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https://www.readbyqxmd.com/read/28541745/graphical-data-display-for-clinical-cardiopulmonary-exercise-testing
#1
Daniel Dumitrescu, Stephan Rosenkranz
Cardiopulmonary exercise testing is a well-known, valuable tool in the clinical evaluation of patients with different causes of exercise limitation, and unexplained dyspnea. A wealth of data is generated by each individual test. This may be challenging with regard to a comprehensive and reliable interpretation of an exercise study in a timely manner. An optimized graphical display of exercise data may substantially help to improve the efficacy and reliability of the interpretation process. However, there are limited and heterogeneous recommendations on standardized graphical display in current exercise testing guidelines...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28538301/proposal-of-a-new-specific-cardiopulmonary-exercise-test-for-taekwondo-athletes
#2
Marcus P Araujo, Antônio C L Nóbrega, Gabriel Espinosa, Matheus R Hausen, Renata R T Castro, Pedro P Soares, Jonas L Gurgel
Araujo, MP, Nóbrega, ACL, Espinosa, G, Hausen, MR, Castro, RRT, Soares, PP, and Gurgel, JL. Proposal of a new specific cardiopulmonary exercise test for taekwondo athletes. J Strength Cond Res 31(6): 1525-1535, 2017-The objective of this study is to evaluate the cardiorespiratory variables of Taekwondo athletes while performing incremental exercise test on an ergometer using a ramp protocol and to propose a specific protocol for assessing these physiological variables during Taekwondo practice. Fourteen athletes participated in 2 incremental exercise tests: a treadmill exercise test (TREADtest) and a Taekwondo-specific exercise test (TKDtest)...
June 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28528994/clinical-significance-of-the-overshoot-phenomena-of-respiratory-gas-indices-during-recovery-from-maximal-exercise-testing
#3
Yuta Takayanagi, Akira Koike, Osamu Nagayama, Arisa Nagamine, Rujie Qin, Jo Kato, Isao Nishi, Tomoko Himi, Yuko Kato, Akira Sato, Takeshi Yamashita, Kazutaka Aonuma
BACKGROUND: Overshoot phenomena of the gas exchange ratio (R:VCO2/VO2), ventilatory equivalent for O2 (VE/VO2), and end-tidal O2 pressure (PETO2) are commonly observed during recovery from maximal cardiopulmonary exercise testing (CPX). We investigated the clinical significance of the overshoots of these indices by comparing their magnitudes between healthy subjects and cardiac patients with left ventricular dysfunction. METHODS: In total, 121 subjects (73 healthy subjects and 48 cardiac patients with left ventricular ejection fraction<40%) who underwent CPX and achieved peak R≥1...
May 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28525624/early-and-asymptomatic-cardiac-dysfunction-in-chronic-kidney-disease
#4
Shanmugakumar Chinnappa, Edward White, Nigel Lewis, Omer Baldo, Yu-Kang Tu, Griet Glorieux, Raymond Vanholder, Meguid El Nahas, Andrew Mooney
Background: . Heart failure (HF) is highly prevalent and associated with high mortality in chronic kidney disease (CKD). However, the pathophysiology of cardiac dysfunction in CKD, especially in the early asymptomatic stage, is not well understood. We studied subclinical cardiac dysfunction in asymptomatic CKD patients without comorbid cardiac disease or diabetes mellitus by evaluating peak cardiac performance. Methods.: In a cross-sectional study ( n  = 130) we investigated 70 male non-diabetic CKD patients (21 CKD stage 2-3a, 27 CKD stage 3b-4 and 22 CKD stage 5) employing specialized cardiopulmonary exercise testing to measure peak cardiac output and cardiac power output non-invasively...
May 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28516519/exercise-training-in-diastolic-heart-failure-ex-dhf-rationale-and-design-of-a-multicentre-prospective-randomized-controlled-parallel-group-trial
#5
Frank Edelmann, Anna Bobenko, Götz Gelbrich, Gerd Hasenfuss, Christoph Herrmann-Lingen, André Duvinage, Silja Schwarz, Meinhard Mende, Christiane Prettin, Tobias Trippel, Ruhdja Lindhorst, Daniel Morris, Elisabeth Pieske-Kraigher, Kathleen Nolte, Hans-Dirk Düngen, Rolf Wachter, Martin Halle, Burkert Pieske
Heart failure with preserved ejection fraction (HFpEF) is a common disease with high incidence and increasing prevalence. Patients suffer from functional limitation, poor health-related quality of life, and reduced prognosis. A pilot study in a smaller group of HFpEF patients showed that structured, supervised exercise training (ET) improves maximal exercise capacity, diastolic function, and physical quality of life. However, the long-term effects of ET on patient-related outcomes remain unclear in HFpEF. The primary objective of the Exercise training in Diastolic Heart Failure (Ex-DHF) trial is to investigate whether a 12 month supervised ET can improve a clinically meaningful composite outcome score in HFpEF patients...
