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Exercise intolerance

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https://www.readbyqxmd.com/read/28522658/effect-of-fontan-geometry-on-exercise-haemodynamics-and-its-potential-implications
#1
Elaine Tang, Zhenglun Alan Wei, Kevin K Whitehead, Reza H Khiabani, Maria Restrepo, Lucia Mirabella, James Bethel, Stephen M Paridon, Bradley S Marino, Mark A Fogel, Ajit P Yoganathan
OBJECTIVE: Exercise intolerance afflicts Fontan patients with total cavopulmonary connections (TCPCs) causing a reduction in quality of life. Optimising TCPC design is hypothesised to have a beneficial effect on exercise capacity. This study investigates relationships between TCPC geometries and exercise haemodynamics and performance. METHODS: This study included 47 patients who completed metabolic exercise stress test with cardiac magnetic resonance (CMR). Phase-contrast CMR images were acquired immediately following supine lower limb exercise...
May 18, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28521807/case-report-a-novel-frameshift-mutation-in-the-mitochondrial-cytochrome-c-oxidase-ii-gene-causing-mitochondrial-disorder
#2
Laura Kytövuori, Mikko Kärppä, Hannu Tuominen, Johanna Uusimaa, Markku Saari, Reetta Hinttala, Kari Majamaa
BACKGROUND: Mitochondrial cytochrome c oxidase 2, MT-CO2, encodes one of the three subunits, which form the catalytic core of cytochrome c oxidase (COX), complex IV. Mutations in MT-CO2 are rare and the associated phenotypes are variable including nonsyndromic and syndromic forms of mitochondrial diseases. CASE PRESENTATION: We describe a 30-year-old man with cognitive decline, epilepsy, psychosis, exercise intolerance, sensorineural hearing impairment, retinitis pigmentosa, cataract and lactic acidosis...
May 18, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28511024/cardiopulmonary-exercise-testing-and-surgery
#3
Paul O Older, Denny Zh Levett
The surgical patient population is increasingly elderly and comorbid and poses challenges to perioperative physicians. Accurate pre-operative risk stratification is important to direct perioperative care. Reduced aerobic fitness is associated with increased post-operative morbidity and mortality. Cardiopulmonary exercise testing is an integrated and dynamic test that gives an objective measure of aerobic fitness or functional capacity and identifies the cause of exercise intolerance. Cardiopulmonary exercise testing provides an individualized estimate of patient risk that can be used to predict post-operative morbidity and mortality...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28510006/evaluation-of-the-dsm-5-severity-specifier-for-bulimia-nervosa-in-treatment-seeking-youth
#4
Antonios Dakanalis, Fabrizia Colmegna, Maria Assunta Zanetti, Ester Di Giacomo, Giuseppe Riva, Massimo Clerici
A new severity specifier for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (e.g., laxative misuse, self-induced vomiting, fasting, diuretic misuse, and excessive exercise), has been added to the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing variability and heterogeneity in the severity of the disorder. While existing research provides support for the DSM-5 severity specifier for BN in adult patients, evidence for its validity and clinical utility in youth is currently lacking...
May 16, 2017: Child Psychiatry and Human Development
https://www.readbyqxmd.com/read/28500413/impaired-pulmonary-function-is-an-additional-potential-mechanism-for-the-reduction-of-functional-capacity-in-clinically-stable-fontan-patients
#5
Aída L R Turquetto, Luiz F Canêo, Daniela R Agostinho, Patrícia A Oliveira, Maria Isabel C S Lopes, Patrícia F Trevizan, Frederico L A Fernandes, Maria A Binotto, Gabriela Liberato, Glaucia M P Tavares, Rodolfo A Neirotti, Marcelo B Jatene
Central factors negatively affect the functional capacity of Fontan patients (FP), but "non-cardiac" factors, such as pulmonary function, may contribute to their exercise intolerance. We studied the pulmonary function in asymptomatic FP and its correlations with their functional capacity. Pulmonary function and cardiopulmonary exercise tests were performed in a prospective study of 27 FP and 27 healthy controls (HC). Cardiovascular magnetic resonance was used to evaluate the Fontan circulation. The mean age at tests, the mean age at surgery, and the median follow-up time of FP were 20(±6), 8(±3), and 11(8-17) years, respectively...
