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ventilatory inefficiency

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https://www.readbyqxmd.com/read/27779551/does-exercise-ventilatory-inefficiency-predict-poor-outcome-in-heart-failure-patients-with-copd
#1
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/27734959/respiratory-constraints-during-activities-in-daily-life-and-the-impact-on-health-status-in-patients-with-early-stage-copd-a-cross-sectional-study
#2
Hanneke Ac van Helvoort, Laura M Willems, Pn Richard Dekhuijzen, Hieronymus Wh van Hees, Yvonne F Heijdra
In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL and to study its consequences on dyspnoea, physical activity and health status in early-stage COPD compared with healthy controls. In this cross-sectional study, 39 early-stage COPD patients (mean FEV1 88±s...
October 13, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27701063/physiological-and-sensory-consequences-of-exercise-oscillatory-ventilation-in-heart-failure-copd
#3
Alcides Rocha, Flavio F Arbex, Maria Clara N Alencar, Priscila A Sperandio, Daniel M Hirai, Danilo C Berton, Denis E O'Donnell, J Alberto Neder
BACKGROUND: Exercise oscillatory ventilation (EOV) is associated with poor ventilatory efficiency and higher operating lung volumes in heart failure. These abnormalities may be particularly deleterious to dyspnea and exercise tolerance in mechanically-limited patients, e.g. those with coexistent COPD. METHODS: Ventilatory, gas exchange and sensory responses to incremental exercise were contrasted in 68 heart failure-COPD patients (12 EOV+). EOV was established by standard criteria...
September 24, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27629375/comparing-changing-neurally-adjusted-ventilatory-assist-nava-levels-in-intubated-and-recently-extubated-neonates
#4
B LoVerde, K S Firestone, H M Stein
OBJECTIVE: Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation that delivers ventilatory support in synchrony to the patient's respiratory needs using NAVA level, a proportionality constant that converts the electrical activity of the diaphragm (Edi) into a peak pressure (PIP). Recent published studies suggest that neonates can control the delivered ventilatory support through neural feedback. Systematically increasing the NAVA level initially increases the PIP while maintaining a constant Edi until an inflection point or breakpoint (BrP) is reached, at which time the PIP plateaus and the Edi signal decreases...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27332771/effect-of-exercise-training-on-ventilatory-efficiency-in-patients-with-heart-disease-a-review
#5
D M L Prado, E A Rocco, A G Silva, D F Rocco, M T Pacheco, V Furlan
The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms...
June 20, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/27172093/exercise-ventilation-in-copd-influence-of-systolic-heart-failure
#6
Flavio F Arbex, Maria Clara Alencar, Aline Souza, Adriana Mazzuco, Priscila A Sperandio, Alcides Rocha, Daniel M Hirai, Frederico Mancuso, Danilo C Berton, Audrey Borghi-Silva, Dirceu R Almeida, Denis E O'Donnell, J Alberto Neder
Systolic heart failure is a common and disabling co-morbidity of chronic obstructive pulmonary disease (COPD) which may increase exercise ventilation due to heightened neural drive and/or impaired pulmonary gas exchange efficiency. The influence of heart failure on exercise ventilation, however, remains poorly characterized in COPD. In a prospective study, 98 patients with moderate to very severe COPD [41 with coexisting heart failure; 'overlap' (left ventricular ejection fraction < 50%)] underwent an incremental cardiopulmonary exercise test (CPET)...
December 2016: COPD
https://www.readbyqxmd.com/read/27165419/the-prognostic-role-of-ventilatory-inefficiency-and-exercise-capacity-in-idiopathic-pulmonary-fibrosis
#7
Baruch Vainshelboim, Jose Oliveira, Benjamin Daniel Fox, Mordechai Reuven Kramer
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal interstitial lung disease associated with poor prognosis and limited effective treatment options. Reliable predictors of outcome in daily clinical practice are needed to determine high-risk patients for urgent lung transplantation referral. This study aimed to identify practical prognostic predictors of mortality using cardiopulmonary exercise testing (CPET) in IPF subjects. METHODS: Thirty-four subjects with IPF (22 men and 12 women), median age 68 (range 50-81) y were prospectively studied...
August 2016: Respiratory Care
https://www.readbyqxmd.com/read/27077955/exercise-ventilatory-inefficiency-adds-to-lung-function-in-predicting-mortality-in-copd
#8
J Alberto Neder, Abdullah Alharbi, Danilo C Berton, Maria Clara N Alencar, Flavio F Arbex, Daniel M Hirai, Katherine A Webb, Denis E O'Donnell
Severity of resting functional impairment only partially predicts the increased risk of death in chronic obstructive pulmonary disease (COPD). Increased ventilation during exercise is associated with markers of disease progression and poor prognosis, including emphysema extension and pulmonary vascular impairment. Whether excess exercise ventilation would add to resting lung function in predicting mortality in COPD, however, is currently unknown. After an incremental cardiopulmonary exercise test, 288 patients (forced expiratory volume in one second ranging from 18% to 148% predicted) were followed for a median (interquartile range) of 57 (47) months...
