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Cardiopulmonary exercise testing

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https://www.readbyqxmd.com/read/28443680/periodic-breathing-during-incremental-exercise
#1
Piergiuseppe Agostoni, Ugo Corrà, Michele Emdin
Periodic breathing during incremental cardiopulmonary exercise testing is a regularly recurring waxing and waning of tidal volume due to oscillations in central respiratory drive. Periodic breathing is a sign of respiratory control system instability, which may occur at rest or during exercise. The possible mechanisms responsible of exertional periodic breathing might be related to any instability of the ventilatory regulation caused by: 1) increased circulatory delay (i.e., circulation time from the lung to the brain and chemoreceptors, due to reduced cardiac index leading to delay in information transfer), 2) increase in controller gain (i...
April 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28441030/measuring-cardiac-output-during-cardiopulmonary-exercise-testing
#2
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/28436723/asymptomatic-peripheral-artery-disease-can-limit-maximal-exercise-capacity-in-chronic-obstructive-pulmonary-disease-patients-regardless-of-airflow-obstruction-and-lung-hyperinflation
#3
Ernesto Crisafulli, Chiara Scelfo, Panagiota Tzani, Marina Aiello, Giuseppina Bertorelli, Alfredo Chetta
Background Silent/asymptomatic peripheral artery disease may occur in patients with chronic obstructive pulmonary disease, but it is poorly investigated. The primary aim of this study was to evaluate in chronic obstructive pulmonary disease patients the impact of asymptomatic/silent peripheral artery disease on maximal exercise capacity; the secondary aim was to search for predictors of peripheral artery disease. Methods We prospectively enrolled chronic obstructive pulmonary disease outpatients. Data on anthropometric characteristics, lung function, cardiopulmonary exercise test and ankle-brachial index were recorded...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28436722/exercise-training-improves-characteristics-of-exercise-oscillatory-ventilation-in-chronic-heart-failure
#4
Niki Panagopoulou, Eleftherios Karatzanos, Stavros Dimopoulos, Athanasios Tasoulis, Ioannis Tachliabouris, Styliani Vakrou, Antonios Sideris, Christina Gratziou, Serafim Nanas
Background Exercise oscillatory ventilation in chronic heart failure has been suggested as a factor related to adverse cardiac events, aggravated prognosis and higher mortality. Exercise training is well known to affect exercise capacity and mechanisms of pathophysiology beneficially in chronic heart failure. Little is known, however, about the exercise training effects on characteristics of exercise oscillatory ventilation in chronic heart failure patients. Design and methods Twenty (out of 38) stable chronic heart failure patients exhibited exercise oscillatory ventilation (age 54 ± 11 years, peak oxygen uptake 15...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28435685/quantification-and-physiological-significance-of-the-rightward-shift-of-the-v-slope-during-incremental-cardiopulmonary-exercise-testing
#5
Hirotaka Nishijima, Kazuo Kondo, Kazuya Yonezawa, Hiroki Hashimoto, Masayuki Sakurai
BACKGROUND: Ventilatory anaerobic threshold (VAT) is frequently used as a measure of exercise tolerance, with the V-slope method being the standard; however, this needs to be visually determined. Over the years, we have observed that the V-slope itself often appears to shift rightward before the appearance of the VAT (RtShift: rightward shift of V-slope). This phenomenon has long been known to occur during the first 1-2 min of steady-state exercise and disappears thereafter; it is attributed to CO2 storage, presumably in active muscle...
