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Exercise physiology heart failure

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https://www.readbyqxmd.com/read/28636647/hemodynamic-and-metabolic-characteristics-associated-with-development-of-a-right-ventricular-outflow-tract-pressure-gradient-during-upright-exercise
#1
Annelieke C M J van Riel, David M Systrom, Rudolf K F Oliveira, Michael J Landzberg, Barbara J M Mulder, Berto J Bouma, Bradley A Maron, Amil M Shah, Aaron B Waxman, Alexander R Opotowsky
BACKGROUND: We recently reported a novel observation that many patients with equal resting supine right ventricular(RV) and pulmonary artery(PA) systolic pressures develop an RV outflow tract(RVOT) pressure gradient during upright exercise. The current work details the characteristics of patients who develop such an RVOT gradient. METHODS: We studied 294 patients (59.7±15.5 years-old, 49% male) referred for clinical invasive cardiopulmonary exercise testing, who did not have a resting RVOT pressure gradient defined by the simultaneously measured peak-to-peak difference between RV and PA systolic pressures...
2017: PloS One
https://www.readbyqxmd.com/read/28597791/value-of-latent-outflow-obstruction-to-predict-clinical-course-of-patients-with-hypertrophic-cardiomyopathy
#2
Fatih Bayrak, Gokhan Kahveci, Ali Buturak, Tansu Karaahmet, Ulaankhuu Batgerel, Atilla Koyuncu, Bulent Mutlu
Objective The frequency, significance and prognostic value of left ventricle obstruction (LVO) induced with provocation (latent LVO) is controversial for hypertrophic cardiomyopathy (HC) patients. This study was designed to assess the value of latent LVO in predicting the clinical course in 101 patients with HC. Methods and results Patients were followed for a mean of 82 ± 48 months (range 2 to 148 months) for clinical end points defined as a composite of cardiovascular death resuscitated cardiac arrest, appropriate defibrillator shock or hospitalization due to worsening of heart failure symptoms...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28552098/cardiopulmonary-exercise-testing-in-aortic-stenosis
#3
Van Doan Tuyet Le
Patients with moderate to severe aortic stenosis (AVA <1.3 cm(2)) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm(2)/m(2). By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation corresponding to NYHA≥II...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28525585/the-effects-of-gender-on-electrical-therapies-for-the-heart-physiology-epidemiology-and-access-to-therapies-a-report-from-the-xii-congress-of-the-italian-association-on-arrhythmology-and-cardiostimulation-aiac
#4
Giuseppe Boriani, Stefano Lorenzetti, Elisabetta Cerbai, Giuseppe Oreto, Gabriele Bronzetti, Vincenzo Livio Malavasi, Alessandro Biffi, Luigi Padeletti, Gianluca Botto, Igor Diemberger
The difference between men and women is clear even just by looking at an electrocardiogram: females present higher resting heart rate, a shorter QRS complex length and greater corrected QT interval. The development of these differences from pubertal age onward suggests that sexual hormones play a key role, although their effect is far from being completely understood. Different incidences between sexes have been reported for many arrhythmias, both ventricular and supraventricular, and also for sudden cardiac death...
May 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28520537/anomalous-origin-of-right-coronary-artery-from-left-coronary-sinus-13-cases-treated-with-the-reimplantation-technique
#5
Alain Cubero, Alejandro Crespo, Gadah Hamzeh, Andrés Cortes, Daniel Rivas, José Ignacio Aramendi
OBJECTIVES: Anomalous aortic origin of a coronary artery is uncommon but potentially clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe our experience with surgical reimplantation and results at midterm follow-up. METHODS: Between February 2003 and July 2016, a total of 13 patients with anomalous origin of the right coronary artery (RCA) from the left sinus underwent surgical reimplantation...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28467921/molecular-mechanisms-underlying-cardiac-adaptation-to-exercise
#6
REVIEW
Rick B Vega, John P Konhilas, Daniel P Kelly, Leslie A Leinwand
Exercise elicits coordinated multi-organ responses including skeletal muscle, vasculature, heart, and lung. In the short term, the output of the heart increases to meet the demand of strenuous exercise. Long-term exercise instigates remodeling of the heart including growth and adaptive molecular and cellular re-programming. Signaling pathways such as the insulin-like growth factor 1/PI3K/Akt pathway mediate many of these responses. Exercise-induced, or physiologic, cardiac growth contrasts with growth elicited by pathological stimuli such as hypertension...