May 17, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28511070/impact-of-exaggerated-blood-pressure-response-in-normotensive-individuals-on-future-hypertension-and-prognosis-systematic-review-according-to-prisma-guideline
#6
REVIEW
Karsten Keller, Kathrin Stelzer, Mir Abolfazl Ostad, Felix Post
PURPOSE: Arterial hypertension (aHT) is the leading risk factor for morbidity and mortality worldwide. Blood pressure (BP) deviation at rest is well defined and accompanies risk for cardiovascular events and cardiovascular mortality. A growing body of evidence emphasises that an exaggerated blood pressure response (EBPR) in cardiopulmonary exercise testing (CPET) could help to identify seemingly cardiovascular healthy and normotensive subjects, who have an increased risk of developing aHT and cardiovascular events in the future...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28511024/cardiopulmonary-exercise-testing-and-surgery
#7
Paul O Older, Denny Zh Levett
The surgical patient population is increasingly elderly and comorbid and poses challenges to perioperative physicians. Accurate pre-operative risk stratification is important to direct perioperative care. Reduced aerobic fitness is associated with increased post-operative morbidity and mortality. Cardiopulmonary exercise testing is an integrated and dynamic test that gives an objective measure of aerobic fitness or functional capacity and identifies the cause of exercise intolerance. Cardiopulmonary exercise testing provides an individualized estimate of patient risk that can be used to predict post-operative morbidity and mortality...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28510737/total-haemoglobin-mass-but-not-haemoglobin-concentration-is-associated-with-preoperative-cardiopulmonary-exercise-testing-derived-oxygen-consumption-variables
#8
J M Otto, J O M Plumb, D Wakeham, E Clissold, L Loughney, W Schmidt, H E Montgomery, M P W Grocott, T Richards
Background: Cardiopulmonary exercise testing (CPET) measures peak exertional oxygen consumption ( V˙O2peak ) and that at the anaerobic threshold ( V˙O2 at AT, i.e. the point at which anaerobic metabolism contributes substantially to overall metabolism). Lower values are associated with excess postoperative morbidity and mortality. A reduced haemoglobin concentration ([Hb]) results from a reduction in total haemoglobin mass (tHb-mass) or an increase in plasma volume. Thus, tHb-mass might be a more useful measure of oxygen-carrying capacity and might correlate better with CPET-derived fitness measures in preoperative patients than does circulating [Hb]...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28510504/cardiopulmonary-exercise-testing-basics-of-methodology-and-measurements
#9
Alessandro Mezzani
Cardiopulmonary exercise testing adds measurement of ventilation and volume of oxygen uptake and exhaled carbon dioxide to routine physiological and performance parameters obtainable from conventional exercise testing, furnishing an all-round vision of the systems involved in both oxygen transport from air to mitochondria and its utilization during exercise. Peculiarities of cardiopulmonary exercise testing methodology are the use of ramp protocols and calibration procedures for flow meters and gas analyzers...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28508270/the-impact-of-combined-cardiopulmonary-exercise-testing-and-spect-myocardial-perfusion-imaging-on-downstream-evaluation-and-management
#10
Georgios Christopoulos, John Bois, Thomas G Allison, Martin Rodriguez-Porcel, Panithaya Chareonthaitawee
OBJECTIVE: The diagnostic yield of combined cardiopulmonary exercise testing (CPET) and myocardial perfusion imaging (MPI) in patients referred for stress testing has received limited study. METHODS: We evaluated consecutive patients who underwent combined CPET-MPI at a single tertiary referral center between 2011 and 2015. An abnormal CPET was defined as any of the following: reduced oxygen consumption, cardiac output impairment, or pulmonary impairment. Normal MPI was defined as the absence of resting or stress perfusion defect...
