmill exercise testing for evaluation of suspected CAD. Eleven quantitative ECG measures related to heart rate, conduction, left ventricular mass, or repolarization were collected digitally. The primary outcome was all-cause mortality. The prognostic importance of a composite ECG score was assessed by measuring its impact on the c-index (analogous to area under ROC curve), and by measures of reclassification. Results During a median follow-up of 10.7 years 1,585 patients died. The four most predictive digital ECG variables were higher ventricular rate, more left-ward QRS axis, and more downward ST segment deviation, and longer QT interval. The ECG score was independently associated with mortality (75th vs. 25th percentile HR 1.36, 95% CI [1.25 to 1.49], P<.0001). The ECG score had modest impact on discrimination (change in c-index 0.04) and reclassification of risk (3.0% decrease of relative integrated discrimination improvement, P<.001). Conclusions Subtle ECG findings relating to heart rate, conduction, left ventricular mass, or repolarization in patients with clinically normal ECGs referred for exercise testing may provide modest additional prognostic information over and above clinical and exercise measures. PMID:19540393

Gorodeski, Eiran Z.; Ishwaran, Hemant; Blackstone, Eugene H.

2014-01-01

247

Concerns About Exercise Are Related to Walk Test Results in Pulmonary Rehabilitation for Patients with COPD  

Microsoft Academic Search

Background  Although international guidelines on pulmonary rehabilitation acknowledge that psychological factors contribute to exercise\\u000a intolerance in patients with chronic obstructive pulmonary disease (COPD), the few empirical studies investigating this association\\u000a have found inconsistent results.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose  The purpose of this study is to investigate whether negative affect and beliefs about exercise of patients with COPD would\\u000a be related to baseline 6-min walk (6-MW)

Maarten J. Fischer; Margreet Scharloo; Jannie Abbink; Alex van ’t Hul; Dirk van Ranst; Arjan Rudolphus; John Weinman; Klaus F. Rabe; Adrian A. Kaptein

248

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

PubMed Central

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

2013-01-01

249

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

PubMed Central

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

2012-01-01

250

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

251

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

Microsoft Academic Search

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

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

1996-01-01

252

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

PubMed

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

Raub, James A

2002-12-01

253

Plasma nitric oxide metabolite levels increase during successive exercise stress testing - A link to delayed ischemic preconditioning?  

PubMed Central

BACKGROUND: Animal studies have shown that nitric oxide is involved in delayed ischemic preconditioning. OBJECTIVES: To determine whether plasma nitrates and nitrites (NOx?, as measure of nitric oxide) are modified by two consecutive effort tests and whether these changes translate into clinical improvement METHODS: Twenty-two patients with ischemic heart disease each performed two effort tests at 24-h intervals. Plasma NOx? level was determined and compared before and after both stress tests. Peak effort, double product at peak effort and maximal ST segment depression were considered clinical endpoints and were compared between the two tests. RESULTS: Plasma NOx?increased slightly after the first exercise test compared with pretest value (17.05±1.6 ?mol/mL versus 15.38±1.4 ?mol/mL). In turn, after the second test there was a significant rise in NOx? level (23.65±2.2 ?mol/mL versus 15.10±1.3 ?mol/mL, P<0.03). The pretest values were almost identical between the two tests. Peak effort and double product at peak effort remained unchanged between the two tests. Although ischemic stress was the same, ST depression was significantly lower (P<0.01) for the second test (0.85±0.06 mm versus 1.73±0.16 mm). CONCLUSION: Our study shows an increased plasma NOx?level after the second of two consecutive exercise stress tests at 24-h intervals, along with a decrease of electrocardiographic consequences of approximately the same ischemic stress. These findings are consistent with experimental data in animals, which point to nitric oxide as a trigger and effector of ischemic preconditioning. PMID:19644584

Zdrenghea, Dumitru; Bodizs, Gyorgy; Ober, Mihai Claudiu; Ilea, Maria

2003-01-01

254

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

PubMed Central

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

Coats, Valerie; Maltais, Francois; Simard, Sebastien; Frechette, Eric; Tremblay, Lise; Ribeiro, Fernanda; Saey, Didier

2013-01-01

255

Dirofilaria immitis infection in dogs: Cardiopulmonary biomarker levels  

Microsoft Academic Search

Cardiopulmonary biomarkers are biological parameters that can be objectively measured and quantified as indicators of pathogenic processes (heartworm disease) or as indicators of response to therapeutic intervention. To determine levels of cardiopulmonary biomarkers in canine dirofilariasis, measurements of cardiac troponin T, cardiac troponin I, myoglobin, and D-dimer concentrations were performed for dogs with and without evidence of adult heartworm infection.

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

2011-01-01

256

MEASUREMENT OF CARDIOPULMONARY FUNCTION BY REBREATHING METHODOLOGY IN PIGLETS  

EPA Science Inventory

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

257

[Fundamental features on percutaneous cardiopulmonary support].  

PubMed

The fundamental features on percutaneous cardiopulmonary support (PCPS) were reviewed. The number of PCPS installation in Japan has been increasing especially in the area of emergency medicine and cardiology. All-in-one package for PCPS system is becoming a mainstream in clinical practice. It is considered to be crucial to understand the details in characteristics and pitfalls on respective products. The results of nation-wide questionnaire indicate that the detailed criteria for PCPS usage in clinical practice appear to be variable among facilities in Japan;therefore, the formulation of guideline and educational system for PCPS installation is required. PMID:25138934

Hayatsu, Yukihiro; Saiki, Yoshikatsu

2014-07-01

258

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

PubMed Central

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

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

2014-01-01

259

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

PubMed Central

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

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

2003-01-01

260

Lactate and cardiopulmonary responses to simulated arm-pulling and leg-kicking in collegiate and recreational swimmers.  

PubMed

Investigations into the changes due to training in the metabolism of the arms or the legs in swimmers of different training status are limited. The purpose of this study was to compare the lactate and cardiopulmonary responses to simulated arm-pulling and leg-kicking in collegiate and recreational swimmers. Sixteen males (9 collegiate swimmers; SW, 7 recreational swimmers; RSW, mean+/-SD; age 22+/-3 years, body mass 81+/-9 kg, stature 1.84+/-0.06 m), gave written consent and performed continuous incremental exercise tests using either simulated front-crawl arm-pulling or leg-kicking. Lactate concentration (HLa) and oxygen consumption (VO2) were determined at 20 W intervals and at exhaustion (HLa(peak); VO2(peak)). The exercise intensity at a lactate concentration of 4 mM (EI4mM) and at exhaustion (EI(peak)) for arm-pulling and leg-kicking were also established. The arm:leg ratios for EI4mM, HLa(peak) and VO2(peak) were computed. The results showed that for arm-pulling, the SW had higher EI4mM (P=0.02), EI(peak) (P=0.006), but lower HLa(peak) (P=0.03) compared to the RSW. For leg-kicking, none of the responses differed significantly. These results suggest that it is rather the metabolism and local muscle endurance of the arms that are enhanced with competitive swimming endurance. PMID:10190773

Konstantaki, M; Swaine, I L

1999-02-01

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

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

263

Pyruvate enhances neurological recovery following cardiopulmonary arrest and resuscitation  

PubMed Central

Purpose Cerebral oxidative stress and metabolic dysfunction impede neurological recovery from cardiac arrest-resuscitation. Pyruvate, a potent antioxidant and energy-yielding fuel, has been shown to protect against oxidant- and ischemia-induced neuronal damage. This study tested whether acute pyruvate treatment during cardiopulmonary resuscitation can prevent neurological dysfunction and cerebral injury following cardiac arrest. Methods Anesthetized, open-chest mongrel dogs underwent 5 min cardiac arrest, 5 min open chest cardiac compression (OCCC), defibrillation and 3 day recovery. Pyruvate (n = 9) or NaCl volume control (n = 8) were administered (0.125 mmol/kg/min iv) throughout OCCC and the first 55 min recovery. Sham dogs (n = 6) underwent surgery and recovery without cardiac arrest-resuscitation. Results Neurological deficit score (NDS), evaluated at 2 day recovery, was sharply increased in NaCl-treated dogs (10.3 ± 3.5) vs. shams (1.2 ± 0.4), but pyruvate treatment mitigated neurological deficit (NDS = 3.3 ± 1.2; P < 0.05 vs. NaCl). Brain samples were taken for histological examination and evaluation of inflammation and cell death at 3 d recovery. Loss of pyramidal neurons in the hippocampal CA1 subregion was greater in the NaCl controls than in pyruvate treated dogs (11.7 ± 2.3% vs. 4.3 ± 1.2%; P < 0.05). Cardiac arrest increased caspase 3 activity, matrix metalloproteinase activity, and DNA fragmentation in the CA1 subregion; pyruvate prevented caspase-3 activation and DNA fragmentation, and suppressed matrix metalloproteinase activity. Conclusion Intravenous pyruvate therapy during cardiopulmonary resuscitation prevents initial oxidative stress and neuronal injury and enhances neurological recovery from cardiac arrest. PMID:17618729

Sharma, Arti B.; Barlow, Matthew A.; Yang, Shao-Hua; Simpkins, James W.; Mallet, Robert T.

2009-01-01

264

Risk stratification of patients in an emergency department chest pain unit: prognostic value of exercise treadmill testing using the Duke score  

Microsoft Academic Search

Background  Exercise treadmill testing (ETT) has been standard for evaluating outpatients at risk for cardiovascular events. Few studies\\u000a have demonstrated its prognostic usefulness in emergency department chest pain units or have used the Duke score [(exercise\\u000a duration in minutes) ? (5 × ST-segment deviation in millimeters) ? (4 × treadmill angina index)] to grade its performance.\\u000a \\u000a \\u000a \\u000a Aims   Our objective was to

Gregory G. Johnson; Wyatt W. Decker; Joseph K. Lobl; Dennis A. Laudon; Jennifer J. Hess; Christine M. Lohse; Amy L. Weaver; Deepi G. Goyal; Peter A. Smars; Guy S. Reeder

2008-01-01

265

The effects of cardiopulmonary bypass temperature on neuropsychologic outcome after coronary artery operations: A prospective randomized trial  

Microsoft Academic Search

The effect of systemic perfusion temperature on postoperative cognitive function was investigated in 96 adult patients undergoing elective coronary revascularization with cardiopulmonary bypass at 28º C, 32º C, or 37º C. Neuropsychologic performance was assessed 1 day before the operation and 6 weeks after the operation. Five tests were adapted from the Wechsler Adult Intelligence Scale and two from the

Idriss Regragui; Inderpaul Birdi; Mohammad Bashar Izzat; Andrew M. S. Black; Athanasios Lopatatzidis; Christopher J. E. Day; Freda Gardner; Alan J. Bryan; Gianni D. Angelini

1996-01-01

266

Cardiopulmonary fitness in a sample of Malaysian population.  

PubMed

Lung capacity and maximum oxygen uptake (VO2max) were measured directly in 167 healthy males, from all the main races in Malaysia. Their ages ranged from 13 to 59 years. They were divided into five age groups (A to E), ranging from the second to the sixth decade. Lung capacities were determined using a dry spirometer and VO2max was taken as the maximum rate of oxygen consumption during exhaustive exercise on a cycle ergometer. Mean forced vital capacity (FVC) was 3.3 +/- 0.5 l and it correlated negatively with age. Mean VO2max was 3.2 +/- 0.2 l.min-1 (56.8 +/- 3.5 ml.kg-1.min-1) in Group A (13-19 years) compared to 1.7 +/- 0.2 l.min-1 (28.9 +/- 2.9 ml.kg-1.min-1) in Group E (50-59 years). Regression analysis revealed an age-related decline in VO2max of 0.77 ml.kg-1.min-1.year-1. Multiple regression of the data gave the following equations for the prediction of an individual's VO2max: VO2max (l.min-1) = 1.99 + 0.035 (weight)-0.04 (age), VO2max (ml.kg-1.min-1) = 67.7-0.77 (age), where age is in years, weight in kg. In terms of VO2max as an index of cardiopulmonary performance. Malaysians have a relatively lower capacity when related to the Swedish norms or even to those of some Chilean workers. Malaysians were, however, within the average norms of the American Heart Association's recommendations. Age-related decline in VO2max was also somewhat higher in the Malaysians. PMID:2601189

Singh, R; Singh, H J; Sirisinghe, R G

1989-01-01

267

The role of Levosimendan in cardiopulmonary resuscitation.  

