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clinical exercise physiology

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https://www.readbyqxmd.com/read/28210939/deep-phenotyping-of-systemic-arterial-hemodynamics-in-hfpef-part-1-physiologic-and-technical-considerations
#1
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/28209728/evaluation-of-cell-therapy-on-exercise-performance-and-limb-perfusion-in-peripheral-artery-disease-the-cctrn-patients-with-intermittent-claudication-injected-with-aldh-bright-cells-pace-trial
#2
Emerson C Perin, Michael P Murphy, Keith L March, Roberto Bolli, John Loughran, Phillip C Yang, Nicholas J Leeper, Ronald L Dalman, Jason Q Alexander, Timothy D Henry, Jay H Traverse, Carl J Pepine, R David Anderson, Scott Berceli, James T Willerson, Raja Muthupillai, Amir A Gahremanpour, Ganesh Raveendran, Omaida C Velazquez, Joshua M Hare, Ivonne H Schulman, Vijaykumar S Kasi, William R Hiatt, Bharath Ambale-Venkatesh, João A Lima, Doris A Taylor, Micheline M Resende, Adrian P Gee, April G Durett, Jeannette Bloom, Sara Richman, Patricia G'Sell, Shari Williams, Fouzia Khan, Elsie G Ross, Michelle R Santoso, JoAnne Goldman, Dana Leach, Eileen Handberg, Benjamin Y C Cheong, Nichole A Piece, Darcy DiFede, Barb Bruhn-Ding, Emily Caldwell, Judy Bettencourt, Dejian Lai, Linda B Piller, Lara M Simpson, Michelle Cohen, Shelly L Sayre, Rachel W Vojvodic, Lem Moyé, Ray F Ebert, Robert D Simari, Alan T Hirsch
Background -Atherosclerotic peripheral artery disease (PAD) affects 8-12% of Americans over 65 and is associated with a major decline in functional status, increased myocardial infarction and stroke rates, and increased risk of ischemic amputation. Current treatment strategies for claudication have limitations. PACE is an NHLBI-sponsored, randomized, double-blind, placebo-controlled phase 2, exploratory clinical trial designed to assess safety and efficacy of autologous bone marrow-derived aldehyde dehydrogenase bright (ALDHbr) cells in PAD patients and to explore associated claudication physiologic mechanisms...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28208954/effect-of-surgical-curve-correction-on-exercise-tolerance-and-physical-capacities-in-patients-of-severe-spinal-deformity
#3
Prateek C Patil, Ashok K Rathod, Mandar Borde, Vishwajeet Singh, Hemant U Singh
INTRODUCTION: Traditionally, surgical intervention for patients with a spinal deformity has been considered for cosmetic benefits, but surgical intervention can alter the lung physiology or volumes and in turn leads to increase in physical capacity and exercise tolerance. Therefore, we conducted this to determine whether a surgical correction would restore the lung physiology, physical capacity and exercise tolerance in patients with kyphoscoliosis. AIM: To evaluate the usage of six-minute walk test scores and modified Borg scores as tools/measures for exercise tolerance in patients with spinal deformity and to study the effects of surgical correction of spinal deformity on exercise tolerance with above parameters as the measures...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28185807/specific-circulating-phospholipids-acylcarnitines-amino-acids-and-biogenic-amines-are-aerobic-exercise-markers
#4
Thomas K Felder, Susanne Ring-Dimitriou, Simon Auer, Selma M Soyal, Ludmilla Kedenko, Mark Rinnerthaler, Janne Cadamuro, Elisabeth Haschke-Becher, Elmar Aigner, Bernhard Paulweber, Wolfgang Patsch
OBJECTIVES: Regular aerobic exercise provides beneficial effects on human health and reduces all-cause mortality. Aerobic exercise has profound metabolic effects, and specific metabolites may reflect physiological changes. We aimed to identify endogenous metabolites that distinguish the trained from the untrained state to increase the spectrum of analytes amenable for hypothesis testing and to expand understanding of putative beneficial pathways. DESIGN: Cross sectional laboratory repeated measures study...
January 24, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28177716/a-role-for-maternally-derived-myokines-to-optimize-placental-function-and-fetal-growth-across-gestation
#5
Chantal Dubé, Céline Aguer, Kristi Adamo, Shannon Bainbridge
Exercise during pregnancy is associated with improved health outcomes for both mother and baby, including a reduced risk of future obesity and susceptibility to chronic diseases. Overwhelming evidence demonstrates a protective effect of maternal exercise against fetal birth weight extremes, reducing the rates of both large- and small-for-gestational-age infants. It is speculated that this protective effect is mediated in part through exercise-induced regulation of maternal physiology and placental development/function...