May 2, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28417963/loop-diuretics-affect-skeletal-myoblast-differentiation-and-exercise-induced-muscle-hypertrophy
#7
Shintaro Mandai, Susumu Furukawa, Manami Kodaka, Yutaka Hata, Takayasu Mori, Naohiro Nomura, Fumiaki Ando, Yutaro Mori, Daiei Takahashi, Yuki Yoshizaki, Yuri Kasagi, Yohei Arai, Emi Sasaki, Sayaka Yoshida, Yasuro Furuichi, Nobuharu L Fujii, Eisei Sohara, Tatemitsu Rai, Shinichi Uchida
Muscle wasting or sarcopenia contributes to morbidity and mortality in patients with cancer, renal failure, or heart failure, and in elderly individuals. Na(+)-K(+)-2Cl(-) cotransporter 1 (NKCC1) is highly expressed in mammalian skeletal muscle, where it contributes to the generation of membrane ion currents and potential. However, the physiologic function of NKCC1 in myogenesis is unclear. We investigated this issue using the NKCC1 inhibitors bumetanide and furosemide, which are commonly used loop diuretics...
April 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28380304/cardiopulmonary-exercise-testing-in-heart-failure-patients-with-specific-comorbidities
#8
Massimo F Piepoli, Ugo Corrà, Piergiuseppe Agostoni
Exercise capacity is one of the most powerful predicting factors of life expectancy, both in patients with and without cardiac disease. Cardiopulmonary exercise testing provides a global assessment of the integrative exercise responses involving the pulmonary, cardiovascular, hematopoietic, neuropsychological, and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. This relatively noninvasive, dynamic, physiologic overview allows the evaluation of both submaximal and peak exercise responses, providing the physician with relevant information for clinical decision making...
April 5, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28283496/physical-activity-guided-by-pulse-pressure-in-patients-with-continuous-flow-left-ventricular-assist-devices-a-pilot-study
#9
LETTER
Sven Haufe, Christoph Bara, Julian Eigendorf, Kristine Chobanyan-Jürgens, Sebastian V Rojas, Jan Schmitto, Uwe Tegtbur, Jens Jordan, Jens Tank
No abstract text is available yet for this article.
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28275174/physiological-and-clinical-relevance-of-exercise-ventilatory-efficiency-in-copd
#10
REVIEW
J Alberto Neder, Danilo C Berton, Flavio F Arbex, Maria Clara Alencar, Alcides Rocha, Priscila A Sperandio, Paolo Palange, Denis E O'Donnell
Exercise ventilation (V'E) relative to carbon dioxide output (V'CO2 ) is particularly relevant to patients limited by the respiratory system, e.g. those with chronic obstructive pulmonary disease (COPD). High V'E-V'CO2 (poor ventilatory efficiency) has been found to be a key physiological abnormality in symptomatic patients with largely preserved forced expiratory volume in 1 s (FEV1). Establishing an association between high V'E-V'CO2 and exertional dyspnoea in mild COPD provides evidence that exercise intolerance is not a mere consequence of detraining...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28255866/heart-failure-with-preserved-ejection-fraction-and-skeletal-muscle-physiology
#11
REVIEW
Stephen D Farris, Farid Moussavi-Harami, April Stempien-Otero
Heart failure with preserved ejection fraction (HFpEF) accounts for half of all heart failure in the USA, increases in prevalence with aging, and has no effective therapies. Intriguingly, the pathophysiology of HFpEF has many commonalities with the aged cardiovascular system including reductions in diastolic compliance, chronotropic defects, increased resistance in the peripheral vasculature, and poor energy substrate utilization. Decreased exercise capacity is a cardinal symptom of HFpEF. However, its severity is often out of proportion to changes in cardiac output...
