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Sample records for cardiopulmonary exercise tests

  1. Cardiopulmonary exercise testing in the MRI environment.

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2010-01-01

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

  3. Cardiopulmonary exercise testing: arm crank vs cycle ergometry.

    PubMed

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

    2013-05-01

    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.

  4. Cardiopulmonary exercise testing in a patient with a permanent tracheostomy.

    PubMed

    Tran, Steven; Krige, Anton

    2016-11-01

    The benefits of cardiopulmonary exercise testing have been well established. Certain patient groups present challenges for conducting such a test. We were presented with a patient with a permanent tracheostomy at the preoperative assessment clinic. We describe our technique in overcoming the problem of connecting him to the testing machine, as this is normally done with the aid of a tight-fitting face mask. We used a cuffed tracheostomy tube together with some widely available tubing from theaters to connect the patient to the gas analyzer. The test was only stopped because of excessive secretions from the patient, and we had already established enough data to tell us that the patient was fit enough to proceed to surgery. As more patients present with tracheostomies, we feel that this case would be a useful reference in managing and assessing such patients. PMID:27687390

  5. Cardiopulmonary exercise testing after laryngectomy: A connection conundrum.

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  7. Cardiopulmonary exercise testing in children and adolescents with asthma who report symptoms of exercise-induced bronchoconstriction.

    PubMed

    Joyner, Benny L; Fiorino, Elizabeth K; Matta-Arroyo, Esther; Needleman, Joshua P

    2006-11-01

    Patients with asthma often report symptoms of exercise-induced bronchoconstriction. We performed cardiopulmonary exercise testing to establish the cause of exercise limitation in patients with asthma, under treatment, who reported symptoms of exercise-induced bronchoconstriction. Ten of the 42 patients meeting criteria for inclusion in our study (24%) developed exercise-induced bronchoconstriction. Exercise limitation without exercise-induced bronchoconstriction was found in both obese and non-obese patients, suggesting that poor fitness is a problem independent of body habitus. Including cardiopulmonary exercise testing in the management of children with suspected exercise-induced bronchoconstriction would provide a better understanding of the etiology of their symptoms and facilitate more appropriate treatment.

  8. [The role of cardiopulmonary exercise testing in the assessment of pulmonary hypertension].

    PubMed

    Dumitrescu, D; Rosenkranz, S

    2008-10-01

    Cardiopulmonary exercise testing (CPET) is an important diagnostic instrument for early detection, differential diagnosis and follow-up evaluation in pulmonary hypertension (PH). A pulmonary vasculopathy as the underlying cause for pulmonary arterial hypertension (PAH) can be detected in early stages by measuring gas exchange during exercise. There are characteristic patterns which are typically seen in patients with PAH. Regarding follow-up assessments, CPET can quantify cardiopulmonary exercise capacity in a more differentiated way than global exercise tests like the 6-minute walking distance. Different pathophysiological mechanisms accounting for pulmonary hypertension can be separately evaluated by CPET. Although tremendous progress has been made regarding sensor technology and data processing, CPET is still a method that is technically challenging. In order to obtain reliable results, strict quality control is of crucial importance. Additionally, standardization of result display, independent of equipment manufacturers or institutions, is desirable, in order to ensure a uniform interpretation of results. PMID:18814090

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  11. Chronic heart failure in the elderly: value of cardiopulmonary exercise testing in risk stratification

    PubMed Central

    Davies, L; Francis, D; Piepoli, M; Scott, A; Ponikowski, P; Coats, A

    2000-01-01

    OBJECTIVE—To assess the value of cardiopulmonary exercise testing in predicting prognosis in a cohort of elderly patients with chronic heart failure (CHF).
DESIGN—A retrospective cohort study of all patients with CHF over the age of 70 years assessed between January 1992 and May 1997.
SETTING—Tertiary centre.
PATIENTS—50 patients (mean (SD) age 75.9 (4.5) years, 8 women) with CHF New York Heart Association (NYHA) class I (3 patients), II (25 patients), III (20 patients), and IV (2 patients). Follow up was complete for two years in all patients.
RESULTS—The patients underwent cardiopulmonary exercise testing (peak oxygen consumption 15.2 (4.5) ml/kg/min, minute ventilation/carbon dioxide production (VE/VCO2) slope 38.7 (11.8)); radionucleide ventriculography (left ventricular ejection fraction 32.8 (14.3)%); serum sodium measurement (139 (2.8) mmol/l); and echocardiography (left ventricular end diastolic dimension 6.1 (1.1) cm, left ventricular end systolic dimension 4.7 (1.5) cm). At the end of follow up in May 1999, 26 patients had died. The median follow up of the survivors was 47.7 months (interquartile range 31.5-53.5 months). On univariate analysis VE/VCO2 slope (p < 0.0001), NYHA class (p < 0.001), peak oxygen uptake (VO2) (p < 0.01), left ventricular end systolic dimension (p < 0.05), and serum sodium concentration (p < 0.05) had significant predictive power. Stepwise multivariate analysis identified only VE/VCO2 slope (p < 0.01), NYHA class (p < 0.05), and peak VO2 (p< 0.05) as conveying significant independent prognostic information.
CONCLUSION—Elderly patients with CHF have a high mortality, with the majority dead within two years. Cardiopulmonary exercise testing provides important information for risk stratification within this group and its use should not be neglected.


Keywords: cardiopulmonary exercise testing; chronic heart failure; elderly patients; risk factor stratification PMID

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

    PubMed Central

    Kelsey, CR; Scott, JM; Lane, A; Schwitzer, E; West, MJ; Thomas, S; Herndon, JE; Michalski, MG; Horwitz, ME; Hennig, T; Jones, LW

    2015-01-01

    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−1min−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

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

    PubMed Central

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

    2010-01-01

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

  14. Rationale for cardiopulmonary exercise test in the assessment of surgical risk.

    PubMed

    Iorio, Annamaria; Magrì, Damiano; Paolillo, Stefania; Salvioni, Elisabetta; Di Lenarda, Andrea; Sinagra, Gianfranco; Agostoni, Piergiuseppe; Sciomer, Susanna

    2013-04-01

    Although in the past years a reduced mortality in peri-operative care has been observed, cardiovascular mortality and morbidity still is a major burden in patients undergoing noncardiac surgery and its evaluation is still a difficult task. An accurate risk stratification can improve quality of peri-operative care and may improve survival, while reducing healthcare costs. In clinical practice, we make our assessment of a patient's cardiac status based on history, examination and investigations, together with risks related to the surgical procedure, to generate an 'individualized cardiac risk assessment'. At the present, risk stratification with clinical risk score and cardiac testing have been shown to be suboptimal in identifying high-risk patients. Surgery, like exercise, increases oxygen consumption. Indeed, one of the key elements in determining risk assessment is exercise intolerance, but future research in this field is needed to clarify this statement. Cardiopulmonary exercise testing (CPET) provides a global assessment of functional capacity involving and integrating the physiological measurement during incremental exercise. The pattern of CPET's variables identifies the abnormal exercise capacity, often providing an objective evaluation of cause and, moreover, predicting outcomes in both apparently healthy and chronic disease populations. An anaerobic threshold VO2 above 11 ml/kg per min seems to identify individuals with a very low surgical risk even if undergoing major surgery. This review is focused on tools of risk assessment in patients undergoing noncardiac surgery and on the physiological basis for CPET in detecting patients 'at risk'.

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

    PubMed Central

    Mohammad, Majid Malek; Dadashpour, Shahdak

    2012-01-01

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

  16. Graded comprehensive cardiopulmonary exercise testing in the evaluation of dyspnea unexplained by routine evaluation.

    PubMed

    Martinez, F J; Stanopoulos, I; Acero, R; Becker, F S; Pickering, R; Beamis, J F

    1994-01-01

    The evaluation of dyspnea is problematic when a cause is inapparent after initial diagnostic studies. We examined the results and role of cardiopulmonary exercise testing (CPET) in 50 patients with a mean 23 months of dyspnea and normal FEV1 and FVC. The CPET studies were interpreted by a panel and a consensus reached. Subsequent tests ordered by the primary physician were reviewed, and a final diagnosis was agreed on by the panel. Seven of 50 patients had cardiac limitation, 17 of 50 had pulmonary limitation, 14 of 50 had obesity and/or deconditioning, 1 of 50 had gastroesophageal reflux, and 16 of 50 had either psychogenic dyspnea or no identifiable disease. Five patients had more than one clinical diagnosis accounting for 55 diagnoses in the 50 patients. Those with a normal CPET had a higher VO2max and O2 pulse than those with cardiac disease, deconditioning, or hyperactive airways disease (HAD) (p < 0.05). Electrocardiographic changes identified cardiac disease while studies demonstrating ventilatory limitation identified a pulmonary process. In 24, deconditioning could not be distinguished from cardiac limitation. Of these, 14 responded to exercise training and/or weight loss, whereas 3 had cardiac disease, 7 had HAD, and 4 had psychogenic dyspnea (4 had more than one clinical diagnosis). In the 13 patients with normal CPET results, one had gastroesophageal reflux, two had HAD, four had psychogenic dyspnea, and six had no identifiable disease. We conclude that a diagnosis can be made in most patients with chronic dyspnea; however, further studies including bronchoprovocation are often required. Cardiopulmonary exercise testing is useful in identifying a cardiac or pulmonary process, but it is insensitive in distinguishing cardiac disease from deconditioning.

  17. Exertional dyspnoea in COPD: the clinical utility of cardiopulmonary exercise testing.

    PubMed

    O'Donnell, Denis E; Elbehairy, Amany F; Faisal, Azmy; Webb, Katherine A; Neder, J Alberto; Mahler, Donald A

    2016-09-01

    Activity-related dyspnoea is often the most distressing symptom experienced by patients with chronic obstructive pulmonary disease (COPD) and can persist despite comprehensive medical management. It is now clear that dyspnoea during physical activity occurs across the spectrum of disease severity, even in those with mild airway obstruction. Our understanding of the nature and source of dyspnoea is incomplete, but current aetiological concepts emphasise the importance of increased central neural drive to breathe in the setting of a reduced ability of the respiratory system to appropriately respond. Since dyspnoea is provoked or aggravated by physical activity, its concurrent measurement during standardised laboratory exercise testing is clearly important. Combining measurement of perceptual and physiological responses during exercise can provide valuable insights into symptom severity and its pathophysiological underpinnings. This review summarises the abnormal physiological responses to exercise in COPD, as these form the basis for modern constructs of the neurobiology of exertional dyspnoea. The main objectives are: 1) to examine the role of cardiopulmonary exercise testing (CPET) in uncovering the physiological mechanisms of exertional dyspnoea in patients with mild-to-moderate COPD; 2) to examine the escalating negative sensory consequences of progressive respiratory impairment with disease advancement; and 3) to build a physiological rationale for individualised treatment optimisation based on CPET. PMID:27581832

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  3. Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

    PubMed Central

    Mirdamadi, Mahsa; Safavi, Enayat; Abtahi, Hamidreza; Peiman, Soheil

    2016-01-01

    Background The precise head to head relationships between Cardio-pulmonary exercise testing (CPET) parameters and patients’ daily symptoms/activities and the disease social/emotional impact are less well defined. In this study, the correlation of COPD daily symptoms and quality of life [assessed by St. George’s Respiratory Questionnaire (SGRQ)] and COPD severity index (BODE-index) with CPET parameters were investigated. Methods Symptom-limited CPET was performed in 37 consecutive COPD (GOLD I-III) subjects during non-exacerbation phase. The SGRQ was also completed by each patient. Results SGRQ-score correlated negatively with FEV1 (r=−0.49, P<0.01), predicted maximal work-rate (%WR-max) (r=−0.44, P<0.01), V’O2/WR (r=−0.52, P<0.01) and breathing reserve (r=−0.50, P<0.01). However it did not correlate with Peak-V’O2% predicted (r=−0.27, P=0.10). In 20 (54.1%) subjects in which leg fatigue was the main cause for stopping the test, Peak-V’O2, %WR-max, HR-Reserve and Breathing reserve were higher (P=0.04, <0.01, 0.04 and <0.01 respectively) than the others. There was also a significant correlation between BODE-index and ∆VO2/∆WR (r=−0.64, P<0.001) and breathing-reserve (r=−0.38, P=0.018). Conclusions The observed relationships between CPET parameter and daily subjective complaints in COPD were not strong. Those who discontinued the CPET because of leg fatigue were in the earlier stages of COPD. Significant negative correlation between ∆VO2/∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought. PMID:27621870

  4. Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

    PubMed Central

    Mirdamadi, Mahsa; Safavi, Enayat; Abtahi, Hamidreza; Peiman, Soheil

    2016-01-01

    Background The precise head to head relationships between Cardio-pulmonary exercise testing (CPET) parameters and patients’ daily symptoms/activities and the disease social/emotional impact are less well defined. In this study, the correlation of COPD daily symptoms and quality of life [assessed by St. George’s Respiratory Questionnaire (SGRQ)] and COPD severity index (BODE-index) with CPET parameters were investigated. Methods Symptom-limited CPET was performed in 37 consecutive COPD (GOLD I-III) subjects during non-exacerbation phase. The SGRQ was also completed by each patient. Results SGRQ-score correlated negatively with FEV1 (r=−0.49, P<0.01), predicted maximal work-rate (%WR-max) (r=−0.44, P<0.01), V’O2/WR (r=−0.52, P<0.01) and breathing reserve (r=−0.50, P<0.01). However it did not correlate with Peak-V’O2% predicted (r=−0.27, P=0.10). In 20 (54.1%) subjects in which leg fatigue was the main cause for stopping the test, Peak-V’O2, %WR-max, HR-Reserve and Breathing reserve were higher (P=0.04, <0.01, 0.04 and <0.01 respectively) than the others. There was also a significant correlation between BODE-index and ∆VO2/∆WR (r=−0.64, P<0.001) and breathing-reserve (r=−0.38, P=0.018). Conclusions The observed relationships between CPET parameter and daily subjective complaints in COPD were not strong. Those who discontinued the CPET because of leg fatigue were in the earlier stages of COPD. Significant negative correlation between ∆VO2/∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  7. Exponential protocols for cardiopulmonary exercise testing on treadmill and cycle ergometer.

    PubMed

    Jamison, J P; Megarry, J; Riley, M

    2010-01-01

    An extended exponential exercise protocol was validated by comparing submaximal and maximal parameters with those obtained by linear protocol. Normal subjects (n = 16, 20-69 years) undertook maximal exercise tests on treadmill and cycle ergometer. The subjects had a wide range of exercise capacity, and all were accommodated by the protocol. Mean oxygen uptake (V(O2)) agreed between protocols at gas exchange anaerobic threshold (theta) (95% CI of difference -0.1 to +0.06 l min(-1)) and at peak (95% CI of difference -0.1 to +0.1 l min(-1)). Mean pre-thetaDeltaV(O2)/Deltawork rate (W) slope on the cycle ergometer agreed between protocols (95% CI of the difference -0.9 to +0.25 ml min(-1) W(-1)). Post-thetaDeltaV(O2)/DeltaW slope was steeper than pre-theta, and steeper by linear than by exponential protocol (P = 0.0001). It is concluded that the exponential protocol is valid for the measurement of submaximal and maximal exercise parameters in subjects with a wide range of exercise capacity.

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

    PubMed

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

    2015-04-01

    Physiologic contributors to reduced exercise capacity in individuals with sickle cell anemia (SCA) are not well understood. The objective of this study was to characterize the cardiopulmonary response to maximal cardiopulmonary exercise testing (CPET) and determine factors associated with reduced exercise capacity among children and young adults with SCA. A cross-sectional cohort of 60 children and young adults (mean 15.1 ± 3.4 years) with hemoglobin SS or S/β(0) thalassemia and 30 matched controls (mean 14.6 ± 3.5 years) without SCA or sickle cell trait underwent maximal CPET by a graded, symptom-limited cycle ergometry protocol with breath-by-breath, gas exchange analysis. Compared to controls without SCA, subjects with SCA demonstrated significantly lower peak VO2 (26.9 ± 6.9 vs. 37.0 ± 9.2 mL/kg/min, P < 0.001). Subjects demonstrated slower oxygen uptake (ΔVO2/ΔWR, 9 ± 2 vs. 12 ± 2 mL/min/watt, P < 0.001) and lower oxygen pulse (ΔVO2/ΔHR, 12 ± 4 vs. 20 ± 7 mL/beat, P < 0.001) as well as reduced oxygen uptake efficiency (ΔVE/ΔVO2, 42 ± 8 vs. 32 ± 5, P < 0.001) and ventilation efficiency (ΔVE/ΔVCO2, 30.3 ± 3.7 vs. 27.3 ± 2.5, P < 0.001) during CPET. Peak VO2 remained significantly lower in subjects with SCA after adjusting for age, sex, body mass index (BMI), and hemoglobin, which were independent predictors of peak VO2 for subjects with SCA. In the largest study to date using maximal CPET in SCA, we demonstrate that children and young adults with SCA have reduced exercise capacity attributable to factors independent of anemia. Complex derangements in gas exchange and oxygen uptake during maximal exercise are common in this population.

  9. Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing: Data From the Fitness Registry and the Importance of Exercise National Database

    PubMed Central

    Kaminsky, Leonard A.; Arena, Ross; Myers, Jonathan

    2016-01-01

    Objective To develop standards for cardiorespiratory fitness by establishing reference values derived from cardiopulmonary exercise testing (CPX) in the United States. Patients and Methods Eight laboratories in the US experienced in CPX administration with established quality control procedures contributed data from January 1, 2014, through February 1, 2015, from 7783 maximal (respiratory exchange ratio, ≥1.0) treadmill tests from men and women (aged 20–79 years) without cardiovascular disease (CVD) to the Fitness Registry and the Importance of Exercise: A National Data Base (FRIEND). Percentiles of maximal oxygen consumption (V̇O2max) for men and women were determined for each decade from 20 years of age through 79 years of age. Comparisons of V̇O2maxwere made to reference data established with CPX data from Norway and to US reference data established without CPX measurements. Results There were significant differences between sex and age groups for V̇O2max. In FRIEND, the 50th percentile V̇O2max of men and women aged 20 to 29 years decreased from 48.0 and 37.6 mLO2·kg−1·min−1 to 24.4 and 18.3 mLO2·kg−1·min−1 for ages 70 to 79 years, respectively. The rate of decline in this cohort during a 5-decade period was approximately 10% per decade. Conclusion These are the first cardiorespiratory fitness reference data using measures obtained from CPX in the United States. FRIEND can be used to provide a more accurate interpretation of measured V̇O2max from maximal exercise tests for the US population compared with previous standards on the basis of workload-derived estimations. PMID:26455884

  10. Classification of selected cardiopulmonary variables of elite athletes of different age, gender, and disciplines during incremental exercise testing.

    PubMed

    Zinner, Christoph; Sperlich, Billy; Wahl, Patrick; Mester, Joachim

    2015-01-01

    Incremental exercise testing is frequently used as a tool for evaluating determinants of endurance performance. The available reference values for the peak oxygen uptake (VO2peak), % of VO2peak, running speed at the lactate threshold (vLT), running economy (RE), and maximal running speed (vpeak) for different age, gender, and disciplines are not sufficient for the elite athletic population. The key variables of 491 young athletes (age range 12-21 years; 250 males, 241 females) assessed during a running step test protocol (2.4 m s(-1); increase 0.4 m s(-1) 5 min(-1)) were analysed in five subgroups, which were related to combat-, team-, endurance-, sprint- and power-, and racquet-related disciplines. Compared with female athletes, male athletes achieved a higher vpeak (P = 0.004). The body mass, lean body mass, height, abs. VO2peak (ml min(-1)), rel. VO2peak (ml kg(-1) min(-1)), rel. VO2peak (ml min(-1) kg(-0.75)), and RE were higher in the male participants compared with the females (P < 0.01). The % of VO2 at vLT was lower in the males compared with the females (P < 0.01). No differences between gender were detected for the vLT (P = 0.17) and % of VO2 at vLT (P = 0.42). This study is one of the first to provide a broad spectrum of data to classify nearly 500 elite athletes aged 12-21 years of both gender and different disciplines. PMID:26413450

  11. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men.

    PubMed

    Costa, D C; Santi, G L de; Crescêncio, J C; Seabra, L P; Carvalho, E E V; Papa, V; Marques, F; Gallo Junior, L; Schmidt, A

    2015-12-01

    This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG) was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V˙O2)peak(predicted)and V˙O2peak(real)(nonparametric Wilcoxon test). In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V˙O2peak(real)was 40% lower than V˙O2peak(predicted)(nonparametric Wilcoxon test). There was no agreement between the real and predicted measurements as analyzed by Lin's coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer.

  12. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men

    PubMed Central

    Costa, D. C.; de Santi, G. L.; Crescêncio, J. C.; Seabra, L. P.; Carvalho, E. E. V.; Papa, V.; Marques, F.; Gallo, L.; Schmidt, A.

    2015-01-01

    This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG) was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V˙O2)peak(predicted)and V˙O2peak(real)(nonparametric Wilcoxon test). In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V˙O2peak(real)was 40% lower than V˙O2peak(predicted)(nonparametric Wilcoxon test). There was no agreement between the real and predicted measurements as analyzed by Lin’s coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer. PMID:26397972

  13. Comparison of the six-minute walk test with a cycle-based cardiopulmonary exercise test in people following curative intent treatment for non-small cell lung cancer.

    PubMed

    Cavalheri, Vinicius; Jenkins, Sue; Cecins, Nola; Gain, Kevin; Hill, Kylie

    2016-05-01

    This study is aimed to (i) compare both the magnitude of impairment in exercise capacity and exercise responses measured during the six-minute walk test (6MWT) and the cardiopulmonary exercise test (CPET) and (ii) investigate the effect of test repetition on six-minute walk distance (6MWD) in people following curative intent treatment for non-small cell lung cancer (NSCLC). Twenty participants (67 ± 10 years; 14 females), 6-10 weeks following lobectomy, underwent a CPET and two 6MWTs. Peak exercise responses, dyspnoea and leg fatigue, as well as heart rate (HR) and oxygen saturation (SpO2) during the 6MWT, were compared to those during the CPET. Compared with exercise capacity when expressed as peak rate of oxygen consumption (%pred) measured during the CPET, exercise capacity when expressed as 6MWD (%pred) was less impaired (81 ± 10 vs. 63 ± 15 %pred; p < 0.001). Compared with the CPET, the 6MWT elicited lower peak HR (119 ± 15 vs. 128 ± 18 beats minute(-1); p = 0.02), lower SpO2 (93 ± 2 vs. 95 ± 3%; p < 0.05), less dyspnoea (3.1 ± 1.6 vs. 6.9 ± 2.6; p < 0.01) and less leg fatigue (2.0 ± 1.9 vs. 6.8 ± 2.4; p < 0.01). The 6MWD increased 19 ± 19 metre (4 ± 4%) with test repetition (p < 0.001). In people following curative intent treatment for NSCLC, the 6MWT appears to elicit sub-maximal exercise responses when compared with the CPET. There is a significant effect of test repetition on 6MWD. PMID:26869579

  14. [Exercise test and respiratory muscle function test].

    PubMed

    Akashiba, Tsuneto

    2011-10-01

    Dyspnea on exertion is a chief complaint of patients with COPD, and it has a major effect on the quality of their lives. Dyspnea is, by definition, subjective, but objective approaches are needed for a comprehensive understanding of these patients' conditions. Thus, measuring changes in cardiopulmonary variables during exercise can be very helpful when evaluating patients with COPD. The main purpose of exercise testing is to evaluate exercise tolerance and to identify the factors limiting exercise. Although incremental exercise testing is ideal for these purposes, simple walking tests such as 6-minute walking test, are also useful. PMID:22073578

  15. Cardiopulmonary adaptation to exercise in coal miners

    SciTech Connect

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

    1980-11-01

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

  16. Exercise stress test

    MedlinePlus

    Exercise ECG; ECG - exercise treadmill; EKG - exercise treadmill; Stress ECG; Exercise electrocardiography; Stress test - exercise treadmill; CAD - treadmill; Coronary artery disease - treadmill; Chest pain - treadmill; Angina - treadmill; ...

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

    PubMed

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

    2016-02-14

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

  18. Genetics of β2-Adrenergic Receptors and the Cardiopulmonary Response to Exercise

    PubMed Central

    Snyder, Eric M.; Johnson, Bruce D.; Joyner, Michael J.

    2009-01-01

    Exercise elicits a number of physiologic responses to increase oxygen delivery to working muscles. The β2-adrenergic receptors (ADRB2) play a role in the cardiopulmonary response to exercise. This review is focused on how the gene that encodes the ADRB2 influences the cardiopulmonary response to exercise. In addition, we discuss possible interactions between ADRB2 and other genes important in exercise performance. PMID:18362692

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

    NASA Technical Reports Server (NTRS)

    Moore, Alan D.

    2011-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

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

    PubMed

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

    2016-01-01

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

  2. Cardiopulmonary exercise: a recently discovered secret of tai chi.

    PubMed

    Ng, R K

    1992-08-01

    Every piece of literature or book about tai chi claims it to be the supreme martial art (soft style) and a therapeutic exercise. Nevertheless, none of the authors can describe scientifically how and why it works. Many people did not gain any health benefit in practicing tai chi and only very few people were able to apply its legendary secret power. During the last 10 years, the author thought he had discovered the secret in Hong Kong and brought it to Los Angeles. The secret lies in the fundamental movements of the body, called tai chi basic exercise routines. The entry level of the exercise has many similarities with medical treatments for respiratory illness and with walking exercise--the most recommended aerobic exercise for coronary artery disease. PMID:1399544

  3. Cardiopulmonary exercise: a recently discovered secret of tai chi.

    PubMed

    Ng, R K

    1992-08-01

    Every piece of literature or book about tai chi claims it to be the supreme martial art (soft style) and a therapeutic exercise. Nevertheless, none of the authors can describe scientifically how and why it works. Many people did not gain any health benefit in practicing tai chi and only very few people were able to apply its legendary secret power. During the last 10 years, the author thought he had discovered the secret in Hong Kong and brought it to Los Angeles. The secret lies in the fundamental movements of the body, called tai chi basic exercise routines. The entry level of the exercise has many similarities with medical treatments for respiratory illness and with walking exercise--the most recommended aerobic exercise for coronary artery disease.

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

  5. The Effect of Cardiac Rehabilitation Exercise Training on Cardiopulmonary Function in Ischemic Cardiomyopathy With Reduced Left Ventricular Ejection Fraction

    PubMed Central

    2016-01-01

    Objective To observe the effect and safety of cardiac rehabilitation (CR) exercise in ischemic cardiomyopathy and to compare the results between patients with preserved left ventricular ejection fraction (LVEF) and reduced LVEF. Methods Patients with ischemic cardiomyopathy with LVEF <50% were included as subjects. The patients were classified into the preserved LVEF (pLVEF; LVEF 41%–49%) group and the reduced LVEF (rLVEF; LVEF ≤40%) group. Patients underwent hourly aerobic exercise training sessions with an intensity of 60%–85% of heart rate reserve, three times a week for 6 weeks. Graded exercise test and transthoracic echocardiogram were performed in all study patients before and after completion of the CR exercise program. Results After completion of the CR exercise program, both groups (pLVEF, n=30; rLVEF, n=18) showed significant increases in LVEF and VO2max. In the pLVEF group, LVEF and VO2max increased from 45.1%±4.8% to 52.5%±9.6% (p<0.001) and from 24.1±6.3 to 28.1±8.8 mL/kg/min (p=0.002), respectively. In the rLVEF group, LVEF and VO2max increased from 29.7%±7.7% to 37.6%±10.3% (p<0.001) and from 17.6±4.7 to 21.2±5.1 mL/kg/min (p<0.001), respectively. Both groups completed their exercise program safely. Conclusion In both groups, patients with ischemic cardiomyopathy who completed a 6-week supervised CR exercise program demonstrated remarkable improvements in cardiopulmonary function. This result implies that neither of the two groups showed higher efficacy in comparison to each other, but we can conclude that CR exercise in the rLVEF group was as effective and safe as that in the pLVEF group.

  6. The Effect of Cardiac Rehabilitation Exercise Training on Cardiopulmonary Function in Ischemic Cardiomyopathy With Reduced Left Ventricular Ejection Fraction

    PubMed Central

    2016-01-01

    Objective To observe the effect and safety of cardiac rehabilitation (CR) exercise in ischemic cardiomyopathy and to compare the results between patients with preserved left ventricular ejection fraction (LVEF) and reduced LVEF. Methods Patients with ischemic cardiomyopathy with LVEF <50% were included as subjects. The patients were classified into the preserved LVEF (pLVEF; LVEF 41%–49%) group and the reduced LVEF (rLVEF; LVEF ≤40%) group. Patients underwent hourly aerobic exercise training sessions with an intensity of 60%–85% of heart rate reserve, three times a week for 6 weeks. Graded exercise test and transthoracic echocardiogram were performed in all study patients before and after completion of the CR exercise program. Results After completion of the CR exercise program, both groups (pLVEF, n=30; rLVEF, n=18) showed significant increases in LVEF and VO2max. In the pLVEF group, LVEF and VO2max increased from 45.1%±4.8% to 52.5%±9.6% (p<0.001) and from 24.1±6.3 to 28.1±8.8 mL/kg/min (p=0.002), respectively. In the rLVEF group, LVEF and VO2max increased from 29.7%±7.7% to 37.6%±10.3% (p<0.001) and from 17.6±4.7 to 21.2±5.1 mL/kg/min (p<0.001), respectively. Both groups completed their exercise program safely. Conclusion In both groups, patients with ischemic cardiomyopathy who completed a 6-week supervised CR exercise program demonstrated remarkable improvements in cardiopulmonary function. This result implies that neither of the two groups showed higher efficacy in comparison to each other, but we can conclude that CR exercise in the rLVEF group was as effective and safe as that in the pLVEF group. PMID:27606271

  7. Sample Proficiency Test exercise

    SciTech Connect

    Alcaraz, A; Gregg, H; Koester, C

    2006-02-05

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

  8. Evolving Role of Exercise Testing in Contemporary Cardiac Rehabilitation.

    PubMed

    Reeves, Gordon R; Gupta, Shuchita; Forman, Daniel E

    2016-01-01

    Symptom-limited (maximal) exercise testing before cardiac rehabilitation (CR) was once an unambiguous standard of care. In particular, it served as an important screen for residual ischemia and instability before initiating a progressive exercise training regimen. However, improved revascularization and therapy for coronary heart disease has led many clinicians to downplay this application of exercise testing, especially because such testing is also a potential encumbrance to CR enrollment (delaying ease and efficiency of enrollment after procedures and hospitalizations) and patient burden (eg, added costs, logistic hassle, and anxiety). Nonetheless, exercise testing has enduring value for CR, especially because it reveals dynamic physiological responses as well as ischemia, arrhythmias, and symptoms pertinent to exercise prescription and training and to overall stability and prognosis. Moreover, as indications for CR have expanded, the value of exercise testing and functional assessment is more relevant than ever in the growing population of eligible patients, including those with heart failure, valvular heart disease, and posttransplantation, especially as current patients also tend to be more clinically complex, with advanced ages, multimorbidity, frailty, and obesity. This review focuses on the appropriate use of exercise testing in the CR setting. Graded exercise tests, cardiopulmonary exercise tests, submaximal walking tests, and other functional assessments (strength, frailty) for CR are discussed. PMID:27120040

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

    PubMed

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

    2011-12-01

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

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

    PubMed

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

    2011-12-01

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

  11. The Utility of Exercise Testing in Patients with Lung Cancer.

    PubMed

    Ha, Duc; Mazzone, Peter J; Ries, Andrew L; Malhotra, Atul; Fuster, Mark

    2016-09-01

    The harm associated with lung cancer treatment include perioperative morbidity and mortality and therapy-induced toxicities in various organs, including the heart and lungs. Optimal treatment therefore entails a need for risk assessment to weigh the probabilities of benefits versus harm. Exercise testing offers an opportunity to evaluate a patient's physical fitness/exercise capacity objectively. In lung cancer, it is most often used to risk-stratify patients undergoing evaluation for lung cancer resection. In recent years, its use outside this context has been described, including in nonsurgical candidates and lung cancer survivors. In this article we review the physiology of exercise testing and lung cancer. Then, we assess the utility of exercise testing in patients with lung cancer in four contexts (preoperative evaluation for lung cancer resection, after lung cancer resection, lung cancer prognosis, and assessment of efficiency of exercise training programs) after systematically identifying original studies involving the most common forms of exercise tests in this patient population: laboratory cardiopulmonary exercise testing and simple field testing with the 6-minute walk test, shuttle walk test, and/or stair-climbing test. Lastly, we propose a conceptual framework for risk assessment of patients with lung cancer who are being considered for therapy and identify areas for further studies in this patient population. PMID:27156441

  12. The implication of tissue Doppler echocardiography and cardiopulmonary exercise in early detection of cardiac dysfunction in systemic lupus erythematosus patients

    PubMed Central

    Elnady, Basant M.; Abdelghafar, Ayman Saeed Mohamed; Khalik, El Shazly Abdul; Algethami, Mohammed Mesfer; Basiony, A.S.; Al-otaibi, Mona Dhaif Allah; Al-otaibi, Maram Eidhah

    2016-01-01

    Objective Systemic lupus erythematosus (SLE) can present limitations to exercise capacity and quality of life (QoL) because of various clinical conditions, such as pulmonary disease or heart disease. Tissue Doppler echocardiography (TDE) offers the promise of an objective measurement to quantify regional and global ventricular function through the assessment of myocardial velocity data. This study aimed to assess the intensity of left ventricular (LV) and right ventricular (RV) systolic and diastolic dysfunction in SLE patients by means of TDE and cardiopulmonary exercise (CPX) testing to determine their impact on QoL. Material and Methods Overall, 56 SLE patients within two tertiary healthcare centers as well as 50 healthy controls were examined with TDE after the exclusion of cardiovascular risk factors. TDE was performed for maximal systolic (S), early diastolic (E′), and late diastolic (A′) velocities of the mitral and tricuspid annulus. Pulsed wave (PW) Doppler of mitral and tricuspid valve inflow was performed in addition to the estimation of the left ventricle ejection fraction and assessment of right ventricle systolic function by tricuspid annular plane systolic excursion (TAPSE). Disease activity was assessed by the Systemic Lupus Activity Measure (SLAM), and the damage index was assessed by the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). CPX tests according to the modified Bruce protocol were performed. Results SLE patients in both subgroups had more or less similar laboratory data and statistically higher values of ESR, CRP, and anticardiolipin (aCL) antibodies compared to the control group. LV function showed statistically insignificant EF compared to the control group, being lower in the patient group. Tissue Doppler image revealed that E′ and A′ of the mitral annulus were lower in the patient group than in the control group. Concerning RV, TAPSE in the patient group was

  13. Exercise stress testing

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1975-01-01

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

  14. Specificity of a Maximal Step Exercise Test

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  15. Validation of a point-of-care prothrombin time test after cardiopulmonary bypass in cardiac surgery.

    PubMed

    Meesters, M I; Kuiper, G; Vonk, A B A; Loer, S A; Boer, C

    2016-10-01

    Point-of-care coagulation monitoring can be used for the guidance of haemostasis management. However, the influence of time on point-of-care prothrombin time testing following protamine administration after cardiopulmonary bypass has not been investigated. Bland-Altman and error grid analysis were used to analyse the level of agreement between prothrombin time measurements from point-of-care and laboratory tests before cardiopulmonary bypass, and then 3 min, 6 min and 10 min after protamine administration. Prothrombin times were expressed as International Normalised Ratios. While the point-of-care and laboratory prothrombin time measurements showed a high level of agreement before bypass, this agreement deteriorated following protamine administration to a mean (SD) bias of -0.22 (0.13) [limits of agreement 0.48-0.04]. Error grid analysis revealed that 35 (70%) of the paired values showed a clinically relevant discrepancy in international normalised ratio. At 3 min, 6 min and 10 min after cardiopulmonary bypass there is a clinical unacceptable discrepancy between the point-of-care and laboratory measurement of prothrombin time. PMID:27501250

  16. Validation of a point-of-care prothrombin time test after cardiopulmonary bypass in cardiac surgery.

    PubMed

    Meesters, M I; Kuiper, G; Vonk, A B A; Loer, S A; Boer, C

    2016-10-01

    Point-of-care coagulation monitoring can be used for the guidance of haemostasis management. However, the influence of time on point-of-care prothrombin time testing following protamine administration after cardiopulmonary bypass has not been investigated. Bland-Altman and error grid analysis were used to analyse the level of agreement between prothrombin time measurements from point-of-care and laboratory tests before cardiopulmonary bypass, and then 3 min, 6 min and 10 min after protamine administration. Prothrombin times were expressed as International Normalised Ratios. While the point-of-care and laboratory prothrombin time measurements showed a high level of agreement before bypass, this agreement deteriorated following protamine administration to a mean (SD) bias of -0.22 (0.13) [limits of agreement 0.48-0.04]. Error grid analysis revealed that 35 (70%) of the paired values showed a clinically relevant discrepancy in international normalised ratio. At 3 min, 6 min and 10 min after cardiopulmonary bypass there is a clinical unacceptable discrepancy between the point-of-care and laboratory measurement of prothrombin time.

