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Jeness Campodonico, Massimo Mapelli, Emanuele Spadafora, Stefania Ghilardi, Piergiuseppe Agostoni, Cristina Banfi, Susanna Sciomer
Alveolar-capillary membrane evaluated by carbon monoxide diffusion (DLCO) plays an important role in heart failure (HF). Surfactant Proteins (SPs) have also been suggested as a worthwhile marker. In HF, Levosimendan improves pulmonary hemodynamics and reduces lung fluids but associated SPs and DLCO changes are unknown. Sixty-five advanced HF patients underwent spirometry, cardiopulmonary exercise test (CPET) and SPs determination before and after Levosimendan. Levosimendan caused natriuretic peptide-B (BNP) reduction, peakVO2 increase and VE/VCO2 slope reduction...
March 13, 2018: Respiratory Physiology & Neurobiology
Tiago Pereira-da-Silva, Rui M Soares, Ana Luísa Papoila, Iola Pinto, Joana Feliciano, Luís Almeida-Morais, Ana Abreu, Rui Cruz Ferreira
INTRODUCTION AND AIMS: Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. METHODS: Ambulatory patients followed in our center with symptomatic heart failure and left ventricular ejection fraction ≤40% prospectively underwent a comprehensive baseline assessment including clinical, laboratory, electrocardiographic, echocardiographic, and cardiopulmonary exercise testing parameters...
March 5, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Maria E Marketou, Joanna E Kontaraki, Spyros Maragkoudakis, Alexandros Patrianakos, John Konstantinou, Helen Nakou, Despoina Vougia, John Logakis, Gregory Chlouverakis, Panos E Vardas, Fragiskos I Parthenakis
Background: MicroRNAs (miRs) regulate gene expression and play an important role in ventricular and vascular remodeling. However, there are limited data regarding their role in heart failure with preserved ejection fraction (HFpEF). The aim of this study was to assess gene expression of miR-1, miR-133a, miR-21, miR-208b, miR-499, and miR-26b in peripheral blood mononuclear cells (PBMCs) in hypertensive patients with HFpEF and to evaluate their association with their exercise capacity...
March 1, 2018: American Journal of Hypertension
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
Jonathan K Ehrman, Clinton A Brawner, Ali Shafiq, David E Lanfear, Matthew Saval, Steven J Keteyian
BACKGROUND: This study evaluated if different prognostic characteristics exist for peak VO2 , percent predicted peak VO2 (ppVO2 ), and the VE -VCO2 slope between men and women with heart failure and reduced ejection fraction (HFrEF). METHODS: Analysis of the FIT-CPX database (n=1,085; 33% women, 55% black) of individuals with HFrEF who completed a physician-referred CPX between 1997 and 2010. Primary outcome was a composite of all-cause death, left ventricular assist device (LVAD) placement, and orthotopic heart transplant (OHT)...
February 26, 2018: Journal of Cardiac Failure
Zachary J Il'Giovine, Nicole Solomon, Adam D DeVore, Daniel Wojdyla, Chetan B Patel, Joseph G Rogers
INTRODUCTION: The prognostic value of peak VO2 and VE/VCO2 slope measured during cardiopulmonary exercise (CPX) testing has been well established in patients with advanced heart failure, but blood pressure response to exercise is less well characterized. METHODS: We retrospectively studied 151 outpatients who underwent CPX testing as part of an advanced heart failure (HF) evaluation. The outcome of interest was failure of medical management, defined by death, cardiac transplantation, or left ventricular assist device placement...
February 21, 2018: Medicine and Science in Sports and Exercise
O V Kamenskaya, I Y Loginova, D V Doronin, A M CHernyavskiy
Aim of the study was assessment of efficiency of lung ventilation and its relationship with quality of life in patients undergoing orthotopic heart transplantation (OHT). MATERIALS AND METHODS: The study involved 40 patients with terminal chronic heart failure (CHF) included in the waiting list for heart transplantation. Before surgery and after OHT all patients underwent cardiopulmonary exercise testing, evaluation of clinical status and quality of life (QL) according to the 36-Item Short Form Survey (SF-36)...
