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Sample records for cardiopulmonary exercise testing

  1. Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing

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    Michael K. Stickland

    2012-01-01

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

  2. Cardiopulmonary Exercise Testing in Heart Failure.

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    Malhotra, Rajeev; Bakken, Kristian; D'Elia, Emilia; Lewis, Gregory D

    2016-08-01

    Exercise intolerance, indicated by dyspnea and fatigue during exertion, is a cardinal manifestation of heart failure (HF). Cardiopulmonary exercise testing (CPET) precisely defines maximum exercise capacity through measurement of peak oxygen uptake (VO2). Peak VO2 values have a critical role in informing patient selection for advanced HF interventions such as heart transplantation and ventricular assist devices. Oxygen uptake and ventilatory patterns obtained during the submaximal portion of CPET are also valuable to recognize because of their ease of ascertainment during low-level exercise, relevance to ability to perform activities of daily living, independence from volitional effort, and strong relationship to prognosis in HF. The ability of peak VO2 and other CPET variables to be measured reproducibly and to accurately reflect HF severity is increasingly recognized and endorsed by scientific statements. Integration of CPET with invasive hemodynamic monitoring and cardiac imaging during exercise provides comprehensive characterization of multisystem reserve capacity that can inform prognosis and the need for cardiac interventions. Here, we review both practical aspects of conducting CPETs in patients with HF for clinical and research purposes as well as interpretation of gas exchange patterns across the spectrum of preclinical HF to advanced HF. PMID:27289406

  3. Cardiopulmonary Exercise Testing in Children and Adolescents With Dystrophinopathies : A Pilot Study

    NARCIS (Netherlands)

    Bartels, Bart; Takken, Tim; Blank, A. Christian; van Moorsel, Huib; van der Pol, W. Ludo; de Groot, Janke F.

    2015-01-01

    Purpose: To determine exercise response during cardiopulmonary exercise testing in children and adolescents with dystrophinopathies. Methods: Exercise response on the cardiopulmonary exercise test (CPET) was compared with a standard care test protocol. Results: Nine boys (aged 10.8 +/- 4.7 years) wi

  4. The Role of Cardiopulmonary Exercise Test in IPF Prognosis

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    Christina Triantafillidou

    2013-01-01

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

  5. The role of cardiopulmonary exercise test for individualized exercise training recommendation in young obese subjects

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    Lucian Hoble; Loredana Meşină; Alexandra Rusu; Claudiu Avram; Mihaela Oraviţan

    2010-01-01

    Obesity is affecting a growing segment of the population and should be considered a serious health problem which will lead to medical complications and decreased life span. Lifestyle changes by adopting healthy food and increase energy consumption through physical activity is the most important treatment for obesity. Cardiopulmonary exercise test (CPET) is considered the gold standard for exercise capacity assessment. Purpose: This study is aiming to demonstrate that individualized exercise t...

  6. Cardiopulmonary exercise testing after laryngectomy: A connection conundrum

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    Shana Overstreet

    2015-01-01

    Full Text Available 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.

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

    Science.gov (United States)

    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

  8. The role of cardiopulmonary exercise test for individualized exercise training recommendation in young obese subjects

    Directory of Open Access Journals (Sweden)

    Lucian Hoble

    2010-06-01

    Full Text Available Obesity is affecting a growing segment of the population and should be considered a serious health problem which will lead to medical complications and decreased life span. Lifestyle changes by adopting healthy food and increase energy consumption through physical activity is the most important treatment for obesity. Cardiopulmonary exercise test (CPET is considered the gold standard for exercise capacity assessment. Purpose: This study is aiming to demonstrate that individualized exercise training programs, designed using CPET results, leads to increase of physical fitness, aerobic capacity, ventilatory and cardiac exercise performance in young obese subjects.Material and method:We performed a prospective research study of 6 months. 43 sedentary subjects without contraindications to exercise, 21.3±3.1 years old, 93% female were included in the study. Assessments were made at baseline and after six months of intervention and consists of cardiopulmonary exercise test on bicycle ergometer. After we recorded oxygen uptake at aerobic threshold (AT, anaerobic threshold (in the range of respiratory compensation point – RCP and maximal oxygen uptake (VO2max we designed the training program according to these parameters and individualized heart rate training zones of each subject. Exercise training (60 minutes/session, 3 sessions/week was performed taking in consideration the training zones and using a circuit on cardio devices. Each subject was supervised by a physiotherapist and using heart rate monitors. The number of subjects evaluated at the end of the study was 27 (dropout rate 37%.Results:After six months of intervention we noticed an improvement of maximum oxygen uptake (VO2max (from 22.7±3.69 to 27.44±5.55, aerobic threshold (VO2_AT (from 15.48±2.66 to 20.07±4.64 ml/min/kg, p<0.0001 and anaerobic threshold (VO2_RCP (from 20.3±3.66 to 25.11±5.84 ml/min/kg, p<0.0001, cardiac performance during exercise evaluated trough maximal oxygen

  9. Accuracy of transcutaneous carbon dioxide tension measurements during cardiopulmonary exercise testing.

    NARCIS (Netherlands)

    Stege, G.; Elshout, F.J.J. van den; Heijdra, Y.F.; Ven, M.J.T. van de; Dekhuijzen, P.N.R.; Vos, P.J.E.

    2009-01-01

    BACKGROUND: Measurements of transcutaneous carbon dioxide tension (PtcCO(2)) with current devices are proven to provide clinically acceptable agreement with measurements of partial arterial carbon dioxide tension (PaCO(2)) in several settings but not during cardiopulmonary exercise testing (CPET). O

  10. Developing pulmonary vasculopathy in systemic sclerosis, detected with non-invasive cardiopulmonary exercise testing.

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    Daniel Dumitrescu

    Full Text Available 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.

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

    OpenAIRE

    Daniel DUMITRESCU; 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-U...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

    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 (I...

  14. Cardiopulmonary exercise testing – the gold standard in physical performance assesment

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    Claudiu Avram

    2008-12-01

    Full Text Available Background: Cardiopulmonary exercise testing (CPX is a modern procedure that allows us to evaluate the global performanceof a subject. Because CPX devices are expensive and less popular due to a less amount of specialists in this field, many oflaboratories uses the more common ECG stress tests for physical performance assessment. Aim: to demonstrate theimportance and accuracy of cardiopulmonary exercise testing comparing with traditional maximal electrocardiographic (ECGstress test without gas exchange analysis. Methods: 18th elite soccer players (age 22.7±6 years, body mass 74.6±9.5 kg,height 175.4±9.8 cm participated in the study. The subjects accomplished two treadmill effort tests with and without gasanalyses, in 2 consecutive days interval. Results: At the end of the study we noticed a highly significant statistical difference(p<0.0001 between the investigated testing methods. In gas exchange testing method we found a decreased level of all theparameters evaluated comparing to stress ECG: VO2 peak (ml*kg-1*min-1 = 55.4±5.2 vs. 67.8±5.7; AT (ml*kg-1*min-1 =41.2±7.6 vs. 47.4±6.9; VO2/HR (ml = 23.8±2.5 vs. 23.8±2.5. Conclusions: Asessment of exercise performance based solelyon a maximal stress ECG without gas analyzing is inaccurate. Furthermore, estimation of peak exercise responses based uponcalculation of VO2 peak from peak work rate are inappropriate in sportsman. The study demonstrate once again that CPXremain the most accurate and reliable test for detection of AT and for a comprehensive physical performance assessment andcannot be replace by other surrogate laboratory exercise tests like stress ECG.

  15. Exertional-induced bronchoconstriction: Comparison between cardiopulmonary exercise test and methacholine challenging test

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    Mostafa Ghanei

    2015-01-01

    Full Text Available Introduction: Exertional-induced bronchoconstriction is a condition in which the physical activity causes constriction of airways in patients with airway hyper- responsiveness. In this study, we tried to study and evaluate any relationship between the findings of cardiopulmonary exercise testing (CPET and the response to methacholine challenge test (MCT in patients with dyspnea after activity. Materials and Methods: Thirty patients with complaints of dyspnea following activity referred to "Lung Clinic" of Baqiyatallah Hospital but not suffering from asthma were entered into the study. The subjects were excluded from the study if: Suffering from any other pulmonary diseases, smoking more than 1 cigarette a week in the last year, having a history of smoking more than 10 packets of cigarettes/year, having respiratory infection in the past 4 weeks, having abnormal chest X-ray or electrocardiogram, and cannot discontinue the use of medicines interfering with bronchial provocation. Baseline spirometry was performed for all the patients, and the values of forced expiratory volume in 1 second (FEV1, forced vital capacity (FVC, and FEV/FVC were recorded. The MCT and then the CPET were performed on all patients. Results: The mean VO 2 (volume oxygen in patients with positive methacholine test (20.45 mL/kg/min was significantly lower than patients with negative MCT (28.69 mL/kg/min (P = 0.000. Respiratory rates per minute (RR and minute ventilation in the group with positive MCT (38.85 and 1.636 L were significantly lower than the group with negative methacholine test (46.78 and 2.114 L (P < 0.05. Also, the O 2 pulse rate in the group with negative methacholine test (116.27 mL/beat was significantly higher than the group with positive methacholine test (84.26 mL/beat (P < 0.001. Conclusion: Pulmonary response to exercise in patients with positive methacholine test is insufficient. The dead space ventilation in these patients has increased. Also, dynamic

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

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    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

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

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    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

  18. Cardiopulmonary exercise testing – effective method for evaluation and recommendation of individualized exercise training in patients with metabolic syndrome

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    Claudiu Avram

    2011-12-01

    Full Text Available The present study aims to emphasize the role of cardiopulmonary exercise training (CPET in evaluation and recommendation of individualized exercise training in patients with a metabolic syndrome. Methods: We performed a prospective longitudinal study of 9 months. The study group consisted of 28 young patients (21.3±3.1 years old without contraindications to exercise, previously diagnosed with metabolic syndrome according to NCEP-ATPIII criteria. All patients were evaluating at baseline and after 3 months of intervention and at the end of the study (after 9 months. The evaluation consists in performing a CPET on bicycle ergometer in which subjects were monitored in terms of cardiac and respiratory parameters. The CPET results allow us to establish the range of effort intensity in which the patient should exercise in order to burn calories and achieve the maximum fat oxidation rate. All patients benefit from an intensive interval exercise training programme, supervised and guided by a physical therapist. Exercise training consisted in 50 minutes sessions, 3 times per week, at intensive endurance training zone (in the range of anaerobic threshold, completed by 1 minute interval in the range between anaerobic threshold (AT and respiratory compensation point (RCP, for every 5 minutes of training. Results: After 9 months of intervention we noticed an improvement of abdominal obesity (waist circumference decreased from 98.98±10.14 cm to 89.54±12.32 cm, p<0.001, physical fitness (V’O2peak increased from 1.83±0.33 l/min to 2.13±0.4 l/min, p<0.001 and endurance (Oxygen uptake in the range of anaerobic treshold increase from 1.27±0.27 l/min to 1.55±0.31 l/min, p<0.001. Conclusions: Cardiopulmonary exercise testing together with training zones determinations is a useful tool for assessing the exercise capacity and drawing up individual workouts. Active and closely monitored intervention by individualized exercise training programmes leads to

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

    Science.gov (United States)

    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 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

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

    Science.gov (United States)

    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

  1. The role of MR imaging and cardio-pulmonary exercise test (CPET) in oncology patient - a case report

    International Nuclear Information System (INIS)

    Background: Thromboembolic complications are the second cause of mortality in patients with malignant neoplasms. Their course can be apparently asymptomatic, masked by other dominant symptoms of a malignant process. Therefore, there is a need for an unbiased diagnostic method to establish the causes of the patients' clinical condition. Case Report: The authors present a case of a 42-year-old neoplastic male patient admitted for bone marrow transplant. Examinations performed routinely before marrow transplantation showed pulmonary embolism in CT, while Trans Thoracic Echocardiography (TTE) revealed abnormal findings in the heart. Trans Esophageal Echocardiography (TEE) was indecisive and did not discriminate between a thrombus or neoplastic character of the observed pathological structures. MR helped to identify the findings as a thrombus. For unbiased initial assessment, the patient was referred for cardiopulmonary exercise test (CPET). Cardiopulmonary exercise test allowed to rule out any signs of restrictive or occlusive lung disease, and along with other diagnostic tests confirmed chronic thromboembolic pulmonary hypertension (CTEPH). Conclusions: Pulmonary embolism is found significantly more often in patients with neoplastic disease. Its course can be apparently asymptomatic, masked by other dominant symptoms of a malignant process. Magnetic resonance is a valuable tool in assessment of heart morphology, allowing proper diagnosis especially in thrombus identification, or detection of metastases. Cardiopulmonary exercise test can be useful in diagnosis and assessment of chronic thromboembolic pulmonary hypertension in apparently asymptomatic patients. CPET used in conjunction with MR seem to be a valuable combination capable of providing correct diagnosis where other methods fail. (author)

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

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    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, Prate (%WR-max) (r=−0.44, Pbreathing reserve (r=−0.50, PBreathing reserve were higher (P=0.04, 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.

  3. The clinical utility of cardiopulmonary exercise testing: results of a university hospital

    Directory of Open Access Journals (Sweden)

    Tajana Jalusic-Gluncic

    2012-08-01

    Full Text Available Objective: To determine the main reasons for cardiopulmonary exercise test (CPET referrals in our hospital over the last two years; to evaluate clinical usefulness of CPET. Methods: We included 207 patients between 17 and 76 years of age. For every patient, we measured electrocardigraphy (ECG, arterial blood gases, spirometry, maximal voluntary ventilation (MVV and diffusing capacity. CPET was then performed; using a treadmill, according to the modified Bruce protocol; then spirometry and diffusing capacity were repeated. Results: The most common reason for sending patients for CPET was dyspnea during exertion (85%, then preoperative assessment of lung cancer patients (11.6%, and preoperative assessment of heart transplant candidates (3.4%. After CPET in a dyspnea group, 33.5% had normal findings, 22.2% had pulmonary limitation, 31.8% had non pulmonary pathology, and 12.5% reached submaximal effort due to subjective problems (poor condition, feeling discomfort but no objective reasons to stop. From a lung cancer group, 25% were deemed unsuitable surgical candidates, and 14.29% of a heart transplant group was recommended immediate surgery, the remainder needed re-evaluation. Conclusion: Dyspnea of unknown cause is optimally investigated with CPET, allowing us to differentiate between the major causes of limitation (lung, heart, cardiovascular, muscular and, within each area, the specific causes of limitation. The most common diagnoses after CPET are pulmonary and cardiac diagnoses. CPET helps us to detect concurrent cardiovascular disease at respiratory impaired patients. CPET is the gold standard for evaluation of morbidity and mortality risk of lung cancer surgery and for selection of patients for heart transplant. [J Exp Integr Med 2012; 2(4: 297-303

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

    Science.gov (United States)

    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.

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

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    Roussos Charis

    2010-05-01

    Full Text Available Abstract Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF. The Medical Research Chronic (MRC chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET and the 6-minute walk test (6MWT are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p 2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p VO2 peak/kg (r = -.731, p 2 at peak exercise (r = -. 682, p 2 slope (r = .731, p 2 at AT (r = .630, p = 0.002 and the Borg scale at peak exercise (r = .50, p = 0.01 for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT. Conclusion In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.

  6. Efeito do estradiol sobre as respostas cardiopulmonar e metabólica em mulheres normotensas após a menopausa submetidas à cicloergoespirometria Effect of estradiol on cardiopulmonary and metabolic responses of postmenopausal normotensive women undergoing cardiopulmonary exercise testing

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    Roberto Calvoso Júnior

    2005-01-01

    Full Text Available OBJETIVO: Avaliar pela cicloergoespirometria as respostas cardiopulmonar e metabólica, em 30 usuárias de estrogênio após a menopausa, durante exercício físico máximo, sendo que 25 completaram o estudo. MÉTODOS: Em estudo prospectivo, duplo-cego, randomizado, controlado por placebo foram avaliados dois grupos de mulheres: um, constituído por 14 mulheres (57,6±4,8 anos após a menopausa, usuárias de estradiol na dose de 2 mg/dia por via oral durante 90 dias, e, outro, por 11 mulheres (55,8±6,7 anos usuárias de placebo no mesmo período. Ambos os grupos foram submetidos a testes cicloergoespirométricos e analisadas as variáveis: volume de oxigênio consumido por kg/min no pico do exercício (VO2 pico, limiar anaeróbio (LA, volume de oxigênio consumido por Kg/min no limiar anaeróbio (VO2 no LA, ponto de descompensação respiratória (PDR, tempo de exercício (TE, carga máxima atingida (CM, freqüência cardíaca máxima (FC, pressão arterial sistólica (PAS, pressão arterial diastólica (PAD, antes e após administração dos medicamentos. RESULTADOS: Constataram-se reduções estatisticamente significantes em VO2 pico (p=0,002, LA (p=0,01, VO2 no LA (p=0,001 e TE (p=0,05 somente no grupo de usuárias de estradiol. As outras variáveis não sofreram alterações. CONCLUSÃO: O estradiol não promoveu melhora nas respostas cardiopulmonar e metabólica, quando comparado ao placebo.OBJECTIVE: To assess the cardiopulmonary and metabolic responses of 30 postmenopausal women using estrogen during maximum physical activity during cardiopulmonary exercise testing. Twenty-five women completed the test. METHODS: A prospective, double-blind, randomized, placebo-controlled study was carried out to assess 2 groups of women: estradiol group - comprising 14 postmenopausal women (57.6±4.8 years receiving oral estradiol at the dosage of 2 mg/day for 90 days; and placebo group - comprising 11 women (55.8±6.7 years receiving placebo during the

  7. Teste de esforço cardioplumonar na avaliação de doenças musculares Cardiopulmonary exercise testing for evaluation of muscle diseases

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    HELGA C. ALMEIDA SILVA

    1998-06-01

    Full Text Available OBJETIVO: Analisar o teste de esforço cardiopulmonar (TECP no diagnóstico de miopatias. MÉTODOS: 27 pacientes com miopatia realizaram TECP (protocolo de bicicleta em rampa, máximo, interrompido por sintoma. RESULTADOS: Pacientes distróficos e pacientes com mitocondriopatias mostraram diferenças significativas em relação aos controles para as variáveis potência do trabalho desenvolvido (watt e pico do consumo de oxigênio (VO2 máx. Pacientes com mitocondriopatias mostraram diminuição significativa do limiar anaeróbio em relação aos controles, além de elevação dos valores do quociente respiratório (QR do pico do exercício em relação aos demais grupos. CONCLUSÕES: TECP pode ser útil na avaliação evolutiva do grau de limitação física dos pacientes com miopatia. As variáveis potência do trabalho desenvolvido, VO2 máx, limiar anaeróbio e QR do pico do exercício podem sugerir o diagnóstico de miopatia e seus subtipos, excluindo quadros psicológicos.PURPOSE: To evaluate the cardiopulmonary exercise testing (CPX for the diagnosis of myopathies. METHODS: 27 patients with myopathy were submitted to CPX testing (symptom limited bike protocol. RESULTS: Dystrophic patients and patients with mitochondrial disease, compared with controls, showed significant differences for the power of work perfomed (watt and the maximum oxygen consumption (VO2 max. Patients with mitochondrial disease presented significantly lower values of anaerobic threshold when compared to controls and elevation of exercise peak respiratory exchange ratio (RER values when compared to the others groups. CONCLUSIONS: CPX testing may be useful in evaluating degree of physical limitation of patients with myopathy at inicial stage as well on follow-up examinations. Power of work performed, VO2 max, anaerobic threshold and RER at exercise peak may suggest the diagnosis of myopathy and its sub-types and therefore exclude psychologic causes of limitation.

  8. Compromised Cardiopulmonary Exercise Capacity in Patients Early After Endoscopic Atraumatic Coronary Artery Bypass Graft: Implications for Rehabilitation

    OpenAIRE

    Hansen, Dominique; Roijackers, Ruben; Jackmaert, Lore; Robic, Boris; Hendrikx, Marc; Yilmaz, Alaaddin; Frederix, Ines; Rosseel, Michael; DENDALE, PAUL

    2016-01-01

    Objective: The purpose of this work was to test the hypothesis that cardiopulmonary exercise tolerance is better preserved early after endoscopic atraumatic coronary artery bypass graft (endo-ACAB) surgery versus coronary artery bypass graft (CABG) surgery. Design: Twenty endo-ACAB surgery patients, 20 CABG surgery patients, and 15 healthy subjects executed a maximal cardiopulmonary exercise test, with assessment and comparison of cycling power output, O2 uptake, CO2 output, respiratory ...

  9. Resposta cronotrópica ao teste cardiopulmonar após o uso de cimetidina Effects of cimetidine on chronotropic response to cardiopulmonary exercise t esting

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    Gicela Risso Rocha

    2006-03-01

    Full Text Available OBJETIVO: Testar a hipótese, por meio de ensaio clínico randomizado, de que a administração de cimetidina altera a resposta cronotrópica ao exercício. MÉTODOS: Foram selecionados 24 indivíduos saudáveis, com idade entre 20 e 68 anos, não-atletas, os quais concordaram em ser submetidos a testes cardiopulmonares, após uso de placebo e de cimetidina, 400 mg, duas vezes ao dia, durante uma semana. Os testes foram realizados em esteira rolante, com protocolo de rampa com análises diretas dos gases expirados. Foi avaliada freqüência cardíaca máxima atingida, além da freqüência cardíaca de repouso e do limiar anaeróbico. RESULTADOS: Os indivíduos estudados foram igualmente distribuídos por sexo, com idade média (± desvio padrão de 43 ±11 anos. Os exames com placebo e com cimetidina tiveram igual duração (578±90 seg vs 603±131 seg e igual VO2 pico (35±8 ml/kg.min vs 35±8 ml/kg.min. A administração de cimetidina não apresentou efeito significativo na freqüência cardíaca de repouso (75±10 vs 74±8 bpm, no pico do esforço (176±12 vs 176±11 bpm e, da mesma forma, também não houve diferença entre as variações das freqüências cardíacas (pico - repouso, nos dois estudos (101±14 vs 101±13 bpm. CONCLUSÃO: A administração de cimetidina por sete dias não altera a resposta cronotrópica ao exercício.OBJECTIVE: To test the hypothesis that the administration of cimetidine will modify the chronotropic response to exercise testing through a random clinical trial. METHODS: The study selected 24 eligible healthy subjects, ages between 20 and 68 years, not athletes, who agreed to undergo cardiopulmonary exercise testing after the administration of placebo and 400 mg of cimetidine twice a day for one week. The tests were performed on a treadmill using a ramp protocol and direct analysis of the expired gases. Peak, resting and anaerobic threshold heart rate were recorded. RESULTS: The twenty subjects studied were

  10. From Clinical Application of Cardiopulmonary Exercise Testing to View the Requirement for Holistic Integrative Physiology and Medicine%从心肺运动的应用价值看医学整体整合的需求

    Institute of Scientific and Technical Information of China (English)

    谭晓越; 孙兴国

    2013-01-01

    The cardiopulmonary exercise testing is one important clinical functional test method.While patients do the loaded exercise, from rest to peak exercise to recovery, we continuously record the functions of respiratory, circulatory, metabolic and neurohumoral etc.systems.Based on these results, we can non-invasively evaluate the whole functional capacity and healthy condition, diagnose the diseases, grade the diseases' severity, evaluate the effective effect of the drug or treatment, and prognoses the death survival outcome.From the view of clinical using of cardiopulmonary exercise testing, we need a theoretical system of physiology and medicine for the all systems in human body in whole.%心肺运动试验是一个重要的人体整体功能学检测方法.让患者运动,连续动态记录以呼吸、循环、代谢和神经体液等多系统的功能活动,由此实现人体整体生理功能状态评价、疾病诊断、病情评估、治疗效果评估和预后转归预测.从心肺运动试验的临床应用出发,需要建立生理学医学的整体整合理论用以指导该技术的正确运用和解读.

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

    Science.gov (United States)

    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.

  12. Pediatric exercise testing. In health and disease

    NARCIS (Netherlands)

    Bongers, B.C.

    2013-01-01

    Measuring peak oxygen uptake (VO2peak) during progressive cardiopulmonary exercise testing (CPET) up to maximal exertion is widely recognized as the best single measure of aerobic exercise capacity. It is an important determinant of health, even in childhood and adolescence. Measuring VO2peak facili

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

    Science.gov (United States)

    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

  14. A STUDY ON CARDIOPULMONARY CHANGES WITH EXERCISE IN ADOLESCENT BOYS AND GIRLS

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    Lakshmi

    2015-02-01

    Full Text Available INTRODUCTION: Exercise is an important part of keeping adolescents healthy . The prevalence of obesity - related hypertension , in children and adolescents is on the rise . Exercise regimen can reverse or retard the rate of progression from prehypertension to hypertension in adolescents . The incidence of lung diseases including bronchial asthma is high in adolescent age group . There are gender differences in cardiopulmonary changes with exercise . The pulmonary function testing during exercise is often used for further assessme nt and determ in ing the degree of airway impairment and response to treatment . The present study was performed t o study the effect of various intensity of exercise on cardiopulmonary variables and to evaluate quantitative relationship between the variables . MATERIALS AND METHODS: The present study is carried out in a group of 100 healthy First year medical students of both sexes , who were not regular athletes . The subjects being medical students presented an added advantage of belonging to matching age groups of between 18 - 21 years of comparable physical standards and also medically screened at the time of admission . Before undertaking the exercise regimen blood hemoglobin concentration , RMV , MVV , FVC , FEV1 , PEFR , RR , HR and Blood Pressure ( BP were determined in all the subjects . Then the subject exercised on a bicycle ergometer with incremental loads . The Pulse Rate of the subject is noted and mentioned as the heart rate per minute . During the exercise the pulse was monitored by a pulse Oximeter . Blood Pressure was manually measured using standard mercury sphygmomanometer . The recordings before exercise , during exercise and 30 minutes after end of exercise of FVC , FEV - 1 and PEFR were measured using a digital spirometer . RESULTS: All the observations recorded in Group - A ( Boys subjects and of Group - B ( Girls subjects were noted . The arithmetical mean , standard deviation and standard

  15. 心肺运动试验在心肌缺血早期诊断中的应用价值探讨%The value of cardiopulmonary exercise testing in patients with myocardial ischemia

    Institute of Scientific and Technical Information of China (English)

    邓思健; 袁桂影; 伍惠红; 钟海波; 余慧文; 汪得喜

    2011-01-01

    Objective To investigate the value of cardiopulmonary exercise testing in patients with myocardial ischemia. Methods Fifty-two patients with chest pain were divided into two groups according the results of 99Tcm-MIBI stress-rest perfusion imaging: ischemia group and non- ischemia group. All patients received cardiopulmonary exercise testing and noninvasive echocardiography. The differences of cardiopulmonary exercise testing data were evaluated. Results No significant difference in age, gender, body weight index, E/A and EF between two groups. Compared to non-ischemia group, VO2 peak/kg[(27 ±6)ml/(kg · min) vs (33 ±7)ml/(kg · min) ,P<0.01], VO2 peak[(1.5 ±0.5)L/min vs (2.1 ±0.5)L/min,P<0.01],VO2 peak/HR[(10.7 ±2.6) ml/beat vs (14.1 ±3.0)ml/beat,P <0.01],HR[(143 ± 15)beats/min vs (154 ± 17)beats/min,P <0.05]and AT[(16.4 ±3. 0) ml/( kg · min) vs ( 20.6 ± 5. 0) ml/( kg · min) , P < 0. 01], VO2 peak/HR @ AT in eardiopulmonary exercise [(9.0 ± 1.8) m l/beat vs (11.3 ±2.3) ml/beat, P <0.01]in ischemia group were significant decreased.Conclusion VO2 peak/Kg, VO2 peak, VO2peak/HR, AT and VO2/HR @ AT have potential value in early discovery of myocardial ischemia.%目的 研究心肺运动试验(CPET)相关指标在心肌缺血患者诊断中的价值。方法 52例胸痛患者患者分别行CPET、99Tcm-MIBI心肌灌注显像检查及心脏彩色多普勒超声检查。根据心肌灌注显像检查结果分为心肌缺血组(30例)及非缺血组(22例)。比较2组患者的CPET相关指标如每千克体重峰摄氧量( VO2 peak/kg)、峰摄氧最(VO2 peak)、峰氧脉搏(VO2 peak/HR)、最大呼吸频率、氧斜率、呼吸储备、最大心率、心率储备和无氧阈、无氧阈时氧气通气当最、无氧阈时二氧化碳通气当量、无氧阈时氧脉搏以及心脏彩色多普勒超声检查二尖瓣口血流舒张早期峰值速度(E)与舒张晚期峰值速度(A)的比值(E/A值)和左

  16. Ponto ótimo cardiorrespiratório: uma variável submáxima do teste cardiopulmonar de exercício Cardiorespiratory optimal point: a submaximal variable of the cardiopulmonary exercise testing

    Directory of Open Access Journals (Sweden)

    Plínio Santos Ramos

    2012-11-01

    Full Text Available FUNDAMENTO: No Teste Cardiopulmonar de Exercício (TCPE máximo são analisadas diversas variáveis ventilatórias, incluindo o equivalente ventilatório de oxigênio (VE/VO2. O valor mínimo do VE/VO2 reflete a melhor integração entre os sistemas respiratório e cardiovascular, podendo ser denominado Ponto Ótimo Cardiorrespiratório (POC. OBJETIVO: Determinar o comportamento do POC em função do gênero e da idade em adultos saudáveis e verificar a associação com outras variáveis do TCPE. MÉTODOS: De 2.237 indivíduos, foram selecionados 624 (62% homens e 48 ± 12 anos de idade, não atletas, saudáveis, submetidos ao TCPE máximo. O POC ou VE/VO2 mínimo foi obtido a partir da análise da ventilação e do consumo de oxigênio em cada minuto do TCPE. Foi verificada a relação entre idade e POC para os dois gêneros, assim como as associações com: VO2máx, VO2 no limiar anaeróbico (VO2LA, eficiência da inclinação de consumo de oxigênio (OUES e com VE máxima. Comparou-se ainda a intensidade do esforço (MET no POC, LA e VO2máx. RESULTADOS: O POC aumenta com a idade, sendo 23,2 ± 4,48 e 25,0 ± 5,14, respectivamente, em homens e mulheres (p BACKGROUND: At the maximal Cardiopulmonary Exercise Testing (CPET, several ventilatory variables are analyzed, including the ventilatory equivalent for oxygen (VE/VO2. The minimum VE/VO2 value reflects the best integration between the respiratory and cardiovascular systems and may be called "Cardiorespiratory Optimal Point (COP". OBJECTIVE: To determine the behavior of the COP according to gender and age in healthy adults and verify its association with other CPET variables. METHODS: Of 2,237 individuals, 624 were selected (62% men and 48 ± 12 years, non- athletes, healthy, who were submitted to maximal CPET. COP or minimum VE/VO2 was obtained from the analysis of ventilation and oxygen consumption in every minute of CPET. We investigated the association between age and COP for both

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

    OpenAIRE

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

    2015-01-01

    Objective To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. Methods We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to ...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    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 (pressure products (PRPPs) in KD group 1 to 3 were all lower than corresponding control groups significantly (P = 0.010, 0.020, and 0.049, respectively). PRPPs correlated with Max-Z of CA by both equations modest inversely (by Dallaire, P = 0.017, Spearman rho = -0.301; by Fuse, P = 0.014, Spearman rho = -0.309).Our study recruited larger number of KD patients and provided a newer data of EC of KD patients. Our finding suggests that after acute stage of KD, patients could maintain normal cardiorespiratory fitness. Therefore, we believe that it is important to promote cardiovascular health to KD patients and KD patients should exercise as normal peers. However, since KD patients might still have compromised coronary perfusion during exercise, it remains crucial to assess and monitor cardiovascular risk of KD patients. Max-Z of CA correlates with PRPP modest inversely and might be used as a follow-up indicator of CA reserve during exercise after acute stage of KD. PMID:26765431

  20. Cardiopulmonary exercise testing for elderly with chronic thromboembolic pulmonary hypertension%老年慢性血栓栓塞性肺动脉高压患者的心肺运动试验研究

    Institute of Scientific and Technical Information of China (English)

    奚群英; 柳志红; 赵智慧; 顾晴; 罗勤; 马秀平; 熊长明; 倪新海

    2015-01-01

    目的:明确老年慢性血栓栓塞性肺动脉高压(CTEPH)患者与年轻患者相比心肺运动试验(CPET)指标的变化。方法2011年1月至2014年5月在阜外医院肺血管病房住院的57名CTEPH患者行CPET。按年龄是否≥60岁分为老年组(19例)和青年组(38例)。结果两组间性别、既往深静脉血栓形成(DVT)病史的概率、接受肺动脉高压靶向药物治疗的概率、基于核素肺通气/灌注显像计算的肺血管阻塞率、世界卫生组织(WHO)功能分级差异无统计学意义(P>0.05)。与青年组相比,老年CTEPH患者运动心率反应减慢,一秒用力呼气量(FEV1)、用力肺活量(FVC)下降,峰值分钟通气量(VE@峰值)、峰值潮气量(VT@峰值)更低,峰值氧脉搏(VO2/HR@峰值)占预计值的百分率增高,无氧阈(AT)时的生理死腔通气与潮气量比值(VD/VT)增高,峰值时的潮气末氧分压更低。结论老年CTEPH患者有特殊的CPET表现。%ObjectiveTo investigate the differences in the indices of cardiopulmonary exercise testing (CPET) between the elderly and young patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods Fifty-seven CTEPH patients admitted to the Center for Pulmonary Vascular Diseases, Fuwai Hospital during January 2011 to May 2014 were enrolled in this study. They all underwent CPET, and were divided into 2 groups according to their age, that is, the elderly group (≥60 years old,n=19), and the younger group (<60 years old,n=38).Results There was no difference in gender, prevalence of deep venous thrombosis (DVT), pulmonary targeted drug therapy, pulmonary vascular occlusion rate detected by ventilation-perfusion lung scanning, and WHO functional class between the 2 groups. Compared with the younger patients, the elderly CTEPH patients had lower heart rate response during exercise, decreased forced expiratory volume in one second (FEV1) and forced vital

  1. Changes in the Cardiopulmonary Response to Exercise after Cardiac Transplantation in Patients Enrolled in an Early Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Lizanne M Bussières

    1997-01-01

    Full Text Available OBJECTIVE: To evaluate the changes in the cardiopulmonary response to exercise in the first year after cardiac transplantation in patients enrolled in a rehabilitation program in the first three months post-transplantation.

  2. Prueba de esfuerzo cardiopulmonar (PEC en el síndrome de falla cardíaca. Una propuesta basada en la evidencia Cardiopulmonary exercise testing in congestive heart failure. a proposal based on evidence

    Directory of Open Access Journals (Sweden)

    Juan Manuel Sénior Sánchez

    2008-06-01

    ; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}

    The purpose of this document is to present recommendations for the clinical utilization of the cardiopulmonary exercise testing in patients with congestive heart failure with special emphasis on the evidence-based medicine, by means of a systematic search of the literature. The cardiopulmonary exercise testing is a useful tool in the evaluation and follow-up of patients with heart failure, but it is infrequently used in the daily practice of specialists in internal medicine and clinical cardiology. It allows differential diagnoses in patients with dyspnea of unexplained cause; to evaluate the tolerance to exercise, the functional capacity and prognosis; to select patients for heart transplantation; to provide parameters for the prescription of exercise, and to monitor the response to training in rehabilitation programs.

  3. Metabolic and clinical comparative analysis of treadmill six-minute walking test and cardiopulmonary exercise testing in obese and eutrophic women Análise clínica e metabólica comparativa entre o teste de caminhada de seis minutos e o teste de exercício cardiopulmonar em mulheres obesas e eutróficas

    Directory of Open Access Journals (Sweden)

    Luciana Di Thommazo-Luporini

    2012-01-01

    Full Text Available BACKGROUND: Impaired exercise tolerance is directly linked to decreased functional capacity as a consequence of obesity. OBJECTIVES: To analyze and compare the cardiopulmonary, metabolic, and perceptual responses during a cardiopulmonary exercise test (CPX and a treadmill six-minute walking test (tread6MWT in obese and eutrophic women. METHOD: Twenty-nine female participants, aged 20-45 years were included. Fourteen were allocated to the obese group and 15 to the eutrophic group. Anthropometric measurements and body composition assessment were performed. RESULTS: In both tests, obese women presented with significantly higher absolute oxygen uptake, minute ventilation, and systolic and diastolic blood pressure; they also presented with lower speed, distance walked, and oxygen uptake corrected by the weight compared to eutrophics. During the maximal exercise test, perceived dyspnea was greater and the respiratory exchange ratio was lower in obese subjects compared to eutrophics. During the submaximal test, carbon dioxide production, tidal volume, and heart rate were higher in obese subjects compared to eutrophic women. When analyzing possible correlations between the CPX and the tread6MWT at peak, there was a strong correlation for the variable heart rate and a moderate correlation for the variable oxygen uptake. The heart rate obtained in the submaximal test was able to predict the one obtained in the maximal test. Bland-Altman plots demonstrated the agreement between both tests to identify metabolic and physiological parameters at peak exercise. CONCLUSIONS: The six-minute walking test induced ventilatory, metabolic, and cardiovascular responses in agreement with the maximal testing. Thus, the six-minute walking test proves to be important for functional evaluation in the physical therapy routine.CONTEXTUALIZAÇÃO: A reduzida tolerância ao exercício está relacionada à diminuída capacidade funcional consequente da obesidade. Objetivos

  4. Exercises commonly used in rehabilitation of patients with chronic obstructive pulmonary disease: cardiopulmonary responses and effect over time

    NARCIS (Netherlands)

    Helvoort, H.A.C. van; Boer, R.C. de; Broek, L. van den; Dekhuijzen, R.; Heijdra, Y.F.

    2011-01-01

    OBJECTIVES: To compare conventional exercise-based assessment of pulmonary rehabilitation (PR) with improvement in training exercises employed during a PR program, and to describe the cardiopulmonary response of different training exercises during PR of patients with chronic obstructive pulmonary di

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

    OpenAIRE

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

    2016-01-01

    Abstract Coronary artery (CA) abnormalities influence exercise capacity (EC) of patients with Kawasaki disease (KD), and Z-score of CA is a well established method for detecting CA aneurysm. We studied the influence of KD on cardiopulmonary function and EC; meanwhile we analyzed echocardiographic findings of KD patients. We also assessed the correlation between CA Z-score and EC of KD patients to see if CA Z-score of KD patients could reflect EC during exercise. Sixty-three KD patients were r...

  6. Teste de esforço cardiopulmonar com protocolo de rampa em adultos com insuficiência cardíaca Cardiopulmonary exercise test with ramp protocol in adults with heart failure

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    Danielle Aparecida Gomes Pereira

    2012-12-01

    Full Text Available INTRODUÇÃO E OBJETIVO: O teste de esforço com protocolo de rampa é descrito como o que mais se adéqua à condição física de indivíduos com insuficiência cardíaca (IC. Porém, não há padronização descrita sobre incrementos de velocidade e inclinação. Este estudo teve como objetivo descrever resultados encontrados a partir da aplicação de um teste de esforço com protocolo de rampa adaptado para indivíduos com IC, classes II e III da New York Heart Association (NYHA. MÉTODOS: 41 indivíduos com média de idade de 46,37 ± 8,98 anos e fração de ejeção de 31,51 ± 9,45% fizeram o teste de esforço com análise de gases expirados em esteira, com protocolo de rampa desenvolvido a partir de critérios definidos pelo estudo de Barbosa e Silva e Sobral. Análise estatística: Foi realizada análise descritiva com distribuição de frequência e o tempo de teste foi apresentado como média ± desvio padrão. Foi realizado o modelo de regressão linear incluindo classe da NYHA, idade e fração de ejeção como variáveis explicativas para tempo de teste. Foi considerado significativo p INTRODUCTION AND OBJECTIVE: The exercise test with ramp protocol is described as the one which best adapts to physical condition of subjects with heart failure (HF. However, velocity and inclination standard increments have not been described yet. This study aimed to describe the results found after application of an exercise test with ramp protocol adjusted for subjects with HF, New York Heart Association (NYHA class II and III. METHODS: 41 subjects with mean age 46.37 ± 8.98 years and ejection fraction of 31.51 ± 9.45% performed the exercise test with expired gas analysis on treadmill with ramp protocol developed from criteria defined in a study by Barbosa and Silva et al. Statistical Analysis: descriptive analysis was performed with frequency distribution and the test time was presented as mean ± standard deviation. Linear regression model was

  7. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Sant, Jetske Van't; Versteeg, Henneke;

    2016-01-01

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time CRT...... response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only...... correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time. CONCLUSIONS: During the first 6 months of CRT there was a significant positive association between reverse...

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

    Science.gov (United States)

    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).

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

    Science.gov (United States)

    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

  10. 运动型高血压患者心肺运动能力研究%Cardiopulmonary Exercise Capacity of Patients With Exercise Hypertension

    Institute of Scientific and Technical Information of China (English)

    徐佳; 郭航远; 何益平

    2016-01-01

    Objective To evaluate the cardiopulmonary exercise capacity of patients with exercise hypertension.Methods From April 2014 to May 2015, 110 patients with chest distress who received treatment in Shaoxing People′s Hospital were enrolled.Cardiopulmonary exercise test ( CPET) was conducted on all the patients.According to blood pressure reactions, the patients were divided into two groups: exercise hypertension group ( n =48 ) and non exercise hypertension group (n=62) .Comparison was made between the two groups in blood pressure and CPET indexes.Results The two groups were not significantly different in gender, age, history of smoking, history of diabetes, TC, TG, HDL-C, LDL-C and LVEF (P>0.05); the exercise hypertension group was higher than non exercise hypertension group in BMI, the proportion of patients with family history of hypertension, CRP level and LVMI (P0.05); while exercise hypertension group was higher than non exercise hypertension group in exercise SBP, exercise SBP increase, exercise peak pulse pressure, 3 min SBP during convalescence and 3 min pulse pressure during convalescence ( P0.05 ); exercise hypertension group was lower than non exercise hypertension group in VO2/kg@AT, METS@AT, Peak VO2/kg, Peak METS, Peak VO2/HR and VE/VCO2 ( P <0.05 ) .Conclusion Exercise hypertension patients have worse exercise performance and cardiopulmonary reserve, which may be related with left ventricular hypertrophy and diastolic dysfunction.%目的:探讨运动型高血压患者的心肺运动能力。方法选取2014年4月—2015年5月在绍兴市人民医院就诊的胸闷待查患者110例,均行心肺运动试验( CPET),根据运动中的血压反应分为运动型高血压组( n =48)和运动血压正常组(n=62)。比较两组运动血压情况及CPET指标。结果两组性别、年龄、吸烟史、糖尿病史、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、左

  11. The clinical importance of cardiopulmonary exercise testing and aerobic training in patients with heart failure A importância clínica de testes de exercícios cardiopulmonares e treinamento aeróbico em pacientes com insuficiência cardíaca

    Directory of Open Access Journals (Sweden)

    R Arena

    2008-04-01

    Full Text Available INTRODUCTION: The appropriate physiological response to an acute bout of progressive aerobic exercise requires proper functioning of the pulmonary, cardiovascular and skeletal muscle systems. Unfortunately, these systems are all negatively impacted in patients with heart failure (HF, resulting in significantly diminished aerobic capacity compared with apparently healthy individuals. Cardiopulmonary exercise testing (CPX is a noninvasive assessment technique that provides valuable insight into the health and functioning of the physiological systems that dictate an individual’s aerobic capacity. The values of several key variables obtained from CPX, such as peak oxygen consumption and ventilatory efficiency, are often found to be abnormal in patients with HF. In addition to the ability of CPX variables to acutely reflect varying degrees of pathophysiology, they also possess strong prognostic significance, further bolstering their clinical value. Once thought to be contraindicated in patients with HF, participation in a chronic aerobic exercise program is now an accepted lifestyle intervention. Following several weeks/months of aerobic exercise training, an abundance of evidence now demonstrates an improvement in several pathophysiological phenomena contributing to the abnormalities frequently observed during CPX in the HF population. These exercise-induced adaptations to physiological function result in a significant improvement in aerobic capacity and quality of life. CONCLUSIONS: Furthermore, there is initial evidence to suggest that aerobic exercise training improves morbidity and mortality in patients with HF. This paper provides a review of the literature highlighting the clinical significance of aerobic exercise testing and training in this unique cardiac population.INTRODUÇÃO: A resposta fisiológica aguda ao exercício aeróbio progressivo demanda funcionamento adequado dos sistemas pulmonares, cardiovasculares e m

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

    OpenAIRE

    2015-01-01

    Cardiopulmonary response to unloaded cycling may be related to higher workloads. This was assessed in male subjects: 18 healthy sedentary subjects (controls), 14 hypoxemic patients with chronic obstructive pulmonary disease (COPD), and 31 overweight individuals (twelve were hypoxemic). They underwent an incremental exercise up to the maximal oxygen uptake (VO2max), preceded by a 2 min unloaded cycling period. Oxygen uptake (VO2), heart rate (HR), minute ventilation (VE), and respiratory frequ...

