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https://www.readbyqxmd.com/read/28441030/measuring-cardiac-output-during-cardiopulmonary-exercise-testing
#1
Carlo Vignati, Gaia Cattadori
Cardiac output is a key parameter in the assessment of cardiac function, and its measurement is fundamental to the diagnosis, treatment, and prognostic evaluation of all heart diseases. Until recently, cardiac output determination during exercise had been only possible through invasive methods, which were not practical in the clinical setting. Since oxygen uptake (V.O2) is cardiac output times arteriovenous content difference [C(a-v)O2)], evaluation of cardiac output is usually included its measurement. Because of the difficulty of directly measuring peak exercise cardiac output, indirect surrogate parameters have been proposed, but with only modest clinical usefulness...
April 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28438042/ethnic-differences-in-the-cardiac-responses-to-aerobic-exercise
#2
Heather J A Foulds, Shannon S D Bredin, Darren E R Warburton
BACKGROUND: Cardiovascular disease disproportionately affects North American Indigenous populations. Ethnic differences in cardiac responses to exercise are known, though Indigenous populations response is unknown. To evaluate cardiac responses to aerobic exercise among Canadian Indigenous and European adults. METHODS: Indigenous (N = 12, 4 females, 1 male incomplete) and European (N = 12, all completed) Canadian age and sex-matched adults 19-40 years and free of cardiovascular disease or diabetes completed a cycle ergometer maximal aerobic power test and 30 min at 60% maximal aerobic capacity on two separate days...
April 24, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28435239/pulmonary-rehabilitation-for-copd-improves-exercise-time-rather-than-exercise-tolerance-effects-and-mechanisms
#3
Keisuke Miki, Ryoji Maekura, Seigo Kitada, Mari Miki, Kenji Yoshimura, Hiroshi Yamamoto, Toshiko Kawabe, Hiroyuki Kagawa, Yohei Oshitani, Akitoshi Satomi, Kohei Nishida, Nobuhiko Sawa, Kimiko Inoue
BACKGROUND: COPD patients undergoing pulmonary rehabilitation (PR) show various responses. The purpose of this study was to investigate the possible mechanisms and predictors of the response to PR in COPD patients. METHODS: Thirty-six stable COPD patients underwent PR including a 4-week high-intensity exercise training program, and they were evaluated by cardiopulmonary exercise testing. All patients (mean age 69 years, severe and very severe COPD 94%) were classified into four groups by whether the exercise time (Tex) or the peak oxygen uptake [Formula: see text] increased after PR: two factors increased (both the Tex and the peak [Formula: see text] increased); two factors decreased; time only increased (the Tex increased, but the peak [Formula: see text] economized); and [Formula: see text] only increased (the Tex decreased, but the peak [Formula: see text] increased)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28408022/left-ventricular-assist-device-as-a-bridge%C3%A2-to-recovery-for-patients-with-advanced-heart-failure
#4
Djordje G Jakovljevic, Magdi H Yacoub, Stephan Schueler, Guy A MacGowan, Lazar Velicki, Petar M Seferovic, Sandeep Hothi, Bing-Hsiean Tzeng, David A Brodie, Emma Birks, Lip-Bun Tan
BACKGROUND: Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery. OBJECTIVES: This study evaluated whether patients undergoing an LVAD bridge-to-recovery protocol can achieve cardiac and physical functional capacities equivalent to those of healthy controls. METHODS: Fifty-eight male patients-18 implanted with a continuous-flow LVAD, 16 patients with LVAD explanted (recovered patients), and 24 heart transplant candidates (HTx)-and 97 healthy controls performed a maximal graded cardiopulmonary exercise test with continuous measurements of respiratory gas exchange and noninvasive (rebreathing) hemodynamic data...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28394194/the-higher-the-insulin-resistance-the-lower-the-cardiac-output-in-men-with-type-1-diabetes-during-the-maximal-exercise-test
#5
Pawel Niedzwiecki, Dariusz Naskret, Stanislaw Pilacinski, Maciej Pempera, Aleksandra Uruska, Anna Adamska, Dorota Zozulinska-Ziolkiewicz
BACKGROUND: The aim of this study was to assess the hemodynamic parameters analyzed in bioimpedance cardiography during maximal exercise in patients with type 1 diabetes differing in insulin resistance. METHODS: The study group consisted of 40 men with type 1 diabetes. Tissue sensitivity to insulin was assessed on the basis of the glucose disposal rate (GDR) analyzed during hyperinsulinemic-euglycemic clamp. Patients were divided into groups with GDR <4.5 mg/kg/min (G1 group-lower insulin sensitivity) and GDR ≥4...