  17. Eccentric exercise testing and training

    NASA Technical Reports Server (NTRS)

    Clarkson, Priscilla M.

    1994-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2011-05-01

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

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

    PubMed

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

    2011-03-01

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

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

    PubMed

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

    2008-04-01

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

  3. [Cardiopulmonary Comorbidities].

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2014-11-01

    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.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  8. Exercise testing in the clinical management of patients affected by pulmonary arterial hypertension.

    PubMed

    Paolillo, Stefania; Farina, Stefania; Bussotti, Maurizio; Iorio, Annamaria; PerroneFilardi, Pasquale; Piepolil, Massimo F; Agostoni, Piergiuseppe

    2012-10-01

    Patients affected by pulmonary arterial hypertension (PAH) show a reduced exercise tolerance with early occurrence of dyspnoea and fatigue. The origin of functional capacity limitation is multifactorial and several mechanisms have been proposed, including right heart failure, which leads to a limited increase in cardiac output during exercise, and hyperventilation with a reduced perfusion of properly ventilated alveoli. In addition, abnormalities in arterial blood gases are observed, with the occurrence of hypoxemia and hypocapnia, related to an abnormal ventilation/perfusion match, gas diffusion abnormalities, low mixed venous oxygen saturation and to the development of intra- and extra-pulmonary right-to-left shunts. At present, the 6-minute walking test is the most used method to assess exercise tolerance in PAH; it is also useful to monitor the response to therapy and provides prognostic information. However, the assessment of functional capacity by cardiopulmonary exercise test (CPET) seems to be more complete, because CPET allows for discrimination between the metabolic, cardiovascular and pulmonary components of exercise limitation. Moreover, CPET estimates the severity of disease and assesses patients' prognosis and response to therapy. In PAH, a typical CPET-response is observed, characterized by a severe reduction in peak VO2, work rate, O2 pulse and anaerobic threshold and by a marked increase in VE/VCO2 slope and in the dead space to tidal volume ratio. However, the use of CPET should be limited to experienced centres. This review will focus on resting lung function and exercise tolerance tests, showing that CPET can provide the physiological explanation of functional limitation in PAH. PMID:23126000

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

    ERIC Educational Resources Information Center

    Lamont, Linda S.

    1981-01-01

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

  10. Diagnostic value of exercise testing in asbestosis

    SciTech Connect

    Zejda, J. )

    1989-01-01

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

  11. Cystic fibrosis and physiological responses to exercise.

    PubMed

    Williams, Craig A; Saynor, Zoe L; Tomlinson, Owen W; Barker, Alan R

    2014-12-01

    Cardiopulmonary exercise testing is underutilized within the clinical management of patients with cystic fibrosis. But within the last 5 years, there has been considerable interest in its implementation, which has included deliberations by the European Cystic Fibrosis Society about incorporating this method within the clinical assessment of patients. This review examines the current use of cardiopulmonary exercise testing in assessing the extent and cause(s) of exercise limitation from a pediatric perspective. Examples of the measured parameters and their interpretation are provided. Critical synthesis of recent work in the oxygen uptake (VO2) kinetics response to and following exercise is also discussed, and although identified more as a research tool, its utilization advances researchers understanding of the cardiovascular, respiratory and muscular limitations to exercise tolerance. Finally, exercise and its application in therapeutic interventions are highlighted and a number of recommendations made about the utility of exercise prescription.

  12. Cystic fibrosis and physiological responses to exercise.

    PubMed

    Williams, Craig A; Saynor, Zoe L; Tomlinson, Owen W; Barker, Alan R

    2014-12-01

    Cardiopulmonary exercise testing is underutilized within the clinical management of patients with cystic fibrosis. But within the last 5 years, there has been considerable interest in its implementation, which has included deliberations by the European Cystic Fibrosis Society about incorporating this method within the clinical assessment of patients. This review examines the current use of cardiopulmonary exercise testing in assessing the extent and cause(s) of exercise limitation from a pediatric perspective. Examples of the measured parameters and their interpretation are provided. Critical synthesis of recent work in the oxygen uptake (VO2) kinetics response to and following exercise is also discussed, and although identified more as a research tool, its utilization advances researchers understanding of the cardiovascular, respiratory and muscular limitations to exercise tolerance. Finally, exercise and its application in therapeutic interventions are highlighted and a number of recommendations made about the utility of exercise prescription. PMID:25395018

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2015-11-01

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

  15. Testing an intervention to improve functional capability in advanced cardiopulmonary illness.

    PubMed

    Dougherty, Cynthia M; Steele, Bonnie G; Hunziker, Jim

    2011-01-01

    The development of a conceptually driven exercise and self-management intervention for improving functional capability and reducing health care costs using social cognitive theory is described. The intervention has 2 components: a 1-month outpatient exercise intervention followed by a home component, lasting 5 months. The intervention is expected to have significant impact on daily function, quality of life, gait/balance, self-efficacy, and health care utilization in persons with advanced heart failure or chronic obstructive pulmonary disease. We report preliminary results related to process-related variables, including feasibility, safety, and intervention adherence. Intervention outcomes are currently under study and will be reported when available.

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

    PubMed

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

    2009-12-01

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

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

    PubMed

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

    2014-10-01

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

  18. Energy System Contributions During Incremental Exercise Test

    PubMed Central

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

    2013-01-01

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

  19. [Exercise test after acute myocardial infarction: without therapy?].

    PubMed

    Gregorio, G

    2001-12-01

    In this article we analyze the role of ECG exercise test in the clinical evaluation and prognostic stratification of patients after acute myocardial infarction. Moreover, we analyze if test results may be influenced by drugs. In clinical practice, most of the cardiologists working in hospital perform pre-discharge tests while patients are on medical therapy; after the acute event, exercise test is performed after pharmacological wash-out. In the thrombolytic age exercise test has a well-defined role in the evaluation and prognostic stratification of postinfarction patients, but some aspects regarding the way of performance and the opportunity of a pharmacological wash-out need further investigation.

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

    PubMed Central

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

    2013-01-01

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

  1. Exercise testing and prescription. Practical recommendations for the sedentary.

    PubMed

    King, C N; Senn, M D

    1996-05-01

    A sedentary lifestyle is prevalent in most industrialised societies. Persuasive evidence allows us to demonstrate that a physically active lifestyle protects against the development and progression of many chronic diseases. The assessment of sedentary individuals for the purpose of exercise testing and or exercise prescription should always culminate in the determination of the relative risk of the individual for traumatic events which may be precipitated by participation in moderate physical activity. Sedentary individuals may be categorised in a low to high risk stratification as apparently healthy (Class I), higher risk (Class II), or known coronary heart disease and/or symptomatic of chronic disease (Class III). An expanded role for allied health professionals, such as a clinical exercise physiologist, may enhance and extend the services of physicians and nurses as they relate to exercise testing, exercise prescription and preventative healthcare in general. Risk stratification will determine the type of exercise test, the exercise prescription and the exercise environment (low to high levels of supervision). The exercise prescription may include a determination of mode, duration, frequency, intensity, and progression of activity. Although target heart rate remains one of the most effective instruments for monitoring exercise intensity, the rate of perceived exertion should be incorporated especially in the titration of exercise prescriptions for those on beta-blockade therapy. Finally the benefits of an exercise programme, derived from a foundation of proper assessment, are numerous and include improvements in cardiovascular fitness, body composition, blood lipid profile and retention of essential muscle mass during the course of the life-cycle. A considerable public health benefit will result if sedentary individuals become regularly more physically active.

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

    PubMed Central

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

    2016-01-01

    Background Cardiovascular diseases are a leading cause of morbidity and mortality in solid organ transplant recipients. In addition, low physical activity is a risk factor for cardiac and cerebrovascular complications. Objectives This study examined potential relationships between physical activity, health-related quality of life (HRQoL), risk factors for cardiovascular disease, and an exercise test in liver-graft recipients. Patients and Methods A total of 107 participants (62 men/45 women) who had received a liver transplantation (LT) at least 6 months previously were evaluated. Physical activity was assessed using three different questionnaires, while HRQoL was assessed using the medical outcomes study short form (SF)-36 questionnaire, and health behaviors were evaluated using the health behavior inventory (HBI). The exercise test was performed in a standard manner. Results Seven participants (6.5%) had a positive exercise test, and these individuals were older than those who had a negative exercise test (P = 0.04). A significant association between a negative exercise test and a higher level of physical activity was shown by the Seven-day physical activity recall questionnaire. In addition, HRQoL was improved in various domains of the SF-36 in participants who had a negative exercise test. No correlations between physical activity, the exercise test and healthy behaviors, as assessed via the HBI were observed. Conclusions Exercise test performance was affected by lower quality of life and lower physical activity after LT. With the exception of hypertension, well known factors that affect the risk of coronary artery disease had no effect on the exercise test results. PMID:27226801

  3. Subclinical cardiopulmonary dysfunction in stage 3 chronic kidney disease

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Saint Paul Technical Vocational Inst., MN.

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

  5. Blood Pressure Response to Submaximal Exercise Test in Adults

    PubMed Central

    Szmigielska, Katarzyna; Leszczynska, Joanna; Jegier, Anna

    2016-01-01

    Background. The assessment of blood pressure (BP) response during exercise test is an important diagnostic instrument in cardiovascular system evaluation. The study aim was to determine normal values of BP response to submaximal, multistage exercise test in healthy adults with regard to their age, gender, and workload. Materials and Methods. The study was conducted in randomly selected normotensive subjects (n = 1015), 512 females and 498 males, aged 18–64 years (mean age 42.1 ± 12.7 years) divided into five age groups. All subjects were clinically healthy with no chronic diseases diagnosed. Exercise stress tests were performed using Monark bicycle ergometer until a minimum of 85% of physical capacity was reached. BP was measured at rest and at peak of each exercise test stage. Results. The relations between BP, age, and workload during exercise test were determined by linear regression analysis and can be illustrated by the equations: systolic BP (mmHg) = 0.346 × load (W) + 135.76 for males and systolic BP (mmHg) = 0.103 × load (W) + 155.72 for females. Conclusions. Systolic BP increases significantly and proportionally to workload increase during exercise test in healthy adults. The relation can be described by linear equation which can be useful in diagnostics of cardiovascular diseases. PMID:27703976

  6. Exercise testing after myocardial infarction: relative values of the low level predischarge and the postdischarge exercise test.

    PubMed

    Senaratne, M P; Hsu, L A; Rossall, R E; Kappagoda, C T

    1988-12-01

    This study was undertaken to compare the relative values of the low level predischarge exercise test and the postdischarge (6 weeks) symptom-limited test in 518 consecutive patients admitted with an acute myocardial infarction. Of the patients who did not develop significant ST segment depression or angina during the predischarge test, the symptom-limited test also remained negative in 91.5 and 91.9% of the patients, respectively. Similar results were obtained with ST segment elevation and the systolic blood pressure response during the two exercise tests with only 2.1 and 11.4% changing from normal to abnormal, respectively. Discriminant function analysis was done to predict the occurrence of coronary events (unstable angina, reinfarction, cardiac failure, cardiac death) with use of the data from the exercise tests together with other clinical and investigational data. The jackknife method correctly classified 71.9 and 71.4% of the patients with the data from the predischarge exercise test and symptom-limited test, respectively. Combining the data from the two tests improved the overall predictive accuracy to only 75.0%. It is concluded that the routine performance of a symptom-limited test 6 to 8 weeks after infarction does not reveal any significant additional information in those patients who have undergone a predischarge low level exercise test. Thus the 6 to 8 week test should be restricted to selected patients after myocardial infarction.

  7. A prognostic scoring system for arm exercise stress testing

    PubMed Central

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

    2016-01-01

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

  8. The Sunflower Cardiopulmonary Research Project of Children.

    ERIC Educational Resources Information Center

    Greene, Leon

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

  9. Exercise testing and hemodynamic performance in healthy elderly persons

    SciTech Connect

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

    1984-11-01

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

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

    PubMed

    Elliott, Adrian D; Grace, Fergal

    2010-10-01

    Both cycle ergometry and treadmill exercise are commonly employed to examine the cardiopulmonary system under conditions of precisely controlled metabolic stress. Although both forms of exercise are effective in elucidating a maximal stress response, it is unclear whether breathing strategies or ventilator efficiency differences exist between exercise modes. The present study examines breathing strategies, ventilatory efficiency and ventilatory capacity during both incremental cycling and treadmill exercise to volitional exhaustion. Subjects (n = 9) underwent standard spirometric assessment followed by maximal cardiopulmonary exercise testing utilising cycle ergometry and treadmill exercise using a randomised cross-over design. Respiratory gases and volumes were recorded continuously using an online gas analysis system. Cycling exercise utilised a greater portion of ventilatory capacity and higher tidal volume at comparable levels of ventilation. In addition, there was an increased mean inspiratory flow rate at all levels of ventilation during cycle exercise, in the absence of any difference in inspiratory timing. Exercising V(E)/VCO₂slope and the lowest V(E)/VCO₂value, was lower during cycling exercise than during the treadmill protocol indicating greater ventilatory efficiency. The present study identifies differing breathing strategies employed during cycling and treadmill exercise in young, trained individuals. Exercise mode should be accounted for when assessing breathing patterns and/or ventilatory efficiency during incremental exercise.

  11. [Application of the 6-Minute Walking Test and Shuttle Walking Test in the Exercise Tests of Patients With COPD].

    PubMed

    Ho, Chiung-Fang; Maa, Suh-Hwa

    2016-08-01

    Exercise training improves the management of stable chronic obstructive pulmonary disease (COPD). COPD patients benefit from exercise training programs in terms of improved VO2 peak values and decreased dyspnea, fatigue, hospital admissions, and rates of mortality, increasing exercise capacity and health-related quality of life (HRQOL). COPD is often associated with impairment in exercise tolerance. About 51% of patients have a limited capacity for normal activity, which often further degrades exercise capacity, creating a vicious circle. Exercise testing is highly recommended to assess a patient's individualized functions and limitations in order to determine the optimal level of training intensity prior to initiating an exercise-training regimen. The outcomes of exercise testing provide a powerful indicator of prognosis in COPD patients. The six-minute walking test (6MWT) and the incremental shuttle-walking test (ISWT) are widely used in exercise testing to measure a patient's exercise ability by walking distances. While nursing-related articles published in Taiwan frequently cite and use the 6MWT to assess exercise capacity in COPD patients, the ISWT is rarely used. This paper introduces the testing method, strengths and weaknesses, and application of the two tests in order to provide clinical guidelines for assessing the current exercise capacity of COPD patients. PMID:27492301

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

    PubMed Central

    Gappmaier, Eduard

    2012-01-01

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

  13. Impact of Obesity on Cardiopulmonary Disease.

    PubMed

    Chandler, Marjorie L

    2016-09-01

    Although there are known detrimental effects of obesity on the heart and lungs, few data exist showing obesity as risk factor for cardiopulmonary disorders in dogs and cats. It is probable that increased abdominal fat is detrimental as it is in humans, and there is evidence of negative effects of increased intrathoracic fat. As well as physical effects of fat, increased inflammatory mediators and neurohormonal effects of obesity likely contribute to cardiopulmonary disorders. Weight loss in overweight individuals improves cardiac parameters and exercise tolerance. Obesity in patients with obstructive airway disorders is recognized to increase disease severity. PMID:27264052

  14. An Exercise for Illustrating the Logic of Hypothesis Testing

    ERIC Educational Resources Information Center

    Lawton, Leigh

    2009-01-01

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

  15. Validity of the Eating Attitude Test among Exercisers.

    PubMed

    Lane, Helen J; Lane, Andrew M; Matheson, Hilary

    2004-12-01

    Theory testing and construct measurement are inextricably linked. To date, no published research has looked at the factorial validity of an existing eating attitude inventory for use with exercisers. The Eating Attitude Test (EAT) is a 26-item measure that yields a single index of disordered eating attitudes. The original factor analysis showed three interrelated factors: Dieting behavior (13-items), oral control (7-items), and bulimia nervosa-food preoccupation (6-items). The primary purpose of the study was to examine the factorial validity of the EAT among a sample of exercisers. The second purpose was to investigate relationships between eating attitudes scores and selected psychological constructs. In stage one, 598 regular exercisers completed the EAT. Confirmatory factor analysis (CFA) was used to test the single-factor, a three-factor model, and a four-factor model, which distinguished bulimia from food pre-occupation. CFA of the single-factor model (RCFI = 0.66, RMSEA = 0.10), the three-factor-model (RCFI = 0.74; RMSEA = 0.09) showed poor model fit. There was marginal fit for the 4-factor model (RCFI = 0.91, RMSEA = 0.06). Results indicated five-items showed poor factor loadings. After these 5-items were discarded, the three models were re-analyzed. CFA results indicated that the single-factor model (RCFI = 0.76, RMSEA = 0.10) and three-factor model (RCFI = 0.82, RMSEA = 0.08) showed poor fit. CFA results for the four-factor model showed acceptable fit indices (RCFI = 0.98, RMSEA = 0.06). Stage two explored relationships between EAT scores, mood, self-esteem, and motivational indices toward exercise in terms of self-determination, enjoyment and competence. Correlation results indicated that depressed mood scores positively correlated with bulimia and dieting scores. Further, dieting was inversely related with self-determination toward exercising. Collectively, findings suggest that a 21-item four-factor model shows promising validity coefficients among

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

    SciTech Connect

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

    1989-10-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Minorsky, Peter V.; Willing, R. Paul

    1999-01-01

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

  19. Inflight exercise affects stand test responses after space flight

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

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

    SciTech Connect

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

    1986-04-01

    A medical screening exercise test is presented which accurately predicts relative heat tolerance during work in very hot environments. The test consisted of 15-20 min of exercise at a standard absolute intensity of about 600 kcal/hr (140W) with the subject wearing a vapor-barrier suit. Five minutes after the subject exercised, recovery heart rate was measured. When this heart rate is used, a physiological limit (+/- approximately 5 min) can be predicted with 95% confidence for the most intense work-heat conditions found in nuclear power stations. In addition, site health and safety personnel can establish qualification criteria for work on hot jobs, based on the test results. The test as developed can be performed in an office environment with the use of a minimum of equipment by personnel with minimal expertise and training. Total maximal test duration is about 20-25 min per person and only heart rate need be monitored (simple pulse palpation will suffice). Test modality is adaptable to any ergometer, the most readily available and least expensive of which is bench-stepping. It is recommended that this test be available for use for those persons who, based upon routine medical examination or past history, are suspected of being relatively heat intolerant.

  1. Effect of Saral meditation on intelligence, performance and cardiopulmonary functions.

    PubMed

    Shah, A H; Joshi, S V; Mehrotra, P P; Potdar, N; Dhar, H L

    2001-11-01

    Meditation is a mental exercise to improve mental faculty. Present attempt was to evaluate effect of Saral Meditation on development of intelligence, academic performance & cardiopulmonary functions. Results show significant improvement in development of intelligence and academic performance. There was apparent improvement in confidence and they were free from anxiety. There were also considerable changes in psychomotor ability and cardiopulmonary functions however, result was not significant.

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

    PubMed

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

    2016-05-01

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

  3. [Exercise test and ventricular tachycardia: the French experience].

    PubMed

    Douard, H; Mora, B; Broustet, J P

    1987-03-01

    The incidence of severe ventricular arrhythmia requiring electric shock or prompt intravenous therapy was evaluated during or immediately after 458,000 exercise tests performed in 46 french centres between 1975 and 1985; 177,000 tests were performed exclusively in cardiac patients during supervised exercise training sessions. Sixty cases of severe arrhythmia (ventricular fibrillation 23, ventricular tachycardia 35, asystole 2) occurred (1/7600 tests). One or several electric shocks were necessary in 35 cases. Six patients died (1/76,333 tests), 2 of them during training sessions; 5 had phase II or III myocardial infarction, and the 6th patient had moderately tight valvular aortic stenosis. The five coronary patients were taking various anti-arrhythmic drugs. Among the 54 survivors, 14 were lost sight of and 4 died, 2 of these suddenly including one who passed away during a bicycle ride. All others are alive after a 3.25 +/- 2.9 years follow-up. The association of a multiple-vessel disease with an extensive fibrous plaque is a syndrome that is highly sensitive but fortunately little specific in predicting severe arrhythmia during exercise tests.

  4. Exercises

    MedlinePlus

    ... Obstructive Pulmonary Disease (COPD) COPD: Lifestyle Management Exercises Exercises Make an Appointment Refer a Patient Ask a ... riding a stationary bike. Medication to Help You Exercise People with COPD often use a metered-dose ...

  5. Blood lactate diagnostics in exercise testing and training.

    PubMed

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

    2011-03-01

    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

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

    PubMed

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

    2009-01-01

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

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

    MedlinePlus

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

  8. Role of exercise stress test in master athletes

    PubMed Central

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

    2005-01-01

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

  9. Cardiopulmonary adaptation to weightlessness

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  10. Chest compression quality, exercise intensity, and energy expenditure during cardiopulmonary resuscitation using compression-to-ventilation ratios of 15:1 or 30:2 or chest compression only: a randomized, crossover manikin study

    PubMed Central

    Kwak, Se-Jung; Kim, Young-Min; Baek, Hee Jin; Kim, Se Hong; Yim, Hyeon Woo

    2016-01-01

    Objective Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). Methods This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR. Results Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group (31.2±30.3% vs. 55.1±37.5% vs. 54.0±36.9%, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups. Conclusion CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure. PMID:27752633

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

    PubMed

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

    2014-10-01

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

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

    PubMed

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

    2014-10-01

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

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

    SciTech Connect

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

    1988-02-01

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

  14. Exercise capacity in patients with obstructive sleep apnea syndrome.

    PubMed

    Przybyłowski, T; Bielicki, P; Kumor, M; Hildebrand, K; Maskey-Warzechowska, M; Korczyński, P; Chazan, R

    2007-11-01

    Obstructive sleep apnea syndrome (OSAS) is a common disease characterized by repetitive partial or complete closure of the upper airway during sleep. Cardiovascular disturbances are the most important complications responsible for increased morbidity and mortality. It is suggested that daytime somnolence, chronic fatigue, and nocturnal hypoxemia may further impair muscle function and decrease exercise fitness. The aim of this study was to evaluate cardiopulmonary response to exercise in OSAS patients. One hundred and eleven middle aged (50.2+/-10 yr), obese (BMI 31.0+/-4.6 kg/m2) patients (109 M, 2F) with severe OSAS (AHI 47.2+/-23.1 h(-1)) were enrolled into the study. OSAS was diagnosed with overnight polysomnography and a symptom-limited cardiopulmonary exercise test was performed on a treadmill using Bruce protocol. The results showed that the most frequent reason for exercise termination were: muscle fatigue and/or dyspnea (66+/-), increase in systolic blood pressure>220 mmHg (20%), ECG abnormalities, and chest pain (6%). Although the mean VO2 peak was within the reference value (29.6+/-6 mlO2/kg/min), in 52 patients (46%) VO2 peak was <84% of predicted. Hypertensive response to exercise was diagnosed in 39 of patients (35%). Patients with severe sleep apnea (AHI40>or=h(-1)) were characterized by higher mean blood pressure at rest, at 25%, 50% of maximal work load, at peak exercise and at post-exercise recovery. Several significant correlations between hemodynamic responses to exercise and sleep apnea severity were also noted. We conclude that exercise tolerance can be limited due to hypertensive response in about 20% of patients. Patients with severe OSAS have exaggerated hemodynamic response to exercise and delayed post-exercise blood pressure recovery. Cardiopulmonary response to exercise seems to be related to sleep apnea severity.

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

    PubMed

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

    2015-01-01

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

  16. Exercise testing and training in patients with peripheral vascular disease and lower extremity amputation.

    PubMed

    Priebe, M; Davidoff, G; Lampman, R M

    1991-05-01

    Patients with peripheral vascular disease have a high risk of coronary artery disease. The risk is even greater when the peripheral vascular disease leads to lower extremity amputation. Exercise testing using lower extremity exercise has been the "gold standard" for screening for coronary artery disease, but many patients with peripheral vascular disease and those with amputations have difficulty doing this type of exercise. Arm exercise ergometry has been shown to be a safe and effective alternative for the detection of coronary artery disease in patients who cannot do leg exercise. This test has also been used to determine safe exercise levels and may be able to predict the ultimate level of prosthetic use in amputees. Exercise training with arm ergometry also improves cardiovascular efficiency and upper body strength in poorly conditioned patients. Studies are needed to appreciate fully the role of exercise testing and training in the recovery of these patients after amputation. PMID:1866958

  17. Small Airway Dysfunction and Abnormal Exercise Responses

    PubMed Central

    Petsonk, Edward L.; Stansbury, Robert C.; Beeckman-Wagner, Lu-Ann; Long, Joshua L.; Wang, Mei Lin

    2016-01-01

    Rationale Coal mine dust exposure can cause symptoms and loss of lung function from multiple mechanisms, but the roles of each disease process are not fully understood. Objectives We investigated the implications of small airway dysfunction for exercise physiology among a group of workers exposed to coal mine dust. Methods Twenty coal miners performed spirometry, first breathing air and then helium-oxygen, single-breath diffusing capacity, and computerized chest tomography, and then completed cardiopulmonary exercise testing. Measurements and Main Results Six participants meeting criteria for small airway dysfunction were compared with 14 coal miners who did not. At submaximal workload, miners with small airway dysfunction used a higher proportion of their maximum voluntary ventilation and had higher ventilatory equivalents for both O2 and CO2. Regression modeling indicated that inefficient ventilation was significantly related to small airway dysfunction but not to FEV1 or diffusing capacity. At the end of exercise, miners with small airway dysfunction had 27% lower O2 consumption. Conclusions Small airway abnormalities may be associated with important inefficiency of exercise ventilation. In dust-exposed individuals with only mild abnormalities on resting lung function tests or chest radiographs, cardiopulmonary exercise testing may be important in defining causes of exercise intolerance. PMID:27073987

  18. Cardiopulmonary discipline science plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  19. Hypoxaemia during cardiopulmonary bypass

    PubMed Central

    Muir, A. L.; Davidson, I. A.

    1971-01-01

    Blood oxygenation was studied in patients undergoing cardiopulmonary bypass using the Rygg-Kyvsgaard bubble oxygenator. Oxygenation was satisfactory in perfusions carried out at normothermia and during hypothermia. During the rewarming phase of hypothermic perfusions hypoxaemia occurred. This could be prevented by a ganglion blocking agent (trimetaphan) given during the cooling phase. PMID:5565791

  20. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    PubMed Central

    Cortinas, Inés Vidal; Beretta, Mario; Alonso, Omar; Mut, Fernando

    2015-01-01

    Background Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. Objectives In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. Methods In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Results Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). Conclusions The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP. PMID:26039661

  1. Exercise testing and training in chronic lung disease and pulmonary arterial hypertension.

    PubMed

    Arena, Ross

    2011-01-01

    Research examining the clinical value of exercise testing and training in patients with chronic lung disease and pulmonary arterial hypertension (PAH) is less robust compared with cardiac populations but nevertheless highly supportive. Functional limitations are common in these patients, and exercise testing provides important information pertaining to the degree of this limitation, disease severity, and prognosis. Moreover, exercise testing, particularly in conjunction with ventilatory expired gas analysis, serves as a valuable diagnostic tool when the mechanism of the functional limitation and abnormal exertional symptoms is uncertain. Most work with respect to the benefits of exercise training has been performed in chronic obstructive lung disease cohorts and is used to support pulmonary rehabilitation. Emerging data indicate that exercise training is likewise beneficial in patients with interstitial lung disease and PAH. This review summarizes the evidence supporting the value of exercise testing and training and provides recommendations for clinical practice. PMID:21545932

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

    SciTech Connect

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

    1983-01-01

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

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

    PubMed

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

    2011-04-01

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

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

    SciTech Connect

    Vincent, N.R.; Denis, L.

    1986-10-01

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

  5. Attenuation of the influence of cardiolocomotor coupling in heart rate variability interpretation during exercise test.

    PubMed

    Hernando, A; Hernando, D; Garatachea, N; Casajus, J A; Bailon, R

    2015-08-01

    During exercise test, cardiolocomotor coupling related components appear in heart rate variability (HRV), blurring its interpretation as autonomic nervous system (ANS) marker. These cardiolocomotor coupling related components are centered at the pedalling and running stride frequency, as well as at their aliases, and may overlap with the low frequency (LF) and high frequency (HF) components of HRV. In this work cardiolocomotor-related HRV components are studied during maximal exercise test on treadmill and cycle ergometer. Power in the bands related to cardiolocomotor coupling increases with exercise intensity in cycle ergometer but not in treadmill exercise test, where it displays higher values for all exercise intensities. A method is proposed to reduce the effect of this coupling in the interpretation of HRV. Evolution of the power in the low frequency (LF) and high frequency (HF) bands are studied after the proposed reduction of cardiolocomotor coupling, showing more significant changes with exercise intensity than before the method is applied. PMID:26736557

  6. Oxygen desaturation during a 6-minute walk test as a predictor of maximal exercise-induced gas exchange abnormalities in sarcoidosis

    PubMed Central

    Chenivesse, Cecile; Boulanger, Sarah; Langlois, Carole; Wemeau-Stervinou, Lidwine; Perez, Thierry

    2016-01-01

    Background Common tests for evaluating gas exchange impairment have different strengths and weaknesses. Alveolar-to-arterial oxygen pressure difference (AaDO2) at peak exercise is a sensitive indicator but it cannot be measured repeatedly. Diffusing capacity of the lung for carbon monoxide (DLco) is measured at rest and may be too insensitive to predict the effects of exercise on gas exchange impairment. Oxygen desaturation during a 6-minute walk test (∆SpO2-6MWT) can be measured repeatedly, but its value in sarcoidosis is unknown. Here, we evaluated the ability of ∆SpO2-6MWT and DLco to predict gas exchange impairment during exercise in sarcoidosis. Methods This retrospective study of 130 subjects with sarcoidosis investigated the relationship between DLco, ∆SpO2-6MWT, and peak AaDO2 using correlation tests, inter-test reliability analyses, and predictive values. For the analyses of inter-test reliability and predictive values, DLco, peak AaDO2, and ∆SpO2-6MWT were considered as binary variables (normal/abnormal) according to previously defined thresholds. Results Correlation coefficients between DLco, ∆SpO2-6MWT, and peak AaDO2 were intermediate (0.53–0.67, P<0.0003) and Kappa coefficients were low (0.21–0.42, P=0.0003–0.02). DLco predicted (I) increased peak AaDO2 with a positive predictive value (PPV) of 66% and a negative predictive value (NPV) of 78% and (II) increased ∆SpO2-6MWT with a PPV at 36% and an NPV at 88%. Normal DLco was a good predictor of the absence of severe desaturation during the 6MWT (94% NPV) and at peak exercise during cardiopulmonary exercise test (CPET) (100% NPV). ∆SpO2-6MWT predicted peak AaDO2 increase with a PPV of 74% and an NPV of 60%. Conclusions In a large population of sarcoidosis patients, neither ∆SpO2-6MWT nor DLco was a good predictor of increased peak AaDO2. In contrast, normal DLco was a good predictor of the absence of severe desaturation during the 6MWT and at peak exercise during CPET.

  7. Oxygen desaturation during a 6-minute walk test as a predictor of maximal exercise-induced gas exchange abnormalities in sarcoidosis

    PubMed Central

    Chenivesse, Cecile; Boulanger, Sarah; Langlois, Carole; Wemeau-Stervinou, Lidwine; Perez, Thierry

    2016-01-01

    Background Common tests for evaluating gas exchange impairment have different strengths and weaknesses. Alveolar-to-arterial oxygen pressure difference (AaDO2) at peak exercise is a sensitive indicator but it cannot be measured repeatedly. Diffusing capacity of the lung for carbon monoxide (DLco) is measured at rest and may be too insensitive to predict the effects of exercise on gas exchange impairment. Oxygen desaturation during a 6-minute walk test (∆SpO2-6MWT) can be measured repeatedly, but its value in sarcoidosis is unknown. Here, we evaluated the ability of ∆SpO2-6MWT and DLco to predict gas exchange impairment during exercise in sarcoidosis. Methods This retrospective study of 130 subjects with sarcoidosis investigated the relationship between DLco, ∆SpO2-6MWT, and peak AaDO2 using correlation tests, inter-test reliability analyses, and predictive values. For the analyses of inter-test reliability and predictive values, DLco, peak AaDO2, and ∆SpO2-6MWT were considered as binary variables (normal/abnormal) according to previously defined thresholds. Results Correlation coefficients between DLco, ∆SpO2-6MWT, and peak AaDO2 were intermediate (0.53–0.67, P<0.0003) and Kappa coefficients were low (0.21–0.42, P=0.0003–0.02). DLco predicted (I) increased peak AaDO2 with a positive predictive value (PPV) of 66% and a negative predictive value (NPV) of 78% and (II) increased ∆SpO2-6MWT with a PPV at 36% and an NPV at 88%. Normal DLco was a good predictor of the absence of severe desaturation during the 6MWT (94% NPV) and at peak exercise during cardiopulmonary exercise test (CPET) (100% NPV). ∆SpO2-6MWT predicted peak AaDO2 increase with a PPV of 74% and an NPV of 60%. Conclusions In a large population of sarcoidosis patients, neither ∆SpO2-6MWT nor DLco was a good predictor of increased peak AaDO2. In contrast, normal DLco was a good predictor of the absence of severe desaturation during the 6MWT and at peak exercise during CPET. PMID

  8. Exercise

    MedlinePlus

    ... article Exercise / physical activity with MS Judy Boone, physical therapist Lynn Williams, Dan Melfi and Dave Altman discuss ... adjusted as changes occur in MS symptoms. A physical therapist experienced with MS can be helpful in designing, ...