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

    Science.gov (United States)

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

    2013-01-01

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

  14. Efeito da plástica mitral nas variáveis do teste cardiopulmonar em pacientes com insuficiência mitral crônica Effect of mitral valve repair on cardiopulmonary exercise testing variables in patients with chronic mitral regurgitation

    Directory of Open Access Journals (Sweden)

    Dorival Julio Della Togna

    2013-04-01

    Full Text Available FUNDAMENTO: A plástica valvar mitral é o procedimento cirúrgico de escolha para pacientes com Insuficiência Mitral (IM crônica. Os bons resultados imediatos e tardios permitem a indicação cirúrgica antes do início dos sintomas. O teste cardiopulmonar de exercício (TCPE pode avaliar objetivamente a capacidade funcional, mas pouco se conhece o efeito da cirurgia em suas variáveis. OBJETIVOS: Avaliar os efeitos da plástica mitral nas variáveis do TCPE em pacientes com IM crônica. MÉTODOS: Foram selecionados 47 pacientes com IM grave e submetidos plástica da valva mitral, sendo nestes, realizado TCPE ± 30 dias antes da cirurgia, e de seis a 12 meses após a cirurgia. RESULTADOS: Houve predominância da classe funcional I ou II pela NYHA em 30 pacientes (63,8% e 34 pacientes (72,3%, respectivamente. Após a cirurgia foi observado uma diminuição significativa do consumo de oxigênio (VO2, de 1.719 ± 571 para 1.609 ± 428 mL.min-1, p = 0,036. Houve redução do Oxygen Uptake Efficiency Slope (OUES, de 1.857 ± 594 para 1.763 ± 514, p = 0,073 e o pulso de oxigênio (O2 aumentou após a cirurgia, de 11,1 ± 3,2 para 11,9 ± 3,2 mL.bat-1 (p = 0,003. CONCLUSÃO: A plástica da valva mitral, não determinou aumento do VO2 pico e do OUES apesar do remodelamento cardíaco positivo observado após sete meses de cirurgia. Entretanto, o pulso de O2 aumentou no pós-operatório, sugerindo melhora do desempenho sistólico do VE. O TCPE é uma ferramenta útil, podendo auxiliar na conduta médica em pacientes com IM.BACKGROUND: Mitral valve repair is the surgical procedure of choice for patients with chronic Mitral Regurgitation (MR. The good early and late results allow surgical indication before symptom onset. The cardiopulmonary exercise test (CPET can objectively assess functional capacity, but little is known about the effect of surgery on their variables. OBJECTIVE: Evaluate the effects of mitral repair on CPET variables in patients with

  15. exercise treadmill test

    Directory of Open Access Journals (Sweden)

    Seyed Rasoul Zakavi

    2013-04-01

    Full Text Available Objective: Although coronary artery disease (CAD is the leading cause of death in type 2 diabetic patients, it is frequently asymptomatic. Myocardial perfusion imaging (MPI is reported to show ischemia in a significant number of asymptomatic diabetic patients. We studied the prevalence and severity of myocardial perfusion defects in asymptomatic diabetic patients and its clinical impact. Methods and patients: One hundred thirty consecutive asymptomatic patients, aged 35-65 years with type 2 diabetes mellitus and with no history of CAD and no cardiac symptoms were recruited in the study. Echocardiography, electrocardiography (ECG, routine laboratory tests and exercise treadmill test (ETT were performed and patients with weakly positive or negative ETT underwent Dipyridamole MPI. Patients with positive ETT were referred to coronary angiography. Patients were followed for at least 17 months (mean 21.7 months and any cardiac event was recorded. Results: We studied 81 female and 49 male patients with mean age of 51.8 years. Negative, weakly positive and positive ETT result was noted in 74.3%, 15% and 10.7% respectively. 75% of patients with positive ETT had coronary artery disease in angiography. Gated myocardial perfusion SPECT was done in 106 patients. MPI showed reversible defect in 26.9% of the patients with a mean summed stress score of 3.3±1.8. Follow up completed in 112 patients and only one patient with abnormal MPI underwent coronary angiography followed by PTCA. No cardiac death, MI, UA or hospital admission occurred among our patients during follow up (17-26 months. Mean stress end diastolic volume (EDV was significantly higher in patients with reversible defect compared to patients without reversible defect based on MPI findings (62.0±31.6 Vs 48.5±18.4 ml, P=0.04. Blood glucose and HA1c were significantly higher in patients with ischemia compared to patients without ischemia (P

  16. Panic disorder and exercise avoidance

    Directory of Open Access Journals (Sweden)

    Ricardo W. Muotri

    2014-03-01

    Full Text Available Objectives: 1 To identify whether patients with panic disorder in general and those with the respiratory subtype in particular actively avoid exercise; 2 to investigate physiological differences in cardiopulmonary function parameters in patients with panic disorder in general, patients with the respiratory subtype of panic disorder, and healthy controls upon exercise challenge. Methods: Patients with panic disorder were classified as having either the respiratory or the non-respiratory subtype. Both groups were compared to controls in terms of exercise avoidance patterns and performance on cardiopulmonary exercise testing. Results: Patients with panic disorder exhibited higher exercise avoidance scores and worse performance on cardiopulmonary exercise testing as compared with controls. No differences were found between patients with the respiratory and non-respiratory subtypes. Conclusions: Exercise avoidance is present in panic disorder and is associated with poorer performance on cardiopulmonary exercise testing. These findings are not limited to patients with the respiratory subtype of the disorder.

  17. Avaliação ergoespirométrica em atleta paraolímpico de esqui alpino: estudo de caso = Cardiopulmonary exercise test on a treadmill for a paralympic alpine skiing athlete: case study

    Directory of Open Access Journals (Sweden)

    Vinagre, Nelson Alexandre Campos

    2012-01-01

    Conclusões: O esquiador pôde responder ao procedimento de diferentes cargas durante o teste. No teste aplicado o atleta tem que aprender a gerenciar sua resistência, força e capacidades coordenativas. A avaliação da capacidade aeróbica poderá ajudar o desempenho durante o treinamento e competições, visto que os atletas devem dividir sua atenção com uma gama de exigências que juntas são atendidas em grande parte pelo sistema aeróbio

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

    Science.gov (United States)

    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

  19. Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

    Directory of Open Access Journals (Sweden)

    R.R. Perim

    2011-07-01

    Full Text Available During cardiopulmonary exercise testing (CPET, stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR, and relative O2 pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0.9 vs 63.5 ± 0.9 mL O2•kg-1•min-1, HR (190 ± 1 vs188 ± 1 bpm and relative O2 pulse (32.9 ± 0.6 vs 32.6 ± 0.6 mL O2•beat-1•kg-1 were similar for the two CPETs (P > 0.05, while the final treadmill velocity increased from 18.5 ± 0.9 to 18.9 ± 1.0 km/h (P < 0.01. Relative O2 pulse increased linearly and similarly in both evaluations (r² = 0.64 and 0.63 up to 90% of the running time. Between 90 and 100% of the running time, the values were less stable, with up to 50% of the players showing a tendency to a plateau in the relative O2 pulse. In young healthy men in good to excellent aerobic condition, the morphology of the relative O2 pulse curve is consistent up to close to the peak effort for a CPET repeated within a 1-year period. No increase in relative O2pulse at peak effort could represent a physiologic stroke volume limitation in these athletes.

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

    OpenAIRE

    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...

  1. Proprioceptive isokinetic exercise test

    Science.gov (United States)

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

    1993-01-01

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

  2. Role of cardiopulmonary exercise testing in evaluating the efficiency of targeted drug therapy for patients with chronic thromboembolic pulmonary hypertension%心肺运动试验在评估慢性血栓栓塞性肺动脉高压患者靶向药物治疗效果中的作用

    Institute of Scientific and Technical Information of China (English)

    奚群英; 柳志红; 赵智慧; 顾晴; 罗勤; 马秀平; 熊长明; 倪新海

    2015-01-01

    目的:以心肺运动试验(CPET)评估慢性血栓栓塞性肺动脉高压(CTEPH)患者接受肺动脉高压靶向药物治疗后运动能力有无改善。方法2011年1月至2014年5月在阜外医院心内科肺血管病房住院的14例CTEPH患者,接受肺动脉靶向药物治疗3~12个月,治疗前后均进行CPET评估其运动能力。结果 CTEPH患者接受靶向药物治疗3~12个月后峰值氧耗量和氧脉搏均有明显改善(P<0.05);潮气末肺泡二氧化碳分压明显增加(P<0.001);分钟通气量/二氧化碳排出量(VE/VCO2)斜率及VE/VCO2最低值均显著下降(P<0.05)。但世界卫生组织功能分级较治疗前无明显改变(P>0.05);超声心动图检测右心室舒张末期内径及其与左心室舒张末期内径之比、肺动脉收缩压无明显差异(P>0.05);N端脑钠肽前体水平在治疗前后无显著性差异(P>0.05)。结论 CPET是评估CTEPH患者肺动脉高压靶向药物治疗后运动耐力的良好工具。%ObjectiveTo investigate the value of cardiopulmonary exercise testing (CPET) in the evaluation of the motor function improvement in the patients with chronic thromboembolic pulmonary hypertension (CTEPH) after targeted therapeutic drugs.Methods Fourteen CTEPH patients admitted to the Center for Pulmonary Vascular Diseases, Fuwai Hospital from January 2011 to May 2014 were enrolled in this study. They all received targeted drug therapy for 3 to 12 months. CPET was employed to evaluate their motor functions before and after the treatment.Results Significant improvements were observed in peak oxygen consumption (peak VO2), oxygen consumption/heart rate peak (VO2/HR peak), along with remarkably reduced minute ventilation volume/CO2 production (VE/VCO2) slope, the lowest VE/VCO2 ratio, and the increased levels of end-tidal partial pressure of CO2 (PetCO2) after 3 to 12 months’ treatment with targeted drug therapy for pulmonary arterial

  3. 射血分数正常的心力衰竭患者心肺运动试验与心脏多普勒超声检测的相关性%Comparative analysis between cardiopulmonary exercise testing and echocardiography in patients of heart failure with normal ejection fraction

    Institute of Scientific and Technical Information of China (English)

    任雅琦; 王宁夫; 潘浩; 汪莉莉; 钟益刚; 周占林

    2012-01-01

    Objective To assess the clinical and predictive value of cardiopulmonary exercise testing (CPET) used in heart failure with normal left ventricular ejection fraction (HFNEF).Methods A total of 49 HFNEF patients of (New York Heart Association) NYHA class Ⅱ were randomly selected from September 2010 to July 2012.The parameters of CPET and ultrasonic cardiogram (UCG) were collected at Day 3 post-admission.Person's and partial correlations were used to perform to compare CPET and UCG.Results Pearson's correlation revealed that mitral peak velocity of early filling/early diastolic mitral annular velocity(E/E',10.14 ± 2.05) was significantly correlated with peak oxygen uptake (VO2 peak,(24.15 ±8.31)ml · kg-1 · min-1,r =-0.287,P =0.046),carbon dioxide production (VCO2,(1.63 ±0.51)L/min,r =-0.429,P =0.002),partial pressure of end-tidal carbon dioxide (PET CO2,(39.50 ±7.77) mm Hg,r =-0.282,P =0.050) and minute ventilation/carbon dioxide production (VE/VCO2,31.69 ± 5.32,r =0.411,P =0.003).Early diastolic mitral annular velocity (E',(6.46 ± 1.60) cm/s)was relevant to VO2 peak (r =0.351,P =0.013),VCO2 (r =0.452,P =0.001),PET CO2 (r =0.310,P =0.030),VE/VCO2 (r =-0.434,P =0.002) and respiratory exchange ratio (RER,1.18 ± 0.13,r =0.350,P =0.014).After adjustment,VCO2 was correlated with E/E' (r =-0.369,P =0.019) and E'(r =0.393,P =0.010).VE/VCO2 was relevant to E/E' (r =0.414,P =0.006) and E' (r =-0.334,P =0.031).Conclusion For HFNFE patients,CPET has high values of assessment and prognosis.%目的 探索心肺运动试验(CPET)应用于评估射血分数正常心力衰竭(HFNEF)患者病情及预后的价值.方法 2010年9月至2012年7月,在杭州市第一人民医院住院的心力衰竭患者中抽取49例HFNEF,NYHA分级为Ⅱ级的患者.于入院后第3天行CPET及心脏多普勒超声(UCG)检查.采用Person相关分析及偏相关分析研究CPET与UCG各项指标间相关性.结果 CPET与UCG指标存在一定相关性.其中二尖瓣口舒张早期血流

  4. Exercise electrocardiogram testing in two brothers with different outcome – a case study exercise testing in master cyclists

    Directory of Open Access Journals (Sweden)

    Rüst CA

    2013-06-01

    Full Text Available Christoph Alexander Rüst,1 Beat Knechtle,1,2 Thomas Rosemann11Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland; 2Gesundheitszentrum St Gallen, St Gallen, SwitzerlandAbstract: The cases of two brothers training and competing as master cyclists and both preparing for a cycling tour are presented. The older brother aged 66 years went first to the primary care physician and presented with an asymptomatic depression in the exercise stress test of the ST segment in V5 and V6 during recovery after complete exhaustion. Coronary angiography revealed a multi vessel coronary artery disease and he underwent bypass surgery. One year later, he successfully completed his planned cycling tour of ~600 km in seven stages and covering ~12,000 m of total ascent. The younger brother aged 59 years went a few months later to the primary care physician and also performed asymptomatic exercise stress testing without changes in the ST segments. Unfortunately, 2 months later he suffered a cardiac arrest during his cycling tour and survived following immediate successful cardiopulmonary resuscitation on the road by his cycling colleagues. Immediate invasive coronary arteriography showed a complete stenosis of the trunk of arteria coronaria sinistra (left coronary artery, a 40%–50% stenosis of ramus circumflexus, and a 20% stenosis of arteria coronaria dextra (right coronary artery. The left coronary artery was dilated and he continued cycling 2 months later. In both brothers, familial hypercholesterolemia was the main cardiovascular risk factor for the multi vessel coronary artery disease. A negative exercise electrocardiogram in siblings with an increased risk for coronary artery disease seemed not to exclude an advanced multi vessel coronary artery disease. In master athletes with asymptomatic exercise electrocardiogram but a positive family history, further examinations should be performed in order to detect

  5. [Informative value of cardio-pulmonary exertion test in dyspnea diagnosis among asbestos-cement goods production workers].

    Science.gov (United States)

    Zhabina, S A

    2009-01-01

    The article deals with diagnosis of respiratory system changes through cardio-pulmonary exertion test in dyspneic individuals over 10 years exposed to dust at work. The results help to assess changes in the cardio-respiratory system, further prognosis and expedience of continued work in the hazardous conditions. PMID:19882774

  6. Clinical value of cardiopulmonary exercise testing derived oxygen uptake efficiency parameters in patients with end-stage chronic heart failure%终末期慢性心力衰竭患者运动中摄氧通气效率指标的临床应用

    Institute of Scientific and Technical Information of China (English)

    卢志南; 黄洁; 孙兴国; 谭晓越; 李子煦; 胡盛寿

    2015-01-01

    cardiopulmonary exercise testing (CPET) derived performance of oxygen uptake and ventilation efficiency parameters,including oxygen uptake efficiency plateau (OUEP),oxygen uptake efficiency slope (OUES),(V)E/(V)CO2 slope and lowest (V)E/(V)CO2,in patients with end-stage chronic heart failure(CHF) and evaluate their clinical value on monitoring cardiac function and hemodynamic status.Methods A total of 26 end-stage CHF patients considered for heart transplantation were enrolled in this study.CPET,echocardiography and invasive hemodynamic examinations with Swan-Ganz flowing balloon catheter were performed.Correlation analysis was made between oxygen uptake and ventilation efficiency parameters from CPET and echocardiographic and hemodynamic parameters.Results OUEP and OUES showed good correlation with peak oxygen consumption (peak (V)O2) (r =0.535,P < 0.01 ; r =0.840,P < 0.001).In end-stage CHF patients,the slope of OUEP with respect to peak (V)O2 is about 32,but the slope of OUES with respect to peak (V)O2 is only about 2.The difference was 16 times.The change of OUEP was more sensitive and significant than those of OUES and peak (V)O2 (P < 0.05).OUEP,peak (V)O2 (% pred),(V)E/(V)CO2 slope and lowest (V)E/(V)CO2 were all correlated well with non-invasive hemodynamic parameters peak cardiac output (r=0.535,P<0.01; r=0.652,P<0.001; r=-0.640,P<0.001 ; r=-0.606,P=0.001 respectively) and peak cardiac index (r =0.556,P<0.01;r =0.772,P <0.001; r =-0.641,P < 0.001 ; r =-0.620,P < 0.001 respectively) derived from CPET,but not correlated with invasive hemodynamic parameters cardiac output and cardiac index at rest (P >0.05).Both peak (V)O2 (% pred) and (V)E/(V)CO2 slope were significantly correlated with invasive hemodynamic parameters systolic pulmonary arterial pressure (r =-0.424,P < 0.05 ; r =0.509,P < 0.01) and mean pulmonary arterial pressure (r=-0.479,P<0.05; r=0.405,P<0.05).Peak (V)O2(%pred)was also significantly correlated with pulmonary capillary

  7. Statement on Exercise Testing in Cystic Fibrosis

    NARCIS (Netherlands)

    Hebestreit, Helge; Arets, Hubertus G M; Aurora, Paul; Boas, Steve; Cerny, Frank; Hulzebos, Erik H J; Karila, Chantal; Lands, Larry C; Lowman, John D; Swisher, Anne; Urquhart, Don S

    2015-01-01

    This statement summarizes the information available on specific exercise test protocols and outcome parameters used in patients with cystic fibrosis (CF) and provides expert consensus recommendations for protocol and performance of exercise tests and basic interpretation of results for clinicians. T

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

    OpenAIRE

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

    2015-01-01

    [Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after t...

  9. Clinical Study of Cardiopulmonary Exercise Testing in the Evaluation of the Changes of Holistic Function of Patients With Esophagus Cancer After Chemotherapy%心肺运动试验评价食管癌患者化疗后整体功能变化的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙兴国; Curtis Hightower; 刘方; William W. Stringer; 葛万刚

    2016-01-01

    Background Chemotherapy has a serious damage on the holistic function of human body,while there is a lack of reliable methods for the objective and quantitative assessment of the changes of holistic function of patients after chemotherapy. Objective To investigate the role of cardiopulmonary exercise testing(CPET)in the evaluation of the changes of holistic function of patients with esophagus cancer after chemotherapy. Methods From 2006 to 2007,we enrolled 6 Caucasian male patients with esophagus cancer who underwent preoperative chemotherapy in MD Anderson Cancer Center of University of Texas and conducted CPET examinations on them before and after chemotherapy. According to standard continuously increasing power scheme of UCLA Medical Center,we completed symptom - limited extreme sports and calculated the core indexes by standardized data analysis. The circulation indexes and respiration indexes in a quiescent state,a warm - up state,an anaerobic threshold(AT)state and an extreme state were derived by system software. Results Of the 6 esophagus cancer patients,only one patient had increase in AT and the rest patients all saw decrease in peak VO2 ,AT,peak oxygen pulse,oxygen uptake efficiency plateau,peak load power and increasing power movement time after chemotherapy;only one patient had decrease in the slope of ventilatory equivalent for carbon dioxide and the rest patients all had increase in the slope of ventilatory equivalent for carbon dioxide and the minimum ventilatory equivalent for carbon dioxide. The AT(L/ min,ml·min - 1 ·kg - 1 ,% pred),slope of ventilatory equivalent for carbon dioxide(slope,% pred),and increasing power movement time(min)after chemotherapy of the patients were not significantly different from those before chemotherapy(P > 0. 05);the peak VO2 (L/ min,ml·min - 1 · kg - 1 ,% pred),peak oxygen pulse(ml/ time,% pred),oxygen uptake efficiency plateau(ratio,% pred),and peak load power (W)were lower than those before chemotherapy

  10. Cardiopulmonary stress testing using ambulatory radionuclide monitoring system: The relationship between vascular endothelial function and cardiac response in patients with ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Akima, Takashi; Tabata, Hirotsugu [Self-Defense Forces Central Hospital, Tokyo (Japan); Takase, Bonpei [National Defense Medical Coll., Tokorozawa, Saitama (Japan)] [and others

    2002-02-01

    The relationship in the title was studied with a new type ambulatory radionuclide monitoring system. Subjects were 12 male patients with ischemic heart diseases. After cardiac scintigraphy at rest of {sup 99m}Tc-human serum albumin (740 MBq) with GE Mirenium, patients wore the C-VEST jacket (Capintec medset cardiolight), which consisted from 2 radioactivity detectors and Holter ECG recorder, and underwent the cardiopulmonary stress testing with Treadmill Ramp exercise to evaluate the anaerobic threshold (AT), VO{sub 2}, left ventricular ejection flow (EF) and stroke volume (SV). Vascular endothelial function was recorded by ultrasonography of brachial artery by monitoring the flow-mediated dilation (FD). Mean EF at rest was 56% and there was no relationship between VO{sub 2} at rest or exercise and FD. However, the relationship between FD and change of SV or EF from rest to AT was recognized and thus FD was suggested to participate in cardiac function change at exercise of those patients. (K.H.)

  11. Breathing pattern and gas exchange at cardiopulmonary exercise testing in stable moderate to severe chronic obstructive pulmonary chisease patients with different extent of lung hyperinflation%肺过度充气对稳定期中重度慢性阻塞性肺疾病患者在运动过程中呼吸模式及气体交换的影响

    Institute of Scientific and Technical Information of China (English)

    张艳; 刘锦铭; 谭晓越; 杨文兰; 孙兴国; 刘海舰; 陈淑娟

    2012-01-01

    下降、通气功能受限、换气效率下降及呼吸困难程度.%Objective To study the influence of lung hyperinflation on breathing pattern and gas exchange at cardiopulmonary exercise testing (CPET) in stable moderate to severe chronic obstructive pulmonary disease (COPD) patients.Methods Pulmonary function test (PFT) and CPET were tested in 54 patients with stable moderate to severe COPD,and measured the parameters of ventilation,breathing pattern and gas exchange.The stopped reasons at the end of exercise testing were be noted.Patients who had an emphysematous profile with the perccntage of thoracic gas volume predicted value (Vtg%pred)<150% and the percentage of diffusing lung capacity for carbon monoxide predicted value (DL.CO%pred)≥80% (low lung hyperinflation,Group A),versus patients with Vtg%pred≥150% and DLCO%pred<80% (high lung hyperinflation,Group B).Results At rest,there was no significant difference in tidal volume (VT) and breathing frequency between these two groups,at peak exercise,VT and minute volume ((V)E) in Group A were significant higher than Group B (P<0.001).Between the two groups,tl/tE,VT/tl and VT/tE had significant difference at peak exercise (P<0.01).The dyspnea of Group B was more severe than Group A (P<0.001).At peak exercise,the peak load,peak oxygen consumption ((V)O2),the efficiency of gas exchange and peak oxygen pulse (O2 pulse) in Gropu B were lower than Group A (P<0.05).The reason for stopping exercise was significantly different between the two groups.Peak (V)O2%pred was significant associated with Vtg%pred and DLCO%pred(r=-0.55and 0.68,P<0.001),peak (V)O2 was significant associated with peak VT (r=0.77,P<0.001),moreover,peak VT was significant associated with inspiratory capacity (r=0.63,P<0.001).Conclusions COPD patients who with the higher lung hyperinflation had the less exercise capacity,less ventilation function,reduced efficiency of gas exchange,and worse dyspnea.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Emanuele Asti

    2015-01-01

    Full Text Available 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.

  14. The Influence of Lung Function on Exercise Capacity in Patients with Type 2 Diabetes

    OpenAIRE

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

    2010-01-01

    Patients with type 2 diabetes have impaired exercise capacity. While numerous factors are known to contribute to impaired exercise capacity, the role of lung function remains unclear. We conducted the present study to investigate the influence of lung function on exercise capacity in patients with type 2 diabetes. Cardiopulmonary exercise testing was carried out in 31 male patients with type 2 diabetes without diabetic complications or cardiopulmonary diseases. Patients with abnormal spir...

  15. Exercise thallium testing in ventricular preexcitation

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    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.

  17. Cardiopulmonary Resuscitation (CPR)

    Science.gov (United States)

    MENU Return to Web version Cardiopulmonary Resuscitation (CPR) Cardiopulmonary Resuscitation (CPR) What is CPR? Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that involves chest compressions and giving ...

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

    Directory of Open Access Journals (Sweden)

    Grosbois JM

    2016-03-01

    Full Text Available JM Grosbois,1,2 C Riquier,3 B Chehere,4 J Coquart,5 H Béhal,6 F Bart,2 B Wallaert,2,3 C Chenivesse3 1FormAction Santé, Pérenchies, France; 2Department of Respiratory Medicine, Centre Hospitalier Germon et Gauthier, Béthune, France; 3Department of Respiratory Medicine Immunology and Allergy, Centre Hospitalier Universitaire de Lille, Competence Center for rare lung diseases, University Lille 2, Lille, France; 4EA 7369, URePSSS, Multidisciplinary Research Unit in Sport Health Society, University Lille 2, Lille, France; 5Faculty of Sport Sciences, Sports and Physical Activity, Center for Ecology and Transformation, University of Rouen, Mont Saint Aignan, France; 6Department of Statistical Methods and Biostatistics, Centre Hospitalier Universitaire de Lille, University of Lille Nord, Lille, France Introduction: Exercise tolerance testing is an integral part of the pulmonary rehabilitation (PR management of patients with chronic obstructive pulmonary disease (COPD. The 6-minute stepper test (6MST is a new, well-tolerated, reproducible exercise test, which can be performed without any spatial constraints.Objective: The aim of this study was to compare the results of the 6MST to those obtained during a 6-minute walk test (6MWT and cardiopulmonary exercise testing (CPET in a cohort of COPD patients.Methods: Ninety-one COPD patients managed by outpatient PR and assessed by 6MST, 6MWT, and CPET were retrospectively included in this study. Correlations between the number of steps on the 6MST, the distance covered on the 6MWT, oxygen consumption, and power at the ventilatory threshold and at maximum effort during CPET were analyzed before starting PR, and the improvement on the 6MST and 6MWT was compared after PR.Results: The number of steps on the 6MST was significantly correlated with the distance covered on the 6MWT (r=0.56; P<0.0001, the power at maximum effort (r=0.46; P<0.0001, and oxygen consumption at maximum effort (r=0.39; P<0

  19. [Cardiopulmonary Comorbidities].

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  1. Exercise Testing and Training with the Young Cystic Fibrosis Patient

    OpenAIRE

    Daniel Stevens; Craig A. Williams

    2007-01-01

    The purpose of the article is to review the literature related to exercise and Cystic fibrosis (CF), with particular focus on the young CF patient. Exercise intolerance is a characteristic of CF, however, recent studies in adults have advanced our understanding of how exercise can be used effectively as a prognostic marker and for rehabilitation purposes. New analyses from exercise testing have shown to have prognostic value, and different methods of exercise training have been reported to im...

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

    Science.gov (United States)

    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

  3. Diagnostic value of exercise testing in asbestosis

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    Benoit Wallaert

    2012-01-01

    Full Text Available In patients with fibrotic idiopathic interstitial pneumonia (f-IIP, the diffusing capacity for carbon monoxide (DLCO has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-aO2 at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT. Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF, n=88 and fibrotic nonspecific interstitial pneumonias (NSIP, n=33. All but 3 patients (97.5% had low DLCO values (35 mmHg and 100 (83% demonstrated significant oxygen desaturation during 6MWT (>4%. Interestingly 27 patients had low DLCO and normal P(A-aO2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-aO2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-aO2, peak, or 6MWT SpO2.

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

    Science.gov (United States)

    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.

  6. Exercise test in acute myocardial infarction.

    Science.gov (United States)

    Hsi, W L; Lai, J S

    1996-01-01

    Although maximal oxygen consumption (VO2max) and oxygen consumption at anaerobic threshold (VO2AT) were used to measure cardiac function, the clinical significance in acute myocardial infarction (MI) has not been reported. The purpose of this study was to compare VO2max and VO2AT between post-MI patients and healthy men and to correlate the parameters to other clinical measures. Forty-three active healthy men, 44 sedentary healthy men, and 43 post-MI patients were studied using incremental cycle exercise test. Their work rates, oxygen consumption, heart rates, oxygen pulses, ventilation, and other parameters at VO2max and VO2AT were determined with spirometer, gas concentration analyzer, and electrocardiograph. Anaerobic threshold was determined by analyzing the ventilatory parameters. Most of the exercise test parameters at VO2max were greatest in the active men, intermediate in the sedentary men, and least in the post-MI patients (P pressure products of the active men and sedentary men were not significantly different from each other and were greater than those of the post-MI patients (P < 0.01). In the post-MI patients, VO2max was inversely correlated to the peak serum level of creatine phosphokinase MB isoenzyme (P < 0.01) and associated with extensive infarction (P < 0.05). Most of the parameters at VO2AT were greater in the active men than in the sedentary men (P < 0.01) but not significantly different between the sedentary men and post-MI patients. In the post-MI patients, VO2AT was significantly correlated to left ventricular ejection fraction (P < 0.01) and associated with heart failure (P < 0.05). The results revealed that VO2max and VO2AT had different clinical significance in post-MI patients; VO2max was related to the infarct size, and VO2AT was related to the pumping function of heart. PMID:8777021

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Modeling the oxygen uptake kinetics during exercise testing of patients with chronic obstructive pulmonary diseases using nonlinear mixed models

    DEFF Research Database (Denmark)

    Baty, Florent; Ritz, Christian; van Gestel, Arnoldus;

    2016-01-01

    BACKGROUND: The six-minute walk test (6MWT) is commonly used to quantify exercise capacity in patients with several cardio-pulmonary diseases. Oxygen uptake ([Formula: see text]O2) kinetics during 6MWT typically follow 3 distinct phases (rest, exercise, recovery) that can be modeled by nonlinear...... regression. Simultaneous modeling of multiple kinetics requires nonlinear mixed models methodology. To the best of our knowledge, no such curve-fitting approach has been used to analyze multiple [Formula: see text]O2 kinetics in both research and clinical practice so far. METHODS: In the present study, we...... describe functionality of the R package medrc that extends the framework of the commonly used packages drc and nlme and allows fitting nonlinear mixed effects models for automated nonlinear regression modeling. The methodology was applied to a data set including 6MWT [Formula: see text]O2 kinetics from 61...

  9. Clinical value of exercise testing in elderly patients

    NARCIS (Netherlands)

    J. Pool (Jan); M.G. Scheffer; M.L. Simoons (Maarten); N. Patijn

    1984-01-01

    textabstractBetween 1978 and 1983, 1391 exercise tests were performed by 1083 males and 308 females over 64 years of age. This represents 17% of the total number of 8213 exercise tests. A history of myocardial infarction was present in 53% of the males and 30% of the females, while 12% of patients h

  10. ENERGY SYSTEM CONTRIBUTIONS DURING INCREMENTAL EXERCISE TEST

    Directory of Open Access Journals (Sweden)

    Rômulo Bertuzzi

    2013-09-01

    Full Text Available 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

  11. Austenitic steel piping testing exercises in PISC

    International Nuclear Information System (INIS)

    In this paper capability and reliability studies of NDT procedures for the inspection of wrought and cast stainless steel piping used in nuclear power plants will be presented. The capability study was designed to identify procedures that have the potential to detect and size defects and to discriminate between flawed and unflawed material. The reliability study was undertaken to quantify on real and realistic flaws in-service inspection performance (detection and false call capability) under realistic field conditions. Furthermore parametric studes were performed to complement the capability and reliability studies by evaluating the effect of important material and flaw variables.The specimens used in these studies were cast-to-cast, cast-to-wrought, and wrought-to-wrought pipework welds. The evaluation methods used to quantify the inspection performance were selected to be as comparable as possible to the PISC II methods. These were adapted to allow also the evaluation of the effect of false calls. During the PISC II screening exercise for the cast-to-cast stainless steel round robin test and other piping round robin studies, it was indeed found that false call probabilities were large and could not be ignored in the evaluation of the inspection performance. The matrix of samples has also been designed to allow the implementation of specific statistical analysis procedures for the evaluation of results such as for example the relative operative characteristics analysis. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Kotarska

    2016-03-01

    Full Text Available 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.

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

    OpenAIRE

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

    2016-01-01

    A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST...

  14. The value of exercise tests after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F;

    1992-01-01

    The aim of the present study was to relate the clinical course in patients after a first acute myocardial infarction with the response to exercise-tests performed one month after discharge. 90 consecutive patients who suffered an acute myocardial infarction for the first time were followed-up after...... (W) were predictive with respect to mortality, heart failure, and angina pectoris requiring drug treatment. Exercise tests following acute myocardial infarction could not predict the chances of returning to work....

  15. Effects of different doses of perindopril on cardiopulmonary exercise function in patients with chronic heart failure%不同剂量培哚普利对慢性心力衰竭患者运动心肺功能的影响

    Institute of Scientific and Technical Information of China (English)

    张振英; 高华; 曹倩; 张建秀; 刘艳玲

    2013-01-01

    目的:观察不同剂量培哚普利对慢性心力衰竭患者运动心肺功能的影响。方法45例临床症状稳定的慢性心力衰竭患者在接受基础治疗的基础上随机分为两组:培哚普利4 mg组(n=21)和8 mg组(n=24)。分别在培哚普利治疗开始时和治疗3个月后评估其运动心肺功能、血压和血浆肌酐水平。运动心肺功能采用 Yaeger 心肺功能测试系统评定,采用 V-slope 法计算无氧阈值,观察指标有最大心率、最大摄氧量、无氧阈、氧脉搏(摄氧量/心率)、最大运动负荷和运动时间。运动试验采用症状限制性运动,运动方案采用改良的 Bruce 运动方案。结果两种剂量培哚普利治疗后患者运动时间、无氧阈、最大摄氧量、最大运动负荷等指标均较给药前显著改善(P<0.05);与4 mg组比较,8 mg组患者运动时间、最大摄氧量及最大运动负荷分别增加12.0%(P<0.05)、8.3%(P<0.05)、7.8%(P<0.05)。8 mg 培哚普利显著降低患者血压,对血浆肌酐无明显影响。结论8 mg 培哚普利较4 mg 更有效改善慢性心力衰竭患者运动心肺功能,患者耐受性较好。%Objective To investigate the effects of different doses of perindopril on cardiopulmonary exercise function in patients with chronic heart failure. Methods Forty-five patients with stable chronic heart failure who were receiving basic treatment for heart failure were randomly divided into 4 mg perindopril group (n=21) and 8 mg perindopril group (n=24). Cardiopulmonary exercise function, blood pressure and plasma creatinine were assessed respectively before and after 3 months perindopril treatment. Both groups underwent a symptom limited exercise testing using a modified-Bruce protocol. The parameters of cardiopulmonary function, including maximal heart rate (HRmax), maximum oxygen consumption (VO2max), anaerobic threshold (AT), O2 pulse (oxygen consumption/heart rate

  16. PR Interval Behavior During Exercise Stress Test

    OpenAIRE

    Lee, Jae Ung; Kim, Kyung Soo; Kim, Jeong Hyun; Lim, Heon Kil; Lee, Bang Hun; Lee, Chung Kyun

    1995-01-01

    Objectives: The PR interval on the electrocardiogram represents conduction time from the onset of atrial activation through His-Purkinje conduction system during a normal cardiac cycle. While its behavior at rest and during exposure to various cardioactive drugs is well documented, there exist few reports which describe PR interval variations during exercise in normal control and patient groups. In the present study, We examined the behavior of the PR intervals during various stages of exerci...

  17. Exercise capacity in adult patients with congenitally corrected transposition of the great arteries

    OpenAIRE

    Fredriksen, P; Chen, A.; Veldtman, G; S Hechter; Therrien, J.; Webb, G.

    2001-01-01

    OBJECTIVE—To examine cardiopulmonary values, static lung function, and ejection fraction in adult patients with congenitally corrected transposition of the great arteries (CCTGA).
PATIENTS AND METHODS—41 patients who had undergone static lung function testing and cardiopulmonary exercise tests with measurements of ejection fraction were identified at the Toronto Congenital Cardiac Centre for Adults.
RESULTS—Aerobic capacity in patients with CCTGA was severely diminished, varying from 30-50% o...

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

    OpenAIRE

    Pastré, Jean; Prévotat, Anne; Tardif, Catherine; Langlois, Carole; Duhamel, Alain; Wallaert, Benoit

    2014-01-01

    Background Adult patients with cystic fibrosis (CF) frequently have reduced exercise tolerance, which is multifactorial but mainly due to bronchial obstruction. The aim of this retrospective analysis was to determine the mechanisms responsible for exercise intolerance in patients with mild-to-moderate or severe disease. Methods Cardiopulmonary exercise testing with blood gas analysis at peak exercise was performed in 102 patients aged 28 ± 11 years: 48 patients had severe lung disease (FEV1 ...

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

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

  1. Impact of Obesity on Cardiopulmonary Disease.

    Science.gov (United States)

    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

  2. Validity of the Eating Attitude Test among Exercisers.

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

  4. 有氧运动对维持性血液透析患者生理功能、心肺耐力及生活质量的影响%Effects of aerobic exercise training on physical functioning, cardiopulmonary endurance and health related quality of life in maintenance hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    王欣欣; 宋桂芸; 宿志梅; 恽小平; 马迎春

    2012-01-01

    Objectives To explore the effect of the 12-week aerobic exercise on physiology function, cardiopulmonary endurance and health related life quality in maintenance hemodialysis (MHD) patients. Methods Fourteen patients from our hospital were enrolled in this study. We measured peak oxygen uptake (VO2peak), metabolic equivalents (METs) and stress test duration while taking treadmill exercise of Bruce Sport program, meanwhile, blood pressure and heart rate were recorded. Furthermore, the physical function was evaluated by the results of six-minute walking test (6MWT), cardiopulmonary endurance was measured by VO2peak, METs and stress test duration, and health related quality of life was evaluated by the Health-Related Short Form questionnaire (SF-36) recommended by Kidney Disease Outcomes Quality Initiative (K/ DOQI) clinical practice. Aerobic exercise was defined as treadmill exercise in inter-dialysis of moderate intensity that reaches 50%~80% VO2peak. The strategy of exercise was 30 minutes each time, three times per week for 12 weeks, which included 15 minutes warming-up before exercises and 5 minutes relaxing after exercises. We then evaluated the parameters after 12 weeks, and explored if there were statistical differences in these parameters before and after aerobic exercise training for 12 weeks. Results 6MWT slightly enhanced (Z =-1.132, P= 0.241), and VO2peak and stress test duration increased obviously (Z =-2.226, P =0.028 and Z=-2.701, P =0.007, respectively). MRTs was partially improvement but without statistical significance (Z = -1.632, P =0.103). The results of SF-36 improved significantly (Z =-2.701, P=0.007) after the 12-week exercise. Conclusion The 12-week exercise can partially improve physiological function, cardiopulmonary endurance and health related quality of life in M.HD patients.%目的 探讨12周有氧运动对维持性血液透析(maintenance hemodialysis,MHD)患者生理功能、心肺耐力、健康相关生活质量的影响.

  5. Negative Exercise Stress Test: Does it Mean Anything? Case study

    Directory of Open Access Journals (Sweden)

    Hassan A. Mohamed

    2007-01-01

    Full Text Available Despite its low sensitivity and specificity (67% and 72%, respectively, exercise testing has remained one of the most widely used noninvasive tests to determine the prognosis in patients with suspected or established coronary disease.As a screening test for coronary artery disease, the exercise stress test is useful in that it is relatively simple and inexpensive. It has been considered particularly helpful in patients with chest pain syndromes who have moderate probability for coronary artery disease, and in whom the resting electrocardiogram (ECG is normal. The following case presentation and discussion will question the predictive value of a negative stress testing in patients with moderate probability for coronary artery disease.

  6. Exercise Testing Induces Fatal Thromboembolism: from Mechanical Mitral Valve

    OpenAIRE

    Yavuzgil, Oguz; Ozerkan, Filiz; Gurgun, Cemil; Zoghi, Mehdi; Can, Levent.; AKIN, Mustafa

    2002-01-01

    Thromboembolism is still one of the most important complications of prosthetic heart valves. Embolism to a major coronary branch is rare, but acute proximal occlusions can be fatal, even when the coronary arteries are otherwise normal and intervention is rapid. We report a fatal complication of an exercise test in a patient who had a St. Jude bileaflet mitral valve.

  7. Effect of exercise test on pulmonary function of obese adolescents

    Directory of Open Access Journals (Sweden)

    Alethéa Guimarães Faria

    2014-06-01

    Full Text Available OBJECTIVE: to investigate the pulmonary response to exercise of non-morbidly obese adolescents, considering the gender. METHODS: a prospective cross-sectional study was conducted with 92 adolescents (47 obese and 45 eutrophic, divided in four groups according to obesity and gender. Anthropometric parameters, pulmonary function (spirometry and oxygen saturation [SatO2], heart rate (HR, blood pressure (BP, respiratory rate (RR, and respiratory muscle strength were measured. Pulmonary function parameters were measured before, during, and after the exercise test. RESULTS: BP and HR were higher in obese individuals during the exercise test (p = 0.0001. SatO2values decreased during exercise in obese adolescents (p = 0.0001. Obese males had higher levels of maximum inspiratory and expiratory pressures (p = 0.0002 when compared to obese and eutrophic females. Obese males showed lower values of maximum voluntary ventilation, forced vital capacity, and forced expiratory volume in the first second when compared to eutrophic males, before and after exercise (p = 0.0005. Obese females had greater inspiratory capacity compared to eutrophic females (p = 0.0001. Expiratory reserve volume was lower in obese subjects when compared to controls (p < 0,05. CONCLUSION: obese adolescents presented changes in pulmonary function at rest and these changes remained present during exercise. The spirometric and cardiorespiratory values were different in the four study groups. The present data demonstrated that, in spite of differences in lung growth, the model of fat distribution alters pulmonary function differently in obese female and male adolescents.