PubMed

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

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

2014-10-01

268

Assessment of cardiopulmonary alterations in endotoxic shock  

SciTech Connect

Using radionuclide first-pass technique, seven sheep were studied prior to and during endotoxic shock. In vitro labeled /sup 99m/TC red blood cells were used to measure right and left ventricular ejection fractions (RVEF and LVEF) and cardiopulmonary transit time (CPTT) prior to and at 1, 4, 30, and 60 minutes after the intravenous injection of endotoxin Escherichia coli, 3 mg/kg bodyweight. The LVEF decreased slightly from 51 to 42% but became normal four minutes later, while the RVEF remained decreased from 49 to 26% for 60 minutes. The CPTT was prolonged from 13 to 26 cardiac beats. The decrease in RVEF was well correlated with the prolongation of the CPTT.

Christenson, J.T.; Kuikka, J.; Al-Sarraf, A.A.; Owunwanne, A.

1986-01-01

269

Exercise and Memory  

NSDL National Science Digital Library

This activity (on page 2 of the PDF) is a full inquiry investigation into the effects of exercise on short term memory. Groups of learners will set a baseline score with an initial memory test. Then they split into two teams, one participating in physical exercise while the other remains sedentary. After ten minutes, both teams take another memory test to tabulate and graph score changes. Relates to linked video, DragonflyTV: Exercise and Memory.

Twin Cities Public Television, Inc.

2005-01-01

270

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

PubMed Central

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

2014-01-01

271

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

PubMed Central

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

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

2014-01-01

272

Elevated CK-MB isoenzyme after exercise stress test and atrial pacing in patients with ischemic heart disease  

SciTech Connect

Using a highly sensitive monoclonal antibody kit for CK-MB, significant release of small amounts of CK-MB isoenzyme after exercise stress test was detected 4 to 6 h after induction of ischemia. This occurred in ten out of 15 patients with ischemic heart disease (66 percent) and in only one of the 18 healthy subjects (5.6 percent) serving as a control group. In five patients with coronary artery disease in whom atrial pacing was performed with simultaneous blood sampling from coronary sinus, a drastic elevation in CK-MB isoenzyme (from 2.04 +/- 2.06 ng/L to 10.88 +/- 6.9 ng/L; p less than 0.001) was detected within 10 to 30 min after induction of acute ischemia. A small but significant increase in total CK also was detected (from 21 +/- 12 IU/L to 52 +/- 14IU/L; p less than 0.01). These preliminary observations have to be further investigated in a larger group of patients before a definitive conclusion can be reached about the clinical significance of CK-MB release during exercise.

Marmor, A.T.; Klein, R.; Plich, M.; Groshar, D.; Schneeweiss, A.

1988-12-01

273

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

274

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

275

Questionable Exercises.  

ERIC Educational Resources Information Center

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

Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

1999-01-01

276

[Evaluation by exercise test of effects of a single oral dose of atenolol in patients with stable angina (author's transl)].  

PubMed

Thirty patients with stable angina have been undergone a multistage treadmill test, after a single oral dose of 100 mg of Atenolol, a beta 1 . selective blocking agent, in comparison to a previous test carried out after an identical looking placebo tablet. After placebo all the patients showed ischemic ST segment response (ST depression greater than 1 mm), 25 of them interrupting the test because of anginal pain (20 patients), or of ST depression greater than 3 mm (3 patients), or of ventricular ectopics (one patient), or of fatigue (one patient). After Atenolol 10 patients completed the planned test, 7 of them without ischemic changes of ST. 27 patients (90%) showed increased working capacity with significant reduction of heart-rate (FC), systolic blood pressure (PAS) and their product and of ST depression, either before and during and at the end of exercise. The recovery time of ischemic ECG change has been significantly reduced. The observed increased working capacity is attributed to the reduced myocardial O2 consumption expressed from the reduction of the product FC x PAS. Nevertheless at the end of exercise test after beta-blocking drug this product didn't reach the threshold value at which the test was interrupted in the first test after placebo. The authors discuss the possible cause of this effect of beta-blocking drugs, which could be attributed to a reduction of coronary blood flow and/or to an increased myocardial tension because of increased end diastolic ventricular volume. However the Authors outline that the per cent increases of FC, PAS, and FC x PAS have not been reduced by the Atenolol, unlike their absolute values, at the threshold of angina: the ischemic reveals itself at same levels of per cent increase of the factors of O2 myocardial consumption, the later reaching of threshold values depending on the lower starting values. The advantages of Atenolol as regards the other beta-blocking drugs (better acceptability, stability and duration of action) are outlined too. PMID:7049818

de Divitiis, O; de Simone, G; Maddalena, G; Castaldo, M; Ruggiano, A

1981-01-01

277

Value of standardised exercise tests and blood biochemistry in the selection and training of breeding stallions  

Microsoft Academic Search

Stallions selected by the Royal Dutch Warmblood Society were submitted to a standardised lungeing test at the beginning and at the end of a 100-day test of performance and ability. The heart rate, haematology and biochemistry values obtained in the first lungeing test showed no significant differences between the 15 stallions which were rejected by the Royal Dutch Warmblood Society

MM Sloet van Oldruitenborgh-Oosterbaan; T Wensing; A Barneveld; HJ Breukink

1991-01-01

278

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

279

Yo-Yo intermittent recovery test versus the Université de Montréal Track Test: relation with a high-intensity intermittent exercise.  

PubMed

The first purpose of this study was to determine whether the peak velocity (V(Yo-Yo)) achieved during the Yo-Yo intermittent recovery test (Yo-Yo) and the maximal aerobic velocity (MAV) determined from the Université de Montréal Track Test (UMTT) could be used interchangeably. The second purpose was to check that the V(Yo-Yo) is related to the intermittent exercise performance, which consisted of repeated 90 m distance runs in 15s performed until exhaustion, alternated with 15s of passive recovery (15/15). Fourteen amateur soccer players performed, in a random order, the 15/15 and two incremental field-tests: the Yo-Yo and the UMTT. The results of this study showed that MAV was significantly correlated to the V(Yo-Yo) (r=0.79, p<0.01). However, the error was not constant, when the V(Yo-Yo) and the MAV values were higher than 16.3 km h(-1), the MAV values tends to be higher than the V(Yo-Yo), while when the V(Yo-Yo) and the MAV values were lower than 16.3 km h(-1), the MAV values tends to be lower than the V(Yo-Yo). MAV and V(Yo-Yo) were significantly correlated to the time to exhaustion of the 15/15 (r=0.74 and r=0.72, respectively) and show that both tests are similarly related to the high-intensity intermittent exercise performance. PMID:19121978

Dupont, Gregory; Defontaine, Mathieu; Bosquet, Laurent; Blondel, Nicolas; Moalla, Wassim; Berthoin, Serge

2010-01-01

280

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

PubMed Central

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

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

2014-01-01

281

Can pregnant women be safely placed on cardiopulmonary bypass?  

PubMed Central

A best evidence topic was written according to a structured protocol. The question addressed was whether cardiopulmonary bypass can be used safely with satisfactory maternal and foetal outcomes in pregnant patients undergoing cardiac surgery. A total of 679 papers were found using the reported searches of which 14 represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated. Reported measures were maternal and foetal mortality and complications, mode of delivery, cardiopulmonary bypass and aortic cross-clamp times, perfusate flow rate and temperature and maternal NYHA functional class. The most recent of the best evidence studies, a retrospective observational study of 21 pregnant patients reported early and late maternal mortalities of 4.8 and 14.3%, respectively, and a foetal mortality of 14.3%. Median cardiopulmonary bypass and aortic cross-clamp times were 53 and 35 min, respectively, and the median bypass temperature was 37°C. Three larger retrospective reviews of the literature reported maternal mortality rates of 2.9–5.1% and foetal mortality rates of 19–29%. Mean cardiopulmonary bypass times ranged from 50.5 to 77.8 min. Another retrospective observational study reported maternal mortality of 13.3% and foetal mortality of 38.5%. Mean cardiopulmonary bypass and aortic cross-clamp times were 89.1 and 62.8 min, respectively, with a mean bypass temperature of 31.8°C. A retrospective case series reported no maternal mortality and one case of foetal mortality. Median cardiopulmonary bypass and aortic cross-clamp times were 101 and 88 min, respectively. Eight case reports described 10 patients undergoing cardiopulmonary bypass. There were no reports of maternal mortality and one report of foetal mortality. Mean cardiopulmonary bypass and aortic cross-clamp times were 105 and 50 min, respectively. We conclude that while the use of cardiopulmonary bypass during pregnancy poses a high risk for both the mother and the foetus, the use of high-flow, high-pressure, pulsatile, normothermic bypass and continuous foetal and uterine monitoring can allow cardiac surgery with the use of cardiopulmonary bypass to be performed with the greatest control of risk in the pregnant patient. PMID:22945848

Sepehripour, Amir H.; Lo, Tammy T.; Shipolini, Alex R.; McCormack, David J.

2012-01-01

282

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.) PMID:23130146

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

2012-01-01

283

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

PubMed Central

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

2014-01-01

284

Maximal Aerobic Capacity for Repetitive Lifting: Comparison with Three Standard Exercise Testing Modes.  

National Technical Information Service (NTIS)

The purpose of this study was to develop a reliable multi-stage repetitive lifting VO2max test to be used as a laboratory tool, which paralleled standard ergometer VO2max testing procedures. A secondary purpose was to compare the repetitive lifting VO2max...

M. A. Sharp, E. Harman, J. A. Vogel, J. J. Knapik, S. J. Legg

1987-01-01

285

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

PubMed Central

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

2014-01-01

286

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

PubMed

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

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

2010-01-01

287

Role of Corticosteroids During Cardiopulmonary Bypass  

PubMed Central

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

Kristeller, Judith L.

2014-01-01

288

Postoperative abdominal complications after cardiopulmonary bypass  

PubMed Central

Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB). Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4%) developed abdominal complications postoperatively, including 11(33.3%) cases of paralytic ileus, 9(27.3%) of gastrointestinal haemorrhage, 2(6.1%) of gastroduodenal ulcer perforation, 2(6.1%) of acute calculus cholecystitis, 3(9.1%) of acute acalculus cholecystitis, 4(12.1%) of hepatic dysfunction and 2(6.1%) of ischemia bowel diseases. Of the 33 patients, 26 (78.8%) accepted medical treatment and 7 (21.2%) underwent subsequent surgical intervention. There were 5(15.2%) deaths in this series, which was significantly higher than the overall mortality (2.7%). Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients. PMID:23046511

2012-01-01

289

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

290

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

PubMed Central

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

2013-01-01

291

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

292

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

PubMed Central

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

Irusta, Unai; Ruiz, Jesus; Ayala, Unai; Aramendi, Elisabete; Eftest?l, Trygve

2014-01-01

293

Usefulness of blood pressure rise prior to exercise stress testing to predict the risk of future hypertension in normotensive korean men.  