August 2016: COPD
https://www.readbyqxmd.com/read/27073987/small-airway-dysfunction-and-abnormal-exercise-responses-a-study-in-coal-miners
#9
Edward L Petsonk, Robert C Stansbury, Lu-Ann Beeckman-Wagner, Joshua L Long, Mei Lin Wang
RATIONALE: Coal mine dust exposure can cause symptoms and loss of lung function from multiple mechanisms, but the roles of each disease process are not fully understood. OBJECTIVES: We investigated the implications of small airway dysfunction for exercise physiology among a group of workers exposed to coal mine dust. METHODS: Twenty coal miners performed spirometry, first breathing air and then helium-oxygen, single-breath diffusing capacity, and computerized chest tomography, and then completed cardiopulmonary exercise testing...
July 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27072860/impaired-right-ventricular-pulmonary-arterial-coupling-and-effect-of-sildenafil-in-heart-failure-with-preserved-ejection-fraction-an-ancillary-analysis-from-the-phosphodiesterase-5-inhibition-to-improve-clinical-status-and-exercise-capacity-in-diastolic-heart
#10
MULTICENTER STUDY
Imad Hussain, Selma F Mohammed, Paul R Forfia, Gregory D Lewis, Barry A Borlaug, Dianne S Gallup, Margaret M Redfield
BACKGROUND: Right ventricular (RV) dysfunction (RVD) is a poor prognostic factor in heart failure with preserved ejection fraction (HFpEF). The physiological perturbations associated with RVD or RV function indexed to load (RV-pulmonary arterial [PA] coupling) in HFpEF have not been defined. HFpEF patients with marked impairment in RV-PA coupling may be uniquely sensitive to sildenafil. METHODS AND RESULTS: In a subset of HFpEF patients enrolled in the Phosphodiesteas-5 Inhibition to Improve Clinical Status And Exercise Capacity in Diastolic Heart Failure (RELAX) trial, physiological variables and therapeutic effect of sildenafil were examined relative to the severity of RVD (tricuspid annular plane systolic excursion [TAPSE]) and according to impairment in RV-PA coupling (TAPSE/pulmonary artery systolic pressure) ratio...
April 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27059429/risk-of-postoperative-complications-in-chronic-obstructive-lung-diseases-patients-considered-fit-for-lung-cancer-surgery-beyond-oxygen-consumption
#11
Hanaa Shafiek, Jose Luis Valera, Bernat Togores, Juan Antonio Torrecilla, Jaume Sauleda, Borja G Cosío
OBJECTIVES: Patients with poor lung function usually undergo cardiopulmonary exercise testing (CPET) and those with a predicted postoperative maximal oxygen consumption (VO2 max) of >10 ml/kg/min undergo lung resection surgery and still some complications are observed. We aimed to determine other parameters beyond VO2 able to predict postoperative complications in patients undergoing lung resection surgery. METHODS: This is an observational study with longitudinal follow-up...
October 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/26935880/exercise-oscillatory-ventilation-in-heart-failure
#12
REVIEW
Ugo Corrà
Ventilation inefficiency has become a matter of interest for heart failure (HF) specialists, the most remarkable being exertional oscillatory ventilation (EOV). EOV is an abnormal ventilatory phenomenon, originally described as anecdotal, but now considered a marker of disease severity and worst prognosis in HF. EOV is a cyclic fluctuation of minute ventilation (VE) and expired gas kinetics occurring during exercise: it is a slow, prominent, consistent rather than random, fluctuation in VE that may be evanescent or transient and can follow several distinct patterns...
March 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/26800304/non-invasive-measurement-of-abnormal-ventilatory-mechanics-in-amyotrophic-lateral-sclerosis
#13
Aimee M Layton, Sienna L Moran, Arindham Roychoudhury, Jonathan Hupf, Byron M Thomashow, Hiroshi Mitsumoto
INTRODUCTION: In this study we investigated non-invasive, effort-independent measurement of ventilatory mechanics in patients with amyotrophic lateral sclerosis (ALS). METHODS: Ventilatory mechanics were measured by optoelectronic plethysmography (OEP) in ALS patients and matched controls. Analysis determined whether OEP measurements correlated with standard clinical measures. RESULTS: ALS patients (N = 18) had lower forced vital capacity percent predicted (55...
August 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/26506063/aerobic-development-of-elite-youth-ice-hockey-players
#14
Jeff R Leiter, Dean M Cordingley, Peter B MacDonald
Ice hockey is a physiologically complex sport requiring aerobic and anaerobic energy metabolism. College and professional teams often test aerobic fitness; however, there is a paucity of information regarding aerobic fitness of elite youth players. Without this knowledge, training of youth athletes to meet the standards of older age groups and higher levels of hockey may be random, inefficient, and or effective. Therefore, the purpose of this study was to determine the aerobic fitness of elite youth hockey players...