  8. Effect of exercise test on pulmonary function of obese adolescents,

    Directory of Open Access Journals (Sweden)

    Alethéa Guimarães Faria

    2014-04-01

    Full Text Available OBJECTIVE:to investigate the pulmonary response to exercise of non-morbidly obese adolescents, considering the gender.METHODS:a prospective cross-sectional study was conducted with 92 adolescents (47 obese and 45 eutrophic, divided in four groups according to obesity and gender. Anthropometric parameters, pulmonary function (spirometry and oxygen saturation [SatO2], heart rate (HR, blood pressure (BP, respiratory rate (RR, and respiratory muscle strength were measured. Pulmonary function parameters were measured before, during, and after the exercise test.RESULTS:BP and HR were higher in obese individuals during the exercise test (p = 0.0001. SatO2values decreased during exercise in obese adolescents (p = 0.0001. Obese males had higher levels of maximum inspiratory and expiratory pressures (p = 0.0002 when compared to obese and eutrophic females. Obese males showed lower values of maximum voluntary ventilation, forced vital capacity, and forced expiratory volume in the first second when compared to eutrophic males, before and after exercise (p = 0.0005. Obese females had greater inspiratory capacity compared to eutrophic females (p = 0.0001. Expiratory reserve volume was lower in obese subjects when compared to controls (p < 0,05.CONCLUSION:obese adolescents presented changes in pulmonary function at rest and these changes remained present during exercise. The spirometric and cardiorespiratory values were different in the four study groups. The present data demonstrated that, in spite of differences in lung growth, the model of fat distribution alters pulmonary function differently in obese female and male adolescents.

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

    OpenAIRE

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

    2010-01-01

    Background Congenital heart disease, a common and serious birth defect, affects 8 per 1000 live-born infants. Decreased exercise capacity and development of obesity is common in this population. These children may benefit from therapies, such as massage therapy, that could enhance cardiovascular and skeletal muscle function when they exercise. Purpose A pilot study conducted at the pediatric cardiology clinic of the Mattel Children’s Hospital of the University of California–Los Angeles examin...

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

    Directory of Open Access Journals (Sweden)

    Abdullah M. Al-Alawi

    2016-05-01

    Full Text Available 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.

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

    Science.gov (United States)

    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.

  12. VALIDITY OF THE EATING ATTITUDE TEST AMONG EXERCISERS

    Directory of Open Access Journals (Sweden)

    Hilary Matheson

    2004-12-01

    Full Text Available 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

  13. Exercises

    Science.gov (United States)

    ... Physical Therapist View full profile COPD: Lifestyle Management Exercise An exercise program is another very important step ... riding a stationary bike. Medication to Help You Exercise People with COPD often use a metered-dose ...

  14. Screening for childhood asthma using an exercise test.

    OpenAIRE

    Jones, A.; Bowen, M

    1994-01-01

    BACKGROUND. Screening for asthma in children in the community could have advantages at a time when prevalence rates of the condition and associated hospital admission rates are rising. AIM. The aim of this study was to assess the usefulness of a standard exercise test as a marker of asthma or potential asthma in children, and to examine the relationship between asthma and other respiratory tract illnesses. METHOD. In 1985 a cross-sectional research study was undertaken in 10 primary schools i...

  15. Pulmonary artery pressure limits exercise capacity at high altitude.

    OpenAIRE

    Naeije, Robert; Huez, Sandrine; Lamotte, Michel; Retailleau, Kathleen; Neupane, S; Abramowicz, Daniel; Faoro, Vitalie

    2010-01-01

    Altitude exposure is associated with decreased exercise capacity and increased pulmonary vascular resistance (PVR). Echocardiographic measurements of pulmonary haemodynamics and a cardiopulmonary exercise test were performed in 13 healthy subjects at sea level, in normoxia and during acute hypoxic breathing (1 h, 12% oxygen in nitrogen), and in 22 healthy subjects after acclimatisation to an altitude of 5,050 m. The measurements were obtained after randomisation, double-blinded to the intake ...

  16. The steep ramp test in dutch white children and adolescents: Age- and sex-related normative values

    NARCIS (Netherlands)

    Bongers, B.C.; Vries, S.I. de; Obeid, J.; Buuren, S. van; Helders, P.J.M.; Takken, T.

    2013-01-01

    Background. The Steep Ramp Test (SRT), a feasible, reliable, and valid exercise test on a cycle ergometer, may be more appealing for use in children in daily clinical practice than the traditional cardiopulmonary exercise test because of its short duration, its resemblance to children's daily activi

  17. Cardiopulmonary adaptation to weightlessness

    Science.gov (United States)

    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.

  18. Transient left ventricular apical ballooning and exercise induced hypertension during treadmill exercise testing: is there a common hypersympathetic mechanism?

    Directory of Open Access Journals (Sweden)

    Oh Jae K

    2008-07-01

    Full Text Available Abstract Objective To describe two cases of Takotsubo like myocardial contractile pattern during exercise stress test secondary to hypertensive response. Background Treadmill exercise testing is known to cause sympathetic stimulation, leading to increased levels of catecholamine, resulting in alteration in vascular tone. Hypertensive response during exercise testing can cause abnormal consequences, resulting in false positive results. Cases We present the cases of two patients experiencing apical and basal akinesis during exercise stress echocardiography, in whom normal wall motion response was observed on subsequent pharmacologic stress testing. The first patient developed transient left ventricular (LV apical akinesis during exercise stress echocardiography. Due to high suspicion that this abnormality might be secondary to hypertensive response, pharmacologic stress testing was performed after three days, which was completely normal and showed no such wall motion abnormality. Qualitative assessment of myocardial perfusion using contrast was also performed, which showed good myocardial blood flow, indicating low probability for significant obstructive coronary artery disease. The second patient developed LV basal akinesis as a result of hypertensive response during exercise testing. Coronary angiogram was not performed in either patient due to low suspicion for coronary artery disease, and subsequently negative stress studies. Results Transient stress induced cardiomyopathy can develop secondary to hypertensive response during exercise stress testing. Conclusion These cases provide supporting evidence to the hyper-sympathetic theory of left ventricular ballooning syndrome.

  19. Determinants of exercise peak arterial blood pressure, circulatory power, and exercise cardiac power in a population based sample of Finnish male and female aged 30 to 47 years: the Cardiovascular Risk in Young Finns Study

    OpenAIRE

    Hulkkonen, Janne; Aatola, Heikki; Pälve, Kristiina; Lehtimäki, Terho; Hutri-Kähönen, Nina; Viikari, Jorma SA; Raitakari, Olli T.; Kähönen, Mika

    2014-01-01

    Background Novel parameters derived from peak maximal oxygen uptake (VO2) and exercise arterial blood pressure, such as peak circulatory power (CP) and exercise cardiac power (ECP), can be used in the risk assessment of cardiovascular disease and stroke. However, the determinants of these factors are poorly characterized in the general population. Methods We assessed peak arterial blood pressure, CP and ECP with standardized cardiopulmonary exercise test (CPET) on 281 female and 257 male part...

  20. Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis – The Predictive Value of Exercise Capacity and Gas Exchange Efficiency

    OpenAIRE

    Gläser, Sven; Obst, Anne; Koch, Beate; Henkel, Beate; Grieger, Anita; Stephan B. Felix; Halank, Michael; Bruch, Leonhard; Bollmann, Tom; Warnke, Christian; Schäper, Christoph; Ewert, Ralf

    2013-01-01

    Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 1...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Bronchial provocation testing does not detect exercise-induced laryngeal obstruction

    DEFF Research Database (Denmark)

    Walsted, Emil Schwarz; Hull, James H; Sverrild, Asger;

    2016-01-01

    Introduction Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for asthma in the presence of exertional respiratory symptoms. Continuous laryngoscopy during exercise (CLE), the current gold standard diagnostic test for EILO, has practical limitations. We aimed to estab......Introduction Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for asthma in the presence of exertional respiratory symptoms. Continuous laryngoscopy during exercise (CLE), the current gold standard diagnostic test for EILO, has practical limitations. We aimed...

  3. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2010-11-01

    Full Text Available Background: Systolic blood pressure recovery (rSBP is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR in a population-based sample of patients undergoing coronary artery bypass grafting (CABG.Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined as the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise.Results: An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents (β = -0.617, SE = 0.127, p value < 0.001 and peak O2 consumption (β = -1.950, SE = 0.363, p value < 0.001 measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction.Conclusion: The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program.

  4. Blood lactate diagnostics in exercise testing and training.

    Science.gov (United States)

    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 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

  5. Successful application of acute cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Derya ztrk; Erturul Altinbilek; Murat Koyuncu; Bedriye Mge Snmez; ilem altili; Ibrahim Ikzcel; Cemil Kavalci; Glsm Kavalci

    2015-01-01

    Objective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR atŞŞişli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 ± 16) years and 64%of the patients were male. The initial rhythms of the CPR-applied patients were different (P 0.05). The CPR response time was longer in ED (P Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.

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

    Science.gov (United States)

    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.

  7. Teste cardiopulmonar do exercício na prática clínica Cardiopulmonary stress testing in clinical practice

    Directory of Open Access Journals (Sweden)

    Eva Cantalejo Munhoz Stadler de Souza

    2000-12-01

    Full Text Available O teste cardiopulmonar do exercício (CPX apresenta-se como uma metodologia de grande utilidade diagnóstica e prognóstica. O presente estudo teve por objetivo demonstrar que os dados obtidos em laboratório fora do ambiente hospitalar comportam-se como os dados descritos na literatura, com aplicabilidade na prática clínica em nosso meio. METODOLOGIA: Trata-se de um relato de experiência, através da análise retrospectiva dos casos. O CPX foi realizado em condições de laboratório controladas, com bocal e clipe nasal, protocolo de rampa em esteira rolante e eletrocardiograma de 13 canais. RESULTADOS: Entre os 261 testes, 53,3% eram em homens, idade média de 48,2 ± 14,3 anos; ativos (45,2% ou sedentários (34,5%. A capacidade aeróbia máxima foi superior e com declínio significativo para cada década de aumento na faixa etária entre os homens, enquanto nas mulheres o declínio significativo ocorreu entre os 30 e 60 anos. As mulheres apresentaram maior distribuição (p = 0,0006 nas classes funcionais "em programa de treinamento ou bem treinadas e motivadas". O consumo de oxigênio pico (O2 foi significativamente superior nos testes máximos, mas o O2 do limiar anaeróbio (O2LA não apresentou diferenças significativas, quando o teste obtido foi máximo ou submáximo. A capacidade funcional, avaliada pelo O2LA como porcentagem do O2 máximo previsto, comparado à porcentagem do O2 máximo atingido, classificou mais indivíduos com compromisso circulatório (p = 0,002 ou com menor aptidão física em comparação com pacientes ativos ou em programa de treinamento (p O2 máximo previsto foi a causa mais comum de anormalidade, mais freqüente e significativo entre as mulheres. CONCLUSÃO: Os dados obtidos são comparáveis aos descritos na literatura, sugerindo que o CPX é uma metodologia factível, que poderia ser empregada rotineiramente na prática clínica em nosso meio.Cardiopulmonary stress testing (CPT is a very useful tool to

  8. Exercise induced fatigue: unfit or unwell?

    LENUS (Irish Health Repository)

    Moore, D M

    2011-05-01

    This case report outlines the diagnoses of a rare myophosphorylase deficiency (McArdle Syndrome) in a unique way. A set of characteristic values from a Cardiopulmonary Exercise Test (CPET) combined with a typical patient history pointed to a failure of the glycolytic pathway in the skeletal muscle. McArdle Syndrome was confirmed with a skeletal muscle biopsy. There is no evidence of such a diagnostic method in the literature.

  9. Cardiorespiratory responses to moderate exercise and determination of aerobic power in first year medical students

    OpenAIRE

    Subha Kavundapadi Chandrasekaran; Rajkumar Devaraj

    2016-01-01

    Background: Cardiovascular and metabolic disorder has become common in individuals leading a sedentary life. Exercise stress tests are carried out as part of the investigations for determining the individual fitness level. Aerobic power or VO2max which involves a full functional support from cardio respiratory and metabolic pathways is an appropriate test to study cardio pulmonary fitness. The main objective of the study is to find out the normal cardiopulmonary responses to exercise and thei...

  10. Passive Leg Raising Correlates with Future Exercise Capacity after Coronary Revascularization

    OpenAIRE

    Huang, Shu-Chun; Wong, May-Kuen; Lin, Pyng-Jing; Tsai, Feng-Chun; Wen, Ming-Shien; Kuo, Chi-Tai; Hsu, Chih-Chin; Wang, Jong-Shyan

    2015-01-01

    Hemodynamic properties affected by the passive leg raise test (PLRT) reflect cardiac pumping efficiency. In the present study, we aimed to further explore whether PLRT predicts exercise intolerance/capacity following coronary revascularization. Following coronary bypass/percutaneous coronary intervention, 120 inpatients underwent a PLRT and a cardiopulmonary exercise test (CPET) 2–12 days during post-surgery hospitalization and 3–5 weeks after hospital discharge. The PLRT included head-up, le...

  11. Small Airway Dysfunction and Abnormal Exercise Responses

    Science.gov (United States)

    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

  12. Cardiopulmonary bypass in pregnancy.

    Science.gov (United States)

    Pomini, F; Mercogliano, D; Cavalletti, C; Caruso, A; Pomini, P

    1996-01-01

    The cardiopathic patient can sustain acute heart failure during pregnancy. In such cases, if open heart operation is necessary to save the patient's life, the fetus could be seriously compromised after exposure to cardiopulmonary bypass. From 1958 to 1992, 69 reports of cardiac operations during pregnancy with the aid of cardiopulmonary bypass have been published. Maternal mortality was 2.9%. Embryofetal mortality was 20.2%. Examining only the last 40 patients, maternal and embryofetal mortality were 0.0% and 12.5%, respectively. Embryofetal mortality was 24.0% when hypothermia was used, compared with 0.0% while operating in normothermia. Maternal mortality did not change. The use of hypothermia during cardiopulmonary bypass provoked uterine contractions in several patients. Hypothermia decreases O2 exchange through the placenta. Pump flow and mean arterial pressure during cardiopulmonary bypass seem to be the most important parameters that influence fetal oxygenation. We speculate that cardiac operation is not a contraindication to pregnancy prolongation. PMID:8561577

  13. Cardiopulmonary discipline science plan

    Science.gov (United States)

    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.

  14. Bosentan Improves Exercise Capacity in Adolescents and Adults After Fontan Operation

    DEFF Research Database (Denmark)

    Hebert, Anders; Mikkelsen, Ulla Ramer; Thilen, Ulf;

    2014-01-01

    this study was therefore to examine the efficacy and safety of bosentan in Fontan patients. METHODS AND RESULTS: Seventy-five adolescents and adults were randomized 1:1 to 14 weeks of treatment with bosentan or placebo. Cardiopulmonary exercise test, functional class, blood samples, and quality...

  15. Understanding Exercise, Diet and Lung Disease

    Science.gov (United States)

    ... Your exercise program will include a walking or cycling program that is designed to improve your endurance ... you start your program. Endurance (Cardiopulmonary) Exercise ❑ Walking ❑ Cycling ❑ Treadmill ❑ Other (specify)______________ Frequency: _____ days per week Duration: _____ ...

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

    Energy Technology Data Exchange (ETDEWEB)

    Cortinas, Inés Vidal, E-mail: invi@montevideo.com.uy; Beretta, Mario; Alonso, Omar; Mut, Fernando [Departamento de Medicina Nuclear do Hospital ‘Asociación Española’, Br. Artigas 1515, Montevideo (Uruguay)

    2015-08-15

    Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. 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. 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. 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). 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.

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

    Directory of Open Access Journals (Sweden)

    Inés Vidal Cortinas

    2015-08-01

    Full Text Available AbstractBackground: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.

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

    International Nuclear Information System (INIS)

    Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. 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. 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. 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). 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

  19. Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease

    OpenAIRE

    Guo, Jian; Zheng, Cong; Xiao, Qiang; Gong, Sugang; Zhao, Qinhua; Wang, Lan; He, Jing; Yang, Wenlan; Shi, Xue; Sun, Xingguo; Liu, Jinming

    2015-01-01

    Objective This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). Setting The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base with...

  20. Comparison of cardiovascular responses to isometric (static) and isotonic (dynamic) exercise tests in chronic atrial fibrillation.

    Science.gov (United States)

    Akdur, Hülya; Yigit, Zerrin; Arabaci, Umit; Polat, Mine Gülden; Gürses, Hülya Nilgün; Güzelsoy, Deniz

    2002-11-01

    The aim of the present study was to evaluate the tolerance to various exercises by determining the cardiovascular response to static and dynamic exercises in patients with nonvalvular atrial fibrillation. Fifty patients (mean age: 63.6 +/- 10.3 years; male: 25, female: 25) with chronic (more than one year) nonvalvular atrial fibrillation were included in the study. All patients underwent exercise tests, adjusted appropriately according to their symptoms, as dynamic exercise on a Marquette Case 15 device according to a modified Bruce protocol. Heart rate, and systolic and diastolic arterial pressures were measured at rest and at all stages of the exercise; and the heart rate-pressure products were evaluated. A handgrip test was also conducted as static exercise. The measurements were made before, at the 1st, 2nd and 3rd minutes, and in the recovery periods of the exercise. The percent values of the changes of the 1st, 2nd and 3rd minute measurements in relation to the initial values for both exercises were compared. In addition, the maximal responses to the exercise tests and the post exercise values were also compared. For statistical evaluations, the paired Student-t test was used. Heart rate and pressure-heart rate product values obtained at 1, 2, and 3 minutes during the treadmill exercise test were significantly high compared to the handgrip values (P < 0.0001). The arterial systolic and diastolic pressure values in the 1st minute were also significantly higher during the handgrip test (P = 0.0100 and P = 0.0320, respectively). The values of diastolic arterial pressure at the 2nd minute during the handgrip test, and systolic arterial pressure at the 3rd minute during the treadmill test were found to be statistically significant (P = 0.0240, P = 0.0340, respectively). The mean exercise time and MET value during the treadmill exercise test were 7.18 +/- 2.65 minutes and 5.32 +/- 1.38 mL.kg(-1) x dk(-1). respectively. During the recovery period, the 5th minute

  1. Diagnostic and prognostic implications of exercise testing in coronary artery disease

    NARCIS (Netherlands)

    J.W. Deckers (Jaap)

    1988-01-01

    textabstractThe clinical indications for exercise testing as a diagnostic and prognostic tool in the assessment of patients with ischemic heart disease have gradually evolved since Master introduced the two-step exercise test in 1929 (1). New information from correlations between electrocardiographi

  2. Exercise

    Science.gov (United States)

    ... 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, ...

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

    Science.gov (United States)

    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

  4. Exercise And Heart Failure: Advancing Knowledge And Improving Care

    Science.gov (United States)

    Alvarez, Paulino; Hannawi, Bashar; Guha, Ashrith

    2016-01-01

    Exercise limitation is the hallmark of heart failure, and an increasing degree of intolerance is associated with poor prognosis. Objective evaluation of functional class (e.g., cardiopulmonary exercise testing) is essential for adequate prognostication in patients with advanced heart failure and for implementing an appropriate exercise training program. A graded exercise program has been shown to be beneficial in patients with heart failure and has become an essential component of comprehensive cardiac rehabilitation in these patients. An exercise program tailored to the patient's preferences, possibilities, and physiologic reserve has the greatest chance of being successful. Despite being safe, effective, and a guideline-recommended treatment to improve quality of life, exercise training remains grossly underutilized. Patient, physician, insurance and practice barriers need to be addressed to improve this quality gap. PMID:27486494

  5. Thrombin during cardiopulmonary bypass.

    Science.gov (United States)

    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

  6. Exercise Intolerance in Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Robin M. Fowler

    2012-01-01

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

  7. Acute and chronic effects of surgical thromboendarterectomy on exercise capacity and ventilatory efficiency in patients with chronic thromboembolic pulmonary hypertension

    OpenAIRE

    Iwase, T.; Nagaya, N; Ando, M.; Satoh, T.; Sakamaki, F; Kyotani, S; Takaki, H; Goto, Y.; Ohkita, Y; Uematsu, M.; Nakanishi, N; Miyatake, K

    2001-01-01

    OBJECTIVE—To assess acute and chronic effects of surgical thromboendarterectomy on exercise capacity and ventilatory efficiency in patients with chronic thromboembolic pulmonary hypertension (CTEPH).
DESIGN—Cardiopulmonary exercise testing was performed in 20 patients with CTEPH before thromboendarterectomy (baseline), one month after (early phase), and four months after (late phase). Peak oxygen uptake (peak V̇O2) and the ventilatory response to carbon dioxide production (V̇E-V̇CO2 slope) we...

  8. Impaired exercise capacity following atrial septal defect closure: an invasive study of the right heart and pulmonary circulation

    OpenAIRE

    Santos, Mário; Systrom, David; Epstein, Stephen E.; John, Anitha; Ruiz, George; Landzberg, Michael J.; Opotowsky, Alexander R.

    2014-01-01

    Patients with early repair of an isolated atrial septal defect (ASD) are expected to have unremarkable right ventricular (RV) and pulmonary circulation physiology. Some studies, however, suggest persistent functional impairment. We aimed to examine the role of abnormal RV and pulmonary vascular response to exercise in patients who had undergone ASD closure. Using a previously published data set, we reviewed invasive exercise cardiopulmonary testing with right-sided hemodynamic data for 12 asy...

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

    Science.gov (United States)

    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…

  10. Estimation of aerobic fitness among young men without exercise test

    OpenAIRE

    Tanskanen Minna M.; Kyröläinen Heikki; Santtila Matti; Tammelin Tuija

    2015-01-01

    Study aim: to develop and estimate the validity of non-exercise methods to predict VO2max among young male conscripts entering military service in order to divide them into the different physical training groups. Material and methods: fifty males (age 19.7 ± 0.3 years) reported their physical activity before military service by IPAQ and SIVAQ questionnaires. Furthermore, Jackson’s non-exercise method was used to estimate VO2max. Body mass and height were measured, body mass index ...

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Aguilaniu B

    2014-09-01

    Full Text Available Bernard Aguilaniu,1,2 Hubert Roth,3 Jesus Gonzalez-Bermejo,4 Marie Jondot,5 Jocelyne Maitre,5 François Denis,6 Thomas Similowski4,7 1Medicine Faculty, Université Joseph Fourier, Grenoble, France; 2McGill University, Montreal, Canada; 3Centre de Recherche en Nutrition Humaine Rhône-Alpes, CHU Grenoble, France; 4Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Respiratory and Intensive Care Medicine, Paris, France; 5Clinique Universitaire de Pneumologie, CHU Grenoble, France, Grenoble, France; 6Boehringer Ingelheim, 7Université Paris, Paris, France Abstract: The functional work capacity of chronic obstructive pulmonary disease (COPD patients is usually assessed with walk tests such as the 6-minute walk test (6MWT or the shuttle test. Because these exercise modalities require a controlled environment which limits their use by pulmonologists and severely restricts their use among general practitioners, different modalities of a short (1 minute or less sit-to-stand test were recently proposed. In this study, we evaluated a new modality of a semipaced 3-minute chair rise test (3CRT in 40 patients with COPD, and compared the reproducibility of physiological responses and symptoms during the 3CRT and their interchangeability with the 6MWT. The results demonstrate that physiological variables, heart rate, pulse oxygen saturation, work done, and symptoms (Borg dyspnea and fatigue scores, during the 3CRT were highly reproducible, and that the physiological responses and symptoms obtained during the 3CRT and the 6MWT were interchangeable for most patients. Moreover, these preliminary data suggest that patients able to perform more than 50 rises during 3 minutes had no significant disability. The simplicity and ease of execution of the 3CRT will facilitate the assessment of exercise symptoms and disability in COPD patients during routine consultations with pulmonologists and general practitioners, and will thus contribute

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

    Directory of Open Access Journals (Sweden)

    Lin-Fen Hsieh

    2014-01-01

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

  14. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

    Full Text Available Cardiac surgery carried out on cardiopulmonary bypass (CPB in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  15. Incidence of Pneumothorax in Patients With Lymphangioleiomyomatosis Undergoing Pulmonary Function and Exercise Testing.

    Science.gov (United States)

    Taveira-DaSilva, Angelo M; Julien-Williams, Patricia; Jones, Amanda M; Moss, Joel

    2016-07-01

    Because pneumothorax is frequent in lymphangioleiomyomatosis, patients have expressed concerns regarding the risk of pneumothorax associated with pulmonary function or exercise testing. Indeed, pneumothorax has been reported in patients with lung disease after both of these tests. The aim of this study was to determine the incidence of pneumothorax in patients with lymphangioleiomyomatosis during admissions to the National Institutes of Health Clinical Research Center between 1995 and 2015. Medical records were reviewed to identify patients who had a pneumothorax during their stay at the National Institutes of Health. A total of 691 patients underwent 4,523 pulmonary function tests and 1,900 exercise tests. Three patients developed pneumothorax after pulmonary function tests and/or exercise tests. The incidence of pneumothorax associated with lung function testing was 0.14 to 0.29 of 100 patients or 0.02 to 0.04 of 100 tests. The incidence of pneumothorax in patients undergoing exercise testing was 0.14 to 0.28 of 100 patients or 0.05 to 0.10 of 100 tests. The risk of pneumothorax associated with pulmonary function or exercise testing in patients with lymphangioleiomyomatosis is low. PMID:27396798

  16. Impact of training at ventilatory threshold on cardiopulmonary and functional capacity in overweight patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Danilo Takashi Aoike

    2012-06-01

    Full Text Available INTRODUCTION: Chronic kidney disease (CKD and obesity are both associated with reduced physical capacity. The potential benefit of aerobic training on physical capacity has been recognized. The exercise intensity can be established using different methods mostly subjective or indirect. Ventilatory threshold (VT is a direct and objective method that allows prescribing exercise intensity according to individual capacity. OBJECTIVES: To evaluate the impact of aerobic training at VT intensity on cardiopulmonary and functional capacities in CKD patients with excess of body weight. METHODS: Ten CKD patients (eight men, 49.7 ± 10.1 years; BMI 30.4 ± 3.5 kg/m², creatinine clearance 39.4 ± 9.8 mL/min/1.73 m² underwent training on a treadmill three times per week during 12 weeks. Cardiopulmonary capacity (ergoespirometry, functional capacity and clinical parameters were evaluated. RESULTS: At the end of 12 weeks, VO2PEAK increased by 20%, and the speed at VO2PEAK increased by 16%. The training resulted in improvement in functional capacity tests, such as six-minute walk test (9.2%, two-minute step test (20.3%, arm curl test (16.3%, sit and stand test (35.7%, and time up and go test (15.3%. In addition, a decrease in systolic and diastolic blood pressures was observed despite no change in body weight, sodium intake and antihypertensive medication. CONCLUSION: Aerobic exercise performed at VT intensity improved cardipulmonary and functional capacities of overweight CKD patients. Additional benefit on blood pressure was observed. These results suggest that VT can be effectively applied for prescribing exercise intensity in this particular group of patients.

  17. Non-invasive measurement of adrenal response after standardized exercise tests in prepubertal children

    NARCIS (Netherlands)

    Heijsman, Sigrid M.; Koers, Nicoline F.; Bocca, Gianni; van der Veen, Betty S.; Appelhof, Maaike; Kamps, Arvid W. A.

    2012-01-01

    Objective: To determine the feasibility of non-invasive evaluation of adrenal response in healthy prepubertal children by standardized exercise tests. Methods: On separate occasions, healthy prepubertal children performed a submaximal cycling test, a maximal cycling test, and a 20-m shuttle-run test

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

    OpenAIRE

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

    2004-01-01

    Our purpose is to report on the epidemiological variables and their association with the results of the exercise tolerance test (ETT) in the series of patients referred for standard diagnostic ETT at Seremban Hospital during the year 2001. ETT is widely performed, but, in Malaysia, an analysis of the associations between the epidemiological data and the results of the ETT has not been presented. All patients referred for ETT at Seremban Hospital who underwent exercise treadmill tests for the ...

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

    Directory of Open Access Journals (Sweden)

    Abiodun OO

    2015-08-01

    Full Text Available Olugbenga O Abiodun, Michael O Balogun, Anthony O Akintomide, Rasaaq A Adebayo, Olufemi E Ajayi, Suraj A Ogunyemi, Valentine N Amadi, Victor O Adeyeye Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC, Ile-Ife, Osun state, Nigeria 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 significantly 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. Keywords: maximal exercise, treadmill, bicycle ergometer, hypertension, Nigerians

  20. Biochemical changes in relation to a maximal exercise test in patients with fibromyalgia

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Mehlsen, J;

    1994-01-01

    Patients with fibromyalgia often complain of fatigue and pain during exercise and of worsening of pain days after exercise. The aim of the study described here was to determine if abnormal changes in potassium or lactate could be observed during an exercise test in fibromyalgia. Whether an abnormal...... incline in plasma creatine kinase or myoglobin could be observed days after the test was studied also. Fifteen female fibromyalgia patients and 15 age- and sex-matched controls performed a stepwise incremental maximal bicycle-ergometer test. Blood samples were collected from a catheter in a cubital vein......-1 was reached at a heart rate of 124 min-1 in the patients with fibromyalgia as compared to 140 min-1 in the controls (P = 0.02). In relation to workload, the patients scored higher on a Borg scale for perceived exertion during exercise, but if the Borg score was related to lactate no significant...

  1. Effect of exercise test on pulmonary function of obese adolescents,

    OpenAIRE

    Alethéa Guimarães Faria; Maria Angela G.O. Ribeiro; Fernando Augusto de Lima Marson; Camila Isabel S. Schivinski; Silvana Dalge Severino; José Dirceu Ribeiro; Antônio A. Barros Filho

    2014-01-01

    OBJECTIVE: to investigate the pulmonary response to exercise of non-morbidly obese adolescents, considering the gender. METHODS: a prospective cross-sectional study was conducted with 92 adolescents (47 obese and 45 eutrophic), divided in four groups according to obesity and gender. Anthropometric parameters, pulmonary function (spirometry and oxygen saturation [SatO2]), heart rate (HR), blood pressure (BP), respiratory rate (RR), and respiratory muscle strength were measured. Pulmonary ...

  2. Diagnostic and prognostic value of ST segment depression limited to the recovery phase of exercise stress test

    OpenAIRE

    Lanza, G A; Mustilli, M; Sestito, A; Infusino, F; Sgueglia, G A; Crea, F

    2004-01-01

    Objectives: To investigate the diagnostic and prognostic value of ST segment depression limited to the recovery phase of an exercise stress test, as compared with that of ST segment depression appearing during exercise.

  3. Quantitative evaluation of cardiopulmonary functional reserve in treated patients with pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    YAN Wen-wen; WANG Le-min; CHE Lin; SONG Hao-ming; JIANG Jin-fa; XU Jia-hong; SHEN Yu-qin; ZHANG Qi-ping

    2012-01-01

    Background There is no research,either at home or abroad,focusing on assessing the cardiopulmonary functional reserve and exercise tolerance in patients with pulmonary embolism (PE),but the benefits of early exercise are well recognized.The goals of this study were to assess cardiopulmonary functional reserve in treated PE patients using the inert gas rebreathing method of the cardiopulmonary exercise test (CPET),and to compare it with traditional methods.Methods CPET on the bicycle ergometer were performed in 40 patients with age,gender,body mass index,systolic blood pressure,and pulmonary function matched.The first group was the PE group composed of 16 PE patients (5 male,11 female) who were given the standard antithrombotic therapy for two weeks.The second group was composed of 24 normal individuals (10 male,14 female).Both groups were evaluated by cardiac ultrasound examination,6-minute walking test (6MVVT),and CPET.Results (1) Right ventricular systolic pressure (RVSP) in the PE group increased significantly compared to the control group,(34.81±8.15) mmHg to (19.75±3.47) mmHg (P <0.01).But neither right atrial end-systolic diameter (RASD) nor right ventricular end-diastolic diameter (RVDD) in the PE patients had changed when compared with the controls.The 6-minute walk distance was significantly reduced in the PE patients compared with normal subjects,(447.81±79.20) m vs.(513.75±31.45) m (P <0.01).Both anaerobic threshold oxygen consumption (VO2AT) and peak oxygen consumption (VO2peak) were significantly lower in patients with PE,while CO2 equivalent ventilation (VE/VCO2 slope) was higher;VO2AT (9.44±3.82) ml·kg1.min-1 vs.(14.62±2.93) ml.kg-1.min-1 (P <0.01) and VO2peak (12.26±4.06) ml.kg-1.min-1 vs.(23.46±6.15) ml.kg-1.min-1 (P <0.01) and VE/VCO2 slope 35.47±6.66 vs.26.94±3.16 (P <0.01).There was no significant difference in resting cardiac output (CO) between the PE and normal groups,whereas peak cardiac output (peak CO)and the

  4. 高血压飞行人员运动负荷试验研究%Research of exercise load test in hypertensive aircrews

    Institute of Scientific and Technical Information of China (English)

    刘晶; 王露今; 刘玉华; 徐先荣; 刘红巾; 徐蜀宣; 崔丽; 付兆君; 熊巍

    2015-01-01

    目的 探讨影响高血压飞行人员心肺储备能力的主要因素. 方法 根据《中国高血压防治指南2010》选择高血压和非高血压飞行人员各17例,进行心肺运动试验,测量并比较两组的每千克体重峰值摄氧量(peak oxygen uptake per kilogram,VO2peak/kg)、无氧阈(anaerobic threshold,AT)时的摄氧量(oxygen uptate per kilogram at AT,VO2/kg@AT)、峰值氧脉搏(peak oxygen pulse,O2 pulsepeak)、血压、心率、运动时间等指标. 结果 高血压组与正常组的VO2peak、VO2@AT、O2 pulsepeak差异无统计学意义(P>0.05);两组的运动峰值收缩压、舒张压、峰值心率、运动前后收缩压变化值、心率变化值、运动后6 min血压、运动时间比较差异有统计学意义(t=2.622~4.945,P<0.01或P<0.05). 结论 高血压飞行人员运动耐量的气体代谢指标变化不明显,血压的运动反应更敏感.在飞行人员高血压病的诊治、鉴定和随访中,运动血压应作为诊室血压和动态血压的补充.%Objective To investigate the main factors influencing cardiac pulmonary reserve of hypertensive aircrews.Methods The aircrews were divided into hypertension group (n=17) and normal group (n=17) by the diagnosis of hypertension that defined in Chinese Hypertension Guideline 2010.Such parameters as peak oxygen uptake per kilogram (VO2peak/kg),VO2/kg at anaerobic threshold (VO2/kg@AT),peak oxygen pulse (O2 pulsepeak),blood pressure (BP),heart rate (HR),exercise time in cardiopulmonary exercise test (CPET) were recorded in cardiopulmonary exercise and analyzed.Results There were no differences in VO2peak,VO2@AT and VO2peak between two groups (P>0.05).Significant differences existed in peak SBP,DBP and HR,△SBP,△HR,BP levels at 6 minutes after exercise,exercise time between groups (t=2.622-4.945,P<0.01or <0.05).Conclusions BP responses are more sensitive than gaseous metabolism indexes during hypertensive aircrews' CPET.Exercise BP would be the

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

    OpenAIRE

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

    2004-01-01

    The present study was undertaken to test the hypothesis that chronic, low-level paraquat exposure causes restrictive lung function with gas transfer impairment. Three hundred thirty-eight Costa Rican farm workers from banana, coffee and palm oil farms completed a questionnaire, spirometry and single-breath carbon monoxide diffusing capacity. Subjects 40 years of age or older, without other medical risk factors, completed maximal cardiopulmonary exercise tests. Most (66.6%) were paraquat hand...

  6. Exercise stress testing in healthy subjects during cholinergic stimulation after a single dose of pyridostigmine

    Directory of Open Access Journals (Sweden)

    Salvador M. Serra

    2001-04-01

    Full Text Available OBJETIVE: The evaluation, by exercise stress testing, of the cardiorespiratory effects of pyridostigmine (PYR, a reversible acetylcholinesterase inhibitor. METHODS: A double-blind, randomized, cross-over, placebo-controlled comparison of hemodynamic and ventilation variables of 10 healthy subjects who underwent three exercise stress tests (the first for adaptation and determination of tolerance to exercise, the other two after administration of placebo or 45mg of PYR. RESULTS: Heart rate at rest was: 68±3 vs 68±3bpm before and after placebo, respectively (P=0.38; 70±2 vs 59±2bpm, before and after pyridostigmine, respectively (P<0.01. During exercise, relative to placebo: a significantly lower heart rate after PYR at, respectively, 20% (P=0.02, 40% (P=0.03, 80% (P=0.05 and 100% (P=0.02 of peak effort was observed. No significant differences were observed in arterial blood pressure, oxygen consumption at submaximal and maximal effort, exercise duration, respiratory ratio, CO2 production, ventilation threshold, minute ventilation, and oxygen pulse. CONCLUSION: Pyridostigmine, at a dose of 45mg, decreases heart rate at rest and during exercise, with minimal side effects and without interfering with exercise tolerance and ventilation variables.

  7. Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women?

    Directory of Open Access Journals (Sweden)

    Júlia G. Reis

    2012-06-01

    Full Text Available BACKGROUND: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. OBJECTIVE: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. METHODS: The women were randomized into control group (n=31, which performed no exercise, and exercise group (n=27, which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions, reaching 85% until the end of the 3-month period (4 series of 6 repetitions each. RESULTS: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05, but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p CONCLUSION: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women.

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

    International Nuclear Information System (INIS)

    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 201T1 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

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  11. Exercise electrocardiogram testing in two brothers with different outcome – a case study exercise testing in master cyclists

    OpenAIRE

    Rüst CA; Knechtle B; Rosemann T.

    2013-01-01

    Christoph Alexander Rüst,1 Beat Knechtle,1,2 Thomas Rosemann11Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland; 2Gesundheitszentrum St Gallen, St Gallen, SwitzerlandAbstract: The cases of two brothers training and competing as master cyclists and both preparing for a cycling tour are presented. The older brother aged 66 years went first to the primary care physician and presented with an asymptomatic depression in the exercise stre...

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

    Science.gov (United States)

    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.

  13. Electrocardiographically and symptomatically silent myocardial ischemia during exercise testing

    International Nuclear Information System (INIS)

    Certain patients with coronary artery disease (CAD) may have neither ST depression nor chest pain during exercise despite the presence of myocardial ischemia. The frequency and characteristics of such electrocardiographically and symptomatically silent ischemia were studied in 171 patients with both angiographically documented CAD and scintigraphically documented ischemia. Fifty-six (33%) of 171 patients had neither ST depression nor chest pain (Group N), and 115 (67%) had ST depression and/or chest pain (Group P). The two groups were similar with respect to age, gender, the prevalence of prior infarction, and peak systolic blood pressure. Group N patients, however, had a higher mean peak heart rate and rate-pressure product, less severe scintigraphic ischemia, a lower lung thallium-201 uptake, and a smaller number of diseased vessels. Stepwise discriminant analysis showed a history of effort angina, lung thallium-201 uptake, and scintigraphic severity of ischemia to be significant discriminators between Groups N and P. In conclusion, electrocardiographically and symptomatically silent ischemia may be common during exercise in patients with CAD, and less severe ischemia may be one of important determinants. (author)

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

    Science.gov (United States)

    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.

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

    OpenAIRE

    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 ex...

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

    Science.gov (United States)

    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 exercise compared to pre-exercise. This was associated with a 63 ± 29% increase (P exercise contributes to visual-cognitive deficits in the peripheral visual field without an apparent affect to the central visual field. PMID:27550986

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

    Science.gov (United States)

    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 exercise (p exercise.

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Hyperamylasemia following cardiopulmonary bypass.

    Science.gov (United States)

    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

  20. Characteristic findings of exercise ECG test, perfusion SPECT and coronary angiography in patients with exercise induced myocardial stunning

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol; Seo, Ji Hyoung; Bae, Jin Ho; Jeong, Shin Young; Park, Hun Sik; Lee, Jae Tae; Chae, Shung Chull; Lee, Kyu Bo [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2004-06-01

    Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV ejection fraction (LVEF) was {>=}5% lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1% (non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs 9.2%, p=0.029; severity 13.5 vs 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis(80{approx}99%) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than

  1. Characteristic findings of exercise ECG test, perfusion SPECT and coronary angiography in patients with exercise induced myocardial stunning

    International Nuclear Information System (INIS)

    Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV ejection fraction (LVEF) was ≥5% lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1% (non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs 9.2%, p=0.029; severity 13.5 vs 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis(80∼99%) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than

  2. "Giant R wave" electrocardiogram pattern during exercise treadmill test: A case report

    Directory of Open Access Journals (Sweden)

    Puebla-Rojo Victor

    2011-07-01

    Full Text Available Abstract Introduction The exercise treadmill test is widely used in the evaluation of patients with suspected or known coronary artery disease. The typical ischemic response used to be ST-segment depression. Case presentation We describe a case of a 51-year-old Caucasian man with an unusual ischemic response during the exercise treadmill test: a "giant R wave" electrocardiogram pattern as a manifestation of hyperacute ischemia that resolved with sublingual nitroglycerin. Coronary catheterization showed a severe stenosis in a proximal dominant circumflex coronary artery. We hypothesize that, in this case, the "giant R wave" pattern was related to severe hyperacute ischemia due to coronary spasm superimposed on the atherosclerotic lesion, which probably caused complete occlusion of the artery. The patient was successfully treated with coronary percutaneous revascularization. Conclusions This is a dramatic and rare ischemic response during the exercise treadmill test, in which, a rapid administration of nitroglycerin can prevent life-threatening events.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-05

    In 2014 the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) undertook the Integrated Field Exercise (IFE) in Jordan. The exercise consisted of a simulated 0.5 – 2 kT underground explosion triggering an On-site Inspection (OSI) to search for evidence of a Treaty violation. This research evaluates two of the OSI techniques, including laboratory-based gamma-spectrometry of soil samples and in situ gamma-spectrometry for 17 particulate radionuclides indicative of nuclear weapon tests. 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 OSI timeframes.

  4. What is the real practice of exercise echocardiographic testing inasymptomatic patients with severe aortic stenosis?

    Institute of Scientific and Technical Information of China (English)

    Eun Jeong Cho; Sung-Ji Park; Jung-Eun Song; Seol-Hwa Kim; Yung-Joo Lee; Ji-Hye Gak; Sung-A Chang

    2013-01-01

    Background Although exercise testing has been suggested to help predict clinical outcome,limited data are available to guide how exercise Doppler echocardiography (ECG) can be used clinically in asymptomatic patients with aortic stenosis (AS).The aim of this study was to assess the clinical value of exercise echocardiographic testing in asymptomatic patients with severe AS.Methods Symptom-limited treadmill exercise testing using the modified Bruce protocol was performed in 31 asymptomatic patients (mean age (62±11) years) with severe AS (aortic valve area <1 cm2,peak aortic velocity (AV Vmax) >4 m/sec,or a mean transaortic pressure gradient (AV mean PG) >40 mmHg (1 mmHg=0.133 kPa)) with normal left ventricular (LV)systolic function (LV ejection fraction (EF) >50%).Clinical symptoms,vital signs,ECG,and Doppler hemodynamics were obtained during and/or immediately after exercise.Results Aortic valve replacement (AVR) was performed in 18 patients during follow-up.The patients who had AVR exhibited higher baseline AV mean PG (51 (35-84) vs.44 (25.2-57.0) mmHg; P=0.031).There were no significant differences between the AVR group and non-AVR group including exercise duration (7.47 (2.32-11.59) vs.7.25 (4.06-10.52) minutes,P=0.917),exercise capacity (10.1 (4.6-12.8) vs.10.1 (7.0-12.8) metabolic equivalents,P=0.675),and an increment in AV mean PG by exercise (18.5 (3.2-48.0) vs.12.6 (4.4-32.1) mmHg,P=0.366).Univariate regression analysis revealed that independent determinant of AVR was the baseline AV mean PG (P=0.031).Conclusions Although additional value of exercise ECG was demonstrated,baseline transaortic mean pressure gradient is the major determinant of AVR.Further large-scale prospective studies are required to determine whether surgery should be recommended in the presence of an abnormal exercise ECG in asymptomatic severe AS.