PubMed

The aim of this study was to test the hypothesis that blood pressure (BP) increase before exercise stress testing is associated with the incidence of hypertension in a prospective study of 3,805 normotensive men without hypertension at baseline. Changes in BP were defined as the difference between seated BP at rest and BP measured immediately before exercise stress testing. Hypertension was defined as systolic and diastolic BP ?140/90 mm Hg or hypertension diagnosed by a physician at the second examination. During 18,923 patient-years of follow-up, 371 new cases of hypertension developed (incidence rate 19.6 per 1,000 patient-years). Men with systolic BP changes >0 mm Hg and diastolic BP changes >7 mm Hg had 1.70 times (95% confidence interval [CI] 1.37 to 2.12) and 2.23 times (95% CI 1.76 to 2.82) increased relative risk for incident hypertension compared with men whose systolic BP changes were <0 mm Hg and diastolic BP changes were <7 mm Hg after adjustment for confounders. Men in the highest quartile of mean BP change (>10 mm Hg) had a higher incidence of hypertension (relative risk 2.98, 95% CI 2.19 to 4.06) compared with those in the lowest quartile (<0 mm Hg), and each 1 mm Hg increment in mean BP was associated with a 6% (95% CI 1.05 to 1.09) higher incidence of hypertension after adjustment for risk factors. In conclusion, BP increase before exercise stress testing is associated with incident hypertension, independent of risk factors in normotensive men. The assessment of BP immediately before exercise testing may be a useful addition to the standard exercise stress testing procedures. PMID:25152425

Jae, Sae Young; Kurl, Sudhir; Laukkanen, Jari A; Choi, Yoon-Ho; Park, Won Hah; Bunsawat, Kanokwan; Heffernan, Kevin S; Fernhall, Bo; Kang, Seok-Min; Park, Jeong Bae

2014-10-15

294

Lung function of healthy boys and girls in Jamaica in relation to ethnic composition, test exercise performance, and habitual physical activity  

Microsoft Academic Search

Miller, G. J., Saunders, M. J., Gilson, R. J. C., and Ashcroft, M. T. (1977).Thorax, 32, 486-496. Lung function of healthy boys and girls in Jamaica in relation to ethnic composition, test exercise performance, and habitual physical activity. The relationships of forced expiratory volume and forced vital capacity on height, age, sex, area of residence, and ethnic composition were assessed

G. J. Miller; M. J. Saunders; R. J. C. Gilson; M. T. Ashcroft

1977-01-01

295

Suppressed increase in blood endothelial progenitor cell content as result of single exhaustive exercise bout in male revascularised coronary artery disease patients.  

PubMed

Endothelial progenitor cells (EPCs) significantly affect endothelial repair capacity and, hence, cardiovascular disease incidence. In healthy subjects, blood EPC content increases significantly as result of a single maximal exercise test, hereby stimulating endothelial repair capacity. It remains to be shown whether a single exercise positively affects blood EPCs in revascularised coronary artery disease (CAD) patients. From male revascularised CAD patients (n = 60) and healthy volunteers (n = 25) blood samples were collected before and immediately after a maximal cardiopulmonary exercise test. Blood samples were analyzed by optimised flow cytometry methodology for EPC content (CD34+, CD34+ CD133+, CD34+VEGFR2+, CD34+CD133+VEGFR2+, and CD34+CD133-VEGFR2+ cells) and compared between groups. CFU-Hill colonies were additionally assessed. As a result of a maximal exercise test, blood CD34+, CD34+VEGFR2+ (all EPCs), CD34+CD133+, and CD34+ CD133-VEGFR2+ (mature EPCs) cells increased significantly in CAD patients (p < 0.05), but less than in healthy subjects (p < 0.05, and p = 0.06 for CD34+VEGFR2+). CD34+CD133+VEGFR2+ cells (immature EPCs) did not change as result of exercise (p > 0.05). No changes in CFU-Hill colonies as result of exercise were observed. This study shows that blood mature EPCs (CD34+CD133-VEGFR2+) increase significantly as result of a single exercise bout in revascularised CAD patients, but with smaller magnitude compared to healthy subjects. Blood immature EPCs (CD34+CD133+VEGFR2+) did not change significantly as result of exercise. PMID:23019801

Rummens, J L; Daniëls, A; Dendale, P; Hensen, K; Hendrikx, M; Berger, J; Koninckx, R; Hansen, D

2012-01-01

296

Exercise Prescription.  

ERIC Educational Resources Information Center

If exercise programs are to become effective in producing the desired results, then the correct exercise prescription must be applied. Four variables should be controlled in the prescription of exercise: (a) type of activity, (b) intensity, (c) duration, and (d) frequency. The long-term prescription of exercise involves the use of a (a) starter…

Ribisl, Paul M.

297

Physiological measurements and upper and lower respiratory tract evaluation in French Standardbred Trotters during a standardised exercise test on the treadmill.  

PubMed

There are a variety of reasons for poor performance in racehorses. Exercise intolerance has often been associated with subclinical respiratory abnormalities, and diagnostic aids are therefore used to enhance clinical detection. Physiological variables can also be measured in order to evaluate the metabolic reponse to exercise. This study evaluated the relationship between physiological measurements and upper airway videoendoscopy during a standardised treadmill exercise test and bronchoalveolar lavage (BAL) cytology in control horses (good racing performance, n = 14) and poor performers (n = 27). The poor performers were divided into 2 groups: Group 1 = both upper and lower respiratory airway abnormal findings (n = 10); Group 2 = lower respiratory airway abnormal findings (n = 17). Horses in Group 2 were divided into 3 categories: Group 2A = exercise-induced pulmonary haemorrhage (EIPH ; n = 5); Group 2B = small airway inflammation (SAI +/- EIPH; n = 7) and Group 2C = other (n = 5). During exercise, the poor performers had significantly lower arterial PaO2 and higher HR and blood lactate concentrations compared to controls. Total nucleated cell count of BAL fluid collected from poor racing performers was significantly higher than in controls; also, epithelial cells and haemosiderophage percentage collected from poor racing performers were significantly higher than in controls. Eight horses with dorsal displacement of the soft palate also had cytological evidence of lower respiratory airway disease. The results of this study suggest that there is a significantly different metabolic response (HR, blood lactate, PaO2) to exercise in poor compared to good performers. As both upper and/or lower respiratory problems can be associated with poor racing performance, a detailed examination of the upper and lower respiratory tracts at rest, during and after exercise is advised. PMID:12405724

Couroucé-Malblanc, A; Pronost, S; Fortier, G; Corde, R; Rossignol, F

2002-09-01

298

Specific Features of Metabolism in Humans Performing a Physical Exercise Test after 7Day Dry Immersion  

Microsoft Academic Search

Healthy male volunteers (n = 5) aged 27–42 years participated in experimental studies (7-day immersion) designed to simulate the effects of microgravity. To study the metabolic changes caused by decreased weight bearing on the musculoskeletal system and a change in the position of the body relative to the gravity vector, a 15-min load test before and after immersion was used.

L. B. Buravkova; I. M. Larina; I. A. Popova

2003-01-01

299

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

ERIC Educational Resources Information Center

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

Chang, J. C.; And Others

1986-01-01

300

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

301

[Wolff-Parkinson-White syndrome. Correlation between the results of electrophysiological investigation and exercise tolerance testing on the electrical aspect of preexcitation].  

PubMed

Fourteen patients with permanent electrocardiographical features of the Wolff-Parkison-White syndrome in sinus rhythm referred for electrophysiological investigation also underwent maximal exercise tolerance tests. The working hypothesis was that in patients with the Wolff-Parkinson-White syndrome with accessory pathways of longer effective refractory periods than the normal pathway (group I) the delta wave should disappear on exercise, whilst in patients with accessory pathways with shorter refractory periods than the normal pathway (group II) the delta wave should persist. Of the 9 patients in group I,the delta wave regressed in 8 and persisted in 1 patient; of the 5 patients in group II, the delta wave persisted in 4 of them. Three patients had attacks of tachycardia during or just after the exercise tolerance test. These results suggest that the exercise tolerance test may help in the identification of patients with accessory pathways with long refractory periods, less susceptible to rapid ventricular rhythms should atrial fibrillation occur, and therefore with better prognoses. PMID:115419

Lévy, S; Broustet, J P; Clémenty, J; Vircoulon, B; Guern, P; Bricaud, H

1979-06-01

302

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

303

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. PMID:24719767

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

304

Venous air embolism after cardiopulmonary resuscitation: the first case with histological confirmation.  

PubMed

We report a case of intracerebral air embolism after cardiopulmonary resuscitation in a patient with a fatal myocardial infarct. Cases of cerebral air embolism rarely occur as a result of cardiopulmonary resuscitation in cases of cardiopulmonary arrest on arrival. This is the first case with postmortem histological confirmation. PMID:19144542

Arena, Vincenzo; Capelli, Arnaldo

2010-01-01

305

Normoxic and Hyperoxic Cardiopulmonary Bypass in Congenital Heart Disease  

PubMed Central

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

Mokhtari, Amir

2014-01-01

306

DC information preservation for cardiopulmonary monitor utilizing CW Doppler radar.  

PubMed

Direct conversion RF receivers introduce large DC offsets, reducing the dynamic range of the baseband signal. Coupled with the relatively small time varying signals in human vital sign monitoring using CW Doppler radar, extraction of cardio-pulmonary information becomes difficult. Previous DC offset compensation techniques utilizing AC coupling have proven detrimental to the performance of the system and the integrity of the low-frequency cardiopulmonary signals. A proposed system utilizing digitally controlled voltage feedback and center finding preserves the important DC information for optimal extraction of phase information in the quadrature system. PMID:19162892

Vergara, Alexander M; Boric-Lubecke, Olga; Lubecke, Victor M

2008-01-01

307

A panel priority rating exercise for the British Forces Germany Health Services Market test.  

PubMed

We report on the application to the BFG Health Services Market Testing (MT) study of the response to a users' questionnaire and panel discussions to determine in which priority and how services should be provided. The questionnaire served to inform lay and health care panel members on users' views on the relative importance of future health services and the way they will be provided. Based on the questionnaire results and data contained in the BAOR Report of Public Health for 1992/93 the panel assigned the highest priorities to emergency services, followed by routine General Practitioner services and essential hospital services. The lowest ranking were non-essential hospital services, health care for children with special needs and provision of designated transport. There was a high consistency in views between the lay and health care members of the panel. PMID:7602554

Jefferson, T O; Demicheli, V

1995-02-01

308

Cerebral hemodynamics in the presence of decreased systemic venous compliance in patients with Fontan physiology may limit anaerobic exercise capacity.  

PubMed

Patients who have had the Fontan procedure report poor exercise performance. Fontan subjects can tolerate a higher level of sub maximal activity than might be anticipated from VO2, suggesting a different mechanism of exercise limitation. Near-infrared spectroscopy (NIRS) provides a non-invasive, continuous method to monitor regional tissue oxygenation (rSO2) and thereby a window into regional oxygen supply-demand relationships. We hypothesized that Fontan patients would have altered rSO2 trends from normal population that might reflect the mechanisms of exercise limitation. All the patients without structural or acquired heart disease and Fontan patients were eligible for inclusion if they were ordered to undergo cardiopulmonary exercise testing (CPET). Four-site regional rSO2 were recorded continuously during exercise. The difference between the oxyhemoglobin saturation measured by pulse oximetry (SpO2) and NIRS (rSO2) was computed as the regional arterial-venous saturation difference (AVDO2). A total of 33 normal subjects and five Fontan subjects scheduled for CPET were recruited. None of the Fontan subjects had a fenestration of the conduit. In the cerebral circulation, the Fontan patients have a significantly higher initial slope of increasing AVDO2 compared with normals. After vAT, the AVDO2 slope is flat for Fontan patients (p = 0.02). There is also a substantially larger rebound of cerebral rSO2 than in normal subjects after QT (p < 0.0001). Reduced anaerobic exercise capacity in Fontan patients may be secondary to limitation of cerebral blood flow, secondary to low systemic venous compliance due to absence of a sub-pulmonary ventricle, and augmented hyperventilatory response during exercise. PMID:19915888

Rao, Rohit P; Danduran, Michael J; Hoffman, George M; Ghanayem, Nancy S; Berger, Stuart; Frommelt, Peter C

2010-02-01

309

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

PubMed

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

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

2015-01-01

310

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

PubMed Central

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

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

2013-01-01

311

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

PubMed

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 (S(m)), early diastolic myocardial velocity (E(m)), and late diastolic myocardial velocity (A(m)) 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 ?S(m) 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 ?E(m) 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 S(m) and E(m) 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 S(m) and E(m) are reduced in healthy older adults during IFHG and CPT. We speculate that suboptimal LV adaptations to SNS stress may partly explain why acute heavy exertion can trigger myocardial ischemia. PMID:23154996

Muller, Matthew D; Mast, Jessica L; Patel, Hardikkumar; Sinoway, Lawrence I

2013-01-15

312

Regular exercise participation mediates the affective response to acute bouts of vigorous exercise.  

