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https://www.readbyqxmd.com/read/27884421/interpreting-the-incremental-cardiopulmonary-exercise-test
#1
REVIEW
Samir Nusair
The incremental cardiopulmonary exercise test (CPET) is an increasingly used diagnostic method that serves to evaluate patients with chief complaint of dyspnea during exercise. Performing maximal symptom-limited CPET can show if the tested subject has a reduced exercise capacity and give clues to the mechanism of such exercise capacity reduction, cardiac, pulmonary, or pulmonary vascular source. In this review, it is suggested that the evaluation of the complex results of CPET should be performed by first determining if myocardial/circulatory insufficiency is present and second if there is gas exchange abnormality...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27875410/should-we-use-driving-pressure-to-set-tidal-volume
#2
Domenico L Grieco, Lu Chen, Martin Dres, Laurent Brochard
PURPOSE OF REVIEW: Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CRS) is mostly affected by the volume of the baby lung, the ratio VT/CRS (i.e. the driving pressure, ΔP) may potentially help tailoring interventions on VT setting. RECENT FINDINGS: Driving pressure is the ventilatory variable most strongly associated with changes in survival and has been shown to be the key mediator of the effects of mechanical ventilation on outcome in the acute respiratory distress syndrome...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27865723/mechanisms-of-effort-intolerance-in-patients-with-rheumatic-mitral-stenosis-combined-echocardiography-and-cardiopulmonary-stress%C3%A2-protocol
#3
Michal Laufer-Perl, Yaniv Gura, Jason Shimiaie, Jack Sherez, Gregg S Pressman, Galit Aviram, Simon Maltais, Ricki Megidish, Amir Halkin, Meirav Ingbir, Simon Biner, Gad Keren, Yan Topilsky
OBJECTIVES: This study sought to evaluate mechanisms of effort intolerance in patients with rheumatic mitral stenosis (MS). BACKGROUND: Combined stress echocardiography and cardiopulmonary testing allows assessment of cardiac function, hemodynamics, and oxygen extraction (A-Vo2 difference). METHODS: Using semirecumbent bicycle exercise, 20 patients with rheumatic MS (valve area 1.36 ± 0.4 cm(2)) were compared to 20 control subjects at 4 pre-defined activity stages (rest, unloaded, anaerobic threshold, and peak)...
November 10, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27832610/diaphragm-electromyographic-activity-following-unilateral-mid-cervical-contusion-injury-in-rats
#4
Sabhya Rana, Gary C Sieck, Carlos B Mantilla
Contusion type injuries to the spinal cord are characterized by tissue loss and disruption of spinal pathways. Mid-cervical spinal cord injuries impair the function of respiratory muscles and may contribute to significant respiratory complications. This study systematically assessed the impact of a 100-kDy unilateral C4 contusion injury on diaphragm muscle activity across a range of motor behaviors in rats. Chronic diaphragm EMG was recorded prior to injury, and at 1 and 7 days post injury. Histological analyses assessed the extent of perineuronal net formation, white matter sparing and phrenic motoneuron loss...