  5. Cardiac arrhythmias during exercise testing in healthy men.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Yu-Kai eChang

    2015-04-01

    Full Text Available 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  9. Exercise testing of patients after a period of prolonged mechanical ventilation

    Directory of Open Access Journals (Sweden)

    R. Roos

    2004-02-01

    Full Text Available In this study, physical recovery of patients who received prolonged mechanical ventilation (PMV was assessed with a six-phase functional exercise test after the period of ventilation. A prospective correlation study using a consecutive sampling method was carried out over a six-month period. Thirty-one patients were tested but five were lost to follow-up Statistical tests included the Pearson’s correlation coefficient, student’s paired t-test and Kaplan-Meier survival estimate. Subjective perceived effort changed significantly from phase to phase in the exercise test and over time (p < 0.00 Heart rate and respiratory rate responses indicated increased cardio-respiratory effort during the test. No correlation existed between subjective perceived

  10. Predischarge maximal exercise test identifies risk for cardiac death in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, J R; Mickley, H; Damsgaard, E M;

    1990-01-01

    capacity and systolic blood pressure increase in AMI patients was 59% that of control subjects (p less than 0.001). Seventeen AMI patients had significant ST-segment shifts, 13 with ST depression and 4 with ST elevation. In AMI patients experiencing a cardiac death during follow-up the maximal work...... were of no significant value. In this study maximal work capacity turned out to be the best single exercise variable for identifying groups of AMI patients with very low and relative high risk of cardiac death. When all 3 exercise variables were combined, the predischarge maximal exercise test...... was of great value in identifying AMI patients at low risk for cardiac death (predictive value of a negative test: 95%)....

  11. EFFECT OF PRANAYAMA AND EYE EXERCISES ON EYE TO HAND COORDINATION: STUDY BY FINGER DEXTERITY TEST

    Directory of Open Access Journals (Sweden)

    Nitin

    2015-10-01

    Full Text Available BACKGROUND: Our eyes are bo dy's most well developed sensory organs. Indeed, a far larger part of our brain is devoted to the functions of eyesight than to those of hearing, taste, touch or smell together. We usually take our eyesight for granted, although when vision problems develop, most of us will do everything in our capacity to restore our eyesight to normal . Eyes work together to perceive depth thus allowing us to coordinate with motor actions. Practicing relaxation exercises in the form of pranayama and eye exercise has been shown to improve motor functions and attention. AIM: To study the effect of pranayama and eye exercises on eye to hand coordination. MATERIALS AND METHODS: The present study consisted of 60 healthy subjects divided equally into two groups. One group practiced kapalabhati pranayama and eye exercises for eight weeks whereas other group did not participate in any kind of exercise. The effect of pranayama and eye exercises on eye to hand coordination were assessed by finger dexterity test by using O′Connor finger dexterity task. RESULTS: There was significant improvement in eye to hand coordination in subjects practicing pranayama and eye exercises. Fi nger dexterity test values in study group before and after intervention were 31±4.94 and 33±4.98 respectively. Whereas in control group the values were 29.9±5.7 and 30.1±5.31 respectively. CONCLUSION: Both Kapalabhati pranayama and eye to hand coordination can improve fine motor skills

  12. The Role of Exercise Testing in the Modern Management of Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Martin K. Johnson

    2014-05-01

    Full Text Available A culture of exercise testing is firmly embedded in the management of pulmonary arterial hypertension (PAH but its clinical relevance and utility have recently been under some debate. The six minute walk test (6MWT has been used as a primary outcome measure to enable the licensing of many of the medications used for this condition. Recent reviews have questioned the validity of this test as a surrogate of clinical outcomes. At the same time, other questions are emerging where exercise testing may be the solution. With the rise in understanding of genetic markers of idiopathic PAH (IPAH, the screening of an otherwise healthy population for incipient pulmonary hypertension (PH will be required. The proliferation in treatment choices and identification of populations with PH where PAH treatment is not indicated, such as left heart and lung disease, requires more definitive differentiation from patients with PAH. There is a continuing question about the existence and clinical relevance of exercise induced PAH as a cause of unexplained dyspnoea and fatigue and as a latent phase of resting PH. This review presents a summary and critical analysis of the current role of exercise testing in PAH and speculates on future trends.

  13. Protective effect of D-ribose against inhibition of rats testes function at excessive exercise

    Directory of Open Access Journals (Sweden)

    Chigrinskiy E.A.

    2011-09-01

    Full Text Available An increasing number of research studies point to participation in endurance exercise training as having significant detrimental effects upon reproductive hormonal profiles in men. The means used for prevention and correction of fatigue are ineffective for sexual function recovery and have contraindications and numerous side effects. The search for substances effectively restoring body functions after overtraining and at the same time sparing the reproductive function, which have no contraindications precluding their long and frequent use, is an important trend of studies. One of the candidate substances is ribose used for correction of fatigue in athletes engaged in some sports.We studied the role of ribose deficit in metabolism of the testes under conditions of excessive exercise and the potentialities of ribose use for restoration of the endocrine function of these organs.45 male Wistar rats weighing 240±20 g were used in this study. Animals were divided into 3 groups (n=15: control; excessive exercise; excessive exercise and received ribose treatment. Plasma concentrations of lactic, β-hydroxybutyric, uric acids, luteinizing hormone, total and free testosterone were measured by biochemical and ELISA methods. The superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glucose-6-phosphate dehydrogenase activities and uric acids, malondialdehyde, glutathione, ascorbic acids, testosterone levels were estimated in the testes sample.Acute disorders of purine metabolism develop in rat testes under conditions of excessive exercise. These disorders are characterized by enhanced catabolism and reduced reutilization of purine mononucleotides and activation of oxidative stress against the background of reduced activities of the pentose phosphate pathway and antioxidant system. Administration of D-ribose to rats subjected to excessive exercise improves purine reutilization, stimulates the pentose phosphate pathway work

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2016-06-20

    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

  16. Effect of preoperative exercise training on cardiopulmonary function in perioperative period of lung cancer patients with COPD%术前运动训练对肺癌合并 COPD 患者围术期心肺功能的影响

    Institute of Scientific and Technical Information of China (English)

    贺斌; 李新; 张鹏; 曹玎

    2015-01-01

    目的:探讨术前心肺运动训练对肺癌合并慢性阻塞性肺疾病(COPD)患者围术期心肺功能及术后并发症的影响。方法选取98例拟行肺癌切除术且合并COPD的肺癌患者,随机分为观察组和对照组各49例,两组术前均给予改善肺功能治疗,观察组同时行心肺运动训练2周。比较两组术前1天静态肺功能[用力肺活量(FVC)、1秒用力呼气容积、最大自主通气量(MVV)、一氧化碳弥散总量(DLCO)及术后预计FEV1]运动心肺功能[最大摄氧量(VO2max)、公斤摄氧量(VO2/kg)、无氧阈(AT)、氧脉搏(O2 pulse)、最大心率、最大分钟通气量(VEmax)及呼吸困难指数]的变化。比较两组术后并发症、氧疗时间、机械通气时间和住院时间。结果观察组FVC、MVV、DL CO、VO2 max、VO2/kg、AT、O2 pulse、VEmax较对照组均有不同程度的改善(P均<0.05);两组术后总体心肺并发症及单个并发症的发生率、术后氧疗时间、机械通气时间及住院天数比较差异均有统计学意义(P均<0.05)。结论术前心肺运动训练能明显改善肺癌合并 COPD患者的心肺功能,减少术后并发症、缩短住院时间,利于患者早日康复。%Objective To investigate the effect of preoperatively cardiopulmonary exercise training on the cardiopul -monary function and postoperative complications in lung cancer patients with chronic obstructive pulmonary disease ( COPD) .Methods Ninety-eight lung cancer patients with COPD who would receive lung cancer resection were randomly divided into two groups:the observation group and the control group , 49 cases in each group .Both groups were treated to improve the lung function before surgery , and the observation group was treated with cardiopulmonary exercise training for two weeks .The indicators of static lung function and dynamic cardiopulmonary exercise were compared between the two groups the day

  17. Aerobic exercise and cold pressor test induce hypoalgesia in active and inactive men and women

    DEFF Research Database (Denmark)

    Vægter, Henrik Bjarke; Handberg, Gitte; Jørgensen, Maria N.;

    2015-01-01

    ). Conditioned pain modulation (CPM) was assessed by cold pressor testing. Exercise-induced hypoalgesia (EIH) was assessed after 15 minutes bicycling at a heart rate corresponding to 75% VO2max. A control session of 15 minutes quiet rest was also included. Pressure pain thresholds (PPTs) were recorded...

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

    Science.gov (United States)

    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 pressure products remained below 36,000. The mean difference between DASI and ETT METs was -0.8 (-0.98, -0.65), indicating equivalence at our threshold. In conclusion, the ETT can be performed within cardiac rehabilitation, providing a functional capacity assessment equivalent to the DASI and objective physiologic measures for developing exercise prescriptions and measuring progress. PMID:23814381

  19. The impact of discussing exercise test results of young asthmatic children on adherence to maintenance medication

    NARCIS (Netherlands)

    Visser, R.; Brusse-Keizer, M.; Palen, van der J.; Klok, T.; Thio, B.J.

    2015-01-01

    Objective: Parents’ awareness of their child’s asthma may improve by discussing an exercise challenge test (ECT) result with them. We investigated the influence of discussing an ECT result with parents on adherence to inhaled maintenance medication, parental illness perceptions and medication belief

  20. Delayed heart rate recovery after treadmill test: comparison with clinical, exercise and myocardial perfusion parameters

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, S.Y.; Seo, J. H.; Bae, J. H.; Ahn, B. C.; Lee, J.; Lee, K. B.; Chae, S. C [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2004-07-01

    Imbalance autonomic nervous tone are fundamental risk factors for cardiac death. Recent studies reported abnormal heart rate recovery(HRR) after the treadmill exercise test is a powerful predictor of significant excess mortality. To evaluate HRR as an index of coronary artery disease(CAD). we have compared perfusion defect. 252 patients(147 men) underwent exercise myocardial perfusion imaging were included. The value for HRR was defined as the decrease in heart rate from peak exercise to 1 minute after termination of exercise. Myocardial perfusion imaging was acquired at 1 hour after 740MBq {sup 99m}Tc-MIBI injection using dual head gamma camera(Vertex Plus, ADAC, USA). Summed stress score(SSS) and stress ejection fraction(sEF) were obtained from AutoQUANT program. 23 beats/min was defined as the lowest normal value for HRR. Patients were divided two groups: abnormal HRR(abHRR) and normal HRR(nHRR). We compared clinical(age, sex, pervious CAD history, DM, HTN), exercise test(exercise capacity, duration) and myocardial perfusion parameters(SSS, sEF) between two groups. Mean value of HRR was 50.814.2 beat/min. There were 25 patients(9.9%) with an abHRR. Patient with abHRR were generally in older age(61.59.2 vs 54.48.9yr), were more likely men(72 vs 56.8%), had a higher frequency of DM(16.7 vs 9%), HTN(52 vs 27.6%) and CAD history (28 vs 7%) compared to nHRR. In exercise and myocardial perfusion parameters, abHRR were showed more positive result(60 vs 30%), had short exercise duration(7.0{+-}3.0 vs 9.1{+-}2.7min) and small exercise capacity(7.2{+-}2.3 vs 10.0{+-}2.7Mets) compared to nHRR, had a higher frequency of CAD(76 vs 41.4%) and multivessel disease(25 vs 6.5%), had larger SSS(8.1{+-}8.8 vs 3.7{+-}6.3) and had smaller sEF(47.7{+-}14.3 vs 57.9{+-}10.3%) compared to nHRR. AbHRR was frequently found in patients with CAD, large myocardial perfusion defect and decreased LV function. It seems that the HRR may be considered a reliable index of the severity of CAD.

  1. QT hysteresis in long-QT syndrome children with exercise testing

    Institute of Scientific and Technical Information of China (English)

    GAO Dong-sheng; FANG Wei-yi; Christine Chiu-Man; Joel Kirsh; Gil Gross; Robert M.Hamilton

    2007-01-01

    Background Congenital long QT syndrome (LQTS) is an inherited ion channel disorder resulting in abnormal cardiac repolarization that can cause syncope and sudden death associated with a prolonged rate-corrected QT interval and polymorphic ventricular tachycardia. Several studies in adults showed that LQTS patients have altered QT adaptation to heart rate changes compared with normal subjects which forming a "hysteresis loop" in the QT-circle length plot. This study was to observe the QT interval changing during exercise testing in children long QT syndrome (LQTS) patients,explore the new diagnosis methods of LQTS.Methods The subjects were divided into 3 groups according to 1993 LQTS diagnostic criteria. Group 1: LQTS group(n=17) who scored > or = 4 points indicating definite LQTS. Group 2: Middle group (n=16), patients who have prolonged QT interval but scored 1.5 to 3.5. Group 3: Normal control group (n=18). The average age of all study population is (12.3±5.8) years. No case had beta-adrenergic antagonists administration before exercise testing. All subjects were underwent tread mill exercise testing and electrocardiograph in whole exercise testing and recovery were recorded. QT and heart rate changing during whole exercise testing period were recorded. △QT, the QT interval at 1, 2, 4, 6 minutes into recovery subtract from the QT interval at a similar heart rate during exercise, were calculated.Results In all three groups, QT intervals were shortening with the increasing of heart rate, but QTc had no significant change. △QT at 1 minute ((45±11) ms), 2 minutes ((37±15) ms), 4 minutes ((23±12) ms) into recovery in LQTS group were significantly greater than that of the other two groups (P<0.05, P<0.01, P<0.01, respectively). There was no△QT significant difference between middle group and normal control group at recovery time. During the recovery phase in LQTS group, the QT interval remained shortened despite a decelerating heart rate, forming a

  2. [Exercise-induced ST segment shift in vasospastic angina with special reference to comparisons between treadmill and bicycle ergometer exercise testings].

    Science.gov (United States)

    Kasai, A; Yamakado, T; Masuda, T; Aoki, T; Futagami, Y; Hamada, M; Nakano, T

    1991-01-01

    To assess the difference between cardiovascular responses to treadmill exercise (TM) and those to bicycle ergometer exercise (EM) in provoking coronary spasm, we compared the ST segment shifts (elevation or depression) during TM and EM in 67 patients with vasospastic angina. Coronary artery spasm was demonstrated on angiography. Both TM and EM were performed on the same day during a medication-free period. For both tests, multistage, symptom-limited exercise protocols were used; EM in the morning and TM in the afternoon. The results obtained were as follows: 1. Rate-pressure products at peak exercise during TM and EM were similar. Systolic blood pressure levels at peak exercise were higher during EM than during TM (p < 0.01). The patients' heart rates at peak exercise were higher during TM than during EM (p < 0.01). Diastolic blood pressure levels at peak exercise were higher during EM than during TM (p < 0.05). 2. Exercise-induced ST elevation occurred more frequently with TM than with EM (19% vs 9%, p < 0.05). 3. Exercise-induced ST depression was provided in 27 patients during TM and in 13 during EM (40% vs 19%, p < 0.01). Among 45 patients without significant lesions, ST depression occurred in 19 during TM, but in only 7 during EM (42% vs 16%, p < 0.01). In conclusion, coronary spasm seemed to occur more frequently with TM than with EM. The mechanism causing such difference remains to be elucidated, however, we speculate that the difference between TM and EM as to enhanced autonomous nervous system activity and coronary perfusion exercise may be related to the difference in the incidence of coronary spasm. PMID:1841908

  3. Comparison of adenosine and treadmill exercise thallium-201 stress tests for the detection of coronary artery disease.

    Science.gov (United States)

    Abe, S; Takeishi, Y; Chiba, J; Ikeda, K; Tomoike, H

    1993-12-01

    To determine the clinical usefulness of adenosine Tl-201 imaging for the evaluation of coronary artery disease, 22 patients with suspected coronary artery disease who underwent adenosine and exercise Tl-201 single photon emission computed tomography (SPECT) were studied. The peak levels of heart rate (83 vs 123 bpm, p pressure products (10220 vs 20410 bpm x mmHg, p < 0.001) were markedly smaller during adenosine infusion than during exercise. Segmental agreements between adenosine and exercise tests were 90% (218 of 242 segments) regarding the presence of perfusion defects and 89% (215 of 242 segments) regarding the presence of redistribution. Regional Tl-201 uptake (r = 0.85, p < 0.001) and the extent (r = 0.75, p < 0.001) and intensity (r = 0.83, p < 0.001) of Tl-201 defects during adenosine testing were closely correlated with those of exercise testing. Adenosine and exercise tests showed similar sensitivities for the identification of individual coronary stenosis (85% vs 78%). However, in patients who were unable to perform adequate exercise (maximal heart rate < 120 bpm), the sensitivity of adenosine imaging tended to be higher than that of exercise imaging (92% vs 69%, p = 0.07). Adenosine Tl-201 imaging is an alternative to the exercise test for assessing the severity and loci of coronary artery disease, especially in patients who are unable to perform adequate physical exercise. PMID:8283603

  4. The accuracy of the electrocardiogram during exercise stress test based on heart size.

    Directory of Open Access Journals (Sweden)

    Jason C Siegler

    Full Text Available BACKGROUND: Multiple studies have shown that the exercise electrocardiogram (ECG is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy. HYPOTHESIS: The purpose of this investigation was to assess the diagnostic accuracy of the exercise ECG based on heart size. METHODS: We evaluated 1,011 consecutive patients who were referred for an exercise nuclear stress test. Patients were divided into two groups: small heart size defined as left ventricular end diastolic volume (LVEDV <65 mL (Group A and normal heart size defined as LVEDV ≥65 mL (Group B and associations between ECG outcome (false positive vs. no false positive and heart size (small vs. normal were analyzed using the Chi square test for independence, with a Yates continuity correction. LVEDV calculations were performed via a computer-processing algorithm. SPECT myocardial perfusion imaging was used as the gold standard for the presence of coronary artery disease (CAD. RESULTS: Small heart size was found in 142 patients, 123 female and 19 male patients. There was a significant association between ECG outcome and heart size (χ(2 = 4.7, p = 0.03, where smaller hearts were associated with a significantly greater number of false positives. CONCLUSIONS: This study suggests a possible explanation for the poor diagnostic accuracy of exercise stress testing, especially in women, as the overwhelming majority of patients with small heart size were women.

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

    OpenAIRE

    Wijngaart, L.S. van den; Roukema, J; Merkus, P.J.F.M.

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kitada S

    2012-05-01

    Full Text Available Kenji Yoshimura, Ryoji Maekura, Toru Hiraga, Seigo Kitada, Keisuke Miki, Mari Miki, Yoshitaka TateishiDepartment of Respiratory Medicine, Toneyama National Hospital, Osaka, JapanBackground: Tiotropium partially relieves exertional dyspnea and reduces the risk of congestive heart failure in chronic obstructive pulmonary disease (COPD patients. However, its effect on the sympathetic activation response to exercise is unknown.Aims: This study aimed to determine whether tiotropium use results in a sustained reduction in sympathetic activation during exercise.Methods: We conducted a 12-week, open-label (treatments: tiotropium 18 µg or oxitropium 0.2 mg × 3 mg, crossover study in 17 COPD patients. Treatment order was randomized across subjects. The subjects underwent a pulmonary function test and two modes of cardiopulmonary exercise (constant work rate and incremental exercise testing using a cycle ergometer, with measurement of arterial catecholamines after each treatment period.Results: Forced expiratory volume in 1 second and forced vital capacity were significantly larger in the tiotropium treatment group. In constant exercise testing, exercise endurance time was longer, with improvement in dyspnea during exercise and reduction in dynamic hyperinflation in the tiotropium treatment group. Similarly, in incremental exercise testing, exercise time, carbon dioxide production, and minute ventilation at peak exercise were significantly higher in the tiotropium treatment group. Plasma norepinephrine concentrations and dyspnea intensity were also lower during submaximal isotime exercise and throughout the incremental workload exercise in the tiotropium treatment group.Conclusion: Tiotropium suppressed the increase of sympathetic activation during exercise at the end of the 6-week treatment, as compared with the effect of oxipropium. This effect might be attributed to improvement in lung function and exercise capacity and reduction in exertional dyspnea

  7. Effects of age, exercise duration and test conditions on heart rate variability in young endurance horses

    Directory of Open Access Journals (Sweden)

    Mohamed YOUNES

    2016-05-01

    Full Text Available 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 three-year period, 77 young Arabian horses aged 4 to 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 minutes 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 and the recovery heart rate (R= - 0.56 and -0.53 respectively; p<0.05. At rest and during exercise and recovery, RMSSD and several HRV variables differed significantly as a function of the test conditions. HRV in endurance horses appears to be strongly influenced by age and environmental factors (such as ambient temperature, ambient humidity and track quality. Nevertheless, RMSSD can be used to select endurance horses with the fastest cardiac recovery.

  8. The serum protein carbonyl content level in relation to exercise stress test

    Directory of Open Access Journals (Sweden)

    Titiporn Mekrungruangwong

    2012-01-01

    Full Text Available Background: Protein carbonyl (P is oxidatively-modified protein with diagnostic potential for acute myocardial infarction. However, many findings indicated the elevation of serum PC content level related to exercise, which could cause false positive results and limiting the specificity for acute coronary syndrome diagnosis. This study aims to evaluate the level of serum protein carbonyl content in healthy volunteers subjected to exercise stress test (EST. Materials and Methods: Serum from healthy volunteers was collected 5-10 min before performing EST and 1 hour after the EST was achieved. The serum was collected, and the serum PC content level was determined by spectrophotometric DNPH assay. Results: The serum PC content level after exercise stress test was significantly higher than that of before performing EST (0.373 ± 0.05 nM/mg vs. 0.275 ± 0.02 nM/mg, P < 0.0001. The results demonstrated that in both male and female, serum PC content level after EST was significantly higher than that of before performing EST (0.29 ± 0.03 nM/mg vs. 0.36 ± 0.05 nM/mg P < 0.0001 in male, 0.27 ± 0.02 nM/mg vs. 0.38 ± 0.06 nM/mg P < 0.0001 in female, respectively. Conclusions: This study demonstrated that exercise stress test could result in non-specificity and false positive increasing in serum PC content level in healthy subjects, which may cause misinterpretation when using PC as cardiac marker, especially in patients, who underwent exercise stress test or patients who performing heavy physical activities.

  9. Limited value of recovery phase-limited ST segment depression of treadmill exercise test

    Institute of Scientific and Technical Information of China (English)

    Yang Hongbo; Huang Zheyong; Lou Yi; Shen Yunli; Qian Juying; Ge Junbo

    2014-01-01

    Background Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial.The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.Methods Clinical,exercise and angiographic data were retrospectively collected from 602 patients in the study.Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).Results With similar major clinical features,the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs.group 1,50.0% vs.66.9%,P=0.031 and group 2 vs.group 1,1.5 vs.8.5,P=0.04).At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients,the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60,95% Cl 1.00-2.54,P=0.049).Conclusion The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.

  10. Failure to identify an acute exercise effect on executive function assessed by the Wisconsin Card Sorting Test

    OpenAIRE

    Chun-Chih Wang; Chia-Hao Shih; Caterina Pesce; Tai-Fen Song; Tsung-Min Hung; Yu-Kai Chang

    2015-01-01

    Purpose: Acute exercise has been linked to the facilitation of executive function, but little is known regarding executive function assessed by the Wisconsin Card Sorting Test (WCST). The present research consisted of two experiments aimed to determine whether acute aerobic exercise influences successive WCST performance. Methods: In Study 1, 27 young adults were randomly assigned to the exercise or reading control group and then instructed to perform the WCST before and after assigned tre...

  11. Failure to identify an acute exercise effect on executive function assessed by the Wisconsin Card Sorting Test

    Directory of Open Access Journals (Sweden)

    Chun-Chih Wang

    2015-03-01

    Conclusion: Acute aerobic exercise failed to influence executive function as assessed by the WCST, revealing that this classical neuropsychological test tapping executive function may not be sensitive to acute exercise. Our findings suggest that acute exercise does not broadly affect the entire family of executive functions, or its effect on a specific aspect of executive function may be task-dependent, as proposed by Etnier and Chang (2009.

  12. Mini cardiopulmonary bypass: Anesthetic considerations

    OpenAIRE

    Alsatli, Raed A.

    2012-01-01

    This review article is going to elaborate on the description, components, and advantages of mini-cardiopulmonary bypass (mini-CPB), with special reference to the anesthetic management and fast track anesthesia with mini-CPB. There are several clinical advantages of mini-CPB like, reduced inflammatory reaction to the pump, reduced need for allogenic blood transfusion and lower incidence of postoperative neurological complications. There are certainly important points that have to be considered...

  13. Preparation, Conduct and Evaluation of Exercises to Test Preparedness for a Nuclear or Radiological Emergency - Training Materials

    International Nuclear Information System (INIS)

    Emergency response exercises are a key component of a good program of preparation in emergencies. They can provide a unique insight on the State of preparation of emergency response organizations. They can also be the basis for continuous improvement programs of the infrastructure of response in emergencies. However, to be more useful, the exercises in emergency response need to be well organized, professionally conducted and its assessment should focus on the potential for constructive improvement. The course of the IAEA on preparedness, conduction and evaluation exercises to test the preparation before a nuclear emergency or radiation designed for people and organizations that want to increase their ability to carry out effective and significant emergency exercises. The objectives of this course are: To familiarize participants with concepts, terminology, process of preparation, conduction and evaluation of the exercise to test the preparation before a nuclear emergency or radiation; Provide participants with knowledge practical and the ability to organize, lead and evaluate an exercise to test the preparation for a nuclear emergency or radiation in their own countries; Submit an exercise response model in emergency prepared by the IAEA; and give participants the skill to adapt the proposal of model exercise and organize and lead this exercise model right in your own country.

  14. Simulated Cardiopulmonary Arrests in a Hospital Setting.

    Science.gov (United States)

    Mishkin, Barbara H.; And Others

    1982-01-01

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

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

    Science.gov (United States)

    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

    Energy Technology Data Exchange (ETDEWEB)

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

    Science.gov (United States)

    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.

  18. Motivation Contagion When Instructing Obese Individuals: A Test in Exercise Settings

    OpenAIRE

    Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie; Ng, J

    2012-01-01

    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, a...

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

    Science.gov (United States)

    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.

  20. Comportamento da hiperinsuflação dinâmica em teste em esteira rolante em pacientes com DPOC moderada a grave Dynamic hyperinflation during treadmill exercise testing in patients with moderate to severe COPD

    Directory of Open Access Journals (Sweden)

    Priscila Kessar Cordoni

    2012-02-01

    Full Text Available OBJETIVO: Caracterizar a presença, extensão e padrões de hiperinsuflação dinâmica (HD durante teste em esteira rolante em pacientes com DPOC moderada a grave. Métodos: Estudo transversal com 30 pacientes não hipoxêmicos (VEF1= 43 ± 14% do previsto submetidos a teste cardiopulmonar de exercício em esteira rolante em velocidade constante (70-80% da velocidade máxima até o limite da tolerância (Tlim. Manobras seriadas de capacidade inspiratória (CI foram utilizadas para avaliação da HD. RESULTADOS: Dos 30 pacientes estudados, 19 (63,3% apresentaram HD (grupo HD+, que apresentaram maior comprometimento funcional em repouso do que os pacientes sem HD (grupo HD-. Nenhuma das variáveis obtidas relacionou-se com a tolerância ao exercício no grupo HD-, enquanto Tlim, CI e percepção de dispneia ao esforço foram significativamente correlacionados no grupo HD+ (p OBJECTIVE: To characterize the presence, extent, and patterns of dynamic hyperinflation (DH during treadmill exercise testing in patients with moderate to severe COPD. METHODS: This was a cross-sectional study involving 30 non-hypoxemic patients (FEV1= 43 ± 14% of predicted who were submitted to a cardiopulmonary exercise test on a treadmill at a constant speed (70-80% of maximum speed to the tolerance limit (Tlim. Serial inspiratory capacity (IC maneuvers were used in order to assess DH. RESULTS: Of the 30 patients studied, 19 (63.3% presented with DH (DH+ group, having greater pulmonary function impairment at rest than did those without DH (DH- group. None of the variables studied correlated with exercise tolerance in the DH- group, whereas Tlim, IC, and perception of dyspnea during exercise did so correlate in the DH+ group (p < 0.05. In the DH+ group, 7 and 12 patients, respectively, presented with a progressive and a stable pattern of DH (ΔIC Tlim,2min = -0.28 ± 0.11 L vs. 0.04 ± 0.10 L; p < 0.01. Patients with a progressive pattern of DH presented with higher

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

    OpenAIRE

    Yu-Kai eChang; Caterina ePesce; Yi-Te eChiang; Cheng-Yuh eKuo; Dong-Yang eFong

    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 inte...

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

    Directory of Open Access Journals (Sweden)

    Ana Carla Pereira de Araujo

    2014-11-01

    Full Text Available 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.

  3. Reference value of long-time exercise test in the diagnosis of primary periodic paralysis

    Institute of Scientific and Technical Information of China (English)

    Ding Zeyu; Liu Mingsheng; Cui Liying

    2014-01-01

    Background The long-time exercise test (ET) is used to diagnose the primary periodic paralyses (PPs).However the reference values of ET are many and various.This study aimed to investigate the reference value of long-time ET in the diagnosis of PPs.Methods We recruited 108 healthy subjects,68 patients with PPs,and 72 patients with other diseases for the study.The procedure of ET was made on the basis of the McManis' method.Electrical responses were recorded from right abductor digiti minimi (ADM) muscle when stimulation of the ulnar nerve at the wrist.After the compound muscle action potential (CMAP) was monitored,subjects were then asked to contract the muscle as strongly as possible for 5 minutes.CMAPs were recorded for 2 seconds immediately after cessation of exercise,then every 5 minutes for 10 minutes,and finally every 10 minutes for 50 minutes.In general,the CMAP amplitudes will fall below the pre-exercise levels in an hour.The largest decrease was calculated and used as results of ET.Results The CMAP amplitude decreases had no significant differences between groups when the healthy adults were grouped according to age,gender,height,weight and test time.Decreases in PPs patients (57.76%) were significantly more than in healthy subjects (15.21%) and other disease patients (18.10%,P <0.001).Receiver operating characteristic (ROC) curve analysis showed that the best threshold is 35.50%.Conclusions In the long-time exercise test,threshold of 35.50% for the CMAP amplitude decrease was identified for abnormal.The result is not influenced by age,gender,height,weight,and test time.About 7.4% of healthy subjects were abnormal in ET.

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

    Science.gov (United States)

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

    2004-07-01

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

  5. Health Evaluation for Hypertensive Population Using Exercise Testing and Health-related Quality of Life Questionnaire

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF and SP-16 questionnaire and exercise testing. 57 normotensive and 76 hypertensive subjects aged 35-65 year-old participated the health survey using this instrument.Based on the exercise testing results of the two groups, a discriminate function was established and used to investigate cardiovascular risk factors for hypertensive population. Results The results showed that persons with hypertension rated significantly lower scores on physical health (i.e. limitation in performing daily activities and problems with work or mobility) than did normotensives (P < 0.01). The discriminant score obtained from the exercise testing results was capable of reflecting the impacts of hypertension on CVFS. Conclusions The method presented in this paper provides a more powerful tool to estimate the effects of health interventions and medical therapy for hypertensive population than just self-rated HRQOL questionnaire.

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

    Science.gov (United States)

    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.

  7. Peak systolic blood pressure in exercise testing is associated with scintigraphic severity of myocardial ischemia in patients with exercise-induced ST-segment depression

    Energy Technology Data Exchange (ETDEWEB)

    Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Yamazaki, Keisuke; Satoh, Hiroshi; Watanabe, Hiroshi; Terada, Hajime [Hamamatsu Univ. School of Medicine, Shizuoka (Japan)

    2000-08-01

    Some electrocardiographic variables, including the degree of maximal ST-segment depression (STD), may not necessarily indicate the severity of exercise-induced myocardial ischemia. The present study examined whether maximal STD correlates with the severity and extent of exercise-induced myocardial ischemia, as assessed by thallium-201 ({sup 201}Tl) imaging, and which parameter of exercise testing reflects scintigraphic severity and extent in 270 patients who had a 1 mm or greater horizontal or down-sloping STD on exercise {sup 201}Tl imaging. The scintigraphic severity and extent of exercise-induced ischemia was assessed and correlated with maximal STD, number of positive leads, workload, peak heart rate, peak systolic blood pressure (SBP), rate-pressure product, chest pain and the Duke treadmill score. Most of the scintigraphic markers of the severity and extent of ischemia had significant but weak correlation with all of those parameters. Multivariate analysis demonstrated that peak SBP and the Duke treadmill score (chest pain in only simple variables model) correlated independently with scintigraphic severity and extent of ischemia. Furthermore, most of the patients with a peak SBP of 200 mmHg or more had milder and less extensive ischemia. In patients with exercise-induced STD, the scintigraphic severity and extent of ischemia may be estimated by peak SBP and the Duke treadmill score. (author)

  8. Peak systolic blood pressure in exercise testing is associated with scintigraphic severity of myocardial ischemia in patients with exercise-induced ST-segment depression

    International Nuclear Information System (INIS)

    Some electrocardiographic variables, including the degree of maximal ST-segment depression (STD), may not necessarily indicate the severity of exercise-induced myocardial ischemia. The present study examined whether maximal STD correlates with the severity and extent of exercise-induced myocardial ischemia, as assessed by thallium-201 (201Tl) imaging, and which parameter of exercise testing reflects scintigraphic severity and extent in 270 patients who had a 1 mm or greater horizontal or down-sloping STD on exercise 201Tl imaging. The scintigraphic severity and extent of exercise-induced ischemia was assessed and correlated with maximal STD, number of positive leads, workload, peak heart rate, peak systolic blood pressure (SBP), rate-pressure product, chest pain and the Duke treadmill score. Most of the scintigraphic markers of the severity and extent of ischemia had significant but weak correlation with all of those parameters. Multivariate analysis demonstrated that peak SBP and the Duke treadmill score (chest pain in only simple variables model) correlated independently with scintigraphic severity and extent of ischemia. Furthermore, most of the patients with a peak SBP of 200 mmHg or more had milder and less extensive ischemia. In patients with exercise-induced STD, the scintigraphic severity and extent of ischemia may be estimated by peak SBP and the Duke treadmill score. (author)

  9. Effect of chronic neuromuscular electrical stimulation on primary cardiopulmonary exercise test variables in heart failure patients: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Laura Maria Tomazi Neves

    2014-11-01

    Conclusions: CPX performance has substantial prognostic and functional importance in the HF population. Our results suggest that NMES improves CPX performance and thus may be a valuable therapeutic intervention, positively altering the clinical trajectory of patients with HF.

  10. Stress analysis of HLW containers. Preliminary ring test exercise Compas project

    International Nuclear Information System (INIS)

    This document describes the series of experiments and associated calculations performed as the Compas preliminary ring test exercise. A number of mild steel rings, representative of sections through HLW containers, some notched and pre-cracked, were tested in compression right up to and beyond their ultimate load. The Compas project partners independently modelled the behaviour of these rings using their finite element codes. Four different ring types were tested, and each test was repeated three times. For three of the ring types, the three test repetitions gave identical results. The fourth ring, which was not modelled by the partners, had a 4 mm thick layer of weld metal deposited on its surface. The three tests on this ring did not give identical results and suggested that the effect of welding methods should be addressed at a later stage of the project. Fracture was not found to be a significant cause of ring failure. The results of the ring tests were compared with the partners predictions, and additionally some time was spent assessing where the use of the codes could be improved. This exercise showed that the partners codes have the ability to produce results within acceptable limits. Most codes were unable to model stable crack growth. There were indications that some codes would not be able to cope with a significantly more complex three-dimensional analysis

  11. Treadmill exercise testing of asymptomatic men and women without evidence of heart disease

    Directory of Open Access Journals (Sweden)

    W.A. Chalela

    2009-12-01

    Full Text Available The aim of this study was to test the hypothesis of differences in performance including differences in ST-T wave changes between healthy men and women submitted to an exercise stress test. Two hundred (45.4% men and 241 (54.6% women (mean age: 38.7 ± 11.0 years were submitted to an exercise stress test. Physiologic and electrocardiographic variables were compared by the Student t-test and the chi-square test. To test the hypothesis of differences in ST-segment changes, data were ranked with functional models based on weighted least squares. To evaluate the influence of gender and age on the diagnosis of ST-segment abnormality, a logistic model was adjusted; P < 0.05 was considered to be significant. Rate-pressure product, duration of exercise and estimated functional capacity were higher in men (P < 0.05. Sixteen (6.7% women and 9 (4.5% men demonstrated ST-segment upslope ≥0.15 mV or downslope ≥0.10 mV; the difference was not statistically significant. Age increase of one year added 4% to the chance of upsloping of segment ST ≥0.15 mV or downsloping of segment ST ≥0.1 mV (P = 0.03; risk ratio = 1.040, 95% confidence interval (CI = 1.002-1.080. Heart rate recovery was higher in women (P < 0.05. The chance of women showing an increase of systolic blood pressure ≤30 mmHg was 85% higher (P = 0.01; risk ratio = 1.85, 95%CI = 1.1-3.05. No significant difference in the frequency of ST-T wave changes was observed between men and women. Other differences may be related to different physical conditioning.

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

    Science.gov (United States)

    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.

  13. Multiple dimensions of cardiopulmonary dyspnea

    Institute of Scientific and Technical Information of China (English)

    HAN Jiang-na; XIONG Chang-ming; YAO Wei; FANG Qiu-hong; ZHU Yuan-jue; CHENG Xian-sheng; Karel P Van de Woestijne

    2011-01-01

    Background The current theory of dyspnea perception presumes a multidimensional conception of dyspnea.However,its validity in patients with cardiopulmonary dyspnea has not been investigated.Methods A respiratory symptom checklist incorporating spontaneously reported descriptors of sensory experiences of breathing discomfort,affective aspects,and behavioral items was administered to 396 patients with asthma,chronic obstructive pulmonary disease (COPD),diffuse parenchymal lung disease,pulmonary vascular disease,chronic heart failure,and medically unexplained dyspnea.Symptom factors measuring different qualitative components of dyspnea were derived by a principal component analysis.The separation of patient groups was achieved by a variance analysis on symptom factors.Results Seven factors appeared to measure three dimensions of dyspnea:sensory (difficulty breathing and phase of respiration,depth and frequency of breathing,urge to breathe,wheeze),affective (chest tightness,anxiety),and behavioral (refraining from physical activity) dimensions.Difficulty breathing and phase of respiration occurred more often in COPD,followed by asthma (R2=0.12).Urge to breathe was unique for patients with medically unexplained dyspnea (R2=0.12).Wheeze occurred most frequently in asthma,followed by COPD and heart failure (R2=0.17).Chest tightness was specifically linked to medically unexplained dyspnea and asthma (R2=0.04).Anxiety characterized medically unexplained dyspnea (R2=0.08).Refraining from physical activity appeared more often in heart failure,pulmonary vascular disease,and COPD (R2=0.15).Conclusions Three dimensions with seven qualitative components of dyspnea appeared in cardiopulmonary disease and the components under each dimension allowed separation of different patient groups.These findings may serve as a validation on the multiple dimensions of cardiopulmonary dyspnea.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  16. Preparation, Conduct and Evaluation of Exercises to Test Preparedness for a Nuclear or Radiological Emergency

    International Nuclear Information System (INIS)

    The aim of this publication is to serve as a practical tool for the preparation, conduct and evaluation of exercises to test preparedness for response to a nuclear or radiological emergency. It fulfils in part the functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning the methodologies, techniques and available results of research on such emergencies. To ensure effective response to radiation emergencies when needed, provisions should be made for regular training of emergency response personnel. As stated in Preparedness and Response for a Nuclear or Radiological Emergency (Safety Requirements, Safety Standard Series No. GS-R-2), 'The operator and the response organizations shall make arrangements for the selection of personnel and training to ensure that the personnel have the requisite knowledge, skills, abilities, equipment, procedures and other arrangements to perform their assigned response functions'. A further requirement is that 'Exercise programmes shall be conducted to ensure that all specified functions required to be performed for emergency response and all organizational interfaces for facilities in threat category I, II or III and the national level programmes for threat category IV or V are tested at suitable intervals'. In 2004 the IAEA General Conference, in resolution GC(48)/RES/10 encouraged Member States to 'implement the Safety Requirements for Preparedness and Response to a Nuclear or Radiological Emergency'. This document is published as part of the IAEA Emergency Preparedness and Response Series to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. It was developed based on a number of assumptions about national and local capabilities. Therefore, the exercise structure, terms and scenarios must be

  17. Visualisation of Proficiency Test Exercise by Means of Kiri Plots. Informatics Application

    International Nuclear Information System (INIS)

    This report describes the visualisation procedure of the proficiency tests by means of Kiri Plots, based on three tests: z-score, zeta-score and the relative uncertainty outlier. The results assessment of the intercomparison exercises and proficiency tests among Spanish environmental radioactivity laboratories and Spanish Nuclear Power Plants Laboratories is performed by Environmental Radioactivity and Radiological Surveillance Unit following the ISO-43 e ISO/ IUPAC standards and applying the z-score test. The application of new graphics methods and tests to a better evaluation of uncertainties reported by Labs is described in this paper. An informatics programme has been developed in Visual Basic for applications that allows the graphic representation of Tables and Figures automatically in an excel-sheet and later statistical simulations changing the ratios between the reference value uncertainties and the concentration activities values from the participants laboratories. (Author) 26 refs.

  18. Design and resolution of exercises based on the detection of errors in documents using the DeepTest tool

    OpenAIRE

    Moriyón, Roberto; Saiz, Francisco

    2005-01-01

    Reprinted from the World Conference on E-Learning in Corporate, Government, Healthcare, and Higher Education, October 2005, with permission of AACE (http://www.aace.org). We present DeepTest, a tool for the design and resolution through Internet of highly interactive exercises based on documents related to virtually any subject. Existing educational contents based on documents can be reused in order to design interactive exercises with DeepTest. We explain the reasons that indicate that in...

  19. Early exercise testing after treatment with thrombolytic drugs for acute myocardial infarction: importance of reciprocal ST segment depression.

    OpenAIRE

    Stevenson, R N; Umachandran, V.; Ranjadayalan, K; Roberts, R. H.; Timmis, A D

    1994-01-01

    OBJECTIVE--To investigate the clinical importance of reciprocal ST depression induced by exercise testing early after acute myocardial infarction in patients treated with thrombolysis. DESIGN--Prospective observational study. SETTING--District general hospital in London. SUBJECTS--202 patients (170 men) aged 33-69 with acute myocardial infarction treated with thrombolysis. MAIN OUTCOME MEASURES--All patients underwent exercise testing and coronary arteriography. ST depression induced by exerc...

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

    Directory of Open Access Journals (Sweden)

    Jordan A. Guenette

    2013-01-01

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

  1. Evaluation of coma patients after cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    SU Ying-ying; YANG Qing-lin; PANG Ying; LV Xiang-ping

    2005-01-01

    Background Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR .Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS),brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG),brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD) .Results Twenty-four of 35 patients(68.57%)were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient.Twenty-four patients died within 1 month and 11 of them(45.83%)were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeⅠin 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients.Two patients(18.18%)regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively.Conclusion Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.

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

    Directory of Open Access Journals (Sweden)

    Jennifer M Petrosino

    Full Text Available 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

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

    Science.gov (United States)

    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 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.