PubMed

Physical inactivity is a leading factor associated with cardiovascular disease and a major contributor to the global burden of disease in developed countries. Subjective mood states associated with acute exercise are likely to influence future exercise adherence and warrant further investigation. The present study examined the effects of a single bout of vigorous exercise on mood and anxiety between individuals with substantially different exercise participation histories. Mood and anxiety were assessed one day before an exercise test (baseline), 5 minutes before (pre-test) and again 10 and 25 minutes post-exercise. Participants were 31 university students (16 males, 15 females; Age M = 20), with 16 participants reporting a history of regular exercise with the remaining 15 reporting to not exercise regularly. Each participant completed an incremental exercise test on a Monark cycle ergometer to volitional exhaustion. Regular exercisers reported significant post-exercise improvements in mood and reductions in state anxiety. By contrast, non-regular exercisers reported an initial decline in post-exercise mood and increased anxiety, followed by an improvement in mood and reduction in anxiety back to pre-exercise levels. Our findings suggest that previous exercise participation mediates affective responses to acute bouts of vigorous exercise. We suggest that to maximise positive mood changes following exercise, practitioners should carefully consider the individual's exercise participation history before prescribing new regimes. Key pointsPrevious exercise participation mediates the affective response to acute bouts of vigorous exercise.Regular exercisers respond positively to acute bouts of vigorous physical activity, reporting less state anxiety and fatigue, and more vigour.Non-regular exercisers respond with an initial reduction in positive mood states, followed by a rebound to baseline levels 25 minutes post-exercise.To maximise positive post-exercise mood states, especially among novice exercisers, practitioners should carefully consider previous exercise participation when prescribing new exercise regimes. PMID:24149790

Hallgren, Mats Å; Moss, Nathan D; Gastin, Paul

2010-01-01

313

Work performance evaluation using the exercising rat model  

SciTech Connect

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

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

1987-01-01

314

Compulsive Exercise  

MedlinePLUS

... overdoing it for almost anyone. Much like with eating disorders, many people who engage in compulsive exercise do ... compulsive exercising doesn't have to accompany an eating disorder, the two often go hand in hand. In ...

315

Optimization of high intensity interval exercise in coronary heart disease  

Microsoft Academic Search

High intensity interval training has been shown to be more effective than moderate intensity continuous training for improving\\u000a maximal oxygen uptake (VO2max) in patients with coronary heart disease (CHD). However, no evidence supports the prescription of one specific protocol of\\u000a high intensity interval exercise (HIIE) in this population. The purpose of this study was to compare the acute cardiopulmonary\\u000a responses

Thibaut Guiraud; Martin Juneau; Anil Nigam; Mathieu Gayda; Philippe Meyer; Said Mekary; François Paillard; Laurent Bosquet

2010-01-01

316

Tissue oxygenation with graded dissolved oxygen delivery during cardiopulmonary bypass  

Microsoft Academic Search

Background: Intravascular perfluorochemical emulsions together with a high oxygen tension may increase the delivery of dissolved oxygen to useful levels. The hypothesis of this study is that increasing the dissolved oxygen content of blood with incremental doses of a perfluorochemical emulsion improves tissue oxygenation during cardiopulmonary bypass in a dose-related fashion. Methods and Results: Oxygen utilization was studied in a

William L. Holman; Russell D. Spruell; Edward R. Ferguson; Janice J. Clymer; Walter V. A. Vicente; C. Patrick Murrah; Albert D. Pacifico

1995-01-01

317

Mechanisms of Thrombin Generation During Surgery and Cardiopulmonary Bypass  

Microsoft Academic Search

URING cardiopulmonary bypass (CPB) for open D heart surgery, blood is diverted into an extracorporeal circulation (ECC). The foreign surfaces of the bypass equip- ment are considered to exert a strong procoagulant effect.' To counter this, anticoagulants (heparin alone or in combi- nation with aprotinin) are administered in high concentra- tion during the period of ECC.2,3 The anticoagulation regi- mens

Michael D. Boisclair; Helen Philippou; M. Peter Esnouf; Sajila Sheikh; Beverley Hunt; Kenneth J. Smith

318

Family presence during cardiopulmonary resuscitation and invasive procedures in children  

PubMed Central

Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes. PMID:24676198

Ferreira, Cristiana Araujo G.; Balbino, Flavia Simphronio; Balieiro, Maria Magda F. G.; Mandetta, Myriam Aparecida

2014-01-01

319

Retention of Cardiopulmonary Resuscitation Skills by Medical Students.  

ERIC Educational Resources Information Center

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

Fossel, Michael; And Others

1983-01-01

320

Laparoscopic insufflation of the abdomen depresses cardiopulmonary function  

Microsoft Academic Search

Recently we have used the laparoscope to remove the gallbladder in critically ill patients in order to spare them the operative trauma of laparotomy. However, increased intraperitoneal pressure may have deleterious cardiopulmonary effects. This was investigated in a dog model. Insufflation of the abdomen with carbon dioxide decreased the mean cardiac output to less than 80% of baseline (PPCO2 and

Mark D. Williams; Peter C. Murr

1993-01-01

321

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

SciTech Connect

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

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

2009-11-15

322

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

323

Achievement of VO2max criteria during a continuous graded exercise test and a verification stage performed by college athletes.  

PubMed

The purpose of this study was to determine the incidence of meeting specific VO2max criteria and to test the effectiveness of a VO2max verification stage in college athletes. Thirty-five subjects completed a continuous graded exercise test (GXT) to volitional exhaustion. The frequency of achieving various respiratory exchange ratio (RER) and age-predicted maximum heart rate (HRmax) criteria and a VO2 plateau within 2 and 2.2 ml·kg(-1)·min(-1) (<2SD of the expected increase in VO2) were measured and tested against expected frequencies. After 10 minutes of active recovery, 10 subjects who did not demonstrate a plateau completed a verification stage performed at supramaximal intensity. From the GXT, the number of subjects meeting VO2max plateau was 5 (?2 ml·kg(-1)·min(-1)) and 7 (?2.2 ml·kg(-1)·min(-1)), RER criteria 34 (?1.05), 32 (?1.10), and 24 (?1.15), HRmax criteria, 35 (<85%), 29 (<10 b·min(-1)) and 9 (HRmax). The VO2max and HRmax did not differ between GXT and the verification stage (53.6 ± 5.6 vs. 55.5 ± 5.6 ml·kg(-1)·min(-1) and 187 ± 7 vs. 187 ± 6 b·min(-1)); however, the RER was lower during the verification stage (1.15 ± 0.06 vs. 1.07 ± 0.07, p = 0.004). Six subjects achieved a similar VO2 (within 2.2 ml·kg(-1)·min(-1)), whereas 4 achieved a higher VO2 compared with the GXT. These data demonstrate that a continuous GXT limits the college athlete's ability to achieve VO2max plateau and certain RER and HR criteria. The use of a verification stage increases the frequency of VO2max achievement and may be an effective method to improve the accuracy of VO2max measurements in college athletes. PMID:22076102

Mier, Constance M; Alexander, Ryan P; Mageean, Amanda L

2012-10-01

324

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

PubMed Central

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

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

2014-01-01

325

What the exercise of the SPICE source inversion validation BlindTest 1 did not tell you  

NASA Astrophysics Data System (ADS)

Uncertainties of earthquake finite-fault inversions based upon strong motion data are investigated using the source inversion validation BlindTest 1 exercise of the SPICE (Seismic Wave Propagation and Imaging in Complex Media: A European Network) project, motivated by previous counterintuitive results. The distribution of slip and the shapes of asymmetric slip rate functions are simultaneously inverted by matching 10 or 33 broad-band three-component velocity waveforms within the period ranging from 0.02 to 2 Hz, using a finite-fault method that carries out the waveform inversion in the wavelet domain. The effects of subfault size, data noise and the number of stations have been explored. Our results suggest: (1) Although there are inevitable discrepancies between the inverted model and the target model because of ignoring the spatial slip variations within individual subfaults, the fault slip and rise-time distributions can be well constrained even with the data including large Gaussian noise. (2) It is crucial for source studies to develop new inversion schemes that can properly honour the frequency- and time-dependent energy distribution of seismic radiation and data noise. For instance, inversions using the variance reduction function of velocity waveforms as the objective function have low sensitivities to the total seismic moment and peak slip. (3) Although the relative value of the objective function is guided in the inversion, the absolute value of the objective function cannot be used to evaluate the quality of an inverted model. (4) Because the source inversion is based on surface observations, the spatiotemporal resolution of source inversion is affected not only by the data quality but also by the earthquake itself. For vertical strike-slip faults, the along-strike resolution is better than that along the downdip direction.

Shao, Guangfu; Ji, Chen

2012-04-01

326

Cardiopulmonary resuscitation skills in nurses and nursing students.  

PubMed

The purpose of this study is to describe the basic cardiac life-support (BLS) skills of nurses and nursing students in southern Finland and Hungary, and to assess the influence of resuscitation teaching and other group characteristics on performance. The data for the study were collected in the spring and autumn of 1997. The study group consisted of 75 nurses from Helsinki University Central Hospital's medical outcome unit, 188 final term students in four nursing institutes in Uusimaa county and 35 final term students in a Hungarian institute of nursing. A total of 298 people (34 men and 264 women) participated in the study. Background information was collected using a structured questionnaire devised specifically for this study. Resuscitation skills were measured using the Skillmeter Anne manikin. The manikin was placed supine during the test. After completing the questionnaire, every participant attempted resuscitation on the manikin - which was supplied with a printer - for 4 min. The results were printed out and attached to the questionnaires. The data were analysed using two-way frequency tables and logistic regression. Statistical differences were calculated using the chi(2)-test. The results showed that 53% of the participants had studied resuscitation during the last 6 months, but 7% had never participated in resuscitation teaching. Before testing, 55% of the participants estimated that their resuscitation skills were good. The results showed that 36% first assessed the patient's response, 67% opened the airway but only 3% determined pulselessness before starting to resuscitate. Twenty-one percent of the participants compressed correctly for at least half of the test and 33% ventilated correctly at least half of the time. Logistic regression showed that the best predictors for good response assessment skills went to those who were nursing students who had studied resuscitation skills sometime during the previous 6 months. The best predictor of the skill to open the airway was a positive attitude towards personal cardiopulmonary resuscitation (CPR) skills, i.e. self-confidence. The predictor for adequate skills in artificial ventilation was that they belonged in the group of nursing students who had benefited from recent resuscitation training (<6 months). In conclusion, the skills of the participants of the study can not be considered adequate in terms of an adequate and prompt assessment of the need for resuscitation, and a 50% success rate in artificial ventilation and chest compression. PMID:11008156

Nyman, J; Sihvonen, M

2000-10-01

327

Identification of Three Exercise-induced Mortality Risk Factors in Patients with COPD.  

PubMed

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

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

2014-12-01

328

Exercise-induced asthma and doxantrazole  

Microsoft Academic Search

In a double-blind cross-over trial in 13 patients with exercise-induced asthma, doxantrazole 200 mg taken orally 1 hour before a standardized exercise test involving stair climbing failed to block post-exercise bronchoconstriction. In an open assessment study with the same patients, increasing the doxantrazole dose to 400 mg did not affect post-exercise bronchoconstriction.

H. Poppius; B. Stenius

1977-01-01

329

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

PubMed Central

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

Lee, Bo-Ae; Oh, Deuk-Ja

2014-01-01

330

Modified Chrispin-Norman score: correlation with peak exercise capacity and efficiency of ventilation in children with cystic fibrosis.  