November 9, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27810293/usefulness-of-stroke-volume-monitoring-during-upright-ramp-incremental-cycle-exercise-in-young-patients-with-fontan-circulation
#5
Antoine Legendre, Aurore Guillot, Magalie Ladouceur, Damien Bonnet
BACKGROUND: Aerobic capacity (VO2 max) of patients with Fontan circulation (FC) is lowest within patients with congenital heart disease. The reasons have not been completely elucidated. METHODS: Twenty five young patients with non-failing FC underwent a cardiopulmonary test during an upright ramp cycling. By using a signal morphology impedance cardiography device (physioflow®), stroke volume (SV) was evaluated along with effort. The results were compared with paired healthy controls...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27803354/high-mid-flow-to-vital-capacity-ratio-and-the-response-to-exercise-in-children-with-congenital-heart-disease
#6
Daphna Vilozni, Maria Rosario Alcaneses-Ofek, Ronen Reuveny, Omer Rosenblum, Omri Inbar, Uriel Katz, Tomer Ziv-Baran, Gal Dubnov-Raz
BACKGROUND: Pulmonary mechanics may play a role in exercise intolerance in patients with congenital heart disease (CHD). A reduced FVC volume could increase the ratio between mid-flow (FEF25-75%) and FVC, which is termed high dysanapsis. The relationship between high dysanapsis and the response to maximum-intensity exercise in children with CHD had not yet been studied. The aim of this work was to examine whether high dysanapsis is related to the cardiopulmonary response to maximum-intensity exercise in pediatric subjects with CHD...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27786541/postexercise-cold-water-immersion-improves-intermittent-high-intensity-exercise-performance-in-normothermia
#7
Avina McCarthy, James Mulligan, Mikel Egaña
A brief cold water immersion between 2 continuous high-intensity exercise bouts improves the performance of the latter compared with passive recovery in the heat. We investigated if this effect is apparent in normothermic conditions (∼19 °C), employing an intermittent high-intensity exercise designed to reflect the work performed at the high-intensity domain in team sports. Fifteen young active men completed 2 exhaustive cycling protocols (Ex1 and Ex2: 12 min at 85% ventilatory threshold (VT) and then an intermittent exercise alternating 30-s at 40% peak power (Ppeak) and 30 s at 90% Ppeak to exhaustion) separated by 15 min of (i) passive rest, (ii) 5-min cold-water immersion at 8 °C, and (iii) 10-min cold-water immersion at 8 °C...
July 25, 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/27779551/does-exercise-ventilatory-inefficiency-predict-poor-outcome-in-heart-failure-patients-with-copd
#8
Maria Clara Alencar, Flavio F Arbex, Aline Souza, Adriana Mazzuco, Priscila A Sperandio, Alcides Rocha, Daniel M Hirai, Frederico Mancuso, Danilo C Berton, Audrey Borghi-Silva, Dirceu Almeida, Denis E OʼDonnel, J Alberto Neder
PURPOSE: To investigate whether the opposite effects of heart failure (HF) and chronic obstructive pulmonary disease (COPD) on exercise ventilatory inefficiency (minute ventilation [(Equation is included in full-text article.)E]-carbon dioxide output [(Equation is included in full-text article.)CO2] relationship) would negatively impact its prognostic relevance. METHODS: After treatment optimization and an incremental cardiopulmonary exercise test, 30 male patients with HF-COPD (forced expiratory volume in 1 second [FEV1] = 57% ± 17% predicted, ejection fraction = 35% ± 6%) were prospectively followed up during 412 ± 261 days for major cardiac events...
November 2016: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/27768397/creatine-monohydrate-supplementation-does-not-augment-fitness-performance-or-body-composition-adaptations-in-response-to-four-weeks-of-high-intensity-interval-training-in-young-females
#9
Scott C Forbes, Nathan Sletten, Cody Durrer, Étienne Myette-Cote, Darren Candow, Jonathan P Little
High-intensity interval training (HIIT) has been shown to improve cardiorespiratory fitness, performance, body composition, and insulin sensitivity. Creatine (Cr) supplementation may augment responses to HIIT, leading to even greater physiological adaptations. The purpose of this study was to determine the effects of four weeks of HIIT (three sessions/week) combined with Cr supplementation in recreationally active females. Seventeen females (age = 23 ± 4 yrs; BMI = 23.4 ± 2.4) were randomly assigned to either Cr (Cr; 0...
October 21, 2016: International Journal of Sport Nutrition and Exercise Metabolism
https://www.readbyqxmd.com/read/27750131/exercise-training-effects-on-elderly-and-middle-age-patients-with-chronic-heart-failure-after-acute-decompensation-a-randomized-controlled-trial
#10
Domenico Acanfora, Pietro Scicchitano, Gerardo Casucci, Bernardo Lanzillo, Nicola Capuano, Giuseppe Furgi, Chiara Acanfora, Marialaura Longobardi, Raffaele Antonelli Incalzi, Giuseppe Piscosquito, Marco Matteo Ciccone
BACKGROUND: The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. METHODS: This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) <40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group...
