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Cardiopulmonary exercise testing. (CPET)

Ugo Corrà
Cardiopulmonary exercise testing (CPET) is a specialized subtype of exercise testing that provides a more accurate and objective measure of cardiorespiratory fitness (CRF). CPET relies on measurement of ventilatory gases during exercise, i.e., a non-invasive procedure that involves the acquisition of expired ventilation and concentrations of oxygen (O2) and carbon dioxide (CO2) during progressive exercise. The non-invasive measurement of ventilation and expired gases permits the most accurate and reproducible quantification of CRF, a grading of the etiology and severity of impairment, and an objective assessment of the response to an intervention...
October 14, 2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Tieh-Cheng Fu, Wen-Chen Lin, Jong-Shyan Wang, Chao-Hung Wang, Chun-Tien Chang, Cheng-Lun Tsai, Yun-Shien Lee, Kang-Ping Lin
Exercise periodic breathing (EPB) is associated with exercise intolerance and poor prognosis in patients with heart failure (HF). However, EPB detection during cardiopulmonary exercise test (CPET) is difficult. The present study investigated the use of a wireless monitoring device to record the EPB during CPET and proposed quantization parameter estimates for the EPB. A total of 445 patients with HF were enrolled and underwent exercise tests. The ventilation data from the wearable device were compared with the data obtained during the CPET and were analyzed based on professional opinion and on 2 automated programs (decision tree [DT] and oscillatory pattern methods)...
October 15, 2016: Medical & Biological Engineering & Computing
Leonida Compostella, Nenad Lakusic, Nicola Russo, Tiziana Setzu, Caterina Compostella, Elia Vettore, Giambattista Isabella, Giuseppe Tarantini, Sabino Iliceto, Fabio Bellotto
BACKGROUND: Depressed heart rate variability (HRV) is usually considered a negative long-term prognostic factor after acute myocardial infarction. Anyway, most of the supporting research was conducted before the era of immediate reperfusion by percutaneous coronary intervention (PCI). Main aim of this study was to evaluate if HRV still retains prognostic significance in our era of immediate PCI. METHODS AND RESULTS: Two weeks after STEMI treated by primary PCI, time-domain HRV was assessed from 24-h Holter recordings in 186 patients: markedly depressed HRV (SDNN <70ms or <50ms) was present in 16% and in 5% of cases, respectively; patients with left ventricle ejection fraction (LVEF) <40% presented more often SDNN values in the lowest quartile...
September 23, 2016: International Journal of Cardiology
Ludovic Giloteaux, Maureen R Hanson, Betsy A Keller
BACKGROUND Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) present with profound fatigue, flu-like symptoms, pain, cognitive impairment, orthostatic intolerance, and post-exertional malaise (PEM), and exacerbation of some or all of the baseline symptoms. CASE REPORT We report on a pair of 34-year-old monozygotic twins discordant for ME/CFS, with WELL, the non-affected twin, and ILL, the affected twin. Both twins performed a two-day cardiopulmonary exercise test (CPET), pre- and post-exercise blood samples were drawn, and both provided stool samples for biochemical and molecular analysis...
October 10, 2016: American Journal of Case Reports
Francesco Carli, Enrico M Minnella
Functional capacity has been shown to be a major determinant of surgical outcome since it is related to postoperative complications, activity and daily function, level of independence and quality of life. Anesthesiologists as "perioperative physicians", can identify those scoring systems that assess functional capacity, whether from the basic physical history and walk test to the most complex such as cardiopulmonary exercise testing (CPET), and formulate intraoperative and postoperative interventions (rehabilitation) to minimize the impact of surgery on the recovery process...
October 6, 2016: Minerva Anestesiologica
Gaia Cattadori, Piergiuseppe Agostoni, Ugo Corrà, Gianfranco Sinagra, Fabrizio Veglia, Elisabetta Salvioni, Alice Bonomi, Rocco La Gioia, Angela B Scardovi, Alessandro Ferraironi, Michele Emdin, Marco Metra, Andrea Di Lenarda, Giuseppe Limongelli, Rosa Raimondo, Federica Re, Marco Guazzi, Romualdo Belardinelli, Gianfranco Parati, Sergio Caravita, Damiano Magrì, Carlo Lombardi, Maria Frigerio, Fabrizio Oliva, Davide Girola, Alessandro Mezzani, Stefania Farina, Massimo Mapelli, Domenico Scrutinio, Giuseppe Pacileo, Anna Apostolo, AnnaMaria Iorio, Stefania Paolillo, Pasquale Perrone Filardi, Paola Gargiulo, Maurizio Bussotti, Giovanni Marchese, Michele Correale, Roberto Badagliacca, Susanna Sciomer, Pietro Palermo, Mauro Contini, Pantaleo Giannuzzi, Elisa Battaia, Mariantonietta Cicoira, Francesco Clemenza, Chiara Minà, Simone Binno, Claudio Passino, Massimo F Piepoli
BACKGROUND: Anemia is frequent in heart failure (HF), and it is associated with higher mortality. The predictive power of established HF prognostic parameters in anemic HF patients is unknown. METHODS: Clinical, laboratory, echocardiographic and cardiopulmonary-exercise-test (CPET) data were analyzed in 3913 HF patients grouped according to hemoglobin (Hb) values. 248 (6%), 857 (22%), 2160 (55%) and 648 (17%) patients had very low (<11g/dL), low (11-12 for females, 11-13 for males), normal (12-15 for females, 13-15 for males) and high (>15) Hb, respectively...