PubMed

The modified Chrispin-Norman radiography score (CNS) is used in evaluation of radiographic changes in children with cystic fibrosis (CF). We evaluated the correlation of modified CNS with peak exercise capacity (Wpeak) and ventilatory efficiency (reflected by breathing reserve index-BRI) during progressive cardiopulmonary exercise testing (CPET). Thirty-six children aged 8-17 years were stratified according to their CNS into 3 groups: mild (<10), moderate (10-15), and severe (>15). CPET was performed on a cycle ergometer. Lung function tests included spirometry and whole-body plethysmography. Patients with higher CNS had lower FEV1 (p < .001), Wpeak predicted (%; p = .01) and lower mean peak oxygen consumption (VO2peak/kg; p = .014). The BRI at the anaerobic threshold and at Wpeak was elevated in patients with the highest CNS values (p < .001). The modified CNS correlates moderately with Wpeak (R = -0.443; p = .007) and BRI (R = -0.419; p = .011). Stepwise multiple linear regression showed that RV/TLC was the best predictor of Wpeak/pred (%; B = -0.165; ? = -0.494; R2 = .244; p = .002). Children with CF who have high modified CNS exhibit decreased exercise tolerance and ventilatory inefficacy during progressive effort. PMID:25111160

Sovtic, Aleksandar; Minic, Predrag; Kosutic, Jovan; Markovic-Sovtic, Gordana; Gajic, Milan

2014-08-01

331

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

PubMed

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

Lee, Bo-Ae; Oh, Deuk-Ja

2014-06-01

332

Aortic arch shape is not associated with hypertensive response to exercise in patients with repaired congenital heart diseases  

PubMed Central

Background Aortic arch geometry is linked to abnormal blood pressure (BP) response to maximum exercise. This study aims to quantitatively assess whether aortic arch geometry plays a role in blood pressure (BP) response to exercise. Methods 60 age- and BSA-matched subjects – 20 post-aortic coarctation (CoA) repair, 20 transposition of great arteries post arterial switch operation (ASO) and 20 healthy controls – had a three-dimensional (3D), whole heart magnetic resonance angiography (MRA) at 1.5 Tesla, 3D geometric reconstructions created from the MRA. All subjects underwent cardiopulmonary exercise test on the same day as MRA using an ergometer cycle with manual BP measurements. Geometric analysis and their correlation with BP at peak exercise were assessed. Results Arch curvature was similarly acute in both the post-CoA and ASO cases [0.05?±?0.01 vs. 0.05?±?0.01 (1/mm/m2); p?=?1.0] and significantly different to that of normal healthy controls [0.05?±?0.01 vs. 0.03?±?0.01 (1/mm/m2), p?exercise did not correlate with arch curvature (r?=?0.203, p?=?0.120), but showed inverse correlation with indexed minimum cross sectional area of transverse arch and isthmus (r?=?-0.364, p?=?0.004), and ratios of minimum arch area/ descending diameter (r?=?-0.491, p?exercise following CoA repair. PMID:24219806

2013-01-01

333

Food related, exercise induced anaphylaxis.  

PubMed Central

Four children under 12 years of age with food dependent, exercise induced anaphylaxis (EIAn) were investigated. These children and five controls performed exercise challenges when fasting and one hour after a meal without food suspected to predispose to the reaction. Patients then performed exercise tests after intake of each suspected food. Three out of 15 food-exercise combination challenges were positive, but no reactions were provoked after exercise without prior intake of suspected foods. Patients underwent skin prick tests to foods and serum total and specific IgE antibodies were measured. Skin prick test results were positive and RAST results were positive in two of three instances. In case 3, food-exercise combination challenges did not provoke any clinical reaction. The diagnosis of food dependent EIAn should be considered in young children with EIAn of unknown origin. PMID:8869196

Caffarelli, C; Terzi, V; Perrone, F; Cavagni, G

1996-01-01

334

Climate change. A global threat to cardiopulmonary health.  

PubMed

Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies. PMID:24400619

Rice, Mary B; Thurston, George D; Balmes, John R; Pinkerton, Kent E

2014-03-01

335

Role of cardiopulmonary mechanoreceptors in the postural regulation of renin  

SciTech Connect

To change the stretch on cardiopulmonary mechanoreceptors, large shifts of blood in the capacity space were elicited by tilting and by exerting positive lower body pressure in the tilted position. Twelve volunteers underwent invasive hemodynamic studies and in 10 other subjects cardiac size was determined by radionuclide cardiography. In all 22 subjects tilting caused the expected increase of renin, which was abolished by lower body compression. Decompression caused renin to increase again. Right atrial pressure in invasive studies and end-systolic and end-diastolic counts in noninvasive studies showed a significant and strong negative correlation with renin and norepinephrine levels. Thus, the degree of stretch of the cardiopulmonary mechanoreceptors is a major determinant of reflex regulation of renin release in humans.

Sanchez, R.A.; Marco, E.J.; Oliveri, C.; Otero, F.J.; Degrossi, O.; Moledo, L.I.; Julius, S.

1987-04-01

336

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

PubMed Central

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

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

2012-01-01

337

Methyl prednisolone and lung function after cardiopulmonary bypass.  

PubMed Central

Thirty-one patients who were undergoing cardiopulmonary bypass for elective aortic valve replacement were studied. The effects on some aspects of lung function of intravenous methyl prednisolone, administered immediately before bypass, were assessed by measuring alveolar-arterial oxygen differences and shunt fractions. No significant differences in pulmonary function were found between the treated and control groups. The use of methyl prednisolone in this context is not justified. PMID:396686

Enderby, D H; Boylett, A; Parker, D J

1979-01-01

338

Clinical effects of the heparin coated surface in cardiopulmonary bypass  

Microsoft Academic Search

Objective: In a randomised study of 120 patients, undergoing primary operation for coronary heart decease, two groups were investigated as regards to the effects of heparin coated cardiopulmonary bypass on brain function parameters and general clinical outcome. The study group (n56) was perfused using an extra-corporeal circuit treated with covalent bonded heparin; the control group (n59) used an identical set-up

Staffan Svenmarker; Erik Sandstrom; Thomas Karlsson; Erica Jansson; Soren Haggmark; Ronny Lindholm; Micael Appelblad; Torkel Aberg

1997-01-01

339

Porcine heparin increases postoperative bleeding in cardiopulmonary bypass patients  

Microsoft Academic Search

Summary One hundred thirteen patients undergoing cardiopulmonary bypass were randomly assigned to receive either bovine or porcine heparin. Heparin was infused at 4.5 mg\\/kg during bypass and administered at the lesser of 70 units\\/kg or 5000 units\\/dose at 12-hour intervals postoperatively. Platelet counts decreased to 45% of preoperative levels during the first 3 days postoperatively (porcine, 44±13%, n =50; bovine,

Leigh I. G. Iverson; Francis G. Duhaylongsod; J. Nilas Young; Roger R. Ecker; Coyness L. Ennix; Richard L. Moretti; M. Farrar; R. Hayes; J. Lee; Ivan A. May

1990-01-01

340

Examining the use of forceful language when designing exercise persuasive messages for adults: a test of conceptualizing reactance arousal as a two-step process.  

PubMed

This investigation tests a conceptualization of reactance as a two-step process. This conceptualization was recently tested with college students, but research testing this conceptualization among primarily adult samples does not currently exist. Psychological reactance theory (PRT) states that individuals exposed to a threat or elimination of a freedom will experience reactance and subsequently be motivated to restore the freedom. Specifically, it is hypothesized that individuals will perceive persuasive messages containing forceful language as a threat to their personal freedom, which will be followed by reactance, manifested in a latent variable composed of anger and negative cognitions. This hypothesis was tested within the context of persuasive messages aimed at encouraging members (N = 247) to participate in weight lifting or group exercise programs at a health and fitness center. Results support conceptualizing reactance as a 2-step process. In addition, results indicate that a primarily adult sample responds unfavorably to forceful persuasive messages advocating the aforementioned exercise activities. In finding support for conceptualizing reactance as a two-step process, we encourage health campaigners and PRT researchers to employ this measure to provide consistency to future PRT studies. PMID:18850395

Quick, Brian L; Considine, Jennifer R

2008-09-01

341

No effect of short-term arginine supplementation on nitric oxide production, metabolism and performance in intermittent exercise in athletes  

Microsoft Academic Search

Arginine supplementation has been shown to alleviate endothelial dysfunction and improve exercise performance through increasing nitric oxide production in patients with cardiopulmonary diseases. In addition, arginine supplementation could decrease accumulations of lactate and ammonia, metabolites involved in development of muscular fatigue. The aim of this study was to investigate the effect of short-term arginine supplementation on performance in intermittent anaerobic

Tsung-Han Liu; Ching-Lin Wu; Chi-Wei Chiang; Yu-Wei Lo; Hung-Fu Tseng; Chen-Kang Chang

2009-01-01

342

Quantitative effects of a water exercise program on functional and physiological capacity in subjects with knee osteoarthritis: a pilot study  

Microsoft Academic Search

Osteoarthritis (OA) is a common and debilitating disease that often affects the knees. Patients suffer from pain and disability and have associated reductions in muscle and cardiopulmonary function. We quantitatively evaluated the effects of an 8-week water exercise program (WEP) on muscle, cardiovascular, and functional capacity on patients with knee OA. Functional capacity (walking time, Jette functional status index, habitual

N. M. Fisher; D. M. Dolan; C. Brenner; D. R. Pendergast

2004-01-01

343

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

344

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. PMID:23158531

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

345

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

346

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

PubMed Central

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

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

2014-01-01

347

Circulating adrenaline and noradrenaline concentrations during exercise in patients with exercise induced asthma and normal subjects  

Microsoft Academic Search

A failure of the usual increase in plasma adrenaline and noradrenaline concentrations during submaximal exercise has been suggested as a contributory cause of exercise induced asthma. Six normal subjects and six asthmatic patients underwent a standard graded maximal exercise test. Measurements of oxygen consumption, minute ventilation, exercise time, blood lactate concentration, and heart rate indicated that the two groups achieved

K E Berkin; G Walker; G C Inglis; S G Ball; N C Thomson

1988-01-01

348

ORIGINAL ARTICLE Acute Exercise Improves Physical Sexual Arousal in Women  

E-print Network

ORIGINAL ARTICLE Acute Exercise Improves Physical Sexual Arousal in Women Taking Antidepressants of Behavioral Medicine 2012 Abstract Background Antidepressants can impair sexual arousal. Exercise increases. Purpose Test if exercise increases genital arousal in women taking antidepressants, including selective

Meston, Cindy

349

Experimental use of a compact centrifugal pump and membrane oxygenator as a cardiopulmonary support system.  

PubMed

Compactness and high performance are the most important requirements for a cardiopulmonary support system. The Nikkiso (HPM-15) centrifugal pump is the smallest (priming volume; 25 ml, impeller diameter; 50 mm) in clinically available centrifugal pumps. The Kuraray Menox (AL-2000) membrane oxygenator, made of double-layer polyolefin hollow fiber, has a minimum priming volume (80 ml) and a low pressure loss (65 mm Hg at 2.0 L/min of blood flow) compared with other oxygenators. The aim of this study was to evaluate the performance of the most compact cardiopulmonary support system (total priming volume: 125 ml) in animal experiments. The cardiopulmonary bypass was constructed in a canine model with the Nikkiso pump and Menox oxygenator in comparison with a conventional cardiopulmonary support system. The partial cardiopulmonary bypass was performed for 4 h to evaluate the gas exchange ability, blood trauma, serum leakage, hemodynamics, and blood coagulative parameters. The postoperative plasma free hemoglobin level of the compact cardiopulmonary system was 29.5 +/- 10.21 mg/dl (mean +/- SD), which was lower than that of the conventional cardiopulmonary system, 48.75 +/- 27.39 mg/dl (mean +/- SD). This compact cardiopulmonary system provided the advantage in terms of reduction of the priming volume and less blood damage. These results suggested the possibility of miniaturization for the cardiopulmonary bypass support system in open-heart surgery in the near future. PMID:11119082

Suenaga, E; Naito, K; Cao, Z L; Suda, H; Ueno, T; Natsuaki, M; Itoh, T

2000-11-01

350

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

PubMed Central

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

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

2014-01-01

351

Nedocromil sodium and exercise induced asthma  

Microsoft Academic Search

Serial exercise tests were carried out by 12 children with asthma on two study days. After a control exercise test either nedocromil sodium 4 mg or placebo were given double blind by metered dose inhaler. Highly significant inhibition of exercise induced asthma occurred after nedocromil, lasting for over two hours.