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

    Science.gov (United States)

    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. PMID:26815178

  5. The Effect of Aerobic Training for Lower Limbs on the Early Cardiopulmonary Function Recovery of Racing Athletes%下肢有氧训练对竞速运动员早期心肺功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    刘伟; 王振涛

    2016-01-01

    为探讨下肢有氧训练对竞速运动员早期心肺功能恢复的影响,制定科学合理的有氧运动策略。本文基于对竞速运动员的运动特点及心肺功能情况全面了解,选取10名山东省竞速运动员作为测试对象,采用产自德国耶格公司的心肺功能测试系统,对训练对象进行下肢有氧训练,并对训练前后的心肺功能指标进行比较,利用EXCEL进行评测数据整理统计。结果表明:(1)受测运动员在心肺耐受时间、耐受负荷、肺部通气量和摄氧量等方面都得到了有效改善,加速了心肺功能的恢复;(2)适度的运动量非常重要,过小或者过大的训练量都不利于早期心肺功能的恢复;(3)男女运动员由于生理结构的差异性,机体指标存在差异,因此,在制定有氧训练策略时,应考虑性别差异。%To study the effect of aerobic training for lower limbs on the early cardiopulmonary function recovery of racing athletes, this paper selected ten athletes who were known well their profiles about the movement characteristics and cardiopulmonary function to detect them with the cardiopulmonary function detector made in Germany and compared cardiopulmonary function indexes before and after exercise with EXCEL to analyze the test data. The results showed that tested athletes effectively improved in the cardiopulmonary tolerance time, resistance load, pulmonary ventilation, oxygen uptake etc. and accelerated the cardiopulmonary function recovery. It was important for early cardiopulmonary function recovery to suitably exercise rather than an excess. In view of physiological differences between men and women, when athletes were trained, they were treated differently according to a gender.

  6. Influence of cerebrovascular arteriosclerosis on cerebral oxygenation during exercise

    International Nuclear Information System (INIS)

    Although it is assumed that cerebral oxygenation during exercise is influenced by both cardiopulmonary function and cerebrovascular arteriosclerosis, the latter factor has not been fully clarified. In the present study the relationship between the degree of cerebrovascular arteriosclerosis and cerebral oxygenation during exercise was investigated. A total of 109 patients (69 patients with coronary artery disease, 40 patients with hypertensive heart disease) (61.7±9.7 years) performed a symptom-limited exercise test with respiratory gas measurements (CPX). From the respiratory gas analysis, peak O2 uptake (VO2), the slope of the increase in VO2 to the increase in work rate (ΔVO2/ΔWR), and the slope of the increase in ventilation to the increase in CO2 output (VE/VCO2 slope) were calculated. Oxyhemoglobin (O2Hb) at the forehead was monitored using near-infrared spectroscopy. The brain ischemic score was counted based upon fluid-attenuated inversion recovery images of magnetic resonance imaging and expressed from 0 to 4. When compared with patients with a lower ischemic score (2Hb during exercise (-1.08±2.7 vs 0.77±4.1 μmol/L, p=0.011). Of brain ischemic score, left ventricular ejection fraction, peak VO2, ΔVO2/ΔWR, and the VE/VCO2 slope, ΔVO2/ΔWR was found to be the sole independent index determining cerebral O2Hb during exercise. The CPX parameters were also significantly related to the degree of cerebrovascular arteriosclerosis. Although cerebral oxygenation during exercise is mainly related to cardiopulmonary function, the degree of cerebrovascular arteriosclerosis partly influences cerebral oxygenation in patients with risk factors for atherosclerosis. (author)

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

    Science.gov (United States)

    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. EFFECTS OF MAXIMAL SQUAT EXERCISE TESTING ON VERTICAL JUMP PERFORMANCE IN AMERICAN COLLEGE FOOTBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Jay R. Hoffman

    2007-03-01

    Full Text Available Maximal strength and power testing are common assessments that are used to evaluate strength/power athletes. The validity and reliability of these tests have been well established (Hoffman, 2006, however the order of testing may have a profound effect on test performance outcome. It is generally recommended that the least fatiguing and highly-skilled tests are performed first, while highly fatiguing tests are performed last (Hoffman, 2006. Recent research has demonstrated that maximal isometric contractions and maximal or near- maximal dynamic exercise can augment the rate of force development, increase jump height and enhance sprint cycle performance (Chiu et al., 2003; French et al., 2003. The use of a maximal or near-maximal activity to enhance strength and power performance has been termed "muscle postactivation potentiation", and appears to be more common in the experienced resistance-trained athletes than in the recreationally-trained population (Chiu et al., 2003. It is believed that postactivation potentiation can enhance muscle performance by increasing the neural signal that activates the muscle (Hamada et al., 2000. Since heavy loading in a similar movement pattern of exercise appears to enhance maximal strength and power performance in the experienced resistance-trained athlete, it may be hypothesized that the postactivation potentiation associated with heavy loading has the potential to augment subsequent performance of tests utilizing similar motion. Therefore, consideration of an appropriate sequence of athletic performance testing in strength and power athletes is warranted. We would like to share our experience on the effect of performing a maximal lower body strength test on vertical jump performance in experienced resistance-trained strength/power athletes.We examined 64 NCAA Division III American collegiate football players (age = 20.1 ± 1.9 yr; body mass = 97.5 ± 17.8 kg; height = 1.80 ± 0.12 m. All testing was performed

  9. Cardiorespiratory Responses and Prediction of Peak Oxygen Uptake during the Shuttle Walking Test in Healthy Sedentary Adult Men

    OpenAIRE

    Camila D C Neves; Ana Cristina Rodrigues Lacerda; Lage, Vanessa K. S.; Lima, Liliana P.; Fonseca, Sueli F.; Núbia C. P. Avelar; Teixeira, Mauro M; Mendonça, Vanessa A

    2015-01-01

    BACKGROUND: The application of the Shuttle Walking Test (SWT) to assess cardiorespiratory fitness and the intensity of this test in healthy participants has rarely been studied. This study aimed to assess and correlate the cardiorespiratory responses of the SWT with the cardiopulmonary exercise testing (CEPT) and to develop a regression equation for the prediction of peak oxygen uptake (VO2 peak) in healthy sedentary adult men. METHODS: In the first stage of this study, 12 participants underw...

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

    Directory of Open Access Journals (Sweden)

    Zaugg Christian

    2004-08-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

  12. Cardiopulmonary Bypass and Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Mustafa Zakkar

    2015-01-01

    Full Text Available The development of the cardiopulmonary bypass (CPB revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes. The administration of agents with antioxidant properties during surgery either intravenously or in the cardioplegia solution may reduce ROS burst and oxidative stress during CPB. Alternatively, the use of modified circuits such as minibypass can modify both proinflammatory responses and oxidative stress.

  13. Cardiopulmonary function and laparoscopic cholecystectomy.

    Science.gov (United States)

    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

  14. Evaluation of the cardiac performance in patients with coronary arterty disease by the pulmonary blood volume change in exercise testing

    International Nuclear Information System (INIS)

    Evaluation of the cardiac performance was studied by the change of the pulmonary blood volume (PBV) during the exercise testing in 17 normal subjects (group N), 18 patients with angina pectoris (group A) and 25 with both old myocardial infarction and angina pectoris (group M). The exercise testing was performed by bicycle ergometer in supine position. Blood pressure, heart rate, cardiac output measured by dye dilution method, left ventricular ejection fraction (EF) by multi-gate method, pulmonary artery pressure by Swan-Ganz catheter and PBV was measured during exercise. PBV was estimated by the radioactivity of the systemically administered Tc-99m labeled RBC in the lung field. ROI was adjusted over the right upper and lower lung field. And also the effect of the nitroglycerin was examined. In the result, (1) EF at the peak exercise increased in group N but decreased in Groups A and M. (2) Increased pulmonary artery diastolic pressure at the peak exercise (PAd at exercise) was remarkably higher in groups A and M than group M. (3) PBV was unchanged in group N; however, increased 9.6% in group A and 10.9% in group M. (4) Increased rate of PBV revealed good correlation with ΔEF (r=-0.68, p<0.01) and PAd at exercise (r=0.83, p<0.01), and was considered as the pulmonary congestion due to left ventricular dysfunction. (5) After the sublingual administration of nitroglycerin, the increased PAd and PBV at the peak exercise was suppressed. Particularly, it was remarkable in group A. Thus it was concluded that the noninvasive measurement of PBV during exercise could suggest the extent of the pulmonary congestion and was very useful for evaluation of the cardiac performance in coronary artery disease. (author)

  15. The ECG component of thallium-201 exercise testing significantly alters patient management

    Energy Technology Data Exchange (ETDEWEB)

    Deague, J.; Salehi, N.; Grigg, L.; Lichtenstein, M.; Better, N. [Royal Melbourne Hospital, Parkville, VIC (Australia). Departments Nuclear Medicine and Cardiology

    1998-02-01

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG component of the Tlex (ECGTI) was associated with an improved outcome compared with a positive ECGTI, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive ECGTI) for 12 months. The ECG was reviewed as positive (1 mm ST depression 0.08 seconds after J point or > 2 mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. Over the ensuing 12 months no patients with negative ECGTl was admitted with unstable angina, myocardium infarction or had a cardiac death. It is concluded that in patients with reversible defects on Tlex, a negative ECGTl is associated with a low incidence of cardiac events and a decreased incidence of a cardiac intervention

  16. The ECG component of Thallium-201 exercise testing impacts on cardiac intervention rates

    Energy Technology Data Exchange (ETDEWEB)

    Deague, J.; Salehi, N.; Grigg, L.; Lichtenstein, M.; Better, N. [Royal Melbourne Hospital, Parkville, VIC (Australia). Departments of Nuclear Medicine and Cardiology

    1998-06-01

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG Component of the Tlex (ECGTl) was associated with an improved outcome compared with a positive ECGTl, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive ECGTI) for 12 months. The ECG was reviewed as positive (1mm ST depression 0.08 seconds after J point or >2mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. End-points included angiography, cardiac interventions and cardiac event rate (CER) incorporating unstable angina, acute myocardial infarction, and cardiac death. In conclusion 24% of patients with reversible defects on Tlex who had a negative ECGTI still proceeded to PTCA or CABG. Those with a positive ECGTI had a higher incidence of angiography and cardiac revascularisation, but this difference was only evident in patients with mild to moderate reversibility

  17. The ECG component of thallium-201 exercise testing significantly alters patient management

    International Nuclear Information System (INIS)

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG component of the Tlex (ECGTI) was associated with an improved outcome compared with a positive ECGTI, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive (ECGTI) for 12 months. The ECG was reviewed as positive (1 mm ST depression 0.08 seconds after J point or > 2 mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. Over the ensuing 12 months no patients with negative ECGTl was admitted with unstable angina, myocardium infarction or had a cardiac death. It is concluded that in patients with reversible defects on Tlex, a negative ECGTl is associated with a low incidence of cardiac events and a decreased incidence of a cardiac intervention

  18. The ECG component of Thallium-201 exercise testing impacts on cardiac intervention rates

    International Nuclear Information System (INIS)

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG Component of the Tlex (ECGTl) was associated with an improved outcome compared with a positive ECGTl, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive ECGTI) for 12 months. The ECG was reviewed as positive (1mm ST depression 0.08 seconds after J point or >2mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. End-points included angiography, cardiac interventions and cardiac event rate (CER) incorporating unstable angina, acute myocardial infarction, and cardiac death. In conclusion 24% of patients with reversible defects on Tlex who had a negative ECGTI still proceeded to PTCA or CABG. Those with a positive ECGTI had a higher incidence of angiography and cardiac revascularisation, but this difference was only evident in patients with mild to moderate reversibility

  19. Prospective evaluation of a new protocol for the provisional use of perfusion imaging with exercise stress testing

    Energy Technology Data Exchange (ETDEWEB)

    Duvall, W.L. [Hartford Hospital, Division of Cardiology (Henry Low Heart Center), Hartford, CT (United States); Mount Sinai Medical Center, Division of Cardiology (Mount Sinai Heart), New York, NY (United States); Savino, John A.; Levine, Elliot J.; Croft, Lori B.; Henzlova, Milena J. [Mount Sinai Medical Center, Division of Cardiology (Mount Sinai Heart), New York, NY (United States); Hermann, Luke K. [Mount Sinai Medical Center, Department of Emergency Medicine, New York, NY (United States)

    2014-11-04

    Previous literature suggests that myocardial perfusion imaging (MPI) adds little to the prognosis of patients who exercise >10 metabolic equivalents (METs) during stress testing. With this in mind, we prospectively tested a provisional injection protocol in emergency department (ED) patients presenting for the evaluation of chest pain in which a patient would not receive an injection of radioisotope if adequate exercise was achieved without symptoms and a negative ECG response. All patients who presented to the ED over a 5-year period who were referred for stress testing as part of their ED evaluation were included. Patients considered for a provisional protocol were: exercise stress, age <65 years, no known coronary artery disease, and an interpretable rest ECG. Criteria for not injecting included a maximal predicted heart rate ≥85 %, ≥10 METs of exercise, no anginal symptoms during stress, and no ECG changes. Groups were compared based on stress test results, all-cause and cardiac mortality, follow-up cardiac testing, subsequent revascularization, and cost. A total of 965 patients were eligible with 192 undergoing exercise-only and 773 having perfusion imaging. After 41.6 ± 19.6 months of follow-up, all-cause mortality was similar in the exercise-only versus the exercise plus imaging group (2.6 % vs. 2.1 %, p = 0.59). There were no cardiac deaths in the exercise-only group. At 1 year there was no difference in the number of repeat functional stress tests (1.6 % vs. 2.1 %, p = 0.43), fewer angiograms (0 % vs. 4.0 %, p = 0.002), and a significantly lower cost (65 ± 332 vs 506 ± 1,991, p = 0.002; values are in US dollars) in the exercise-only group. The radiation exposure in the exercise plus imaging group was 8.4 ± 2.1 mSv. A provisional injection protocol has a very low mortality, few follow-up diagnostic tests, and lower cost compared to standard imaging protocols. If adopted it would decrease radiation exposure, save time and decrease health-care costs

  20. Prospective evaluation of a new protocol for the provisional use of perfusion imaging with exercise stress testing

    International Nuclear Information System (INIS)

    Previous literature suggests that myocardial perfusion imaging (MPI) adds little to the prognosis of patients who exercise >10 metabolic equivalents (METs) during stress testing. With this in mind, we prospectively tested a provisional injection protocol in emergency department (ED) patients presenting for the evaluation of chest pain in which a patient would not receive an injection of radioisotope if adequate exercise was achieved without symptoms and a negative ECG response. All patients who presented to the ED over a 5-year period who were referred for stress testing as part of their ED evaluation were included. Patients considered for a provisional protocol were: exercise stress, age <65 years, no known coronary artery disease, and an interpretable rest ECG. Criteria for not injecting included a maximal predicted heart rate ≥85 %, ≥10 METs of exercise, no anginal symptoms during stress, and no ECG changes. Groups were compared based on stress test results, all-cause and cardiac mortality, follow-up cardiac testing, subsequent revascularization, and cost. A total of 965 patients were eligible with 192 undergoing exercise-only and 773 having perfusion imaging. After 41.6 ± 19.6 months of follow-up, all-cause mortality was similar in the exercise-only versus the exercise plus imaging group (2.6 % vs. 2.1 %, p = 0.59). There were no cardiac deaths in the exercise-only group. At 1 year there was no difference in the number of repeat functional stress tests (1.6 % vs. 2.1 %, p = 0.43), fewer angiograms (0 % vs. 4.0 %, p = 0.002), and a significantly lower cost (65 ± 332 vs 506 ± 1,991, p = 0.002; values are in US dollars) in the exercise-only group. The radiation exposure in the exercise plus imaging group was 8.4 ± 2.1 mSv. A provisional injection protocol has a very low mortality, few follow-up diagnostic tests, and lower cost compared to standard imaging protocols. If adopted it would decrease radiation exposure, save time and decrease health-care costs

  1. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    OpenAIRE

    Akram Sardari; Mostafa Nejatian; Mehrdad Sheikhvatan

    2010-01-01

    Background: Systolic blood pressure recovery (rSBP) is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD). This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR) in a population-based sample of patients undergoing coronary artery bypass grafting (CABG).Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent sta...

  2. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... regular exercise. Exercise also helps people with high blood pressure, balance problems, or difficulty walking. To learn about exercise and diabetes, see "Exercise and Type 2 Diabetes" from Go4Life®, the exercise and physical ...

  3. Dynamic Cerebral Autoregulation after Cardiopulmonary Bypass

    DEFF Research Database (Denmark)

    Christiansen, Claus Behrend; Berg, Ronan M G; Plovsing, Ronni;

    2016-01-01

    Background Cerebral hemodynamic disturbances in the peri- or postoperative period may contribute to postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). We therefore examined dynamic cerebral autoregulation (d...

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

    Science.gov (United States)

    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 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.

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

    Science.gov (United States)

    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.

  6. Cardiopulmonary resuscitation: update, controversies and new advances

    OpenAIRE

    Alexandre C. Zago; Cristine E. Nunes; Viviane R. da Cunha; Euler Manenti; Luís Carlos Bodanese

    1999-01-01

    Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of...

  7. LUCAS - Lund University Cardiopulmonary Assist System

    OpenAIRE

    Liao, Qiuming

    2011-01-01

    Lund University Cardiopulmonary Assist System (LUCAS) is a mechanical device providing automatic 5 cm deep chest compressions and active decompressions back to normal anatomical position with a frequency of 100 per minute, and a duty cycle of 50%, i.e., LUCAS is constructed to give chest compressions according to the latest international guidelines in cardiopulmonary resuscitation (CPR). The aim of the thesis was to study cardiac arrest using different porcine models of ventricular fi...

  8. Vasopressin decreases neuronal apoptosis during cardiopulmonary resuscitation

    OpenAIRE

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

    2014-01-01

    The American Heart Association and the European Resuscitation Council recently recommended that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopulmonary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, ...

  9. Screening Test of Greenhouse Seeding Exercise Matrix for Tissue Culture Seeding of Dendrobium Officinale Kimura et Migo

    Directory of Open Access Journals (Sweden)

    Zhou Yuan

    2015-01-01

    Full Text Available The Dendrobium officinale Kimura et Migo has a high demand on planting matrix, while its tissue culture seeding has much more demands on planting matrix. To find out a seeding exercise matrix to enhance the survival rate of tissue culture seeding of Dendrobium officinale Kimura et Migo more efficiently, this article carries out a screening test of greenhouse seeding exercise matrix material for tissue culture seeding of Dendrobium officinale Kimura et Migo. The test adopts full random test design, mainly for screening test of five matrix materials, namely pine bark, camphor tree bark, fern root, peanut shell and longan bark. Compare the impact of prepared seeding exercise matrix on the survival rate and growth trend (including plant height, growth rate and bud growth rate. The test result shows that: The seeding exercise matrix prepared by fern root is the most efficient, and the survival rate, plant height, growth rate and bud growth rate have achieved 100%, 4.5cm, 43.67% and 54.33% respectively. The main reason may be that the seeding exercise matrix C prepared by fern root is fairly loose and has a great water permeability, which is conducive to the growth of Dendrobium officinale Kimura et Migo.

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

    Science.gov (United States)

    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) 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

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

    OpenAIRE

    Edmunds, Jemma; Ntoumanis, Nikos; Duda, Joan L.

    2007-01-01

    Drawing from self-determination theory (SDT), this study examined the effect of an autonomy supportive, well structured and interpersonally involving teaching style on exercise class participants’ psychological need satisfaction, motivational regulations, exercise behaviour, behavioural intention and affect. Female exercise class participants enrolled in a 10-week exercise program were exposed to an SDT-based (i.e. SDTc; n¼25) or typical (i.e. control group; n¼31) teaching style. The control ...

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

    International Nuclear Information System (INIS)

    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

  13. Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

    Full Text Available PURPOSE: Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD, a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation. METHODS: CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM voxel-based morphometry (VBM. Pseudo-continuous arterial spin labeling (pcASL was used to produce cerebral blood flow (CBF images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables. RESULTS: In 30 men with CAD (mean age 65±7 years, VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t = 9.6, df = 28, p<0.0001. Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak. CONCLUSION: Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients.

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

    Directory of Open Access Journals (Sweden)

    Zafeiris Louvaris

    2015-06-01

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

  15. Doppler ultrasonography and exercise testing in diagnosing a popliteal artery adventitial cyst.

    Science.gov (United States)

    Taurino, Maurizio; Rizzo, Luigi; Stella, Nazzareno; Mastroddi, Massimo; Conteduca, Fabio; Maggiore, Claudia; Faraglia, Vittorio

    2009-01-01

    We describe popliteal arterial adventitial cystic disease which causes intermittent claudication in a young athletic man, with atypical manifestation, without loss of foot pulses on knee flexion nor murmur in the popliteal fossa. The findings obtained from Magnetic Resonance Imaging were non-diagnostic. The diagnosis resulted from Echo-Doppler ultrasonography along with peak exercise testing. Ultrasonography also provided useful physiopathological informations suggesting that a popliteal artery adventitial cyst can become symptomatic if muscle exertion increases fluid pressure within the cyst, enough to cause hemodynamically significant endoluminal stenosis. Rapid diagnosis is essential to prevent progressive claudication threatening limb viability. To guarantee this professional sportsman a reliable and durable outcome, instead of less aggressive management, we resected the involved arterial segment and interposed an autologous saphenous-vein graft. PMID:19473494

  16. Effect of Exercise Testing on Short-term Heart Rate Variability in Patients with Coronary Heart Disease

    DEFF Research Database (Denmark)

    Niu, Hui-Yan; Zhang, Dai-Fu; Liang, Bo;

    2005-01-01

    Objective To study the effect of exercise testing on short term heart rate variability in patients with CHD.Methods In 12 patients with CHD and 12 age-and sex-matched healthy controls, short-term frequency domain analysis was performed at respective stage before, during and after ET.Results It sh......Objective To study the effect of exercise testing on short term heart rate variability in patients with CHD.Methods In 12 patients with CHD and 12 age-and sex-matched healthy controls, short-term frequency domain analysis was performed at respective stage before, during and after ET...

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

    Directory of Open Access Journals (Sweden)

    Chan Jason

    2011-12-01

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

  18. Assessment of Speckle-Tracking Echocardiography-Derived Global Deformation Parameters During Supine Exercise in Children.

    Science.gov (United States)

    Liu, Michael Y; Tacy, Theresa; Chin, Clifford; Obayashi, Derek Y; Punn, Rajesh

    2016-03-01

    Exercise echocardiography is an underutilized tool in pediatrics with current applications including detecting segmental wall abnormalities, assessing the utility of global ventricular function, and measuring pulmonary hemodynamics. No prior study has applied speckle-tracking echocardiography (STE) during exercise echocardiography in children. The aim of this study was to determine the feasibility of measuring speckle-tracking-derived peak systolic velocities, global longitudinal and circumferential strain, and global strain rates at various phases of exercise. Ninety-seven healthy children underwent cardiopulmonary exercise testing using supine cycle ergometry. The exercise stress test consisted of baseline pulmonary function testing, monitoring of blood pressure and heart rate responses, electrocardiographic recordings, and oxygen saturations while subjects pedaled against a ramp protocol based on body weight. Echocardiographic measurements and specifically speckle-tracking analysis were performed during exercise at baseline, at a heart rate of 160 beats per minute and at 10 min after exercise. Peak systolic velocity, peak systolic strain, and peak systolic strain rate at these three phases were compared in the subjects in which all measurements were accurately obtained. We were able to complete peak velocity, strain, and strain rate measurements in all three exercise phases for 36 out of the 97 subjects tested. There was no significant difference between the feasibility of measuring circumferential versus longitudinal strain (p = 0.25, B-corrected = 0.75). In the 36 subjects studied, the magnitude of circumferential strain values decreased from -18.3 ± 4.8 to -13.7 ± 4.0 % from baseline to HR 160 (p exercise. We studied the effects of frame rate on deformation measurements and we observed no difference between measurements taken at lower (exercising pediatric subjects with STE. The majority of subjects that were excluded from the study had inadequate

  19. Hemodynamic Changes After Static and Dynamic Exercises and Treadmill Stress Test; Different Patterns in Patients with Primary Benign Exertional Headache?

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    Mohsen Rostami

    2012-06-01

    Full Text Available The pathophysiology of primary benign exertional headache (EH is not still clearly defined. Some researchers have suggested an impaired vascular response as the etiology of this disorder. In this study we investigated whether there are any differences in blood pressure (BP and heart rate (HR of the subjects in course of the static and dynamic exercises and the treadmill stress test between those with and without EH. From university students, 22 patients with EH (mean age: 19.8 ± 2.10, Female to Male: 7:15 and 20 normal subjects (mean age: 19.3 ± 1.97, Female: Male: 8:12 were recruited. All the subjects performed the static and dynamic exercises at 30 and 20 percent of the maximal voluntary contraction (MVC and Bruce treadmill stress test according to the standard protocols. HR and BP of all the cases at the baseline and during and immediately after each test were measured. No significant difference was found between the mean rise of HR, systolic and diastolic BP of the subjects with and without EH in static and dynamic exercises and also treadmill stress test. It seems that between those with and without EH, there is no significant difference in rise of HR and BP response to static and dynamic exercises and treadmill stress test. Further studies are required to find the pathophysiology and risk factors of EH.

  20. Evaluation of exercise tolerance patients in cardiac rehabilitation D model based on 6 Minute Walk Test

    Directory of Open Access Journals (Sweden)

    Bielawa Lukasz.

    2012-12-01

    Full Text Available Evaluation of the results of 6-minute walk test depending on gender, age, left ventricular ejection fraction, the primary disease and BMI. Patients underwent assessment of Cardiac Rehabilitation Department in Szymbark in 2012 (80 people. Duration of rehabilitation for all patients was 21 days. The test was performed at the beginning and end of the cycle. Following the 3-week cardiac rehabilitation in the model D in a group of 80 patients with a mean age of 72 years achieved a statistically significant improvement in exercise capacity, expressed in the increase in test 6MWT distance by an average of 52 meters. In the study, men received final results statistically superior to women. The largest increase in the distance gained to patients after aortic valve prosthesis. People who are obese with a body mass index BMI over 30 have an average trip distance underperform both at baseline, final, and in the resulting increase of the distance than those with a BMI under 30. Prevention of obesity, one of the modifiable risk factors for cardiovascular disease should be the goal of training during cardiac rehabilitation patient education.

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

    International Nuclear Information System (INIS)

    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. Prognosis of patients with positive exercise test and normal myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Ahn, B. C.; Lee, J.; Lee, K. B [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of)

    2004-07-01

    Exercise SPECT myocardial perfusion imaging(Ex-MPI) is regarded as a predictive technique particularly in patients with coronary artery disease(CAD) capable of performing exercise testing. In clinical practice, we encounter equivocal situations of discordant findings between exercise ECG and MPI. We evaluated the prognosis of subjects with positive ECG and normal MPI findings, and predictive factors for cardiac events. 2571 Ex-MPI studies were reviewed over a period of 3 years. Subjects were followed for more than 2 years(24-56 months, mean 35{+-}10months) for cardiac events after study. The cardiac events were defined as hard events(cardiac death and nonfatal myocardial infarction(MI)) and soft events(aggravation of CAD necessitating revascularization, congestive heart failure necessitating hospital admission). We evaluated age, sex, typical angina pain, rest ECG, hypertension, diabetes mellitus(DM), serum levels of cholesterol and LDL, smoking history, history of cerebrovascular disease(CVD) and peripheral artery disease(PAD), and rest left ventricular ejection fraction(LVEF) as clinical variables. Of 83 subjects with positive ECG and normal MPS findings, 6 were considered as false negative results confirmed with coronary angiography. There were 77 patients (mean age 52{+-}10 years, 39 males) with positive ECG and normal MPI results. During the follow-up period, of 77 there were 3 cardiac events (annual rate 1.9%), no cardiac death, 2 nonfatal MIs (annual rate 1.3%) and 1 soft event (annual rate 0.6%). 2/39 males(5.1%), and 1/38 females(2.6%) had cardiac events. All cardiac events were observed within 2 years. 1-year cardiac event rate was 0.6% and 2-year cardiac event rate was 1.9%. Among clinical factors, male sex, typical chest pain and smoking history at the time of MPI were predictive of cardiac events. Patients with positive ECG and negative EX-MPI results have low risk for cardiac events. Nevertheless, the cardiac events cannot be excluded totally in some

  3. Prognosis of patients with positive exercise test and normal myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Exercise SPECT myocardial perfusion imaging(Ex-MPI) is regarded as a predictive technique particularly in patients with coronary artery disease(CAD) capable of performing exercise testing. In clinical practice, we encounter equivocal situations of discordant findings between exercise ECG and MPI. We evaluated the prognosis of subjects with positive ECG and normal MPI findings, and predictive factors for cardiac events. 2571 Ex-MPI studies were reviewed over a period of 3 years. Subjects were followed for more than 2 years(24-56 months, mean 35±10months) for cardiac events after study. The cardiac events were defined as hard events(cardiac death and nonfatal myocardial infarction(MI)) and soft events(aggravation of CAD necessitating revascularization, congestive heart failure necessitating hospital admission). We evaluated age, sex, typical angina pain, rest ECG, hypertension, diabetes mellitus(DM), serum levels of cholesterol and LDL, smoking history, history of cerebrovascular disease(CVD) and peripheral artery disease(PAD), and rest left ventricular ejection fraction(LVEF) as clinical variables. Of 83 subjects with positive ECG and normal MPS findings, 6 were considered as false negative results confirmed with coronary angiography. There were 77 patients (mean age 52±10 years, 39 males) with positive ECG and normal MPI results. During the follow-up period, of 77 there were 3 cardiac events (annual rate 1.9%), no cardiac death, 2 nonfatal MIs (annual rate 1.3%) and 1 soft event (annual rate 0.6%). 2/39 males(5.1%), and 1/38 females(2.6%) had cardiac events. All cardiac events were observed within 2 years. 1-year cardiac event rate was 0.6% and 2-year cardiac event rate was 1.9%. Among clinical factors, male sex, typical chest pain and smoking history at the time of MPI were predictive of cardiac events. Patients with positive ECG and negative EX-MPI results have low risk for cardiac events. Nevertheless, the cardiac events cannot be excluded totally in some

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

    Directory of Open Access Journals (Sweden)

    Nilva Regina Gelamo Pelegrino

    2009-01-01

    Full Text Available OBJETIVO: A massa magra corporal (MMC tem sido associada à mortalidade em pacientes com DPOC, mas seu impacto na limitação funcional é pouco conhecido. O objetivo deste trabalho foi analisar as variáveis cardiopulmonares em pacientes com DPOC, com ou sem depleção da MMC, antes e após a realização do teste de caminhada de seis minutos (TC6. MÉTODOS: Foram avaliados pacientes com DPOC, 36 sem depleção de MMC e 32 com depleção de MMC. Todos os pacientes foram submetidos à avaliação clínica, espirometria, avaliação da composição da massa corpórea e TC6 e responderam a questionários de qualidade de vida e de percepção de dispnéia. RESULTADOS: Não foram observadas diferenças significativas na gravidade de obstrução das vias aéreas, na percepção da dispnéia e na qualidade de vida entre os grupos. A distância percorrida no TC6 foi similar nos pacientes com DPOC com e sem depleção de MMC (470,3 ± 68,5 m vs. 448,2 ± 89,2 m. Entretanto, durante a realização do teste, os pacientes com depleção de MMC apresentaram aumento significativamente maior na diferença entre os valores final e basal da frequência cardíaca e do índice da escala de Borg para cansaço dos membros inferiores. A distância percorrida no TC6 apresentou correlação significativa positiva com o VEF1 (r = 0,381; p = 0,01. CONCLUSÕES: Não houve influência da depleção da MMC na capacidade funcional de exercício e na qualidade de vida dos pacientes estudados. Entretanto, os pacientes com depleção de MMC apresentam sintomas de fadiga dos membros inferiores mais acentuados durante o TC6, o que reforça a importância da avaliação e tratamento das manifestações sistêmicas da DPOC.OBJECTIVE: Although lean body mass (LBM has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM

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

    Directory of Open Access Journals (Sweden)

    Melissa Rizk

    Full Text Available "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

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

    Science.gov (United States)

    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.

    Science.gov (United States)

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

    International Nuclear Information System (INIS)

    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

  9. "Orpheus" cardiopulmonary bypass simulation system.

    Science.gov (United States)

    Morris, Richard W; Pybus, David A

    2007-12-01

    In this paper we describe a high-fidelity perfusion simulation system intended for use in the training and continuing education of perfusionists. The system comprises a hydraulic simulator, an electronic interface unit and a controlling computer with associated real-time computer models. It is designed for use within an actual operating theatre, or within a specialized simulation facility. The hydraulic simulator can be positioned on an operating table and physically connected to the circuit of the institutional heart-lung machine. The institutional monitoring system is used to display the arterial and central venous pressures, the ECG and the nasopharyngeal temperature using appropriate connections. The simulator is able to reproduce the full spectrum of normal and abnormal events that may present during the course of cardiopulmonary bypass. The system incorporates a sophisticated blood gas model that accurately predicts the behavior of a modern, hollow-fiber oxygenator. Output from this model is displayed in the manner of an in-line blood gas electrode and is updated every 500 msecs. The perfusionist is able to administer a wide variety of drugs during a simulation session including: vasoconstrictors (metaraminol, epinephrine and phenylephrine), a vasodilator (sodium nitroprusside), chronotropes (epinephrine and atropine), an inotrope (epinephrine) and modifiers of coagulation (heparin and protamine). Each drug has a pharmacokinetic profile based on a three-compartment model plus an effect compartment. The simulation system has potential roles in the skill training of perfusionists, the development of crisis management protocols, the certification and accreditation of perfusionists and the evaluation of new perfusion equipment and/or techniques. PMID:18293807

  10. IEA Common Exercise 4: ARX, ARMAX and grey-box models for thermal performance characterization of the test box

    DEFF Research Database (Denmark)

    Bacher, Peder; Andersen, Philip Hvidthøft Delff

    In this report results of applying time series models for assessing the thermal performance of the IEA Annex 58 test box based on data given in the Common Exercise 4 (CE4), which was measured in Almeria, Spain. Both ARX, ARMAX and grey-box models are applied. Finally, the same models are fitted...

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

    Science.gov (United States)

    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. Derivation and validation of a simple exercise-based algorithm for prediction of genetic testing in relatives of LQTS probands

    NARCIS (Netherlands)

    R.W. Sy; C. van der Werf; I.S. Chattha; P. Chockalingam; A. Adler; J.S. Healey; M. Perrin; M.H. Gollob; A.C. Skanes; R. Yee; L.J. Gula; P. Leong-Sit; S. Viskin; G.J. Klein; A.A. Wilde; A.D. Krahn

    2011-01-01

    Genetic testing can diagnose long-QT syndrome (LQTS) in asymptomatic relatives of patients with an identified mutation; however, it is costly and subject to availability. The accuracy of a simple algorithm that incorporates resting and exercise ECG parameters for screening LQTS in asymptomatic relat

  13. Aerobic exercise attenuates blood pressure reactivity to cold pressor test in normotensive, young adult African-American women.

    Science.gov (United States)

    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)) (Pstress 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

  14. Heart rate as an indicator for exercise prescription for normal, overweight, and obese adolescents

    OpenAIRE

    Kamilla Bolonha Gomes; Anselmo José Perez; Luciana Carletti; Adilson Marques

    2016-01-01

    Abstract This study aimed to investigate the relationship between heart rate (HR) predicted and VO2max using a CPET (cardiopulmonary exercise testing) among normal weight, overweight, and obese adolescents. The sample comprised 299 adolescents (142 boys), from Vitória (ES, Brazil), aged 10-14 years (12.6±1.4). Adolescents were classified into normal weight (n=236), overweight (n=34), and obese (n=29). Adolescents were subjected to a CPET ramp protocol on a treadmill. It was observed that the ...

  15. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Science.gov (United States)

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Erica Scioli-Salter, PhD

    2016-02-01

    Full Text Available 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.

  17. Myocardial perfusion imaging in patients with a recent, normal exercise test

    DEFF Research Database (Denmark)

    Bovin, Ann; Klausen, Ib Christian; Petersen, Lars Jelstrup

    2013-01-01

    To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG).......To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG)....

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

    Science.gov (United States)

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

    2011-01-01

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

  19. Pulmonary Hypertension and Cardiopulmonary Exercise in Heart Failure

    OpenAIRE

    Kim, Chul-Ho; Jae, Sae Young; Johnson, Bruce D.

    2014-01-01

    In heart failure (HF), pulmonary hypertension (PH) is initially associated with a rise in the left ventricular filling pressure. PH is defined by pulmonary hemodynamic measurements including pulmonary capillary wedge pressure, mean pulmonary arterial pressure and pulmonary vascular resistance. Eventually, PH in HF may become more of a reactive process. Although the mechanism of the reactive PH development is not clearly understood, vascular dysfunction induced by remodeling, vasoactive substa...

  20. Prognostic value of QTc interval dispersion changes during exercise testing in hypertensive men

    Directory of Open Access Journals (Sweden)

    Đorđević Dragan

    2008-01-01

    Full Text Available INTRODUCTION The prognostic significance of QTc dispersion changes during exercise testing (ET in patients with left ventricular hypertrophy is not clear. OBJECTIVE The aim was to study the dynamics of QTc interval dispersion (QTcd in patients (pts with left ventricular hypertrophy (LVH during the exercise testing and its prognostic significance. METHOD In the study we included 55 men (aged 53 years with hypertensive left ventricular hypertrophy and a negative ET (LVH group, 20 men (aged 58 years with a positive ET and 20 healthy men (aged 55 years. There was no statistically significant difference in the left ventricular mass index (LVMI between LVH group and ILVH group (160.9±14.9 g/m2 and 152.8±22.7 g/m2. The first ECG was done before the ET and the second one was done during the first minute of recovery, with calculation of QTc dispersion. The patients were followed during five years for new cardiovascular events. RESULTS During the ET, the QTcd significantly increased in LVH group (56.8±18.0 - 76.7±22.6 ms; p<0.001. A statistically significant correlation was found between the amount of ST segment depression at the end of ET and QTc dispersion at the beginning and at the end of ET (r=0.673 and r=0.698; p<0.01. The QTc dispersion was increased in 35 (63.6% patients and decreased in 20 (36.4% patients during the ET. Three patients (5.4% in the first group had adverse cardiovascular events during the five-year follow-up. A multiple stepwise regression model was formed by including age, LVMI, QTc interval, QTc dispersion and change of QTc dispersion during the ET. There was no prognostic significance of QTc interval and QTc dispersion during five-year follow-up in regard to adverse cardiovascular events, but prognostic value was found for LVMI (coefficient β=0.480; p<0.001. CONCLUSION The increase of QTc interval dispersion is common in men with positive ET for myocardial ischemia and there is a correlation between QTc dispersion and

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

    Directory of Open Access Journals (Sweden)

    Humberto Andres Vaz

    2016-04-01

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

  2. Dobutamine stress echo is superior to exercise stress testing in achieving target heart rate among patients on beta blockers.

    Science.gov (United States)

    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.

  3. Prognostic Value of the Six-Minute Walk Test in Heart Failure Patients Undergoing Cardiac Surgery: A Literature Review

    OpenAIRE

    Dominika Zielińska; Jerzy Bellwon; Andrzej Rynkiewicz; Mohamed Amr Elkady

    2013-01-01

    Background. The prognostic value of cardiopulmonary exercise testing (CPET) is known, but the predictive value of 6MWT in patients with heart failure (HF) and patients undergoing coronary artery bypass grafting (CABG) is not established yet. Objective. We conducted a systematic review exploring the prognostic value of 6MWT in HF patients undergoing cardiac surgery. The aim was to find out whether the change in the distance walked during follow-up visits was associated with prognosis. Data Sou...

  4. Is a fully heparin-bonded cardiopulmonary bypass circuit superior to a standard cardiopulmonary bypass circuit?

    OpenAIRE

    Mahmood, Sarah; Bilal, Haris; Zaman, Mahvash; Tang, Augustine

    2012-01-01

    A best-evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘Is a fully heparin bonded cardiopulmonary bypass circuit superior to a standard cardiopulmonary bypass circuit?’ Altogether more than 792 papers were found using the reported search, of which 13 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of...

  5. Alternatives to the six-minute walk test in pulmonary arterial hypertension.

    Directory of Open Access Journals (Sweden)

    Vincent Mainguy

    Full Text Available INTRODUCTION: The physiological response during the endurance shuttle walk test (ESWT, the cycle endurance test (CET and the incremental shuttle walk test (ISWT remains unknown in PAH. We tested the hypothesis that endurance tests induce a near-maximal physiological demand comparable to incremental tests. We also hypothesized that differences in respiratory response during exercise would be related to the characteristics of the exercise tests. METHODS: Within two weeks, twenty-one PAH patients (mean age: 54(15 years; mean pulmonary arterial pressure: 42(12 mmHg completed two cycling exercise tests (incremental cardiopulmonary cycling exercise test (CPET and CET and three field tests (ISWT, ESWT and six-minute walk test (6MWT. Physiological parameters were continuously monitored using the same portable telemetric device. RESULTS: Peak oxygen consumption (VO(2peak was similar amongst the five exercise tests (p = 0.90 by ANOVA. Walking distance correlated markedly with the VO(2peak reached during field tests, especially when weight was taken into account. At 100% exercise, most physiological parameters were similar between incremental and endurance tests. However, the trends overtime differed. In the incremental tests, slopes for these parameters rose steadily over the entire duration of the tests, whereas in the endurance tests, slopes rose sharply from baseline to 25% of maximum exercise at which point they appeared far less steep until test end. Moreover, cycling exercise tests induced higher respiratory exchange ratio, ventilatory demand and enhanced leg fatigue measured subjectively and objectively. CONCLUSION: Endurance tests induce a maximal physiological demand in PAH. Differences in peak respiratory response during exercise are related to the modality (cycling vs. walking rather than the progression (endurance vs. incremental of the exercise tests.

  6. Attitudes and exercise adherence: test of the Theories of Reasoned Action and Planned Behaviour.

    Science.gov (United States)

    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.

  7. Mathematical analysis of the heart rate performance curve during incremental exercise testing.

    Science.gov (United States)

    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.

  8. International standard problem (ISP) No. 41. Containment iodine computer code exercise based on a radioiodine test facility (RTF) experiment

    International Nuclear Information System (INIS)

    International Standard Problem (ISP) exercises are comparative exercises in which predictions of different computer codes for a given physical problem are compared with each other or with the results of a carefully controlled experimental study. The main goal of ISP exercises is to increase confidence in the validity and accuracy of the tools, which were used in assessing the safety of nuclear installations. Moreover, they enable code users to gain experience and demonstrate their competence. The ISP No. 41 exercise, computer code exercise based on a Radioiodine Test Facility (RTF) experiment on iodine behaviour in containment under severe accident conditions, is one of such ISP exercises. The ISP No. 41 exercise was borne at the recommendation at the Fourth Iodine Chemistry Workshop held at PSI, Switzerland in June 1996: 'the performance of an International Standard Problem as the basis of an in-depth comparison of the models as well as contributing to the database for validation of iodine codes'. [Proceedings NEA/CSNI/R(96)6, Summary and Conclusions NEA/CSNI/R(96)7]. COG (CANDU Owners Group), comprising AECL and the Canadian nuclear utilities, offered to make the results of a Radioiodine Test Facility (RTF) test available for such an exercise. The ISP No. 41 exercise was endorsed in turn by the FPC (PWG4's Task Group on Fission Product Phenomena in the Primary Circuit and the Containment), PWG4 (CSNI Principal Working Group on the Confinement of Accidental Radioactive Releases), and the CSNI. The OECD/NEA Committee on the Safety of Nuclear Installations (CSNI) has sponsored forty-five ISP exercises over the last twenty-four years, thirteen of them in the area of severe accidents. The criteria for the selection of the RTF test as a basis for the ISP-41 exercise were; (1) complementary to other RTF tests available through the PHEBUS and ACE programmes, (2) simplicity for ease of modelling and (3) good quality data. A simple RTF experiment performed under controlled

  9. ST segment elevation in lead aVR during exercise testing is associated with LAD stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Neill, Johanne; Harbinson, Mark [Royal Victoria Hospital, Regional Medical Cardiology Centre, Belfast (United Kingdom); Queens University, Belfast (United Kingdom); Shannon, Heather J.; Morton, Amanda; Muir, Alison R.; Adgey, Jennifer A. [Royal Victoria Hospital, Regional Medical Cardiology Centre, Belfast (United Kingdom)

    2007-03-15

    To evaluate, in patients with chest pain, the diagnostic value of ST elevation (STE) in lead aVR during stress testing prior to {sup 99m} Tc-sestamibi scanning correlating ischaemic territory with angiographic findings. Consecutive patients attending for {sup 99m} Tc-sestamibi myocardial perfusion imaging (MPI) completed a treadmill protocol. Peak exercise ECGs were coded. STE {>=}0.05 mV in lead aVR was considered significant. Gated perfusion images and findings at angiography were assessed. STE in lead aVR occurred in 25% (138/557) of the patients. More patients with STE in aVR had a reversible defect on imaging compared with those who had no STE in aVR (41%, 56/138 vs 27%, 114/419, p=0.003). Defects indicating a left anterior descending artery (LAD) culprit lesion were more common in the STE in aVR group (20%, 27/138 vs 9%, 39/419, p=0.001). There was a trend towards coronary artery stenosis (>70%) in a double vessel distribution involving the LAD in those patients who had STE in aVR compared with those who did not (22%, 8/37 vs 5%, 4/77, p=0.06). Logistic regression analysis demonstrated that STE in aVR (OR 1.36, p=0.233) is not an independent predictor of inducible abnormality when adjusted for STD >0.1 mV (OR 1.69, p=0.026). However, using anterior wall defect as an end-point, STE in aVR (OR 2.77, p=0.008) was a predictor even after adjustment for STD (OR 1.43, p=0.281). STE in lead aVR during exercise does not diagnose more inducible abnormalities than STD alone. However, unlike STD, which is not predictive of a territory of ischaemia, STE in aVR may indicate an anterior wall defect. (orig.)