September 28, 2016: European Journal of Internal Medicine
Mélanie Métrich, Fortesa Mehmeti, Helene Feliciano, David Martin, Julien Regamey, Piergiorgio Tozzi, Philippe Meyer, Roger Hullin
BACKGROUND: Maximal exercise capacity after heart transplantion (HTx) is reduced to the 50-70% level of healthy controls when assessed by cardiopulmonary exercise testing (CPET) despite of normal left ventricular function of the donor heart. This study investigates the role of donor heart β1 and β2- adrenergic receptor (AR) polymorphisms for maximal exercise capacity after orthotopic HTx. METHODS: CPET measured peak VO2 as outcome parameter for maximal exercise in HTx recipients ≥9 months and ≤4 years post-transplant (n = 41; mean peak VO2: 57±15% of predicted value)...
2016: PloS One
Samantha R Warnakulasuriya, David R Yates, Jonathan T Wilson, Michael Stone, Jonathan Redman, Simon Davies
BACKGROUND: Cardiopulmonary exercise testing (CPET) can identify patients at risk of adverse post-operative outcomes following major abdominal surgery including bariatric surgery. Scoring systems that also aim to predict post-operative outcome in this group include the validated obesity surgery mortality risk score (OSMRS). This study aims to investigate if CPET has additive value to other scoring systems in predicting post-operative outcomes following bariatric surgery. METHODS: Data was collected retrospectively on 398 patients who underwent CPET between October 2008 and April 2013...
September 16, 2016: Obesity Surgery
Damiano Magrì, Federica Re, Giuseppe Limongelli, Piergiuseppe Agostoni, Elisabetta Zachara, Michele Correale, Vittoria Mastromarino, Caterina Santolamazza, Matteo Casenghi, Giuseppe Pacileo, Fabio Valente, Marco Morosin, Beatrice Musumeci, Erika Pagannone, Antonello Maruotti, Massimo Uguccioni, Massimo Volpe, Camillo Autore
BACKGROUND: Heart failure (HF) progression and its complications represent major emergent concerns in hypertrophic cardiomyopathy (HCM). We investigated the possible adjunctive role of cardiopulmonary exercise testing (CPET) in predicting HF-related events. An exercise-derived risk model, theHYPertrophicExercise-derivedRiskHF(HYPERHF), has been developed. METHODS AND RESULTS: A multicenter cohort of 620 consecutive HCM outpatients was recruited and followed (2007 to 2015)...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Mahsa Mirdamadi, Besharat Rahimi, Enayat Safavi, Hamidreza Abtahi, Soheil Peiman
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...
August 2016: Journal of Thoracic Disease
Cecile Chenivesse, Sarah Boulanger, Carole Langlois, Lidwine Wemeau-Stervinou, Thierry Perez, Benoit Wallaert
BACKGROUND: Common tests for evaluating gas exchange impairment have different strengths and weaknesses. Alveolar-to-arterial oxygen pressure difference (AaDO2) at peak exercise is a sensitive indicator but it cannot be measured repeatedly. Diffusing capacity of the lung for carbon monoxide (DLco) is measured at rest and may be too insensitive to predict the effects of exercise on gas exchange impairment. Oxygen desaturation during a 6-minute walk test (∆SpO2-6MWT) can be measured repeatedly, but its value in sarcoidosis is unknown...
August 2016: Journal of Thoracic Disease
Jittima Saengsuwan, Lucia Berger, Corina Schuster-Amft, Tobias Nef, Kenneth J Hunt
BACKGROUND: Exercise testing devices for evaluating cardiopulmonary fitness in patients with severe disability after stroke are lacking, but we have adapted a robotics-assisted tilt table (RATT) for cardiopulmonary exercise testing (CPET). Using the RATT in a sample of patients after stroke, this study aimed to investigate test-retest reliability and repeatability of CPET and to prospectively investigate changes in cardiopulmonary outcomes over a period of four weeks. METHODS: Stroke patients with all degrees of disability underwent 3 separate CPET sessions: 2 tests at baseline (TB1 and TB2) and 1 test at follow up (TF)...