January 17, 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/28159654/physiological-basis-behind-ergogenic-effects-of-anabolic-androgens
#6
Ada S Cheung, Mathis Grossmann
Anabolic androgenic steroids (AAS) are widely abused by the sporting community. Demonstrating performance enhancing effects of AAS in rigorous scientific studies is fraught with difficulty. In controlled studies, AAS have consistently been reported to increase muscle mass and strength. The clinical evidence that these anabolic effects are independent of, and additive to exercise are supported by preclinical studies suggesting that AAS and exercise affect muscle by overlapping, yet distinct mechanisms. AAS may also improve performance by their actions on other organ systems, such as the vasculature, and the erythropoietic and central nervous system, although this evidence is less strong...
January 31, 2017: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/28158895/mimicking-exercise-in-three-dimensional-bioengineered-skeletal-muscle-to-investigate-cellular-and-molecular-mechanisms-of-physiological-adaptation
#7
REVIEW
Andreas M Kasper, Daniel C Turner, Neil R W Martin, Adam P Sharples
Bioengineering of skeletal muscle in-vitro in order to produce highly aligned myofibres in relevant three dimensional (3D) matrices have allowed scientists to model the in-vivo skeletal muscle niche. This review discusses essential experimental considerations for developing bioengineered muscle in order to investigate exercise mimicking stimuli. We identify current knowledge in the use of electrical stimulation and co-culture with motor neurons to enhance skeletal muscle maturation and contractile function in bioengineered systems in-vitro...
February 3, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28153943/the-cardiovascular-system-after-exercise
#8
Steven A Romero, Christopher Todd Minson, John R Halliwill
Recovery from exercise refers to the time period between the end of a bout of exercise and the subsequent return to a resting or recovered state. It also refers to specific physiological processes or states, occurring after exercise, which are distinct from the physiology of either the exercising or the resting states. In this context, recovery of the cardiovascular system after exercise occurs across a period of minutes to hours, during which many characteristics of the system, even how it is controlled, are changing over time...
February 2, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28153628/evaluation-of-dose-response-relationship-between-smoking-load-and-cardiopulmonary-fitness-in-adult-smokers-a-cross-sectional-study
#9
V T Lauria, E F Sperandio, T L W de Sousa, W de Oliveira Vieira, M Romiti, A R de Toledo Gagliardi, R L Arantes, V Z Dourado
OBJECTIVE: To evaluate the dose-response relationship between smoking load and cardiopulmonary fitness, as measured with cardiopulmonary exercise testing (CPET), in adult smokers free of respiratory diseases. METHODS: After a complete clinical evaluation and spirometry, 95 adult smokers (35 men and 60 women) underwent CPET on a treadmill. RESULTS: The physiological responses during CPET showed lower cardiorespiratory fitness levels, regardless of smoking load, with a peak [Formula: see text] lower than 100% of the expected value and a lower maximum heart rate...
January 30, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28151424/vascular-adaptation-to-exercise-in-humans-role-of-hemodynamic-stimuli
#10
REVIEW
Daniel J Green, Maria T E Hopman, Jaume Padilla, M Harold Laughlin, Dick H J Thijssen
On the 400th anniversary of Harvey's Lumleian lectures, this review focuses on "hemodynamic" forces associated with the movement of blood through arteries in humans and the functional and structural adaptations that result from repeated episodic exposure to such stimuli. The late 20th century discovery that endothelial cells modify arterial tone via paracrine transduction provoked studies exploring the direct mechanical effects of blood flow and pressure on vascular function and adaptation in vivo. In this review, we address the impact of distinct hemodynamic signals that occur in response to exercise, the interrelationships between these signals, the nature of the adaptive responses that manifest under different physiological conditions, and the implications for human health...
April 2017: Physiological Reviews
https://www.readbyqxmd.com/read/28148335/a-pediatric-cardiology-fellowship-boot-camp-improves-trainee-confidence
#11
Catherine K Allan, Paul Tannous, Elizabeth DeWitt, Michael Farias, Laura Mansfield, Christina Ronai, David Schidlow, Stephen P Sanders, James E Lock, Jane W Newburger, David W Brown
: Introduction New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children's Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice. METHODS: The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28143679/a-pilot-randomized-trial-of-exercise-as-adjunct-therapy-in-a-heroin-assisted-treatment-setting
#12
Flora Colledge, Marc Vogel, Kenneth Dürsteler-Macfarland, Jonas Strom, Susanne Schoen, Uwe Pühse, Markus Gerber
BACKGROUND: Although the potential of exercise as an adjunct treatment for substance dependence is persuasive in theory, few controlled trials have assessed its effectiveness. Existing research has also largely focused on individuals aiming towards, or having already achieved, abstinence. This study employed a randomized design in a pilot trial to assess the feasibility, acceptance, and effects of an exercise intervention for individuals receiving outpatient heroin-assisted treatment...