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

    PubMed

    Lin, R Y; Barnard, M

    1993-06-01

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

  10. A multi-parametric protocol to study exercise intolerance in McArdle's disease.

    PubMed

    Ricci, Giulia; Bertolucci, Federica; Logerfo, Annalisa; Simoncini, Costanza; Papi, Riccardo; Franzoni, Ferdinando; Dell'Osso, Giacomo; Servadio, Adele; Masoni, Maria Chiara; Siciliano, Gabriele

    2015-12-01

    McArdle's disease is the most common metabolic myopathy of muscle carbohydrate metabolism, due to deficiency of myophosphorylase and alteration of glycogen breakdown in muscle. The clinical manifestations usually begin in young adulthood, with exercise intolerance, exercise-induced muscle cramps, pain and recurrent episodes of myoglobinuria. Many patients experience the second wind phenomenon, characterized by an improved tolerance for aerobic exercise approximately after eight minutes of motor activity, secondary to the increased availability of blood glucose and free fatty acids associated to an enhanced glucose uptake by muscle cells. In this study, we aimed to test a multi-parametric protocol in order to detect the impairment of muscular metabolism and motor performance in patients with McArdle's disease. We enrolled 5 patients and 5 age-matched healthy subjects, that were evaluated by: (01) monitoring of physical activity with an electronic armband; (02) testing of cardiopulmonary, metabolic and respiratory responses to exercise with a cardiopulmonary exercise test and analyzing muscle fatigue during exercise test by surface electromyography (04) evaluating blood lactate and oxidative stress biomarkers at rest and during exercise. The patients were tested at baseline and after three days of carbohydrate-rich diet integrated with tricarboxylic acid cycle intermediate and creatine. The multiparametric protocol proved to be useful to detect the oxidative capacity impairment and the second wind phenomenon of patients. We did not observe any significant differences of muscle metabolic response during the exercise test after three days of carbohydrate-rich diet. PMID:27199539

  11. Cardiopulmonary resuscitation: current guidelines.

    PubMed

    Green, Bart N; Clark, Tammi

    2005-01-01

    It is critical for health care providers to have the skills and composure required to administer cardiopulmonary resuscitation (CPR) when necessary. Unfortunately, it is easy to postpone updating one's CPR certification when confronted with the demands of leading a practice. New guidelines for CPR have been in effect since 2000. This clinical update provides a brief overview of the new guidelines, some suggestions for incorporating CPR training into the clinician's practice, and clarification for some common legal misconceptions that doctors may have pertaining to administering CPR. PMID:19674653

  12. Thrombin during cardiopulmonary bypass.

    PubMed

    Edmunds, L Henry; Colman, Robert W

    2006-12-01

    Cardiopulmonary bypass (CPB) ignites a massive defense reaction that stimulates all blood cells and five plasma protein systems to produce a myriad of vasoactive and cytotoxic substances, cell-signaling molecules, and upregulated cellular receptors. Thrombin is the key enzyme in the thrombotic portion of the defense reaction and is only partially suppressed by heparin. During CPB, thrombin is produced by both extrinsic and intrinsic coagulation pathways and activated platelets. The routine use of a cell saver and the eventual introduction of direct thrombin inhibitors now offer the possibility of completely suppressing thrombin production and fibrinolysis during cardiac surgery with CPB. PMID:17126170

  13. Test-retest reliability of the Aerobic Power Index submaximal exercise test in an obese population.

    PubMed

    Wallman, Karen E; Campbell, Leanne

    2007-06-01

    Many overweight and obese individuals have difficulty in performing aerobic fitness tests that require maximal exertion. Therefore, the purpose of this study was to investigate the reliability of the Aerobic Power Index (API) submaximal aerobic exercise test, as well as associated variables consisting of oxygen uptake (mlkg(-1)min(-1)) and ratings of perceived exertion (RPE) in an obese population. Twenty-two obese subjects (3 males and 19 females) aged between 36 and 68 years (mean=45.7+/-9.8 years), with BMI's ranging between 30.45 and 39.18kgm(-2) (mean=33.63+/-2.6), participated in two trials that was performed on the same weekday at the same time, but 1 week apart. Intraclass correlation coefficient (ICC) scores for power output (Wkg(-1)) and oxygen uptake O(2) (mlkg(-1)min(-1)) were highly reliable (R(1)=0.95 and 0.96, respectively), while the ICC score for RPE was moderately reliable (R(1)=0.88). Technical error of measurement results for power output (Wkg(-1)), O(2) (mlkg(-1)min(-1)), and RPE were 0.07Wkg(-1), 0.71mlkg(-1)min(-1), and 0.92, respectively. Additionally, a Pearson product-moment correlation coefficient demonstrated a strong relationship between power output (Wkg(-1)) and O(2) (mlkg(-1)min(-1)) for trial 1 (r=0.90) and for trial 2 (r=0.89). Results from this study demonstrated that the API submaximal aerobic exercise test is a highly reliable protocol for use in an obese population, and can be considered as an alternative exercise test to other submaximal cycle tests.

  14. Exercise testing of leg amputees and the result of prosthetic training.

    PubMed

    van Alsté, J A; Cruts, H E; Huisman, K; de Vries, J

    1985-01-01

    Thirty-nine patients undergoing rehabilitation following leg amputation were examined to determine cardiac status, which included clinical examination and a graded exercise ECG test, using an arm ergometer. Results were compared to final walking ability. It was found that the cardiac status of these patients was generally poor and that the exercise ECG results did co-relate to walking ability. PMID:4066177

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

    ERIC Educational Resources Information Center

    Gronlund, Wayne R.; And Others

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

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

    ERIC Educational Resources Information Center

    Petosa, R. Lingyak; Holtz, Brian

    2013-01-01

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

  17. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

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

    1997-10-28

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

  18. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

    Kangas, Lars J.; Keller, Paul E.

    1997-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

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

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

    PubMed

    Gray, Jennifer B; Harrington, Nancy G

    2011-03-01

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

  1. An exercise performance test does not measure physical fitness for the average person.

    PubMed

    Hopkins, W G; Robinson, S M

    1988-08-10

    One hundred and thirty five members of the public who attended a medical school open day and who volunteered for a physical fitness assessment were asked to rate their own physical fitness and to give a reason for their rating; subjects then performed a submaximal exercise test for an estimation of maximum oxygen uptake. More than two-thirds of the reasons given for self-rating of fitness were related to level of regular exercise, while physical exercise performance, health or obesity each accounted for 10% or less of the reasons given. There was no significant correlation between self-rating of fitness and maximum oxygen uptake. It is concluded that for the average person an estimate of the level of regular exercise is likely to be a more appropriate measure of physical fitness than performance in an exercise test.

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

    PubMed Central

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

    2015-01-01

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

  3. Prognostic value of radionuclide exercise testing after myocardial infarction

    SciTech Connect

    Schocken, D.D.

    1984-08-01

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

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

    ERIC Educational Resources Information Center

    Tinker, John R., Jr.

    1978-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

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

  6. The effects of space flight on the cardiopulmonary system

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

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

    PubMed

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

    2010-02-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1977-01-01

    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.

  9. Diagnostic Value of Electrocardiogram in Predicting Exaggerated Blood Pressure Response to Exercise Stress Testing

    PubMed Central

    Eshraghi, Ali; Ebdali, Reyhaneh Takalloo; Sajjadi, Seyed Sajed; Golnezhad, Reza

    2016-01-01

    Introduction It is believed that an exaggerated blood pressure response (EBPR) to exercise stress test is associated with a higher risk of cardiovascular events. It is also assumed that QT dispersion (QT-d), which was originally proposed to measure the spatial dispersion of ventricular recovery times, may have a relationship to cardiovascular events. The objective of this study was to examine the difference of changes in QT-d, Maxi-QT, Mini-QT, and QT-c (corrected QT interval) of the electrocardiogram in two groups of patients with exaggerated blood pressure responses (EBPR group) and normal responses (control group) to exercise testing. Also, the diagnostic value of each of these criteria in the prediction of EBPR was studied. Methods This cross-sectional study was conducted from May 2015 to February 2016 on patients suspected of coronary artery disease (CAD) undergoing exercise testing who had been referred to Ghaem and Imam Reza hospitals in Mashhad (Iran). All patients underwent a treadmill exercise test with the 12-lead ECG, which was optically scanned and digitized for analysis of QT-d, QT max, and QT min. Patients were divided into two groups of normal and EBPR to exercise testing. QT changes of ECG were compared between the two groups, and the diagnostic accuracy of QT variables for prediction of EBPR to exercise testing was studied. A multiple linear regression analysis (MLR), Pearson Chi-qquare, independent samples t-test, and receiver operating characteristic (ROC) curve were used as statistical methods in IBM SPSS version 19. Results Sixty patients (55% male) with a mean age of 50.48 ± 10.89 years were studied in two groups of normal (n=30) and exaggerated blood pressure response (n=30) to exercise testing. Maximum QT and QT dispersion were statistically different in individuals’ exaggerated blood pressure response to exercise stress test (p < 0.05). The logistic regression analysis revealed that none of our parameters predicted the EBPR. The ROC

  10. Cardiopulmonary loading in motocross riding.

    PubMed

    Konttinen, Tomi; Häkkinen, Keijo; Kyröläinen, Heikki

    2007-07-01

    The present study was designed to examine physiological responses during motocross riding. Nine Finnish A-level motocross riders performed a 15-min ride at a motocross track and a test of maximal oxygen uptake (VO2max) in the laboratory. Cardiopulmonary strain was measured continuously during the ride as well as in the VO2max test. During the ride, mean VO2 was 32 ml x kg(-1) x min(-1) (s = 4), which was 71% (s = 12) of maximum, while ventilation (V(E)) was 73% (s = 15) of its maximum. The relative VO2 and V(E) values during the riding correlated with successful riding performance (r = 0.80, P < 0.01 and r = 0.79, P < 0.01, respectively). Mean heart rate was maintained at 95% (s = 7) of its maximum. Mean blood lactate concentration was 5.0 mmol x l(-1) (s = 2.0) after the ride. A reduction of 16% (P < 0.001) in maximal isometric handgrip force was observed. In conclusion, motocross causes riders great physical stress. Both aerobic and anaerobic metabolism is required for the isometric and dynamic muscle actions experienced during a ride. PMID:17497401

  11. Comparison of tests for measuring maximal exercise ability in elite swimmers

    PubMed Central

    Suk, Min-Hwa; Yu, Kyung-Hun; Shin, Yun-A

    2016-01-01

    The purpose of this study was to compare of tests for measuring maximal exercise ability in elite swimmers. The high-school male elite swimmers (n=17) were performed maximal exercise ability tests. The experimental method consisted of a crossover design at 1-week intervals with the swimming tests (field test, water VAMEVAL test, 200-m test, and 400-m test) in random order. It measured the heart rate, ratings of perceived exertion (RPE), and lactate level by physiological factors, and swimming velocity (SV), stroke rate (SR), and stroke length (SL) by mechanical factors. The change of SV, SR, and SL in swimming tests was no significantly different. To compare tests, however, the lactate level and RPE in 200-m test was higher than water VAMEVAL test. The RPE of the 200-m and 400-m tests were higher than the field test and the water VAMEVAL test. Correlations showed between the field test and the 400-m test in heart rate and RPE. Moreover, a correlation observed between the field test and 200-m test in heart rate. In this study, 200-m and 400-m tests were suit to apply the test methods for establishing the exercise intensity appropriate for the underwater training of swimmers. PMID:27419117

  12. Comparison of tests for measuring maximal exercise ability in elite swimmers.

    PubMed

    Suk, Min-Hwa; Yu, Kyung-Hun; Shin, Yun-A

    2016-06-01

    The purpose of this study was to compare of tests for measuring maximal exercise ability in elite swimmers. The high-school male elite swimmers (n=17) were performed maximal exercise ability tests. The experimental method consisted of a crossover design at 1-week intervals with the swimming tests (field test, water VAMEVAL test, 200-m test, and 400-m test) in random order. It measured the heart rate, ratings of perceived exertion (RPE), and lactate level by physiological factors, and swimming velocity (SV), stroke rate (SR), and stroke length (SL) by mechanical factors. The change of SV, SR, and SL in swimming tests was no significantly different. To compare tests, however, the lactate level and RPE in 200-m test was higher than water VAMEVAL test. The RPE of the 200-m and 400-m tests were higher than the field test and the water VAMEVAL test. Correlations showed between the field test and the 400-m test in heart rate and RPE. Moreover, a correlation observed between the field test and 200-m test in heart rate. In this study, 200-m and 400-m tests were suit to apply the test methods for establishing the exercise intensity appropriate for the underwater training of swimmers. PMID:27419117

  13. Comparison of respiratory response of jogging in place and Bruce treadmill exercise test.

    PubMed

    Papazoglou, N; Tsarouchas, P; Loussidis, P; Giannoulopoulos, A; Kioussis, A; Karatzas, N B

    1991-11-01

    A comparison of the respiratory responses of jogging in place, an alternative exercise test we recently proposed, was made with those of the Bruce exercise test. We obtained on-line measurements of heart rate, ventilation, oxygen uptake, and carbon dioxide production from 9 healthy subjects of mean age 25 years. There was a higher heart rate and ventilatory response with jogging than with the Bruce test, but by 10 minutes the responses of the two tests were similar. Oxygen consumption, while higher with jogging, rose in parallel with that of the Bruce test from the second to the seventh min, and the change of the ratio of minute ventilation to oxygen consumption indicated that the anaerobic threshold occurred earlier during jogging. These results show that jogging in place is more vigorous than the graded exercise test and may produce ischemia earlier.

  14. Blood pressure response to heart rate during exercise test and risk of future hypertension.

    PubMed

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

    2002-03-01

    Previous works have shown that exaggerated blood pressure response to exercise is a valid risk marker for future hypertension, yet the use of an exercise test as a means of early prediction of hypertension still requires methodological development and confirmation. The purpose of this study was to determine abnormal ranges of blood pressure responses in relation to heart rate increase during exercise and to examine the clinical utility of exercise blood pressure measurement in evaluating individual risk for developing hypertension. We examined exercise test data from a population-based sample of 1033 nonmedicated normotensive men (mean age, 42.9+/-8.5 years; range, 20 to 59 years). Percentile curves of systolic and diastolic blood pressure responses to relative heart rate increments during submaximal exercise were constructed using a third-order polynomial model with multiple regression analysis. Of the original study sample, a cohort of 726 subjects was followed for hypertensive outcome for an average period of 4.7 years. Progression to hypertension, defined as a blood pressure of > or =140/90 mm Hg or the initiation of antihypertensive therapy, was found in 114 subjects (15.4%). Kaplan-Meier survival estimates showed that the cumulative incidence of hypertension increased progressively with higher percentiles of systolic and diastolic blood pressure response (both, P<0.01). A Cox proportional survival analysis revealed a significantly increased risk for developing hypertension associated with exaggerated blood pressure response to exercise after multivariable adjustments for traditional risk factors (relative risk, 3.8; 95% confidence interval, 2.3 to 6.1). These results suggest that an exaggerated blood pressure response to heart rate during exercise is predictive of future hypertension independent of other important risk factors and lend further support to the concept that blood pressure measurement during exercise test is a valuable means of identifying

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

    SciTech Connect

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

    1989-04-01

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

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

    ERIC Educational Resources Information Center

    Zwiren, Linda D.; And Others

    1991-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  18. Exercise oscillatory ventilation: Mechanisms and prognostic significance

    PubMed Central

    Dhakal, Bishnu P; Lewis, Gregory D

    2016-01-01

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

  19. Comparison of Peak Cardiopulmonary Performance Parameters on a Robotics-Assisted Tilt Table, a Cycle and a Treadmill

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  2. Comparison between treadmill and bicycle ergometer exercise tests in mild-to-moderate hypertensive Nigerians

    PubMed Central

    Abiodun, Olugbenga O; Balogun, Michael O; Akintomide, Anthony O; Adebayo, Rasaaq A; Ajayi, Olufemi E; Ogunyemi, Suraj A; Amadi, Valentine N; Adeyeye, Victor O

    2015-01-01

    Background Comparative cardiovascular responses to treadmill and bicycle ergometer (bike) exercise tests in hypertensive Nigerians are not known. This study compared cardiovascular responses to the two modes of exercise testing in hypertensives using maximal exercise protocols. Methods One hundred and ten male subjects with mild-to-moderate hypertension underwent maximal treadmill and bike test one after the other at a single visit in a simple random manner. Paired-sampled t-test was used to compare responses to both exercise tests while chi-squared test was used to compare categorical variables. Results The maximal heart rate (P<0.001), peak systolic blood pressure (P=0.02), rate pressure product (P<0.001), peak oxygen uptake (P<0.001), and exercise capacity (P<0.001) in metabolic equivalents were signifcantly higher on the treadmill than on the bike. Conclusion Higher cardiovascular responses on treadmill in Nigerian male hypertensives in this study, similar to findings in non-hypertensives and non-Nigerians in earlier studies, suggest that treadmill may be of better diagnostic utility in our population. PMID:26316811

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

    NASA Technical Reports Server (NTRS)

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Lindwall, Magnus; Palmeira, Antonio

    2009-01-01

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

  5. Abnormal EKG stress test in rats with type 1 diabetes is deterred with low-intensity exercise programme.

    PubMed

    Smirnova, I V; Kibiryeva, N; Vidoni, E; Bunag, R; Stehno-Bittel, L

    2006-11-01

    The focus of this study was to determine whether minimal levels of exercise could halt the formation of diabetes-induced heart pathology. Seven-week-old male rats were divided into four groups: sedentary nondiabetic, exercise-trained non-diabetic, sedentary diabetic and exercise-trained diabetic. Individualised exercise programmes were based on the animal's tolerance, and continued for 7 weeks after the induction of diabetes. At the completion of the study, no differences were found in skeletal muscle citrate synthase activity between diabetic sedentary and exercise-trained rats, indicating that the exercise was low intensity. Diabetes-induced heart hypertrophy was not reversed with exercise as measured by heart-to-body weight ratios and EKG (R wave height). There was no statistical difference between groups in the response to an exercise stress test prior to the induction of diabetes. However, 4 weeks of diabetes resulted in a significant decrease in resting and post-stress test heart rates (9% and 20%, respectively), which remained depressed at week 7. The sedentary diabetic animals demonstrated an abnormal response during the recovery period of the EKG exercise test, which was not present in non-diabetic or exercise-trained diabetic animals. In conclusion, lowintensity exercise training improved the cardiac response to an exercise stress test in diabetic animals.

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

    PubMed Central

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

    1987-01-01

    Growth hormone (GH) was measured before and 10 minutes after a standardised bicycle exercise test (duration 15 minutes) in 37 short children (group 1: mean (SD) age 12.8 (3.5) years; mean (SD) bone age 10.4 (3.6) years; mean (SD) height standard deviation score (SDS) -2.8 (0.7], 16 tall children (group 2: mean age 12.9 (2.8) years; mean bone age 13.9 (1.4) years; mean height SDS 3.0 (0.8], and 30 normal children (group 3: mean age 13.3 (3.2) years; mean bone age 12.8 (3.4) years; mean height SDS -0.4 (0.8]. Results of GH are expressed as mean (SEM). The pre-exercise GH was similar in the three groups (group 1, 8.0 (2.3) mU/l, group 2, 8.5 (2.5) mU/l, and group 3, 8.3 (2.3) mU/l). There was a significant rise in GH after exercise in all three groups. GH after exercise was higher in group 2 (35.1 (2.5) mU/l) compared with groups 1 and 3 (17.8 (3.0) and (20.8 (3.2) mU/l). Post-exercise GH was less than 10 mU/l in 29 children (34% total; 49% group 1, 6% group 2, and 34% group 3). There was a positive relation between post-exercise GH and both bone age and public hair stage. Multiple regression analysis revealed that relevant predictors of a rise in GH with exercise were different for the sexes in these children with varying stature: for boys, bone age and pubic hair stage; for girls, height and height SDS. All the tall girls were in puberty. No statistical relation was observed between post-experience GH and cardiovascular response to exercise, time of day of exercise, time of eating before exercise, and plasma insulin or insulin to glucose ratio at time of exercise. We conclude that the GH response to the physiological stimulus of exercise is higher in puberty compared with childhood. Therefore, although children may be suspected of having GH deficiency after a failure of GH to increase after exercise, a non-response may be a normal finding in prepubertal children, independent of stature. PMID:3813636

  7. Does lung diffusion impairment affect exercise capacity in patients with heart failure?

    PubMed Central

    Agostoni, P G; Bussotti, M; Palermo, P; Guazzi, M

    2002-01-01

    Objective: To determine whether there is a relation between impairment of lung diffusion and reduced exercise capacity in chronic heart failure. Design: 40 patients with heart failure in stable clinical condition and 40 controls participated in the study. All subjects underwent standard pulmonary function tests plus measurements of resting lung diffusion (carbon monoxide transfer, Tlco), pulmonary capillary volume (Vc), and membrane resistance (Dm), and maximal cardiopulmonary exercise testing. In 20 patients and controls, the following investigations were also done: (1) resting and constant work rate Tlco; (2) maximal cardiopulmonary exercise testing with inspiratory O2 fractions of 0.21 and 0.16; and (3) rest and peak exercise blood gases. The other subjects underwent Tlco, Dm, and Vc measurements during constant work rate exercise. Results: In normoxia, exercise induced reductions of haemoglobin O2 saturation never occurred. With hypoxia, peak exercise uptake (peak V̇o2) decreased from (mean (SD)) 1285 (395) to 1081 (396) ml/min (p < 0.01) in patients, and from 1861 (563) to 1771 (457) ml/min (p < 0.05) in controls. Resting Tlco correlated with peak V̇o2 in heart failure (normoxia < hypoxia). In heart failure patients and normal subjects, Tlco and peak V̇o2 correlated with O2 arterial content at rest and during peak exercise in both normoxia and hypoxia. Tlco, Vc, and Dm increased during exercise. The increase in Tlco was greater in patients who had a smaller reduction of exercise capacity with hypoxia. Alveolar–arterial O2 gradient at peak correlated with exercise capacity in heart failure during normoxia and, to a greater extent, during hypoxia. Conclusions: Lung diffusion impairment is related to exercise capacity in heart failure. PMID:12381630

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

    PubMed

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

    2015-12-15

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

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

    PubMed

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

    2014-12-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  12. Hyperamylasemia following cardiopulmonary bypass.

    PubMed

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

    1992-01-01

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

  13. Risk stratification in patients with non Q wave myocardial infarction: a role for thallium exercise testing.

    PubMed

    Brophy, J M; Kerouac, M

    1990-12-01

    The ability of maximal exercise thallium testing to stratify patients after non Q wave myocardial infarction was prospectively examined in 20 patients. Patients were enrolled in the study if there was no evidence of residual ischemia nor congestive heart failure during initial hospitalization. The thallium exercise test showed four patients to be at high risk, three of whom had successful revascularization. The remaining 16 patients were considered to be at low risk. There were no re-admissions for unstable angina, no myocardial infarctions and no deaths in the follow-up period (average 15 months). Thus patients with no evidence of early ischemia, no signs of left ventricular failure and a negative maximum thallium exercise test are at low risk following non Q wave myocardial infarction.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-05-01

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

  16. Effects of maximal oxygen uptake test and prolonged cycle ergometer exercise on the quiet standing control.

    PubMed

    Mello, Roger Gomes Tavares; de Oliveira, Liliam Fernandes; Nadal, Jurandir

    2010-06-01

    This work aims at testing the influence of peripheral and central fatigue, after maximal oxygen uptake test (Test1) and prolonged (Test2) cycle ergometer exercises, respectively, on sway density curve (SDC) parameters of postural control. Sixteen healthy male subjects were submitted to stabilometric tests, before and after the exercises. The Test1 was started at 12.5W, with 12.5W/min increments and 50rpm cadence until exhaustion. From the respiratory gas exchange signals, the first ventilatory threshold was obtained by the v-slope method. After a minimum of 72h, the subjects performed the Test2 for 60min, at a power output corresponding to 70% of such threshold. Before and just after these exercises, a set of 10 stabilometric trials of 50s was performed, alternating the eyes open and closed conditions, intercalated by a 10s resting period. The resulting signals were used to obtain the SDC. The Test1 caused decrease of the mean of peaks duration in SDC (p<0.05), decreasing the stability level, with small changes in the rates of central nervous system (CNS) and muscular torque controls. Conversely, Test2 increased the mean of time intervals between peaks in SDC (p<0.05), thus decreasing the CNS commands rate with minor changes in the stability level. Visual privation had a greater effect on body sway than these exercises, which were applied to muscles that are not the main actuators in body sway control. Concluding, this study allowed discriminating the effects of exercise intensities on body sway control.

  17. Cardiac arrhythmias during exercise testing in healthy men.

    NASA Technical Reports Server (NTRS)

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

    1973-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Kim, Youngil

    2015-01-01

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

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

    SciTech Connect

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

    1990-07-01

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

  2. Genetic research and testing in sport and exercise science: a review of the issues.

    PubMed

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

    2009-09-01

    This review is based on the BASES position stand on "Genetic Research and Testing in Sport and Exercise Science". Our aims are first to introduce the reader to research in sport and exercise genetics and then to highlight ethical problems arising from such research and its applications. Sport and exercise genetics research in the form of transgenic animal and human association studies has contributed significantly to our understanding of exercise physiology and there is potential for major new discoveries. Researchers starting out in this field will have to ensure an appropriate study design to avoid, for example, statistically underpowered studies. Ethical concerns arise more from the applications of genetic research than from the research itself, which is assessed by ethical committees. Possible applications of genetic research are genetic performance tests or genetic tests to screen, for example, for increased risk of sudden death during sport. The concerns are that genetic performance testing could be performed on embryos and could be used to select embryos for transplantation or abortion. Screening for risk of sudden death may reduce deaths during sporting events but those that receive a positive diagnosis may suffer severe psychological consequences. Equally, it will be almost impossible to keep a positive diagnosis confidential if the individual tested is an elite athlete.

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

    PubMed Central

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

    2013-01-01

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

  4. The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

    PubMed Central

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

    2013-01-01

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

  5. [Thanatological problems in cardiopulmonary surgery].

    PubMed

    Klochkov, N D; Timofeev, I V

    1992-01-01

    The pattern of immediate causes of death and types of terminal states (mechanisms of death) has been examined on the basis of thanatological analysis of 190 deaths occurred after operations on the heart (valve prosthesis) and lung (pneumonectomy). The differences in the thanatological profile of the respective surgical units are shown. Ways for reducing postoperative death in cardiopulmonary surgery are discussed.

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

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  7. Effect of exercise training on ventilatory efficiency in patients with heart disease: a review

    PubMed Central

    Prado, D.M.L.; Rocco, E.A.; Silva, A.G.; Rocco, D.F.; Pacheco, M.T.; Furlan, V.

    2016-01-01

    The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved. PMID:27332771

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

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

  10. [Guidelines of the Spanish Society of Cardiology for clinical practice in exercise testing].

    PubMed

    Arós, F; Boraita, A; Alegría, E; Alonso, A M; Bardají, A; Lamiel, R; Luengo, E; Rabadán, M; Alijarde, M; Aznar, J; Baño, A; Cabañero, M; Calderón, C; Camprubí, M; Candell, J; Crespo, M; de la Morena, G; Fernández, A; Ferrero, J A; Gayán, R; Bolao, I G; Hernández, M; Maceira, A; Marín, E; Muela de Lara, A; Placer, L; San Román, J A; Serratosa, L; Sosa, V; Subirana, M T; Wilke, M

    2000-08-01

    Most exercise testing is performed in adults with known or suspected ischemic heart disease. In the last few years cardiac imaging techniques have been applied in this field, improving the information obtained with the procedure. However, the exceptions to this rule are emerging rapidly not only in healthy people (asymptomatic individuals, athletes, handicapped people) but also in cardiac patients (advanced congestive heart failure, hypertension, rhythm disorders, congenital heart disease, etc.). All the-se issues justify the need for a multidisciplinary consensus document in Spain. This paper reviews and updates the methodological aspects of the stress test, including those related to oxygen consumption measurements. The main aim of this review was to determine the role of exercise testing in the evaluation of ischemic heart disease as well as the applications of imaging stress testing. The usefulness of this test in other non-ischemic cardiac disorders and in selected subsets of healthy people is also reviewed.

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  14. The shuttle walk exercise test in idiopathic pulmonary fibrosis.

    PubMed

    Moloney, E D; Clayton, N; Mukherjee, D K; Gallagher, C G; Egan, J J

    2003-06-01

    The shuttle walk test (SWT) is a validated, incremental walking test for chronic obstructive pulmonary disease, but not for idiopathic pulmonary fibrosis (IPF). The measurement of maximal oxygen consumption (VO2 max) is considered to be the gold standard measurement of functional capacity. This study examines the relationship between IPF patients' performance on the SWT and VO2 max. Twenty patients were recruited for the study, which consisted of two separate experiments. Firstly, the relationship between SWT performance on a conventional corridor SWT, with that on a programmable treadmill SWT designed to reproduce the corridor SWT was examined (n=10). In the second experiment, the relationship between performance on the treadmill equivalent SWT and VO2 max measurements was studied (n=10). There was a significant correlation between distance walked on the corridor SWT, and that walked on the treadmill equivalent SWT without VO2 max measurements (367 m vs. 410 m) (r=0.91, P=0.0003). There was a significant correlation between distance walked on the treadmill equivalent SWT (277 m), and the directly determined VO2 max (14.87 ml/kg/min) (r=0.74, P=0.01). During both experiments, a significant correlation was also observed between baseline PaO2 and SWT performance, and between DLCO and SWT performance. The shuttle walk test is a simple objective measure of functional capacity in IPF patients, which should facilitate the evaluation of new therapeutic compounds for IPF.

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

    SciTech Connect

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

    1981-12-01

    The usefulness of computer-enhanced thallium-201 myocardial perfusion scintigraphy in excluding the diagnosis of coronary artery disease in asymptomatic patients showing abnormal exercise electrocardiograms is evaluated. Multigated thallium scans were obtained immediately following and 3 or 4 hours after maximal exercise testing in 191 consecutive asymptomatic Air Force aircrew members who had shown abnormal exercise electrocardiograms and who were due to undergo coronary angiography. Computer enhancement of the raw images is found to lead to four false positive and two false negative scintigrams as revealed by angiographic results, while the group of 15 with subcritical coronary disease exhibited equivocal results. Results reveal that enhanced thallium scintigrams are an accurate diagnostics tool in detecting myocardial ischemia in asymptomatic patients and may be used in counseling asymptomatic patients on their likelihood of having coronary artery disease.

  16. [Applicability to exercise test of thermodilution technique for right ventricular ejection fraction].

    PubMed

    Kakimoto, T; Yamabe, H; Itoh, K; Yasaka, Y; Namura, H; Hashimoto, Y; Fujita, H; Yokoyama, M

    1993-04-01

    To assess the reliability of right ventricular ejection fraction (RVEF) during exercise measured by thermodilution technique using a modified Swan-Gantz catheter with a fast-response thermister, we measured RVEF under several conditions in 19 patients with cardiac disease. Measurements were repeated 5 times in each condition, and average RVEF and coefficient of variation (CV) were evaluated. 1) Injectate volume did not affect RVEF and CV. 2) A reduction in RVEF occurred with the thermister moved from proximal portion to distal portion within the pulmonary artery. 3) There were no differences in measurements of RVEF and CV between those during spontaneous breathing and those during apnea. 4) Postural change from supine to sitting decreased RVEF (38 +/- 8 to 35 +/- 9%; p < 0.05) and increased CV (7 +/- 2 to 13 +/- 5%). 5) Exercise increased RVEF (35 +/- 9 to 37 +/- 10%; p < 0.05) but did not change CV (13 +/- 5 vs 13 +/- 5%) compared with rest in the sitting position. 6) Cardiac rhythm (sinus vs atrial fibrillation) did not affect CV. 7) Average value of RVEF and CV during exercise were not different among 3, 4, 5 times repeated measurements. We considered that thermodilution technique for RVEF was applicable to exercise test, and 3 measurements were enough to determine the average value of RVEF during exercise.

  17. Post-exercise syncope: Wingate syncope test and visual-cognitive function.

    PubMed

    Sieck, Dylan C; Ely, Matthew R; Romero, Steven A; Luttrell, Meredith J; Abdala, Pedro M; Halliwill, John R

    2016-08-01

    Adequate cerebral perfusion is necessary to maintain consciousness in upright humans. Following maximal anaerobic exercise, cerebral perfusion can become compromised and result in syncope. It is unknown whether post-exercise reductions in cerebral perfusion can lead to visual-cognitive deficits prior to the onset of syncope, which would be of concern for emergency workers and warfighters, where critical decision making and intense physical activity are combined. Therefore, the purpose of this experiment was to determine if reductions in cerebral blood velocity, induced by maximal anaerobic exercise and head-up tilt, result in visual-cognitive deficits prior to the onset of syncope. Nineteen sedentary to recreationally active volunteers completed a symptom-limited 60° head-up tilt for 16 min before and up to 16 min after a 60 sec Wingate test. Blood velocity of the middle cerebral artery was measured using transcranial Doppler ultrasound and a visual decision-reaction time test was assessed, with independent analysis of peripheral and central visual field responses. Cerebral blood velocity was 12.7 ± 4.0% lower (mean ± SE; P < 0.05) after exercise compared to pre-exercise. This was associated with a 63 ± 29% increase (P < 0.05) in error rate for responses to cues provided to the peripheral visual field, without affecting central visual field error rates (P = 0.46) or decision-reaction times for either visual field. These data suggest that the reduction in cerebral blood velocity following maximal anaerobic exercise contributes to visual-cognitive deficits in the peripheral visual field without an apparent affect to the central visual field. PMID:27550986

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

    PubMed Central

    Alkahtani, Shaea

    2014-01-01

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

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

    PubMed

    Alkahtani, Shaea

    2014-01-01

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

  20. Cerebral Regulation in Different Maximal Aerobic Exercise Modes.

    PubMed

    Pires, Flávio O; Dos Anjos, Carlos A S; Covolan, Roberto J M; Pinheiro, Fabiano A; St Clair Gibson, Alan; Noakes, Timothy D; Magalhães, Fernando H; Ugrinowitsch, Carlos

    2016-01-01

    We investigated cerebral responses, simultaneously with peripheral and ratings of perceived exertion (RPE) responses, during different VO2MAX-matched aerobic exercise modes. Nine cyclists (VO2MAX of 57.5 ± 6.2 ml·kg(-1)·min(-1)) performed a maximal, controlled-pace incremental test (MIT) and a self-paced 4 km time trial (TT4km). Measures of cerebral (COX) and muscular (MOX) oxygenation were assessed throughout the exercises by changes in oxy- (O2Hb) and deoxy-hemoglobin (HHb) concentrations over the prefrontal cortex (PFC) and vastus lateralis (VL) muscle, respectively. Primary motor cortex (PMC) electroencephalography (EEG), VL, and rectus femoris EMG were also assessed throughout the trials, together with power output and cardiopulmonary responses. The RPE was obtained at regular intervals. Similar motor output (EMG and power output) occurred from 70% of the duration in MIT and TT4km, despite the greater motor output, muscle deoxygenation (↓ MOX) and cardiopulmonary responses in TT4km before that point. Regarding cerebral responses, there was a lower COX (↓ O2Hb concentrations in PFC) at 20, 30, 40, 50 and 60%, but greater at 100% of the TT4km duration when compared to MIT. The alpha wave EEG in PMC remained constant throughout the exercise modes, with greater values in TT4km. The RPE was maximal at the endpoint in both exercises, but it increased slower in TT4km than in MIT. Results showed that similar motor output and effort tolerance were attained at the closing stages of different VO2MAX-matched aerobic exercises, although the different disturbance until that point. Regardless of different COX responses during most of the exercises duration, activation in PMC was preserved throughout the exercises, suggesting that these responses may be part of a centrally-coordinated exercise regulation. PMID:27458381

  1. Cerebral Regulation in Different Maximal Aerobic Exercise Modes

    PubMed Central

    Pires, Flávio O.; dos Anjos, Carlos A. S.; Covolan, Roberto J. M.; Pinheiro, Fabiano A.; St Clair Gibson, Alan; Noakes, Timothy D.; Magalhães, Fernando H.; Ugrinowitsch, Carlos

    2016-01-01

    We investigated cerebral responses, simultaneously with peripheral and ratings of perceived exertion (RPE) responses, during different VO2MAX-matched aerobic exercise modes. Nine cyclists (VO2MAX of 57.5 ± 6.2 ml·kg−1·min−1) performed a maximal, controlled-pace incremental test (MIT) and a self-paced 4 km time trial (TT4km). Measures of cerebral (COX) and muscular (MOX) oxygenation were assessed throughout the exercises by changes in oxy- (O2Hb) and deoxy-hemoglobin (HHb) concentrations over the prefrontal cortex (PFC) and vastus lateralis (VL) muscle, respectively. Primary motor cortex (PMC) electroencephalography (EEG), VL, and rectus femoris EMG were also assessed throughout the trials, together with power output and cardiopulmonary responses. The RPE was obtained at regular intervals. Similar motor output (EMG and power output) occurred from 70% of the duration in MIT and TT4km, despite the greater motor output, muscle deoxygenation (↓ MOX) and cardiopulmonary responses in TT4km before that point. Regarding cerebral responses, there was a lower COX (↓ O2Hb concentrations in PFC) at 20, 30, 40, 50 and 60%, but greater at 100% of the TT4km duration when compared to MIT. The alpha wave EEG in PMC remained constant throughout the exercise modes, with greater values in TT4km. The RPE was maximal at the endpoint in both exercises, but it increased slower in TT4km than in MIT. Results showed that similar motor output and effort tolerance were attained at the closing stages of different VO2MAX-matched aerobic exercises, although the different disturbance until that point. Regardless of different COX responses during most of the exercises duration, activation in PMC was preserved throughout the exercises, suggesting that these responses may be part of a centrally-coordinated exercise regulation. PMID:27458381

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2006-04-01

    A fatiguing exercise protocol was combined with single-leg hop testing to improve the possibilities of evaluating the effects of training or rehabilitation interventions. In the first test-retest experiment, 11 healthy male subjects performed two trials of single-leg hops under three different test conditions: non-fatigued and following fatiguing exercise, which consisted of unilateral weight machine knee extensions at 80% and 50%, respectively, of 1 repetition maximum (1 RM) strength. Intraclass correlation coefficients ranged from 0.75 to 0.98 for different hop test conditions, indicating that all tests were reliable. For the second experiment, eight healthy male subjects performed the fatiguing exercise protocol to investigate how fatigue influences lower-extremity joint kinematics and kinetics during single-leg hops. Hip, knee and ankle joint angles, moments and powers, as well as ground-reaction forces were recorded with a six-camera, motion-capture system and a force platform. Recovery of hop performance following the fatiguing exercise was also measured. During the take-off for the single-leg hops, hip and knee flexion angles, generated powers for the knee and ankle joints, and ground-reaction forces decreased for the fatigued hop conditions compared with the non-fatigued condition (P<0.05). Compared with landing during the non-fatigued condition, hip moments and ground-reaction forces were lower for the fatigued hop conditions (P<0.05). The negative joint power was two to three times greater for the knee than for the hip and five to 10 times greater for the knee than for the ankle during landing for all test conditions (P<0.05). Most measured variables had recovered three minutes post-exercise. It is concluded that the fatiguing exercise protocol combined with single-leg hop testing was a reliable method for investigating functional performance under fatigued test conditions. Further, subjects utilized an adapted hop strategy, which employed less hip and

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

    PubMed

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

    1976-01-01

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

  7. Mechanism Development, Testing, and Lessons Learned for the Advanced Resistive Exercise Device

    NASA Technical Reports Server (NTRS)

    Lamoreaux, Christopher D.; Landeck, Mark E.