N Chudry; F Correa; M Silverman

1987-01-01

352

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. PMID:24244220

Hughes, Carroll W.; Barnes, Shauna; Barnes, Conrad; DeFina, Laura F.; Nakonezny, Paul; Emslie, Graham J.

2013-01-01

353

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. PMID:17707133

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

2007-01-01

354

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

PubMed Central

The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve (%V?O2?R) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and V?O2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL·kg-1·min-1 (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and %V?O2?R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and %V?O2?R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise. PMID:25003546

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

2014-01-01

355

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

PubMed

The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve (%VO2 R) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and VO2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL · kg(-1) · min(-1) (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and % VO2 R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and % VO2 R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise. PMID:25003546

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

2014-08-01

356

Gender differences in the endocrine and metabolic responses to hypoxic exercise.  

PubMed

This study tested the hypothesis that women would have blunted physiological responses to acute hypoxic exercise compared with men. Fourteen women taking oral contraceptives (28 +/- 0.9 yr of age) and 15 men (30 +/- 1.0 yr of age) with similar peak O(2) consumption (VO(2 peak)) values (56 +/- 1.1 vs. 57 +/- 0.8 ml x kg fat-free mass(-1) x min(-1)) were studied under hypoxic (H; fraction of inspired oxygen = 13%) vs. normoxic (fraction of inspired oxygen = 20.93%) conditions. Cardiopulmonary, metabolic, and neuroendocrine measures were taken before, during, and 30 min after three 5-min consecutive workloads at 30, 45, and 60% VO(2 peak). In women compared with men, glucose levels were greater during recovery from H (P < 0.05) and lactate levels were lower at 45% VO(2 peak), 60% VO(2 peak), and up to 20 min of recovery (P < 0.05), regardless of trial (P < 0.0001). Although the women had greater baseline levels of cortisol and growth hormone (P < 0.0001), gender did not affect these hormones during H or exercise. Catecholamine responses to H were also similar between genders. Thus the endocrine response to hypoxia per se was not blunted in women as we had hypothesized. Other mechanisms must be at play to cause the gender differences in metabolic substrates in response to hypoxia. PMID:11796657

Sandoval, Darleen A; Matt, Kathleen S

2002-02-01

357

Survey on Air Pollution and Cardiopulmonary Mortality in Shiraz from 2011 to 2012: An Analytical-Descriptive Study  

PubMed Central

Background: Expanding cities with rapid economic development has resulted in increased energy consumption leading to numerous environmental problems for their residents. The aim of this study was to investigate the correlation between air pollution and mortality rate due to cardiovascular and respiratory diseases in Shiraz. Methods: This is an analytical cross-sectional study in which the correlation between major air pollutants (including carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2] and particle matter with a diameter of less than 10 ? [PM10]) and climatic parameters (temperature and relative humidity) with the number of those whom expired from cardiopulmonary disease in Shiraz from March 2011 to January 2012 was investigated. Data regarding the concentration of air pollutants were determined by Shiraz Environmental Organization. Information about climatic parameters was collected from the database of Iran's Meteorological Organization. The number of those expired from cardiopulmonary disease in Shiraz were provided by the Department of Health, Shiraz University of Medical Sciences. We used non-parametric correlation test to analyze the relationship between these parameters. Results: The results demonstrated that in all the recorded data, the average monthly pollutants standard index (PSI) values of PM10 were higher than standard limits, while the average monthly PSI value of NO2 were lower than standard. There was no significant relationship between the number of those expired from cardiopulmonary disease and the air pollutant (P > 0.05). Conclusions: Air pollution can aggravate chronic cardiopulmonary disease. In the current study, one of the most important air pollutants in Shiraz was the PM10 component. Mechanical processes, such as wind blowing from neighboring countries, is the most important parameter increasing PM10 in Shiraz to alarming conditions. The average monthly variation in PSI values of air pollutants such as NO2, CO, and SO2 were lower than standard limits. Moreover, there was no significant correlation between the average monthly variation in PSI of NO2, CO, PM10, and SO2 and the number of those expired from cardiopulmonary disease in Shiraz. PMID:25013693

Dehghani, Mansooreh; Anushiravani, Amir; Hashemi, Hassan; Shamsedini, Narges

2014-01-01

358

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. PMID:20952631

Sarzynski, Mark A.; Rankinen, Tuomo; Sternfeld, Barbara; Grove, Megan L.; Fornage, Myriam; Jacobs, David R.; Sidney, Stephen; Bouchard, Claude

2011-01-01

359

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. PMID:24848378

Coolbaugh, Crystal L.; Anderson, Ivan B.; Wilson, Machelle D.; Hawkins, David A.; Amsterdam, Ezra A.

2014-01-01

360

Utility of 3-dimensional echocardiography, global longitudinal strain, and exercise stress echocardiography to detect cardiac dysfunction in breast cancer patients treated with doxorubicin-containing adjuvant therapy.  

PubMed

Conventional resting left ventricular ejection fraction (LVEF) assessments have limitations for detecting doxorubicin (DOX)-related cardiac dysfunction. Novel resting echocardiographic parameters, including 3-dimensional echocardiography (3DE) and global longitudinal strain (GLS), have potential for early identification of chemotherapy-related myocardial injury. Exercise "stress" is an established method to uncover impairments in cardiac function but has received limited attention in the adult oncology setting. We evaluated the utility of an integrated approach using 3DE, GLS, and exercise stress echocardiography for detecting subclinical cardiac dysfunction in early breast cancer patients treated with DOX-containing chemotherapy. Fifty-seven asymptomatic women with early breast cancer (mean 26 ± 22 months post-chemotherapy) and 20 sex-matched controls were studied. Resting left ventricular (LV) function was assessed by LVEF using 2-dimensional echocardiography (2DE) and 3DE and by GLS using 2-dimensional speckle-tracking echocardiography (2D-STE). After resting assessments, subjects completed cardiopulmonary exercise testing with stress 2DE. Resting LVEF was lower in patients than controls by 3DE (55 ± 4 vs. 59 ± 5 %; p = 0.005) but not 2DE (56 ± 4 vs. 58 ± 3 %; p = 0.169). 10 of 51 (20 %) patients had GLS greater than or equal to -17 %, which was below the calculated lower limit of normal (control mean 2SD); this patient subgroup had a mean 20 % impairment in GLS (-16.1 ± 0.9 vs. -20.1 ± 1.5 %; p < 0.001), despite similar LVEF by 2DE and 3DE compared to controls (p > 0.05). Cardiopulmonary function (VO2peak) was 20 % lower in patients than controls (p < 0.001). Exercise stress 2DE assessments of stroke volume (61 ± 11 vs. 69 ± 15 ml; p = 0.018) and cardiac index (2.3 ± 0.9 vs. 3.1 ± 0.8 l min(-1) m(-2) mean increase; p = 0.003) were lower in patients than controls. Post-exercise increase in cardiac index predicted VO2peak (r = 0.429, p = 0.001). Resting 3DE, GLS, and exercise stress 2DE detect subclinical cardiac dysfunction not apparent with resting 2DE in post-DOX breast cancer patients. PMID:24390149

Khouri, Michel G; Hornsby, Whitney E; Risum, Niels; Velazquez, Eric J; Thomas, Samantha; Lane, Amy; Scott, Jessica M; Koelwyn, Graeme J; Herndon, James E; Mackey, John R; Douglas, Pamela S; Jones, Lee W

2014-02-01

361

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

PubMed Central

Background After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. Methods/Design This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (?20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject’s inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Discussion Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics-assisted treadmill exercise is a relatively recent intervention method and might be used to train and evaluate aerobic capacity in this population. The present pilot trial is expected to provide new insights into the implementation of early cardiovascular exercise for individuals with severe motor impairment. The findings of this study may guide future research to explore the effects of early cardiovascular activation after severe neurological events. Trial registration This trial is registered with the Clinical Trials.gov Registry (NCT01679600). PMID:24053609

2013-01-01

362

A non-exercise testing method for estimating cardiorespiratory fitness: associations with all-cause and cardiovascular mortality in a pooled analysis of eight population-based cohorts  

PubMed Central

Aims Cardiorespiratory fitness (CRF) is a key predictor of chronic disease, particularly cardiovascular disease (CVD), but its assessment usually requires exercise testing which is impractical and costly in most health-care settings. Non-exercise testing cardiorespiratory fitness (NET-F)-estimating methods are a less resource-demanding alternative, but their predictive capacity for CVD and total mortality has yet to be tested. The objective of this study is to examine the association of a validated NET-F algorithm with all-cause and CVD mortality. Methods and results The participants were 32 319 adults (14 650 men) aged 35–70 years who took part in eight Health Survey for England and Scottish Health Survey studies between 1994 and 2003. Non-exercise testing cardiorespiratory fitness (a metabolic equivalent of VO2max) was calculated using age, sex, body mass index (BMI), resting heart rate, and self-reported physical activity. We followed participants for mortality until 2008. Two thousand one hundred and sixty-five participants died (460 cardiovascular deaths) during a mean 9.0 [standard deviation (SD) = 3.6] year follow-up. After adjusting for potential confounders including diabetes, hypertension, smoking, social class, alcohol, and depression, a higher fitness score according to the NET-F was associated with a lower risk of mortality from all-causes (hazard ratio per SD increase in NET-F 0.85, 95% confidence interval: 0.78–0.93 in men; 0.88, 0.80–0.98 in women) and CVD (men: 0.75, 0.63–0.90; women: 0.73, 0.60–0.92). Non-exercise testing cardiorespiratory fitness had a better discriminative ability than any of its components (CVD mortality c-statistic: NET-F = 0.70–0.74; BMI = 0.45–0.59; physical activity = 0.60–0.64; resting heart rate = 0.57–0.61). The sensitivity of the NET-F algorithm to predict events occurring in the highest risk quintile was better for CVD (0.49 in both sexes) than all-cause mortality (0.44 and 0.40 for men and women, respectively). The specificity for all-cause and CVD mortality ranged between 0.80 and 0.82. The net reclassification improvement of CVD mortality risk (vs. a standardized aggregate score of the modifiable components of NET-F) was 27.2 and 21.0% for men and women, respectively. Conclusion The CRF-estimating method NET-F that does not involve exercise testing showed consistent associations with all-cause and cardiovascular mortality, and it had good discrimination and excellent risk reclassification improvement. As such, it merits further attention as a practical and potentially and useful risk prediction tool. PMID:22555215

Stamatakis, Emmanuel; Hamer, Mark; O'Donovan, Gary; Batty, George David; Kivimaki, Mika

2013-01-01

363

Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis  

PubMed Central

Background Previous studies have shown the beneficial effects of aerobic exercise in chronic stroke. Most motor and functional recovery occurs in the first months after stroke. Improving cardiovascular capacity may have potential to precipitate recovery during early stroke rehabilitation. Currently, little is known about the effects of early cardiovascular exercise in stroke survivors. The aim of this systematic review was to evaluate the effectiveness of cardiovascular exercise early after stroke. Methods A systematic literature search was performed. For this review, randomized and non-randomized prospective controlled cohort studies using a cardiovascular, cardiopulmonary or aerobic training intervention starting within 6 months post stroke were considered. The PEDro scale was used to detect risk of bias in individual studies. Inter-rater agreement was calculated (kappa). Meta-analysis was performed using a random-effects model. Results A total of 11 trials were identified for inclusion. Inter-rater agreement was considered to be “very good” (Kappa: 0.81, Standard Error: 0.06, CI95%: 0.70–0.92), and the methodological quality was “good” (7 studies) to “fair” (4 studies). Peak oxygen uptake data were available for 155 participants. Pooled analysis yielded homogenous effects favouring the intervention group (standardised mean difference (SMD)?=?0.83, CI95%?=?0.50–1.16, Z?=?4.93, P?Test comprised 278 participants. Pooled analysis revealed homogenous effects favouring the cardiovascular training intervention group (SMD?=?0.69, CI95%?=?0.45–0.94, Z?=?5.58, P?exercise. Conclusion This meta-analysis shows that stroke survivors may benefit from cardiovascular exercise during sub-acute stages to improve peak oxygen uptake and walking distance. Thus, cardiovascular exercise should be considered in sub-acute stroke rehabilitation. However, concepts to influence and evaluate aerobic capacity in severely affected individuals with sub-acute stroke, as well as in the very early period after stroke, are lacking. Further research is needed to develop appropriate methods for cardiovascular rehabilitation early after stroke and to evaluate long-term effects of cardiovascular exercise on aerobic capacity, physical functioning, and quality-of-life. PMID:22727172

2012-01-01

364

Vitamin d status and v[combining dot above]o2peak during a skate treadmill graded exercise test in competitive ice hockey players.  