March 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28246204/science-signaling-podcast-for-28-february-2017-balancing-autophagy-in-the-stressed-heart
#12
Saumya Das, Annalisa M VanHook
This Podcast features an interview with Saumya Das, senior author of a Research Article that appears in the 28 February 2017 issue of Science Signaling, about a protein that inhibits pathological cardiac hypertrophy in mice. Temporary increases in cardiac workload, such as those caused by exercise or pregnancy, induce physiological cardiac hypertrophy, a beneficial type of heart enlargement that is adaptive. However, a sustained increase in workload due to metabolic stress or uncontrolled high blood pressure induces pathological cardiac hypertrophy, which can contribute to heart failure...
February 28, 2017: Science Signaling
https://www.readbyqxmd.com/read/28246202/ddit4l-promotes-autophagy-and-inhibits-pathological-cardiac-hypertrophy-in-response-to-stress
#13
Bridget Simonson, Vinita Subramanya, Mun Chun Chan, Aifeng Zhang, Hannabeth Franchino, Filomena Ottaviano, Manoj K Mishra, Ashley C Knight, Danielle Hunt, Ionita Ghiran, Tejvir S Khurana, Maria I Kontaridis, Anthony Rosenzweig, Saumya Das
Physiological cardiac hypertrophy, in response to stimuli such as exercise, is considered adaptive and beneficial. In contrast, pathological cardiac hypertrophy that arises in response to pathological stimuli such as unrestrained high blood pressure and oxidative or metabolic stress is maladaptive and may precede heart failure. We found that the transcript encoding DNA damage-inducible transcript 4-like (DDiT4L) was expressed in murine models of pathological cardiac hypertrophy but not in those of physiological cardiac hypertrophy...
February 28, 2017: Science Signaling
https://www.readbyqxmd.com/read/28210939/deep-phenotyping-of-systemic-arterial-hemodynamics-in-hfpef-part-1-physiologic-and-technical-considerations
#14
REVIEW
Julio A Chirinos
A better understanding of the pathophysiology of heart failure with a preserved left ventricular ejection fraction (HFpEF) is important. Detailed phenotyping of pulsatile hemodynamics has provided important insights into the pathophysiology of left ventricular remodeling and fibrosis, diastolic dysfunction, microvascular disease, and impaired oxygen delivery to peripheral skeletal muscle, all of which contribute to exercise intolerance, the cardinal feature of HFpEF. Furthermore, arterial pulsatile hemodynamic mechanisms likely contribute to the frequent presence of comorbidities, such as renal failure and dementia, in this population...
February 16, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28151429/the-influence-of-adipose-tissue-on-spatially-resolved-near-infrared-spectroscopy-derived-skeletal-muscle-oxygenation-the-extent-of-the-problem
#15
Victor M Niemeijer, Jasper P Jansen, Thomas van Dijk, Ruud F Spee, Eduard J Meijer, Hareld M C Kemps, Pieter F F Wijn
OBJECTIVE: Near-infrared spectroscopy (NIRS) measurements of tissue oxygen saturation (StO2) are useful for the assessment of skeletal muscle perfusion and function during exercise, however, they are influenced by overlying skin and adipose tissue. This study explored the extent and nature of the influence of adipose tissue thickness (ATT) on StO2. APPROACH: NIR spatially resolved spectroscopy (SRS) derived oxygenation was measured on vastus lateralis in 56 patients with chronic heart failure (CHF) and 20 healthy control (HC) subjects during rest and moderate intensity exercise with simultaneous assessment of oxygen uptake kinetics (τ [Formula: see text])...