    2006-01-01

    The Advanced Resistive Exercise Device (ARED) has been developed at NASA Johnson Space Center, for the International Space Station (ISS) program. ARED is a multi-exercise, high-load resistive exercise device, designed for long duration, human space missions. ARED will enable astronauts to effectively maintain their muscle strength and bone mass in the micro-gravity environment more effectively than any other existing devices. ARED's resistance is provided via two, 20.3 cm (8 in) diameter vacuum cylinders, which provide a nearly constant resistance source. ARED also has a means to simulate the inertia that is felt during a 1-G exercise routine via the flywheel subassembly, which is directly tied to the motion of the ARED cylinders. ARED is scheduled to fly on flight ULF 2 to the ISS and will be located in Node 1. Presently, ARED is in the middle of its qualification and acceptance test program. An extensive testing program and engineering evaluation has increased the reliability of ARED by bringing potential design issues to light before flight production. Some of those design issues, resolutions, and design details will be discussed in this paper.

  8. Role of alpha1-blockade in congenital long QT syndrome: investigation by exercise stress test.

    PubMed

    Furushima, H; Chinushi, M; Washizuka, T; Aizawa, Y

    2001-07-01

    Beta-blockade is widely reported to reduce the incidence of syncope in 75-80% of patients with congenital long QT syndrome (LQTS). However, despite full-dose beta-blockade, 20-25% of patients continue to have syncopal episodes and remain at high risk for sudden cardiac death. In some patients refractory to beta-blockade, the recurrence of arrhythmias is successfully prevented by left stellate ganglionectomy, and also by labetalol, a nonselective beta-blockade with alpha1-blocking action. These observations suggest that not only beta-adrenoceptors, but also alpha1-adrenoceptors, play an important pathogenic role, especially under sympathetic stimulation, in LQTS. The clinical effects of alpha1-blockade in congenital LQTS were investigated in 8 patients with familial or sporadic LQTS. Two measurements of the QT interval were taken, from the QRS onset to the T wave offset (QT) and from the QRS onset to the peak of the T wave (QTp). Using the Bruce protocol, an exercise test was performed after administration of beta-blockade alone and again after administration of alpha1-blockade. The following were compared: (1) Bazzet-corrected QT (QTc) and QTp (QTpc) intervals in the supine and standing position before exercise and in the early recovery phase after exercise; and (2) the slopes (reflecting the dynamic change in the QT interval during exercise) of the QT interval to heart rate were obtained from the linear regression during the exercise test. In the supine position before exercise, there was no change in the QTc before or after the addition of alpha1-blockade (498+/-23 vs 486+/-23 ms [NS]). However, in the upright position before exercise and in the early recovery phase after exercise, QTc was significantly shortened from 523+/-21 to 483+/-22ms (p<0.01), and from 521+/-30 to 490+/-39ms (p<0.01), respectively, by alpha1-blockade. The QTpc was unchanged in any situation. Consequently, QTc-QTpc was significantly shortened by alpha1-blockade in the upright position

  9. Quality management in cardiopulmonary imaging.

    PubMed

    Kanne, Jeffrey P

    2011-02-01

    Increased scrutiny of the practice of medicine by government, insurance providers, and individual patients has led to a rapid growth of quality management programs in health care. Radiology is no exception to this trend, and quality management has become an important issue for individual radiologists as well as their respective practices. Quality control has been a mainstay of the practice of radiology for many years, with quality assurance and quality improvement both relative newcomers. This article provides an overview of quality management in the context of cardiopulmonary imaging and describes specific areas of cardiopulmonary radiology in which the components of a quality management program can be integrated. Specific quality components are discussed, and examples of quality initiatives are provided.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Wright, D; Tan, L

    1999-01-01

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


Keywords: exercise testing; heart failure PMID:10646020

  12. Effects of maximal oxygen uptake test and prolonged cycle ergometer exercise on sway density plot of postural control.

    PubMed

    Mello, Roger G T; Oliveira, Liliam F; Nadal, Jurandir

    2009-01-01

    This work aims at testing the influence of the maximal oxygen uptake test and prolonged cycle ergometer exercise on sway density plot (SDP) parameters of postural control. Sixteen healthy male subjects were submitted to stabilometric tests with eye open and closed, before and after two different exercises. The maximal oxygen uptake test caused decrease of the mean duration of peaks in SDP, decreasing the stability level, without modify the rates of central and muscular torque controls. Conversely, 60 min exercise increased the mean time interval between two consecutive peaks in SDP, thus decreasing the control rate but not changing the stability level. Visual privation had a greater effect on body sway than these exercises, which were applied to muscles that are not the main actuators in body sway control. Concluding, the changes in postural control are dependent on the intensity and duration of exercise.

  13. Daily exercise routines

    NASA Technical Reports Server (NTRS)

    Anderson, Patrick L.; Amoroso, Michael T.

    1990-01-01

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

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

    SciTech Connect

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

    1987-01-01

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

  15. Self-priming hemodynamic reservoir and inline flow meter for a cardiopulmonary bypass simulation.

    PubMed

    Raasch, David; Austin, Jon; Tallman, Richard

    2010-06-01

    Simulator exercises are used at Midwestern University to augment academic and laboratory training toward consolidating particular skills, increasing situation awareness, and preparing the student for practice within the team environment of an operating room. This paper describes an enhanced cardiopulmonary bypass simulator consisting of a self-priming hemodynamic reservoir that includes an inline flow meter. A typical cardiopulmonary bypass adult perfusion circuit was assembled using a roller pump console and integrated oxygenator/heat exchanger/reservoir and primed with 2 liters of water. For patient simulation, a soft-sided reservoir bag was mounted onto an inclined platform. A 1-liter soft-sided bag was placed just above the reservoir, providing an overflow reservoir. The priming line extended to the head of the mannequin. The arterial, venous, and suction lines extended through the open chest. The primed perfusion circuit was connected to ports on the filled reservoir bag. To test the patient simulation, the arterial pump output was adjusted to flow rates ranging from 1-7 liters per minute, with a complete interruption (to zero flow) between each test run. An inline flow meter was added to the bypass circuit and an analog to digital converter board was used to pass flow data into the computer-based simulation program. The use of an inclined hemodynamic reservoir bag proved to be self-priming and functional without problems over a wide range of flows tested. By including a reservoir with the mannequin, plus processing and displaying real-time flow data using the CPB-Sim simulation program, a higher fidelity and more realistic simulation experience was created. PMID:20648900

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

    SciTech Connect

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

    1987-12-01

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

  17. Routine initial exercise stress testing for treatment stratification in comprehensive cardiac rehabilitation.

    PubMed

    Salzwedel, Annett; Rieck, Angelika; Reibis, Rona K; Völler, Heinz

    2015-12-01

    There is evidence of substantial benefit of cardiac rehabilitation (CR) for patients with low exercise capacity at admission. Nevertheless, some patients are not able to perform an initial exercise stress test (EST). We aimed to describe this group using data of 1094 consecutive patients after a cardiac event (71±7 years, 78% men) enrolled in nine centres for inpatient CR. We analysed sociodemographic and clinical variables (e.g. cardiovascular risk factors, comorbidities, complications at admission), amount of therapy (e.g. exercise training, nursing care) and the results of the initial and the final 6-min walking test (6MWT) with respect to the application of an EST. Fifteen per cent of patients did not undergo an EST (non-EST group). In multivariable analysis, the probability of obtaining an EST was higher for men [odds ratio (OR) 1.89, P=0.01], a 6MWT (per 10 m, OR 1.07, P<0.01) and lower for patients with diabetes mellitus (OR 0.48, P<0.01), NYHA-class III/IV (OR 0.27, P<0.01), osteoarthritis (OR 0.39, P<0.01) and a longer hospital stay (per 5 days, OR 0.87, P=0.02). The non-EST group received fewer therapy units of exercise training, but more units of nursing care and physiotherapy than the EST group. However, there were no significant differences between both groups in the increase of the 6MWT during CR (123 vs. 108 m, P=0.122). The present study confirms the feasibility of an EST at the start of CR as an indicator of disease severity. Nevertheless, patients without EST benefit from CR even if exercising less. Thus, there is a justified need for individualized, comprehensive and interdisciplinary CR.

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

    PubMed

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

    2012-08-01

    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.

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

    NASA Technical Reports Server (NTRS)

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

    1973-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  1. An MR-compatible bicycle ergometer for in-magnet whole-body human exercise testing.

    PubMed

    Jeneson, Jeroen A L; Schmitz, Joep P J; Hilbers, Peter A J; Nicolay, Klaas

    2010-01-01

    An MR-compatible ergometer was developed for in-magnet whole-body human exercise testing. Designed on the basis of conventional mechanically braked bicycle ergometers and constructed from nonferrous materials, the ergometer was implemented on a 1.5-T whole-body MR scanner. A spectrometer interface was constructed using standard scanner hardware, complemented with custom-built parts and software to enable gated data acquisition during exercise. High-quality 31P NMR spectra were reproducibly obtained from the medial head of the quadriceps muscle of the right leg of eight healthy subjects during two-legged high-frequency pedaling (80 revolutions per minute) at three incremental workloads, including maximal. Muscle phosphocreatine content dropped 82%, from 32.2+/-1.0 mM at rest to 5.7+/-1.1 mM at maximal workload (mean+/-standard error; n=8), indicating that the majority of quadriceps motor units were recruited. The cardiovascular load of the exercise was likewise significant, as evidenced by heart rates of 150 (+/-10%) beats per minute, measured immediately afterward. As such, the newly developed MR bicycling exercise equipment offers a powerful new tool for clinical musculoskeletal and cardiovascular MR investigation. The basic design of the ergometer is highly generic and adaptable for application on a wide selection of whole-body MR scanners.

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

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

  3. Study to Evaluate Current Trends in Appropriate Usage of Tread Mill Exercise Testing

    PubMed Central

    Sukhani, Neha; Machanur, Basavaraj; Patil, Shashidhar

    2016-01-01

    Introduction Non-invasive tests are used to diagnose and prognosticate Coronary Artery Disease (CAD) patients and also in pre-operative evaluation and rehabilitation. Millions of these tests are performed worldwide in these situations. However, previous studies have shown inappropriate use of these tests. Aim The study was to evaluate the appropriate use of treadmill exercise test. Materials and Methods The present retrospective study was done in Rajiv Gandhi Super Speciality Hospital, Raichur and Institute of Medical sciences and RKB Super Speciality Clinic, Raichur, Karnataka, India. Tread Mill Tests (TMT) which were done between November 2013 and February 2016 were included in the study. A total of 600 tests were evaluated for appropriateness. Demographic, clinical and risk factors, indications were studied. Results Overall 298 (49.66%) tests were found to be inappro-priate. Younger age, female sex, pre-operative evaluation, evaluation in master health check up and insurance were predictors of inappropriate use (p<0.05) in this study. Conclusion The treadmill exercise testing appears to be particularly vulnerable to overuse in clinical setting due to its wide availability, affordability and awareness. The inappropriate use of the method, however, may result in additional unnecessary cost to health care system. PMID:27790492

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2013-07-01

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

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

    PubMed

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

    2014-10-01

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

  7. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  8. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  9. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  10. Preliminary testing of the role of exercise and predator recognition for bonytail and razorback sucker

    USGS Publications Warehouse

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

    2007-01-01

    Razorback suckers exercised (treatment) in water current (<0.3 m/s) for 10 weeks exhibited greater swimming stamina than unexercised, control fish. When exercised and unexercised razorback suckers were placed together with large predators in 2006, treatment fish had significantly fewer (n = 9, z = 1.69, p = 0.046) mortalities than control fish, suggesting increased stamina improved predator escape skills. Predator/prey tests comparing razorback suckers that had been previously exposed to a predation event with control fish, found treatment fish also had significantly fewer losses than predatornaïve fish (p = 0.017). Similar tests exposing predator-savvy and predator-naïve bonytail with largemouth bass showed a similar trend; predator-savvy bonytail suffered 38 percent fewer losses than control fish. However, there was not a statistically significant difference between the test groups (p = 0.143) due to small sample size. All exercise and predator exposure trials increased the survival rate of razorback sucker and bonytail compared to untreated counterparts.

  11. The mathematical analysis of the heart rate and blood lactate curves during incremental exercise testing.

    PubMed

    Rosic, Mirko; Ilic, V; Obradovic, Z; Pantovic, S; Rosic, G

    2011-12-01

    This paper describes a new mathematical approach for the analysis of HR (heart rate) and BL (blood lactate) curves during incremental exercise testing using a HR/BL curve and its derivatives, taking into account the native shape of all curves, without any linear approximation. Using this approach the results indicate the appearance of three characteristic points (A, B and C) on the HR/BL curve. The point A on the HR/BL curve which is the value that corresponds to the load (12.73 ± 0.46 km h-1) at which BL starts to increase above the resting levels (0.9 ± 0.06 mM), and is analogous to Lactate Turn Point 1 (LTP1). The point C on the HR/BL curve which corresponds to a BL of approximately 4mM, and is analogous to LTP2. The point B on the HR/BL curve, which corresponds to the load (16.32 ± 0.49 km h-1) at which the moderate increase turns into a more pronounced increase in BL. This point has not been previously recognized in literature. We speculate this point represents attenuation of left ventricular ejection fraction (LVEF) increase, accompanied by the decrease in diastolic time duration during incremental exercise testing. Proposed mathematical approach allows precise determination of lactate turnpoints during incremental exercise testing.

  12. Body Weight and Not Exercise Capacity Determines Central Systolic Blood Pressure, a Surrogate for Arterial Stiffness, in Children and Adolescents.

    PubMed

    Müller, Jan; Meyer, Joanna; Elmenhorst, Julia; Oberhoffer, Renate

    2016-08-01

    Cardiopulmonary fitness benefits cardiovascular health. Various studies have shown a strong negative correlation between exercise capacity and arterial stiffness in adults. However, evidence for this connection in children and adolescents is scarce. About 320 healthy children and adolescents (252 male, 14.0±2.1 years) were evaluated with regard to their demographic, anthropometric and hemodynamic parameters, and their peak oxygen uptake. Peripheral and central systolic blood pressures were measured with patients in a supine position using an oscillometric device. Peak oxygen uptake was assessed by cardiopulmonary exercise testing. In multivariate regression, only peripheral systolic blood pressure (β=0.653, P<.001) and body weight (β=0.284, P<.001) emerged as independent determinants for central systolic blood pressure. Body weight therefore determines central systolic blood pressure in children and adolescents rather than measures of cardiorespiratory fitness. The prevention of overweight in childhood is necessary to reduce stiffening of the arteries and delay the onset of cardiovascular disease.

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

    PubMed

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

    2012-03-01

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

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

    PubMed

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

    2012-03-01

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

  15. Oxidative stress in response to aerobic and anaerobic power testing: influence of exercise training and carnitine supplementation.

    PubMed

    Bloomer, Richard J; Smith, Webb A

    2009-01-01

    The purpose of this study is to compare the oxidative stress response to aerobic and anaerobic power testing, and to determine the impact of exercise training with or without glycine propionyl-L-carnitine (GPLC) in attenuating the oxidative stress response. Thirty-two subjects were assigned (double blind) to placebo, GPLC-1 (1g PLC/d), GPLC-3 (3g PLC/d) for 8 weeks, plus aerobic exercise. Aerobic (graded exercise test: GXT) and anaerobic (Wingate cycle) power tests were performed before and following the intervention. Blood was taken before and immediately following exercise tests and analyzed for malondialdehyde (MDA), hydrogen peroxide (H2O2), and xanthine oxidase activity (XO). No interaction effects were noted. MDA was minimally effected by exercise but lower at rest for both GPLC groups following the intervention (p = 0.044). A time main effect was noted for H2O2 (p = 0.05) and XO (p = 0.003), with values increasing from pre- to postexercise. Both aerobic and anaerobic power testing increase oxidative stress to a similar extent. Exercise training plus GPLC can decrease resting MDA, but it has little impact on exercise-induced oxidative stress biomarkers.

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

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

  17. Turbine flowmeter vs. Fleisch pneumotachometer: a comparative study for exercise testing.

    PubMed

    Yeh, M P; Adams, T D; Gardner, R M; Yanowitz, F G

    1987-09-01

    The purpose of this study was to investigate the characteristics of a newly developed turbine flowmeter (Alpha Technologies, model VMM-2) for use in an exercise testing system by comparing its measurement of expiratory flow (VE), O2 uptake (VO2), and CO2 output (VCO2) with the Fleisch pneumotachometer. An IBM PC/AT-based breath-by-breath system was developed, with turbine flowmeter and dual-Fleisch pneumotachometers connected in series. A normal subject was tested twice at rest, 100-W, and 175-W of exercise. Expired gas of 24-32 breaths was collected in a Douglas bag. VE was within 4% accuracy for both flowmeter systems. The Fleisch pneumotachometer system had 5% accuracy for VO2 and VCO2 at rest and exercise. The turbine flowmeter system had up to 20% error for VO2 and VCO2 at rest. Errors decreased as work load increased. Visual observations of the flow curves revealed the turbine signal always lagged the Fleisch signal at the beginning of inspiration or expiration. At the end of inspiration or expiration, the turbine signal continued after the Fleisch signal had returned to zero. The "lag-before-start" and "spin-after-stop" effects of the turbine flowmeter resulted in larger than acceptable error for the VO2 and VCO2 measurements at low flow rates.

  18. The six-minute walk--an adequate exercise test for pacemaker patients?

    PubMed

    Langenfeld, H; Schneider, B; Grimm, W; Beer, M; Knoche, M; Riegger, G; Kochsiek, K

    1990-12-01

    In many pacemaker patients bicycle and treadmill ergometry are not practicable. As an alternative, we performed a 6-minute walk on a 20-m corridor in 97 pacemaker patients, who were asked to walk as far as possible determining their speed by themselves. Results were compared with those of bicycle ergometry in 42 of these patients and with treadmill exercise of a group of 92 other pacemaker patients. In the 6-minute walk, performance and maximal heart rate were slightly lower (49 +/- 18 W; 96 +/- 23 beats/min) than in bicycle (57 +/- 16 W; 110 +/- 26 beats/min) and treadmill ergometry (50 +/- 37 W; 102 +/- 35 beats/min). A good correlation was found between walking and bicycling (r = 0.74) and in subgroups of patients with different pacemaker indications. All patients preferred the walk to bicycle ergometry considering it to be more related to daily physical activity. In conclusion, a 6-minute walk is a simple and physiological exercise test for nearly all pacemaker patients with good correlation to other types of exercise. It seems to be preferable to other tests because of its better acceptance and practicability. PMID:1704537

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

    PubMed

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

    2016-03-01

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

  20. The free running athletic screening test as a screening test for exercise-induced asthma in high school.

    PubMed

    Randolph, C; Fraser, B; Matasavage, C

    1997-01-01

    As part of a multicenter study envisioned by the American College of Allergy Sports Committee to screen for exercise-induced asthma, 303 high school students, freshman and sophomore gym classes, completed a questionnaire concerning exercise-related asthma, chronic asthma, and atopy. The study group included 124 females (41%) and 179 males (59%) with an average and median age of 15 years and a range of 13-17 years, and included 99% Caucasian and 1% nonCaucasian students, all attending the same parochial high school. After obtaining informed consent, 112 (37%) agreed to a free running test with initial challenge on an outdoor cinder track during April-June 1995. All challenges were conducted between 8:00 A.M. and noon with relative-humidity 59% and average temperature 15 degrees C. The challenge consisted of 7 minutes of continuous running on the cinder track with a doubling of pulse rate to 160/min during the run. Peak expiratory flows were taken at baseline, 0, 5, and 10 minutes postexercise. Twenty nine of 112 (26%) of the students were initially assessed as positive challenges, defined as a 15% decline in peak flow following exercise on the first challenge. However, four students self-recovered; thus 25 of 112 (22%) were qualified as true positives. Of these 25, 20 (80%) agreed to be reexercised. Fourteen of 20 (70%) were positive, yielding a prevalence rate of 14/112 (12.5%). Sixteen of these 20 (80%) were then exercised a third time using spirometry pre- and postexercise. Eight were positive, yielding a prevalence rate of 8/112 (7%). The questionnaire correlated significantly with the challenge, particularly when read by section (p = 0.000001) rather than globally positive or negative (p = 0.00008), with a specificity of 64%, sensitivity of 94%, positive predictive value of 44%, and negative predictive value of 97%. In summary, inexpensive and familiar free-running tests can be a useful screening test to confirm the questionnaire which is sensitive (94%) in

  1. Nurses' accounts of cardiopulmonary resuscitation.

    PubMed

    Page, S; Meerabeau, L

    1996-08-01

    The relationship between theory and practice has received considerable attention within the nursing literature. This paper uses qualitative data from debriefing interviews with nurses following episodes of cardiopulmonary resuscitation (CPR) to illustrate the complexities of translating sanitized theory into the messiness of practice. The interplay of affect and cognition on both learning from experience and on professional practice are explored. The feelings engendered by the CPR event and the labour required for their management form the second and major part of the paper. These are explored by examining the realities of a CPR event with its accompanying threat of death; success and failure, dignity versus indignity and the place of appropriate emotions throughout.

  2. History of cardiopulmonary bypass (CPB).

    PubMed

    Hessel, Eugene A

    2015-06-01

    The development of cardiopulmonary bypass (CPB), thereby permitting open-heart surgery, is one of the most important advances in medicine in the 20th century. Many currently practicing cardiac anesthesiologists, cardiac surgeons, and perfusionists are unaware of how recently it came into use (60 years) and how much the practice of CPB has changed during its short existence. In this paper, the development of CPB and the many changes and progress that has taken place over this brief period of time, making it a remarkably safe endeavor, are reviewed. The many as yet unresolved questions are also identified, which sets the stage for the other papers in this issue of this journal.

  3. Geophysics, Remote Sensing, and the Comprehensive Nuclear-Test-Ban Treaty (CTBT) Integrated Field Exercise 2014

    NASA Astrophysics Data System (ADS)

    Sussman, A. J.; Macleod, G.; Labak, P.; Malich, G.; Rowlands, A. P.; Craven, J.; Sweeney, J. J.; Chiappini, M.; Tuckwell, G.; Sankey, P.

    2015-12-01

    The Integrated Field Exercise of 2014 (IFE14) was an event held in the Hashemite Kingdom of Jordan (with concurrent activities in Austria) that tested the operational and technical capabilities of an on-site inspection (OSI) within the CTBT verification regime. During an OSI, up to 40 international inspectors will search an area for evidence of a nuclear explosion. Over 250 experts from ~50 countries were involved in IFE14 (the largest simulation of a real OSI to date) and worked from a number of different directions, such as the Exercise Management and Control Teams (which executed the scenario in which the exercise was played) and those participants performing as members of the Inspection Team (IT). One of the main objectives of IFE14 was to test and integrate Treaty allowed inspection techniques, including a number of geophysical and remote sensing methods. In order to develop a scenario in which the simulated exercise could be carried out, suites of physical features in the IFE14 inspection area were designed and engineered by the Scenario Task Force (STF) that the IT could detect by applying the geophysical and remote sensing inspection technologies, in addition to other techniques allowed by the CTBT. For example, in preparation for IFE14, the STF modeled a seismic triggering event that was provided to the IT to prompt them to detect and localize aftershocks in the vicinity of a possible explosion. Similarly, the STF planted shallow targets such as borehole casings and pipes for detection using other geophysical methods. In addition, airborne technologies, which included multi-spectral imaging, were deployed such that the IT could identify freshly exposed surfaces, imported materials, and other areas that had been subject to modification. This presentation will introduce the CTBT and OSI, explain the IFE14 in terms of the goals specific to geophysical and remote sensing methods, and show how both the preparation for and execution of IFE14 meet those goals.

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

    PubMed

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

    2014-01-01

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

  5. [Two cases of food-dependent exercise-induced anaphylaxis difficult to evoke symptoms by provocation test].

    PubMed

    Morimoto, Kenichi; Sanada, Seiko; Hara, Takeshi; Hide, Michihiro

    2006-11-01

    We report two cases of food-dependent exercise-induced anaphylaxis (FDEIA), which were hardly induced by provocation test in the hospital. Case 1: A 28-years-old Japanese female suffers repeated episodes of sternutation, nasal discharge and edema of eyelids after wheat ingestion of wheat followed by exercise. Case 2: A 14-years-old Japanese male suffers repeated episodes of wheal formation on whole body and dyspnea after lunch containing apple followed by exercise. Both of them had never developed symptoms by either ingestion or exercise alone. Provocation tests were performed on admission by combinations of the ingestion of suspected foods, exercise, and aspirin, but no symptoms were reproduced by any combination of them. After discharge, case 1 reproduced symptoms during exercise after the ingestion of wheat under prostration and cold climate. Case 2 reproduced symptoms during exercise after ingestion of apple when he suffered from common cold. Warm and comfortable condition in admission may make it harder to evoke symptoms by the provocation test. Frigidity, cold, prostration, and stress should be reckoned with in the provocation test to improve the accuracy of diagnosis for FDEIA. PMID:17159435

  6. Ventilatory regulation of arterial H(+) (pH) during exercise.

    PubMed

    Wasserman, Karlman; Cox, Timothy A; Sietsema, Kathy E

    2014-01-01

    We hypothesized that exercise ventilation and arterial H(+) ([H(+)]a) are mutually interactive, [H(+)]a stimulating V(E) and V(E) regulating [H(+)]a increase. Fifty-five patients were studied, 10 normal and 45 with cardio-respiratory disorders. Each patient underwent cardiopulmonary exercise testing with simultaneous serial arterial blood gas and pH measurements. Subsequently, they were classified into one of 7 clinical groups: (1) normal, (2) exercise-induced hypoxemia (PaO2<50mmHg), (3) exercise-induced myocardial ischemia, (4) heart failure, (5) COPD, (6) interstitial lung disease, and (7) pulmonary vasculopathy. The average resting pHa was 7.42 or 7.43 for each group. At anaerobic (lactic acidosis) threshold (AT), [H(+)]a increased due to PaCO2 increase (+2mmHg), primarily. At peak exercise, [H(+)]a increased further due to arterial HCO3(-) decrease. In summary, [H(+)]a appears to be closely regulated at rest to AT and further to peak exercise by CO2 elimination from the venous return. No evidence was observed for over-ventilation of CO2, causing the arterial blood to become more alkaline during exercise in the patient groups studied.

  7. Development of an exercise testing protocol for patients with a lower limb amputation: results of a pilot study.

    PubMed

    Vestering, Myrthe M; Schoppen, Tanneke; Dekker, Rienk; Wempe, Johan; Geertzen, Jan H B

    2005-09-01

    Due to a decrease in physical activity, lower limb amputees experience a decline in physical fitness. This causes problems in walking with a prosthesis because energy expenditure in walking with a prosthesis is much higher than in walking with two sound legs. Exercise training may therefore increase the functional walking ability of these patients. To generate a safe and effective aerobic training program, exercise testing of amputees is recommended. The objectives of this study were to develop a maximal exercise testing protocol for lower limb amputees and to compare two different testing methods: combined arm-leg ergometry and arm ergometry. The protocols were tested in five amputee patients. Combined ergometry elicited a higher oxygen uptake and heart rate than arm ergometry. Electrocardiography during combined ergometry was easier to read. Combined ergometry was judged most comfortable by the amputees. The exercise testing protocol was useful in lower limb amputees to determine their maximal aerobic capacity and their main exercise limitation. Future exercise training programs may be based on this testing protocol. Combined arm-leg ergometry is appropriate for unilateral amputees without significant claudication of the remaining leg. Continuous arm ergometry is suitable for unilateral amputees with significant claudication of the remaining limb or bilateral amputees. PMID:16046917

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  10. Penetrating heart wounds repaired without cardiopulmonary bypass. Evaluation and follow-up of recent war injuries.

    PubMed Central

    Catipović-Veselica, K; Sincić, V; Durijanĕk, J; Kozmar, D; Burić, D; Juranić, B; Kristek, J; Amidzić, V

    1993-01-01

    Penetrating cardiac injuries requires urgent management. Between September 1991 and June 1992, 10 patients with penetrating cardiac injuries sustained in war were treated at our hospital in Croatia, which does not have cardiopulmonary bypass facilities. Seven of these patients survived cardiorrhaphy and were discharged from the hospital, subject to follow-up. In 5 of the survivors, the injuries were inflicted by fragments from explosive devices; in 1 survivor, by a bullet; and in 1 survivor, by a rib fragment. The left ventricle was lacerated in 4 patients, the right ventricle in 2, the left atrium in 1, and the right atrium in 2. One patient had sustained laceration of the left anterior descending coronary artery in addition to a left ventricular laceration. During early post-cardiorrhaphy evaluation, all patients showed ST segment changes on electrocardiography. The most common echocardiographic findings were pericardial effusion in 5 patients (71%) and intramyocardial foreign bodies in 3 patients (43%). After 5 to 10 months of follow-up, the most common echocardiographic findings were enlargement of the injured chamber in 6 patients (86%), intramyocardial foreign bodies in 3 patients (43%), and hypokinesis of the injured wall in 2 patients (29%). Resting electrocardiographic results and exercise testing results were normal in all patients. One patient had arrhythmias during 24-hour Holter monitoring. Patients surviving operation had a rapid recovery, and were asymptomatic when last seen at follow-up. This demonstrates that treatment of penetrating injuries of the heart can be very successful, at least in the short term, even in hospitals without cardiopulmonary bypass facilities. Images PMID:8334372

  11. Systolic blood pressure response to exercise as a predictor of mortality in patients with chronic heart failure.

    PubMed

    Nishiyama, Yasuhiro; Morita, Hirohiko; Harada, Haruhito; Katoh, Atsushi; Adachi, Hisashi; Koga, Yoshinori; Ikeda, Hisao

    2010-03-01

    It is well known that peak oxygen consumption and heart rate (HR) recovery after exercise obtained from the cardiopulmonary exercise test are prognostic parameters in patients with chronic heart failure (CHF). However, it is unclear whether exercise-induced parameters obtained from the routine exercise stress test predict mortality in patients with CHF. We studied 136 patients (93 males/43 females) with CHF. All patients underwent symptom-limited exercise stress testing. Exercise parameters included exercise duration, exercise-induced HR and systolic blood pressure (SBP), and metabolic equivalents (METs). During the follow-up period (mean 6.2 years), 34 patients died. Survival rates at the 3rd and 5th years were 90% and 83%, respectively. Body mass index was significantly smaller in the nonsurvival group than in the survival group (P < 0.01). The incidence of patients with New York Heart Association III class was higher in the nonsurvival group than in the survival group (P < 0.05). In univariate analysis, predictors of mortality included peak HR and SBP, increases in HR and SBP during exercise, HR and SBP at the 1st minute after exercise, HR at the 3rd minute after exercise, and METs. The use of beta-adrenergic blocking agents was not associated with prognosis. In Cox hazard model analysis, the increase in SBP (P < 0.002), HR at the 3rd minute after exercise (P < 0.05), and METs (P < 0.05) were independent predictors of mortality. SBP response to exercise, HR recovery after exercise, and METs obtained from the routine exercise test predicted mortality in patients with CHF irrespective of the use of beta-adrenergic blocking agents.

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

    SciTech Connect

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

    1984-07-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    SciTech Connect

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

    1981-12-01

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

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

    SciTech Connect

    Rubler, S.; Fisher, V.J.

    1985-12-01

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

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

    PubMed

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

    2016-02-01

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

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

    SciTech Connect

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

    1984-05-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  20. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass cardiotomy return sucker... Cardiopulmonary bypass cardiotomy return sucker. (a) Identification. A cardiopulmonary bypass cardiotomy return... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

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

    PubMed

    Rimal, R N

    2001-01-01

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

  3. Rationale and design of the Henry Ford Exercise Testing Project (the FIT project).

    PubMed

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

    2014-08-01

    Although physical fitness is a powerful prognostic marker in clinical medicine, most cardiovascular population-based studies do not have a direct measurement of cardiorespiratory fitness. In line with the call from the National Heart Lung and Blood Institute for innovative, low-cost, epidemiologic studies leveraging electronic medical record (EMR) data, we describe the rationale and design of the Henry Ford ExercIse Testing Project (The FIT Project). The FIT Project is unique in its combined use of directly measured clinical exercise data retrospective collection of medical history and medication treatment data at the time of the stress test, retrospective supplementation of supporting clinical data using the EMR and administrative databases and epidemiologic follow-up for cardiovascular events and total mortality via linkage with claims files and the death registry. The FIT Project population consists of 69 885 consecutive physician-referred patients (mean age, 54 ± 10 years; 54% males) who underwent Bruce protocol treadmill stress testing at Henry Ford Affiliated Hospitals between 1991 and 2009. Patients were followed for the primary outcomes of death, myocardial infarction, and need for coronary revascularization. The median estimated peak metabolic equivalent (MET) level was 10, with 17% of the patients having a severely reduced fitness level (METs < 6). At the end of the follow-up duration, 15.9%, 5.6%, and 6.7% of the patients suffered all-cause mortality, myocardial infarction, or revascularization procedures, respectively. The FIT Project is the largest study of physical fitness to date. With its use of modern electronic clinical epidemiologic techniques, it is poised to answer many clinically relevant questions related to exercise capacity and prognosis.

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

    Johnson, J.E.; Anders, G.T.; Blanton, H.M.; Hawkes, C.E.; Bush, B.A.; McAllister, C.K.; Matthews, J.I. )

    1990-03-01

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

  6. Warming during cardiopulmonary bypass is associated with jugular bulb desaturation.

    PubMed

    Croughwell, N D; Frasco, P; Blumenthal, J A; Leone, B J; White, W D; Reves, J G

    1992-05-01

    The objective of this study was to characterize cerebral venous effluent during normothermic nonpulsatile cardiopulmonary bypass. Thirty-one (23%) of 133 patients met desaturation criteria (defined as jugular bulb venous oxygen saturation less than or equal to 50% or jugular bulb venous oxygen tension less than or equal to 25 mm Hg) during normothermic cardiopulmonary bypass (after hypothermic cardiopulmonary bypass at 27 degrees to 28 degrees C). Cerebral blood flow, calculated using xenon 133 clearance methodology, was significantly (p less than 0.005) higher in the saturated group (33.7 +/- 10.3 mL.100 g-1.min-1) than in the desaturated group (26.2 +/- 6.9 mL.100 g-1.min-1), whereas the cerebral metabolic rate for oxygen was significantly lower (p less than 0.005) in the saturated group (1.28 +/- 0.39 mL.100 g-.min-1) than in the desaturated group (1.52 +/- 0.36 mL.100 g-1.min-1) at normothermia. The arteriovenous oxygen difference at normothermia was lower in the saturated group (3.92 +/- 1.12 mL/dL) than in the desaturated group (5.97 +/- 1.05 mL/dL). Neuropsychological testing was performed in 74 of the 133 patients preoperatively and on day 7 postoperatively. There was a general decline in mean scores of all tests postoperatively in both groups with no significant difference between the groups. We conclude that cerebral venous desaturation represents a global imbalance in cerebral oxygen supply-demand that occurs during normothermic cardiopulmonary bypass and may represent transient cerebral ischemia. These episodes, however, are not associated with impared neuropsychological test performance as compared with the performance of patients with no evidence of desaturation.