2017: BMC Sports Science, Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28435239/pulmonary-rehabilitation-for-copd-improves-exercise-time-rather-than-exercise-tolerance-effects-and-mechanisms
#6
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/28427551/cardiopulmonary-exercise-factors-predict-survival-in-patients-with-advanced-interstitial-lung-disease-referred-for-lung-transplantation
#7
Aimee M Layton, Hilary F Armstrong, Hanyoung P Kim, Kimbery S Meza, Frank D'Ovidio, Selim M Arcasoy
BACKGROUND: The purpose of this work was to determine if parameters assessed during Cardiopulmonary Exercise Testing (CPET) while using supplemental oxygen can independently predict one-year transplant-free survival in patients with Interstitial Lung Disease (ILD) referred for lung transplant evaluation. METHODS: We performed a chart review of patients with ILD who completed CPET with 30% FiO2 and gathered spirometry, pulmonary hemodynamic, six-minute walk, and CPET data...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#8
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28419206/short-term-preoperative-exercise-therapy-does-not-improve-long-term-outcome-after-lung-cancer-surgery-a-randomized-controlled-study%C3%A2
#9
Wolfram Karenovics, Marc Licker, Christoph Ellenberger, Michel Christodoulou, John Diaper, Chetna Bhatia, John Robert, Pierre-Olivier Bridevaux, Frédéric Triponez
OBJECTIVES: Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer. This randomized trial evaluates the impact of adding rehabilitation (Rehab) with high-intensity interval training (HIIT) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome. METHODS: Patients with operable lung cancer were randomly assigned to usual care (UC, n  = 77) or to intervention group (Rehab, n  = 74) that entailed HIIT that was implemented only preoperatively...
April 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28419026/the-gas-sampling-interval-effect-on-vo2peak-is-independent-of-exercise-protocol
#10
Cory M Scheadler, Matthew J Garver, Nicholas J Hanson
INTRODUCTION: There is a plethora of gas sampling intervals available during cardiopulmonary exercise (CPX) testing to measure peak oxygen consumption (VO2peak). Different intervals can lead to altered VO2peaks. Whether differences are affected by the exercise protocol or subject sample is not clear. The purpose of this investigation was to determine whether VO2peak differed due to manipulation of sampling intervals and whether differences were independent of the protocol and subject sample...
April 18, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28417202/cardiorespiratory-fitness-and-muscle-strength-in-pancreatic-cancer-patients
#11
Dorothea Clauss, Christine Tjaden, Thilo Hackert, Lutz Schneider, Cornelia M Ulrich, Joachim Wiskemann, Karen Steindorf
PURPOSE: Cancer patients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancer patients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancer patients. METHODS: We included 65 pancreatic cancer patients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT)...
April 17, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28415097/p544the-importance-of-contractile-reserve-when-assessing-asymptomatic-patients-with-aortic-stenosis
#12
J J Van Zalen, S Badiani, L Hart, A Marshall, N Patel, G Lloyd
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28409004/effect-of-%C3%AE-blockade-on-lung-function-exercise-performance-and-dynamic-hyperinflation-in-people-with-arterial-vascular-disease-with-and-without-copd
#13
Angela Key, Matthew Parry, Malcolm A West, Rebecca Asher, Sandy Jack, Nick Duffy, Francesco Torella, Paul P Walker
INTRODUCTION: β Blockers are important treatment for ischaemic heart disease and heart failure; however, there has long been concern about their use in people with chronic obstructive pulmonary disease (COPD) due to fear of symptomatic worsening of breathlessness. Despite growing evidence of safety and efficacy, they remain underused. We examined the effect of β-blockade on lung function, exercise performance and dynamic hyperinflation in a group of vascular surgical patients, a high proportion of who were expected to have COPD...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28408022/left-ventricular-assist-device-as-a-bridge%C3%A2-to-recovery-for-patients-with-advanced-heart-failure
#14
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/28400247/quality-of-life-dyspnea-and-functional-exercise-capacity-following-a-first-episode-of-pulmonary-embolism-results-of-the-elope-cohort-study
#15
Susan R Kahn, Arash Akaberi, John T Granton, David R Anderson, Philip S Wells, Marc A Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Chris Rush, Paul Hernandez, Shawn D Aaron, Andrew M Hirsch
BACKGROUND: We aimed to evaluate health-related quality of life (QOL), dyspnea and functional exercise capacity during the year following the diagnosis of a first episode of pulmonary embolism. METHODS: Prospective multicenter cohort study of 100 patients with acute pulmonary embolism recruited at 5 Canadian hospitals from 2010-2013. We measured the outcomes QOL (by SF-36 and PEmb-QOL measures), dyspnea (by the University of California San Diego Shortness of Breath Questionnaire (SOBQ)) and six-minute walk distance at Baseline, 1, 3, 6, and 12 months after acute pulmonary embolism...