April 10, 2017: Metabolic Syndrome and related Disorders
https://www.readbyqxmd.com/read/28393420/high-adventure-shunts-old-notions-of-pulmonary-vascular-control-during-hypoxic-exercise-contrasting-views-that-might-just-burst-your-bubble
#6
Ken D O'Halloran
In the absence of intracardiac shunt, the entire cardiac output embraces the lungs through the pulmonary vascular system. This article is protected by copyright. All rights reserved.
April 10, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28389218/walking-training-at-the-heart-rate-of-pain-threshold-improves-cardiovascular-function-and-autonomic-regulation-in-intermittent-claudication-a-randomized-controlled-trial
#7
Marcel Chehuen, Gabriel G Cucato, Celso Ricardo F Carvalho, Raphael M Ritti-Dias, Nelson Wolosker, Anthony S Leicht, Cláudia Lúcia M Forjaz
OBJECTIVES: This study investigated the effects of walking training (WT) on cardiovascular function and autonomic regulation in patents with intermittent claudication (IC). DESIGN: Randomized controlled trial. METHODS: Forty-two male patients with IC (≥50years) were randomly allocated into two groups: control (CG, n=20, 30min of stretching exercises) and WT (WTG, n=22, 15 bouts of 2min of walking interpolated by 2min of upright rest-walking intensity was set at the heart rate of pain threshold)...
March 21, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28381447/acute-cardiac-functional-and-mechanical-responses-to-isometric-exercise-in-prehypertensive-males
#8
Jamie M O'Driscoll, Katrina A Taylor, Jonathan D Wiles, Damian A Coleman, Rajan Sharma
Isometric exercise (IE) training has been shown to reduce resting arterial blood pressure (ABP) in hypertensive, prehypertensive, and normotensive populations. However, the acute hemodynamic response of the heart to such exercise remains unclear. We therefore performed a comprehensive assessment of cardiac structure, function, and mechanics at rest and immediately post a single IE session in 26 male (age 44.8 ± 8.4 years) prehypertensive participants. Conventional echocardiography recorded standard and tissue Doppler measures of left ventricular (LV) structure and function...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28373412/ventriculo-arterial-coupling-detects-occult-rv-dysfunction-in-chronic-thromboembolic-pulmonary-vascular-disease
#9
Richard G Axell, Simon J Messer, Paul A White, Colm McCabe, Andrew Priest, Thaleia Statopoulou, Maja Drozdzynska, Jamie Viscasillas, Elizabeth C Hinchy, James Hampton-Till, Hatim I Alibhai, Nicholas Morrell, Joanna Pepke-Zaba, Stephen R Large, Stephen P Hoole
Chronic thromboembolic disease (CTED) is suboptimally defined by a mean pulmonary artery pressure (mPAP) <25 mmHg at rest in patients that remain symptomatic from chronic pulmonary artery thrombi. To improve identification of right ventricular (RV) pathology in patients with thromboembolic obstruction, we hypothesized that the RV ventriculo-arterial (Ees/Ea) coupling ratio at maximal stroke work (Ees/Eamax sw) derived from an animal model of pulmonary obstruction may be used to identify occult RV dysfunction (low Ees/Ea) or residual RV energetic reserve (high Ees/Ea)...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28370674/reduced-blood-flow-through-intrapulmonary-arteriovenous-anastomoses-during-exercise-in-lowlanders-during-acclimatization-to-high-altitude
#10
Lindsey M Boulet, Andrew T Lovering, Michael M Tymko, Trevor A Day, Mike Stembridge, Trang Anh Nguyen, Philip N Ainslie, Glen E Foster
Blood flow through intrapulmonary arteriovenous anastomoses (Q̇IPAVA ) is elevated during exercise at sea level (SL) and at rest in acute normobaric hypoxia. Following high altitude (HA) acclimatization, resting Q̇IPAVA is similar to SL, but it is unknown if this is true during exercise at HA. We reasoned that exercise at HA (5,050 m) would exacerbate Q̇IPAVA due to heightened pulmonary arterial pressure. Using a supine cycle ergometer, seven healthy adults free from intracardiac shunts underwent an incremental exercise test at SL (25, 50, 75% of SL V̇O2peak ) and at HA (25, 50% of SL V̇O2peak )...