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

    NASA Technical Reports Server (NTRS)

    1989-01-01

    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.

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

    NASA Astrophysics Data System (ADS)

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

    2014-06-01

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

  9. Cardiopulmonary consequences of obstructive sleep apnea.

    PubMed

    Caples, Sean M; Kara, Tomas; Somers, Virend K

    2005-02-01

    Ongoing research in obstructive sleep apnea (OSA) suggests strong associations with cardiopulmonary disorders. There is an abundance of studies describing physiological pathways in OSA that acutely impact the cardiovascular system. These mechanisms, if proven to carry over into the daytime hours, could form the basis for clinical disease. The challenge remains in disentangling these mechanistic processes from the many comorbid conditions often present in patients with OSA. Examples include male gender, obesity, and diabetes mellitus, all of which exert their own influence on the development of cardiopulmonary disease. This review discusses some of the physiological mechanisms associated with disordered breathing during sleep and explores putative cardiopulmonary disease associations.

  10. Evaluation of pulse oximetry during cardiopulmonary resuscitation.

    PubMed

    Spittal, M J

    1993-08-01

    This study evaluates whether the pulse oximeter is useful during cardiopulmonary resuscitation. The instrument was of undoubted benefit in the management of primary respiratory arrest, but of equivocable value in cardiac arrest. Data were displayed during external chest compressions, but were generally unreliable. The ear probe was not able to produce a consistently good signal during cardiopulmonary resuscitation. Nevertheless, the provision of an oximeter amongst the first-line resuscitation equipment available at a cardiopulmonary arrest significantly altered the management of seven out of 20 patients, five of whom survived.

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

    PubMed Central

    2012-01-01

    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 < 0.05). Metabolic responses and RQ at maximum 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 < 0.05). When peak VO2 was normalized to leg muscle mass sex differences disappeared (females: 161 ± 21 ml/min/kg vs. males: 170 ± 23 ml/min/kg). The increase in cardiac index during 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

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

    SciTech Connect

    Leppo, J.A.

    1984-01-01

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

  13. The Physiology of Cardiopulmonary Resuscitation.

    PubMed

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

    2016-03-01

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

  14. Translating exercise biology into the Venezuelan medical education and health care system.

    PubMed

    Del Corral, Pedro

    2007-09-01

    In the absence of pharmacological agents, physical exercise was widely used by physicians in the late 19th century to treat a number of maladies. In the 1950's, epidemiological evidence suggested an association between physical activity and health, and increased interest in clinical exercise biology. By the 1990's, sufficient research data was accumulated on the benefits of exercise, such that North American medical associations, government agencies, and the World Health Organization have published guidelines on exercise for public and clinical populations. Despite this, leaders in medical education have remained reluctant to incorporate exercise biology into the core medical curriculum, or to systematically implement it in graduate medical education. This work reviews Venezuelan exercise biology literature, and its medical applications. Venezuelan scientists and clinicians have invested efforts in cardiopulmonary exercise testing, skeletal muscle adaptations to training and exercise cardiovascular pharmacology in patients, sedentary subjects and athletes. It is suggested here, that there is a need to develop education and research programs in basic and clinical exercise biology in the formal training of medical students, physicians in residency programs, and allied health care professionals. Tentative steps to initiate this process are proposed.

  15. Cardiopulmonary function and laparoscopic cholecystectomy.

    PubMed

    Wahba, R W; Béïque, F; Kleiman, S J

    1995-01-01

    This review analyzes the literature dealing with cardiopulmonary function during and pulmonary function following laparoscopic cholecystectomy in order to describe the patterns of changes in these functions and the mechanisms involved as well as to identify areas of concern and lacunae in our knowledge. Information was obtained from a Medline literature search and the annual meeting supplements of Anesthesiology, Anesth Analg, Br J Anaesth, and Can J Anaesth. The principal findings were that changes in cardiovascular function due to the insufflation are characterized by an immediate decrease in cardiac index and an increase in mean arterial blood pressure and systemic vascular resistance. In the next few minutes there is partial restoration of cardiac index and resistance but blood pressure and heart rate do not change. The pattern is the result of the interaction between increased abdominal pressure, neurohumoral responses and absorbed CO2. Pulmonary function changes are characterized by reduced compliance without large alterations in PaO2, but tissue oxygenation can be adversely affected due to reduced O2 delivery. A major difficulty in maintaining normocarbia is due to the abdominal distention reducing pulmonary compliance and to CO2 absorption. End tidal CO2 tension is not a reliable index of PaCO2, particularly in ASA III-IV patients. The pattern of lung function following LC is characterized by a transient reduction in lung volumes and capacities with a restrictive breathing pattern and the loss of the abdominal contribution to breathing. Atelectasis also occurs. These changes are qualitatively similar to but of a lesser magnitude than those following "open" abdominal operations. It is concluded that the changes in cardiopulmonary function during laparoscopic upper abdominal surgery lead us to suggest judicious invasive monitoring and careful interpretation in ASA III-IV patients. Lung function following extensive procedures in sick patients has not been

  16. Graded exercise testing of mentally retarded adults: a study of feasibility.

    PubMed

    Fernhall, B; Tymeson, G

    1987-06-01

    There is a striking absence of data on the cardiovascular fitness of mentally retarded adults and what limited data are reported reflect field or submaximal laboratory tests. This study sought to develop a protocol that would allow maximal aerobic testing (VO2max) of mentally retarded adults in the laboratory. Of 21 subjects recruited, 17 (eight men and nine women) were successfully tested. Their mean IQ (+/- SD) was 52.68 +/- 16.3; their weight was 149.76 +/- 35.3 lbs, height 64.4 +/- 4.2 in, and age 29.29 +/- 6.6 yr. The testing occurred in three phases: (1) familiarization with the laboratory environs; (2) training to walk on the treadmill and breathe through the respiratory collection system; and (3) data collection via graded exercise testing. The treadmill protocol consisted of walking at 3 mph at 0% grade for two minutes, followed by 3 mph at a 2.5% grade for two minutes. The speed was then held constant at 3 mph and the grade increased 2.5% every minute until exhaustion. Metabolic data were collected every minute using a Beckman MCC cart connected to the subjects through a Hans-Rudolph valve. Heart rates (HR) were collected with a Quinton electrocardiograph. The mean maximal cardiorespiratory data were as follows (+/- SD):VO2max = 26.3 +/- 8.0 ml X kg-1 X min-1; HRmax = 171 +/- 14 beats/min; VEmax = 62.8 +/- 21.8 L/min; and respiratory quotient (R) = 1.09 +/- .07. The R values obtained were within an acceptable range for valid maximal data. In addition, 15 subjects produced supramaximal work and showed a decline in VO2 during the last minute of exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3592950

  17. Cardiopulmonary Syndromes (PDQ®)—Patient Version

    Cancer.gov

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2015-02-01

    It is a matter of controversy whether core stability exercise is preferred to other types of exercise for chronic low back pain. Lumbopelvic stability is an important element in low back pain. No study was found using lumbopelvic stability tests in comparing core stability and other exercises. The single leg squat, dip test, and runner pose test appear to be suitable as tests for lumbopelvic stability. The aim of this study was to compare "core stability" and "traditional trunk exercise" using these tests and also the Oswestry disability questionnaire and pain intensity. Twenty-nine non-specific chronic low back pain subjects were alternately allocated in one of the two exercise groups. For both groups, a 16-sessions exercise program was provided. Before and after training: (1) video was recorded while subjects performed the tests; (2) Oswestry disability questionnaire was completed; and (3) pain intensity was measured by visual analogue scale. The test videos were scored by three physiotherapists. Statistical analysis revealed a significant improvement in stability test scores (p = 0.020 and p = 0.041) and reduction in disability (p < 0.001) and pain (p < 0.001) within each group. No significant difference was seen between two groups in the three outcomes p = 0.41, p = 0.14, and p = 0.72. Insignificant differences between the two groups may indicate either non-specificity of CSE to increase lumbopelvic stability or equal effectiveness of TTE and CSE on improving LPS. The non-significant differences may also be attributable to the lack of sensitivity of our tests to assess stability change in two groups after training given the relatively small sample size.

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

    NASA Technical Reports Server (NTRS)

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

    1998-01-01

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

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

    PubMed

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

    2012-07-01

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

  2. Pulmonary haemodynamics during recovery from maximum incremental cycling exercise.

    PubMed

    Oliveira, Rudolf K F; Waxman, Aaron B; Agarwal, Manyoo; Badr Eslam, Roza; Systrom, David M

    2016-07-01

    Assessment of cardiac function during exercise can be technically demanding, making the recovery period a potentially attractive diagnostic window. However, the validity of this approach for exercise pulmonary haemodynamics has not been validated.The present study, therefore, evaluated directly measured pulmonary haemodynamics during 2-min recovery after maximum invasive cardiopulmonary exercise testing in patients evaluated for unexplained exertional intolerance. Based on peak exercise criteria, patients with exercise pulmonary hypertension (ePH; n=36), exercise pulmonary venous hypertension (ePVH; n=28) and age-matched controls (n=31) were analysed.By 2-min recovery, 83% (n=30) of ePH patients had a mean pulmonary artery pressure (mPAP) <30 mmHg and 96% (n=27) of ePVH patients had a pulmonary arterial wedge pressure (PAWP) <20 mmHg. Sensitivity of pulmonary hypertension-related haemodynamic measurements during recovery for ePH and ePVH diagnosis was ≤25%. In ePVH, pulmonary vascular compliance (PVC) returned to its resting value by 1-min recovery, while in ePH, elevated pulmonary vascular resistance (PVR) and decreased PVC persisted throughout recovery.In conclusion, we observed that mPAP and PAWP decay quickly during recovery in ePH and ePVH, compromising the sensitivity of recovery haemodynamic measurements in diagnosing pulmonary hypertension. ePH and ePVH had different PVR and PVC recovery patterns, suggesting differences in the underlying pulmonary hypertension pathophysiology. PMID:27126692

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

    SciTech Connect

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

    1991-07-01

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

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

    PubMed

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

    1996-06-01

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

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

    PubMed

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

    1996-06-01

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

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

    SciTech Connect

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

    1986-08-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2014-09-01

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

  9. Influence of inspiratory resistance on performance during graded exercise tests on a cycle ergometer.

    PubMed

    Heus, Ronald; den Hartog, Emiel A; Kistemaker, Lyda J A; van Dijk, Walter J; Swenker, Gerard

    2004-11-01

    Due to more stringent requirements to protect personnel against hazardous gasses, the inspiratory resistance of the present generation of respiratory protective devices tends to increase. Therefore an important question is to what extent inspiratory resistance may increase without giving problems during physical work. In this study the effects of three levels (0.24; 1.4 and 8.3 kPa s l(-1)) of inspiratory resistance were tested on maximal voluntary performance. Nine male subjects performed a graded exercise test on a cycle ergometer with and without these three levels of inspiratory resistance. Oxygen consumption, heart rate, time to exhaustion and external work were measured. The results of these experiments showed that increasing inspiratory resistance led to a reduction of time to exhaustion (TTE) on a graded exercise test(GXT). Without inspiratory resistance the mean TTE was 11.9 min, the three levels of resistance gave the following mean TTE's: 10.7, 7.8 and 2.7 min. This study showed that TTE on a GXT can be predicted when physical fitness (VO2-max) of the subject and inspiratory resistance are known. The metabolic rate of the subjects was higher with inspiratory resistance, but no differences were found between the three selected inspiratory loads. Other breathing parameters as minute ventilation, tidal volume, expiration time and breathing frequency showed no or minor differences between the inspiratory resistances. The most important conclusion of these experiments is that the overall workload increases due to an increase in inspiratory resistance by wearing respiratory protective devices.

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

    PubMed

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

    2010-07-01

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

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

    PubMed

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

    2016-04-01

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

  12. Physiological responses to linear treadmill and cycle ergometer exercise in COPD.

    PubMed

    Hsia, D; Casaburi, R; Pradhan, A; Torres, E; Porszasz, J

    2009-09-01

    Incremental cardiopulmonary exercise testing work rate ideally increases linearly to the subject's tolerance within approximately 10 min. Widely used treadmill protocols often yield shorter exercise times in debilitated patients. We compared a recently described treadmill protocol featuring linear work rate increase, weight adjustments and a priori exercise tolerance estimates with standard cycle and treadmill protocols. We also compared treadmill and cycle responses to examine mechanisms of oxyhaemoglobin desaturation differences. In total, 16 subjects with chronic obstructive pulmonary disease (COPD; mean+/-sd forced expiratory volume in 1 s of 36.5+/-10.9% predicted) performed incremental exercise using cycle, linear treadmill and modified Bruce protocols. Initial linear treadmill speed and grade yielded oxygen uptake (V'(O(2))) similar to cycle unloaded pedalling; Bruce protocol first stage elicited much higher V'(O(2)). Exercise duration was much shorter in Bruce than in cycle or linear treadmill protocols. At peak exercise, greater desaturation was noted in linear treadmill and Bruce protocols compared with cycle (-8.9+/-4.9 versus -8.5+/-4.7 versus -3.7+/-3.3%; p<0.001); at iso-V'(O(2)) values this difference widened as exercise proceeded. Iso-V'(O(2)) desaturation differences were largely related to higher ventilatory response to cycle than to treadmill exercise. The linear incremental treadmill protocol generates responses similar to cycle ergometry in severe COPD. However, cycle ergometry elicits less desaturation than does ambulation, making the linear treadmill protocol advantageous when evaluating COPD patients.

  13. Sufentanil disposition during cardiopulmonary bypass.

    PubMed

    Flezzani, P; Alvis, M J; Jacobs, J R; Schilling, M M; Bai, S; Reves, J G

    1987-11-01

    In order to investigate the ability of a computer-assisted continuous infusion (CACI) system to maintain constant plasma levels of sufentanil during cardiopulmonary bypass (CPB) using pharmacokinetic data derived from healthy surgical patients to determine the infusion rate, ten patients were anaesthetized with diazepam, enflurane and oxygen until ten minutes prior to the expected time of initiation of CPB. At that point, an infusion of sufentanil, aimed to reach a central compartment concentration of 5 ng.ml-1, was started via CACI. Plasma concentrations of sufentanil, haematocrit, total protein and albumin concentrations, and nasopharyngeal and CPB inflow temperatures were obtained at predetermined intervals before and up to 90 min after the initiation of CPB. Plasma concentrations of sufentanil reached 3.8 +/- 0.4 ng.ml-1 before CPB and approached the 5.0 ng.ml-1 set point (4.7 +/- 0.4 ng.ml-1) over the 90 min of CPB. In conclusion, our results show that it is possible to obtain stable plasma levels of sufentanil on CPB using a pharmacokinetically driven infusion scheme; however, our data suggest that use of such a system may lead to accumulation of drug during CPB. PMID:2960465

  14. [Hospital organization of cardiopulmonary resuscitation].

    PubMed

    Gómez-Arnau, J; Lacoma, F; García del Valle, S; Núñez, A; González, A; Burgos, E

    1999-05-01

    That hospital cardiopulmonary resuscitation (CPR) should be supported by an organized plan rather than on the skills of individual health care personnel is a universally agreed-upon principle. Such a plan should guarantee that needed materials are available and in working order in all departments and that the team assigned to carry out CPR arrives promptly. Personnel other than the specialized team should also receive CPR training appropriate to their posts. The main features of a CPR plan are related to the five steps in the chain of survival: a) identification of a patient to be resuscitated, a matter that has important ethical ramifications; b) early recognition of cardiac arrest; c) early defibrillation; d) basic CPR, and e) advanced CPR. The CPR plan should incorporate the automatic recording of system, population, event and outcome variables. Task forces responsible for establishing and maintaining the plan and its quality control will periodically review the data with the aim of detecting errors, correcting them or introducing improvements. Various international societies and CPR committees have recently suggested a uniform way (the Utstein style) of recording and presenting data to allow comparisons either from hospital to hospital or over time within a single center.

  15. Exercise, plasma catecholamine concentrations and decision-making performance of soccer players on a soccer-specific test.

    PubMed

    McMorris, T; Myers, S; MacGillivary, W W; Sexsmith, J R; Fallowfield, J; Graydon, J; Forster, D

    1999-08-01

    The main aim of this study was to compare the decision-making performance of college soccer players on a soccer-specific, tachistoscopically presented test, at rest and while exercising at their adrenaline threshold and at their maximum power output. These were determined following an incremental test to exhaustion on a cycle ergometer. After the initial maximum power test, participants (n = 9) were allowed 10 habituation trials on the soccer decision-making test. Participants' decision-making performance was tested at rest, while cycling at a power output that had previously been determined to elicit their adrenaline threshold and while cycling at maximum power output. Accuracy and speed of decision were the dependent variables. A one-way repeated-measures analysis of variance showed no significant effect of exercise on accuracy, and showed speed of decision to be significantly affected by exercise. Tukey post-hoc tests showed that speed of decision at rest was significantly slower than in the other two conditions, which did not differ significantly from one another. Based on allocatable resources theories of arousal and performance, we conclude that the adrenaline threshold may be indicative of increases in the resources available to the individual. Furthermore, we considered that exercise at maximum power output may only induce a moderate rather than a high level of arousal.

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

    PubMed

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

    2015-12-01

    Although individuals with sickle cell anaemia (SCA) have elevated baseline inflammation and endothelial activation, the acute phase response to maximal exercise has not been evaluated among children with SCA. We measured the acute phase response to maximal exercise testing for soluble vascular cell adhesion molecule (sVCAM) as well as interleukin 6 (IL6), total white blood cell (WBC) count, C-reactive protein (CRP) and D-dimer in a cohort of children with SCA and matched controls at baseline, immediately after, and 30, 60 and 120 min following exercise. Despite higher baseline levels of all biomarkers except CRP, the acute phase response from baseline to immediately after exercise was significantly greater in subjects versus controls for CRP (2·1 vs. 0·2 mg/l, P = 0·02) and D-dimer (160 vs. 10 μg/l, P < 0·01) only. Similar between-group trends were observed over time for all biomarkers, including sVCAM, IL6, total WBC, CRP and D-dimer. Lower fitness, defined by peak oxygen consumption (VO2 ), was independently associated with greater acute phase responses to exercise for sVCAM. Our results suggest maximal exercise may not be associated with any greater escalation of endothelial activation or inflammation in SCA and provide preliminary biomarker evidence for the safety of brief, high-intensity physical exertion in children with SCA.

  17. Evaluation of cardiopulmonary resuscitation techniques in microgravity

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

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

    PubMed

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

    2008-11-01

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

  19. Open-ended time durations for stationary start intense cycle ergometer exercise testing.

    PubMed

    Klopp, Dawn Marie; Vargas, Nicole Theresa; Robergs, Robert Andrew

    2013-05-01

    The study involved application of different applied loads to measure altered test durations, time to peak power, peak power, and peak cadence during intense cycle ergometry exercise. Healthy, physically active male (n = 11) and female (n = 11) subjects (18-45 years) performed the following 3 bouts of intense cycle ergometry at peak cadence to volitional exhaustion on 3 separate days, 48 h to 1 week apart: (i) 85 g·kg(-1) body mass load; (ii) 75 g·kg(-1) body mass load; and (iii) 100 g·kg(-1) body mass load. Trials (ii) and (iii) were performed in random order after trial (i). Exercise consisted of a stationary start, where test termination occurred when cadence decreased to <35 r·min(-1). Mean (±SD) for gender main effects for time to peak power were 7.64 ± 2.76 vs. 9.49 ± 2.76 s (p < 0.001) for males and females, respectively. Relative peak power data for males vs. females for 75, 85, and 100 g·kg(-1) were 10.01 ± 1.371 vs. 7.81 ± 1.25, 10.16 ± 1.61 vs. 7.67 ± 1.35, and 10.91 ± 2.03 vs. 7.31 ± 1.37 W·kg(-1), respectively. The means for test duration for the GENDER × LOAD interaction (p = 0.09) were 68.25 ± 17.80 vs. 56.5 ± 11.56, 63.70 ± 17.21 vs.57.95 ± 10.45, and 51.99 ± 14.59 vs. 49.54 ± 12.45 s for males vs. females for each of 75, 85, and 100 g·kg(-1), respectively. Stepwise multiple regression involving load and gender resulted in an explanation of variance (R(2)) of only 31.2%. Open-ended testing should be performed at a load of 100 g·kg(-1) body mass for males and 85 g·kg(-1) body mass females, causing volitional exhaustion in approximately 60 s and should allow test duration to be another measured variable.

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

    SciTech Connect

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

    1988-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

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

    SciTech Connect

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

    1988-04-01

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

  3. The diagnostic value of treadmill exercise test parameters for coronary artery disease.

    PubMed

    Sun, Jian Ling; Han, Rong; Guo, Ji Hong; Li, Xiao Ying; Ma, Xian Lin; Wang, Chong Yu

    2013-01-01

    The aim of this study was to determine the diagnostic value of treadmill exercise test (TET) in patients with coronary heart disease (CHD) by comparing the diagnostic conclusions with coronary angiography (CAG). Patients (445) with CHD and suspected CHD underwent TET and CAG, and the corresponding diagnostic conclusions were compared. (1) Out of the 200 cases that had the positive result with TET, 150 cases had been diagnosed CHD by means of CAG; Out of the 245 cases that had the negative result during TET, only 39 cases had been diagnosed CHD by means of CAG. The sensitivity, specificity, positive predictive value, negative predictive value, the false positive incidence, the false negative incidence, and agreement rate in diagnosis of CHD by TET were 79.36, 80.40, 75.00, 84.08, 25.00, 15.92, and 80.00 %, respectively. The patients with multi-vessel disease had a higher positive rate of TET as compared with those with single-vessel disease (P < 0.05). (2) The parameters for 189 cases positive CAG (patients diagnosed CHD by CAG) and 256 cases negative CAG (the control group), including the general exercise time, peak heart rate, and the beginning time of ST depression, were lower than that of control group (P < 0.05). However, the extent of ST depression and duration of ST depression were higher in these patients than in the control group (P < 0.05). (3) 189 cases positive CAG, include 87 cases of single coronary artery and 102 cases of binary or more coronary arteries (the control group). The parameters, including the general exercise time, peak heart rate, and the beginning time of ST depression, were lower than the control group (P < 0.05). However, the extent of ST depression and duration of ST depression were higher in these patients than the control group (P < 0.05). The TET is valuable for noninvasive diagnosis of CHD, especially for patients with multi-vessel disease. PMID:22872585

  4. The Impact of Pulmonary Arterial Pressure on Exercise Capacity in Mild-to-Moderate Cystic Fibrosis: A Case Control Study

    PubMed Central

    Manika, Katerina; Pitsiou, Georgia G.; Boutou, Afroditi K.; Tsaoussis, Vassilis; Chavouzis, Nikolaos; Antoniou, Marina; Fotoulaki, Maria; Stanopoulos, Ioannis; Kioumis, Ioannis

    2012-01-01

    Background. Pulmonary hypertension (PH) is an often complication of severe cystic fibrosis (CF); however, data on the presence and impact of pulmonary vasculopathy in adult CF patients with milder disease, is very limited. Aim. To investigate, for the first time, the impact of systolic pulmonary arterial pressure (PASP) on maximal exercise capacity in adults with mild-to-moderate cystic fibrosis, without PH at rest. Methods. This is a Case Control study. Seventeen adults with mild-to-moderate CF, without PH at rest (cases) and 10 healthy, nonsmoking, age, and height matched controls were studied. All subjects underwent maximal cardiopulmonary exercise testing and echocardiography before and within 1 minute after stopping exercise. Results. Exercise ventilation parameters were similar in the two groups; however, cases, compared to controls, had higher postexercise PASP and decreased exercise capacity, established with lower peak work rate, peak O2 uptake, anaerobic threshold, and peak O2 pulse. Furthermore, the change in PASP values before and after exercise was strongly correlated to the parameters of exercise capacity among cases but not among controls. Conclusions. CF adults with mild-to-moderate disease should be screened for the presence of pulmonary vasculopathy, since the elevation of PASP during exercise might contribute to impaired exercise capacity. PMID:22900167

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  8. Exercise response

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

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

    SciTech Connect

    DePuey, E.G.; Rozanski, A. )

    1991-04-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Heaman, Doris J.; Estes, Jenny

    1997-01-01

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

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

    PubMed Central

    Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

    2014-01-01

    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

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

    PubMed Central

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

    2001-01-01

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

 PMID:11462062

  14. Treadmill exercise tests predischarge and six weeks post-myocardial infarction to detect abnormalities of known prognostic value.

    PubMed

    Starling, M R; Crawford, M H; Kennedy, G T; O'Rourke, R A

    1981-06-01

    We evaluated 89 patients with predischarge and 6-week post-myocardial infarction treadmill exercise tests to determine the importance of doing repeat tests to identify abnormalities of known prognostic value, and assess the individual variability of treadmill abnormality responses. Nineteen patients (21%) completed only a predischarge exercise test, nine of whom experienced an early cardiac event precluding repeat testing. All nine had a prognostically important treadmill abnormality during the predischarge test. Electrocardiographic ST segment depression was highly reproducible between the early and 6-week tests (k = 0.968). However, angina, inadequate blood pressure response, and ventricular arrhythmias showed limited reproducibility (k = 0.344, 0.50, and 0.166, respectively) and substantial individual variability. Thus, we concluded that: a predischarge treadmill exercise test is important for determining the immediate short-term prognosis of patients after myocardial infarction; and ST segment depression is highly reproducible, whereas other treadmill abnormality responses show substantial variability between the predischarge and 6-week tests.

  15. 21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass intracardiac suction control. 870.4430 Section 870.4430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....4430 Cardiopulmonary bypass intracardiac suction control. (a) Identification. A cardiopulmonary...

  16. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass temperature controller. 870.4250 Section 870.4250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature...

  17. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is... through the cardiopulmonary bypass circuit. (b) Classification. Class II (performance standards)....

  18. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange... the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions.”...

  19. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  20. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  1. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger....

  2. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  3. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  4. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  5. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  6. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  7. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass bubble detector. 870.4205... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect bubbles in the arterial return line of the cardiopulmonary bypass circuit. (b)...

  8. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass bubble detector. 870.4205... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect bubbles in the arterial return line of the cardiopulmonary bypass circuit. (b)...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  10. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  11. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  12. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  13. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

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

    PubMed

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

    2016-05-15

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

  15. Cardiovascular effects of submaximal aerobic training on a treadmill in Standardbred horses, using a standardized exercise test.

    PubMed

    Bayly, W M; Gabel, A A; Barr, S A

    1983-04-01

    Seven healthy, unexercised, previously trained, adult Standardbred horses were allotted to 2 groups and trained 78 days on a treadmill set at a 7 degree 30' angle. The groups were trained on different schedules, and the effects of training on heart rate, cardiac output, stroke volume, arteriovenous oxygen difference, systemic blood pressure, and venous lactic acid were determined. Measurements were made at rest, during exercise on the treadmill at rates of 55 m/min, 75 m/min, 100 m/min, and 154 m/min, and at 5 minutes after exercise (standardized exercise test). Heart rate and cardiac output decreased during the training period. Significantly slower heart rates were observed at 55 m/min by day 8, at 100 m/min and 154 m/min by day 36, at 1 minute after exercise by day 57, and at 5 minutes after exercise by day 78 (P less than 0.05). Stroke volume increased with exercise, but not significantly. The arteriovenous oxygen difference increased significantly (P less than 0.05) with each increase in work load. There was no significant increase with training, although an upward trend was recorded. Mean systemic blood pressure did not differ from resting with treadmill rates of 55 m/min, 75 m/min, or 100 m/min. It was greater at 154 m/min, although this was not significant. During exercise, the total peripheral resistance decreased to as little as 30% of its resting value. After exercise, diastolic and mean arterial blood pressures and peripheral resistance increased. Marked increases in blood volume and blood viscosity during exercise were closely related to the decrease in peripheral resistance. There was no significant effect of training on blood pressure. Venous lactic acid concentrations at rest were greater than those of the horses on the treadmill at rates of 55 m/min, 75 m/min, and 100 m/min and at 5 minutes after exercise on days 1, 8, and 15. Subsequently, they were not different from resting values. Differences in the effects of the different training programs

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

    PubMed

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Pyfer, Howard R.; And Others

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

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

    PubMed

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

    2014-11-01

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

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

    PubMed

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

    2014-11-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    SciTech Connect

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

    1987-03-01

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

  2. Dysregulated Arginine Metabolism and Cardiopulmonary Dysfunction in Patients with Thalassaemia

    PubMed Central

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

    2015-01-01

    Pulmonary hypertension (PH) commonly develops in thalassaemia syndromes, but is poorly characterized. The goal of this study was to provide a comprehensive description of the cardiopulmonary and biological profile of patients with thalassaemia at risk for PH. A case-control study of thalassaemia patients at high versus low PH-risk was performed. A single cross-sectional measurement for variables reflecting cardiopulmonary status and biological pathophysiology were obtained, including Doppler-echocardiography, 6-minute-walk-test, Borg Dyspnea Score, New York Heart Association functional class, cardiac magnetic resonance imaging (MRI), chest-computerized tomography, pulmonary function testing and laboratory analyses targeting mechanism of coagulation, inflammation, haemolysis, adhesion and the arginine-nitric oxide pathway. Twenty-seven thalassaemia patients were evaluated, 14 with an elevated tricuspid-regurgitant-jet-velocity (TRV) ≥2.5m/s. Patients with increased TRV had a higher frequency of splenectomy, and significantly larger right atrial size, left atrial volume and left septal-wall thickness on echocardiography and/or MRI, with elevated biomarkers of abnormal coagulation, lactate dehydrogenase levels and arginase concentration, and lower arginine-bioavailability compared to low-risk patients. Arginase concentration correlated significantly to several echocardiography/MRI parameters of cardiovascular function in addition to global-arginine-bioavailability and biomarkers of haemolytic rate, including lactate dehydrogenase, haemoglobin and bilirubin. Thalassaemia patients with a TRV ≥2.5m/s have additional echocardiography and cardiac-MRI parameters suggestive of right and left-sided cardiac dysfunction. In addition, low arginine bioavailability may contribute to cardiopulmonary dysfunction in β-thalassaemia. PMID:25907665

  3. Temporary bilateral sensorineural hearing loss following cardiopulmonary bypass -A case report-.

    PubMed

    Son, Hyo Jung; Joh, Jung Hwa; Kim, Wook Jong; Chin, Ji Hyun; Choi, Dae Kee; Lee, Eun Ho; Sim, Ji Yeon; Choi, In-Cheol

    2011-08-01

    Sudden sensorineural hearing loss has been reported to occur following anesthesia and various non-otologic surgeries, mostly after procedures involving cardiopulmonary bypass. Unilateral sensorineural hearing loss resulting from microembolism is an infrequent complication of cardiopulmonary bypass surgery that has long been acknowledged. Moreover, there are few reports on the occurrence of bilateral sensorineural hearing loss without other neurologic deficits and its etiology has also not been determined. We describe here a rare case of bilateral hearing loss without other neurologic deficits in an otherwise healthy 27-year-old woman who underwent cardiopulmonary bypass surgery for repair of severe mitral valve stenosis. The patient suffered from profound sensorineural hearing loss in both ears that was recognized immediately upon extubation, and audiometry tests confirmed the diagnosis. Without any treatment, her hearing recovered almost completely by the time of her discharge one week after surgery.

  4. Temporary bilateral sensorineural hearing loss following cardiopulmonary bypass -A case report-

    PubMed Central

    Son, Hyo Jung; Joh, Jung Hwa; Kim, Wook Jong; Chin, Ji Hyun; Choi, Dae Kee; Lee, Eun Ho; Sim, Ji Yeon

    2011-01-01

    Sudden sensorineural hearing loss has been reported to occur following anesthesia and various non-otologic surgeries, mostly after procedures involving cardiopulmonary bypass. Unilateral sensorineural hearing loss resulting from microembolism is an infrequent complication of cardiopulmonary bypass surgery that has long been acknowledged. Moreover, there are few reports on the occurrence of bilateral sensorineural hearing loss without other neurologic deficits and its etiology has also not been determined. We describe here a rare case of bilateral hearing loss without other neurologic deficits in an otherwise healthy 27-year-old woman who underwent cardiopulmonary bypass surgery for repair of severe mitral valve stenosis. The patient suffered from profound sensorineural hearing loss in both ears that was recognized immediately upon extubation, and audiometry tests confirmed the diagnosis. Without any treatment, her hearing recovered almost completely by the time of her discharge one week after surgery. PMID:21927689

  5. Relationship between exercise induced elevation of left ventricular filling pressure and exercise intolerance in patients with atrial fibrillation

    PubMed Central

    Chen, Shao-Min; He, Rong; Li, Wei-Hong; Li, Zhao-Ping; Chen, Bao-Xia; Feng, Xin-Heng

    2016-01-01

    Background Elevated left ventricular filling pressure (LVFP) is an important cause of exercise intolerance in patients with atrial fibrillation (AF). Exercise stress echocardiography could assess LVFP during exercise. The objective of this study was to investigate the relationship between exercise induced elevation of LVFP and exercise capacity in patients with AF. Methods This study included 145 consecutive patients (81 men and 64 women; mean age 65.5 ± 8.0 years) with persistent non-valvular AF and normal left ventricular systolic function (left ventricular ejection fraction ≥ 50%). All patients underwent a symptom-limited cardiopulmonary exercise test (CPET). Doppler echocardiography was performed both at rest and immediately after exercise. Five consecutive measurements of early diastolic mitral inflow velocity (E) and early diastolic mitral annular velocity (e') were taken and averaged. E/e' ratio was calculated. Elevated LVFP was defined as E/e' > 9, and patients with elevated LVFP at rest were excluded. Results Patients were classified into two groups according to LVFP estimated by E/e' ratio after exercise: 39 (26.9%) with elevated LVFP after exercise and 106 (73.1%) with normal LVFP. As compared with patients with normal LVFP, the ones with elevated LVFP after exercise had significantly lower peak oxygen uptake (VO2 peak) (21.7 ± 2.3 vs. 26.4 ± 3.8 mL/min per kilogram, P < 0.001), lower anaerobic threshold (19.9 ± 2.5 vs. 26.0 ± 4.0 mL/min per kilogram, P < 0.001), and shorter exercise time duration (6.2 ± 0.8 vs. 7.0 ± 1.3 min, P < 0.001). Multivariate analysis showed that age, gender and E/e' after exercise were significantly correlated with VO2 peak. Conclusion Elevated LVFP estimated by E/e' ratio after exercise is independently associated with reduced exercise capacity in AF patients. PMID:27582773

  6. Improved Cardiorespiratory Fitness with Aerobic Exercise Training in Individuals with Traumatic Brain Injury

    PubMed Central

    Chin, Lisa M. K.; Chan, Leighton; Woolstenhulme, Joshua G.; Christensen, Eric J.; Shenouda, Christian N.; Keyser, Randall E.