November 2015: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/26266910/assessment-of-ventilation-inhomogeneity-during-mechanical-ventilation-using-a-rapid-response-oxygen-sensor-based-oxygen-washout-method
#15
Ido G Bikker, Wim Holland, Patricia Specht, Can Ince, Diederik Gommers
PURPOSE: Ventilatory inhomogeneity indexes in critically ill mechanically ventilated patients could be of importance to optimize ventilator settings in order to reduce additional lung injury. The present study compared six inhomogeneity indexes calculated from the oxygen washout curves provided by the rapid oxygen sensor of the LUFU end-expiratory lung volume measurement system. METHODS: Inhomogeneity was tested in a porcine model before and after induction of acute lung injury (ALI) at four different levels of positive end-expiratory pressure (PEEP; 15, 10, 5 and 0 cm H2O)...
December 2014: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/26096801/cardiopulmonary-exercise-testing-in-heart-failure
#16
REVIEW
Jonathan Myers, Ross Arena, Lawarence P Cahalin, Valentina Labate, Marco Guazzi
A growing body of literature has underscored the value of ventilatory gas exchange techniques during exercise testing (commonly termed cardiopulmonary exercise testing, or CPX) and their applications in the management of patients with heart failure (HF). The added precision provided by this technology is useful in terms of understanding the physiology and mechanisms underlying exercise intolerance in HF, quantifying the response to therapy, evaluating disability, making activity recommendations, and quantifying the response to exercise training...
August 2015: Current Problems in Cardiology
https://www.readbyqxmd.com/read/26005171/ventilatory-inefficiency-in-patients-with-rheumatic-mitral-stenosis
#17
LETTER
Fernanda Rodrigues de Almeida, Maria Clara N Alencar, Aline Cristina de Souza, Willian Antônio de Magalhães Esteves, Tássia de Oliveira Meinberg Cunha, Marcia Melo Barbosa, Timothy C Tan, Maria Carmo Pereira Nunes
No abstract text is available yet for this article.
August 15, 2015: International Journal of Cardiology
https://www.readbyqxmd.com/read/25965620/hemodynamic-not-ventilatory-inefficiency-is-associated-with-high-ve-vco2-slope-in-repaired-noncyanotic-congenital-heart-disease
#18
Alessandro Mezzani, Andrea Giordano, Nidhal Ben Moussa, Angelo Micheletti, Diana Negura, Antonio Saracino, Elena Canal, Pantaleo Giannuzzi, Massimo Chessa, Mario Carminati
BACKGROUND: A high slope of the ventilation vs. carbon dioxide relationship (VE/VCO₂ slope) during incremental exercise has been reported in several congenital heart disease (CHD) types, but it is not clear whether the main cause of high VE/VCO₂ slope is excessive ventilation or reduced perfusion. METHODS: We studied 169 adolescent and adult patients with repaired, noncyanotic CHD, divided into 2 groups according to VE/VCO₂ slope %predicted values (≤120 and >120), and 15 age- and sex-matched normals...
July 15, 2015: International Journal of Cardiology
https://www.readbyqxmd.com/read/25911558/type-iii-iv-muscle-afferents-are-not-required-for-steady-state-exercise-hyperpnea-in-healthy-subjects-and-patients-with-copd-or-heart-failure
#19
Chi-Sang Poon, Gang Song
Blockade of group III-IV muscle afferents by intrathecal injection of the μ-opioid agonist fentanyl (IF) in humans has been variously reported to depress exercise hyperpnea in some studies but not others. A key unanswered question is whether such an effect is transient or persists in the steady state. Here we show that in healthy subjects undergoing constant-load cycling exercise IF significantly slows the transient exercise ventilatory kinetics but has no discernible effect on the ventilatory response when exercise is sufficiently prolonged...
September 15, 2015: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/25863972/cardiopulmonary-responses-and-prognosis-in-hypertrophic-cardiomyopathy-a-potential-role-for-comprehensive-noninvasive-hemodynamic-assessment
#20
Gherardo Finocchiaro, Francois Haddad, Joshua W Knowles, Colleen Caleshu, Aleksandra Pavlovic, Julian Homburger, Yael Shmargad, Gianfranco Sinagra, Emma Magavern, Myo Wong, Marco Perez, Ingela Schnittger, Jonathan Myers, Victor Froelicher, Euan A Ashley
OBJECTIVES: This study sought to discover the key determinants of exercise capacity, maximal oxygen consumption (oxygen uptake [Vo2]), and ventilatory efficiency (ventilation/carbon dioxide output [VE/Vco2] slope) and assess the prognostic potential of metabolic exercise testing in hypertrophic cardiomyopathy (HCM). BACKGROUND: The intrinsic mechanisms leading to reduced functional tolerance in HCM are unclear. METHODS: The study sample included 156 HCM patients consecutively enrolled from January 1, 2007 to January 1, 2012 with a complete clinical assessment, including rest and stress echocardiography and cardiopulmonary exercise test (CPET) with impedance cardiography...
May 2015: JACC. Heart Failure
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