  10. Physiological consequences : Cardiopulmonary, vestibular, and sensory aspects

    NARCIS (Netherlands)

    Welsch, H.; Albery, W.; Banks, R.D.; Bles, W.

    2000-01-01

    Discussing the physiological consequences of enhanced fighter manoeuvrability (EFM), aspects of cardiopulmonary reactions will be seen during high G manoeuvres, especially the combination of negative G-load followed by high G-onset manoeuvres ("push-pull"). The aircraft's capability to reach high al

  11. Cardiopulmonary resuscitation: update, controversies and new advances

    Directory of Open Access Journals (Sweden)

    Zago Alexandre C.

    1999-01-01

    Full Text Available Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

  12. Relationship between body composition changes and the blood pressure response to exercise test in overweight Japanese subjects.

    Directory of Open Access Journals (Sweden)

    Numata,Takeyuki

    2007-02-01

    Full Text Available We investigated the link between changes in body composition and the blood pressure (BP response to exercise in overweight Japanese by a retrospective clinical study carried out over a 3-year period. We analyzed data for 38 overweight Japanese aged 22-69 years (47.8 +- 11.4 at baseline. Among the participants, 32 overweight subjects (body mass index : BMI, 29.0 +- 3.0 kg/m2 were further analyzed with a 3-year follow up. BP at rest, the BP response to an exercise test, the aerobic exercise-level determined ventilatory threshold (VT, and body composition were evaluated at an interval of 1 year. During the study period, there were 6 drop outs, who started to receive anti-hypertensive drugs because of the development of hypertension. Based on analysis of follow up data, parameters of body composition were significantly reduced over the 3 years. Systolic BP (SBP at rest and at VT was also reduced. In addition, delta SBP (? : delta represents positive change in parameters at VT was positively correlated with ?parameters of body composition over the 3 years. In overweight subjects with increased body weight, there was a significant time (pre vs year 3 effect and interactions by 2 factor-factorial ANOVA. The present study indicates that changes in body composition are closely linked to the SBP response to an exercise test.

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

    International Nuclear Information System (INIS)

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

  14. APROTININ PRESERVES HEMOSTASIS IN ASPIRIN-TREATED PATIENTS UNDERGOING CARDIOPULMONARY BYPASS

    NARCIS (Netherlands)

    TABUCHI, N; HUET, RCG; STURK, A; EIJSMAN, L; WILDEVUUR, CRH

    1994-01-01

    Various clinical trials have shown that hemostasis is improved by the administration of aprotinin during cardiopulmonary bypass. However, this effect has not been proved for those patients treated preoperatively with aspirin. Therefore, a double-blind, placebo-controlled study was conducted to test

  15. Four ways to ventilate during cardiopulmonary resuscitation in a porcine model

    DEFF Research Database (Denmark)

    Kjærgaard, Benedict; Bavarskis, Egidijus; Magnusdottir, Sigriður Olga;

    2016-01-01

    BACKGROUND: The optimal method for out-of-hospital ventilation during cardiopulmonary rescue (CPR) is controversial. The aim of this study was to test different modes of ventilation during CPR for a prolonged period of 60 min. METHODS: Pigs were randomized to four groups after the induction of...

  16. Comparison of Nottingham Health Profile (NHP) scores with exercise duration and measures of ischaemia during treadmill exercise testing in patients with coronary artery disease.

    Science.gov (United States)

    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 social isolation P perceived health status of patients without a history of angina is significantly better than those with angina (pain, physical mobility P social isolation P social life, sex life, hobbies P 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

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

    International Nuclear Information System (INIS)

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

  18. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Z > Exercise: Benefits of Exercise: Health Benefits In This Topic Health Benefits Benefits for Everyday Life Frequently ... Exercise: How to Stay Active The information in this topic was provided by the National Institute on ...

  19. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... of Exercise Videos quiz yourself MedlinePlus for More Information National Institute on Aging Related Topics Exercise: How ... to Try Exercise: How to Stay Active The information in this topic was provided by the National ...

  20. Exercise: Benefits of Exercise

    Medline Plus

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

  1. Exercise: Benefits of Exercise

    Science.gov (United States)

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

  2. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... 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 ...

  3. Coronary microvascular function, insulin sensitivity and body composition in predicting exercise capacity in overweight patients with coronary artery disease

    DEFF Research Database (Denmark)

    Jürs, Anders; Pedersen, Lene Rørholm; Olsen, Rasmus Huan;

    2015-01-01

    BACKGROUND: Coronary artery disease (CAD) has a negative impact on exercise capacity. The aim of this study was to determine how coronary microvascular function, glucose metabolism and body composition contribute to exercise capacity in overweight patients with CAD and without diabetes. METHODS...... by a cardiopulmonary exercise test. Body composition was determined by whole body dual-energy X-ray absorptiometry scan and magnetic resonance imaging. Coronary flow reserve (CFR) assessed by transthoracic Doppler echocardiography was used as a measure of microvascular function. RESULTS: Median BMI was 31.3 and 72...... metabolism and body composition. CFR, EDV and LVEF remained independent predictors of VO2peak in multivariable regression analysis. CONCLUSION: The study established CFR, EDV and LVEF as independent predictors of VO2peak in overweight CAD patients with no or only mild functional symptoms and a LVEF > 35...

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

    CERN Document Server

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

    2015-01-01

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

  5. Identification of a core set of exercise tests for children and adolescents with cerebral palsy : a Delphi survey of researchers and clinicians

    NARCIS (Netherlands)

    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 ident

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

    Science.gov (United States)

    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…

  7. History of the evolution of cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    George Karlis

    2013-04-01

    Full Text Available Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references

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

    Science.gov (United States)

    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 systemic venous hypertension and reduced systemic oxygen delivery. This physiological substrate has the potential to contribute to end-organ injury. PMID:27032711

  9. Use of Geophysical and Remote Sensing Techniques During the Comprehensive Test Ban Treaty Organization's Integrated Field Exercise 2014

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  11. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

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

  12. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... show that people with arthritis, heart disease, or diabetes benefit from regular exercise. Exercise also helps people ... watch this video To learn about exercise and diabetes, see "Exercise and Type 2 Diabetes" from Go4Life®, ...

  13. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... show that people with arthritis, heart disease, or diabetes benefit from regular exercise. Exercise also helps people ... or difficulty walking. To learn about exercise and diabetes, see "Exercise and Type 2 Diabetes" from Go4Life®, ...

  14. Factor V Leiden and Cardiopulmonary Bypass

    OpenAIRE

    Uppal, Victor; Rosin, Mark; Marcoux, Jo-Anne; Olson, Marnie; Bezaire, Jennifer; Dalshaug, Gregory

    2015-01-01

    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...

  15. Survival after in-hospital Cardiopulmonary Resuscitation

    OpenAIRE

    M Adib Hajbaghery; H. Akbari; GA. Mousavi

    2005-01-01

    Background: During recent years, cardiopulmonary resuscitation (CPR) in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and unt...

  16. Survival after in-hospital Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    M Adib Hajbaghery

    2005-05-01

    Full Text Available Background: During recent years, cardiopulmonary resuscitation (CPR in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and until defibrillation, duration and result of CPR, frequency of tracheal intubations and time served for it were collected in a checklist. Results: In six months study, 206 cases of cardiopulmonary resuscitation attempted. The survival rate was similar for both sexes. Short-term survival observed in19.9% of cases and only 5.3% survived to discharge. Conclusions: Duration of CPR, time of the first defibrillation, response time and the location of cardiac arrest are the key predictors of survival to hospital discharge and in-hospital CPR strategies require improvement. This study promotes a national study on post CPR survival for accurate data on our performance in attention to chain of survival. KeyWords: Cardiopulmonary Resuscitation (CPR, Survival rate, Iran

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

    Science.gov (United States)

    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…

  18. Value of leads V4R and CM5 in the detection of coronary artery disease during exercise electrocardiographic test.

    Science.gov (United States)

    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

  19. Preparation, conduct and evaluation of exercises to test preparedness for a nuclear or radiological emergency. Emergency preparedness and response

    International Nuclear Information System (INIS)

    The aim of this publication is to serve as a practical tool for the preparation, conduct and evaluation of exercises to test preparedness for response to a nuclear or radiological emergency. It fulfils in part the functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning the methodologies, techniques and available results of research on such emergencies. To ensure effective response to radiation emergencies when needed, provisions should be made for regular training of emergency response personnel. As stated in Preparedness and Response for a Nuclear or Radiological Emergency (Safety Requirements, Safety Standard Series No. GS-R-2), 'The operator and the response organizations shall make arrangements for the selection of personnel and training to ensure that the personnel have the requisite knowledge, skills, abilities, equipment, procedures and other arrangements to perform their assigned response functions'. A further requirement is that 'Exercise programmes shall be conducted to ensure that all specified functions required to be performed for emergency response and all organizational interfaces for facilities in threat category I, II or III and the national level programmes for threat category IV or V are tested at suitable intervals'. In 2004 the IAEA General Conference, in resolution GC(48)/RES/10 encouraged Member States to 'implement the Safety Requirements for Preparedness and Response to a Nuclear or Radiological Emergency'. This document is published as part of the IAEA Emergency Preparedness and Response Series to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. It was developed based on a number of assumptions about national and local capabilities. Therefore, the exercise structure, terms and scenarios must be

  20. Voice advisory manikin versus instructor facilitated training in cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Isbye, Dan L; Høiby, Pernilla; Rasmussen, Maria B;

    2008-01-01

    BACKGROUND: Training of healthcare staff in cardiopulmonary resuscitation (CPR) is time-consuming and costly. It has been suggested to replace instructor facilitated (IF) training with an automated voice advisory manikin (VAM), which increases skill level by continuous verbal feedback during...... individual training. AIMS: To compare a VAM (ResusciAnne CPR skills station, Laerdal Medical A/S, Norway) with IF training in CPR using a bag-valve-mask (BVM) in terms of skills retention after 3 months. METHODS: Forty-three second year medical students were included and CPR performance (ERC Guidelines...... for Resuscitation 2005) was assessed in a 2 min test before randomisation to either IF training in groups of 8 or individual VAM training. Immediately after training and after 3 months, CPR performance was assessed in identical 2 min tests. Laerdal PC Skill Reporting System 2.0 was used to collect data. To quantify...

  1. Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review

    Directory of Open Access Journals (Sweden)

    Julia Ratter

    2014-09-01

    [Ratter J, Radlinger L, Lucas C (2014 Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review. Journal of Physiotherapy 60: 144–150

  2. Noninvasive Assessment of Neuromuscular Disease in Dogs: Use of the 6‐minute Walk Test to Assess Submaximal Exercise Tolerance in Dogs with Centronuclear Myopathy

    OpenAIRE

    Cerda‐Gonzalez, S.; Talarico, L.; Todhunter, R

    2016-01-01

    Background Noninvasive methods of quantitating exercise tolerance in dogs with neuromuscular disease are needed both for clinical and research use. The 6‐minute walk test (6MWT) has been validated as a reliable test of exercise tolerance in dogs with pulmonary and cardiac disease, but not in dogs with neuromuscular disease. Hypothesis/Objectives Distance walked and number of steps taken during 6MWT will differ between Labrador retriever dogs with centronuclear myopathy (CNM) and control (ie, ...

  3. The Effect of a Self Exercise Program in Cardiac Rehabilitation for Patients with Coronary Artery Disease

    OpenAIRE

    Kim, Chul; Youn, Jo Eun; Choi, Hee Eun

    2011-01-01

    Objective To investigate the effect of self exercise in cardiac rehabilitation on cardiopulmonary exercise capacity for selected patients with coronary artery disease. Method The subjects of this study were patients who received percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery and who participated in a cardiac rehabilitation program. The supervised exercise group participated in 6-8 weeks of aerobic exercise training with telemetry ECG monitoring in hosp...

  4. Modelos para predição da carga máxima no teste clínico de esforço cardiopulmonar Maximal workload prediction models in the clinical cardio-pulmonary effort test

    Directory of Open Access Journals (Sweden)

    Fernando dos Santos Nogueira

    2006-08-01

    Full Text Available OBJETIVO: Este estudo buscou derivar equações generalizadas para predição da carga máxima para homens e mulheres jovens. MÉTODOS: O método da ergoespirometria direta (Aerosport® TEEM 100, Estados Unidos da América do Norte foi empregado para determinar o VO2máx e a carga máxima (Wmáx, no cicloergômetro (Monark®, Brasil, de 30 homens (25 ± 5 anos, 75,0 ± 10,7 kg; 48,4 ± 8,8 mL . kg -1 . min -1 e 243 ± 51 Watts e 30 mulheres (26 ± 5 anos, 56,7 ± 5,9 kg, 39,8 ± 7,6 mL . kg -1 . min -1 e 172 ± 37 Watts. A idade e a massa corporal foram empregadas como variáveis independentes. Para todos os testes estatísticos aceitou-se o nível de significância de p OBJECTIVE: This study sought to derive generalized equations for predicting maximal workload for young men and women. METHODS: Direct ergospirometry (Aerosport® TEEM 100, USA was used to determine VO2máx and the maximal work load (Wmax on the cycle ergometer test (Monark®, Brazil of thirty men (25 ± 5 years, 75.0 ± 10.7 kg; 48.4 ± 8.8 mL . kg -1 . min -1 and 243 ± 51 Watts and thirty women (26 ± 5 years, 56.7 ± 5.9 kg, 39.8 ± 7.6 mL . kg -1 . min -1 and 172 ± 37 Watts. Age and body mass were used as independent variables. For all statistic tests, a p < 0.05 significance level was adopted. RESULTS: In the multiple linear adjustment, the maximal workload was explained by age and body mass as 54% (r = 0.73 for men, and as 76% (r = 0.87 for women, with standard errors of 0.66 W . kg -1 and 25 Watts. The proposed equations were cross-validated using another sample with similar age and VO2máx characteristics comprised of fifteen men and fifteen women. The intraclass correlation between the predicted Wmax values and those measures by ergospirometry were 0.70 and 0.69, with standard errors of 28.4 and 15.8 Watts, respectively, for men and women. CONCLUSIONS: This study exhibits valid generalized equations for determining the maximal cycle ergonometer workload for men and

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

    Directory of Open Access Journals (Sweden)

    Dale Marita T

    2013-01-01

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

  6. The evaluation of asymptomatic arterial occlusive disease of the legs using an exercise test.

    Directory of Open Access Journals (Sweden)

    Usui,Yoshiyuki

    1984-12-01

    Full Text Available The Doppler-derived ankle pressure index (API is a useful indicator of the necessity for peripheral vascular reconstruction of the lower extremities. But the API at rest dose not reflect the functional capacity of leg circulation, especially in the early stage of disease. Therefore, an asymptomatic but hemodynamically significant lesion in one leg is sometimes missed by pressure measurement at rest when there is a severe lesion with symptoms in the other leg. In this study, the API not only at rest but also after exercise was measured in twenty normal subjects and thirty-two patients with angiographically proven arteriosclerosis obliterans. About 60% of the patients had unilateral symptoms, although they had significant disease bilaterally. The API after exercise proved to be more sensitive than the API at rest and may be useful in assessing asymptomatic legs of such patients and determining their surgical indication.

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

    OpenAIRE

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

    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 ...

  8. Spontaneous improvement in a patient with the hepatopulmonary syndrome assessed by serial exercise tests.

    OpenAIRE

    Saunders, K B; Fernando, S. S.; Dalton, H R; Joseph, A.

    1994-01-01

    A 37 year old patient with chronic active hepatitis progressing to cirrhosis presented with increasing breathlessness and was found to be hypoxic with finger clubbing. A progressive exercise study with measurement of oxygen saturation (SaO2) showed abnormally high ventilation and desaturation to 81% at 100 W. Serial studies over nearly two years showed, first, deterioration, then improvement with lower ventilation and higher saturation levels at all work loads. This could not be correlated wi...

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

    Science.gov (United States)

    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.

  10. Perspective: Does laboratory-based maximal incremental exercise testing elicit maximum physiological responses in highly-trained athletes with cervical spinal cord injury?

    Directory of Open Access Journals (Sweden)

    Christopher R West

    2016-01-01

    Full Text Available 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 standardised exercise intensities.

  11. Exercise after breast cancer treatment: current perspectives

    Directory of Open Access Journals (Sweden)

    Dieli-Conwright CM

    2015-10-01

    Full Text Available Christina M Dieli-Conwright, Breanna Z Orozco Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA Abstract: 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. Keywords: breast cancer, exercise, physical well-being

  12. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Like most people, you've probably heard that physical activity and exercise are good for you. In fact, ... by staying physically active. Even moderate exercise and physical activity can improve the health of people who are ...

  13. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Asked Questions Learn More Exercise: Benefits of Exercise Videos quiz yourself MedlinePlus for More Information National Institute ... accompany aging. Playing Volleyball Helps Me Stay Active Video length: 2 min 51 sec Click to watch ...

  14. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... yourself MedlinePlus for More Information National Institute on Aging Related Topics Exercise: How to Get Started Exercise: ... topic was provided by the National Institute on Aging Topic last reviewed: January 2015 For an enhanced ...

  15. MEASUREMENT OF CARDIOPULMONARY FUNCTION BY REBREATHING METHODOLOGY IN PIGLETS

    Science.gov (United States)

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

  16. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Science.gov (United States)

    2010-04-01

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

  17. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

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

  18. Badminton Specific Testing and Development of Physical On-Court Exercise Capacity in Elite Youth Badminton Players

    DEFF Research Database (Denmark)

    Madsen, Christian Ole Møller

    This thesis describes the development of two badminton-specific tests to evaluate players' maximum movement speed and the endurance capacity using game-like movement patterns and intermittent game-like conditions. The badminton speed test (B-SPEED) is used to assess maximal movements during...... in adult players only. This thesis aims to enhance the existing research within the field by also evaluating badminton-specific speed and endurance in elite youth players in both a cross-sectional and longitudinal manner, and with reference to the physiological capacities of world top-50 single players....... specific on-court actions. It can distinguish between groups of players with different badminton skills, but similar sprint abilities The badminton-specific endurance test (B-ENDURANCE) is applicable for evaluation of badminton-specific endurance. Previous studies have tended to examine exercise capacity...

  19. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Helps Me Control My Blood Pressure Video length: 1 min 18 sec Click to watch this video To learn about exercise and diabetes, see "Exercise and Type 2 Diabetes" from Go4Life®, the exercise and physical ...

  20. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... of this page please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You Can Do ... Studies have shown that exercise provides many health benefits and that older adults can gain a lot ...

  1. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... of this page please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You ... this page to learn more about the health benefits of exercise. To enlarge a video, click the brackets in ...

  2. COMPARATIVE STUDY OF SUB - MAXIMAL EXERCISE TEST IN A GROUP OF 20 COLLEGE STUDENTS IN THE AGE GROUP OF 18 - 21 YEARS

    Directory of Open Access Journals (Sweden)

    Karuna Devi

    2013-10-01

    Full Text Available ABSTRACT : This study aims to compa re two widely applied tests such as step - test and bicycle ergometer. It was seen that body - weight has significant influence on the validity of sub - maximal exercise test [1]. In the development of exercise prescription knowing the actual energy expenditure with prescribed activity is essential particularly in weight loss programmes [2]. Recovery heart - rate from standardized stepping exercise, can classify people on cardiovascular fitness and VO 2 max with reasonable acceptable accuracy. Post - exercise heart - ra te is the primary parameter for estimating aerobic capacity [3], these evaluations are based on the regression among resting heart - rate, load intensity and maximum O 2 uptake. In the present study, the influence of body weight VO 2 max, BMI and speed were ta ken into consideration. The results showed the reliability & sensitivity of two tests are remarkably different. Evaluation of maximal O 2 consumption was determined by Astrand’s evaluation test on Bicycle Ergometer [4] and the step - test evaluated by Von Dob len formula, results seen were significantly different. The participants had a higher O 2 consumption rate in the step - test. The assessment of cardiovascular fitness commonly assessed by the measurements of maximum O 2 uptake can be a useful tool in promotin g health. It enables the baseline of the fitness to be established, it enables an exercise programme to be more individually prescribed, the assessment of aerobic capacity is becoming more common in medical screening.

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

    Science.gov (United States)

    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

  4. Haemodynamic responses to exercise stress test in postmenopausal women with coronary artery disease.

    Science.gov (United States)

    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

  5. Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

    Directory of Open Access Journals (Sweden)

    Dmitry Nikitich Laptev

    2015-04-01

    Full Text Available Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9–18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test.Results. The prevalence of cardiovascular autonomic neuropathy (CAN was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5% patients with CAN (CAN+ compared with 9 (18.4% patients without CAN (CAN-; p=0.042. During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4% CAN+ patients compared with 1 (2% CAN- patient (p=0.0003 and in the second minute in 5 (22.7% CAN+ patients compared with 1 (2% CAN- patient (p=0.0095.Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

  6. Exercise Ventilatory Inefficiency Adds to Lung Function in Predicting Mortality in COPD.

    Science.gov (United States)

    Neder, J Alberto; Alharbi, Abdullah; Berton, Danilo C; Alencar, Maria Clara N; Arbex, Flavio F; Hirai, Daniel M; Webb, Katherine A; O'Donnell, Denis E

    2016-08-01

    Severity of resting functional impairment only partially predicts the increased risk of death in chronic obstructive pulmonary disease (COPD). Increased ventilation during exercise is associated with markers of disease progression and poor prognosis, including emphysema extension and pulmonary vascular impairment. Whether excess exercise ventilation would add to resting lung function in predicting mortality in COPD, however, is currently unknown. After an incremental cardiopulmonary exercise test, 288 patients (forced expiratory volume in one second ranging from 18% to 148% predicted) were followed for a median (interquartile range) of 57 (47) months. Increases in the lowest (nadir) ventilation to CO2 output (VCO2) ratio determined excess exercise ventilation. Seventy-seven patients (26.7%) died during follow-up: 30/77 (38.9%) deaths were due to respiratory causes. Deceased patients were older, leaner, had a greater co-morbidity burden (Charlson Index) and reported more daily life dyspnea. Moreover, they had poorer lung function and exercise tolerance (p 34 was associated with IC/TLC ≤ 0.34 or IC/TLC ≤ 0.31 for all-cause and respiratory mortality, respectively (p COPD severity. Physiological abnormalities beyond traditional airway dysfunction and lung mechanics are relevant in determining the course of the disease. PMID:27077955

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

    Science.gov (United States)

    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; pEFL, but some of them develop DH that is associated with lower VO₂, peak. PMID:23851110

  8. Electroencephalography during surgery with cardiopulmonary bypass and hypothermia.

    Science.gov (United States)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

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

    2009-01-01

    Parents of premature infants often receive infant cardiopulmonary resuscitation (CPR) training prior to discharge from the hospital, but one study showed that 27.5% of parents could not demonstrate adequate CPR skills after completing an instructor-led class. We hypothesized that parents who viewed an instructional video on infant CPR before attending the class would perform better on a standardized skills test than parents who attended the class with no preparation. Parents randomized to the...

  11. Cardiopulmonary effects of a ketamine hydrochloride/acepromazine combination in healthy cats.

    OpenAIRE

    Ingwersen, W; Allen, D G; Dyson, D H; Pascoe, P J; O'Grady, M R

    1988-01-01

    The effect of a ketamine hydrochloride/acepromazine combination on the cardiopulmonary function of 11 healthy cats was studied. Test parameters included cardiac output, measured by thermodilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and arterial blood gas analysis. Values for systemic vascular resistance, cardiac index and stroke volume were calculated. The cardiac output, cardiac index, stroke volume, arterial blood pressure and arterial blood...

  12. Cardiopulmonary effects of a ketamine/acepromazine combination in hypovolemic cats.

    OpenAIRE

    Ingwersen, W; Allen, D G; Dyson, D H; Black, W D; Goldberg, M T; Valliant, A E

    1988-01-01

    The cardiopulmonary effects of a ketamine/ acepromazine combination was studied in ten cats subjected to a 25% whole blood volume loss. Test parameters included cardiac output, measured via thermodilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and blood gas analysis. Values for cardiac index, stroke volume and systemic vascular resistance were calculated from these data. Posthemorrhage, cardiac output, cardiac index, stroke volume, heart rate and...

  13. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Science.gov (United States)

    2010-04-01

    ... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass vascular catheter,...

  14. Cardiorespiratory and sensory responses to exercise in adults with mild cystic fibrosis.

    Science.gov (United States)

    Quon, Bradley S; Wilkie, Sabrina S; Molgat-Seon, Yannick; Schaeffer, Michele R; Ramsook, Andrew H; Wilcox, Pearce G; Guenette, Jordan A

    2015-12-01

    The purpose of this study was to evaluate cardiorespiratory fitness and reasons for exercise curtailment in a contemporary adult cystic fibrosis (CF) cohort with mild lung disease. Adults with mild CF (n = 19, forced expiratory volume in 1 s = 95 ± 17% predicted) were age-, sex-, ethnicity-, and body mass index-matched to healthy controls (n = 19) and underwent a detailed cardiopulmonary cycle exercise test. While CF subjects had a reduced peak oxygen uptake compared with controls, the values were normal when expressed as %predicted in 14/19 (74%) of subjects. Both groups demonstrated a normal cardiovascular limitation to exercise and stopped exercise primarily because of leg fatigue. Despite not being exercise-limited by respiratory factors, there was some evidence of ventilatory abnormalities as patients with mild CF had increased end-inspiratory lung volumes and reached an inflection/plateau in tidal volume relative to minute ventilation at lower exercise intensities compared with controls. Subjects with CF were not more likely to demonstrate expiratory flow limitation compared with controls and did not have evidence of dynamic hyperinflation during exercise. Despite increased end-inspiratory lung volumes and an earlier tidal volume inflection/plateau, CF subjects did not experience higher levels of dyspnea. In an exploratory analysis, a significant inverse correlation was observed between sweat chloride and peak work rate. Adult CF subjects with relatively well preserved spirometry have normal exercise performance relative to reference values and are primarily limited by nonrespiratory factors. However, ventilatory abnormalities were detected even in this mild CF cohort and should be evaluated in future therapeutic trials focused on disease-modifying therapies in mild CF. PMID:26429870

  15. Exercise-induced desaturation in patients with chronic obstructive pulmonary disease on six-minute walk test

    Directory of Open Access Journals (Sweden)

    Archana Chauhan Dogra

    2015-01-01

    Full Text Available Background and Objectives: Exercise-induced desaturation (EID is associated with increased mortality in chronic obstructive pulmonary disease (COPD. However, the relationship of EID with anthropometric and clinical parameters of resting pulmonary function test and six-minute walk test (6MWT in COPD remains unclear. The study was designed to assess the correlate of EID and to identify various possible predictors of EID in stable normoxemic patients of COPD. Materials and Methods: Sixty patients with stable COPD diagnosed and staged as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD guidelines underwent 6MWT. A drop in standard pulse oximetry (SpO 2 of ≥4% or nadir up to ≤88% was defined as EID. Based on EID during 6MWT, two groups were formed: desaturators (DS and nondesaturators (NDS. DS and NDS were compared for baseline and clinical characters by the Student′s t-test while Pearson and Spearman rho correlation coefficient assessed strength of the association of anthropometric and clinical variables with EID. The predictors of EID were identified by logistic regression and receiver operator curve analysis. Result: Out of 60 patients with stable COPD, 33 patients desaturated on exercise (n = 33/60. DS had significantly lower values of FEV 1 (P < 0.001, FVC (P < 0.01 FEV 1 /FVC (P < 0.01 compared to NDS. EID had significant negative correlation with FEV 1 (r = 0.31, P < 0.01, resting oxygen saturation (r = 0.549, P < 0.001 and 6MWD (r = 0.511, P < 0.001. Resting SpO 2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively. Interpretation and Conclusion: The 6MWT is a safe and sensitive test to recognize EID in normoxic stable COPD patients. Resting oxygen saturation is a good predictor of EID.

  16. Exercise as a provocative test in early renal disease in type 1 (insulin-dependent) diabetes

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B; Baker, L; Deckert, T

    1985-01-01

    was employed. In the resting state group 2 patients had elevated systolic blood pressure compared with the normal subjects (132 +/- 13 versus 119 +/- 9 mmHg), and their glomerular filtration rate was significantly reduced compared with group 1 (123 +/- 19 versus 138 +/- 15 ml/min per 1.73 m2, p less than 0.......05). During exercise the urinary albumin excretion rate increased significantly in all three groups (normal subjects: 6 +/- 0.7 to 8 +/- 1.3 (microgram/min); group 1: 6 +/- 0.6 to 9 +/- 1 microgram/min and group 2: 48 +/- 10 to 113 +/- 23 micrograms/min), the relative increase being higher in group 2 (p less...

  17. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  18. Endothelial Function as a Possible Significant Determinant of Cardiac Function during Exercise in Patients with Structural Heart Disease

    Directory of Open Access Journals (Sweden)

    Bonpei Takase

    2009-01-01

    Full Text Available This study was investigated the role that endothelial function and systemic vascular resistance (SVR play in determining cardiac function reserve during exercise by a new ambulatory radionuclide monitoring system (VEST in patients with heart disease. The study population consisted of 32 patients. The patients had cardiopulmonary stress testing using the treadmill Ramp protocol and the VEST. The anaerobic threshold (AT was autodetermined using the V-slope method. The SVR was calculated by determining the mean blood pressure/cardiac output. Flow-mediated vasodilation (FMD was measured in the brachial artery to evaluate endotheilial function. FMD and the percent change f'rom rest to AT in SVR correlated with those from rest to AT in ejection fraction and peak ejection ratio by VEST, respectively. Our findings suggest that FMD in the brachial artery and the SVR determined by VEST in patients with heart disease can possibly reflect cardiac function reserve during aerobic exercise.

  19. Can a fatigue test of the isolated lumbar extensor muscles of untrained young men predict strength progression in a resistance exercise program?

    NARCIS (Netherlands)

    Helmhout, P.; Staal, B.; Dijk, J. van; Harts, C.; Bertina, F.; Bie, R. de

    2010-01-01

    AIM: The aim of this exploratory study was to investigate the predictive value of a fatigue test of the lumbar extensor muscles for training progression in a group of 28 healthy but predominantly sedentary male students, in an 8-week resistance exercise program. METHODS: A three-phased fatigue test

  20. Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

    LENUS (Irish Health Repository)

    McCaul, Conán

    2009-10-01

    Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

  1. Comparison of six-minute walking tests conducted with and without supplemental oxygen in patients with chronic obstructive pulmonary disease and exercise-induced oxygen desaturation

    International Nuclear Information System (INIS)

    There are contradictory reports in the literature on the supplemental oxygen administered before or after exercise tests. In light of this, we compared the results of 6-minute walking tests performed in room-air conditions (A6MWT) in patients with supplemental oxygen (O6MWT) in patients with chronic obstructive pulmonary disease (COPD) and exercise-induced oxygen desaturation. Thirty-one patients with COPD were included in the study. The A6MWT and O6MWT were performed in randomized order on each patient. During the tests, severity dyspenia and tiring of the leg were evaluated by the Modified Borg Scale. Heart rate and pulsed oxygen saturation and blood pressure were measured by pulse oximeter. Walking distance was longer with the O6MWT than with the A6MWT (P=0.001). The O6MWT resulted in a smaller increase in dyspnea, leg fatigue and heart rate and a smaller drop in pulsed saturation than the A6MWT (P<0.05). The walking distance with O6MWT correlated with respiratory function and hemodynamic parameters (P<0.05). The O6MWT, which produced less hemodynamic stress and was safer than the A6MWT, might provide more accurate information on exercise limitations for patients with COPD. These results suggest that the O6MWT can be used as a standard walking exercise test for patients with COPd and exercise-induced oxygen desaturation. (author)

  2. Exercise related ventilation dynamics and clinical correlates in patients with fibrotic idiopathic interstitial pneumonias.

    Science.gov (United States)

    De Martino, Marina; Cobuccio, Raffaele; Bruzzese, Dario; Rea, Gaetano; Meoli, Ilernando; Stefanelli, Francesco; Canora, Angelo; Capaccio, Annalisa; Sanduzzi, Alessandro; Matarese, Alessandro; Bocchino, Marialuisa

    2016-01-01

    Assessment of exercise performance is a key component in the management of interstitial lung diseases, as its limitation may occur very early. Aim of the present study was to assess ventilation dynamics in combination with pulse-oximetry changes in 54 clinically stable patients affected by idiopathic pulmonary fibrosis or idiopathic fibrotic nonspecific interstitial pneumonia. Testing was successfully performed with the Spiropalm 6-MWT Hand-held spirometer by the majority of cases (94%). End test oxygen saturation (SpO2) values positive correlation occurred with the end of test RR and the estimated maximal voluntary ventilation (MVV). RR was also a predictive factor of declining forced vital capacity and lung diffusion capacity for carbon monoxide (DLCO) over a 6-month period. Further factors of DLCO impairment were low SpO2 and MVV. Comparison with the cardio-pulmonary exercise test (CPET) showed that the 6-MWT end of test RR was inversely related to the CPET-derived peak RF and VE/VCO2 suggesting RR as pivotal in exercise limitation assessment. Our results open challenging perspectives in an unexplored field. Future research will include management of latent respiratory failure and monitoring of disease progression and therapy response. PMID:27537719

  3. Clinical Significance of Abnormal Heart Rate Recovery after Treadmill Exercise Test in Patients With Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    Li-feng HONG; Hao ZHANG; Ye-xin MA; He-song ZENG; Yuan WEN

    2009-01-01

    Objectives To evaluate the values of abnormal heart rate recovery (HRR) after treadmill exercise test in patients with coronary artery disease (CAD). Methods One hundred and seventy-eight consecutive cases of suspected CAD who underwent symptom-limited treadmill exercise test (TET) and coronary angiography (CAG) were enrolled and di-vided into normal and abnormal HRR group based on the status of the values of HRR one or two minutes after TET. The clinical characteristics, TET parameters and CAG results of the two groups were compared attempted to assess the value of HRR on patients with CAD. Results (1) The cases of smoking, diabetes mellitus (DM) and ST segment de-viation at rest in abnormal HRR group were more significantly than those in normal HRR group (all P < 0. 05). (2) The subjects of abnormal HRR usually had higher basal heart rate, more cases exhibited ST segment abnormality and or exercise-limited angina during or after TET(P<0.01 and P<0.05, respectively), but lower level of peak heart rate attained (P<0.05) than those in normal group. The values of metabolism equivalents and duration of TET between the two groups displayed phenomenal difference (P<0.05). There were more samples acquired moderate to high level of Duke test score and chronotropic incompetence in the group of abnormal HRR, compared to the normal HRR group (P<0.01). (3) The cases of negative CAG results in the group of normal and abnormal HRR group were 73 (66.97 % ) and 24 (34.78 %). Cases of significant coronary lesions (at least one major coronary vessel ≥ 50 % stenosis) a-mongst the subgroup of positive CAG were 36 (33.03 % ) and 45 (65.22 %), severe coronary lesions (three-vessel, left main or the equivalents of left main) were 10 (9.17 % ) and 17 (24.64 %) for normal and abnormal HRR respec-tively (P<0.01). Accordingly, the Gensini scores in the subunit of abnormal HRR increased. (4)Linear correlation analysis indicate there was a negative correlation between the values of HRR in

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  5. Cardiopulmonary function of dogs with plutonium-induced chronic lung injury

    International Nuclear Information System (INIS)

    Twenty dogs exposed by inhalation in the study, Toxicity of Inhaled 239PuO2 in Beagle Dogs, were evaluated for cardiopulmonary function. Another group of 10 dogs matched by age and sex, but not exposed to 239Pu, was also given the same cardiopulmonary function tests. The plutonium-exposed dogs were 7 or more years after exposure and ten of the dogs had clinical signs and pulmonary function values indicating radiation pneumonitis-pulmonary fibrosis. The occurrence of radiation pneumonitis-pulmonary fibrosis, a nonstochastic effect, over the same time period and range of lung doses as lung cancer, a stochastic effect, complicates the estimation of lung cancer risk for inhaled plutonium. 4 references, 4 figures, 2 tables

  6. Factor V Leiden and Cardiopulmonary Bypass

    Science.gov (United States)

    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

  7. Automated cardiopulmonary resuscitation: a case study.

    Science.gov (United States)

    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.

  8. Real-time laboratory exercises to test contingency plans for classical swine fever: experiences from two national laboratories

    DEFF Research Database (Denmark)

    Koenen, K.; Uttenthal, Åse; Meindl-Böhmer, A.

    2007-01-01

    . It is essential that these plans are established during ‘peace-time’ and are reviewed regularly. This paper provides suggestions on how to perform laboratory exercises to test preparedness and describes the experiences of two national reference laboratories for CSF. The major lesson learnt was the importance...... contingency plans. These plans should ensure that in the event of an outbreak access to facilities, equipment, resources, trained personnel, and all other facilities needed for the rapid and efficient eradication of the outbreak is guaranteed, and that the procedures to follow are well rehearsed...... of a well-documented laboratory contingency plan. The major pitfalls encountered were shortage of space, difficulties in guaranteeing biosecurity and sufficient supplies of sterile equipment and consumables. The need for a standardised laboratory information management system, that is used by all those...

  9. Pre-discharge exercise test for evaluation of patients with complete or incomplete revascularization following primary percutaneous coronary intervention: a DANAMI-2 sub-study

    DEFF Research Database (Denmark)

    Valeur, N.; Clemmensen, P.; Grande, P.;

    2008-01-01

    OBJECTIVES: It is unclear whether the completeness of revascularization impacts on the prognostic value of an exercise test after primary percutaneous coronary intervention (PCI). METHODS: The DANAMI-2 trial included patients with ST elevation acute myocardial infarction randomized to primary PCI...... or fibrinolysis. Of the 790 patients randomized to primary PCI, 572 performed an exercise test. Prospectively, 310 patients were classified as having complete and 216 as having incomplete revascularization. Primary endpoint was a composite of reinfarction and/or death. RESULTS: Patients with incomplete...

  10. 慢性阻塞性肺疾病患者六分钟步行试验中的心肺不良事件%The Cardiopulmonary Adverse Events of Six-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    于书雨; 张冬睿; 李月川

    2013-01-01

    目的 探讨稳定期慢性阻塞性肺疾病(COPD)患者6 min步行试验(6MWT)过程中心肺不良事件的发生情况与不同程度肺功能和心脏合并症的关系.方法 将85例完成试验的COPD患者依合并症情况分为单纯COPD组(Ⅰ组)16例、COPD合并左心舒张功能减低组(Ⅱ组)31例、COPD合并左心舒张功能减低及慢性肺源性心脏病组(Ⅲ组)38例,分别对3组患者6MWT前、试验结束时与试验结束后10 min的心率(HR)、血氧饱和度(SpO2)进行比较.结果 85 例中共27 例(31.76%)休息1~3 次后完成试验,19 例(22.35%)HR 异常;14 例(16.47%)SpO2120 次/min、SpO2120 bpm or SpO2<0.90 in 15 cases (17.65%). There were significant differences in HR before and after the tests between three groups (P < 0.05). There were significant differences in SpO2 before and after the tests between group Ⅱ and group Ⅲ(P< 0.05). Conclusion Severe COPD patients with left ventricular diastolic dysfunction and chronic pulmonary heart disease are more likely to occur cardiopulmonary adverse events during the test of 6MWT, and the HR and SpO2 are not easy to return to the level before the test.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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. PMID:26689169

  13. Alveolar proteinosis lung lavage using partial cardiopulmonary bypass.

    OpenAIRE

    Freedman, A P; Pelias, A; Johnston, R F; Goel, I P; Hakki, H I; Oslick, T; Shinnick, J P

    1981-01-01

    An adult case of pulmonary alveolar proteinosis presented with an arterial oxygen tension of 27 mmHg (3.6 kPa) while breathing air. Dangerous hypoxaemia during lung lavage was avoided by using partial cardiopulmonary bypass.

  14. Exercise after breast cancer treatment: current perspectives.

    Science.gov (United States)

    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.

  15. Cardiopulmonary disease in the geriatric dog and cat

    International Nuclear Information System (INIS)

    The incidence of cardiopulmonary disease increases with age. Degenerative valvular disease, chronic obstructive pulmonary disease, and arrhythmias are common in the geriatric dog. Chronic bronchial disease, pulmonary neoplasia, and arrhythmias occur in the geriatric cat. Systemic diseases in both species often show cardiopulmonary manifestations. Medical management to treat the underlying disease and to control clinical signs is complicated by altered absorption, metabolism, and elimination of drugs

  16. Electrical failure during cardiopulmonary bypass: a critical moment.

    Science.gov (United States)

    Durukan, Ahmet Baris; Gurbuz, Hasan Alper; Ozcelik, Gokhan; Yorgancioglu, Cem

    2016-06-01

    Electrical failure during cardiopulmonary bypass is a crisis situation for the cardiac surgical team. Fortunately, it has a low incidence with low morbidity and mortality rates. Notwithstanding, institutional preventative and management measures should be taken. Here, we report a case of electrical failure during cardiopulmonary bypass, which was successfully managed during the surgery, allowing the patient to recover uneventfully. These unwanted complications can only be managed by promoting awareness and putting in place strategies against them. PMID:27516788

  17. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children

    OpenAIRE

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

    2015-01-01

    Purpose Idiopathic scoliosis is a structural lateral curvature of the spine of unknown etiology. The relationship between degree of spine curvature and cardiopulmonary function has not yet been investigated. The purpose of this study was to determine the association between scoliosis and cardiopulmonary characteristics. Methods Ninety children who underwent preoperative pulmonary or cardiac evaluation at a single spine institution over 41 months were included. They were divided into the thora...