    2015-01-01

    Objective To examine cardiorespiratory fitness in individuals with traumatic brain injury (TBI), prior to and following participation in a supervised 12-week aerobic exercise training program. Methods Ten subjects with non-penetrating TBI (TBI severity: Mild, 50%; Moderate, 40%; Severe, 10%; Time since injury: 6.6 ± 6.8 years, mean ± SD) performed exercise training on a treadmill 3 times a week for 30 minutes at vigorous intensity (70 – 80 % of heart rate reserve). All subjects completed a cardiopulmonary exercise test with gas exchange measured and a questionnaire related to fatigue (Fatigue Severity Scale; FSS) at baseline and following exercise training. Results After training, increases (p<0.01) in peak oxygen consumption (VO2; +3.1 ± 2.4 ml/min/kg), time to volitional fatigue (+1.4 ± 0.8 min), and peak work rate (WR; +59 ± 43 watts) were observed. At the anaerobic threshold, VO2 (+3.6 ± 2.1 ml/kg/min), treadmill time (+1.8 ± 1.1 min) and WR (+37 ± 39 watts) were higher (p<0.01) following exercise training. Subjects also reported significantly lower (p<0.05) FSS composite scores (−0.9 ± 1.3) following exercise training. Conclusion These findings suggest that individuals with TBI may benefit from participation in vigorous aerobic exercise training with improved cardiorespiratory fitness and diminished fatigue. PMID:24901330

  7. Prognostic significance of blood pressure response to exercise in patients with systolic heart failure.

    PubMed

    Kallistratos, Manolis S; Poulimenos, Leonidas E; Pavlidis, Antonios N; Dritsas, Athanasios; Laoutaris, Ioannis D; Manolis, Athanasios J; Cokkinos, Dennis V

    2012-01-01

    High systolic blood pressure (SBP) has been linked to worse cardiovascular outcomes. However, emerging data suggest that in patients with heart failure (HF), low SBP correlates with increased mortality. The purpose was to examine the impact of baseline and post-exercise systolic and diastolic blood pressure (DBP), as well as pulse pressure (PP), on cardiac mortality in patients with systolic HF. One hundred sixty patients with systolic HF (left ventricular ejection fraction 33 ± 8) were studied. Blood pressure (BP) levels were determined at rest and at peak exercise during a cardiopulmonary exercise test. Patients were followed up for a period of 2.5 ± 0.8 years. During this period 22 patients died and 5 subjects underwent heart transplantation. Patients with higher SBP and DBP at rest, and patients with SBP ≥160 mmHg and PP ≥75 mmHg at peak exercise had the most favorable prognosis. There was a fourfold increase in cardiac mortality risk for patients with SBP <160 mmHg at peak exercise (hazard ratio: 3.97, 95% confidence interval: 1.60-9.84) and a threefold increase for patients with PP <75 mmHg at peak exercise (hazard ratio: 2.96, 95% confidence interval: 1.29-6.82). There is an inverse relationship between SBP and cardiac mortality in patients with systolic HF. BP response to exercise could serve as a simple risk stratification model in HF patients.

  8. Cardiorespiratory responses to exercise after anatomic repair of atrioventricular discordance with abnormal ventriculoarterial connection.

    PubMed

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

    2007-01-01

    We evaluated exercise tolerance and cardiorespiratory responses to exercise in patients with atrioventricular discordance (AVD) and abnormal ventriculoarterial connection after anatomic repair. Cardiopulmonary treadmill exercise testing with gas measurement was done 62 times in 19 patients with AVD who had undergone anatomic repair at the National Cardiovascular Center. Exercise duration, oxygen uptake (V(O2)) and heart rate at anaerobic threshold and peak, and oxygen pulse during exercise were significantly lower in patients with AVD after anatomic repair than in controls. Carbon dioxide ventilatory equivalent during exercise was worse in patients with AVD after anatomic repair than in controls. Percentage peak V(O2) significantly correlated positively with percentage peak oxygen pulse and tended to correlate positively with the heart rate increments. Patients with AVD after anatomic repair exhibit impaired responses of heart rate and oxygen pulse with lower exercise capacity. Careful attention should be paid to patients with AVD after anatomic repair in terms of their functional capacity as well as other postoperative complications.

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

    PubMed

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

    2007-03-27

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

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

    PubMed

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

    2014-11-27

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

  11. Dobutamine stress echo is superior to exercise stress testing in achieving target heart rate among patients on beta blockers.

    PubMed

    Sabbath, Adam; Pack, Michael; Markiewicz, Richard; John, Jooby; Gaballa, Mohamed; Goldman, Steven; Thai, Hoang

    2005-01-01

    Published guidelines recommend continuing beta-adrenergic receptor blockade in patients undergoing stress testing. We evaluated the role of pharmacological versus exercise stress testing in achieving target heart rate (THR) among patients on beta-adrenergic blockade. We compared data from 140 patients who underwent dobutamine stress echo (DSE) and 143 patients who underwent exercise treadmill testing (ETT). In both groups, beta-adrenergic blocker was continued at the time of stress testing. Overall, patients undergoing DSE achieved THR more frequently than ETT. With beta-adrenergic blockade, DSE patients met THR more frequently than ETT patients (p < 0.001). Without beta-adrenergic blockade, there was no difference between either modality in achieving THR. In both DSE and ETT patients, absence of beta-adrenergic blockade increased the odds of achieving THR [odds ratio (OR): 2.46, p = 0.042 and OR: 7.44, p < 0.001, respectively]. Atropine use with DSE increased the odds of achieving THR (OR: 3.76, p = 0.006). In conclusion, pharmacological stress testing appears to be superior to exercise stress testing in achieving THR among patients on beta-adrenergic blockade.

  12. Emergency exercise methodology

    SciTech Connect

    Klimczak, C.A.

    1993-01-01

    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.

  13. Basic life support knowledge of secondary school students in cardiopulmonary resuscitation training using a song

    PubMed Central

    Fonseca del Pozo, Francisco Javier; Canales Velis, Nancy Beatriz; Andrade Barahona, Mario Miguel; Siggers, Aidan; Lopera, Elisa

    2016-01-01

    Objectives To examine the effectiveness of a “cardiopulmonary resuscitation song” in improving the basic life support skills of secondary school students. Methods This pre-test/post-test control design study enrolled secondary school students from two middle schools randomly chosen in Córdoba, Andalucia, Spain. The study included 608 teenagers. A random sample of 87 students in the intervention group and 35 in the control group, aged 12-14 years were selected. The intervention included a cardiopulmonary resuscitation song and video. A questionnaire was conducted at three-time points: pre-intervention, one month and eight months post-intervention. Results On global knowledge of cardiopulmonary resuscitation, there were no significant differences between the intervention group and the control group in the trial pre-intervention and at the month post-intervention. However, at 8 months there were significant differences with a p-value = 0.000 (intervention group, 95% CI: 6.39 to 7.13 vs. control group, 95% CI: 4.75 to 5.92), (F (1,120)=16.644, p= 0.000). In addition, significant differences about students’ basic life support knowledge about chest compressions at eight months post-intervention (F(1,120)=15.561, p=0.000) were found. Conclusions Our study showed that incorporating the song component in the cardiopulmonary resuscitation teaching increased its effectiveness and the ability to remember the cardiopulmonary resuscitation algorithm. Our study highlights the need for different methods in the cardiopulmonary resuscitation teaching to facilitate knowledge retention and increase the number of positive outcomes after sudden cardiac arrest. PMID:27442599

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

    PubMed

    Smith, R A; Biddle, S J

    1999-04-01

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

  15. Mathematical analysis of the heart rate performance curve during incremental exercise testing.

    PubMed

    Rosic, G; Pantovic, S; Niciforovic, J; Colovic, V; Rankovic, V; Obradovic, Z; Rosic, Mirko

    2011-03-01

    In this study we performed laboratory treadmill protocols of increasing load. Heart rate was continuously recorded and blood lactate concentration was measured for determination of lactate threshold by means of LTD-max and LT4.0 methods.Our results indicate that the shape of heart rate performance curve (HRPC) during incremental testing depends on the applied exercise protocol (change of initial speed and the step of running speed increase, with the constant stage duration). Depending on the applied protocol, the HRPC can be described by linear, polynomial (S-shaped), and exponential mathematical expression.We presented mathematical procedure for estimation of heart rate threshold points at the level of LTD-max and LT4.0, by means of exponential curve and its relative deflection from the initial trend line (tangent line to exponential curve at the point of starting heart rate). The relative deflection of exponential curve from the initial trend line at the level of LTD-max and/or LT4.0 can be defined, based on the slope of the initial trend line. Using originally developed software that allows mathematical analysis of heart rate-load relation, LTD-max and/or LT4.0 can be estimated without direct measurement of blood lactate concentration.

  16. Aerobic exercise attenuates blood pressure reactivity to cold pressor test in normotensive, young adult African-American women.

    PubMed

    Bond, V; Mills, R M; Caprarola, M; Vaccaro, P; Adams, R G; Blakely, R; Roltsch, M; Hatfield, B; Davis, G C; Franks, B D; Fairfax, J; Banks, M

    1999-01-01

    Exaggerated blood pressure reactivity to behavioral stress has been observed in the African-American population, and such a pressor response is believed to play a role in hypertension. Regular aerobic exercise has been shown to exert an anti-hypertensive effect, and this may alter the blood pressure hyperreactivity observed in African Americans. To test the hypothesis that aerobic exercise attenuates pressor reactivity in African Americans, we studied eight healthy aerobically-trained normotensive African-American females and five similar sedentary females. The stress stimuli consisted of the cold pressor test with the foot immersed in ice water for two minutes. The aerobic exercise training protocol consisted of six weeks of jogging at 60-70% of peak oxygen uptake (VO2peak), three days/week for 35 min/exercise session. Systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, heart rate, cardiac output, total peripheral resistance, and forearm blood flow were measured. Manifestation of a training effect was illustrated by a 24.1 +/- 0.2% increase in VO2peak (26.9 +/- 1.2 mL x kg(-1) min(-1) vs 35.4 +/- 1.6 mL x kg(-1) min(-1)) (P<.05). Within the exercise-trained group there was a 6.3 +/- .15% decrease in systolic pressure (129 +/- 4.6 mm Hg vs. 121 +/- 5.4 mm Hg) (P<.05), and a 5.0 +/- .05% decrement in mean arterial blood pressure (99 +/- 3.3 mm Hg vs 94 +/- 3.6 mm Hg) (P<.05) during the cold pressor test. Pressor reactivity to cold stress did not change in the untrained group. Measures of heart rate, cardiac output, total peripheral resistance, and forearm blood flow were unaltered during conditions of the cold pressor test. We conclude that aerobic exercise attenuates the blood pressure reactivity to behavioral stress in young, adult normotensive African-American females. A lifestyle change such as exercising may play a role in reducing the risk of hypertension in African-American women. PMID:10355479

  17. A Snapshot of Coagulopathy After Cardiopulmonary Bypass.

    PubMed

    Höfer, Judith; Fries, Dietmar; Solomon, Cristina; Velik-Salchner, Corinna; Ausserer, Julia

    2016-09-01

    Cardiac surgery involving cardiopulmonary bypass (CPB) is often associated with important blood loss, allogeneic blood product usage, morbidity, and mortality. Coagulopathy during CPB is complex, and the current lack of uniformity for triggers and hemostatic agents has led to a wide variability in bleeding treatment. The aim of this review is to provide a simplified picture of the data available on patients' coagulation status at the end of CPB in order to provide relevant information for the development of tailored transfusion algorithms. A nonsystematic literature review was carried out to identify changes in coagulation parameters during CPB. Both prothrombin time and activated partial thromboplastin time increased during CPB, by a median of 33.3% and 17.9%, respectively. However, there was marked variability across the published studies, indicating these tests may be unreliable for guiding hemostatic therapy. Some thrombin generation (TG) parameters were affected, as indicated by a median increase in TG lag time of 55.0%, a decrease in TG peak of 17.5%, and only a slight decrease in endogenous thrombin potential of 7%. The most affected parameters were fibrinogen levels and platelet count/function. Both plasma fibrinogen concentration and FIBTEM maximum clot firmness decreased during CPB (median change of 36.4% and 33.3%, respectively) as did platelet count (44.5%) and platelet component (34.2%). This review provides initial information regarding changes in coagulation parameters during CPB but highlights the variability in the reported results. Further studies are warranted to guide physicians on the parameters most appropriate to guide hemostatic therapy.

  18. A Snapshot of Coagulopathy After Cardiopulmonary Bypass.

    PubMed

    Höfer, Judith; Fries, Dietmar; Solomon, Cristina; Velik-Salchner, Corinna; Ausserer, Julia

    2016-09-01

    Cardiac surgery involving cardiopulmonary bypass (CPB) is often associated with important blood loss, allogeneic blood product usage, morbidity, and mortality. Coagulopathy during CPB is complex, and the current lack of uniformity for triggers and hemostatic agents has led to a wide variability in bleeding treatment. The aim of this review is to provide a simplified picture of the data available on patients' coagulation status at the end of CPB in order to provide relevant information for the development of tailored transfusion algorithms. A nonsystematic literature review was carried out to identify changes in coagulation parameters during CPB. Both prothrombin time and activated partial thromboplastin time increased during CPB, by a median of 33.3% and 17.9%, respectively. However, there was marked variability across the published studies, indicating these tests may be unreliable for guiding hemostatic therapy. Some thrombin generation (TG) parameters were affected, as indicated by a median increase in TG lag time of 55.0%, a decrease in TG peak of 17.5%, and only a slight decrease in endogenous thrombin potential of 7%. The most affected parameters were fibrinogen levels and platelet count/function. Both plasma fibrinogen concentration and FIBTEM maximum clot firmness decreased during CPB (median change of 36.4% and 33.3%, respectively) as did platelet count (44.5%) and platelet component (34.2%). This review provides initial information regarding changes in coagulation parameters during CPB but highlights the variability in the reported results. Further studies are warranted to guide physicians on the parameters most appropriate to guide hemostatic therapy. PMID:27268940

  19. Cardiopulmonary Resuscitation and Older Adults' Expectations.

    ERIC Educational Resources Information Center

    Godkin, M. Dianne; Toth, Ellen L.

    1994-01-01

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

  20. Simplified exercise test for the initial differential diagnosis of Pneumocystis carinii pneumonia in HIV antibody positive patients.

    PubMed Central

    Sauleda, J.; Gea, J.; Aran, X.; Aguar, M. C.; Orozco-Levi, M.; Broquetas, J. M.

    1994-01-01

    BACKGROUND--This study was designed to evaluate the usefulness of a simplified exercise test in the differential diagnosis of Pneumocystis carinii pneumonia (PCP). METHODS--Forty five subjects with antibodies against the human immunodeficiency virus (HIV) and pneumonia were included and divided into two groups: those with PCP and those with "other pneumonias" (non-PCP). The test involved pedalling for two minutes on a stretcher bed and was considered positive if SaO2 decreased by at least 3%. RESULTS--During the exercise the mean(SE) SaO2 fell in patients with PCP from 88(4)% to 84(3)%, p < 0.01, whilst it improved slightly in subjects with non-PCP from 91(1)% to 93(3)%, p < 0.05. Sensitivity was 77% and specificity 91%. CONCLUSIONS--This simple test seems potentially useful for the initial investigation of HIV antibody positive patients with pneumonia. PMID:8128398

  1. Reliability of an incremental exercise test to evaluate acute blood lactate, heart rate and body temperature responses in Labrador retrievers.

    PubMed

    Ferasin, Luca; Marcora, Samuele

    2009-10-01

    Thirteen healthy Labrador retrievers underwent a 5-stage incremental treadmill exercise test to assess its reliability. Blood lactate (BL), heart rate (HR), and body temperature (BT) were measured at rest, after each stage of exercise, and after a 20-min recovery. Reproducibility was assessed by repeating the test after 7 days. Two-way MANOVAs revealed significant differences between consecutive stages, and between values at rest and after recovery. There was also a significant reduction in physiological strain between the first and second trial (learning effect). Test reliability expressed as typical error (BL = 0.22 mmol/l, HR = 9.81 bpm, BT = 0.22 degrees C), coefficient of variation (BL = 19.3%, HR = 7.9% and BT = 0.6%) and test-retest correlation (BL = 0.89, HR = 0.96, BT = 0.95) was good. Results support test reproducibility although the learning effect needs to be controlled when investigating the exercise-related problems commonly observed in this breed.

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

    SciTech Connect

    Tilkemeier, P.L.; Guiney, T.E.; LaRaia, P.J.; Boucher, C.A. )

    1990-11-15

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

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

    PubMed Central

    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

    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

  4. Evidence of anaerobic metabolism during low-level exercise testing in high-risk postmyocardial infarction patients.

    PubMed

    Hossack, K F; Wolfel, E

    1988-03-01

    Low-level exercise testing was performed on 31 patients 7.4 +/- 2.7 days following an acute myocardial infarction. Measurements of oxygen consumption (VO2) and arterial serum lactate were made at rest and during exercise in these patients and 15 normal subjects. The patients were subdivided into finishers (F) and nonfinishers (NF) of the low-level protocol. The NF group had 2.5 +/- 6 stenosed vessels and an ejection fraction of 44 +/- 11% compared to F subjects, who had 1.4 +/- 1 vessels stenosed (p less than .001) and an ejection fraction of 54 +/- 14% (p less than .05). Finishers had significantly higher VO2 than the nonfinishers (14.5 +/- 2.5 ml/kg/min vs. 11.2 +/- 3.5 ml/kg/min p less than .01). At the end of exercise serum lactate level was 1.18 +/- .59 mM in normals, 1.43 +/- .52 mM in finishers, and 2.15 +/- .9 mM in nonfinishers. The change in serum lactate from rest to end exercise divided by the change in VO2 from rest to end exercise was .039 +/- .038 mM/ml kg per min in normals, .075 +/- .045 mM/ml kg per min in finishers (p less than .03 vs. normal), and .210 +/- .189 mM/ml kg per min for nonfinishers (p less than .001 vs. normal). These results indicate that nonfinishers produce more lactate and use less oxygen during low-level exercise, suggesting that working muscles are deriving energy by anaerobic metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. 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...

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

    PubMed

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

    2015-08-01

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

  7. Brain microvascular function during cardiopulmonary bypass

    SciTech Connect

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

    1987-11-01

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

  8. Cardiopulmonary Function and Age-Related Decline Across the Breast Cancer Survivorship Continuum

    PubMed Central

    Jones, Lee W.; Courneya, Kerry S.; Mackey, John R.; Muss, Hyman B.; Pituskin, Edith N.; Scott, Jessica M.; Hornsby, Whitney E.; Coan, April D.; Herndon, James E.; Douglas, Pamela S.; Haykowsky, Mark

    2012-01-01

    Purpose To evaluate cardiopulmonary function (as measured by peak oxygen consumption [VO2peak]) across the breast cancer continuum and its prognostic significance in women with metastatic disease. Patients and Methods Patients with breast cancer representing four cross-sectional cohorts—that is, (1) before, (2) during, and (3) after adjuvant therapy for nonmetastatic disease, and (4) during therapy in metastatic disease—were studied. A cardiopulmonary exercise test (CPET) with expired gas analysis was used to assess VO2peak. A Cox proportional hazards model was used to estimate the risk of death according to VO2peak category (< 15.4 v ≥ 15.4 mL · kg−1 · min−1) with adjustment for clinical factors. Results A total of 248 women (age, 55 ± 8 years) completed a CPET. Mean VO2peak was 17.8 ± a standard deviation of 4.3 mL · kg−1 · min−1, the equivalent of 27% ± 17% below age-matched healthy sedentary women. For the entire cohort, 32% had a VO2peak less than 15.4 mL · kg−1 · min−1—the VO2peak required for functional independence. VO2peak was significantly different across breast cancer cohorts for relative (mL · kg−1 · min−1) and absolute (L · min−1) VO2peak (P = .017 and P < .001, respectively); VO2peak was lowest in women with metastatic disease. In patients with metastatic disease (n = 52), compared with patients achieving a VO2peak ≤ 1.09 L · min−1, the adjusted hazard ratio for death was 0.32 (95% CI, 0.16 to 0.67, P = .002) for a VO2peak more than 1.09 L · min−1. Conclusion Patients with breast cancer have marked impairment in VO2peak across the entire survivorship continuum. VO2peak may be an independent predictor of survival in metastatic disease. PMID:22614980

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

    PubMed Central

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

    2016-01-01

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

  10. Cardiopulmonary laboratory biomarkers in the evaluation of acute dyspnea

    PubMed Central

    Stokes, Natalie R; Dietz, Brett W; Liang, Jackson J

    2016-01-01

    Dyspnea is a common chief complaint in the emergency department, with over 4 million visits annually in the US. Establishing the correct diagnosis can be challenging, because the subjective sensation of dyspnea can result from a wide array of underlying pathology, including pulmonary, cardiac, neurologic, psychiatric, toxic, and metabolic disorders. Further, the presence of dyspnea is linked with increased mortality in a variety of conditions, and misdiagnosis of the cause of dyspnea leads to poor patient-level outcomes. In combination with the history and physical, efficient, and focused use of laboratory studies, the various cardiopulmonary biomarkers can be useful in establishing the correct diagnosis and guiding treatment decisions in a timely manner. Use and interpretation of such tests must be guided by the clinical context, as well as an understanding of the current evidence supporting their use. This review discusses current standards and research regarding the use of established and emerging cardiopulmonary laboratory markers in the evaluation of acute dyspnea, focusing on recent evidence assessing the diagnostic and prognostic utility of various tests. These markers include brain natriuretic peptide (BNP) and N-terminal prohormone (NT-proBNP), mid-regional peptides proatrial NP and proadrenomedullin, cardiac troponins, D-dimer, soluble ST2, and galectin 3, and included is a discussion on the use of arterial and venous blood gases. PMID:27307771

  11. The construct and longitudinal validity of the basketball exercise simulation test.

    PubMed

    Scanlan, Aaron T; Dascombe, Ben J; Reaburn, Peter R J

    2012-02-01

    The purpose of this study was to assess the validity of the recently developed Basketball Exercise Simulation Test (BEST). Ten semiprofessional (age, 22.7 ± 6.1 years; height, 189.6 ± 9.5 cm; weight, 86.5 ± 18.7 kg; % body fat, 14.7 ± 3.5%) and 10 recreational (age, 26.6 ± 4.0 years; height, 185.9 ± 7.9 cm; weight, 92.6 ± 8.4 kg; % body fat, 23.8 ± 6.3%) male basketball players volunteered for the study. The participants completed a Yo-Yo Intermittent Recovery Test (Yo-Yo IRT) and BEST trial midway through the playing season. Eight participants (semiprofessional, n = 4; recreational, n = 4) completed an additional Yo-Yo IRT and BEST trial at the end of the playing season. Performance measures from the BEST included sprint decrement (%), mean sprint and circuit time (seconds), and total distance covered (m). Construct validity was calculated using Student's unpaired t-tests to identify the differences in Yo-Yo IRT and BEST performances between playing levels. Longitudinal validity was determined based on the relationship between changes (%) in Yo-Yo IRT1 and BEST performances across the season. Semiprofessional players performed significantly (p < 0.01) better in the Yo-Yo IRT (1,283 ± 62 vs. 636 ± 297 m) and BEST (mean sprint time: 1.45 ± 0.01 vs. 1.65 ± 0.03 seconds; mean circuit time: 18.98 ± 1.79 vs. 22.72 ± 2.01 seconds; sprint decrement: 8.54 ± 0.15 vs. 15.38 ± 0.27%) compared with recreational players. For the group as a whole, a strong relationship was evident between the changes in BEST sprint decrement and changes in Yo-Yo IRT performance (R = -0.815, p = 0.014) across the season. In conclusion, the BEST displayed both discriminative and longitudinal validities and provides a novel match-specific fitness test for basketball players.

  12. Exercise: Benefits of Exercise

    MedlinePlus

    ... version of this page please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You ... activity campaign from the National Institute on Aging. Exercise or Physical Activity? Some people may wonder what ...

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

    NASA Technical Reports Server (NTRS)

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

    1973-01-01

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

  14. Right Ventricular Mass is Associated with Exercise Capacity in Adults with Repaired Tetralogy of Fallot.

    PubMed

    O'Meagher, Shamus; Seneviratne, Martin; Skilton, Michael R; Munoz, Phillip A; Robinson, Peter J; Malitz, Nathan; Tanous, David J; Celermajer, David S; Puranik, Rajesh

    2015-08-01

    The relationship between exercise capacity and right ventricular (RV) structure and function in adult repaired tetralogy of Fallot (TOF) is poorly understood. We therefore aimed to examine the relationships between cardiac MRI and cardiopulmonary exercise test variables in adult repaired TOF patients. In particular, we sought to determine the role of RV mass in determining exercise capacity. Eighty-two adult repaired TOF patients (age at evaluation 26 ± 10 years; mean age at repair 2.5 ± 2.8 years; 23.3 ± 7.9 years since repair; 53 males) (including nine patients with tetralogy-type pulmonary atresia with ventricular septal defect) were prospectively recruited to undergo cardiac MRI and cardiopulmonary exercise testing. As expected, these repaired TOF patients had RV dilatation (indexed RV end-diastolic volume: 153 ± 43.9 mL/m(2)), moderate-severe pulmonary regurgitation (pulmonary regurgitant fraction: 33 ± 14 %) and preserved left (LV ejection fraction: 59 ± 8 %) and RV systolic function (RV ejection fraction: 51 ± 7 %). Exercise capacity was near-normal (peak work: 88 ± 17 % predicted; peak oxygen consumption: 84 ± 17 % predicted). Peak work exhibited a significant positive correlation with RV mass in univariate analysis (r = 0.45, p < 0.001) and (independent of other cardiac MRI variables) in multivariate analyses. For each 10 g higher RV mass, peak work was 8 W higher. Peak work exhibits a significant positive correlation with RV mass, independent of other cardiac MRI variables. RV mass measured on cardiac MRI may provide a novel marker of clinical progress in adult patients with repaired TOF. PMID:25795311

  15. Negative association between resting blood pressure and chest pain in people undergoing exercise stress testing for coronary artery disease.

    PubMed

    Ditto, Blaine; Lavoie, Kim L; Campbell, Tavis S; Gordon, Jennifer; Arsenault, Andre; Bacon, Simon L

    2010-06-01

    Sustained and acute increases in blood pressure can dampen pain in experimental animals and humans. The most important clinical implication of this relationship may be the phenomenon of silent cardiac ischemia. High blood pressure is common in people at risk for cardiac ischemia and may reduce angina, the key symptom of life-threatening ischemia. The relationship between resting blood pressure and angina was examined in 904 people undergoing exercise stress testing for coronary artery disease. The presence or absence of ischemia was documented with single photon emission computed tomography (SPECT). Participants with ischemia had higher scores on the McGill Pain Questionnaire (MPQ) following exercise though this was moderated significantly by diastolic blood pressure (DBP), especially in women. People with higher pre-exercise resting DBP who displayed SPECT-diagnosed ischemia had MPQ scores comparable to people who did not display ischemia, independent of age, exercise duration, medication, and cardiac history. Awareness of the potential association between blood pressure and angina may provide patients with coronary artery disease and their physicians' important guidance.

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    PubMed

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

    2013-10-01

    To assess the occurrence of tidal expiratory flow limitation (EFL) and/or dynamic pulmonary hyperinflation (DH) in chronic heart failure (CHF) during exercise 15 patients with stable systolic CHF, aged 69 ± 6yr, underwent pulmonary function testing and incremental cardio-pulmonary exercise testing. They subsequently performed constant load exercise testing at 30, 60 and 90% of respective maximum workload. At each step the presence of EFL, by negative expiratory pressure technique, and changes in inspiratory capacity (IC) were assessed. Ejection fraction amounted to 36 ± 6% and VO₂, peak (77 ± 19% pred.) was reduced. EFL was absent at any step during constant load exercise. In 6 patients IC decreased more than 10% pred. at highest step. Only in these patients TLC, FRC, RV FEF(25-75%) and DL(CO) were decreased at rest. VO₂, peak correlated with DL(CO), TLC and IC at rest and with IC (r(2)=0.59; p<0.001) and decrease in IC (r(2)=0.44; p<0.001) at 90% of maximum workload. During exercise CHF patients do not exhibit EFL, but some of them develop DH that is associated with lower VO₂, peak.

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

    PubMed

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

    2013-10-01

    To assess the occurrence of tidal expiratory flow limitation (EFL) and/or dynamic pulmonary hyperinflation (DH) in chronic heart failure (CHF) during exercise 15 patients with stable systolic CHF, aged 69 ± 6yr, underwent pulmonary function testing and incremental cardio-pulmonary exercise testing. They subsequently performed constant load exercise testing at 30, 60 and 90% of respective maximum workload. At each step the presence of EFL, by negative expiratory pressure technique, and changes in inspiratory capacity (IC) were assessed. Ejection fraction amounted to 36 ± 6% and VO₂, peak (77 ± 19% pred.) was reduced. EFL was absent at any step during constant load exercise. In 6 patients IC decreased more than 10% pred. at highest step. Only in these patients TLC, FRC, RV FEF(25-75%) and DL(CO) were decreased at rest. VO₂, peak correlated with DL(CO), TLC and IC at rest and with IC (r(2)=0.59; p<0.001) and decrease in IC (r(2)=0.44; p<0.001) at 90% of maximum workload. During exercise CHF patients do not exhibit EFL, but some of them develop DH that is associated with lower VO₂, peak. PMID:23851110

  19. Use of Geophysical and Remote Sensing Techniques During the Comprehensive Test Ban Treaty Organization's Integrated Field Exercise 2014

    NASA Astrophysics Data System (ADS)

    Labak, Peter; Sussman, Aviva; Rowlands, Aled; Chiappini, Massimo; Malich, Gregor; MacLeod, Gordon; Sankey, Peter; Sweeney, Jerry; Tuckwell, George

    2016-04-01

    The Integrated Field Exercise of 2014 (IFE14) was a field event held in the Hashemite Kingdom of Jordan (with concurrent activities in Austria) that tested the operational and technical capabilities of a Comprehensive Test Ban Treaty's (CTBT) on-site inspection (OSI). During an OSI, up to 40 inspectors search a 1000km2 inspection area for evidence of a nuclear explosion. Over 250 experts from ~50 countries were involved in IFE14 (the largest simulation of an OSI to date) and worked from a number of different directions, such as the Exercise Management and Control Teams to execute the scenario in which the exercise was played, to those participants performing as members of the Inspection Team (IT). One of the main objectives of IFE14 was to test Treaty allowed inspection techniques, including a number of geophysical and remote sensing methods. In order to develop a scenario in which the simulated exercise could be carried out, a number of physical features in the IFE14 inspection area were designed and engineered by the Scenario Task Force Group (STF) that the IT could detect by applying the geophysical and remote sensing inspection technologies, as well as other techniques allowed by the CTBT. For example, in preparation for IFE14, the STF modeled a seismic triggering event that was provided to the IT to prompt them to detect and localize aftershocks in the vicinity of a possible explosion. Similarly, the STF planted shallow targets such as borehole casings and pipes for detection by other geophysical methods. In addition, airborne technologies, which included multi-spectral imaging, were deployed such that the IT could identify freshly exposed surfaces, imported materials and other areas that had been subject to modification. This presentation will introduce the CTBT and OSI, explain the IFE14 in terms of goals specific to geophysical and remote sensing methods, and show how both the preparation for and execution of IFE14 meet those goals.

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

    PubMed

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

    2010-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1995-09-01

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

  2. The relationship of treadmill test performance to blood pressure and other cardiovascular risk factors in adolescents.

    PubMed

    Gillum, R F

    1989-07-01

    Associations between treadmill test performance, blood pressure, and other cardiovascular risk factors in over 6000 adolescents, aged 12 to 17 years, were examined with data from the third cycle of the National Health Examination Survey. Exercise tolerance was measured by a 5-minute submaximal treadmill test. Estimated VO2 increased with age in boys but decreased with age in girls. VO2 was higher in boys than girls and similar in black and white subjects. Exercise heart rate was significantly correlated with blood pressure in white boys and girls and with obesity in white and black persons. A small but significant association between exercise heart rate and systolic blood pressure was demonstrated in white boys and girls independent of age and obesity. Aerobic exercise may be useful in adolescents for prevention of adult hypertension by means of obesity control and improved cardiopulmonary fitness.

  3. Changes in exercise capacity induced by heart transplantation: prognostic and therapeutic implications.

    PubMed

    Grigioni, F; Specchia, S; Maietta, P; Potena, L; Bacchi-Reggiani, M L; Ghetti, G; Boriani, G; Foschi, E; Corazza, I; Ionico, T; Magnani, G; Zannoli, R; Tentoni, C; Branzi, A

    2011-08-01

    Survival and exercise performance are key targets of heart transplantation (HT). We designed this study to help in identifying (1) patients with chronic heart failure (CHF) at risk of poor exercise capacity after HT and (2) HT recipients presenting risk factors modifiable with exercise showing a potential impact on outcome. We enrolled 49 HT recipients (age 52 ± 12 years, 84% males) who underwent a cardiopulmonary exercise test before (9 ± 6 months) and after (20 ± 14 months) HT. In the CHF phase, lower peak oxygen consumption (VO(2) ) (odds ratio 0.69, P=0.017) independently predicted peak VO(2) improvement after HT. In the post-HT phase, body mass index (BMI) [adjusted hazard ratio (HR) 1.16, P=0.034] and VE (ventilation)/VCO(2) (carbon dioxide production) slope (adjusted HR 1.07, P=0.031) independently predicted mortality. In conclusion, CHF patients with only a moderate impairment of peak VO(2) are at a risk of failing to achieve a significant improvement of exercise performance after HT. In the post-HT phase, a BMI≥28 and/or a VE/VCO(2) slope ≥47 represent risk factors for death, which are potentially modifiable with exercise. Prospective randomized studies are needed to analyze the effects of training on functional capacity and outcome in the different subsets of HT recipients.

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

    NASA Technical Reports Server (NTRS)

    Sandoval, Darleen A.; Matt, Kathleen S.

    2003-01-01

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

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

    PubMed

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

    2011-10-01

    Maximal oxygen uptake (VO(2max)) can be predicted by fixed-rate step tests. However, it remains to be analyzed as to what exercise intensities are reached during such tests to address medical safety. In this study, we compared the physiological response to a standardized fixed-rate step test with maximal cardiopulmonary exercise testing (CPET). One hundred and thirteen healthy adults executed a maximal CPET on bike, followed by a standardized fixed-rate step test 1 week later. During these tests, heart rate (HR) and VO(2) were monitored continuously. From the maximal CPET, the ventilatory threshold (VT) was calculated. Next, the physiological response between maximal CPET and step testing was compared. The step test intensity was 85 ± 24% CPET VO(2max) and 88 ± 11% CPET HR(max) (VO(2max) and HR(max) were significantly different between CPET and step testing; p < 0.01). In 41% of the subjects, step test exercise intensities >95% CPET VO(2max) were noted. A greater step testing exercise intensity (%CPET VO(2max)) was independently related to higher body mass index, and lower body height, exercise capacity (p < 0.05). Standardized fixed-rate step tests elicit vigorous exercise intensities, especially in small, obese, and/or physically deconditioned subjects. Medical supervision might therefore be required during these tests.

  6. The effects of nitroglycerin during cardiopulmonary resuscitation.

    PubMed

    Stefaniotou, Antonia; Varvarousi, Giolanda; Varvarousis, Dimitrios P; Xanthos, Theodoros

    2014-07-01

    The outcome for both in-hospital and out-of hospital cardiac arrest remains dismal. Vasopressors are used to increase coronary perfusion pressure and thus facilitate return of spontaneous circulation during cardiopulmonary resuscitation. However, they are associated with a number of potential adverse effects and may decrease endocardial and cerebral organ blood flow. Nitroglycerin has a favourable haemodynamic profile which promotes forward blood flow. Several studies suggest that combined use of nitroglycerin with vasopressors during resuscitation, is associated with increased rates of resuscitation and improved post-resuscitation outcome. This article reviews the effects of nitroglycerin during cardiopulmonary resuscitation and postresuscitation period, as well as the beneficial outcomes of a combination regimen consisting of a vasopressor and a vasodilator, such as nitroglycerin.

  7. Practical aspects of advanced paediatric cardiopulmonary resuscitation.

    PubMed

    Tibballs, J

    1988-08-01

    Successful cardiopulmonary resuscitation in the paediatric age group necessitates the acquisition of technical skills for rapid tracheal intubation, external cardiac compression and access to the circulation. Skills and equipment must be adapted to each age group. For optimal mechanical ventilation and the avoidance of complications, correct selection of endotracheal tube diameter and length is necessary. New techniques in resuscitation incorporate an understanding of the mechanism of blood flow during cardiac compression, the use of the intratracheal route for drug administration, and a revision of the use of catecholamines, sodium bicarbonate and calcium solutions in the treatment of asystole-bradycardia, electromechanical dissociation, ventricular fibrillation and tachycardia. Early intubation, adequate ventilation with oxygen, well performed external cardiac compression, prompt defibrillation and administration of adrenaline remain the cornerstones of advanced cardiopulmonary resuscitation. PMID:3064747

  8. [Clinical relevance of cardiopulmonary reflexes in anesthesiology].