March 30, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28364029/intact-blood-pressure-but-not-sympathetic-responsiveness-to-sympathoexcitatory-stimuli-in-a-patient-with-unilateral-carotid-body-resection
#11
Kathryn F Larson, Jacqueline K Limberg, Sarah E Baker, Michael J Joyner, Timothy B Curry
Despite rapidly growing interest in the therapeutic resection of the carotid body (CB) chemoreceptors, few physiologic studies exist on the consequences of unilateral CB resection. We present a case of an otherwise healthy postmenopausal female who underwent unilateral CB resection for a paraganglioma. Approximately 4 years postoperatively, she underwent analysis of her sympathetic and hemodynamic responses to hypoxia, lower body negative pressure, cold pressor test (CPT), and ischemic hand grip exercise and postexercise ischemia (IHE/PEI)...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28345766/%C3%AE-linolenic-acid-and-exercise-training-independently-and-additively-decreases-blood-pressure-and-prevents-diastolic-dysfunction-in-obese-zucker-rats
#12
Pierre-Andre Barbeau, Tanya M Holloway, Jamie Whitfield, Brittany Baechler, Joe Quadrilatero, Luc J C van Loon, Adrian Chabowski, Graham P Holloway
While α-linolenic acid (ALA) and endurance exercise training independently attenuate hyperlipidemia-related cardiovascular derangements, there is a paucity of information pertaining to their mechanisms-of-action and efficacy when combined as a preventative therapeutic approach. Therefore, we used obese Zucker rats to investigate the independent and combined effects of these interventions on cardiovascular disease. Specifically, animals were randomly assigned to one of the following: control diet-sedentary (C-Sed), ALA supplemented-sedentary (ALA-Sed), control diet-exercise trained (C-Ex), or ALA supplemented-exercise trained (ALA-Ex)...
March 27, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28342708/hemodynamic-phenotyping-based-on-exercise-catheterization-predicts-outcome-in-patients-with-heart-failure-and-reduced-ejection-fraction
#13
Andreas Rieth, Manuel Jonas Richter, Henning Gall, Werner Seeger, Hossein A Ghofrani, Veselin Mitrovic, Christian W Hamm
BACKGROUND: Exercise right heart catheterization (RHC) unmasks different phenotypes based on hemodynamic response to exertion in patients with heart failure. The prognostic relevance of this approach in patients with heart failure and reduced ejection fraction (HFrEF) is uncertain. METHODS: We analyzed 167 patients with HFrEF from the Kerckhoff-Klinik Heart Failure Registry who underwent supine exercise RHC with constant external workload between September 2009 and August 2014...
February 28, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28336536/the-effect-of-aging-and-cardiorespiratory-fitness-on-the-lung-diffusing-capacity-response-to-exercise-in-healthy-humans
#14
Kirsten E Coffman, Alex R Carlson, Andrew D Miller, Bruce D Johnson, Bryan Joseph Taylor
Aging is associated with deterioration in the structure and function of the pulmonary circulation. We characterized the lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary membrane conductance (DmCO), and pulmonary-capillary blood volume (VC) response to discontinuous incremental exercise at 25, 50, 75, and 90% of peak work (Wpeak) in four groups: 1) Young [27 ± 3 y, maximal oxygen consumption (V̇O2max) 110 ± 18% age-predicted]; 2) Young Highly-Fit (27 ± 3 y, V̇O2max 147 ± 8% age-predicted); 3) Old (69 ± 5 y, V̇O2max 116 ± 13% age-predicted); and 4) Old Highly-Fit (65 ± 5 y, V̇O2max 162 ± 18% age-predicted)...
