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cardiopulmonary function testing

Erik H Van Iterson, Joshua R Smith, Thomas P Olson
BACKGROUND: Peak exercise V̇O2 is a primary marker of prognosis in heart failure (HF). The pathophysiology of impaired peak V̇O2 is unclear in patients. To what extent alveolar airway function impacts V̇O2 during cardiopulmonary exercise testing (CPET) has not been fully elucidated. This study aimed to phenotype how changes in alveolar ventilation (V̇A ), volume (VA ), and related parameters couple with exercise V̇O2 in HF. METHODS: N=35 HF (LVEF=20±6%; ages, 53±7 years) participated in CPET with breath-to-breath measurements of ventilation and gas-exchange...
August 10, 2018: Journal of Cardiac Failure
Rujie Qin, Akira Koike, Osamu Nagayama, Yuta Takayanagi, Longmei Wu, Isao Nishi, Yuko Kato, Akira Sato, Takeshi Yamashita, Kazutaka Aonuma, Masaki Ieda
Ventilation (VE) increases linearly with the increase of carbon dioxide output (VCO2) during cardiopulmonary exercise testing. VE-VCO2 slope rises in parallel with exercise intensity, reaches a turning point (called the RC point), then steepens because of respiratory compensation for lactic acidosis. While this RC point can be identified universally, it is undetectable in some patients. In this study we evaluated whether the respiratory compensation during exercise testing has clinical significance in cardiac patients...
August 12, 2018: Bioscience Trends
J Alberto Neder, Alcides Rocha, Maria Clara N Alencar, Flavio Arbex, Danilo C Berton, Mayron Faria, Priscila A Sperandio, Luiz E Nery, Denis E O'Donnell
Heart failure with reduced ejection fraction (HF) and chronic obstructive pulmonary disease (COPD) frequently coexist, particularly in the elderly. Given their rising prevalence and the contemporary trend to longer life expectancy, overlapping HF-COPD will become a major cause of morbidity and mortality in the next decade. Areas covered: Drawing on current clinical and physiological constructs, the consequences of negative cardiopulmonary interactions on the interpretation of pulmonary function and cardiopulmonary exercise tests in HF-COPD are discussed...
August 13, 2018: Expert Review of Cardiovascular Therapy
Dany-Michel Marcadet, Bruno Pavy, Gilles Bosser, Frédérique Claudot, Sonia Corone, Hervé Douard, Marie-Christine Iliou, Bénédicte Vergès-Patois, Pascal Amedro, Thierry Le Tourneau, Caroline Cueff, Taniela Avedian, Alain Cohen Solal, François Carré
The exercise test is still a key examination in cardiology, used for the diagnosis of myocardial ischemia, as well as for the clinical evaluation of other heart diseases. The cardiopulmonary exercise test can further define functional capacity and prognosis for any given cardiac pathology. These new guidelines focus on methods, interpretation and indications for an exercise test or cardiopulmonary exercise test, as summarized below. The safety rules associated with the exercise test must be strictly observed...
August 6, 2018: Archives of Cardiovascular Diseases
Damiano Magri, Piergiuseppe Agostoni, Gianfranco Sinagra, Federica Re, Michele Correale, Giuseppe Limongelli, Elisabetta Zachara, 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: A blunted heart rate (HR) response is associated with an impaired peak oxygen uptake (pVO2 ), a powerful outcome predictor in hypertrophic cardiomyopathy (HCM). The present multicenter study sought to determine the prognostic role for exercise-induced HR response in HCM. METHODS: A total of 681 consecutive HCM outpatients on optimized treatment were recruited. The heart failure (HF) end-point was death due to HF, cardiac transplantation, NYHA III-IV class progression, HF worsening leading to hospitalization and severe functional deterioration leading to septal reduction...
August 4, 2018: International Journal of Cardiology
Fred M Wu, Alexander R Opotowsky, Erica R Denhoff, Russell Gongwer, Michelle Z Gurvitz, Michael J Landzberg, Keri M Shafer, Anne Marie Valente, Ahmet Z Uluer, Jonathan Rhodes
BACKGROUND: While the Fontan procedure has improved life expectancy, patients with single ventricle physiology have impaired exercise capacity due to limited increase in pulmonary blood flow during activity. Enhancing the "thoracic pump" using inspiratory muscle training (IMT) may ameliorate this impairment. METHODS: Adult non-smokers with Fontan physiology were recruited through Boston Children's Hospital's outpatient clinic. Participants underwent cardiopulmonary exercise testing and pulmonary function testing, followed by 12 weeks of IMT and then repeat testing...