May 15, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28506086/invasive-cardiopulmonary-exercise-testing-in-the-evaluation-of-unexplained-dyspnea-insights-from-a-multidisciplinary-dyspnea-center
#11
Wei Huang, Stephen Resch, Rudolf Kf Oliveira, Barbara A Cockrill, David M Systrom, Aaron B Waxman
Background Unexplained dyspnea is a common diagnosis that often results in repeated diagnostic testing and even delayed treatments while a determination of the cause is being investigated. Through a retrospective study, we evaluated the diagnostic efficacy of a multidisciplinary dyspnea evaluation center (MDEC) using invasive cardiopulmonary exercise test to diagnose potential causes of unexplained dyspnea. Methods We reviewed the medical records of all patients referred with unexplained dyspnea to the MDEC between March 2011 and October 2014...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28502420/cardiopulmonary-exercise-testing-and-second-line-pulmonary-function-tests-to-detect-obstructive-pattern-in-symptomatic-smokers-with-borderline-spirometry
#12
Fabiano Di Marco, Silvia Terraneo, Sara Job, Rocco Francesco Rinaldo, Giuseppe Francesco Sferrazza Papa, Maria Adelaide Roggi, Pierachille Santus, Stefano Centanni
BACKGROUND: The need for additional research on symptomatic smokers with normal spirometry has been recently emphasized. Albeit not meeting criteria for Chronic obstructive pulmonary disease (COPD) diagnosis, symptomatic smokers may experience activity limitation, evidence of airway disease, and exacerbations. We, therefore, evaluated whether symptomatic smokers with borderline spirometry (post-bronchodilator FEV1/FVC ratio between 5th to 20th percentile of predicted values) have pulmonary function abnormalities at rest and ventilatory constraints during exercise...
June 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28500413/impaired-pulmonary-function-is-an-additional-potential-mechanism-for-the-reduction-of-functional-capacity-in-clinically-stable-fontan-patients
#13
Aída L R Turquetto, Luiz F Canêo, Daniela R Agostinho, Patrícia A Oliveira, Maria Isabel C S Lopes, Patrícia F Trevizan, Frederico L A Fernandes, Maria A Binotto, Gabriela Liberato, Glaucia M P Tavares, Rodolfo A Neirotti, Marcelo B Jatene
Central factors negatively affect the functional capacity of Fontan patients (FP), but "non-cardiac" factors, such as pulmonary function, may contribute to their exercise intolerance. We studied the pulmonary function in asymptomatic FP and its correlations with their functional capacity. Pulmonary function and cardiopulmonary exercise tests were performed in a prospective study of 27 FP and 27 healthy controls (HC). Cardiovascular magnetic resonance was used to evaluate the Fontan circulation. The mean age at tests, the mean age at surgery, and the median follow-up time of FP were 20(±6), 8(±3), and 11(8-17) years, respectively...
May 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28489686/scaling-the-oxygen-uptake-efficiency-slope-for-body-size-in-cystic-fibrosis
#14
Owen William Tomlinson, Alan Robert Barker, Patrick John Oades, Craig Anthony Williams
PURPOSE: The aim of this study was to describe the relationship between body size and the oxygen uptake efficiency slope (OUES) in paediatric patients with cystic fibrosis (CF) and healthy controls (CON), in order to identify appropriate scaling procedures to adjust the influence of body size upon OUES. METHODS: The OUES was derived using maximal and submaximal points from cardiopulmonary exercise testing in 72 children (36 CF and 36 CON). OUES was subsequently scaled for stature, body mass (BM) and body surface area (BSA) using ratio-standard (Y/X) and allometric (Y/X) methods...
May 9, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28480945/aerobic-fitness-in-adolescents-with-chronic-pain-or-chronic-fatigue-parallels-and-mechanisms
#15
Paolo T Pianosi, Eric Emerling, Kristin C Mara, Amy L Weaver, Philip R Fischer
OBJECTIVE: Chronic fatigue and chronic pain both deter people from participating in exercise, even though exercise is often a key component of treatment. While reasons for this may seem obvious, the extent and mechanism(s) of reduced exercise performance among affected individuals, particularly those with chronic pain, are not well described. We hypothesized that patients with chronic fatigue are more deconditioned than those with chronic pain, due to the nature of their illness or disability...