March 23, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28329460/model-based-comparison-of-the-normal-and-fontan-circulatory-systems-part-iii
#15
Raymond L Watrous, Alvin J Chin
BACKGROUND: For patients with the Fontan circulatory arrangement, angiotensin-converting enzyme inhibition, guanylate cyclase activation, phosphodiesterase 5 inhibition, and endothelin receptor antagonism have so far resulted in little or no improvement in [Formula: see text] or peak cardiac index (CI), suggesting that our understanding of the factors that most impact the exercise hemodynamics is incomplete. METHODS: To facilitate comparisons with clinical reports of the exercise performance of preadolescent Fontan patients, we rescaled our previously reported computational models of a two-year-old normal child and similarly aged Fontan patient, extended our Fontan model to capture the nonlinear relationship between flow and resistance quantified from previous computational fluid dynamic analyses of the total cavopulmonary connection (TCPC), and added respiration as well as skeletal muscle contraction...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28315502/the-effect-of-left-ventricular-assist-device-therapy-in-patients-with-heart-failure-and-mixed-pulmonary-hypertension
#16
Hoong S Lim, Neil Howell, Aaron Ranasinghe
BACKGROUND: Diastolic pressure gradient (DPG) of ≥7 mmHg has been proposed to distinguish mixed pulmonary hypertension from isolated post-capillary pulmonary hypertension in heart failure (HF). We evaluated the changes in pulmonary hemodynamics with left ventricular assist devices (LVADs) in patients with DPG of ≥7 or <7 mmHg, and effects on peak oxygen uptake (VO2) in patients with advanced HF. METHODS: Pre- and post-LVAD implant pulmonary hemodynamics (including right atrial (RA) pressures, DPG, pulmonary vascular resistance (PVR), pulmonary capacitance (PCap) and cardiac output), echocardiography, cardiopulmonary exercise test were measured in 38 consecutive patients...
March 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28289632/hemodynamic-adaptations-to-regular-exercise-in-people-with-spinal-cord-injury
#17
Young Hee Lee, Jin Hyeong Lee, Sung Hoon Kim, Dongsoo Yi, Kyung Joon Oh, Ji Hyun Kim, Tae Jun Park, Hanul Kim, Jae Seung Chang, In Deok Kong
OBJECTIVE: To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses. METHODS: The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below)...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28277406/comparable-neutrophil-responses-for-arm-and-intensity-matched-leg-exercise
#18
Christof A Leicht, Victoria L Goosey-Tolfrey, Nicolette C Bishop
INTRODUCTION: Arm exercise is performed at lower absolute intensities than lower body exercise. This may impact on intensity dependent neutrophil responses and it is unknown whether individuals restricted to arm exercise experience the same changes in the neutrophil response as found for lower body exercise. Therefore, we aimed to investigate the importance of exercise modality and relative exercise intensity on the neutrophil response. METHODS: Twelve moderately trained males performed three 45-min constant load exercise trials following determination of peak oxygen uptake for arm exercise (V[Combining Dot Above]O2peak arms) and cycling (V[Combining Dot Above]O2peak legs): (1) arm cranking exercise at 60%V[Combining Dot Above]O2peak arms; (2) moderate cycling at 60%V[Combining Dot Above]O2peak legs; and (3) easy cycling at 60%V[Combining Dot Above]O2peak arms...
March 8, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28256427/midterm-effect-of-balloon-pulmonary-angioplasty-on-hemodynamics-and-subclinical-myocardial-damage-in-chronic-thromboembolic-pulmonary-hypertension
#19
Mai Kimura, Takashi Kohno, Takashi Kawakami, Masaharu Kataoka, Toshimitsu Tsugu, Keitaro Akita, Sarasa Isobe, Yuji Itabashi, Yuichiro Maekawa, Mitsushige Murata, Keiichi Fukuda
BACKGROUND: The acute favourable effect of balloon pulmonary angioplasty (BPA) has been proven in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, data on its effect 6 months after therapy (from now on referred to as mid-term) and influence on the right ventricle and myocardial damage are sparse. To evaluate factors that influence improvement in cardiac output (CO) and subclinical myocardial damage, we examined hemodynamics and serum high-sensitivity troponin T (hs-TnT) levels before, 1 week after, and 6 months after BPA...
December 8, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28255866/heart-failure-with-preserved-ejection-fraction-and-skeletal-muscle-physiology
#20
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
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