July 28, 2018: Seminars in Thoracic and Cardiovascular Surgery
Byeong-Soo Kim, Ji-Hoe Kim, So-Hyun Park, Hyeon-Seon Seo, Hye-Sun Lee, Myung-Mo Lee
BACKGROUND Physical changes due to aging lead to weakening of respiratory muscles and decreased lung functions that result in increasing risk of chronic respiratory disease. A complex respiratory rehabilitation program is needed to prevent respiratory diseases and improve lung functions and quality of life. The purpose of the present study was to examine the effects of respiratory training programs on pulmonary functions, cardiovascular endurance, and quality of life in elderly women. MATERIAL AND METHODS The program was structured with respiration exercise and playing wind musical instruments for 10 weeks (n=13) and 5 weeks (n=16), respectively, for elderly women in 2 different community welfare centers...
July 29, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Tanveer Singh Kundra, P S Nagaraja, K S Bharathi, Parminder Kaur, N Manjunatha
Context: Inhaled levosimendan may act as selective pulmonary vasodilator and avoid systemic side effects of intravenous levosimendan, which include decrease in systemic vascular resistance (SVR) and systemic hypotension, but with same beneficial effect on pulmonary artery pressure (PAP) and right ventricular (RV) function. Aim: The aim of this study was to compare the effect of inhaled levosimendan with intravenous levosimendan in patients with pulmonary hypertension undergoing mitral valve replacement...
July 2018: Annals of Cardiac Anaesthesia
Sara J Abdallah, Benjamin M Smith, Mark A Ware, Michelle Moore, Pei Zhi Li, Jean Bourbeau, Dennis Jensen
RATIONALE: A series of studies conducted ~40 years ago demonstrated an acute bronchodilator effect of smoked cannabis in healthy and asthmatic adults. However, the acute effects of vaporized cannabis on airway function in adults with advanced chronic obstructive pulmonary disease (COPD) remain unknown. OBJECTIVE: To test the hypothesis that inhaled vaporized cannabis would alleviate exertional breathlessness and improve exercise endurance by enhancing static and dynamic airway function in COPD...
July 27, 2018: Annals of the American Thoracic Society
Tieh-Cheng Fu, Chaur-Chin Chen, Ching-Mao Chang, Hen-Hong Chang, Hsueh-Ting Chu
Evaluation of exercise-induced periodic breathing (PB) in cardiopulmonary exercise testing (CPET) is one of important diagnostic evidences to judge the prognosis of chronic heart failure cases. In this study, we propose a method for the quantitative analysis of measured ventilation signals from an exercise test. We used an autoregressive (AR) model to filter the breath-by-breath measurements of ventilation from exercise tests. Then, the signals before reaching the most ventilation were decomposed into intrinsic mode functions (IMF) by using the Hilbert-Huang transform (HHT)...
2018: Computational and Mathematical Methods in Medicine
Kwo-Chen Lee, Wen-Hsuan Hsu, Po-Han Chou, Jia-Jean Yiin, Chih-Hsin Muo, Yun-Ping Lin
BACKGROUND: Dementia is characterized by prolonged progressive disability. Therefore, predicting mortality is difficult. An accurate prediction tool may be useful to ensure that end-of-life patients with dementia receive timely palliative care. PURPOSE: This study aims to establish a survival prediction model for elderly patients with dementia in Taiwan. METHODS: Data from the 2001 to 2010 National Health Insurance Research Database in Taiwan were used to identify 37,289 patients with dementia aged ≥65 years for inclusion in this retrospective longitudinal study...
2018: PloS One
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Piotr Ładziński, Aleksander Pawlak, Marcin Zieliński, Agata Dąbrowska, Aniela Artyńska, Mariusz Gezela, Paweł Sobczyński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region (Greater Poland). The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF) and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication...
July 25, 2018: Artificial Organs
Chatchai Phimphasak, Chulee Ubolsakka-Jones, David A Jones
BACKGROUND: A flow-dependent conical positive expiratory pressure (PEP) resistor incorporated into a oronasal mask was developed, which might reduce dyspnea and dynamic hyperinflation and increase exercise endurance for patients with COPD. We reported here the flow-pressure relationships and the safety and suitability of the device when used by healthy young and older subjects. METHODS: The flow-pressure relationships were determined for a range of resistors with different orifice diameters and cone lengths...
August 2018: Respiratory Care
Nanna A Sobol, Christian Have Dall, Peter Høgh, Kristine Hoffmann, Kristian Steen Frederiksen, Asmus Vogel, Volkert Siersma, Gunhild Waldemar, Steen G Hasselbalch, Nina Beyer
BACKGROUND: Physical activity has the potential to improve physical function in patients with Alzheimer's disease (AD) and may contribute to modify disease processes and cognitive function. OBJECTIVE: The aim of this study was to investigate 1) the effect of moderate-high-intensity aerobic exercise on cardiorespiratory fitness, i.e., peak oxygen uptake (VO2peak) determined by direct breath-by-breath cardiopulmonary exercise test, and 2) the association between changes in VO2peak and changes in cognition and neuropsychiatric symptoms in patients with mild AD...