2016: BMC Neurology
Hilary F Armstrong, David J Lederer, Matthew Bacchetta, Matthew N Bartels
BACKGROUND: Adults with primary graft dysfunction (PGD) after lung transplantation are at increased risk for pulmonary and functional impairment. No prior studies have described the long-term (within 1.5 years of transplant) cardiopulmonary exercise testing (CPET) results in adults with grade 3 PGD. The objective of this study was to compare the functional outcomes of lung transplant patients with and without grade 3 PGD via CPET and six-minute talk tests (6MWD). METHODS: 243 adults underwent lung transplantation between 2003 and 2010, 128 (53%) of whom underwent CPET and 6MWD within 12-18 months of transplantation...
September 1, 2016: Heart & Lung: the Journal of Critical Care
M A West, L Loughney, G Ambler, B D Dimitrov, J J Kelly, M G Mythen, R Sturgess, P M A Calverley, A Kendrick, M P W Grocott, S Jack
BACKGROUND: In 2014 approximately 21,200 patients were diagnosed with oesophageal and gastric cancer in England and Wales, of whom 37 % underwent planned curative treatments. Potentially curative surgical resection is associated with significant morbidity and mortality. For operable locally advanced disease, neoadjuvant chemotherapy (NAC) improves survival over surgery alone. However, NAC carries the risk of toxicity and is associated with a decrease in physical fitness, which may in turn influence subsequent clinical outcome...
2016: BMC Cancer
Shao-Min Chen, Rong He, Wei-Hong Li, Zhao-Ping Li, Bao-Xia Chen, Xin-Heng Feng
BACKGROUND: Elevated left ventricular filling pressure (LVFP) is an important cause of exercise intolerance in patients with atrial fibrillation (AF). Exercise stress echocardiography could assess LVFP during exercise. The objective of this study was to investigate the relationship between exercise induced elevation of LVFP and exercise capacity in patients with AF. METHODS: This study included 145 consecutive patients (81 men and 64 women; mean age 65.5 ± 8.0 years) with persistent non-valvular AF and normal left ventricular systolic function (left ventricular ejection fraction ≥ 50%)...
September 2016: Journal of Geriatric Cardiology: JGC
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, Katherine A Webb, J Alberto Neder, Donald A Mahler
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...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Gianfranco Sinagra, Annamaria Iorio, Marco Merlo, Antonio Cannatà, Davide Stolfo, Elena Zambon, Concetta Di Nora, Stefania Paolillo, Giulia Barbati, Emanuela Berton, Cosimo Carriere, Damiano Magrì, Gaia Cattadori, Marco Confalonieri, Andrea Di Lenarda, Piergiuseppe Agostoni
BACKGROUND: Although cardiopulmonary exercise testing (CPET) is considered as an important tool in risk stratification of patients with heart failure (HF), prognostic data in the specific setting of Idiopathic Dilated Cardiomyopathy (iDCM) are still undetermined. The aim of the study was to test the prognostic value of CPET in a large cohort of iDCM patients. METHODS AND RESULTS: We analyzed 381 iDCM patients who consecutively performed CPET. The study end-point was a composite of cardiovascular death/urgent heart transplantation (CVD/HTx)...
November 15, 2016: International Journal of Cardiology
Roberto Badagliacca, Silvia Papa, Gabriele Valli, Beatrice Pezzuto, Roberto Poscia, Giovanna Manzi, Elisa Giannetta, Susanna Sciomer, Paolo Palange, Robert Naeije, Francesco Fedele, Carmine Dario Vizza
BACKGROUND: Right ventricular (RV) function is a major determinant of exercise intolerance and outcome in idiopathic pulmonary arterial hypertension (IPAH). The aim of the study was to evaluate the incremental prognostic value of echocardiography of the RV and cardiopulmonary exercise testing (CPET) on long-term prognosis in these patients. METHODS: One hundred-thirty treatment-naïve IPAH patients were enrolled and prospectively followed. Clinical worsening (CW) was defined by a reduction in 6-minute walk distance plus an increase in functional class, or non elective hospitalization for PAH, or death...
August 20, 2016: Chest
M Ney, M J Haykowsky, B Vandermeer, A Shah, M Ow, P Tandon
BACKGROUND: Cardiopulmonary exercise testing (CPET) is the gold standard for the objective assessment of functional status. In many conditions, CPET outperforms the traditional variables in predicting mortality. AIM: In patients with cirrhosis listed for liver transplantation, our primary aim was to determine the prognostic value of CPET for pre-and post-transplant mortality and, in particular, whether CPET remained predictive after adjustment for liver disease severity...
October 2016: Alimentary Pharmacology & Therapeutics
Nils Cornelis, Roselien Buys
BACKGROUND: Cardiopulmonary exercise testing (CPET) has become part of screening and evaluation in cardiology. The exercise modalities most often used in CPET are the treadmill (TM) and upright bicycle (UB). Nowadays, also the supine bicycle (SB) is becoming more often used, especially when combined with cardiac imaging. OBJECTIVES: Our aim was to examine whether a maximal CPET on a SB leads to similar results as TM and UB in terms of different CPET measures. Secondly, we explored whether peak VO2 relates to the person's preference and experience with the different exercise modalities...
November 1, 2016: International Journal of Cardiology
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