PubMed

Fitzgerald, JS, Peterson, BJ, Warpeha, JM, Wilson, PB, Rhodes, GS, and Ingraham, SJ. Vitamin D status and V[Combining Dot Above]O2peak during a skate treadmill graded exercise test in competitive ice hockey players. J Strength Cond Res 28(11): 3205-3210, 2014-Vitamin D status has been associated with cardiorespiratory fitness (CRF) in cross-sectional investigations in the general population. Data characterizing the association between 25-hydroxyvitamin D (25(OH)D) concentration and CRF in athletes are lacking. Junior and collegiate ice hockey players were recruited from the Minneapolis, MN (44.9° N), area during the off-season period (May 16-June 28). The purpose of this study was to examine the cross-sectional association between 25(OH)D concentration and CRF in a sample population of competitive ice hockey players. Circulating 25(OH)D level was assessed from a capillary blood sample analyzed using liquid chromatography-tandem mass spectrometry. V[Combining Dot Above]O2peak during a skate treadmill graded exercise test (GXT) was used to assess CRF. Data on both 25(OH)D concentration and V[Combining Dot Above]O2peak were available for 52 athletes. Insufficient 25(OH)D concentrations were found in 37.7% of the athletes (<32 ng·ml). Vitamin D status was not significantly associated with any physiological or physical parameter during the skate treadmill GXT. PMID:24832977

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

2014-11-01

365

The Hemodynamic Effects of Methylene Blue When Administered at the Onset of Cardiopulmonary Bypass  

Microsoft Academic Search

Hypotension occurs during cardiopulmonary bypass (CPB), in part because of induction of the inflammatory response, for which nitric oxide and guanylate cyclase play a central role. In this study we examined the hemodynamic effects of methylene blue (MB), an inhibitor of guanylate cyclase, administered during cardiopulmonary bypass (CPB) to patients taking angiotensin-converting enzyme inhibitors. Thirty patients undergoing cardiac surgery were

Andrew D. Maslow; Gary Stearns; Parag Batula; Carl S. Schwartz; Jeffrey Gough; Arun K. Singh

2006-01-01

366

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

Microsoft Academic Search

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

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

1999-01-01

367

Does Cardiopulmonary Resuscitation Cause Rib Fractures in Children? A Systematic Review  

ERIC Educational Resources Information Center

Background: There is a diagnostic dilemma when a child presents with rib fractures after cardiopulmonary resuscitation (CPR) where child abuse is suspected as the cause of collapse. We have performed a systematic review to establish the evidence base for the following questions: (i) Does cardiopulmonary resuscitation cause rib fractures in…

Maguire, Sabine; Mann, Mala; John, Nia; Ellaway, Bev; Sibert, Jo R.; Kemp, Alison M.

2006-01-01

368

Methylene blue: the drug of choice for catecholamine-refractory vasoplegia after cardiopulmonary bypass  

Microsoft Academic Search

ObjectivesVasoplegia is a frequent complication after cardiopulmonary bypass that often requires the application of norepinephrine. In a number of cases, however, vasoplegia is refractory to norepinephrine. The guanylate cyclase inhibitor methylene blue could be an attractive treatment alternative in such cases. This study examines the results of methylene blue therapy for norepinephrine-refractory vasoplegia after cardiopulmonary bypass.

Rainer G Leyh; Theo Kofidis; Martin Strüber; Stefan Fischer; Karsten Knobloch; Bjoern Wachsmann; Christian Hagl; Andre R Simon; Axel Haverich

2003-01-01

369

Contrast MR of the brain after high-perfusion cardiopulmonary bypass  

SciTech Connect

To study the efficacy of contrast MR imaging in the evaluation of central nervous system complications in the cardiopulmonary bypass patient and attempt to explain their pathophysiology based on the MR appearance and the cardiopulmonary bypass protocol. Nineteen patients were prospectively studied with contrast MR examinations the day before and 3 to 7 days after cardiopulmonary bypass, to determine the nature, extent, and number of new postoperative MR abnormalities. Cardiopulmonary bypass parameters used in our institution included: membrane oxygenation, arterial filtration with a pore size of 25 [mu]m, and a relatively high perfusion rate to produce a cardiac index of 2.0 to 2.5 L min per m[sup 2]. The preoperative noncontrast MR examination showed age-related changes and/or signs of ischemia in 60% of patients on the day before surgery. However, there was no abnormal enhancement or new T2 abnormalities on any postoperative MR examination to suggest hypoperfusion or emboli. None of the 19 patients developed overt neurologic deficits postoperatively. Review of the cardiopulmonary bypass protocol used indicated significant variations in technique at different institutions. Contrast MR imaging demonstrated no new abnormalities in patients after cardiopulmonary bypass performed with strict in-line arterial filtration and relatively high perfusion. MR imaging is feasible in the early postoperative period after cardiopulmonary bypass and may offer a convenient method for evaluation of the neurologic impact of technical factors associated with cardiopulmonary bypass. 17 refs.

Simonson, T.M.; Yuh, W.T.C.; Hindman, B.J.; Embrey, R.P.; Halloran, J.I.; Behrendt, D.M. (Univ. of Iowa College of Medicine, Iowa City, IA (United States))

1994-01-01

370

Prevention of bleeding after cardiopulmonary bypass with high-dose tranexamic acid  

Microsoft Academic Search

This prospective, double-blind, randomized trial assessed the effectiveness of high-dose tranexamic acid given in the preoperative period on blood loss in patients undergoing cardiopulmonary bypass. One hundred fifty patients scheduled to undergo cardiac operations with cardiopulmonary bypass were randomized into three groups of equal size. The first group received 10 gm of tranexamic acid intravenously over 20 minutes before sternotomy

Jacek M. Karski; Sally J. Teasdale; Peter Norman; Jo Carroll; Karl VanKessel; Peter Wong; M. F. X. Glynn

1995-01-01

371

Establishment of total cavopulmonary connection without use of cardiopulmonary bypass1  

Microsoft Academic Search

Objective: To minimize deleterious postoperative influences of cardiopulmonary bypass on the pulmonary circulation immediately after the Fontan type procedure, total cavopulmonary connection was achieved without use of cardiopulmonary bypass. Methods: Since April 1996, 15 patients including five patients with visceral heterotaxy, in whom no intracardiac procedure was needed, have undergone this operative maneuver. Age at operation ranged from 1.2 to

Hideki Uemura; Toshikatsu Yagihara; Katsushi Yamashita; Toru Ishizaka; Ko Yoshizumi; Youichi Kawahira

372

May Exercise Prevent Addiction?  

PubMed Central

Amphetamines exert their persistent addictive effects by activating brain's reward pathways, perhaps through the release of dopamine in the nucleus accumbens (and/or in other places). On the other hand, there is a relationship between dopamine and all behavioural aspects that involve motor activity and it has been demonstrated that exercise leads to an increase in the synthesis and release of dopamine, stimulates neuroplasticity and promotes feelings of well-being. Moreover, exercise and drugs of abuse activate overlapping neural systems. Thus, our aim was to study the influence of chronic exercise in the mechanism of addiction using an amphetamine-induced conditioned-place-preference in rats. Adult male Sprague-Dawley rats were randomly separated in groups with and without chronic exercise. Chronic exercise consisted in a 8 week treadmill running program, with increasing intensity. The conditioned place preference test was performed in both groups using a procedure and apparatus previously established. A 2 mg.kg-1 amphetamine or saline solution was administered intraperitonially according to the schedule of the conditioned place preference. Before conditioning none of the animals showed preference for a specific compartment of the apparatus. The used amphetamine dose in the conditioning phase was able to produce a marked preference towards the drug-associated compartment in the group without exercise. In the animals with exercise a significant preference by the compartment associated with saline was observed. These results lead us to conclude that a previous practice of regular physical activity may help preventing amphetamine addiction in the conditions used in this test. PMID:21886560

Fontes-Ribeiro, C. A; Marques, E; Pereira, F. C; Silva, A. P; Macedo, T. R. A

2011-01-01

373

[Vasoplegic syndrome after cardiac surgery with cardiopulmonary bypass].  

PubMed

A 71-year-old valvular patient with cardiac arrhythmia, low ejection fraction, administered angiotensin converting enzyme inhibitor underwent aortic and mitral valvular replacement. Starting during normothermic cardiopulmonary bypass (CPB), hypotension occurred, refractory to phenylephrine, noradrenaline, terlipressin, hydrocortisone and dexchlorpheniramine. After 3 hr of CPB biventricular hyperkinesia, severe hypotension and metabolic acidosis persisted despite volume loading, sodium bicarbonate, adrenaline infusion and intraaortic conterpulsation. Refractory asystole occurred 5 hr postoperatively. The responsability of sepsis and anaphylaxis were ruled out and post-CPB vasoplegic syndrome appeared to be involved. Moderate and severe vasoplegic syndromes are discussed with regards to risk factors, physiology and treatment, including prophylaxis with vasopressin and methylene blue. PMID:22721515

Lehot, J-J

2012-05-01

374

Exercise and fatigue in rheumatoid arthritis.  

PubMed

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

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

2014-01-01

375

An economic analysis of an aggressive diagnostic strategy with single photon emission computed tomography myocardial perfusion imaging and early exercise stress testing in emergency department patients who present with chest pain but nondiagnostic electrocardiograms: Results from a randomized trial  

Microsoft Academic Search

Study Objective: Conventional emergency department testing strategies for patients with chest pain often do not provide unequivocal diagnosis of acute coronary syndromes. This study was conducted to determine whether the routine use of single photon emission computed tomography (SPECT) imaging at rest and early exercise stress testing to assess intermediate-risk patients with chest pain and no ECG evidence of acute

Stephen A. Stowers; Eric L. Eisenstein; Frans J. Th. Wackers; Daniel S. Berman; Joseph L. Blackshear; Arthur D. Jones; Theodore J. Szymanski; Lai Choi Lam; Tracey A. Simons; Donna Natale; Kevin A. Paige; Galen S. Wagner

2000-01-01

376

Do exercise motives predict obligatory exercise?  