2018: Journal of Alzheimer's Disease: JAD
Ernesto Crisafulli, Matteo Vigna, Antonella Ielpo, Panagiota Tzani, Angelo Mangia, Elisabetta Teopompi, Marina Aiello, Veronica Alfieri, Giuseppina Bertorelli, Paolo Palange, Alfredo Chetta
Background Heart rate recovery delay is a marker of cardiac autonomic dysfunction. In chronic obstructive pulmonary disease patients, the ventilatory response to exercise during incremental cardiopulmonary exercise test may add information about dynamic hyperinflation by low values of inspiratory capacity/total lung capacity ratio (at peak) and excess ventilation by the slope of minute ventilation to carbon dioxide output ratio (VE /VCO2 slope ). We aimed to assess if the ventilatory response to exercise might be a determinant for heart rate recovery delay...
January 1, 2018: European Journal of Preventive Cardiology
Doreen DeFaria Yeh, Ada C Stefanescu Schmidt, Aaron S Eisman, John D Serfas, Mariam Naqvi, Mohamed A Youniss, Aaron D Ryfa, Asaad A Khan, Lucy Safi, Sara R Tabtabai, Ami B Bhatt, Gregory D Lewis
OBJECTIVE: The prevalence of heart failure (HF) among adult patients with congenital heart disease (ACHD) is rising. Right ventricle (RV) exercise reserve and its relationship to outcomes have not been characterised. We aim to evaluate the prognostic impact of impaired RV reserve in an ACHD population referred for cardiopulmonary exercise testing (CPET). METHODS: This retrospective study evaluates patients with ACHD who underwent CPET (n=147) with first-pass radionuclide ventriculography at a single tertiary care centre...
July 20, 2018: Heart: Official Journal of the British Cardiac Society
K Yamanaka, S Inoue, Y Naito, M Kawaguchi
OBJECTIVES: Although amiodarone may cause neurotoxicity that can affect patient outcomes when used during cardiopulmonary resuscitation (CPR), it has been commonly prescribed during CPR. This study investigated the possible neurotoxic effects of amiodarone in a rat model of transient forebrain ischemia. DESIGN: A prospective laboratory animal study was carried out. SETTING: Animal laboratory. MATERIALS: Male Sprague-Dawley rats...
July 17, 2018: Medicina Intensiva
Hideo Ohuchi, Jun Negishi, Hikari Miike, Yuka Toyoshima, Hitomi Morimoto, Midori Fukuyama, Toru Iwasa, Heima Sakaguchi, Aya Miyazaki, Isao Shiraishi, Kenichi Kurosaki, Michikazu Nakai
OBJECTIVE: Exercise training is recommended for its possible favorable effects on Fontan pathophysiology. This study aimed to elucidate the impact of pediatric exercise capacity trajectory, which may mimic the effect of exercise training, on late adult Fontan pathophysiology. METHODS: Since 1990, 97 Fontan patients had consecutively undergone two serial cardiopulmonary exercise tests (CPX1 and CPX2) during childhood (ages 8 ± 2 and 14 ± 2 years) and one during adulthood (CPX3; age 23 ± 5 years)...
July 4, 2018: International Journal of Cardiology
Alejandro Lorente, Carlos Barrios, Rafael Lorente, Rocío Tamariz, Jesús Burgos
BACKGROUND CONTEXT: The evaluation of ventilatory functional restrictions during a maximal exercise tolerance test in patients with Scheuermann disease has never been described. PURPOSE: This study evaluated the respiratory functional capacity of patients with Scheuermann disease compared to healthy adolescents matched in age. STUDY DESIGN/SETTING: Prospective comparative study. PATIENTS SAMPLE: Forty-one consecutive adolescents with Scheuermann hyperkyphosis (SK) and 20 healthy controls matched in age were included in the study...
July 16, 2018: Spine Journal: Official Journal of the North American Spine Society
Meili Yu, Siming Li, Siwei Li, Jingen Li, Hao Xu, Keji Chen
BACKGROUND: Preliminary evidence based on clinical observations suggests that meditative exercise may offer potential benefits for patients with chronic heart failure (CHF). Cardiac rehabilitation (CR), as a class-IA indication in clinical practice guidelines, has been established as an effective strategy to improve quality of life and prognosis of CHF patients. Baduanjin exercise is an important component of traditional Chinese Qigong exercises. However, its benefits for CHF have not been rigorously tested...
July 16, 2018: Trials
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