October 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27741056/differences-in-spatio-temporal-parameters-between-trained-runners-and-untrained-participants
#11
Josué Gómez-Molina, Ana Ogueta-Alday, Christopher Stickley, Jesus Camara Tobalina, Jon Cabrejas-Ugartondo, Juan García-López
The aim of this study was to compare the spatio-temporal parameters of trained runners and untrained participants with the same foot strike pattern (rearfoot) during running at controlled speeds. Twenty-one participants were classified in two groups according to their training experience: Trained (n=10, amateur runners with long distance training experience) and Untrained (n=11, healthy non-trained participants). Anthropometric variables were recorded, and the participants performed both a submaximal (between 9 and 15 km·h) and a graded exercise running test (from 6 km·h until exhaustion) on a treadmill...
October 6, 2016: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/27736248/the-effect-of-dietary-nitrate-supplementation-on-physiology-and-performance-in-trained-cyclists
#12
Joseph A McQuillan, Deborah K Dulson, Paul B Laursen, Andrew E Kilding
PURPOSE: To determine the effect of dietary nitrate (NO3(-)) supplementation on physiology and performance in well-trained cyclists following six to eight-days of NO3(-) supplementation. METHODS: Eight competitive male cyclists (mean ± SD; age = 26 ± 8 y; body mass = 76.7 ± 6.9 kg; VO2peak = 63 ± 4 ml.kg(-1).min(-1)) participated in a double-blind, placebo-controlled, crossover-design study in which participants ingested 70 ml beetroot juice containing ~4 mmol NO3(-) (NIT) or a NO3(-) depleted placebo (PLA), each for 8-days...
October 13, 2016: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/27736037/ventilatory-limitation-and-dynamic-hyperinflation-during-exercise-testing-in-cystic-fibrosis
#13
Solon Karapanagiotis, Simone Gambazza, Anna Brivio, Francesco D'Abrosca, Carla Colombo
OBJECTIVE: To investigate the presence of dynamic hyperinflation after the Modified Shuttle Test (MST) and its relationship with lung function, exercise tolerance, and clinical symptoms in Cystic Fibrosis (CF). METHODS: Retrospective observational study. Subjects in clinically stable condition with a CF diagnosis based on a positive sweat test (chloride >60 mEq/L) and/or presence of two disease causing mutations, with available data on MST, spirometry, maximal voluntary ventilation, and inspiratory capacity manoeuvres were considered for the analysis...
October 13, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27721367/a-pair-of-identical-twins-discordant-for-myalgic-encephalomyelitis-chronic-fatigue-syndrome-differ-in-physiological-parameters-and-gut-microbiome-composition
#14
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
https://www.readbyqxmd.com/read/27697301/-is-there-a-disassociation-of-ventilatory-and-electromyographic-thresholds-in-patients-with-heart-disease-during-a-graded-cycling-exercise
#15
P-M Leprêtre, M Ghannem, S Delanaud, T Porcher, A Barnabé, L Gaillard, N Jaunet, T Weissland
: Exercise prescription was generally based on the determination of ventilatory thresholds (VT1, VT2) during cardiopulmonary exercise testing (CPX). Changes in surface electromyographic activity (EMGth1, EMGth2) were also related to VT1 and VT2 in healthy subjects. OBJECTIVE: To observe the occurrence of EMGth1 and EMGth2 and whether these events accompany VT1 and VT2 during CPX in cardiac patients (CP). METHOD: Thirty-four CP (62.1±7.3years, 172...
September 30, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27693420/association-between-six-minute-walk-distance-and-objective-variables-of-functional-capacity-after-exercise-training-in-elderly-heart-failure-patients-with-preserved-ejection-fraction-a-randomized-exercise-trial
#16
Sara Maldonado-Martín, Peter H Brubaker, Joel Eggebeen, Kathryn P Stewart, Dalane W Kitzman
OBJECTIVE: To evaluate the change in six-minute walk test (6-MWT) relative to changes in key functional capacity measures after 16-week of exercise training in older (>65 years) heart failure with preserved ejection fraction (HFpEF) patients. DESIGN: Prospective, randomized single blinded (by researchers to patient group) comparison of two groups of HFpEF patients. SETTINGS: Hospital and clinic records. Ambulatory outpatients. PARTICIPANTS: Participants (N=47) randomized to attention control (n=24, AC) or exercise training (n=23, ET) group INTERVENTION: The ET group performed cycling and walking at 50-70% VO2peak intensity (3 days per week, 60 min each session)...