    PubMed

    Guerri-Guttenberg, R A; Siaba-Serrate, F; Cacheiro, F J

    2013-10-01

    The baroreflex, chemoreflex, pulmonary reflexes, Bezold-Jarisch and Bainbridge reflexes and their interaction with local mechanisms, are a demonstration of the richness of cardiovascular responses that occur in human beings. As well as these, the anesthesiologist must contend with other variables that interact by attenuating or accentuating cardiopulmonary reflexes such as, anesthetic drugs, surgical manipulation, and patient positioning. In the present article we review these reflexes and their clinical relevance in anesthesiology.

  9. Comparison of Nottingham Health Profile (NHP) scores with exercise duration and measures of ischaemia during treadmill exercise testing in patients with coronary artery disease.

    PubMed

    Skinner, J S; Albers, C J; Hall, R J; Adams, P C

    1995-11-01

    A cross-sectional study of patients with stable coronary artery disease was performed to compare perceived health status with the results of a treadmill exercise test. One hundred and twenty one patients, mean age 55.07 years, 106 male, who had all suffered a myocardial infarction under the age of 56 years, up to 9 years earlier were studied. Perceived health status was assessed using the Nottingham Health Profile, part 1 of which assesses six dimensions of normal living, and part 2 seven areas of daily life. Nottingham Health Profile scores were higher (worse perceived health status) in patients with poor treadmill exercise capacity within all dimensions of part 1 (energy, pain, physical mobility P < 0.001, emotional reactions, sleep P < 0.01, social isolation P < 0.05) and most of those within part 2 (care of home, taking holidays P < 0.001, hobbies P < 0.01, relationships at home, sex life P < 0.05). The perceived health status of patients without a history of angina is significantly better than those with angina (pain, physical mobility P < 0.001, energy, emotional reactions, social isolation P < 0.01, sleep P < 0.05, within part 1, taking holidays P < 0.01, care of the home, social life, sex life, hobbies P < 0.05, within part 2). Thus, patients with a poor perceived health status, also have poorer results using more conventional clinical measures of coronary artery disease. The Nottingham Health Profile may be a useful adjunct in patient assessment. PMID:8881848

  10. Chronotropic incompetence can limit exercise tolerance in COPD patients with lung hyperinflation

    PubMed Central

    Hulo, Sébastien; Inamo, Jocelyn; Dehon, Aurélie; Le Rouzic, Olivier; Edme, Jean-Louis; Neviere, Remi

    2016-01-01

    Purpose Metabolic-chronotropic relationship is the only concept that assesses the entire chronotropic function during exercise, as it takes into account individual fitness. To better understand interrelationships between chronotropic incompetence (CI), dynamic hyperinflation (DH) and exercise limitation among Global initiative for chronic Obstructive Lung Disease (GOLD) stages of chronic obstructive pulmonary disease (COPD) disease severity, we evaluated cardiopulmonary responses to symptom-limited cycle exercise in stable patients. Patients and methods We prospectively studied 47 COPD patients classified by GOLD stage severity. Pulmonary function tests and cardiopulmonary responses to symptom-limited incremental exercise were studied. CI was defined by regression line between percent heart rate (HR) reserve and percent oxygen uptake (V’O2) reserve, ie, chronotropic-metabolic index (CMI). DH was defined from the knot resulting from the nonlinear regressions of inspiratory capacity changes from rest to peak (dynamic inspiratory capacity (ICdyn)) with percentage of maximal HR and CMI. Results Aerobic capacity (median interquartile ranges) peak V’O2, 24.3 (23.6; 25.2), 18.5 (15.5; 21.8), 17.5 (15.4; 19.1) mL·kg−1·min−1 and CMI worsened according to GOLD severity. The optimal knot of ICdyn was equal to −0.34 L. The multivariate logistic regression showed a strong relationship between CI (outcome) and DH (odds ratio [confidence interval 95]) 25 (3.5; 191.6). Conclusion COPD patients with DH have a poor cardiovascular response to exercise, which may be attributed to CI. PMID:27799755

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

    ERIC Educational Resources Information Center

    Flint, Steve; Stewart, Terry

    2010-01-01

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

  12. Using Software Testing Techniques for Efficient Handling of Programming Exercises in an e-Learning Platform

    ERIC Educational Resources Information Center

    Schwieren, Joachim; Vossen, Gottfried; Westerkamp, Peter

    2006-01-01

    e-Learning has become a major field of interest in recent years, and multiple approaches and solutions have been developed. A typical form of e-learning application comprises exercise submission and assessment systems that allow students to work on assignments whenever and where they want (i.e., dislocated, asynchronous work). In basic computer…

  13. Cardiopulmonary changes during clarinet playing.

    PubMed

    Hahnengress, Maria L; Böning, Dieter

    2010-12-01

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

  14. Value of leads V4R and CM5 in the detection of coronary artery disease during exercise electrocardiographic test.

    PubMed

    Puurtinen, Merja; Nieminen, Tuomo; Kähönen, Mika; Lehtimäki, Terho; Lehtinen, Rami; Nikus, Kjell; Hyttinen, Jari; Viik, Jari

    2010-07-01

    The usefulness of the right precordial unipolar leads and the value of the bipolar lead CM5 in the detection of coronary artery disease (CAD) with exercise electrocardiographic (ECG) test are not well documented. The objective of this study was to evaluate the diagnostic performance of leads V4R and CM5. The study population comprised 579 patients referred for a bicycle exercise ECG test in the Finnish Cardiovascular Study. Patients were divided into three groups: angiographically proven CAD (CAD, n = 255), no CAD by angiography (NoCAD, n = 126), and low likelihood of CAD (LLC, n = 198). The maximum ST-segment depression at peak exercise was used as a parameter, and the diagnostic accuracy of different leads was assessed by receiver operating characteristic (ROC) analysis. Sensitivity and specificity values at a cut-off criterion of -0.10 mV ST-segment, 1-mm ST depression, were determined. According to the results, incorporating lead V4R with the standard leads decreased the ROC area from 0.71 to 0.69 (comparison CAD versus LLC) and from 0.55 to 0.53 (comparison CAD versus NoCAD) and had no effect on sensitivity or specificity. Adding lead CM5 to the standard leads did not affect the ROC area but increased the sensitivity and decreased the specificity. In conclusion, the use of right precordial lead V4R along with the standard 12-lead system does not improve the performance of the exercise ECG in diagnosing CAD. Adding lead CM5 to the standard leads increases the sensitivity but does not change the overall diagnostic performance. PMID:20497446

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  16. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4350 Cardiopulmonary...-heart surgery. (b) Classification. Class II (special controls). The special control for this device...

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Costa, D L; Dreher, K L

    1997-01-01

    Many epidemiologic reports associate ambient levels of particulate matter (PM) with human mortality and morbidity, particularly in people with preexisting cardiopulmonary disease (e.g., chronic obstructive pulmonary disease, infection, asthma). Because much ambient PM is derived from combustion sources, we tested the hypothesis that the health effects of PM arise from anthropogenic PM that contains bioavailable transition metals. The PM samples studied derived from three emission sources (two oil and one coal fly ash) and four ambient airsheds (St. Louis, MO; Washington; Dusseldorf, Germany; and Ottawa, Canada). PM was administered to rats by intratracheal instillation in equimass or equimetal doses to address directly the influence of PM mass versus metal content on acute lung injury and inflammation. Our results indicated that the lung dose of bioavailable transition metal, not instilled PM mass, was the primary determinant of the acute inflammatory response for both the combustion source and ambient PM samples. Residual oil fly ash, a combustion PM rich in bioavailable metal, was evaluated in a rat model of cardiopulmonary disease (pulmonary vasculitis/hypertension) to ascertain whether the disease state augmented sensitivity to that PM. Significant mortality and enhanced airway responsiveness were observed. Analysis of the lavaged lung fluids suggested that the milieu of the inflamed lung amplified metal-mediated oxidant chemistry to jeopardize the compromised cardiopulmonary system. We propose that soluble metals from PM mediate the array of PM-associated injuries to the cardiopulmonary system of the healthy and at-risk compromised host. PMID:9400700

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

    PubMed Central

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

    2014-01-01

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

  20. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical... cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery...

  1. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical... cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery...

  2. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical... cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery...

  3. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical... cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery...

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

    PubMed Central

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

    2003-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Naifeh, K.

    1985-01-01

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

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

    PubMed

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

    2015-06-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  9. A Prospective Randomized Trial of Moderately Strenuous Aerobic Exercise After an Implantable Cardioverter Defibrillator (ICD)

    PubMed Central

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

    2015-01-01

    Background Despite its salutary effects on health, aerobic exercise is often avoided after receipt of an implantable cardioverter-defibrillator (ICD) because of fears that exercise may provoke acute arrhythmias. We prospectively evaluated the effects of a home aerobic exercise training and maintenance program (EX) on aerobic performance, ICD shocks and hospitalizations exclusively in ICD recipients. Methods and Results One hundred sixty (124 men, 36 women) were randomized who had an ICD for primary (43%) or secondary (57%) prevention to EX or usual care (UC). The primary outcome was peak oxygen consumption (peakVO2), measured with cardiopulmonary exercise testing at baseline, 8 and 24 weeks. EX consisted of 8 weeks of home walking 1 hour/day, 5 days/week at 60-80% of heart rate reserve, followed by 16 weeks of maintenance home walking for 150 minutes/week. Adherence to EX was determined from exercise logs, ambulatory HR recordings of exercise, and weekly telephone contacts. UC received no exercise directives and were monitored by monthly telephone contact. Adverse events were identified by ICD interrogations, patient reports and medical records. ICD recipients averaged 55±12 years and mean ejection fraction of 40.6±15.7, all were taking beta blocker medications. EX significantly increased peakVO2 ml/kg/min (EX 26.7±7.0; UC 23.9±6.6, p=0.002) at 8 weeks, which persisted during maintenance exercise at 24 weeks (EX 26.9±7,7; UC 23.4±6.0, p<0.001). ICD shocks were infrequent (EX=4 vs UC=8), with no differences in hospitalizations or deaths between groups. Conclusions Prescribed home exercise is safe and significantly improves cardiovascular performance in ICD recipients without causing shocks or hospitalizations. PMID:25792557

  10. Age-related upper limits of normal for maximum upright exercise pulmonary haemodynamics.

    PubMed

    Oliveira, Rudolf K F; Agarwal, Manyoo; Tracy, Julie A; Karin, Abbey L; Opotowsky, Alexander R; Waxman, Aaron B; Systrom, David M

    2016-04-01

    The exercise definition of pulmonary hypertension was eliminated from the pulmonary hypertension guidelines in part due to uncertainty of the upper limits of normal (ULNs) for exercise haemodynamics in subjects >50 years old.The present study, therefore, evaluated the pulmonary haemodynamic responses to maximum upright incremental cycling exercise in consecutive subjects who underwent an invasive cardiopulmonary exercise testing for unexplained exertional intolerance, deemed normal based on preserved exercise capacity and normal resting supine haemodynamics. Subjects aged >50 years old (n=41) were compared with subjects ≤50 years old (n=25). ULNs were calculated as mean + 2 sdPeak exercise mean pulmonary arterial pressure was not different for subjects >50 and ≤50 years old (23 ± 5 versus 22 ± 4 mmHg, p=0.22), with ULN of 33 and 30 mmHg, respectively. Peak cardiac output was lower in older subjects (median (interquartile range): 12.1 (9.4-14.2)versus16.2 (13.8-19.2) L·min(-1), p<0.001). Peak pulmonary vascular resistance was higher in older subjects compared with younger subjects (mean ± sd: 1.20 ± 0.45 versus 0.82 ± 0.26 Wood units, p<0.001), with ULN of 2.10 and 1.34 Wood units, respectively.We observed that subjects >50 and ≤ 50 years old have different pulmonary vascular responses to exercise. Older subjects have higher pulmonary vascular resistance at peak exercise, resulting in different exercise haemodynamics ULNs compared with the younger population.

  11. Stress testing predischarge and six weeks after myocardial infarction to compare submaximal and maximal exercise predischarge and to assess the reproducibility of induced abnormalities.

    PubMed

    Handler, C E; Sowton, E

    1985-10-01

    Submaximal and maximal treadmill exercise tests were performed predischarge in 64 patients after acute myocardial infarction to assess the relative yield of residual ischaemic abnormalities. The reproducibility of individual abnormalities resulting from maximal stress tests performed predischarge and 6 weeks after infarction was also assessed in 55 of these patients. Compared with predischarge submaximal exercise testing, a maximal exercise test identified a significantly greater number of patients with residual myocardial ischaemia (26 vs. 15, P less than 0.05) and this was associated with a significantly longer average maximal exercise duration (P less than 0.001), and a higher rate-pressure product (P less than 0.001). Among the 55 patients who had maximal stress tests both predischarge and 6 weeks after infarction, there was a significant lack of reproducibility in the occurrence of exercise induced angina (P less than 0.01) and an abnormal blood pressure response (P less than 0.02). In contrast, exercise induced ST segment depression and elevation and ventricular arrhythmias were relatively reproducible. More patients had an ischaemic test result (ST depression or angina) at the later test compared to the predischarge test (33 vs. 25 patients) but this increase was not statistically significant. There were, however, significant increases at the later test in mean maximal exercise duration (P less than 0.001). mean maximal heart rate (P less than 0.001) and heart rate-systolic blood pressure double product (P less than 0.001). The majority of patients who had a cardiac event in the period between the two tests had a predischarge test abnormality. We conclude that a significantly greater number of patients with residual reversible myocardial ischaemia after infarction will be identified by symptom limited exercise testing compared with a submaximal predischarge test. Because ST depression and elevation appear reproducible, patients who develop these

  12. Exercise training associated with diet improves heart rate recovery and cardiac autonomic nervous system activity in obese children.

    PubMed

    Prado, D M; Silva, A G; Trombetta, I C; Ribeiro, M M; Guazzelli, I C; Matos, L N; Santos, M S; Nicolau, C M; Negrão, C E; Villares, S M

    2010-12-01

    The purpose of this study was to test the hypotheses that in obese children: 1) hypocaloric diet (D) improves both heart rate recovery at 1 min (Δ HRR1) cfter an exercise test, and cardiac autonomic nervous system activity (CANSA) in obese children; 2) Diet and exercise training (DET) combined leads to greater improvement in both Δ HRR1 after an exercise test and in CANSA, than D alone. Moreover, we examined the relationships among Δ HRR1, CANSA, cardiorespiratory fitness and anthropometric variables (AV) in obese children submitted to D and to DET. 33 obese children (10 ± 0.2 years; body mass index (BMI) >95 (th) percentile) were divided into 2 groups: D (n=15; BMI=31 ± 1 kg/m²)) and DET (n=18; 29 ± 1 kg/m²). All children performed a maximal cardiopulmonary exercise test on a treadmill. The Δ HRR1 or LF/HF ratio (P>0.05). In contrast, the DET group showed increased peak VO₂ ( P=0.01) and improved Δ HRR1 (Δ HRR1=37.3 ± 2.6; P=0.01) and LF/HF ratio ( P=0.001). The DET group demonstrated significant relationships among Δ HRR1, peak VO₂ and CANSA (P<0.05). In conclusion, DET, in contrast to D, promoted improved ÄΔ HRR1 and CANSA in obese children, suggesting a positive influence of increased levels of cardiorespiratory fitness by exercise training on cardiac autonomic activity.

  13. Cardiopulmonary data-acquisition system

    NASA Technical Reports Server (NTRS)

    Crosier, W. G.; Reed, R. A.

    1981-01-01

    Computerized system controls and monitors bicycle and treadmill cardiovascular stress tests. It acquires and reduces stress data and displays heart rate, blood pressure, workload, respiratory rate, exhaled-gas composition, and other variables. Data are printed on hard-copy terminal every 30 seconds for quick operator response to patient. Ergometer workload is controlled in real time according to experimental protocol. Collected data are stored directly on tape in analog form and on floppy disks in digital form for later processing.

  14. W5″ Test: A simple method for measuring mean power output in the bench press exercise.

    PubMed

    Tous-Fajardo, Julio; Moras, Gerard; Rodríguez-Jiménez, Sergio; Gonzalo-Skok, Oliver; Busquets, Albert; Mujika, Iñigo

    2016-11-01

    The aims of the present study were to assess the validity and reliability of a novel simple test [Five Seconds Power Test (W5″ Test)] for estimating the mean power output during the bench press exercise at different loads, and its sensitivity to detect training-induced changes. Thirty trained young men completed as many repetitions as possible in a time of ≈5 s at 25%, 45%, 65% and 85% of one-repetition maximum (1RM) in two test sessions separated by four days. The number of repetitions, linear displacement of the bar and time needed to complete the test were recorded by two independent testers, and a linear encoder was used as the criterion measure. For each load, the mean power output was calculated in the W5″ Test as mechanical work per time unit and compared with that obtained from the linear encoder. Subsequently, 20 additional subjects (10 training group vs. 10 control group) were assessed before and after completing a seven-week training programme designed to improve maximal power. Results showed that both assessment methods correlated highly in estimating mean power output at different loads (r range: 0.86-0.94; p < .01) and detecting training-induced changes (R(2): 0.78). Good to excellent intra-tester (intraclass correlation coefficient (ICC) range: 0.81-0.97) and excellent inter-tester (ICC range: 0.96-0.99; coefficient of variation range: 2.4-4.1%) reliability was found for all loads. The W5″ Test was shown to be a valid, reliable and sensitive method for measuring mean power output during the bench press exercise in subjects who have previous resistance training experience.

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

    NASA Astrophysics Data System (ADS)

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

    2015-07-01

    We present the results of a blind exercise to test the recoverability of stellar rotation and differential rotation in Kepler light curves. The simulated light curves lasted 1000 d and included activity cycles, Sun-like butterfly patterns, differential rotation and spot evolution. The range of rotation periods, activity levels and spot lifetime were chosen to be representative of the Kepler data of solar-like stars. Of the 1000 simulated light curves, 770 were injected into actual quiescent Kepler light curves to simulate Kepler noise. The test also included five 1000-d segments of the Sun's total irradiance variations at different points in the Sun's activity cycle. Five teams took part in the blind exercise, plus two teams who participated after the content of the light curves had been released. The methods used included Lomb-Scargle periodograms and variants thereof, autocorrelation function and wavelet-based analyses, plus spot modelling to search for differential rotation. The results show that the `overall' period is well recovered for stars exhibiting low and moderate activity levels. Most teams reported values within 10 per cent of the true value in 70 per cent of the cases. There was, however, little correlation between the reported and simulated values of the differential rotation shear, suggesting that differential rotation studies based on full-disc light curves alone need to be treated with caution, at least for solar-type stars. The simulated light curves and associated parameters are available online for the community to test their own methods.

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

    PubMed Central

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

    2015-01-01

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

  17. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  18. 21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass gas control unit. 870.4300 Section 870.4300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass gas control unit. (a) Identification. A cardiopulmonary bypass gas control unit is a device...

  19. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  20. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  1. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  2. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  3. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  4. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  5. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  6. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  7. 21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... gas. (b) Classification. Class II (performance standards). ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass gas control unit. 870.4300... bypass gas control unit. (a) Identification. A cardiopulmonary bypass gas control unit is a device...

  8. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  9. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  10. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  11. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  12. Drug therapy of cardiopulmonary resuscitation in children.

    PubMed

    Zaritsky, A

    1989-03-01

    In contrast to adults, cardiopulmonary arrest in infants and children is rarely an acute, primary cardiac event. Instead, it is often the terminal event in a progressive deterioration of respiratory or circulatory function. Successful resuscitation from cardiac arrest therefore is unusual in the paediatric patient and most survivors have persistent neurological impairment. Rapid vascular access and recall of drug dosages are major obstacles in treating paediatric emergencies. This paper reviews vascular access and alternative drug delivery methods. The endotracheal and intraosseous routes provide alternative sites for drug delivery, but the optimal doses and methods of drug administration via these routes are unknown. Indeed, although great progress in cardiopulmonary resuscitation (CPR) research has been made over the past 10 years, there are only limited data on paediatric arrest mechanisms and drug treatment. In this paper, recommended dosages and mechanisms of action of drugs useful during cardiopulmonary resuscitation are reviewed, highlighting recent data which suggest that changes in current drug recommendations may be needed. To avoid delays in management, precalculated tables of drugs should be readily available in emergency departments and other care areas where paediatric cases are likely to be seen. Adrenaline (epinephrine) remains the drug of choice in a cardiac arrest, but the most effective dose may be higher than currently used. Treatment of acidosis during the arrest concentrates on restoration of ventilation and blood flow and not on bicarbonate administration. In the post-arrest setting increasing data suggest bicarbonate may not be beneficial and may actually be detrimental. Calcium and atropine also have relatively minor roles in resuscitation pharmacology. Calcium is only indicated to treat hypocalcaemia, counteract the effects of hyperkalaemia or hypermagnesaemia, or reverse calcium channel blocker toxicity. Finally, the role of isoprenaline

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

    PubMed

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

    2014-12-01

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

  14. Effect of cardiopulmonary C fibre activation on the firing activity of ventral respiratory group neurones in the rat.

    PubMed Central

    Wilson, C G; Bonham, A C

    1997-01-01

    1. Cardiopulmonary C fibre receptor stimulation elicits apnoea and rapid shallow breathing, but the effects on the firing activity of central respiratory neurones are not well understood. This study examined the responses of ventral respiratory group neurones: decrementing expiratory (Edec), augmenting expiratory (Eaug), and inspiratory (I) neurones during cardiopulmonary C fibre receptor-evoked apnoea and rapid shallow breathing. 2. Extracellular neuronal activity, phrenic nerve activity and arterial pressure were recorded in urethane-anaesthetized rats. Cardiopulmonary C fibre receptors were stimulated by right atrial injections of phenylbiguanide. Neurones were tested for antidromic activation from the contra- and ipsilateral ventral respiratory group (VRG), spinal cord and cervical vagus nerve. 3. Edec neurones discharged tonically during cardiopulmonary C fibre-evoked apnoea and rapid shallow breathing, displaying increased burst durations, number of impulses per burst, and mean impulse frequencies. Edec neurones recovered either with the phrenic nerve activity (25 s) or much later (3 min). 4. By contrast, the firing activity of Eaug and most I neurones was decreased, featuring decreased burst durations and number of impulses per burst and increased interburst intervals. Eaug activity recovered in approximately 3 min and inspiratory activity in approximately 1 min. 5. The results indicate that cardiopulmonary C fibre receptor stimulation causes tonic firing of Edec neurones and decreases in Eaug and I neuronal activity coincident with apnoea or rapid shallow breathing. PMID:9365917

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Haemodynamic responses to exercise stress test in postmenopausal women with coronary artery disease.

    PubMed

    Nagpal, Sangeeta; Walia, Lily

    2013-01-01

    Coronary artery disease is the leading cause of death and disability in women. The incidence of coronary artery disease increases sharply after menopause. Coronary artery disease results from imbalance between myocardial oxygen supply and oxygen demand of the heart. Myocardial oxygen consumption is a helpful indicator of the response of the coronary circulation to the myocardial oxygen demand. Myocardial oxygen consumption is calculated by indirect methods like Stroke's work, Fick's principle, tension time index and rate pressure product. Rate pressure product is a major determinant of cardiac oxygen consumption. It is the product of heart rate with systolic blood pressure. It indicates that adequate stress was achieved and is an important indicator of ventricular function. It increases progressively with exercise. Peak rate pressure product is the rate pressure product at peak of exercise. Peak rate pressure product gives an accurate reflection of the myocardial oxygen demand and myocardial workload. The higher the peak rate pressure product, more will be the myocardial oxygen consumption. The ability to reach higher peak rate pressure product is associated with more adequate coronary perfusion. Thus the low value of peak rate pressure product suggests significant compromise of coronary perfusion and decreased left ventricular function. In the present study effect of exercise on haemodynamic parameters of postmenopausal women without coronary artery disease and postmenopausal women with coronary artery disease were compared. The percentage increase in systolic blood pressure was significantly more in postmenopausal women without coronary artery disease. The peak rate pressure product was significantly more in postmenopausal women without coronary artery disease (28.04 +/- 0.8293 mm of Hg beats / minute x 10(3)) as compared to postmenopausal women with coronary artery disease (25.14+/- 0.8993 mm of Hg beats/ minute x 10(3)) indicating more compromised coronary

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

    PubMed Central

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

    2007-01-01

    Background Asymptomatic subjects at intermediate coronary risk may need diagnostic testing for risk stratification. Both measurement of coronary calcium scores and exercise testing are well established tests for this purpose. However, it is not clear which test should be preferred as initial diagnostic test. We evaluated the prevalence of documented coronary artery disease (CAD) according to calcium scores and exercise test results. Methods Asymptomatic subjects with ST-T changes on a rest ECG were selected from the population based PREVEND cohort study and underwent measurement of calcium scores by electron beam tomography and exercise testing. With calcium scores ≥10 or a positive exercise test, myocardial perfusion imaging (MPS) or coronary angiography (CAG) was recommended. The primary endpoint was documented obstructive CAD (≥50% stenosis). Results Of 153 subjects included, 149 subjects completed the study protocol. Calcium scores ≥400, 100–399, 10–99 and <10 were found in 16, 29, 18 and 86 subjects and the primary endpoint was present in 11 (69%), 12 (41%), 0 (0%) and 1 (1%) subjects, respectively. A positive, nondiagnostic and negative exercise test was present in 33, 27 and 89 subjects and the primary endpoint was present in 13 (39%), 5 (19%) and 6 (7%) subjects, respectively. Receiver operator characteristics analysis showed that the area under the curve, as measure of diagnostic yield, of 0.91 (95% CI 0.84–0.97) for calcium scores was superior to 0.74 (95% CI 0.64–0.83) for exercise testing (p = 0.004). Conclusion Measurement of coronary calcium scores is an appropriate initial non-invasive test in asymptomatic subjects at increased coronary risk. PMID:17629903

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

    PubMed Central

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

    2015-01-01

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

  20. Cardiac Dysfunction during Exercise in Uncomplicated Type 2 Diabetes

    PubMed Central

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

    2010-01-01

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

  1. Changes in Exercise Capacity of Cardiac Asymptomatic Hereditary Hemochromatosis Subjects over 5-Year Follow up

    PubMed Central

    Shizukuda, Yukitaka; Smith, Kevin P.; Tripodi, Dorothy J.; Arena, Ross; Yau, Yu-Ying; Bolan, Charles D.; Waclawiw, Myron A.; Leitman, Susan F.; Rosing, Douglas R.

    2012-01-01

    Objective A long-term effect of hereditary hemochromatosis (HH) on aerobic exercise capacity (AEC) has not been well described. Design Forty-three HH and 21 volunteer control (VC) subjects who were asymptomatic underwent cardiopulmonary exercise testing using the Bruce protocol. AEC was assessed with minute ventilation (VE), oxygen uptake (VO2), and carbon dioxide production (VCO2) at baseline (BL) at a 5-year follow up (5Y) assessment. A paired t-test was used for analyses of normality data; otherwise, a Wilcoxon singed rank sum test was used. Results Thirty-three HH subjects and 18 VC subjects returned for a repeat CPX at 5Y (80% overall return rate). At 5Y, AEC was not different between the two groups. As compared with BL measurements, exercise time, peak VO2, and the VE/VCO2 slope did not differ statistically at 5Y between both groups. Iron depletion by phlebotomy for 5 years did not significantly affect AEC in newly diagnosed HH subjects at baseline (n=14) and cardiac arrhythmias during exercise tended to decrease after 5 years of therapy in this group. Conclusions The AEC of asymptomatic HH subjects treated with conventional therapy is not statistically affected by the disease over a 5-year period. PMID:22311055

  2. Assessing recruitment of lung diffusing capacity in exercising guinea pigs with a rebreathing technique

    PubMed Central

    Yilmaz, Cuneyt; Dane, D. Merrill; Hsia, Connie C. W.

    2008-01-01

    Noninvasive techniques for assessing cardiopulmonary function in small animals are limited. We previously developed a rebreathing technique for measuring lung volume, pulmonary blood flow, diffusing capacity for carbon monoxide (DlCO) and its components, membrane diffusing capacity (DmCO) and pulmonary capillary blood volume (Vc), and septal volume, in conscious nonsedated guinea pigs at rest. Now we have extended this technique to study guinea pigs during voluntary treadmill exercise with a sealed respiratory mask attached to a body vest and a test gas mixture containing 0.5% SF6 or Ne, 0.3% CO, and 0.8% C2H2 in 40% or 98% O2. From rest to exercise, O2 uptake increased from 12.7 to 25.5 ml·min−1·kg−1 while pulmonary blood flow increased from 123 to 239 ml/kg. The measured DlCO, DmCO, and Vc increased linearly with respect to pulmonary blood flow as expected from alveolar microvascular recruitment; body mass-specific relationships were consistent with those in healthy human subjects and dogs studied with a similar technique. The results show that 1) cardiopulmonary interactions from rest to exercise can be measured noninvasively in guinea pigs, 2) guinea pigs exhibit patterns of exercise response and alveolar microvascular recruitment similar to those of larger species, and 3) the rebreathing technique is widely applicable to human (∼70 kg), dog (20–30 kg), and guinea pig (1–1.5 kg). In theory, this technique can be extended to even smaller animals provided that species-specific technical hurdles can be overcome. PMID:18483171

  3. Older age is associated with greater central aortic blood pressure following the exercise stress test in subjects with similar brachial systolic blood pressure.

    PubMed

    Kobayashi, Masatake; Oshima, Kazutaka; Iwasaki, Yoichi; Kumai, Yuto; Avolio, Alberto; Yamashina, Akira; Takazawa, Kenji

    2016-08-01

    Brachial systolic pressure (BSP) is often monitored during exercise by the stress test; however, central systolic pressure (CSP) is thought to be a more direct measure of cardiovascular events. Although some studies reported that exercise and aging may play roles in changes of both BSP and CSP, the relationship between BSP and CSP with age following the exercise stress test remains unclear. The aim of this study was to evaluate the effect of age on the relationship between BSP and CSP measured after exercise. Ninety-six subjects underwent the diagnostic treadmill exercise stress test, and we retrospectively divided them into the following 3 groups by age: the younger age group (43 ± 4 years), middle age group (58 ± 4 years), and older age group (70 ± 4 years). Subjects exercised according to the Bruce protocol, to achieve 85 % of their age-predicted maximum heart rate or until the appearance of exercise-associated symptoms. BSP, CSP, and pulse rate (PR) were measured using a HEM-9000AI (Omron Healthcare, Japan) at rest and after exercise. BSP, CSP, and PR at rest were not significantly different among the 3 groups (p = 0.92, 0.21, and 0.99, respectively). BSP and PR immediately after exercise were not significantly different among the groups (p = 0.70 and 0.38, respectively). However, CSP immediately after exercise was 144 ± 18 mmHg (younger age), 149 ± 17 mmHg (middle age), and 158 ± 19 mmHg (older age). CSP in the older age group was significantly higher than that in the younger age group (p < 0.01). Despite similar BSPs in all age groups after exercise, CSP was higher in the older age group. Therefore, older subjects have a higher CSP after exercise, which is not readily assessed by conventional measurements of BSP.

  4. Racial Differences in the Prognostic Value of Cardiorespiratory Fitness (Results from the Henry Ford Exercise Testing Project).

    PubMed

    Al-Mallah, Mouaz H; Qureshi, Waqas T; Keteyian, Steven J; Brawner, Clinton A; Alam, Mohsin; Dardari, Zeina; Nasir, Khurram; Blaha, Michael J

    2016-05-01

    The aim of this analysis was to determine whether racial differences exist in the prognostic value of cardiorespiratory fitness (CRF) in black and white patients undergoing stress testing. We included 53,876 patients (mean age 53 ± 13, 49% women) from the Henry Ford Exercise Testing project free of established coronary disease or heart failure who completed a maximal exercise test from 1991 to 2009. Patients were followed for a mean duration of 11.5 years for all-cause mortality, ascertained by linkage with the Death Master File. Follow-up over mean 6.2 years was also available for incident myocardial infarction. Multivariate Cox proportional hazards regression models were used adjusting for demographic variables, risk factors, medications, and reason for stress test referral, including formal interaction testing by race (black vs white). Black patients (n = 16,725) were younger (54 ± 13 vs 52 ± 13, p <0.001) but had higher prevalence of hypertension (73% vs 57%, p <0.001) and obesity (28% vs 21%, p <0.001). On average, black patients achieved a lower CRF compared with whites (8.4 vs 9.5 metabolic equivalents, p <0.0001). A graded increase in mortality risk was noted with decreasing CRF for both black and white patients. In multivariate Cox regression, CRF was a predictor of both myocardial infarction and mortality, with no significant interaction between race, fitness, and outcomes (all interaction terms p >0.10). CRF is a strong predictor of all-cause mortality in both white and black patients, with no significant interaction observed between race, fitness, and outcomes. PMID:26976790

  5. Racial Differences in the Prognostic Value of Cardiorespiratory Fitness (Results from the Henry Ford Exercise Testing Project).

    PubMed

    Al-Mallah, Mouaz H; Qureshi, Waqas T; Keteyian, Steven J; Brawner, Clinton A; Alam, Mohsin; Dardari, Zeina; Nasir, Khurram; Blaha, Michael J

    2016-05-01

    The aim of this analysis was to determine whether racial differences exist in the prognostic value of cardiorespiratory fitness (CRF) in black and white patients undergoing stress testing. We included 53,876 patients (mean age 53 ± 13, 49% women) from the Henry Ford Exercise Testing project free of established coronary disease or heart failure who completed a maximal exercise test from 1991 to 2009. Patients were followed for a mean duration of 11.5 years for all-cause mortality, ascertained by linkage with the Death Master File. Follow-up over mean 6.2 years was also available for incident myocardial infarction. Multivariate Cox proportional hazards regression models were used adjusting for demographic variables, risk factors, medications, and reason for stress test referral, including formal interaction testing by race (black vs white). Black patients (n = 16,725) were younger (54 ± 13 vs 52 ± 13, p <0.001) but had higher prevalence of hypertension (73% vs 57%, p <0.001) and obesity (28% vs 21%, p <0.001). On average, black patients achieved a lower CRF compared with whites (8.4 vs 9.5 metabolic equivalents, p <0.0001). A graded increase in mortality risk was noted with decreasing CRF for both black and white patients. In multivariate Cox regression, CRF was a predictor of both myocardial infarction and mortality, with no significant interaction between race, fitness, and outcomes (all interaction terms p >0.10). CRF is a strong predictor of all-cause mortality in both white and black patients, with no significant interaction observed between race, fitness, and outcomes.

  6. Electroencephalography during surgery with cardiopulmonary bypass and hypothermia.

    PubMed

    Bashein, G; Nessly, M L; Bledsoe, S W; Townes, B D; Davis, K B; Coppel, D B; Hornbein, T F

    1992-06-01

    After more than 30 yr of use, electroencephalographic (EEG) monitoring during cardiopulmonary bypass has not gained wide clinical acceptance. To assess its utility to predict central nervous system injury, two-channel recordings were made from 78 patients undergoing cardiopulmonary bypass and anesthetized with fentanyl/diazepam/enflurane. The perfusion regimen included the use of high pump flow, a bubble oxygenator, and no arterial tubing filter. Target values were 28-32 degrees C for the minimum rectal temperature, 60-80 mmHg for mean arterial pressure, and 20-25% for hematocrit. Eight descriptors of the Fourier power spectra of the EEG were calculated off-line, and outcome comparisons were made with the results from neuropsychological tests. Among 58 patients yielding complete data of acceptable quality, a statistically significant reduction in total power was observed from prebypass to postbypass, accompanied by an increase in the fractional power in the theta and beta frequency bands and in the spectral edge frequency. The shifts in total and theta power were weakly associated with short-term but not with long-term changes in neuropsychological scores. Nearly 40% of the patients' EEGs were corrupted with electrical noise at some time during bypass. In 15 patients selected for having high-quality recordings and no neuropsychological deficit, an extensive statistical analysis failed to reveal any consistent variation in the EEG descriptors with hypothermia. Under the conditions studied, it appears that for other than gross signal dropout, the strong background variability in the EEG makes it have little value for detecting harbingers of brain injury.