February 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28118062/taurine-supplementation-improves-functional-capacity-myocardial-oxygen-consumption-and-electrical-activity-in-heart-failure
#16
RANDOMIZED CONTROLLED TRIAL
Mehdi Ahmadian, Valiollah Dabidi Roshan, Eadeh Ashourpore
BACKGROUND: Taurine is an amino acid found abundantly in the heart in very high concentrations. It is assumed that taurine contributes to several physiological functions of mammalian cells, such as osmoregulation, anti-inflammation, membrane stabilization, ion transport modulation, and regulation of oxidative stress and mitochondrial protein synthesis. The objective of the current study was to evaluate the effectiveness of taurine supplementation on functional capacity, myocardial oxygen consumption, and electrical activity in patients with heart failure...
July 4, 2017: Journal of Dietary Supplements
https://www.readbyqxmd.com/read/28111407/determinants-of-aortic-size-and-stiffness-and-the-impact-on-exercise-physiology-in-patients-after-the-fontan-operation
#17
Hideo Ohuchi, Yosuke Hayama, Jun Negishi, Kanae Noritake, Aya Miyazaki, Osamu Yamada, Isao Shiraishi
The pathophysiology of congenital heart disease includes aortic dilation and increased stiffness. However, the clinical determinants and significance remain unclear in patients after the Fontan operation.Size and stiffness index (SI) of the ascending and descending aorta (aAO and dAO, respectively) were assessed using angiography in 130 consecutive Fontan patients and 30 age-matched controls. Compared with controls, Fontan patients showed a dilated aAO and smaller dAO (P < 0.0001) with greater SI (3.2 ± 0...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28105791/the-future-of-pleiotropic-therapy-in-heart-failure-lessons-from-the-benefits-of-exercise-training-on-endothelial-function
#18
REVIEW
Gilles W De Keulenaer, Vincent F M Segers, Faiez Zannad, Dirk L Brutsaert
A novel generation of drugs is introduced in the treatment of heart failure (HF). These drugs, including phosphodiesterase-5 inhibitors, guanylate cyclase stimulators and activators, share the feature that their action is either endothelial-mediated or substitutes for endothelial pathways, in particular the nitric oxide-cyclic guanosine monophosphate pathway, thereby influencing homeostatic balances in virtually each organ system in a pleiotropic fashion. Unfortunately, recent clinical trials with some of these drugs have shown disappointing results, at least in the setting of HF with a preserved ejection fraction...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28091823/skeletal-muscle-inflammation-and-atrophy-in-heart-failure
#19
Kory J Lavine, Oscar L Sierra
Heart failure represents a systemic disease with profound effects on multiple peripheral tissues including skeletal muscle. Within the context of heart failure, perturbations in skeletal muscle physiology, structure, and function strongly contribute to exercise intolerance and the morbidity of this devastating disease. There is growing evidence that chronic heart failure imparts specific pathological changes within skeletal muscle beds resulting in muscle dysfunction and tissue atrophy. Mechanistically, systemic and local inflammatory responses drive critical aspects of this pathology...
March 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28069473/high-intensity-training-improves-global-and-segmental-strains-in-severe-congestive-heart-failure
#20
Yair Blumberg, Offir Ertracht, Itai Gershon, Noa Bachner-Hinenzon, Tali Reuveni, Shaul Atar
BACKGROUND: High-intensity training (HIT) is superior to moderate aerobic training (MAT) for improving quality of life in congestive heart failure (CHF) patients. Speckle-tracking echocardiography (STE) has recently been suggested for estimation of left ventricle global and regional function. We evaluated the utility of STE for characterizing differences in cardiac function following MAT or HIT in a CHF rat model. METHODS AND RESULTS: After baseline physiologic assessment, CHF was induced by means of coronary artery ligation in Sprague-Dawley rats...
May 2017: Journal of Cardiac Failure
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