  18. Dynamic hyperinflation is associated with a poor cardiovascular response to exercise in COPD patients

    Directory of Open Access Journals (Sweden)

    Tzani Panagiota

    2011-11-01

    Full Text Available Abstract Background Pulmonary hyperinflation has the potential for significant adverse effects on cardiovascular function in COPD. The aim of this study was to investigate the relationship between dynamic hyperinflation and cardiovascular response to maximal exercise in COPD patients. Methods We studied 48 patients (16F; age 68 yrs ± 8; BMI 26 ± 4 with COPD. All patients performed spirometry, plethysmography, lung diffusion capacity for carbon monoxide (TLco measurement, and symptom-limited cardiopulmonary exercise test (CPET. The end-expiratory lung volume (EELV was evaluated during the CPET. Cardiovascular response was assessed by change during exercise in oxygen pulse (ΔO2Pulse and double product, i.e. the product of systolic blood pressure and heart rate (DP reserve, and by the oxygen uptake efficiency slope (OUES, i.e. the relation between oxygen uptake and ventilation. Results Patients with a peak exercise EELV (%TLC ≥ 75% had a significantly lower resting FEV1/VC, FEF50/FIF50 ratio and IC/TLC ratio, when compared to patients with a peak exercise EELV (%TLC 2Pulse (r = - 0.476, p = 0.001, OUES (r = - 0.452, p = 0.001 and DP reserve (r = - 0.425, p = 0.004. Furthermore, according to the ROC curve method, ΔO2Pulse and DP reserve cut-off points which maximized sensitivity and specificity, with respect to a EELV (% TLC value ≥ 75% as a threshold value, were ≤ 5.5 mL/bpm (0.640 sensitivity and 0.696 specificity and ≤ 10,000 Hg · bpm (0.720 sensitivity and 0.783 specificity, respectively. Conclusion The present study shows that COPD patients with dynamic hyperinflation have a poor cardiovascular response to exercise. This finding supports the view that in COPD patients, dynamic hyperinflation may affect exercise performance not only by affecting ventilation, but also cardiac function.

  19. Improved Left Ventricular Diastolic Function with Exercise Training in Hypertension: A Doppler Imaging Study

    Directory of Open Access Journals (Sweden)

    Huan Zheng

    2011-01-01

    Full Text Available Objective. To study the effects of 6 months’ exercise training on ventricular function in hypertensive patients. Methods. Both groups received routine anti-hypertensive pharmacological therapy and one received a 6 months’ exercise program in addition. All patients underwent incremental cardiopulmonary exercise test and echocardiography in baseline and after 6 months. Results. (1 In 6 months’ follow-up, PeakVO2, Powermax (max workload, AT (anaerobic threshold, VO2AT (VO2 at anaerobic threshold, tAT (time from beginning to anaerobic threshold (<.05, were increased in the exercise group. HRrest (Heart rate at rest was decreased (<.05. LAVI (left atrial volume index, peak mitral filling velocities during early (E and late (A diastole E/A ratio, DT(deceleration time of the mitral E wave, IVST(Interventricular septum thickness in diastole, tissue Doppler indice Mean Ea/Aa ratio (<.05 were also improved. (2 Correlation analysis: 4 variates had significant effect on change of PeakVO2 in the exercise group: age (=−0.39, change of HRrest (=0.59, change of E/A (=0.55, change of Mean Ea/Aa (=0.58; Through analyzing 2 groups patients’ baseline values, their age (=−0.32, VO2AT (=0.29, HRrest (=−0.25, LAVI (=−0.24, E/A (=0.41 were found to be independent predictors of MeanEa/Aa. -value under .05 was considered statistically significant. Conclusion. 6 months’ exercise could enhance hypertensive patients’ aerobic exercise level and diastolic function to a certain extent.

  20. Application of the load separation criterion in J-testing of ductile polymers: A round-robin testing exercise

    NARCIS (Netherlands)

    Agnelli, S.; Baldi, F.; Blackman, B.R.K.; Castellani, L.; Frontini, P.M.; Laiarinandrasana, L.; Pegoretti, A.; Rink, M.; Salazar, A.; Visser, H.A.

    2015-01-01

    Round robin tests carried out under the direction of the Technical Committee 4 of the European Structural Integrity Society (ESIS TC4) have shown that, for determining the fracture resistance of ductile polymers at low loading rates, the multi-specimen methodology based on the construction of the ma

  1. Cardiopulmonary Effects of Constant-Rate Infusion of Lidocaine for Anesthesia during Abdominal Surgery in Goats.

    Science.gov (United States)

    Malavasi, Lais M; Greene, Stephen A; Gay, John M; Grubb, Tammy L

    2016-01-01

    Lidocaine is commonly used in ruminants but has an anecdotal history of being toxic to goats. To evaluate lidocaine's effects on selected cardiopulmonary parameters. Isoflurane-anesthetized adult goats (n = 24) undergoing abdominal surgery received a loading dose of lidocaine (2.5 mg/kg) over 20 min followed by constant-rate infusion of lidocaine (100 μg/kg/min); control animals received saline instead of lidocaine. Data collected at predetermined time points during the 60-min surgery included heart rate, mean arterial blood pressure, pO2, and pCO2. According to Welch 2-sample t tests, cardiopulmonary variables did not differ between groups. For example, after administration of the loading dose, goats in the lidocaine group had a mean heart rate of 88 ± 28 bpm, mean arterial blood pressure of 70 ± 19 mm Hg, pCO2 of 65 ± 13 mm Hg, and pO2 of 212 ± 99 mm Hg; in the saline group, these values were 90 ± 16 bpm, 76 ± 12 mm Hg, 61 ± 9 mm Hg, and 209 ± 83 mm Hg, respectively. One goat in the saline group required an additional dose of butorphanol. Overall our findings indicate that, at the dose provided, intravenous lidocaine did not cause adverse cardiopulmonary effects in adult goats undergoing abdominal surgery. Adding lidocaine infusion during general anesthesia is an option for enhancing transoperative analgesia in goats. PMID:27423150

  2. Effect of a cardiac rehabilitation program on exercise oscillatory ventilation in Japanese patients with heart failure.

    Science.gov (United States)

    Yamauchi, Fumitake; Adachi, Hitoshi; Tomono, Jun-Ichi; Toyoda, Shigeru; Iwamatsu, Koichi; Sakuma, Masashi; Nakajima, Toshiaki; Oshima, Shigeru; Inoue, Teruo

    2016-10-01

    Although exercise oscillatory ventilation has emerged as a potent independent risk factor for adverse prognosis in heart failure, it is not well known whether cardiac rehabilitation can improve oscillatory ventilation. In this study, we investigated the magnitude of oscillations in ventilation before and after cardiac rehabilitation in chronic heart failure patients with exercise oscillatory ventilation. Cardiac rehabilitation (5-month program) was performed in 26 patients with chronic heart failure who showed an oscillatory ventilation pattern during cardiopulmonary exercise testing (CPX). After the 5-month rehabilitation program was completed, the patients again underwent CPX. To determine the magnitude of oscillations in ventilation, the amplitude and cycle length of the oscillations were calculated and compared with several other parameters, including biomarkers that have established prognostic value in heart failure. At baseline before cardiac rehabilitation, both oscillation amplitude (R = 0.625, P rehabilitation decreased oscillation amplitude (P rehabilitation program improves exercise oscillatory ventilation in chronic heart failure patients by reducing the oscillation amplitude. This effect is associated with a reduction of plasma BNP levels, potentially contributing to an improvement of heart failure.

  3. Pulmonary hypertension in patients with idiopathic pulmonary fibrosis - the predictive value of exercise capacity and gas exchange efficiency.

    Directory of Open Access Journals (Sweden)

    Sven Gläser

    Full Text Available Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 135 patients [82 males; median age of 64 (56; 72 years] with IPF had pulmonary hypertension as assessed by right heart catheterization [median mean pulmonary arterial pressure 34 (27; 43 mmHg]. The presence of pulmonary hypertension was best predicted by gas exchange efficiency for carbon dioxide (cut off ≥152% predicted; area under the curve 0.94 and peak oxygen uptake (≤56% predicted; 0.83, followed by diffusing capacity. Resting lung volumes did not predict pulmonary hypertension. Survival was best predicted by the presence of pulmonary hypertension, followed by peak oxygen uptake [HR 0.96 (0.93; 0.98]. Pulmonary hypertension in IPF patients is best predicted by gas exchange efficiency during exercise and peak oxygen uptake. In addition to invasively measured pulmonary arterial pressure, oxygen uptake at peak exercise predicts survival in this patient population.

  4. 加速步行试验与活动平板试验初步对照研究%A COMPARISON STUDY OF SHUTTLE WALKING TEST VERSUS EXERCISE TREADMILL TEST

    Institute of Scientific and Technical Information of China (English)

    王小清; 谢景超; 蹇在金; 赵水平

    2001-01-01

    Objective:The aim was to assess a new kind of exercise test- shuttle walking t est(SWT). Methods: Compariosn of shuttle walking test with exercise treadmill test was assessed in a group of elderly patients with coronary arterydisease (CAD). Results: The exiting rate of shuttle walking test (9.1% ) is significantly lower than that of exercise treadmill test (27.3% ) (P< 0.05 ). There was no obvious difference of the positive rate between shuttle walking test (68.8% ) and exercise treadmill test (75 % ) (P>0. 05). There was no obvious difference between the heart rate after shuttle walking test and the aimed heart rate. Conchusions:Shuttle walking test is feasible and safe, It can be used in the diagnosis of elderly patients with CAD.%目的:评价一种新的运动试验-加速步行试验。方法:选择一组老年冠心痛患者自身对照进行加速步行试验和活动平板试验。结果:加速步行试验退出率明显低于活动平板试验(P0.05),加速步行试验可达到目标心率。结论:加速步行试验安全、可行,可用于老年人冠心病诊断。

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

    Directory of Open Access Journals (Sweden)

    Marília S. Andrade

    2014-05-01

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

  6. Acute mesenteric ischemia after cardio-pulmonary bypass surgery

    Institute of Scientific and Technical Information of China (English)

    Bassam Abboud; Ronald Daher; Joe Boujaoude

    2008-01-01

    Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency.Several pathophysiologic events (arterial obstruction,venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow.Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities,leading to multi-organ failure and death.Early diagnosis is difficult because the clinical presentation is subtle,and the biological and radiological diagnostic tools lack sensitivity and specificity.Therapeutic options vary from conservative resuscitation,medical treatment,endovascular techniques and surgical resection and revascularization.A high index of suspicion is required for diagnosis,and prompt treatment is the only hope of reducing the mortality rate.Studies are in progress to provide more accurate diagnostic tools for early diagnosis.AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB).Several factors contribute to the systemic hypo-perfusion state,which is the most frequent pathophysiologic event.In this particular setting,the clinical presentation of AMI can be misleading,while the laboratory and radiological diagnostic tests often produce inconclusive results.The management strategies are controversial,but early treatment is critical for saving lives.Based on the experience of our team,we consider prompt exploratory laparotomy,irrespective of the results of the diagnostic tests,is the only way to provide objective assessment and adequate treatment,leading to dramatic reduction in the mortality rate.

  7. A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    U. Ayala

    2014-01-01

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

  8. New Theoretical System of Holistic Control and Regulation for Life and Cardiopulmonary Exercise Testing%生命整体调控新理论体系与心肺运动试验

    Institute of Scientific and Technical Information of China (English)

    孙兴国

    2013-01-01

    心肺运动试验是一种直接关系到呼吸、循环、代谢及神经等多系统的临床功能学检测方法.人作为有机整体,其生命是以呼吸为表征,血液循环为基础,代谢为前提,氧化能量物质供应能量为代谢的核心,在神经体液联合调控之下,在消化吸收、泌尿、排泄、皮肤等协助配合之下从而实现的一种动态地趋向于平衡,而永远这不到真正的平衡的一种功能状态.由此提出了全新“整体整合生理学一医学”理论体系的基本架构.%For life, as an organic whole, breathing is the characterization,blood circulation is basics, metabolism is premise, the oxidation energy material supply energy is the core of metabolism, under neurohumoral regulation, with assistance of digestion, absorption, excretion, urinary, skin and all other systems for homeostasis,in order to achieve a dynamic tends to be a balance, but never reach the true balance of a functional state.This paper described the basic architecture of the proposed new theoretical system of Holistic Integrative Physiology-Medicine.

  9. Exercise therapy, cardiorespiratory fitness and their effect on brain volumes: a randomised controlled trial in patients with schizophrenia and healthy controls.

    Science.gov (United States)

    Scheewe, Thomas W; van Haren, Neeltje E M; Sarkisyan, Gayane; Schnack, Hugo G; Brouwer, Rachel M; de Glint, Maria; Hulshoff Pol, Hilleke E; Backx, Frank J G; Kahn, René S; Cahn, Wiepke

    2013-07-01

    The objective of this study was to examine exercise effects on global brain volume, hippocampal volume, and cortical thickness in schizophrenia patients and healthy controls. Irrespective of diagnosis and intervention, associations between brain changes and cardiorespiratory fitness improvement were examined. Sixty-three schizophrenia patients and fifty-five healthy controls participated in this randomised controlled trial. Global brain volumes, hippocampal volume, and cortical thickness were estimated from 3-Tesla MRI scans. Cardiorespiratory fitness was assessed with a cardiopulmonary ergometer test. Subjects were assigned exercise therapy or occupational therapy (patients) and exercise therapy or life-as-usual (healthy controls) for six months 2h weekly. Exercise therapy effects were analysed for subjects who were compliant at least 50% of sessions offered. Significantly smaller baseline cerebral (grey) matter, and larger third ventricle volumes, and thinner cortex in most areas of the brain were found in patients versus controls. Exercise therapy did not affect global brain and hippocampal volume or cortical thickness in patients and controls. Cardiorespiratory fitness improvement was related to increased cerebral matter volume and lateral and third ventricle volume decrease in patients and to thickening in the left hemisphere in large areas of the frontal, temporal and cingulate cortex irrespective of diagnosis. One to 2h of exercise therapy did not elicit significant brain volume changes in patients or controls. However, cardiorespiratory fitness improvement attenuated brain volume changes in schizophrenia patients and increased thickness in large areas of the left cortex in both schizophrenia patients and healthy controls. PMID:22981376

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

    NARCIS (Netherlands)

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

    2011-01-01

    Purpose. Exercise testing is often used to assess cardiac function during physical exertion to obtain diagnostic information. However, this procedure is limited to measuring the electrical activity of the heart using electrocardiography and intermittent blood pressure (BP) measurements and does not

  11. Effect of Resistance Tube Exercises on Kicking Accuracy, Vertical Jump and 40-Yard Technical Test in Competitive Football Players – An Experimental Study

    Directory of Open Access Journals (Sweden)

    Tirumala Alekhya

    2014-09-01

    Full Text Available Purpose. Kicking, jumping and agility are important skills in football. These activities require adequate lower limb strength, which can be enhanced with resistance training. The objective of the study was to evaluate the effect of resistance tube exercises on kicking accuracy, vertical jump performance and 40-yard technical test results in competitive football players. Methods. The study involved 23 competitive football players (11 males, 12 females aged from 18-20 years recruited from three different universities in Belgaum, Karnataka, India. Back heel kick accuracy, vertical jump height and 40-yard technical test time were evaluated before and after a 2-week resistance tube exercise program. Results. Significant improvements in post-intervention kicking accuracy were found when males and females were treated as a single group (p = 0.01. Vertical jump height also showed a highly significant post-intervention improvement in the males and for the combined group of males and females (p = 0.001. The 40-yard technical test values significantly improved in the females and in the combined results for males and females (p = 0.001. Conclusions. The two-week resistance tube exercise program was found to have an effect on kicking accuracy, vertical jump height and 40-yard technical test performance in competitive football players. Resistance tube exercises can thus be included as a component of a regular strength training program for such athletes.

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

    Directory of Open Access Journals (Sweden)

    Daiana C. Bündchen

    2014-10-01

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

  13. Differences in therapeutic consequences of exercise testing in a rural and an urban Danish county

    DEFF Research Database (Denmark)

    Niemann, T.; Nielsen, T.T.; Thorsgaard, N.;

    2001-01-01

    Coronary angiography is the main diagnostic test for deciding whether to refer a patient for coronary revascularisation, but referral for coronary angiography may vary significantly among regions. 1 2 Regional differences have been explained by the fact that access to cardiac catheterisation faci...

  14. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... In This Topic Health Benefits Benefits for Everyday Life Frequently Asked Questions Learn More Exercise: Benefits of ... and physical activity a regular part of your life can improve your health and help you maintain ...

  15. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Mood Regular, moderate physical activity can help manage stress and improve your mood. And, being active on a regular basis may help reduce feelings of depression. Studies also suggest that exercise can improve or maintain ...

  16. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... and exercise are important to the physical and mental health of almost everyone, including older adults. Staying ... specifically planned, structured, and repetitive such as weight training, tai chi, or an aerobics class. Including both ...

  17. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... some older people who already have diseases and disabilities. That's why health experts say that older adults ... can help prevent or delay many diseases and disabilities. In some cases, exercise is an effective treatment ...

  18. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Mood Regular, moderate physical activity can help manage stress and improve your mood. And, being active on a regular basis may help reduce feelings of depression. Studies also suggest that exercise can improve or ...

  19. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... the healthiest things you can do for yourself. Studies have shown that exercise provides many health benefits ... join a gym or have special equipment. Yet, studies show that "taking it easy" is risky. For ...

  20. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... 56 sec Click to watch this video Be as Active as Possible Regular physical activity and exercise are important ... say that older adults should aim to be as active as possible. Being Inactive Can Be Risky ...

  1. Effects of submaximal steady -state aerobic exercise and fitness in random number generation test

    Directory of Open Access Journals (Sweden)

    ANTONIOS K. TRAVLOS

    2009-01-01

    Full Text Available The aim of this study was two-fold. Firstly we wanted to quantify the relationship of isokinetic muscle strength (IMS and long jump performance (LJP in young jumpers, and secondly to compare males and females in IMS. Our measurements in 7 males and 7 females showed that the LJP was correlated with the normalized peak joint moment of the concentric knee extensions and the concentric ankle plantar flexions. A low correlation was observed between the LJP and the eccentric knee extensions. The t-test showed significant gender differences in joint peak moment of concentric knee extensions and in normalized peak joint moment of concentric plantar flexions and eccentric plantar flexions at120 deg/sec. Although, our findings suggest that IMS is a major contributor to LJP, it is suggested that training intervention should not be based exclusively on isokinetic tests because of the differences in musculoskeletal function between the two movements.

  2. The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents.

    Science.gov (United States)

    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 strain, V̇o 2peak, oxygen pulse, and work rate (0.530 ≤ r ≤ 0.784, P 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.

  3. Serial measurements of high-sensitivity cardiac troponin T after exercise stress test in stable coronary artery disease

    DEFF Research Database (Denmark)

    Axelsson, Anna; Ruwald, Martin Huth; Dalsgaard, Morten;

    2013-01-01

    The aim was to assess serial measurements of high-sensitivity cardiac troponin T (hs-cTNT) post-exercise in patients with stable coronary artery disease (CAD).......The aim was to assess serial measurements of high-sensitivity cardiac troponin T (hs-cTNT) post-exercise in patients with stable coronary artery disease (CAD)....

  4. Cognitive Aging and Physical Exercise.

    Science.gov (United States)

    Woo, Ellen; Sharps, Matthew J.

    2003-01-01

    Younger (n=58) and older (n=49) adults completed the Kaufman Brief Intelligence Test and recall tests of verbal and visual stimuli with maximum and minimum semantic support. Category support did not help young adults who exercised less. Older adults' exercise had no effect on use of category support; less-frequent exercisers had poorer results…

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

    Science.gov (United States)

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

    2007-01-01

    Hatchery-reared juvenile, 45-cm TL) flathead catfish. Predator-naïve juveniles (20- to 25-cm TL) exhibited no discernable preference when provided areas with and without (52 percent and 48 percent, n = 16 observations; 46 percent and 54 percent, n = 20 observations) large flathead catfish. However, once predation occurred, use of predator-free areas nearly doubled in two trials (36 percent and 64 percent, n = 50 observations; 33 percent and 67 percent, n = 12 observations). A more stringent test examining available area indicated predator-savvy razorback suckers used predator-free areas (88 percent, n = 21) illustrating predator avoidance was a learned behavior.

  6. The use of the standard exercise test to establish the clinical significance of mild echocardiographic changes in a Thoroughbred poor performer : clinical communication

    Directory of Open Access Journals (Sweden)

    C. Meyer

    2004-06-01

    Full Text Available A 4-year-old Thoroughbred gelding racehorse was referred to the Onderstepoort Veterinary Academic Hospital (OVAH with a history of post-race distress and collapse. In the absence of any obvious abnormalities in the preceding diagnostic work-up, a standard exercise test was performed to determine an underlying cause for the post-race distress reported. In this particular case oxygen desaturation became evident at speeds as slow as 6 m/s, where PO2 was measured at 82.3 mm Hg. Similarly at a blood pH of 7.28, PCO2 had dropped to 30.0mm Hg indicating a combined metabolic acidosis and respiratory alkalosis. The cause of the distress was attributed to a severe hypoxia, with an associated hypocapnoea, confirmed on blood gas analyses, where PO2 levels obtained were as low as 56.6 mm Hg with a mean PCO2 level of 25.4 mm Hg during strenuous exercise. Arterial oxygenation returned to normal immediately after cessation of exercise to 106.44 mm Hg, while the hypocapnoeic alkalosis, PCO2 25.67 mm Hg, persisted until the animal's breathing normalized. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise. The combination of an aortic stenosis and a mitral valve insufficiency may have resulted in a condition similar to that described as high-altitude pulmonary oedema, with respiratory changes and compensation as for acute altitude disease. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise and substantiate the fact that an extensive diagnostic regime may be required to establish a cause for poor performance and that the standard exercise test remains an integral part of this work-up.

  7. Cardiopulmonary effects of intermittent mandatory ventilation.

    Science.gov (United States)

    Douglas, M E; Downs, J B

    1980-01-01

    IMV is a combination of spontaneous and mechanical ventilation. For numerous reasons, IMV is potentially more advantageous than conventional techniques. By maintaining spontaneous breathing, mechanical augmentation can be titrated to adjust alveolar minute ventilation levels to normal, thereby decreasing the incidence of respiratory alkalemia. There are major differences between the cardiopulmonary effects of IMV and conventional mechanical ventilation. Spontaneous inspiration decreases Ppl and results in better distribution of inspired gas, a better V/Q, and less physiological dead space. In addition, transmural filling pressures, venous return, and cardiac output are more normal than during conventional mechanical ventilation. Maintenance of spontaneous ventilation lowers mean Paw and pulmonary vascular resistance. If venous admixture occurs, it can be minimized by titrating PEEP. Thus, more effective therapy for hypoxemia is possible. If spontaneous breathing is to persist and be efective, work-of-breathing must be minimized. This can be accomplished best when a continuous flow of gas provides optimal CPAP to maintain FRC and to minimize the effects of decreased compliance without depressing cardiac function. PMID:7007253

  8. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua

    2012-10-01

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

  9. The Cardiopulmonary effect of passive movement

    Directory of Open Access Journals (Sweden)

    L. Loram

    2002-02-01

    Full Text Available Eleven articles were reviewed on the cardiopulmonary effects of passive movements. These included two articles on theneurological effects of passive movements. Of the eleven articles, four were considered to have level II evidence in accordance with Sackett’s rules of evidence. There was little consensus regarding the rate or duration of passive movements. There were some suggestions that upper limb movement produces a greater ventilatory response than lower limb movement. There was a statistically significant increase (p< 0.05 in minute ventilation when the movement was done at a rate of 40 repetitions per minute or more, but this change may not be clinically significant. Passive movements were not detrimental to neurosurgical patients with a normal or slightly elevated intracranial pressure, although the values of the intracranial pressure were not stated.  The studies were limited in that eight of the eleven had small sample sizes and most studies were conducted using normal subjects. Further studies with higher levels of evidence need to be  conducted to verify any results reported to date in the literature. Studies that are relevant to clinical practice also need to be conducted in populations such as sedated intensive care patients.

  10. Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.

    LENUS (Irish Health Repository)

    Groarke, J

    2010-09-01

    Healthcare professionals, patients and their relatives are expected to discuss resuscitation together. This study aims to identify the differences in the knowledge base and understanding of these parties. Questionnaires examining knowledge and opinion on resuscitation matters were completed during interviews of randomly selected doctors, nurses and the general public. 70% doctors, 24% nurses and 0% of a public group correctly estimated survival to discharge following in-hospital resuscitation attempts. Deficiencies were identified in doctor and nurse knowledge of ethics governing resuscitation decisions. Public opinion often conflicts with ethical guidelines. Public understanding of the nature of cardiopulmonary arrests and resuscitation attempts; and of the implications of a \\'Do Not Attempt Resuscitation (DNAR)\\' order is poor. Television medical dramas are the primary source of resuscitation knowledge. Deficiencies in healthcare professionals\\' knowledge of resuscitation ethics and outcomes may compromise resuscitation decisions. Educational initiatives to address deficiencies are necessary. Parties involved in discussion on resuscitation do not share the same knowledge base reducing the likelihood of meaningful discussion. Public misapprehensions surrounding resuscitation must be identified and corrected during discussion.

  11. Effects of Respiratory Muscle and Endurance Training using an Individualized Training Device on Pulmonary Function and Exercise Capacity in Stroke Patients

    OpenAIRE

    Kim, Jinhong; Park, Jun Hyuck; Yim, Jongeun

    2014-01-01

    Background Because respiratory muscle function plays a strong role in exercise capacity and cardiopulmonary response to exercise, systematic training and measurement of respiratory muscle function should be considered in stroke patients. The purpose of this study was to determine whether an individualized respiratory muscle training device combined with conventional physical therapy exercise can improve the pulmonary function and exercise capacity of stroke patients. Material/Methods Twenty s...

  12. A pulsatile pump for cardiopulmonary bypass and its clinical use.

    Science.gov (United States)

    Sasaki, Y; Kawai, T; Nishiyama, K; Murayama, Y; Toda, S; Wada, T; Kitaura, K; Sato, S; Kadowaki, M; Kanki, Y

    1988-09-01

    A pulsatile pump driven by a coil spring, which was designed and constructed by us, is described in this report. It consists of two main parts, a disposable blood chamber and a driving section. The blood chamber has two leaflet valves and a piston, which is covered with two bellofram rolling diaphragms and moves into the housing to draw in and eject the blood. The driving section consists of three cams, an electric motor and a coil spring. The ejection force is wholly produced by the compressed coil spring and is transmitted to the piston in the blood chamber by a rod. This pump allows the ejection pressure, the beat rates, and the stroke volume all to be changed independently. The performance of the pump was tested by using a circulation model where the beat rate was adjusted from 30 to 250 bpm. The output subsequently increased from 0.8 l/min to 5.7 l/min and the stroke volume, from 20.4 ml to 36.7 ml. This new pump has been used for clinical cardiopulmonary bypasses in 24 patients of open heart surgery and the pressure traces during perfusion resembled those of the patients' own hearts. PMID:3230723

  13. Trainers’ Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training

    Directory of Open Access Journals (Sweden)

    M. Mäkinen

    2016-01-01

    Full Text Available Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers’ attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D, Current Care Guidelines, and associated training. Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N=185 focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree. Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation, Nurse’s Role, Nontechnical Skill, Usefulness, Restrictions, Personal, and Organisation. Cronbach’s alphas were 0.92–0.51. Statistics were Student’s t-test, ANOVA, stepwise regression analysis, and Pearson Correlation. Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with the Nontechnical Skills scale (p<0.01. Participants scoring high on Hesitation scale (p<0.01 were less confident about their Nurse’s Role (p<0.01 and Nontechnical Skills (p<0.01. Conclusion. Quality of undergraduate education affects the work of CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills.

  14. Chronotropic incompetence can limit exercise tolerance in COPD patients with lung hyperinflation

    Directory of Open Access Journals (Sweden)

    Hulo S

    2016-10-01

    Full Text Available Sébastien Hulo,1 Jocelyn Inamo,2 Aurélie Dehon,3 Olivier Le Rouzic,4 Jean-Louis Edme,1 Remi Neviere51Université Lille, CHU Lille, EA 4483, IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France; 2Département de Cardiologie – CHU Fort de France, Martinique – Faculté de Médecine – Université des Antilles, France; 3Pôle d’Anesthésie Réanimation ADRU, CHU Nîmes, Nîmes, France; 4Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France; 5Université Lille, Inserm, CHU Lille, Lille Inflammation Research International Center, Lille, FrancePurpose: 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

  15. The non-invasive and continuous estimation of cardiac output using a photoplethysmogram and electrocardiogram during incremental exercise

    International Nuclear Information System (INIS)

    Cardiac output (CO) monitoring is not only essential for critically ill patients in the hospital, but also for patients at home and those undergoing cardiopulmonary exercise testing. However, CO is difficult to monitor during daily activities and exercise. In this paper, we aim at developing a novel CO estimation method that can be used under these challenging conditions. The tube model was utilized to derive a CO index, namely the pulse time reflection ratio (PTRR) from an electrocardiogram and photoplethysmogram. After calibration, the PTRR can be used to estimate beat-to-beat CO. The proposed method was verified against CO measured by impedance cardiography on 19 healthy subjects in an incremental intensity exercise test. Results showed that there were strong correlations (r) between the PTRR and reference CO in 18 subjects (mean r: 0.88, n = 245 trials). Two calibration approaches reported in the literature were applied to the proposed method and the corresponding bias ± precisions of estimation errors were 0 ± 1.89 L min−1 and −0.22 ± 2.12 L min−1, respectively. The percent errors were 21.94% and 24.90%, smaller than the clinical acceptance limit (30%). To conclude, after calibration, this method can be used to monitor CO on healthy subjects during incremental intensity exercise

  16. Effects of polymorphisms in beta1-adrenoceptor and alpha-subunit of G protein on heart rate and blood pressure during exercise test. The Finnish Cardiovascular Study.

    Science.gov (United States)

    Nieminen, Tuomo; Lehtimäki, Terho; Laiho, Jarno; Rontu, Riikka; Niemelä, Kari; Kööbi, Tiit; Lehtinen, Rami; Viik, Jari; Turjanmaa, Väinö; Kähönen, Mika

    2006-02-01

    We tested whether the Arg389Gly and Ser49Gly polymorphisms of the beta1-adrenergic receptor gene ADRB1 and the T393C polymorphism of the G protein alpha-subunit gene GNAS1 modulate heart rate (HR) and blood pressure responses during an exercise stress test. The study population comprised 890 participants (563 men and 327 women, mean age 58.1 +/- 12.6 yr) of the Finnish Cardiovascular Study. Their HR, systolic (SAP), and diastolic arterial pressures (DAP) at rest, during exercise, and 4 min after the test were measured and analyzed by repeated-measurement ANOVA (RANOVA). Genotypes were detected by TaqMan 5' nuclease assay. In all subjects, and in men and women separately, the T393C of GNAS1 was the only polymorphism with genotype x time interaction in HR over the three study phases (P = 0.04, RANOVA). None of the polymorphisms presented genotype x time interaction in SAP or DAP responses (P > 0.10, RANOVA). In all subjects at rest, the Ser49Gly polymorphism of ADRB1 tended (P = 0.06, ANOVA) to differentiate HR. Arg389Gly polymorphism of ADRB1 affected maximal SAP during exercise (P = 0.04, ANOVA) and the change in SAP from rest to maximal (P = 0.03, ANOVA). Arg389 homozygotes, particularly men, were less likely to have ventricular extrasystoles during the exercise (odds ratio = 0.68, 95% confidence interval = 0.51-0.91, P = 0.009, and odds ratio = 0.60, 95% confidence interval = 0.42-0.86, P = 0.006, respectively) than did Gly389 carriers. In conclusion, polymorphisms examined appear to have modulatory effects on hemodynamics in a clinical exercise test setting. However, the effects in absolute numbers were minor and clinically possibly insignificant. PMID:16210433

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

    Science.gov (United States)

    Jefferson, T O; Demicheli, V

    1995-02-01

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

  18. Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery

    Directory of Open Access Journals (Sweden)

    Ricardo Antonio G. Barbosa

    2009-03-01

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

  19. [Prone position: effect on gas exchange and functional capacity for exercise in patients with pulmonary hypertension].

    Science.gov (United States)

    Bastidas-L, Andrea Carolina; Colina-Chourio, José A; Guevara, Jesnel M; Nunez, Alexis

    2015-03-01

    The objective of this investigation was to evaluate gas exchange and cardiopulmonary functional behavior in patients with pulmonary hypertension (PH) before, during and after the change to a prone position. Thirty patients with PH and alterations in gas exchange were included in the study. Gas exchange measurements were performed in four stages: at the baseline supine position and after 30, 120 and 240 minutes in prone position. Also, the patients were evaluated by the six minutes walking test (6MWT) after 30 days in prone position during night's sleep. After four hours in prone position, all patients showed an increase of PaO2 and arterial saturation of oxygen (SaO2), with a decrease of intrapulmonary shunts, improving the gas exchange and therefore the physiological demand imposed by exercise in patients with PH. PMID:25920183

  20. PREDICTION OF VO2PEAK USING OMNI RATINGS OF PERCEIVED EXERTION FROM A SUBMAXIMAL CYCLE EXERCISE TEST

    Science.gov (United States)

    Mays, Ryan J.; Goss, Fredric L.; Nagle-Stilley, Elizabeth F.; Gallagher, Michael; Schafer, Mark A.; Kim, Kevin H.; Robertson, Robert J.

    2015-01-01

    Summary The primary aim of this study was to develop statistical models to predict peak oxygen consumption (VO2peak) using OMNI Ratings of Perceived Exertion measured during submaximal cycle ergometry. Men (mean ± standard error: 20.90 ± 0.42 yrs) and women (21.59 ± 0.49 yrs) participants (n = 81) completed a load-incremented maximal cycle ergometer exercise test. Simultaneous multiple linear regression was used to develop separate VO2peak statistical models using submaximal ratings of perceived exertion for the overall body, legs, and chest/breathing as predictor variables. VO2peak (L·min−1) predicted for men and women from ratings of perceived exertion for the overall body (3.02 ± 0.06; 2.03 ± 0.04), legs (3.02 ± 0.06; 2.04 ± 0.04) and chest/breathing (3.02 ± 0.05; 2.03 ± 0.03) were similar with measured VO2peak (3.02 ± 0.10; 2.03 ± 0.06, ps > .05). Statistical models based on submaximal OMNI Ratings of Perceived Exertion provide an easily administered and accurate method to predict VO2peak. PMID:25068750

  1. A proximal change experiment testing two communication exercises with intimate partner violent men.

    Science.gov (United States)

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

    2011-06-01

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

  2. Managing the Inflammatory Response after Cardiopulmonary Bypass : Review of the Studies in Animal Models

    NARCIS (Netherlands)

    Liguori, Gabriel Romero; Kanas, Alexandre Fligelman; Moreira, Luiz Felipe Pinho

    2014-01-01

    OBJECTIVE: To review studies performed in animal models that evaluated therapeutic interventions to inflammatory response and microcirculatory changes after cardiopulmonary bypass. METHODS: It was used the search strategy ("Cardiopulmonary Bypass" (MeSH)) and ("Microcirculation" (MeSH) or "Inflammat

  3. Influence of Endurance Exercise Overloading Patterns on the Levels of Left Ventricular Catechoamines After a Bout of Lactate Threshold Test in Male Wistar Rat

    Directory of Open Access Journals (Sweden)

    Azad

    2015-12-01

    Full Text Available Background It is well known that exercise training has positive effect on catecholamine response to a given work load. But in this regard, the effective method of training needs to be studied. Objectives The aim of this study was to compare the effects of 8 weeks endurance exercise with two overloading patterns on the left ventricular catecholamine levels. Materials and Methods 29 male Wistar rats were randomly assigned to control (n = 9, daily sinusoidal overloading (n = 10 and weekly sinusoidal overloading (n = 10 groups. After the last exercise session, left ventricular blood samples were obtained immediately after lactate threshold test. Plasma concentrations of adrenaline and noradrenaline were measured by ELISA method. One way analysis of variance was used for analysis of the data. Results Immediately after lactate threshold test, adrenaline level was significantly (P 0.05 different between three study groups. Conclusions The results showed 8 weeks of endurance exercise with weekly sinusoidal overloading pattern could induce a lower adrenal medulla activity (reflection of physical and physiological improvement than daily sinusoidal loading pattern in response to the same absolute work load.

  4. Chemosensitivity, Cardiovascular Risk, and the Ventilatory Response to Exercise in COPD.

    Directory of Open Access Journals (Sweden)

    Michael K Stickland

    Full Text Available COPD is associated with elevated cardiovascular risk and a potentiated ventilatory response to exercise. Enhanced carotid chemoreceptor (CC activity/sensitivity is present in other clinical conditions, has been shown to contribute to sympathetic vasoconstrictor outflow, and is predictive of mortality. CC activity/sensitivity, and the resulting functional significance, has not been well examined in COPD. We hypothesized that CC activity/sensitivity would be elevated in COPD, and related to increased pulse wave velocity (a marker of CV risk and the ventilatory response to exercise.30 COPD patients and 10 healthy age-matched controls were examined. Participants performed baseline cardiopulmonary exercise and pulmonary function testing. CC activity was later evaluated by the drop in ventilation with breathing 100% O2, and CC sensitivity was then assessed by the ventilatory response to hypoxia (ΔVE/ΔSpO2. Peripheral arterial stiffness was subsequently evaluated by measurement of pulse wave velocity (PWV using applanation tonometry while the subjects were breathing room air, and then following chemoreceptor inhibition by breathing 100% O2 for 2 minutes.CC activity, CC sensitivity, PWV and the ventilatory response to exercise were all increased in COPD relative to controls. CC sensitivity was related to PWV; however, neither CC activity nor CC sensitivity was related to the ventilatory response to exercise in COPD. CC inhibition by breathing 100% O2 normalized PWV in COPD, while no effect was observed in controls.CC activity and sensitivity are elevated in COPD, and appear related to cardiovascular risk; however, CC activity/sensitivity does not contribute to the potentiated ventilatory response to exercise.

  5. Cold pressor test myocardial perfusion SPECT as a predictor of the development of ischemia at exercise in the follow up of asymptomatic patients with moderate cardiovascular risk

    International Nuclear Information System (INIS)

    Introduction: Previous studies have published the correlation between myocardial perfusion SPECT (MP) during cold pressor test (CPT) and intracoronary acetylcholine and its usefulness as independent marker of endothelial dysfunction (ED). Objective: To analyze the incidence of positivization of MP exercise studies in the follow up of asymptomatic patients with moderate cardiovascular risk (CV) and ED detected by PF. Material and Methods: Of 301 patients of the PARADIGMA Registry (normal exercise MP SPECT and clinical probability < 20% of events at 10 years [moderate risk by Framingham index]) 55 had positive PF (+) (18.3%). Prospectively and consecutively, 15 asymptomatic patients with PF (+), and a control group (CG) of 15 patients with negative PF, with paired sex, age and coronary risk factors (CRF), that accomplished a 12 ± 2 months follow up, and that underwent a new exercise and resting MP SPECT were analyzed. An MP extension score was used in a model of 17 segments. The CRF and the incidence of ischemia during follow up exercise MP of each group were assessed. Results: Age: PF (-) 57.3 ± 8.9 versus TF (+) 52.5 ± 7.5 (p = 0,09). Positivized the exercise MP: PF group (+) 5/15: 33.3% and 0 in the CG (p=0.04). No statistically significant differences between CRF in both groups. Conclusions: An abnormal MP SPECT during PF in asymptomatic patients with moderate CV risk differentiated those patients who positivized exercise MP studies at one year follow up and there were no abnormal studies in the control group. (author)

  6. Hydrogen sulfide improves neural function in rats following cardiopulmonary resuscitation

    Science.gov (United States)

    LIN, JI-YAN; ZHANG, MIN-WEI; WANG, JIN-GAO; LI, HUI; WEI, HONG-YAN; LIU, RONG; DAI, GANG; LIAO, XIAO-XING

    2016-01-01

    The alleviation of brain injury is a key issue following cardiopulmonary resuscitation (CPR). Hydrogen sulfide (H2S) is hypothesized to be involved in the pathophysiological process of ischemia-reperfusion injury, and exerts a protective effect on neurons. The aim of the present study was to investigate the effects of H2S on neural functions following cardiac arrest (CA) in rats. A total of 60 rats were allocated at random into three groups. CA was induced to establish the model and CPR was performed after 6 min. Subsequently, sodium hydrosulfide (NaHS), hydroxylamine or saline was administered to the rats. Serum levels of H2S, neuron-specific enolase (NSE) and S100β were determined following CPR. In addition, neurological deficit scoring (NDS), the beam walking test (BWT), prehensile traction test and Morris water maze experiment were conducted. Neuronal apoptosis rates were detected in the hippocampal region following sacrifice. After CPR, as the H2S levels increased or decreased, the serum NSE and S100β concentrations decreased or increased, respectively (P<0.0w. The NDS results of the NaHS group were improved compared with those of the hydroxylamine group at 24 h after CPR (P<0.05). In the Morris water maze experiment, BWT and prehensile traction test the animals in the NaHS group performed best and rats in the hydroxylamine group performed worst. At day 7, the apoptotic index and the expression of caspase-3 were reduced in the hippocampal CA1 region, while the expression of Bcl-2 increased in the NaHS group; and results of the hydroxylamine group were in contrast. Therefore, the results of the present study indicate that H2S is able to improve neural function in rats following CPR. PMID:26893650

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

    Directory of Open Access Journals (Sweden)

    Roberta Ceci

    2014-01-01

    In conclusion, the adherence to an EMRT protocol is able to induce a cellular adaptation allowing healthy elderly trained subjects to cope with the oxidative stress induced by an acute exercise more effectively than the aged-matched sedentary subjects.

  8. Extracorporeal Cardiopulmonary Resuscitation: Predictors of Survival

    Science.gov (United States)

    Kim, Dong Hee; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

    2016-01-01

    Background The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients. PMID:27525236

  9. Teamwork and leadership in cardiopulmonary resuscitation.

    Science.gov (United States)

    Hunziker, Sabina; Johansson, Anna C; Tschan, Franziska; Semmer, Norbert K; Rock, Laura; Howell, Michael D; Marsch, Stephan

    2011-06-14

    Despite substantial efforts to make cardiopulmonary resuscitation (CPR) algorithms known to healthcare workers, the outcome of CPR has remained poor during the past decades. Resuscitation teams often deviate from algorithms of CPR. Emerging evidence suggests that in addition to technical skills of individual rescuers, human factors such as teamwork and leadership affect adherence to algorithms and hence the outcome of CPR. This review describes the state of the science linking team interactions to the performance of CPR. Because logistical barriers make controlled measurement of team interaction in the earliest moments of real-life resuscitations challenging, our review focuses mainly on high-fidelity human simulator studies. This technique allows in-depth investigation of complex human interactions using precise and reproducible methods. It also removes variability in the clinical parameters of resuscitation, thus letting researchers study human factors and team interactions without confounding by clinical variability from resuscitation to resuscitation. Research has shown that a prolonged process of team building and poor leadership behavior are associated with significant shortcomings in CPR. Teamwork and leadership training have been shown to improve subsequent team performance during resuscitation and have recently been included in guidelines for advanced life support courses. We propose that further studies on the effects of team interactions on performance of complex medical emergency interventions such as resuscitation are needed. Future efforts to better understand the influence of team factors (e.g., team member status, team hierarchy, handling of human errors), individual factors (e.g., sex differences, perceived stress), and external factors (e.g., equipment, algorithms, institutional characteristics) on team performance in resuscitation situations are critical to improve CPR performance and medical outcomes of patients.