May 4, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28477381/effect-of-diltiazem-on-exercise-capacity-after-heart-transplantation
#16
Sara Varnado, Yael Peled-Potashnik, Ashley Huntsberry, Brian D Lowes, Ronald Zolty, Adam Burdorf, Elizabeth R Lyden, Michael J Moulton, John Y Um, Eugenia Raichlin
BACKGROUND: Sinus tachycardia (ST) is common after heart transplantation (HTx). The aim of the study was to evaluate the effect of Diltiazem treatment during the first year after HTx on heart rate (HR), cardiac allograft function and exercise capacity. METHODS: From the total cohort, 25 HTx recipients started Diltiazem treatment 4±2 weeks after HTx and continued it for at least 1 year (Diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test (CPET) at one year after HTx...
May 6, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28471812/comparisons-of-noninvasive-methods-used-to-assess-exercise-stroke-volume-in-hfpef
#17
Erik H Van Iterson, Thomas P Olson, Barry A Borlaug, Bruce D Johnson, Eric M Snyder
INTRODUCTION: Cardiopulmonary exercise testing (CPET) plays an important role in properly phenotyping signs and symptoms of heart failure with preserved ejection fraction (HFpEF). The prognostic value of CPET is strengthened when accompanied by cardiac hemodynamic measurements. Although recognized as the 'Gold' standard, cardiac catheterization is impractical for routine CPET. Thus, advancing the scientific/methodologic understanding of noninvasive techniques for exercise cardiac hemodynamic assessment is clinically impactful in HFpEF...
May 4, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28467885/diving-and-pulmonary-physiology-surfactant-binding-protein-lung-fluid-and-cardiopulmonary-test-changes-in-professional-divers
#18
Zora Susilovic-Grabovac, Cristina Banfi, Denise Brusoni, Massimo Mapelli, Stefania Ghilardi, Ante Obad, Darija Bakovic-Kramaric, Zeljko Dujic, Piergiuseppe Agostoni
Alteration of breathing pattern ranging from an increase of respiratory rate to overt hyperventilation during and after SCUBA diving is frequently reported and is associated with intrathoracic fluid overload. This study was undertaken to assess breathing efficiency after diving and the association with damage of alveolar cells. Ventilation efficiency (VE/VCO2) during maximal cardiopulmonary exercise test (CPET) before and 2h after a standard protocol dive has been analyzed in twelve professional males divers (39...
April 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28460707/could-peak-oxygen-uptake-be-estimated-from-proposed-equations-based-on-the-six-minute-walk-test-in-chronic-heart-failure-subjects
#19
Giane A Ribeiro-Samora, Dayane Montemezzo, Danielle A G Pereira, Thaysa L Tagliaferri, Otávia A Vieira, Raquel R Britto
OBJECTIVES: To evaluate the agreement between the measured peak oxygen uptake (VO2peak) and the VO2peak estimated by four prediction equations based on the six-minute walk test (6MWT) in chronic heart failure patients. METHOD: Thirty-six chronic heart failure patients underwent cardiopulmonary exercise testing and the 6MWT to assess their VO2peak. Four previously published equations that include the variable six-minute walk distance were used to estimate the VO2peak: Cahalin, 1996a (1); Cahalin, 1996b (2); Ross, 2010 (3); and Adedoyin, 2010 (4)...
March 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28454836/right-ventricular-dysfunction-in-tetralogy-of-fallot-inhibition-of-the-renin-angiotensin-aldosterone-system-redefine-trial-rationale-and-design-of-a-randomized-double-blind-placebo-controlled-clinical-trial
#20
Jouke P Bokma, Michiel M Winter, Esmée M Kornaat, Hubert W Vliegen, Arie P van Dijk, Joost P van Melle, Folkert J Meijboom, Martijn C Post, Jacqueline K Berbee, Aeilko H Zwinderman, Barbara J M Mulder, Berto J Bouma
Renin-angiotensin-aldosterone system (RAAS) inhibition with angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors is beneficial in patients with acquired left ventricular dysfunction. Adult patients with tetralogy of Fallot (TOF) with right ventricular (RV) dysfunction are at high risk for heart failure, arrhythmias, and sudden cardiac death. However, the efficacy of RAAS inhibition has not been established in these patients. METHODS: The REDEFINE is an investigator-initiated, multicenter, prospective, randomized, double-blind, placebo-controlled trial to study the effects of the angiotensin II receptor blocker losartan (target dosage of 150 mg once daily) in adult patients with TOF...
April 2017: American Heart Journal
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