  7. Computer aided exercise electrocardiographic testing and coronary arteriography in patients with angina pectoris and with myocardial infarction.

    PubMed Central

    Angelhed, J E; Bjurö, T I; Ejdebäck, J; Selin, K; Schlossman, D; Griffith, L S; Bergstrand, R; Vedin, A; Wilhelmsson, C

    1984-01-01

    A set of electrocardiographic criteria for the diagnosis of coronary artery disease was evaluated in two different groups of patients examined by computer aided 12 lead exercise electrocardiographic stress testing and coronary arteriography. One group consisted of patients with severe angina pectoris and the other of patients who had suffered a myocardial infarction three years before the study. Angiographically determined categories of patients could be identified with satisfactory precision by the electrocardiographic criteria under test in the patients with angina pectoris but not in those with infarction. A new method of classifying patients on the basis of data from coronary arteriography improved the correlation with ST segment analysis compared with conventional classification. PMID:6743432

  8. Pre-Exercise Participation Cardiovascular Screening in a Heterogeneous Cohort of Adult Cancer Patients

    PubMed Central

    Kenjale, Aarti A.; Hornsby, Whitney E.; Crowgey, Theresa; Thomas, Samantha; Herndon, James E.; Khouri, Michel G.; Lane, Amy R.; Bishop, Caroline E.; Eves, Neil D.; Peppercorn, Jeffrey; Douglas, Pamela S.

    2014-01-01

    Background. The purpose of this study was to investigate the extent of pre-exercise participation (“preparticipation”) health screening in a heterogeneous cohort of adult cancer patients. Methods. Patients (n = 413) with histologically confirmed solid or hematologic malignancy were categorized into preparticipation health screening risk stratification based on American College Sports Medicine (ACSM) recommendations. Risk of an exercise-related event was evaluated during a symptom-limited cardiopulmonary exercise test (CPET) with 12-lead electrocardiography (ECG). Results. Participant risk was categorized as low risk (n = 59, 14%), moderate risk (n = 217, 53%), and high risk (n = 137, 33%). Mean peak oxygen consumption was 21.7 ± 6.7 mL/kg−1 per minute−1 or 19.5 ± 21.7% below age- and sex-predicted sedentary values. No major serious adverse events or fatal events were observed during CPET procedures. A total of 31 positive ECG tests were observed, for an event rate of 8%. ACSM risk stratification did not predict the risk of a positive test. Age, statin use, antiplatelet therapy use, cardiovascular disease, prior treatment with anthracycline or radiation therapy, and being sedentary were predictors of a positive test (all p < .10). Conclusion. The patient risk-stratification profile strongly suggests that the use of formalized preparticipation health screening is required in all oncology scenarios; however, risk of an exercise-induced event is low, suggesting that the use of exercise testing is not required for pre-exercise clearance in the majority of patients. PMID:25061091

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line... entitled “Guidance for Cardiopulmonary Bypass Arterial Line Blood Filter 510(k) Submissions.”...

  10. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass vascular catheter, cannula... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery...

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Roller-type cardiopulmonary bypass blood pump. 870... Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass... cardiopulmonary bypass circuit during bypass surgery. (b) Classification. Class II (performance standards)....

  12. Effect of mildly attenuated heart rate response during treadmill exercise testing on cardiovascular outcome in healthy men and women.

    PubMed

    Maor, Elad; Kopel, Eran; Sidi, Yechezkel; Goldenberg, Ilan; Segev, Shlomo; Kivity, Shaye

    2013-11-01

    Attenuated heart rate (HR) response during exercise is associated with adverse cardiovascular outcome. The acceptable value for HR response is 85% of the age-predicted maximal HR (APMHR). This study hypothesized that mild attenuation of HR response during exercise among healthy subjects is associated with increased cardiovascular risk. The study population comprised 10,323 healthy men and women without known cardiovascular disease (CVD) or diabetes mellitus who underwent a yearly screening program and were followed up during a mean period of 4.3 years. Participants were grouped to 3 tertiles based on the percentage of their APMHR reached at the baseline stress test. The primary end point was the occurrence of CVD or cerebrovascular disease. A total of 1,015 incident cases of CVD occurred during follow-up. A multivariate Cox proportional hazards regression model showed that the CVD risk of subjects who reached 60% to 96% of their APMHR was 35% greater compared with those who reached their APMHR (p = 0.001). A subgroup analysis among subjects who reached 85% of their APMHR showed that even mildly attenuated heart response (in the range of 85% to 96% APMHR) was independently associated with 36% increase in CVD risk (p <0.001). In conclusion, attenuated HR response during exercise is a powerful and independent predictor of adverse cardiovascular events during long-term follow-up among healthy men and women. The prognostic implications of attenuated HR response in this population are apparent even with a minor decrease of the maximal HR to <96% of the APMHR.

  13. Cardiorespiratory and sensory responses to exercise in adults with mild cystic fibrosis.

    PubMed

    Quon, Bradley S; Wilkie, Sabrina S; Molgat-Seon, Yannick; Schaeffer, Michele R; Ramsook, Andrew H; Wilcox, Pearce G; Guenette, Jordan A

    2015-12-01

    The purpose of this study was to evaluate cardiorespiratory fitness and reasons for exercise curtailment in a contemporary adult cystic fibrosis (CF) cohort with mild lung disease. Adults with mild CF (n = 19, forced expiratory volume in 1 s = 95 ± 17% predicted) were age-, sex-, ethnicity-, and body mass index-matched to healthy controls (n = 19) and underwent a detailed cardiopulmonary cycle exercise test. While CF subjects had a reduced peak oxygen uptake compared with controls, the values were normal when expressed as %predicted in 14/19 (74%) of subjects. Both groups demonstrated a normal cardiovascular limitation to exercise and stopped exercise primarily because of leg fatigue. Despite not being exercise-limited by respiratory factors, there was some evidence of ventilatory abnormalities as patients with mild CF had increased end-inspiratory lung volumes and reached an inflection/plateau in tidal volume relative to minute ventilation at lower exercise intensities compared with controls. Subjects with CF were not more likely to demonstrate expiratory flow limitation compared with controls and did not have evidence of dynamic hyperinflation during exercise. Despite increased end-inspiratory lung volumes and an earlier tidal volume inflection/plateau, CF subjects did not experience higher levels of dyspnea. In an exploratory analysis, a significant inverse correlation was observed between sweat chloride and peak work rate. Adult CF subjects with relatively well preserved spirometry have normal exercise performance relative to reference values and are primarily limited by nonrespiratory factors. However, ventilatory abnormalities were detected even in this mild CF cohort and should be evaluated in future therapeutic trials focused on disease-modifying therapies in mild CF.

  14. Assessment of ventilatory thresholds during graded and maximal exercise test using time varying analysis of respiratory sinus arrhythmia

    PubMed Central

    Blain, G; Meste, O; Bouchard, T; Bermon, S; Segura, R.

    2005-01-01

    Objective: To test whether ventilatory thresholds, measured during an exercise test, could be assessed using time varying analysis of respiratory sinus arrhythmia frequency (fRSA). Methods: Fourteen sedentary subjects and 12 endurance athletes performed a graded and maximal exercise test on a cycle ergometer: initial load 75 W (sedentary subjects) and 150 W (athletes), increments 37.5 W/2 min. fRSA was extracted from heart period series using an evolutive model. First (TV1) and second (TV2) ventilatory thresholds were determined from the time course curves of ventilation and ventilatory equivalents for O2 and CO2. Results: fRSA was accurately extracted from all recordings and positively correlated to respiratory frequency (r = 0.96 (0.03), p<0.01). In 21 of the 26 subjects, two successive non-linear increases were determined in fRSA, defining the first (TRSA1) and second (TRSA2) fRSA thresholds. When expressed as a function of power, TRSA1 and TRSA2 were not significantly different from and closely linked to TV1 (r = 0.99, p<0.001) and TV2 (r = 0.99, p<0.001), respectively. In the five remaining subjects, only one non-linear increase was observed close to TV2. Significant differences (p<0.04) were found between athlete and sedentary groups when TRSA1 and TRSA2 were expressed in terms of absolute and relative power and percentage of maximal aerobic power. In the sedentary group, TRSA1 and TRSA2 were 150.3 (18.7) W and 198.3 (28.8) W, respectively, whereas in the athlete group TRSA1 and TRSA2 were 247.3 (32.8) W and 316.0 (28.8) W, respectively. Conclusions: Dynamic analysis of fRSA provides a useful tool for identifying ventilatory thresholds during graded and maximal exercise test in sedentary subjects and athletes. PMID:15976169

  15. Lessons learned from the first U.S./Russian Federation joint tabletop exercise to prepare for conducting on-site inspections under the Comprehensive Nuclear Test Ban Treaty

    SciTech Connect

    Filarowski, C; Gough, R; Hawkins, W; Knowles, S; Kreek, S; MacLeod, G; Rockett, P; Smith, A; Sweeney, J; Wild, J; Wohletz, K

    1999-03-24

    A U.S./Russian Federation Joint Tabletop Exercise took place in Snezhinsk, Russia, from 19 to 24 October 1998, whose objectives were the following: (1) To simulate the actions of the Inspection Team (IT), including interactions with the inspected State Party (ISP), in order to examine different ways the United States and Russian Federation (RF) approach inspections and develop appropriate recommendations for the international community. (2) To identify ambiguities and contradictions in the interpretation of Treaty and Protocol provisions that might become apparent in the course of an inspection and that need clarification in connection with the development of Operational Manuals and on-site inspection (OSI) infrastructure. (3) To confirm the efficacy of using bilateral tabletop exercises to assist in developing an effective Comprehensive Test Ban Treaty (CTBT) verification regime. (4) To identify strong and weak points in the preparation and implementation methods of such exercises for the purpose of further improving possible future exercises.

  16. Exercise-induced pulmonary artery hypertension in a patient with compensated cardiac disease: hemodynamic and functional response to sildenafil therapy.

    PubMed

    Nikolaidis, Lazaros; Memon, Nabeel; O'Murchu, Brian

    2015-02-01

    We describe the case of a 54-year-old man who presented with exertional dyspnea and fatigue that had worsened over the preceding 2 years, despite a normally functioning bioprosthetic aortic valve and stable, mild left ventricular dysfunction (left ventricular ejection fraction, 0.45). His symptoms could not be explained by physical examination, an extensive biochemical profile, or multiple cardiac and pulmonary investigations. However, abnormal cardiopulmonary exercise test results and a right heart catheterization-combined with the use of a symptom-limited, bedside bicycle ergometer-revealed that the patient's exercise-induced pulmonary artery hypertension was out of proportion to his compensated left heart disease. A trial of sildenafil therapy resulted in objective improvements in hemodynamic values and functional class.

  17. THE CLINICAL TRANSLATION GAP IN CHILD HEALTH EXERCISE RESEARCH: A CALL FOR DISRUPTIVE INNOVATION

    PubMed Central

    2014-01-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health. PMID:25109386

  18. The clinical translation gap in child health exercise research: a call for disruptive innovation.

    PubMed

    Ashish, Naveen; Bamman, Marcas M; Cerny, Frank J; Cooper, Dan M; D'Hemecourt, Pierre; Eisenmann, Joey C; Ericson, Dawn; Fahey, John; Falk, Bareket; Gabriel, Davera; Kahn, Michael G; Kemper, Han C G; Leu, Szu-Yun; Liem, Robert I; McMurray, Robert; Nixon, Patricia A; Olin, J Tod; Pianosi, Paolo T; Purucker, Mary; Radom-Aizik, Shlomit; Taylor, Amy

    2015-02-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health.

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

    PubMed Central

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

    1987-01-01

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

  20. The VO(2)-on kinetics in constant load exercise sub-anaerobic threshold reflects endothelial function and dysfunction in muscle microcirculation.

    PubMed

    Maione, D; Cicero, A Fg; Bacchelli, S; Cosentino, E R; Degli Esposti, D; Manners, D N; Rinaldi, E R; Rosticci, M; Senaldi, R; Ambrosioni, E; Borghi, C

    2015-01-01

    To propose a test to evaluate endothelial function, based on VO(2) on-transition kinetics in sub-anaerobic threshold (AT) constant load exercise, we tested healthy subjects and patients with ischemic-hypertensive cardiopathy by two cardiopulmonary tests on a cycle ergometer endowed with an electric motor to overcome initial inertia: a pre-test and, after at least 24 h, one 6 min constant load exercise at 90 % AT. We measured net phase 3 VO(2)-on kinetics and, by phase 2 time constant (tau), valued endothelial dysfunction. We found shorter tau in repeated tests, shorter time between first and second test, by persisting endothelium-dependent arteriolar vasodilatation and/or several other mechanisms. Reducing load to 80 % and 90 % AT did not produce significant changes in tau of healthy volunteers, while in heart patients an AT load of 70 %, compared to 80 % AT, shortened tau (delta=4.38+/-1.65 s, p=0.013). In heart patients, no correlation was found between NYHA class, ejection fraction (EF), and the two variables derived from incremental cycle cardio-pulmonary exercise, as well as between EF and tau; while NYHA class groups were well correlated with tau duration (r=0.92, p=0.0001). Doxazosin and tadalafil also significantly reduced tau. In conclusion, the O(2) consumption kinetics during the on-transition of constant load exercise below the anaerobic threshold are highly sensitive to endothelial function in muscular microcirculation, and constitute a marker for the evaluation of endothelial dysfunction.

  1. Oral L-arginine modulates blood lactate and interleukin-6 after exercise in HIV-infected men.

    PubMed

    Alves, G N; Tavares, A M V; Vieira, P J C; Sprinz, E; Ribeiro, J P

    2014-04-01

    The acute administration of L-arginine (L-arg), a nitric oxide (NO) precursor, reduces lactate (LAC) concentration after exercise in healthy individuals. Lower concentration of L-arg may enhance the action of some inflammatory cytokines in HIV-1 infected patients. We tested the hypothesis that acute L-arg administration may reduce post-exercise blood LAC and inflammatory cytokines levels in HIV-infected patients. 10 HIV-infected men performed 2 maximal incremental cardiopulmonary exercise tests, separated by one week. 30 min before each test, patients received oral placebo or 20 g of L-arg, in random order. Blood LAC, tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured before and up to 60 min after exercise. L-arg administration had no significant effect on exercise performance. Compared to placebo, L-arg administration reduced maximal post-exercise blood LAC from 8.7±0.6 to 6.9±0.4 mmol.L-1 (p<0.05). L-arg administration had no significant effect on TNF-alpha or IL-10 concentrations, but increased post-exercise IL-6 (placebo=19±3pg.mL-1; L-arg=63±8 pg.mL-1; p<0.05). In HIV-1 infected men, acute administration of L-arg reduces post-exercise blood LAC and increases IL-6 levels, suggesting the activation of the L-arg-NO pathway, with possible anti-inflammatory consequences.

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

    PubMed

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

    2014-07-01

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

  3. Additional value of thallium-201 SPECT to a conventional exercise test for the identification of severe coronary lesions after an episode of unstable coronary artery disease.

    PubMed

    Karlsson, J E; Björkholm, A; Nylander, E; Ohlsson, J; Wallentin, L

    1995-06-01

    The additional value of thallium-201 SPECT to a conventional exercise test for the identification of patients with severe coronary lesions was evaluated in 170 men, one month after an episode of unstable coronary artery disease. Severe coronary lesions at coronary angiography--defined as three vessel disease, left main stenosis or proximal left anterior descending artery stenosis as part of two vessel disease--were observed in 45.9%. In the SPECT image, the left ventricular myocardium was divided into nine segments and each segment was classified as either normal (= 0), reduced uptake (= 1) or uptake defect (= 2). The sum of gradings in all segments post-exercise was denoted "SPECT score". The patients were divided into nine different groups regarding ST-depression during exercise (no ST-depression, ST-depression in 1-2 leads or > or = 3 leads) and "SPECT score" (no SPECT score, 1-3 scores or > or = 4 scores). Severe coronary lesions were, in 68% identified by SPECT score > or = 4 and in 65% by ST-depression in > or = 1 lead at exercise test. The specificity for identification of severe coronary lesions was, for both tests, 65%. SPECT score > or = 4 and/or ST-depression in > or = 3 leads identified 82% of the patients with severe coronary lesions with a specificity of 63%. Furthermore, SPECT score > or = 3 identified more patients with isolated proximal left anterior descending artery stenosis than ST-depression alone at exercise test.

  4. The prognostic value of haemodynamic parameters in the recovery phase of an exercise test. The Finnish Cardiovascular Study.

    PubMed

    Nieminen, T; Leino, J; Maanoja, J; Nikus, K; Viik, J; Lehtimäki, T; Kööbi, T; Lehtinen, R; Niemelä, K; Turjanmaa, V; Kähönen, M

    2008-08-01

    We tested the hypothesis that the change from the peak to recovery values of systolic arterial pressure (SAP recovery) and rate-pressure product (RPP recovery) can be used to predict all-cause and cardiovascular mortality, as well as sudden cardiac death (SCD) in patients referred to a clinical exercise stress test. As a part of the Finnish Cardiovascular Study (FINCAVAS), consecutive patients (n=2029; mean age+/-SD=57+/-13 years; 1290 men and 739 women) with a clinically indicated exercise test using a bicycle ergometer were included in the present study. Capacities of attenuated SAP recovery, RPP recovery and heart rate recovery (HRR) to stratify the risk of death were estimated. During a follow-up (mean+/-s.d.) of 47+/-13 months, 122 patients died; 58 of the deaths were cardiovascular and 33 were SCD. In Cox regression analysis after adjustment for the peak level of the variable under assessment, age, sex, use of beta-blockers, previous myocardial infarction and other common coronary risk factors, the hazard ratio of the continuous variable RPP recovery (in units 1000 mm Hg x b.p.m.) was 0.85 (95% CI: 0.73-0.98) for SCD, 0.87 (0.78-0.97) for cardiovascular mortality, and 0.87 (0.81 to 0.94) for all-cause mortality. SAP recovery was not a predictor of mortality. The relative risks of having HRR below 18 b.p.m., a widely used cutoff point, were as follows: for SCD 1.28 (0.59-2.81, ns), for cardiovascular mortality 2.39 (1.34-4.26) and for all-cause mortality 2.40 (1.61-3.58). In conclusion, as a readily available parameter, RPP recovery is a promising candidate for a prognostic marker. PMID:18509348

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

    SciTech Connect

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

    1986-10-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate.

  6. Lessons learned from the first US/Russian Federation joint tabletop exercise to prepare for conducting on-site inspections under the Comprehensive Nuclear Test Ban Treaty

    SciTech Connect

    Filarowski, C; Kreek, S; Smith, A; Sweeney, J; Wild, J; Gough, R; Rockett, P; MacLeod, G; Hawkins, W; Wohletz, K; Knowles, S

    1999-03-24

    A U.S./Russian Federation Joint Tabletop Exercise took place in Snezhinsk, Russia, from 19 to 24 October 1998 whose objectives were to examine the functioning of an Inspection Team (IT) in a given scenario, to evaluate the strategies and techniques employed by the IT, to identify ambiguous interpretations of treaty provisions that needed clarification, and to confirm the overall utility of tabletop exercises to assist in developing an effective Comprehensive Test Ban Treaty (CTBT) verification regime. To achieve these objectives, the United States and Russian Federation (RF) agreed that two exercises would be conducted. The first would be developed by the RF, who would act as controller and as the inspected State Party (ISP), while the United States would play the role of the IT. The roles would be reversed in the second exercise; the United States would develop the scenario and play the ISP, while the RF would play the IT. A joint control team, comprised of members of both the U.S. and RF control teams, agreed on a number of ground rules for the two exercises and established a joint Evaluation Team to evaluate both of the exercises against the stated objectives. To meet time limitations, the scope of this joint exercise needed to be limited. The joint control team decided that each of the two exercises would not go beyond the first 25 days of an on-site inspection (OSI) and that the focus would be on examining the decision-making of the IT as it utilized the various technologies to clarify whether a nuclear test explosion had taken place. Hence, issues such as logistics, restricted access, and activities prior to Point of Entry (POE) would be played only to the extent needed to provide for a realistic context for the exercises' focus on inspection procedures, sensor deployments, and data interpretation. Each of the exercises began at the POE and proceeded with several iterations of negotiations between the IT and ISP, instrument deployments, and data evaluation by

  7. Effects of general fatigue induced by incremental maximal exercise test on gait stability and variability of healthy young subjects.

    PubMed

    Vieira, Marcus Fraga; de Sá E Souza, Gustavo Souto; Lehnen, Georgia Cristina; Rodrigues, Fábio Barbosa; Andrade, Adriano O

    2016-10-01

    The purpose of this study was to determine whether general fatigue induced by incremental maximal exercise test (IMET) affects gait stability and variability in healthy subjects. Twenty-two young healthy male subjects walked in a treadmill at preferred walking speed for 4min prior (PreT) the test, which was followed by three series of 4min of walking with 4min of rest among them. Gait variability was assessed using walk ratio (WR), calculated as step length normalized by step frequency, root mean square (RMSratio) of trunk acceleration, standard deviation of medial-lateral trunk acceleration between strides (VARML), coefficient of variation of step frequency (SFCV), length (SLCV) and width (SWCV). Gait stability was assessed using margin of stability (MoS) and local dynamic stability (λs). VARML, SFCV, SLCV and SWCV increased after the test indicating an increase in gait variability. MoS decreased and λs increased after the test, indicating a decrease in gait stability. All variables showed a trend to return to PreT values, but the 20-min post-test interval appears not to be enough for a complete recovery. The results showed that general fatigue induced by IMET alters negatively the gait, and an interval of at least 20min should be considered for injury prevention in tasks with similar demands.

  8. USE OF A PROGRAMMABLE CALCULATOR IN CARDIOPULMONARY PERFUSION

    PubMed Central

    Mills, J. David; Tallent, Jerome H.

    1978-01-01

    This study describes a hand-held, battery-powered, programmable instrument (Calculator Model SR-52) that can be taken directly into the operating room by cardiopulmonary perfusionists. Three programs are described in detail: 1) Cardiopulmonary perfusion parameters and estimated blood volume; 2) blood gas parameters and saturations, with temperature corrections; and 3) cardiopulmonary oxygen transfer and oxygenator efficiency. This inexpensive calculator allows perfusion personnel to manipulate easily-derived data into values which heretofore have required elaborate nomograms or special slide rules—or were not available within a reasonable computational time. PMID:15216068

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

    PubMed

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

    2010-01-01

    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.

  10. The association of clinical indication for exercise stress testing with all-cause mortality: the FIT Project

    PubMed Central

    Kim, Joonseok; Al-Mallah, Mouaz; Juraschek, Stephen P.; Brawner, Clinton; Keteyian, Steve J.; Nasir, Khurram; Dardari, Zeina A.; Blumenthal, Roger S.

    2016-01-01

    Introduction We hypothesized that the indication for stress testing provided by the referring physician would be an independent predictor of all-cause mortality. Material and methods We studied 48,914 patients from The Henry Ford Exercise Testing Project (The FIT Project) without known congestive heart failure who were referred for a clinical treadmill stress test and followed for 11 ±4.7 years. The reason for stress test referral was abstracted from the clinical test order, and should be considered the primary concerning symptom or indication as stated by the ordering clinician. Hierarchical multivariable Cox proportional hazards regression was performed, after controlling for potential confounders including demographics, risk factors, and medication use as well as additional adjustment for exercise capacity in the final model. Results A total of 67% of the patients were referred for chest pain, 12% for shortness of breath (SOB), 4% for palpitations, 3% for pre-operative evaluation, 6% for abnormal prior testing, and 7% for risk factors only. There were 6,211 total deaths during follow-up. Compared to chest pain, those referred for palpitations (HR = 0.72, 95% CI: 0.60–0.86) and risk factors only (HR = 0.72, 95% CI: 0.63–0.82) had a lower risk of all-cause mortality, whereas those referred for SOB (HR = 1.15, 95% CI: 1.07–1.23) and pre-operative evaluation (HR = 2.11, 95% CI: 1.94–2.30) had an increased risk. In subgroup analysis, referral for palpitations was protective only in those without coronary artery disease (CAD) (HR = 0.75, 95% CI: 0.62–0.90), while SOB increased mortality risk only in those with established CAD (HR = 1.25, 95% CI: 1.10–1.44). Conclusions The indication for stress testing is an independent predictor of mortality, showing an interaction with CAD status. Importantly, SOB may be associated with higher mortality risk than chest pain, particularly in patients with CAD. PMID:27186173

  11. The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents.

    PubMed

    Pieles, Guido E; Gowing, Lucy; Forsey, Jonathan; Ramanujam, Paramanantham; Miller, Felicity; Stuart, A Graham; Williams, Craig A

    2015-12-15

    Background left ventricular (LV) and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 ± 2.7 yr; stature 159.1 ± 16.4 cm; body mass 49.5 ± 16.6 kg; BSA 1.47 ± 0.33 m(2)) completed an incremental cardiopulmonary exercise test (25 W · 3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V̇o 2peak) of 40.6 ± 8.9 ml · kg(-1) · min(-1) and a work rate of 154 ± 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P < 0.05). LV Sl during exercise was significantly correlated to resting strain, V̇o 2peak, oxygen pulse, and work rate (0.530 ≤ r ≤ 0.784, P < 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology.

  12. Automated cardiopulmonary resuscitation: a case study.

    PubMed

    Spiro, Jon; Theodosiou, Maria; Doshi, Sagar

    2014-02-01

    Rates of survival after cardiac arrest are low and correlate with the quality of cardiopulmonary resuscitation (CPR). Devices that deliver automated CPR (A-CPR) can provide sustained and effective chest compressions, which are especially useful during patient transfer and while simultaneous invasive procedures are being performed. The use of such devices can also release members of resuscitation teams for other work. This article presents a case study involving a man with acute myocardial infarction complicated by cardiogenic shock and pulmonary oedema. It describes how ED nursing and medical teams worked together to deliver A-CPR, discusses the use of A-CPR devices in a tertiary cardiac centre, and highlights the advantages of using such devices.

  13. Factor V Leiden and Cardiopulmonary Bypass

    PubMed Central

    Uppal, Victor; Rosin, Mark; Marcoux, Jo-Anne; Olson, Marnie; Bezaire, Jennifer; Dalshaug, Gregory

    2015-01-01

    Abstract: We present a case of a patient with factor V Leiden with an antithrombin III activity of 67% who received a successful aortic valve replacement supported by cardiopulmonary bypass (CPB). A safe level of anticoagulation was achieved by monitoring activated clotting time (ACT) and heparin concentration ensuring adequate anticoagulation throughout the procedure. Results from ACT, heparin dose response, heparin protamine titration, and thrombelastography are given. Factor V Leiden patients can be safely anti-coagulated using heparin for CPB procedures when monitored with ACT, heparin protamine titration, and thrombelastography. Postoperative chest tube losses were 360 mL, less than half our institutional average. Anticoagulation for the pre-and post-operative phase is also discussed. PMID:26834284

  14. The role of Levosimendan in cardiopulmonary resuscitation.

    PubMed

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

    2014-10-01

    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 benefits 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.

  15. Transient Diabetes Insipidus Following Cardiopulmonary Bypass.

    PubMed

    Ekim, Meral; Ekim, Hasan; Yilmaz, Yunus Keser; Bolat, Ali

    2015-04-01

    Diabetes insipidus (DI) results from inadequate output of Antidiuretic Hormone (ADH) from the pituitary gland (central DI) or the inability of the kidney tubules to respond to ADH (nephrogenic DI). ADH is an octapeptide produced in the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior lobe of the pituitary gland. Cardiopulmonary Bypass (CPB) has been shown to cause a six-fold increased circulating ADH levels 12 hours after surgery. However, in some cases, ADH release may be transiently suppressed due to cardioplegia (cardiac standstill) or CPB leading to DI. We present the postoperative course of a 60-year-old man who developed transient DI after CPB. He was successfully treated by applying nasal desmopressin therapy. Relevant biochemical parameters should be monitored closely in patients who produce excessive urine after open heart surgery.

  16. Equity in access to exercise tolerance testing, coronary angiography, and coronary artery bypass grafting by age, sex and clinical indications

    PubMed Central

    Bowling, A; Bond, M; McKee, D; McClay, M; Banning, A; Dudley, N; Elder, A; Martin, A; Blackman, I

    2001-01-01

    OBJECTIVES—To assess whether patients with heart disease in a single UK hospital have equitable access to exercise testing, coronary angiography, and coronary artery bypass graft surgery (CABG).
METHOD—Retrospective analysis of patients' medical case notes (n = 1790), tracking each case back 12 months and forward 12 months from the patient's date of entry to the study.
SETTING—Single UK district hospital in the Thames Region.
PATIENTS—Patients (elective and emergency) with a cardiac ICD inpatient code at discharge or death, or who were referred to cardiology or care of the elderly unit over a 12 month period in 1996-7 (new episodes) were included.
RESULTS—Analysis of 1790 hospital case notes revealed that, despite having indications for intervention identical to those of younger patients, older patients (that is, those aged > 75 years) and women, independently, were significantly less likely to undergo exercise tolerance testing (exercise ECG) and cardiac catheterisation. The similar trends for age and access to CABG did not achieve significance. While clinical priority scores also independently predicted access to cardiac catheterisation and CABG, considerable numbers of patients in high clinical priority groups were not referred for either procedure.
CONCLUSIONS—The management and treatment of older patients and women with cardiac disease may be different from that of younger patients and men. Given the similarity of the indications for treatment and the lack of significant contraindications or comorbidities as a cause for these differences, one possible explanation is that these patients are being discriminated against principally because of their age and sex. Although clinical priority scores independently predicted access to catheterisation and CABG, large proportions of patients in high priority groups were not referred. This implies that the New Zealand priority scoring system may be more equitable than UK practice. The cost

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

    NASA Technical Reports Server (NTRS)

    Ivanco, Thomas G.

    2013-01-01

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

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

    PubMed Central

    2014-01-01

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

  19. Dietary nitrate supplementation enhances exercise performance in peripheral arterial disease

    PubMed Central

    Kenjale, Aarti A.; Ham, Katherine L.; Stabler, Thomas; Robbins, Jennifer L.; Johnson, Johanna L.; VanBruggen, Mitch; Privette, Grayson; Yim, Eunji; Kraus, William E.

    2011-01-01

    Peripheral arterial disease (PAD) results in a failure to adequately supply blood and oxygen (O2) to working tissues and presents as claudication pain during walking. Nitric oxide (NO) bioavailability is essential for vascular health and function. Plasma nitrite (NO2−) is a marker of vascular NO production but may also be a protected circulating “source” that can be converted to NO during hypoxic conditions, possibly aiding perfusion. We hypothesized that dietary supplementation of inorganic nitrate in the form of beetroot (BR) juice would increase plasma NO2− concentration, increase exercise tolerance, and decrease gastrocnemius fractional O2 extraction, compared with placebo (PL). This was a randomized, open-label, crossover study. At each visit, subjects (n = 8) underwent resting blood draws, followed by consumption of 500 ml BR or PL and subsequent blood draws prior to, during, and following a maximal cardiopulmonary exercise (CPX) test. Gastrocnemius oxygenation during the CPX was measured by near-infrared spectroscopy. There were no changes from rest for [NO2−] (152 ± 72 nM) following PL. BR increased plasma [NO2−] after 3 h (943 ± 826 nM; P ≤ 0.01). Subjects walked 18% longer before the onset of claudication pain (183 ± 84 s vs. 215 ± 99 s; P ≤ 0.01) and had a 17% longer peak walking time (467 ± 223 s vs. 533 ± 233 s; P ≤ 0.05) following BR vs. PL. Gastrocnemius tissue fractional O2 extraction was lower during exercise following BR (7.3 ± 6.2 vs. 10.4 ± 6.1 arbitrary units; P ≤ 0.01). Diastolic blood pressure was lower in the BR group at rest and during CPX testing (P ≤ 0.05). These findings support the hypothesis that NO2−-related NO signaling increases peripheral tissue oxygenation in areas of hypoxia and increases exercise tolerance in PAD. PMID:21454745

  20. Testing in Groups: A "Real" Exercise in Small Group Problem-Solving.

    ERIC Educational Resources Information Center

    Millar, Dan Pyle

    Students in a small group discussion class offered as part of a speech communication curriculum found that testing their knowledge of the theory of the course in small groups was a positive learning experience. Each self-selected test group was made up of three students and was formed at least two class periods prior to the exam. Time was given in…

  1. The relationship between test protocol and the development of exercise-induced hypoxemia (EIH) in highly trained athletes.

    PubMed

    Lama, I L; Wolski, L A; Coutts, K D; McKenzie, D C

    1996-01-01

    Healthy male endurance-trained cyclists [n = 11, age = 27.3 (3.9) years; mass = 73.0 (9.3) kg; height = 180.5 (6.9) cm; maximal oxygen consumption (VO2max) = 71.1 (5.8) ml.kg-1.min-1, mean +/- (SD)] were recruited to assess the relationship between test protocol and the development of desaturation of arterial hemoglobin with oxygen, during incremental exercise tests to maximal aerobic capacity (VO2max). All subjects demonstrated resting pulmonary function within normal limits [forced vital capacity (FVC) = 6.0 (0.9); forced expiratory volume (FEV1.0) = 4.9 (0.6); FEV1.0/FVC = 0.8 (0.1)] and completed three ramped VO2max tests (Mijnhardt KEM-3 electronically braked cycle ergometer) beginning at 0 W with increments of either 20,30 or 40 W.min-1. All periods of testing were separated by a minimum of 72 h. VO2max, peak minute ventilation (VEpeak) (Medical Graphics, CPX-D), peak heart rate (fcpeak), peak power output (Wpeak), and minimum percentage arterial oxyhemoglobin saturation (% SaO2min) (Omeda Biox 3740 pulse oximeter) were determined. There were no significant differences (p > 0.05) in VEpeak [191.5 (26.2), 196.0 (24.4), 194.3 (23.9) l.min-1] fcpeak [191.4 (7.0), 190.3 (5.5), 187.8 (5.9) beats.min-1], VO2max [5.0 (0.5), 5.1 (0.4), 5.1 (0.5) l.min-1] or %SaO2min [89.5 (1.5), 89.6 (1.3), 90.0 (2.3)] between protocols. The 20-W protocol [417 (27) W] demonstrated significantly lower Wpeak (P < 0.05) than the 30-W [434 (36) W] and 40-W [453 (38) W] protocols, indicating that peripheral fatigue may play an important factor in response to these tests. The results of this study demonstrate that arterial desaturation occurs as a result of intense exercise in highly trained athletes independent of the rate of attainment of VO2max.

  2. Cardiopulmonary Syndromes (PDQ®)—Health Professional Version

    Cancer.gov

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

  3. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary..., consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  4. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary..., consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  5. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary..., consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  6. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary..., consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  7. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4240 Cardiopulmonary..., consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  8. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... with an oxygenator during cardiopulmonary bypass surgery to remove gas bubbles from the blood. (b) Classification. Class II (special controls). The special control for this device is the FDA guidance...

  9. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4310... gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood...

  10. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4310... gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood...

  11. Exercise after breast cancer treatment: current perspectives.

    PubMed

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

    Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer.

  12. Exercise after breast cancer treatment: current perspectives.

    PubMed

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

    Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. PMID:26543382

  13. Exercise after breast cancer treatment: current perspectives

    PubMed Central

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

    Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. PMID:26543382

  14. Effect of flunixin meglumine on selected physiologic and performance parameters of athletically conditioned thoroughbred horses subjected to an incremental exercise stress test.

    PubMed

    Colahan, Patrick T; Bailey, James E; Chou, Chi-Chung; Johnson, Martha; Rice, Brett L; Jones, Galin L; Cheeks, Joseph P

    2002-01-01

    Twelve clinically sound, healthy, athletically conditioned Thoroughbred horses were subjected to an incremental exercise stress test to determine the effects and period of detection of a single dose of flunixin meglumine (1.1 mg/kg by intravenous injection) in serum and urine by ELISA. Flunixin concentrations, performance, and hematologic and clinical chemical parameters were measured. All horses were rotated through four treatment groups of a Latin-square design providing for each horse to serve as its own control. Flunixin meglumine reduced prostaglandin F(1alpha) and thromboxane concentrations that had been increased by intense exercise. Performance parameters did not improve and prostaglandin concentrations did not significantly correlate with total run time. Exercise did not change the flunixin elimination profile