January 28, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28125022/pediatric-exercise-testing-value-and-implications-of-peak-oxygen-uptake
#13
REVIEW
Paolo T Pianosi, Robert I Liem, Robert G McMurray, Frank J Cerny, Bareket Falk, Han C G Kemper
Peak oxygen uptake (peak V ˙ O 2 ) measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. Peak V ˙ O 2 was shown to predict longevity in patients aged 7-35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peak V ˙ O 2 as an endpoint that likewise delivered clinically relevant data...
January 24, 2017: Children
https://www.readbyqxmd.com/read/28121915/moderate-exercise-increases-endotoxin-concentration-in-hypoxia-but-not-in-normoxia-a-controlled-clinical-trial
#14
Paola Machado, Aline Caris, Samile Santos, Edgar Silva, Lila Oyama, Sergio Tufik, Ronaldo Santos
BACKGROUND: Hypoxia and high altitudes affect various organs, which impairs important physiological functions, such as a disruption of the intestinal barrier mediated by increased translocation of bacteria and increased circulating endotoxin levels. Physical exercise can alter endotoxin concentration in normoxia. The aim of this study is to evaluate the effects of moderate exercise on endotoxin concentration in normobaric hypoxia. METHODS: Nine healthy male volunteers exercised on a treadmill for 60 minutes at an intensity of 50% VO2peak in normoxic or hypoxic conditions (4200 m)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28117479/the-role-of-physical-exercise-in-obstructive-sleep-apnea
#15
Flávio Maciel Dias de Andrade, Rodrigo Pinto Pedrosa
Obstructive sleep apnea (OSA) is a common clinical condition, with a variable and underestimated prevalence. OSA is the main condition associated with secondary systemic arterial hypertension, as well as with atrial fibrillation, stroke, and coronary artery disease, greatly increasing cardiovascular morbidity and mortality. Treatment with continuous positive airway pressure is not tolerated by all OSA patients and is often not suitable in cases of mild OSA. Hence, alternative methods to treat OSA and its cardiovascular consequences are needed...
November 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28113242/a-novel-method-for-continuous-non-invasive-cuff-less-measurement-of-blood-pressure-evaluation-in-patients-with-non-alcoholic-fatty-liver-disease
#16
Trine Seeberg, James Orr, Hanne Austad, Morten Roed, Steffen Dalgard, David Houghton, David Jones, Frode Strisland
OBJECTIVE: One promising approach for a continuous, non-invasive, cuff-less ambulatory BP monitor is to measure the pulse wave velocity or the inversely proportional pulse transit time (PTT), based on electrical and optical physiological measurements in the chest area. A device termed IsenseU-BP+ has been developed for measuring continuous BP, as well as other physiological data. The objective of this paper is to present results from the first clinical evaluation with a wide range of patients...
September 12, 2016: IEEE Transactions on Bio-medical Engineering
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/28110638/assessing-exercise-cardiac-reserve-using-real-time-cardiovascular-magnetic-resonance
#18
Thu-Thao Le, Jennifer Ann Bryant, Alicia Er Ting, Pei Yi Ho, Boyang Su, Raymond Choon Chye Teo, Julian Siong-Jin Gan, Yiu-Cho Chung, Declan P O'Regan, Stuart A Cook, Calvin Woon-Loong Chin
BACKGROUND: Exercise cardiovascular magnetic resonance (ExCMR) has great potential for clinical use but its development has been limited by a lack of compatible equipment and robust real-time imaging techniques. We developed an exCMR protocol using an in-scanner cycle ergometer and assessed its performance in differentiating athletes from non-athletes. METHODS: Free-breathing real-time CMR (1.5T Aera, Siemens) was performed in 11 athletes (5 males; median age 29 [IQR: 28-39] years) and 16 age- and sex-matched healthy volunteers (7 males; median age 26 [interquartile range (IQR): 25-33] years)...
January 23, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28105791/the-future-of-pleiotropic-therapy-in-heart-failure-lessons-from-the-benefits-of-exercise-training-on-endothelial-function
#19
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...
January 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28096255/sheppheartcabg-trial-comprehensive-early-rehabilitation-after-coronary-artery-bypass-grafting-a-protocol-for-a-randomised-clinical-trial
#20
Ida Elisabeth Højskov, Philip Moons, Niels Viggo Hansen, Søren La Cour, Peter Skov Olsen, Christian Gluud, Per Winkel, Jane Lindschou, Lau Caspar Thygesen, Ingrid Egerod, Selina Kikkenborg Berg
INTRODUCTION: Patients undergoing coronary artery bypass graft surgery often experience a range of symptoms. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation have a positive physiological and psychological effect in early outpatient rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial...
January 17, 2017: BMJ Open
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