April 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28398090/cardiopulmonary-exercise-testing-in-pediatrics
#16
Tim Takken, Bart C Bongers, Marco van Brussel, Eero A Haapala, Erik Hj Hulzebos
Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared to adults. Pediatric exercise testing is imperative to unravel the physiological mechanisms of a reduced aerobic fitness and to evaluate intervention effects in children and adolescents with a chronic disease or disability. Cardiopulmonary exercise testing includes the measurement of respiratory gas exchange and is the gold standard for determining aerobic fitness, as well as for examining the integrated physiological responses to exercise in pediatric medicine...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28394978/-salivary-immunoglobulin-a-siga-kinetics-in-young-adults-with-an-average-or-excellent-aerobic-capacity-before-and-after-a-cardiopulmonary-graded-exercise-test
#17
Paulina Yesica Ochoa-Martínez, Javier Arturo Hall-López, Marco Antonio Martínez-García, Raúl Díaz-Molina, Ana María Miranda Botelho Teixeira, José Antonio Moncada-Jiménez
BACKGROUND: Aim: To compare the concentration of secretory immunoglobulin-A (sIgA) in young adults with average or excellent aerobic capacity before and after a cardiopulmonary graded exercise test. METHODS: Participants were nine apparently healthy physically active males (Mean age = 21.3 ± 2.1 yr.), randomly allocated in two groups based on their VO2max: a) average aerobic capacity (AEC, n = 5) or b) excellent aerobic capacity (EAC, n = 4). Participants performed the Bruce protocol to determine their aerobic capacity...
February 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28392370/out-of-hospital-cardiac-arrest-survivors-with-cognitive-impairments-have-lower-exercise-capacity
#18
Liesbeth W Boyce, Carlien C Reinders, Gerard Volker, Esther Los, Henk J van Exel, Thea P M Vliet Vlieland, Paulien H Goossens
BACKGROUND: Hypoxic brain injury is described in up to 40% of survivors after out-of-hospital cardiac arrest (OHCA). Besides cognitive impairments, lack of circulation may also affect exercise capacity. It is not known if exercise capacity of patients with cognitive impairments differs from other OHCA survivors. METHODS: This retrospective cohort study included patients ≥18 years with myocardial infarction (MI) as cause of OHCA admitted for cardiac rehabilitation between February 2011 and April 2014...
April 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28388274/six-minute-stepper-test-to-set-pulmonary-rehabilitation-intensity-in-patients-with-copd-a-retrospective-study
#19
Tristan Bonnevie, Francis-Edouard Gravier, Marie Leboullenger, Clément Médrinal, Catherine Viacroze, Antoine Cuvelier, Jean-François Muir, Catherine Tardif, David Debeaumont
Pulmonary rehabilitation (PR) improves outcomes in patients with chronic obstructive pulmonary disease (COPD). Optimal assessment includes cardiopulmonary exercise testing (CPET), but consultations are limited. Field tests could be used to individualize PR instead of CPET. The six-minute stepper test (6MST) is easy to set up and its sensitivity and reproducibility have previously been reported in patients with COPD. The aim of this study was to develop a prediction equation to set intensity in patients attending PR, based on the 6MST...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28386795/-metabolic-and-cardiovascular-response-to-exercise-in-patients-with-type-1-diabetes
#20
I Turinese, P Marinelli, M Bonini, M Rossetti, G Statuto, T Filardi, A Paris, A Lenzi, S Morano, P Palange
PURPOSE: Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population. METHODS: This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer...
April 6, 2017: Journal of Endocrinological Investigation
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