PubMed

Few studies have examined whether factors predicting obligatory exercise differ by gender. 303 participants completed the Obligatory Exercise Questionnaire and the Reason for Exercise Inventory. All variables correlated significantly. However, the correlation between exercising for fitness and obligatory exercise was significantly stronger in women than men. In women, obligatory exercise was predicted by exercising to improve body tone, fitness, and to enhance mood; in men, obligatory exercise was predicted by exercising to improve body tone, enjoyment, and perceived attractiveness. Implications for treatment are discussed. PMID:22365798

Pritchard, Mary E; Beaver, Jessica L

2012-04-01

377

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

PubMed

The present study aimed to verify if blood pressure (BP) reactivity could be reduced through a previous single session of active playing when compared to sedentary leisure. Sixteen pre-pubertal healthy children participated in this study. After familiarization with procedures and anthropometric evaluation, participants performed three sessions in randomized order: (1) 30 min of traditional Brazilian games (PLAY); (2) 30 min of video game playing (DDR); and (3) 30 min of watching TV (TV). Each session lasted 80 min, being 10 min of rest; 30 min of intervention activity; and 40 min of recovery. After recovery, the Cold Pressor Test (CPT) was used for the assessment of acute cardiovascular reactivity. BP was recorded at 30 s and 1 min during the CPT. Analysis of variance showed post-exercise hypotension (PEH) only after PLAY, and that systolic and diastolic BP were significantly increased in all conditions during CPT. However, the magnitude of the CPT-induced BP response was significantly less in PLAY compared to DDR and TV. The PEH observed during recovery and the reduced BP response to CPT following playing traditional games may be due its higher cardiovascular and metabolic demand as was indicated by the increased heart rate, oxygen consumption, and BP. It was concluded that BP reactivity to stress may be reduced through a previous single session of traditional games and that PEH was recorded only after this exercise form. This benefit indicates a potential role of playing strategies for cardiovascular health in childhood. PMID:25009506

Rauber, Suliane B; Boullosa, Daniel A; Carvalho, Ferdinando O; de Moraes, José F V N; de Sousa, Ioranny R C; Simões, Herbert G; Campbell, Carmen S G

2014-01-01

378

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

PubMed Central

The present study aimed to verify if blood pressure (BP) reactivity could be reduced through a previous single session of active playing when compared to sedentary leisure. Sixteen pre-pubertal healthy children participated in this study. After familiarization with procedures and anthropometric evaluation, participants performed three sessions in randomized order: (1) 30 min of traditional Brazilian games (PLAY); (2) 30 min of video game playing (DDR); and (3) 30 min of watching TV (TV). Each session lasted 80 min, being 10 min of rest; 30 min of intervention activity; and 40 min of recovery. After recovery, the Cold Pressor Test (CPT) was used for the assessment of acute cardiovascular reactivity. BP was recorded at 30 s and 1 min during the CPT. Analysis of variance showed post-exercise hypotension (PEH) only after PLAY, and that systolic and diastolic BP were significantly increased in all conditions during CPT. However, the magnitude of the CPT-induced BP response was significantly less in PLAY compared to DDR and TV. The PEH observed during recovery and the reduced BP response to CPT following playing traditional games may be due its higher cardiovascular and metabolic demand as was indicated by the increased heart rate, oxygen consumption, and BP. It was concluded that BP reactivity to stress may be reduced through a previous single session of traditional games and that PEH was recorded only after this exercise form. This benefit indicates a potential role of playing strategies for cardiovascular health in childhood. PMID:25009506

Rauber, Suliane B.; Boullosa, Daniel A.; Carvalho, Ferdinando O.; de Moraes, Jose F. V. N.; de Sousa, Ioranny R. C.; Simoes, Herbert G.; Campbell, Carmen S. G.

2014-01-01

379

Retinal hemorrhage after cardiopulmonary resuscitation with chest compressions.  

PubMed

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

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

2013-06-01

380

Myocardial contractile function in survived neonatal piglets after cardiopulmonary bypass  

PubMed Central

Background Hemodynamic function may be depressed in the early postoperative stages after cardiac surgery. The aim of this study was the analysis of the myocardial contractility in neonates after cardiopulmonary bypass (CPB) and mild hypothermia. Methods Three indices of left ventricular myocardial contractile function (dP/dt, (dP/dt)/P, and wall thickening) were studied up to 6 hours after CPB in neonatal piglets (CPB group; n = 4). The contractility data were analysed and then compared to the data of newborn piglets who also underwent median thoracotomy and instrumentation for the same time intervals but without CPB (non-CPB group; n = 3). Results Left ventricular dP/dtmax and (dP/dtmax)/P remained stable in CPB group, while dP/dtmax decreased in non-CPB group 5 hours postoperatively (1761 ± 205 mmHg/s at baseline vs. 1170 ± 205 mmHg/s after 5 h; p < 0.05). However, with regard to dP/dtmax and (dP/dtmax)/P there were no statistically significant differences between the two groups. Comparably, although myocardial thickening decreased in the non-CPB group the differences between the two groups were not statistically significant. Conclusions The myocardial contractile function in survived neonatal piglets remained stable 6 hours after cardiopulmonary bypass and mild hypothermia probably due to regional hypercontractility. PMID:21044329

2010-01-01

381

Canine and feline infections by cardiopulmonary nematodes in central and southern Italy.  

PubMed

Capillaria aerophila, Aelurostrongylus abstrusus, Angiostrongylus vasorum and Dirofilaria immitis are cardiopulmonary nematodes affecting dogs and cats and presently emerging in several countries. The results obtained in 2009 - 2010 during a study aiming to investigate the occurrence of these nematodes in regions from Central (Marche and Abruzzo regions--Sites A and B, respectively) and southern (Apulia--Site C) Italy are here reported. A total of 534 and 436 individual faecal samples collected from dogs and cats were examined, together with 471 and 34 faecal environmental samples taken from dog shelters and catteries. One hundred and ninety-two individual blood samples were also collected from dogs. Faeces were examined using copromicroscopical flotations and Baermann technique, whereas blood samples were tested by Knott's method. Eggs of C. aerophila were detected in 1.48 % and 20 % (Site A), 8.67 % and 2.71 % (Site B), and 16.67 % and 0 % (Site C) of individual and environmental canine samples. C. aerophila was found in 2.90 % (Site A), 3.03 % (Site B) and 14.29 % (Site C) of individual cats. Larvae of A. vasorum were found in 0.96 % and 2.48 % of individual and environmental samples from Site B, respectively, while those of A. abstrusus in 1.82 % (Site A) and 9.96 % (Site B) of individual faeces. Microfilariae of Dirofilaria immitis, identified on the basis of key morphological and morphometric features, were detected in 2.56 % of samples collected from Site B. Despite the small sample size, these results indicate that cardiopulmonary nematodes occur in Central and southern Italy, thus they should be included in the differential diagnosis of pet cardiorespiratory diseases. Larger surveys are necessary to gain more information on the diffusion of these parasites, especially for C. aerophila and A. vasorum, for which the actual distribution is poorly known. PMID:21739378

Di Cesare, Angela; Castagna, Giuseppe; Meloni, Silvana; Milillo, Piermarino; Latrofa, Stefania; Otranto, Domenico; Traversa, Donato

2011-08-01

382

Mineral Classification Exercise  

NSDL National Science Digital Library

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

Perkins, Dexter

383

Exercising Self-Control Increases Approach Motivation  

Microsoft Academic Search

The present research tested the hypothesis that exercising self-control causes an increase in approach motivation. Study 1 found that exercising (vs. not exercising) self-control increases self-reported approach motivation. Study 2a identified a behavior—betting on low-stakes gambles—that is correlated with approach motivation but is relatively uncorrelated with self-control, and Study 2b observed that exercising self-control temporarily increases this behavior. Last, Study

Brandon J. Schmeichel; Cindy Harmon-Jones; Eddie Harmon-Jones

2010-01-01

384

Understanding prognostic benefits of exercise and antidepressant therapy for persons with depression and heart disease: the UPBEAT study — rationale, design, and methodological issues  

Microsoft Academic Search

Background Depression is relatively common in patients with coronary heart disease (CHD) and is associated with worse prognosis. Recently there has been interest in evaluating the impact of treating depression on clinical outcomes. Anti-depressant medications have been shown to be safe and efficacious for many patients; exercise also may be effective for treating depression and may also improve cardiopulmonary functioning.

James A Blumenthal; Andrew Sherwood; Sharon D. Rogers; Michael A. Babyak; P. Murali Doraiswamy; Lana Watkins; Benson M. Hoffman; Cara OConnell; Julie J. Johnson; Seema M. Patidar; Robert Waugh; Alan Hinderliter

2007-01-01

385

Cardiorespiratory Optimal Point: A Submaximal Exercise Variable to Assess Panic Disorder Patients  

PubMed Central

Panic disorder (PD) patients often report respiratory symptoms and tend to perform poorly during maximal cardiopulmonary exercise testing (CPX), at least partially, due to phobic anxiety. Thus, we hypothesized that a submaximal exercise variable, minimum VE/VO2 - hereafter named cardiorespiratory optimal point (COP) -, may be useful in their clinical assessment. Data from 2,338 subjects were retrospectively analyzed and 52 (2.2%) patients diagnosed with PD (PDG) (70% women; aged 48±13 years). PD patients were compared with a healthy control group (CG) precisely matched to number of cases, age and gender profiles. PDG was further divided into two subgroups, based on having achieved a maximal or a submaximal CPX (unwilling to continue until exhaustion). We compared COP, VO2 max, maximum heart rate (HR max) between PDG and CG, and also COP between maximal and submaximal PD subgroups. COP was similar between PDG and CG (21.9±0.5 vs. 23.4±0.6; p?=?0.07), as well as, for PD subgroups of maximal and submaximal CPX (22.0±0.5 vs. 21.6±1.3; p?=?0.746). Additionally, PD patients completing a maximal CPX obtained VO2 max (mL.kg?1.min?1) (32.9±1.57 vs 29.6±1.48; p?=?0.145) and HR max (bpm) similar to controls (173±2.0 vs 168±2.7; p?=?0.178). No adverse complications occurred during CPX. Although clinically safe, it is sometimes difficult to obtain a true maximal CPX in PD patients. Normalcy of cardiorespiratory interaction at submaximal effort as assessed by COP may contribute to reassure both patients and physicians that there is no physiological substrate for exercise-related respiratory symptoms often reported by PD patients. PMID:25157496

Ramos, Plinio Santos; Sardinha, Aline; Nardi, Antonio Egidio; de Araujo, Claudio Gil Soares

2014-01-01

386

Efficacy of a Home-Based Exercise Program for Orthotopic Heart Transplant Recipients  

Microsoft Academic Search

Background:A hospital-based cardiac rehabilitation program can significantly improve the cardiopulmonary endurance and quality of life (QOL) in patients after orthotopic heart transplantation (OHT). Home-based programs for these patients have advantages of low cost and high accessibility, but little is known about their efficacy. This prospective study was designed to evaluate the effect of an 8-week home-based exercise program on muscular

Ying-Tai Wu; Chen-Lin Chien; Nai-Kuan Chou; Shoei-Shen Wang; Jin-Shin Lai; Yen-Wen Wu

2008-01-01

387

Exercise-Induced Urticaria  

MedlinePLUS

... I get hives during exercise? You should stop exercising as soon as you notice the hives. If ... exercise? You probably don't have to quit exercising. Most symptoms can be controlled by taking the ...

388

[Exercise addiction].  

PubMed

Socially valorised, sport like other forms of behaviour, can take on an addictive aspect. A review of the English and French literatures from 1979 to 2012 was conducted, using PubMed, Google Scholar, EMBASE, and PsycInfo, using the following key words alone or combined :sport, dependence, exercise, addiction. Exercise dependence is defined as a craving for physical activity that leads to extreme exercise intensity and generates physiological and psychological symptoms. Measurement scales have been proposed to make the diagnosis. No epidemiological studies have examined the prevalence of exercise dependence in the general population, although some studies suggest a frequency ranging from 10 to 80%. Disorders begin with a search for pleasure in physical effort, which then gives way to an obsession for sport resulting in a need to practice a sport more and more frequently and intensely. This addiction is more common among alcohol and illicit drug addicts than among the general population, while the rate of eating disorders can reach 40%. Personality traits most often associated are perfectionism, extraversion, and sensation seeking, while possible links between sporting activity and intensive doping will be discussed. PMID:23888586

Petit, A; Lejoyeux, M

2013-01-01

389

Aerobic Exercise  

Microsoft Academic Search

This pilot study, using a modified single systems design, attempted to answer the question: what effect does an occupational therapy aerobic exercise program have on adolescents with depression? The sample was comprised of four adolescent boys from a private psychiatric hospital. Their ages ranged from 12 to 18 years and all had a primary diagnosis of major depression. The program

Chestina B. Brollier; Natalie Hamrick; Beth Jacobson

1995-01-01

390