  10. Acute posthypoxic myoclonus after cardiopulmonary resuscitation

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    Bouwes Aline

    2012-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Damien Vitiello

    2014-01-01

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

  12. Hantavirus cardiopulmonary syndrome successfully treated with high-volume hemofiltration

    Science.gov (United States)

    Bugedo, Guillermo; Florez, Jorge; Ferres, Marcela; Roessler, Eric; Bruhn, Alejandro

    2016-01-01

    Hantavirus cardiopulmonary syndrome has a high mortality rate, and early connection to extracorporeal membrane oxygenation has been suggested to improve outcomes. We report the case of a patient with demonstrated Hantavirus cardiopulmonary syndrome and refractory shock who fulfilled the criteria for extracorporeal membrane oxygenation and responded successfully to high volume continuous hemofiltration. The implementation of high volume continuous hemofiltration along with protective ventilation reversed the shock within a few hours and may have prompted recovery. In patients with Hantavirus cardiopulmonary syndrome, a short course of high volume continuous hemofiltration may help differentiate patients who can be treated with conventional intensive care unit management from those who will require more complex therapies, such as extracorporeal membrane oxygenation. PMID:27410413

  13. Hantavirus cardiopulmonary syndrome successfully treated with high-volume hemofiltration.

    Science.gov (United States)

    Bugedo, Guillermo; Florez, Jorge; Ferres, Marcela; Roessler, Eric; Bruhn, Alejandro

    2016-06-01

    Hantavirus cardiopulmonary syndrome has a high mortality rate, and early connection to extracorporeal membrane oxygenation has been suggested to improve outcomes. We report the case of a patient with demonstrated Hantavirus cardiopulmonary syndrome and refractory shock who fulfilled the criteria for extracorporeal membrane oxygenation and responded successfully to high volume continuous hemofiltration. The implementation of high volume continuous hemofiltration along with protective ventilation reversed the shock within a few hours and may have prompted recovery. In patients with Hantavirus cardiopulmonary syndrome, a short course of high volume continuous hemofiltration may help differentiate patients who can be treated with conventional intensive care unit management from those who will require more complex therapies, such as extracorporeal membrane oxygenation. PMID:27410413

  14. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Science.gov (United States)

    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 blood pump is a device that uses a revolving roller mechanism to pump the blood through...

  15. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonroller-type cardiopulmonary bypass blood pump... Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other than revolving rollers to pump the blood...

  16. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class...

  17. Increased Left Ventricular Stiffness Impairs Exercise Capacity in Patients with Heart Failure Symptoms Despite Normal Left Ventricular Ejection Fraction

    Directory of Open Access Journals (Sweden)

    David Sinning

    2011-01-01

    Full Text Available Aims. Several mechanisms can be involved in the development of exercise intolerance in patients with heart failure despite normal left ventricular ejection fraction (HFNEF and may include impairment of left ventricular (LV stiffness. We therefore investigated the influence of LV stiffness, determined by pressure-volume loop analysis obtained by conductance catheterization, on exercise capacity in HFNEF. Methods and Results. 27 HFNEF patients who showed LV diastolic dysfunction in pressure-volume (PV loop analysis performed symptom-limited cardiopulmonary exercise testing (CPET and were compared with 12 patients who did not show diastolic dysfunction in PV loop analysis. HFNEF patients revealed a lower peak performance (=.046, breathing reserve (=.006, and ventilation equivalent for carbon dioxide production at rest (=.002. LV stiffness correlated with peak oxygen uptake (=−0.636, <.001, peak oxygen uptake at ventilatory threshold (=−0.500, =.009, and ventilation equivalent for carbon dioxide production at ventilatory threshold (=0.529, =.005. Conclusions. CPET parameters such as peak oxygen uptake, peak oxygen uptake at ventilatory threshold, and ventilation equivalent for carbon dioxide production at ventilatory threshold correlate with LV stiffness. Increased LV stiffness impairs exercise capacity in HFNEF.

  18. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Directory of Open Access Journals (Sweden)

    Keely Smith

    2016-01-01

    Full Text Available We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2 resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway.

  19. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Science.gov (United States)

    Smith, Keely; Gomez-Rubio, Ana M.; Harris, Tomika S.; Brooks, Lauren E.

    2016-01-01

    We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2) resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV) during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway. PMID:27418995

  20. Utility of the discriminant analysis to categorize untrained Spanish Pure Bred horses on the basis of biochemical and muscle variables before and after a standardized exercise test.

    Science.gov (United States)

    Escribano, B M; Agüera, E I; Rubio, M D; Santisteban, R; Vivo, R; Agüera, S; Tovar, P

    2011-12-01

    We hypothesized that the information obtained from a discriminant analysis could be used to objectively discriminate horses untrained from early ages, in agreement with certain physiological characteristics. In the biopsies of 24 Spanish Pure Bred horses (1.5-3 years old) before and after a standardized exercise test (SET; 4-7 m/s with a change of velocity of 1m/s every 2 min) muscle enzymes, substrate and metabolites were determined. Also, diverse plasma and blood parameters were considered. Three pre-exercise groups (A1: six horses; A2: seven horses and A3: eleven horses) and two post-exercise groups (B1: sixteen horses; B2: eight horses) were defined from a correspondence analysis. Forward stepwise discriminant analysis selected 11 variables which differentiated the groups between each other both pre- and post-exercise. The results of the present study suggested the utility of a discriminant analysis to categorize horses in agreement with certain physiological variables. It could be used for establishing different types of training in each group by expert trainers. PMID:21458835

  1. Exercise stress test

    Science.gov (United States)

    ... chap 13. Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil ... the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/ ...

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

    Science.gov (United States)

    Shao, Guangfu; Ji, Chen

    2012-04-01

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

  3. Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R;

    1993-01-01

    response in group 1 compared with group 2: systolic blood pressure at maximal work load 160 +/- 31 vs 176 +/- 28 mm Hg (p ...The relation between early out-of-hospital ambulatory ST-segment monitoring, clinical characteristics, predischarge maximal exercise testing and cardiac events was determined in 123 consecutive men (age 55 +/- 8 years) with a first acute myocardial infarction (AMI). During 36 hours of ambulatory...

  4. Electrocardiogram signal variance analysis in the diagnosis of coronary artery disease--a comparison with exercise stress test in an angiographically documented high prevalence population.

    Science.gov (United States)

    Nowak, J; Hagerman, I; Ylén, M; Nyquist, O; Sylvén, C

    1993-09-01

    Variance electrocardiography (variance ECG) is a new resting procedure for detection of coronary artery disease (CAD). The method measures variability in the electrical expression of the depolarization phase induced by this disease. The time-domain analysis is performed on 220 cardiac cycles using high-fidelity ECG signals from 24 leads, and the phase-locked temporal electrical heterogeneity is expressed as a nondimensional CAD index (CAD-I) with the values of 0-150. This study compares the diagnostic efficiency of variance ECG and exercise stress test in a high prevalence population. A total of 199 symptomatic patients evaluated with coronary angiography was subjected to variance ECG and exercise test on a bicycle ergometer as a continuous ramp. The discriminant accuracy of the two methods was assessed employing the receiver operating characteristic curves constructed by successive consideration of several CAD-I cutpoint values and various threshold criteria based on ST-segment depression exclusively or in combination with exertional chest pain. Of these patients, 175 with CAD (> or = 50% luminal stenosis in 1 + major epicardial arteries) presented a mean CAD-I of 88 +/- 22, compared with 70 +/- 21 in 24 nonaffected patients (p or = 70, compared with ST-segment depression > or = 1 mm combined with exertional chest pain, the overall sensitivity of variance ECG was significantly higher (p < 0.01) than that of exercise test (79 vs. 48%). When combined, the two methods identified 93% of coronary angiography positive cases. Variance ECG is an efficient diagnostic method which compares favorably with exercise test for detection of CAD in high prevalence population. PMID:8242912

  5. [Ironman and cardiac transplantation. High sporting exercise capacity before and after cardiac transplantation].

    Science.gov (United States)

    Brune, Stephan; Kroidl, Rolf F

    2006-09-01

    The case of a 45-year-old man is reported who was an active competitive sportsman up to his 38th year. In fall of 1998, exercise limitation was noted. The cardiologic work-up revealed dilated cardiomyopathy. In spite of intensive medical therapy clinical course deteriorated within the next 3 years, cardiologic findings and a follow-up in CPET (cardiopulmonary exercise testing) showed a rapid decline. In May 2002, he was listed for cardiac transplantation. In August 2003, an orthotopic bicaval cardiac transplantation was performed at the University of Göttingen, Germany. The patient was followed regularly in the office. Physical exercise capacity increased significantly and he was able to participate in the 10-km New Year's run of 2003. Since 2004, he has been working very successfully as a coach for competitive swimmers. Based on CPET findings, actual views and concepts regarding the pathophysiology and training of chronic heart failure are discussed and the question is raised whether and in which respect a sportive predisposition favors the clinical outcome. PMID:17036190

  6. Effect of repeated sauna treatment on exercise tolerance and endothelial function in patients with chronic heart failure.

    Science.gov (United States)

    Ohori, Takashi; Nozawa, Takashi; Ihori, Hiroyuki; Shida, Takuya; Sobajima, Mitsuo; Matsuki, Akira; Yasumura, Satoshi; Inoue, Hiroshi

    2012-01-01

    Repeated sauna treatment, known as Waon therapy, has been shown to improve cardiac function as well as exercise tolerance in patients with chronic heart failure. However, the underlying mechanisms of this therapy regarding these improvements remain to be elucidated. Forty-one patients with chronic heart failure (mean age 68.3 ± 13.5 years old) underwent Waon therapy 5 times a week for 3 weeks. Before and after treatment, a number of assessments were performed in all subjects: 6-minute walk test, echocardiography, determination of neurohumoral factors and number of circulating CD34(+) cells, and a flow-mediated dilation (FMD) test of endothelial function. Cardiopulmonary exercise testing was also performed in 20 patients. Waon therapy increased the left ventricular ejection fraction (from 30.4 ± 12.6% to 32.5% ± 12.8%, p = 0.023) and reduced plasma levels of norepinephrine (from 400 ± 258 to 300 ± 187 pg/ml, p = 0.015) and brain natriuretic peptide (from 550 ± 510 to 416 ± 431 pg/ml, p = 0.035). Waon therapy increased the 6-minute walk distance (from 337 ± 120 to 379 ± 126 m, p sauna therapy in patients with chronic heart failure improves exercise tolerance in association with improvement in endothelial function.

  7. Comparative Effects of Angiotensin Receptor BlockadeandACE Inhibition on the Fibrinolytic and Inflammatory Responses to Cardiopulmonary Bypass

    OpenAIRE

    Billings, Frederic T.; Balaguer, Jorge M.; Yu, Chang; Wright, Patricia; Petracek, Michael R.; Byrne, John G; Brown, Nancy J.; Pretorius, Mias

    2012-01-01

    The effects of angiotensin-converting enzyme (ACE) inhibition and angiotensin II type 1 receptor blockade (ARB) on fibrinolysis and inflammation following cardiopulmonary bypass (CPB) are uncertain. This study tested the hypothesis that ACE inhibition enhances fibrinolysis and inflammation to greater extent than ARB in patients undergoing CPB.One week to five days prior to surgery, patients were randomized to ramipril 5mg/day,candesartan 16mg/day or placebo.ACE inhibition increased intraopera...

  8. Exercise for the Management of Diabetes Mellitus: A Review of the Evidence

    OpenAIRE

    Md. Shahjamal Khan

    2013-01-01

    Diabetes mellitus is a public health problem in both developed and developing countries and has increased alarmingly, giving the disease the dimension of an epidemic. The aetiology of diabetes is multifactorial involving genetic, environmental, and behavioural origins. Exercise is an important part for the management of diabetes mellitus. Regularly planned exercise reduces insulin resistance, improves glucose tolerance, improves lipid profile and increases cardiovascular and cardiopulmonary f...

  9. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

    Directory of Open Access Journals (Sweden)

    Aymen N Naguib

    2015-01-01

    Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

  10. Cardiopulmonary interactions during mechanical ventilation in critically ill patients

    NARCIS (Netherlands)

    T.G.V. Cherpanath (Thomas); W.K. Lagrand (Wim); M.J. Schultz (Marcus); A.B.J. Groeneveld (Johan)

    2013-01-01

    textabstractCardiopulmonary interactions induced by mechan-ical ventilation are complex and only partly understood. Ap-plied tidal volumes and/or airway pressures largely mediate changes in right ventricular preload and afterload. Effects on left ventricular function are mostly secondary to changes

  11. The influence of biomaterials on inflammatory responses to cardiopulmonary bypass.

    Science.gov (United States)

    Courtney, J M; Matata, B M; Yin, H Q; Esposito, A; Mahiout, A; Taggart, D P; Lowe, G D

    1996-05-01

    The nature of cardiopulmonary bypass and the complexity of the inflammatory response make the detection and interpretation of a biomaterial influence difficult. However, if mediation of the inflammatory response is considered to be an appropriate clinical goal, alteration to the biomaterial influence merits further investigation.

  12. Retention of Cardiopulmonary Resuscitation Skills in Nigerian Secondary School Students

    Science.gov (United States)

    Onyeaso, Adedamola Olutoyin

    2016-01-01

    Background/Objective: For effective bystander cardiopulmonary resuscitation (CPR), retention of CPR skills after the training is central. The objective of this study was to find out how much of the CPR skills a group of Nigerian secondary school students would retain six weeks after their first exposure to the conventional CPR training. Materials…

  13. QUALITY-OF-LIFE AFTER CARDIOPULMONARY-RESUSCITATION

    NARCIS (Netherlands)

    MIRANDA, DR

    1994-01-01

    Objectives: This study evaluates the influence of Cardiopulmonary Resuscitation (CPR) on the components of quality of life (QOL) of patients after discharge from the hospital. Design: Extracted from a prospective national survey on Dutch intensive care units (ICUs). Setting: Thirty-six ICUs of both

  14. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... gases between blood and a gaseous environment to satisfy the gas exchange needs of a patient during...

  15. Release of endogenous vasopressors during and after cardiopulmonary resuscitation.

    OpenAIRE

    Lindner, K. H.; Haak, T; Keller, A; Bothner, U.; Lurie, K. G.

    1996-01-01

    OBJECTIVE: To assess whether plasma endothelin, adrenaline, noradrenaline, arginine vasopressin, adrenocorticotropin, and cortisol concentrations were higher during cardiopulmonary resuscitation in patients in whom resuscitation was successful than in those in whom it failed, and to measure the concentrations of these hormones in the immediate post-resuscitation phase. DESIGN: Prospective, descriptive study. SETTING: Emergency medical service at a university hospital. PATIENTS: 60 patients wi...

  16. Gastrointestinal motility during cardiopulmonary bypass : A sonomicrometric study

    NARCIS (Netherlands)

    Gu, YJ; de Kroon, TL; Elstrodt, JM; Rakhorst, G

    2006-01-01

    Cardiopulmonary bypass (CPB) is known to impair the integrity of the gastrointestinal tract. However, little is known about the movement behavior of the gastrointestinal tract during CPB. This study was aimed to assess the gastrointestinal motility with sonomicrometry, a distance measurement using u

  17. Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Whitlock, Richard P; Chan, Simon; Devereaux, P J;

    2008-01-01

    We sought to establish the efficacy and safety of prophylactic steroids in adult patients undergoing cardiopulmonary bypass (CPB). We performed a meta-analysis of randomized trials reporting the effects of prophylactic steroids on clinical outcomes after CPB. Outcomes examined were mortality...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-11-15

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

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

    International Nuclear Information System (INIS)

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 μm2). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0±5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCODSA=COFick. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  20. Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial

    Energy Technology Data Exchange (ETDEWEB)

    Manganelli, Fiore; Sauro, Rosario; Di Lorenzo, Emilio; Rosato, Giuseppe [San Giuseppe Moscati Hospital, Department of Cardiology and Heart Surgery, Avellino (Italy); Spadafora, Marco; Varrella, Paola; Peluso, Giuseppina [San Giuseppe Moscati Hospital, Nuclear Medicine Unit, Avellino (Italy); Daniele, Stefania [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); University Federico II, Department of Biomorphological and Functional Sciences, Naples (Italy); National Council of Research, Institute of Biostructures and Bioimages, Naples (Italy)

    2011-02-15

    To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT). The study was a prospective, randomized, placebo-controlled design. Patients with suspected or known coronary artery disease who failed to achieve a target HR ({>=}85% of maximal predicted HR) during exercise SPECT imaging were randomized to receive intravenous atropine (n = 100) or placebo (n = 101). The two groups of patients did not differ with respect to demographic or clinical characteristics. A higher proportion of patients in the atropine group achieved the target HR compared to the placebo group (60% versus 3%, p < 0.0001). SPECT imaging was abnormal in a higher proportion of patients in the atropine group as compared to the placebo group (57% versus 42%, p < 0.05). Stress-induced myocardial ischaemia was present in more patients in the atropine group as compared to placebo (47% versus 29%, p < 0.01). In both groups of patients, no major side effects occurred. The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study. (orig.)

  1. Catsius Clay Project. Calculation and Testing of Behaviour of Unsaturated Clay as Barrier in Radioactive Waste Repositories. Stage 2: Validation Exercises at Laboratory scale

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, E. E.; Alcoverro, J.

    1999-07-01

    Stage 2 of CATSIUS CLAY Project: Validation Exercises at Laboratory Scale includes two Benchmarks, Benchmark 2.1: Oedometer Suction Controlled Tests on Samples of compacted Boom Clay and Benchmark 2.2: Small Scale Weltting-Heating Test on Compacted Bentonite. BM 2.1 had two parts: BM 2.1A (volumetric deformation upon wetting-drying cycles) and BM 2.1 B (swelling pressure test). In BM 2.1A, participants were asked to model the results of a series of five tests on samples of compacted Boom clay. In BM 2.1B, a swelling pressure test in which suction, vertical and horizontal stresses were monitored, was proposed as a blind exercise. Participants were asked to use, without further changes, the models calibrated in BM 2.1A. This exercise provides an evaluation of the capabilities of current mechanical constitutive models for unsaturated clay behaviour. It was found that, even if a calibration exercise on the basis of known experimental data is satisfactory, blind predictions of tests involving different paths may prove difficult. The test set up for BM 2.2 consisted of a stainless stell cell filled with highly expansive compacted bentonite (S2 clay from Almeria, Spain). The clay was subjected to a simultaneous central heating and a progressive water inflow through the botton plate. Temperature at various locations within the sample and the boundary radial stress were monitored throughout the test. Water content distribution was also measured at the end of the experiment. Predictions for this benchmark required the solution of field equations for flow, temperature distribution and mechanical analysis. Model parameters were derived from the extensive set of available experiments on this clay. Comparison between model predictions and measurements revealed the significance of water transport in vapour phase, the difficulties to predict boundary stresses and the general good agreement between measured and calculated temperatures. The report provides a detailed accojnt of the

  2. Comparing exercise training modalities in heart failure: A systematic review and meta-analysis.

    Science.gov (United States)

    Cornelis, Justien; Beckers, Paul; Taeymans, Jan; Vrints, Christiaan; Vissers, Dirk

    2016-10-15

    Exercise training (ET) is suggested to improve exercise capacity, prognosis, quality of life (QOL) and functional modifications of the heart in patients with heart failure (HF). However, it is not clear which modality is best. In order to assess the effectiveness of different ET modalities on prognostic cardiopulmonary exercise test (CPET) parameters, QOL and left ventricular remodeling, a systematic review and meta-analysis was performed. Randomized clinical trials (RCTs) were selected in three databases. The primary outcome data were peak oxygen uptake, ventilation over carbon dioxide slope, oxygen uptake efficiency slope, exercise oscillatory ventilation, rest and peak pulmonary end-tidal CO2. Secondary variables were QOL, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD). Twenty RCTs (n=811) met the a priori stated inclusion criteria. Studies were categorized into four different groups: "interval training (IT1) versus combined interval and strength training (IT1S)" (n=156), "continuous training (CT1) versus combined continuous and strength training (CT1S)" (n=130), "interval training (IT2) versus continuous training (CT2)" (n=501) and "continuous training (CT3) versus strength training (S3)" (n=24). No significant random effects of exercise modality were revealed assessing the CPET parameters. There was a significant improvement in QOL applying CT1S (P<0.001). Comparing IT2 with CT2, LVEDD and LVEF were significantly improved favoring IT2 (P<0.001). There is some evidence to support that interval training is more effective to improve LVEF and LVEDD. The fact that patients with HF are actively involved in any kind of ET program seems sufficient to improve the prognosis, QOL and anatomic function. PMID:27434363

  3. Alternatives to Aerobic Exercise Prescription in Patients with Chronic Heart Failure

    Science.gov (United States)

    Oliveira, Mayron F; Zanussi, Gabriela; Sprovieri, Bianca; Lobo, Denise M. L.; Mastrocolla, Luiz E; Umeda, Iracema I. K.; Sperandio, Priscila A

    2016-01-01

    Background Exercise is essential for patients with heart failure as it leads to a reduction in morbidity and mortality as well as improved functional capacity and oxygen uptake (⩒O2). However, the need for an experienced physiologist and the cost of the exam may render the cardiopulmonary exercise test (CPET) unfeasible. Thus, the six-minute walk test (6MWT) and step test (ST) may be alternatives for exercise prescription. Objective The aim was to correlate heart rate (HR) during the 6MWT and ST with HR at the anaerobic threshold (HRAT) and peak HR (HRP) obtained on the CPET. Methods Eighty-three patients (58 ± 11 years) with heart failure (NYHA class II) were included and all subjects had optimized medication for at least 3 months. Evaluations involved CPET (⩒O2, HRAT, HRP), 6MWT (HR6MWT) and ST (HRST). Results The participants exhibited severe ventricular dysfunction (ejection fraction: 31 ± 7%) and low peak ⩒O2 (15.2 ± 3.1 mL.kg-1.min-1). HRP (113 ± 19 bpm) was higher than HRAT (92 ± 14 bpm; p < 0.05) and HR6MWT (94 ± 13 bpm; p < 0.05). No significant difference was found between HRP and HRST. Moreover, a strong correlation was found between HRAT and HR6MWT (r = 0.81; p < 0.0001), and between HRP and HRST (r = 0.89; p < 0.0001). Conclusion These findings suggest that, in the absence of CPET, exercise prescription can be performed by use of 6MWT and ST, based on HR6MWT and HRST PMID:26815313

  4. Alternatives to Aerobic Exercise Prescription in Patients with Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Mayron F Oliveira

    2016-01-01

    Full Text Available Background: Exercise is essential for patients with heart failure as it leads to a reduction in morbidity and mortality as well as improved functional capacity and oxygen uptake (v̇O2. However, the need for an experienced physiologist and the cost of the exam may render the cardiopulmonary exercise test (CPET unfeasible. Thus, the six-minute walk test (6MWT and step test (ST may be alternatives for exercise prescription. Objective: The aim was to correlate heart rate (HR during the 6MWT and ST with HR at the anaerobic threshold (HRAT and peak HR (HRP obtained on the CPET. Methods: Eighty-three patients (58 ± 11 years with heart failure (NYHA class II were included and all subjects had optimized medication for at least 3 months. Evaluations involved CPET (v̇O2, HRAT, HRP, 6MWT (HR6MWT and ST (HRST. Results: The participants exhibited severe ventricular dysfunction (ejection fraction: 31 ± 7% and low peak v̇O2 (15.2 ± 3.1 mL.kg-1.min-1. HRP (113 ± 19 bpm was higher than HRAT (92 ± 14 bpm; p < 0.05 and HR6MWT (94 ± 13 bpm; p < 0.05. No significant difference was found between HRP and HRST. Moreover, a strong correlation was found between HRAT and HR6MWT (r = 0.81; p < 0.0001, and between HRP and HRST (r = 0.89; p < 0.0001. Conclusion: These findings suggest that, in the absence of CPET, exercise prescription can be performed by use of 6MWT and ST, based on HR6MWT and HRST

  5. Peptide glutamine supplementation for tolerance of intermittent exercise in soccer players

    Directory of Open Access Journals (Sweden)

    Alessandra Favano

    2008-01-01

    Full Text Available OBJECTIVE: To investigate whether supplementation of carbohydrate together with peptide glutamine would increase exercise tolerance in soccer players. METHODS: Nine male soccer players (mean age: 18.4 ± 1.1 years; body mass: 69.2 ± 4.6 kg; height: 175.5 ± 7.3 cm; and maximum oxygen consumption of 57.7 ± 4.8 ml.kg-1.min-1 were evaluated. All of them underwent a cardiopulmonary exercise test and followed a protocol that simulated the movements of a soccer game in order to evaluate their tolerance to intermittent exercise. By means of a draw, either carbohydrate with peptide glutamine (CARBOGLUT: 50g of maltodextrin + 3.5g of peptide glutamine in 250 ml of water or carbohydrate alone (CARBO: 50g of maltodextrin in 250 ml of water was administered in order to investigate the enhancement of the soccer players' performances. The solution was given thirty minutes before beginning the test, which was performed twice with a one-week interval between tests. RESULTS: A great improvement in the time and distance covered was observed when the athletes consumed the CARBOGLUT mixture. Total distance covered was 12750 ± 4037m when using CARBO, and 15571 ± 4184m when using CARBOGLUT (p<0.01; total duration of tolerance was 73 ± 23 min when using CARBO and 88 ± 24 min when using CARBOGLUT (p<0.01. CONCLUSION: The CARBOGLUT mixture was more efficient in increasing the distance covered and the length of time for which intermittent exercise was tolerated. CARBOGLUT also reduced feelings of fatigue in the players compared with the use of the CARBO mixture alone.

  6. Compulsive Exercise

    Science.gov (United States)

    ... exercise, especially when it is combined with an eating disorder, can cause serious and permanent health problems, and in extreme cases, death. Because compulsive exercise is closely related to eating disorders, help can be found at community agencies specifically ...

  7. Compulsive Exercise

    Science.gov (United States)

    ... journals about their exercise schedules and obsess about improving themselves. Unfortunately, these behaviors often compound each other, trapping the person in a downward spiral of negative thinking and low self-esteem. continue Why Is Exercising Too Much a Bad ...

  8. Turbulent mixing in a rod bundle with vaned spacer grids: OECD/NEA–KAERI CFD benchmark exercise test

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Seok-Kyu; Kim, Seok; Song, Chul-Hwa, E-mail: chsong@kaeri.re.kr

    2014-11-15

    Highlights: • Detailed velocity profiles have been examined in a rod bundle with mixing spacer grids. • Mixing characteristics strongly depend on the type of the mixing vane on a spacer grid. • The swirl in subchannels is elliptic and the cross-flow in gaps is vigorous in the split-type. • Swirl-type vanes generate a circular swirl in a subchannel and a weak cross-flow in gaps. • Mixing performance is superior in the case of the split-type compared to the swirl-type. - Abstract: An experimental study titled the 2nd International Benchmark Exercise (IBE-2) has been conducted to provide high-precision data of detailed turbulent flow mixing in a rod bundle for validating the CFD codes being used widely in the nuclear power industry. A 5 × 5 rod bundle having mixing spacer grids was adopted as a test rig, and was contained in a square flow housing with a 170 mm side length and 4670 mm length. The 25 rods in a bundle have dimensions of 25.4 mm in outer diameter and a 3863 mm length. The benchmark experiments have been performed at the MATiS-H water loop facility in KAERI. The axial bulk velocity in a rod bundle was maintained at about 1.50 m/s (equivalent to Re ∼50,000) with loop conditions of 35 °C and 1.57 bar measured upstream of the spacer during the experiments. Detailed measurements of the turbulent flow in the subchannels were accomplished using 2-D LDA at four different distances (0.5, 1, 4 and 10 D{sub H}) from the downstream of the mixing spacer grid. The upstream flow profiles also have been measured at the inlet of the mixing spacer grid for the inlet boundary condition. Precise measurements of the lateral and axial velocities in the subchannels are presented at four downstream distances, as well as the inlet from the mixing spacer grid of two types. Turbulence intensities and vorticities in the subchannels are also evaluated from the velocity measurements.

  9. Comparison of end-tidal carbon dioxide levels with cardiopulmonary resuscitation success presented to emergency department with cardiopulmonary arrest.

    Science.gov (United States)

    Akinci, Emine; Ramadan, Hayri; Yuzbasioglu, Yucel; Coskun, Figen

    2014-01-01

    Objective: To measure end-tidal carbon dioxide pressure (PetCO2) in preset interval in order to evaluate the efficiency of cardiopulmonary resuscitation (CPR) performed on patients in cardiopulmonary arrest, evaluate the validity of PetCO2 in predicting the mortality and finally assess the PetCO2 levels of the patients in cardiopulmonary arrest based on the initial presenting rhythm. Methods: This prospective study was conducted at the Ankara Training and Research Hospital on patients who presented with cardiopulmonary arrest. Standard ACLS (Advanced Cardiac Life Support) protocols were performed. Patients were categorized in two groups based on their rhythms as Ventricular Fibrillation and Asystole. Patients’ PetCO2 values were recorded. Results: PetCO2 levels of the Return of Spontaneous Circulation (ROSC) group in the 5th, 10th, 15th and 20th minutes were significantly higher compared to the exitus group (p<0.001). In distinguishing ROSC and exitus, PetCO2 measurements within 5-20 minute intervals showed highest performance on the 20th and lowest on the 5th minutes. Conclusion: PetCO2 values are higher in the ROSC group. During the CPR, the most reliable time for ROSC estimation according to PetCO2 values is 20th minute. None of the patients who had PetCO2 levels less than 14 mmHg survived. PMID:24639823

  10. Earlier application of percutaneous cardiopulmonary support rescues patients from severe cardiopulmonary failure using the APACHE III scoring system.

    Science.gov (United States)

    Song, Suk-Won; Yang, Hong-Suk; Lee, Sak; Youn, Young-Nam; Yoo, Kyung-Jong

    2009-12-01

    Percutaneous cardiopulmonary support (PCPS) is a widely accepted treatment for severe cardiopulmonary failure. This system, which uses a percutaneous approach and autopriming devices, can be rapidly applied in emergency situations. We sought to identify the risk factors that could help predict in-hospital mortality, and to assess its outcomes in survivors. During a 2-yr period, 50 patients underwent PCPS for the treatment of severe cardiopulmonary failure, and of those, 22 (44%) were classified as survivors and 28 (56%) as non-survivors. We compared the 2 groups for risk factors of in-hospital mortality and to establish proper PCPS timing. Twenty patients underwent PCPS for acute myocardial infarction, 20 for severe cardiopulmonary failure after cardiac surgery, 7 for acute respiratory distress syndrome, and 3 for acute myocarditis. Multivariate analysis showed that an acute physiology, age, and chronic health evaluation (APACHE) III score >or=50 prior to PCPS was the only significant predictor of in-hospital mortality (P=0.001). Overall 18-month survival was 42.2%. Cox analysis showed patients with APACHE III scores >or=50 had a poor prognosis (P=0.001). Earlier application of PCPS, and other preemptive strategies designed to optimize high-risk patients, may improve patient outcomes. Identifying patients with high APACHE scores at the beginning of PCPS may predict in-hospital mortality. Survivors, particularly those with higher APACHE scores, may require more frequent follow-up to improve overall survival.

  11. Exercise Dependence

    OpenAIRE

    Vardar, Erdal

    2012-01-01

    Exercise dependence define a condition in which a person performs excessive exercise resulting in deterioration of his or her physical and mental health wellness. Despite many clinical research studies on exercise dependence, exact diagnostic criteria has not been developed yet. Clinical evidences concerning etiology, epidemiology, underlying mechanisms and treatment of exercise dependence are still not sufficient. Moreover, evaluation of this clinical disorder within dependency perspective...

  12. Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Takara, L.S.; Cunha, T.M.; Barbosa, P.; Rodrigues, M.K.; Oliveira, M.F.; Nery, L.E. [Setor de Função Pulmonar e Fisiologia Clínica do Exercício, Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil); Neder, J.A. [Setor de Função Pulmonar e Fisiologia Clínica do Exercício, Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil); Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen' s University, Kingston, ON (Canada)

    2012-10-15

    This study evaluated the dynamic behavior of total and compartmental chest wall volumes [(V{sub CW}) = rib cage (V{sub RC}) + abdomen (V{sub AB})] as measured breath-by-breath by optoelectronic plethysmography during constant-load exercise in patients with stable chronic obstructive pulmonary disease. Thirty males (GOLD stages II-III) underwent a cardiopulmonary exercise test to the limit of tolerance (Tlim) at 75% of peak work rate on an electronically braked cycle ergometer. Exercise-induced dynamic hyperinflation was considered to be present when end-expiratory (EE) V{sub CW} increased in relation to resting values. There was a noticeable heterogeneity in the patterns of V{sub CW} regulation as EEV{sub CW} increased non-linearly in 17/30 “hyperinflators” and decreased in 13/30 “non-hyperinflators” (P < 0.05). EEV{sub AB} decreased slightly in 8 of the “hyperinflators”, thereby reducing and slowing the rate of increase in end-inspiratory (EI) V{sub CW} (P < 0.05). In contrast, decreases in EEV{sub CW} in the “non-hyperinflators” were due to the combination of stable EEV{sub RC} with marked reductions in EEV{sub AB}. These patients showed lower EIV{sub CW} and end-exercise dyspnea scores but longer Tlim than their counterparts (P < 0.05). Dyspnea increased and Tlim decreased non-linearly with a faster rate of increase in EIV{sub CW} regardless of the presence or absence of dynamic hyperinflation (P < 0.001). However, no significant between-group differences were observed in metabolic, pulmonary gas exchange and cardiovascular responses to exercise. Chest wall volumes are continuously regulated during exercise in order to postpone (or even avoid) their migration to higher operating volumes in patients with COPD, a dynamic process that is strongly dependent on the behavior of the abdominal compartment.

  13. Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    L.S. Takara

    2012-12-01

    Full Text Available This study evaluated the dynamic behavior of total and compartmental chest wall volumes [(V CW = rib cage (V RC + abdomen (V AB] as measured breath-by-breath by optoelectronic plethysmography during constant-load exercise in patients with stable chronic obstructive pulmonary disease. Thirty males (GOLD stages II-III underwent a cardiopulmonary exercise test to the limit of tolerance (Tlim at 75% of peak work rate on an electronically braked cycle ergometer. Exercise-induced dynamic hyperinflation was considered to be present when end-expiratory (EE V CW increased in relation to resting values. There was a noticeable heterogeneity in the patterns of V CW regulation as EEV CW increased non-linearly in 17/30 "hyperinflators" and decreased in 13/30 "non-hyperinflators" (P < 0.05. EEV AB decreased slightly in 8 of the "hyperinflators", thereby reducing and slowing the rate of increase in end-inspiratory (EI V CW (P < 0.05. In contrast, decreases in EEV CW in the "non-hyperinflators" were due to the combination of stable EEV RC with marked reductions in EEV AB. These patients showed lower EIV CW and end-exercise dyspnea scores but longer Tlim than their counterparts (P < 0.05. Dyspnea increased and Tlim decreased non-linearly with a faster rate of increase in EIV CW regardless of the presence or absence of dynamic hyperinflation (P < 0.001. However, no significant between-group differences were observed in metabolic, pulmonary gas exchange and cardiovascular responses to exercise. Chest wall volumes are continuously regulated during exercise in order to postpone (or even avoid their migration to higher operating volumes in patients with COPD, a dynamic process that is strongly dependent on the behavior of the abdominal compartment.

  14. Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    This study evaluated the dynamic behavior of total and compartmental chest wall volumes [(VCW) = rib cage (VRC) + abdomen (VAB)] as measured breath-by-breath by optoelectronic plethysmography during constant-load exercise in patients with stable chronic obstructive pulmonary disease. Thirty males (GOLD stages II-III) underwent a cardiopulmonary exercise test to the limit of tolerance (Tlim) at 75% of peak work rate on an electronically braked cycle ergometer. Exercise-induced dynamic hyperinflation was considered to be present when end-expiratory (EE) VCW increased in relation to resting values. There was a noticeable heterogeneity in the patterns of VCW regulation as EEVCW increased non-linearly in 17/30 “hyperinflators” and decreased in 13/30 “non-hyperinflators” (P < 0.05). EEVAB decreased slightly in 8 of the “hyperinflators”, thereby reducing and slowing the rate of increase in end-inspiratory (EI) VCW (P < 0.05). In contrast, decreases in EEVCW in the “non-hyperinflators” were due to the combination of stable EEVRC with marked reductions in EEVAB. These patients showed lower EIVCW and end-exercise dyspnea scores but longer Tlim than their counterparts (P < 0.05). Dyspnea increased and Tlim decreased non-linearly with a faster rate of increase in EIVCW regardless of the presence or absence of dynamic hyperinflation (P < 0.001). However, no significant between-group differences were observed in metabolic, pulmonary gas exchange and cardiovascular responses to exercise. Chest wall volumes are continuously regulated during exercise in order to postpone (or even avoid) their migration to higher operating volumes in patients with COPD, a dynamic process that is strongly dependent on the behavior of the abdominal compartment

  15. Cardiac Parasympathetic Reactivation in Elite Soccer Players During Different Types of Traditional High-Intensity Training Exercise Modes and Specific Tests: Interests and Limits

    Directory of Open Access Journals (Sweden)

    Dellal

    2015-12-01

    Full Text Available Background The cardiac parasympathetic reactivation is currently used in soccer with a daily or weekly monitoring. However, previous studies have not investigated how this cardiac parasympathetic reactivation is in elite soccer players along different types of traditional high-intensity training exercise and specific tests. In this context, the present study aim to analyse it and to determine the interests and limits of this type of physiological information. Objectives The present study aims to examine how different traditional training exercise modes affect the cardiac parasympathetic reactivation function in elite soccer players. Materials and Methods Twenty-two international soccer players participating in UEFA Champion’s League took part in this study (age: 24.3 ± 4.2 years; height: 178.1 ± 6.2 cm; body mass: 80.3 ± 5.7 kg. Players performed different training methods including: short-duration intermittent exercises (INT in-line and with changes of direction (COD (10 - 10 seconds, 15 - 15 seconds, 30 - 30 seconds, e.g. an alternance of 10 - 10 seconds is 10 seconds of running according to the maximal aerobic speed (MAS and 10-sec of recovery, INT including agility and technical skills (8 - 24-seconds, small-sided-games (SSGs with and without goalkeepers (2 vs. 2, 3 vs. 3, 4 vs. 4, and repeated sprint ability (RSA efforts (10 × 20 m, 10 × 30 m, 15 × 20 m. Heart rate (HR decline was recorded 3 minutes after each exercise. Results HR declines were greater after the RSA compared to SSGs (P < 0.001 and INT (P < 0.01, especially at 1 min post-exercise. In addition, when the analysis focused on each type of exercise, greater HR declines were observed in on-field players at 1 minute when there was: inclusion of goalkeepers in SSGs (for 2 vs. 2 and 3 vs. 3, P < 0.01; increase of sprint distances or number of sprint repetitions in RSA (P < 0.01; increase of intensity (% of maximal aerobic speed, and the use of COD or inclusion of technical

  16. [Controlled study of the effect of sports training on cardiopulmonary functions in asthmatic children and adolescents].

    Science.gov (United States)

    Rothe, T; Köhl, C; Mansfeld, H J

    1990-09-01

    The influence of physical training on the cardiopulmonary system and on lung function of asthmatic children was determined in a controlled study. The children were all indoor patients of the Hochgebirgsklinik Davos, Switzerland. 36 children at the age of 10 to 16 years entered the study. They were placed into either a "free running group", a "swimming group" or a "control group." The children of the training groups underwent a training of at least 10 units of 30 minutes each in 3 weeks. The control group did not participate in any regular physical training. Heart rate was measured before and after a bicycle ergometer exercise of 5 minutes at 2.5 watts/kg body weight. This was repeated at the end of the study. In the "free running group" a significant decrease of the heart rate at rest (p less than 0.05) and at the end of bicycle ergometer exercise (p less than 0.01) could be seen. In the "swimming group" the decrease of the latter was significant (p less than 0.05). In both groups an increase in work tolerance could be demonstrated, but not in the "control group." In all three groups an improvement of lung function (IVC, FEV1) was found, but it was not significant in any of the groups. The small improvement might be due to a reduction in allergen exposure and better medical treatment. The study confirms the possibility of physical training of children with asthma even if exercise-induced asthmatic signs and symptoms are present. PMID:2263585

  17. Participation in IAEA proficiency test exercise on major, minor and trace elements in ancient Chinese ceramic (IAEA-CU-2006-06) using low power research reactor

    International Nuclear Information System (INIS)

    A proficiency test (PT) exercise was offered by the International Atomic Energy Agency (IAEA) for major, minor and trace elements in Chinese ceramic reference material (IAEA-CU-2006-06). Neutron activation analysis (NAA) laboratory at PINSTECH, Pakistan participated in the exercise and submitted the results for 28 elements. The aim of participation was to develop a suitable methodology for accurate measurement of as many elements as possible in ceramic material using a low power reactor (PARR-2) as this would help future investigation in a project on the authenticity of art objects, for provenance, conservation and management of ancient cultural heritage of the country. After receiving the final report of the PT exercise, a critical review of our data and final scoring of each element is made to check the suitability of our methodology and reliability of the acquired data. Most of the reported results passed different statistical evaluation criterion such as relative bias, z-score and u-scores and ratio of our results and IAEA target values. One element (Yb) falls in the unacceptable range of relative bias and z-scores. Hf and Tb showed slightly high z-scores within the questionable range. Ho, Mo and Sn were determined during this study but their results were not submitted to the IAEA. The confidence of accuracy observed for most of the elements in ceramic material has made it mandatory to report their results as information values. (author)

  18. Exercise addiction

    DEFF Research Database (Denmark)

    Lichtenstein, Mia Beck; Christiansen, Erik; Elklit, Ask;

    2014-01-01

    Exercise addiction is characterized by excessive exercise patterns with potential negative consequences such as overuse injuries. The aim of this study was to compare eating disorder symptoms, quality of life, personality traits and attachments styles in exercisers with and without indications......-Form 36, the NEO Personality Inventory Revised and the Adult Attachment Scale. The addiction group scored higher on eating disorder symptoms, especially on perfectionism but not as high as eating disorder populations. The characteristic personality traits in the addiction group were high levels...... of exercise addiction. A case-control study with 121 exercisers was conducted. The exercisers were categorized into an addiction group (n=41) or a control group (n=80) on the basis of their responses to the Exercise Addiction Inventory. The participants completed the Eating Disorder Inventory 2, the Short...

  19. Exercise addiction.

    Science.gov (United States)

    Landolfi, Emilio

    2013-02-01

    This article examines the nature of exercise addiction. It presents a broad, congruent and discerning narrative literature review with the aim of providing a deeper understanding of the condition 'exercise addiction', including symptoms and options for treatment. In addition, guidelines are provided with respect to 'healthy' levels of exercise. Criteria used for determining the eligibility of studies evaluated in the review included the provision of relevant information in studies identified using pertinent search terms. The review highlights some of the key distinctions between healthy levels of exercise and exercise addiction. The findings suggest that an individual who is addicted to exercise will continue exercising regardless of physical injury, personal inconvenience or disruption to other areas of life including marital strain, interference with work and lack of time for other activities. 'Addicted' exercisers are more likely to exercise for intrinsic rewards and experience disturbing deprivation sensations when unable to exercise. In contrast, 'committed' exercisers engage in physical activity for extrinsic rewards and do not suffer severe withdrawal symptoms when they cannot exercise. Exercisers must acquire a sense of life-balance while embracing an attitude conducive to sustainable long-term physical, psychological and social health outcomes. Implementation of recommendations by the Canadian Society for Exercise Physiology, which states that all apparently healthy adults between 18 and 64 years of age should accumulate at least 150 minutes of moderate (5 or 6 on a scale of 0-10) to vigorous (7 or 8 on a scale of 0-10) intensity aerobic physical activity per week in bouts of 10 minutes or more, also expressed as 30 minutes per day distributed over 5 days per week, would be a good start.

  20. Does the incremental shuttle walk test require maximal effort in young obese women?

    Science.gov (United States)

    Jürgensen, S P; Trimer, R; Di Thommazo-Luporini, L; Dourado, V Z; Bonjorno-Junior, J C; Oliveira, C R; Arena, R; Borghi-Silva, A

    2016-07-11

    Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX) on a treadmill to responses obtained by the incremental shuttle walk test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 - age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (Pobese women when CPX is not a viable option. PMID:27409333