September 27, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27677888/a-new-method-for-self-paced-peak-performance-testing-on-a-treadmill
#17
Kenneth J Hunt, Prasanna Anandakumaran, Jonas A Loretz, Jittima Saengsuwan
PURPOSE: Self-paced maximal testing methods may be able to exploit central mediation of function-limiting fatigue and therefore have potential to generate more valid estimates of peak oxygen uptake. The aim of this study was to investigate the feasibility of a new method for self-paced peak performance testing on treadmills and to compare peak and submaximal performance outcomes with those obtained using a non-self-paced ('computer-paced') method employing predetermined speed and slope profiles...
September 28, 2016: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/27649579/reliability-of-laser-doppler-near-infrared-spectroscopy-and-doppler-ultrasound-for-peripheral-blood-flow-measurements-during-and-after-exercise-in-the-heat
#18
Hui C Choo, Kazunori Nosaka, Jeremiah J Peiffer, Mohammed Ihsan, Chow C Yeo, Chris R Abbiss
This study examined the test-retest reliability of near-infrared spectroscopy (NIRS), laser Doppler flowmetry (LDF) and Doppler ultrasound to assess exercise-induced haemodynamics. Nine men completed two identical trials consisting of 25-min submaximal cycling at first ventilatory threshold followed by repeated 30-s bouts of high-intensity (90% of peak power) cycling in 32.8 ± 0.4°C and 32 ± 5% relative humidity (RH). NIRS (tissue oxygenation index [TOI] and total haemoglobin [tHb]) and LDF (perfusion units [PU]) signals were monitored continuously during exercise, and leg blood flow was assessed by Doppler ultrasound at baseline and after exercise...
September 21, 2016: Journal of Sports Sciences
https://www.readbyqxmd.com/read/27647376/ultrasonographic-diaphragmatic-excursion-is-inaccurate-and-not-better-than-the-mrc-score-for-predicting-weaning-failure-in-mechanically-ventilated-patients
#19
Cédric Carrie, Chloé Gisbert-Mora, Eline Bonnardel, Bernard Gauche, Matthieu Biais, Frédéric Vargas, Gilles Hilbert
PURPOSE: To assess the ability of diaphragmatic ultrasound (US) to predict weaning failure in mechanically ventilated patients undergoing a first spontaneous breathing trial (SBT). METHODS: During a 4-month period, 67 consecutive patients eligible for a first SBT underwent US measurements of maximal diaphragmatic excursion (MDE) by a right anterior subcostal approach. Weaning failure was defined as either the failure of SBT or the need for resumption of ventilatory support for acute respiratory failure or death within 48h following successful extubation...
September 16, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27631607/oxygenation-threshold-derived-from-near-infrared-spectroscopy-reliability-and-its-relationship-with-the-first-ventilatory-threshold
#20
Stephan van der Zwaard, Richard T Jaspers, Ilse J Blokland, Chantal Achterberg, Jurrian M Visser, Anne R den Uil, Mathijs J Hofmijster, Koen Levels, Dionne A Noordhof, Arnold de Haan, Jos J de Koning, Willem J van der Laarse, Cornelis J de Ruiter
BACKGROUND: Near-infrared spectroscopy (NIRS) measurements of oxygenation reflect O2 delivery and utilization in exercising muscle and may improve detection of a critical exercise threshold. PURPOSE: First, to detect an oxygenation breakpoint (Δ[O2HbMb-HHbMb]-BP) and compare this breakpoint to ventilatory thresholds during a maximal incremental test across sexes and training status. Second, to assess reproducibility of NIRS signals and exercise thresholds and investigate confounding effects of adipose tissue thickness on NIRS measurements...
2016: PloS One
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