January 2018: Kardiologiia
Yoshie Nogami, Yoshihiro Seo, Masayoshi Yamamoto, Tomoko Ishizu, Kazutaka Aonuma
Wave intensity (WI) is a novel noninvasive index of circulatory dynamics that reflects ventriculo-arterial coupling. It is calculated as the product of the first derivative of blood pressure and that of flow velocity measured by carotid echocardiography. This study aimed to clarify the clinical implications of WI and its relation with carbon dioxide production (VE/VCO 2 slope). Twenty-one healthy volunteers (control group) and 21 patients with hypertension (HT group) underwent cardiopulmonary exercise testing (CPX) and exercise stress echocardiography...
February 12, 2018: Heart and Vessels
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Osamu Nagayama, Etsuko Hayama, Takuto Arita, Naoharu Yagi, Hiroto Kano, Shunsuke Matsuno, Takayuki Otsuka, Yuji Oikawa, Takashi Kunihara, Junji Yajima, Takeshi Yamashita
Background Ventilatory efficiency decreases with age. This study aimed to investigate the prognostic significance and cut-off value of the minute ventilation/carbon dioxide production (VE/VCO 2 ) slope according to age in patients with heart failure. Methods and results We analysed 1501 patients with heart failure from our observational cohort who performed maximal symptom-limited cardiopulmonary exercise testing and separated them into three age groups (≤55 years, 56-70 years and ≥71 years) in total and according to the three ejection fraction categories defined by European Society of Cardiology guidelines...
January 1, 2018: European Journal of Preventive Cardiology
Jing Wu, Li Kuang, Lijuan Fu
OBJECTIVE: The aim of this study was to evaluate the effects of inspiratory muscle training (IMT) in chronic heart failure (CHF) patients. DESIGN: We searched MEDLINE, EMBASE, Cochrane Library, CINHAL, and CBMdisc to collect controlled trials on the application of inspiratory muscle training in CHF patients from the establishment of these databases to November 2016. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of literature...
February 8, 2018: Congenital Heart Disease
Yi Tang, Lei Yao, Zhihong Liu, Wenlin Xie, Xiuping Ma, Qin Luo, Zhihui Zhao, Zhiwei Huang, Liu Gao, Qi Jin, Xue Yu, Changming Xiong, Xinhai Ni, Yinkun Yan, Wenwei Qi
BACKGROUND: Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hypertension (IPAH). METHODS: Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation)...
February 2018: Respiratory Medicine
Eduardo Salazar-Martínez, Alfredo Santalla, José Naranjo Orellana, Jochen Strobl, Martin Burtscher, Verena Menz
The aim of this study was to investigate the effects of 3 weeks high-intensity interval training (HIIT) on ventilatory efficiency (VE/VCO2 slope) in endurance athletes. Sixteen male well-trained (67.72 ml kg min-1) athletes participated in this study. Each participant performed an incremental exercise test with gas analysis (i.e. VE, VO2) and a 400 m running field test (T400m) before and after the 3 weeks intervention period. HIIT group (HIITG) performed 11 HIIT sessions consisting of four 4-min interval bouts at an exercise intensity of 90-95% of the VO2max, separated by 4-min active recovery periods (work/rest ratio = 1:1)...
January 30, 2018: Respiratory Physiology & Neurobiology
Dejana Popovic, Ross Arena, Marco Guazzi
BACKGROUND: In heart failure (HF), a flattening oxygen consumption (VO2 ) trajectory during cardiopulmonary exercise test (CPET) reflects an acutely compromised cardiac output. We hypothesized that a flattening VO2 trajectory is helpful in phenotyping disease severity and prognosis in HF with either reduced (HFrEF), mid-range (HFmrEF), or preserved (HFpEF) ejection fraction. METHODS AND RESULTS: Overall, 319 HF patients (198 HFrEF, 80 HFmrEF, and 41 HFpEF) underwent CPET...
February 6, 2018: European Journal of Heart Failure
David J Elmer, Marissa Toney
PURPOSE: The modified Dmax method can accurately determine the second lactate threshold (LT2), which is valuable for predicting aerobic performance and prescribing exercise. The purpose of this study is to determine if the modified Dmax method can accurately find thresholds in VE (VT2), VCO2 (VCO2T), RER (RERT), and RR (RRT) to estimate LT2. METHODS: Forty-one participants (females n=23, males n=18) completed an incremental exercise test to determine LT2, VT2, VCO2T, RERT, RRT, and blood lactate=4 mmol/L (La4)...
January 23, 2018: International Journal of Sports Medicine
Yun-Shan Yen, Daniel Chiung Jui Su, Kuo-Shu Yuan, Po-Wei Chen, Julie Chi Chow, Willy Chou
OBJECTIVES: The significance of the isocapnic buffering (IB) phase - the period between the first ventilatory threshold (1stVT) and respiratory compensation point (RCP) - has not been adequately established in patients. This study aimed to determine the clinical significance of the IB phase in coronary artery disease (CAD) patients. METHODS: This retrospective study included data of sixty-two CAD patients after coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) performed in a single medical center between 2010-2014...
January 10, 2018: Physician and Sportsmedicine
Stine Maren Riksfjord, Siri Merete Brændvik, Ola D Røksund, Inger-Lise Aamot
Objectives: To assess ventilatory efficiency and aerobic capacity in people with multiple sclerosis and whether treadmill walking or progressive strength training has an effect on these parameters in this population. Methods: In all, 24 adults with multiple sclerosis with an Expanded Disability Status Scale score of ≤6 completed a cardiopulmonary exercise test before and after 8 weeks of exercise. They were randomized to treadmill walking of low-to-moderate intensity (50%-70% of peak heart rate) or progressive strength training (six repetitions × two at 80% of one repetition maximum)...
2017: SAGE Open Medicine
Sherin Hassan M Mehani, Heba Ahmed A Abdeen
[Purpose] Ventilatory limitation is a common problem in patients with chronic heart failure and pulmonary hypertension. Excess ventilation may arise from augmented ventilatory drive, over activity of chemoreceptors and muscle ergoreceptors, or premature onset of lactic acidosis. Exertional dyspnea can cause limitations in the activities of daily living and as a result, reduced quality of life for these patients. The aim of the present study was to evaluate the effect of cardiopulmonary rehabilitation program on ventilatory efficiency for these patients...
October 2017: Journal of Physical Therapy Science
Marco Morosin, Stefania Farina, Carlo Vignati, Emanuele Spadafora, Susanna Sciomer, Elisabetta Salvioni, Gianfranco Sinagra, Piergiuseppe Agostoni
AIMS: The two main symptoms referred by chronic heart failure (HF) patients as the causes of exercise termination during maximal cardiopulmonary exercise testing (CPET) are muscular fatigue and dyspnoea. So far, a physiological explanation why some HF patients end exercise because of dyspnoea and others because of fatigue is not available. We assessed whether patients referring dyspnoea or muscular fatigue may be distinguished by different ventilator or haemodynamic behaviours during exercise...
February 2018: ESC Heart Failure
José R Alvero Cruz, Mauro Ronconi, Jerónimo Garcia Romero, José Naranjo Orellana
BACKGROUND: This study investigated the effects of detraining on breathing pattern. The aim of this study was to evaluate the effect of a sixweek detraining period on breathing patterns and ventilatory efficiency. METHODS: Fourteen young soccer players were evaluated at the end of a competitive season and after a sixweek detraining period. Assessment of respiratory efficiency was based on VE/VCO2 slope changes below 70% of exercise intensity. All participants underwent twice an incremental graded exercise test up to exhaustion...
November 17, 2017: Journal of Sports Medicine and Physical Fitness
Benjamin W Van Tassell, Justin Canada, Salvatore Carbone, Cory Trankle, Leo Buckley, Claudia Oddi Erdle, Nayef A Abouzaki, Dave Dixon, Dinesh Kadariya, Sanah Christopher, Aaron Schatz, Jessica Regan, Michele Viscusi, Marco Del Buono, Ryan Melchior, Pranav Mankad, Juan Lu, Robin Sculthorpe, Giuseppe Biondi-Zoccai, Edward Lesnefsky, Ross Arena, Antonio Abbate
BACKGROUND: An enhanced inflammatory response predicts worse outcomes in heart failure (HF). We hypothesized that administration of IL-1 (interleukin-1) receptor antagonist (anakinra) could inhibit the inflammatory response and improve peak aerobic exercise capacity in patients with recently decompensated systolic HF. METHODS AND RESULTS: We randomly assigned 60 patients with reduced left ventricular ejection fraction (<50%) and elevated C-reactive protein levels (>2 mg/L), within 14 days of hospital discharge, to daily subcutaneous injections with anakinra 100 mg for 2 weeks, 12 weeks, or placebo...
November 2017: Circulation. Heart Failure
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