May 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28491438/isolated-unilateral-absence-of-the-right-pulmonary-artery-in-two-cats-visualized-by-computed-tomography-angiography
#6
Tyler Jm Jordan, Brian A Scansen, Agnieszka M Kent, Lora S Hitchcock, Duncan S Russell
CASE SERIES SUMMARY: Two cats were evaluated for progressive exercise intolerance, dyspnea and unilateral infiltrate of the left lung. Computed tomography angiography (CTA) revealed absence of the right pulmonary artery in both cats with systemic arterial collateral vessels perfusing the right segmental pulmonary arteries. In one case, the collateral vessels arose from the esophageal artery, while in the other case they derived off the right costocervical trunk. One cat was diagnosed with pulmonary hypertension and was euthanized owing to progressive respiratory distress despite medical management with sildenafil, pimobendan, clopidogrel and furosemide...
July 2016: JFMS Open Rep
https://www.readbyqxmd.com/read/28482008/the-microcirculation-a-key-player-in-obesity-associated-cardiovascular-disease
#7
Oana Sorop, T Dylan Olver, Jens van de Wouw, Ilkka Heinonen, Richard W van Duin, Dirk J Duncker, Daphne Merkus
It is increasingly recognized that obesity is a risk factor for microvascular disease, i.e. results in structural and functional changes in the microvasculature. This review aims to describe how obesity impacts the microvasculature of visceral adipose tissue, skeletal muscle, heart, brain, kidneys and lungs. These changes involve endothelial dysfunction, which in turn impacts control of vascular tone, contributes to development of microvascular insulin resistance, alters secretion of paracrine factors like nitric oxide and endothelin, but also influences vascular structure and perivascular inflammation...
May 8, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28476924/molecular-effects-of-exercise-training-in-patients-with-cardiovascular-disease-focus-on-skeletal-muscle-endothelium-and-myocardium
#8
Volker Adams, Bernhard Reich, Madlen Uhlemann, Josef Niebauer
For decades we know that exercise training exerts beneficial effects to the human body and clear evidence is available that a higher fitness level is associated with a lower incidence of suffering premature cardiovascular death. Despite this knowledge it took some time also to incorporate physical exercise training into the treatment plan for patients with cardiovascular disease (CVD). In recent years, in addition to continuous exercise training further training modalities like high intensity interval training (HIIT) and pyramid training have been introduced for CAD patients...
May 5, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28476919/v%C3%AC-o2-kinetics-associated-with-moderate-intensity-exercise-in-heart-failure-impact-of-intrathecal-fentanyl-inhibition-of-group-iii-iv-locomotor-muscle-afferents
#9
Erik H Van Iterson, Bruce D Johnson, Michael J Joyner, Timothy B Curry, Thomas P Olson
Heart failure (HF) patients demonstrate impaired pulmonary, circulatory, and nervous system responses to exercise. While HF demonstrate prolonged (time-constant, τ) pulmonary oxygen uptake (V̇O2) on-kinetics contributing to exercise intolerance, it is unknown if abnormal V̇O2 kinetics couple with ventilatory and circulatory dysfunction secondary to impaired group III/IV afferents in HF. Because lower-lumbar intrathecal fentanyl inhibits locomotor muscle afferents resulting in improved exercise ventilation and hemodynamics, we tested the hypotheses, HF will demonstrate: 1) rapid V̇O2 on-kinetics, and 2) attenuated steady-state V̇O2 amplitude and oxygen deficit (O2def) during exercise with fentanyl versus placebo...
May 5, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28472859/lifestyle-interventions-for-the-treatment-of-women-with-gestational-diabetes
#10
REVIEW
Julie Brown, Nisreen A Alwan, Jane West, Stephen Brown, Christopher Jd McKinlay, Diane Farrar, Caroline A Crowther
BACKGROUND: Gestational diabetes (GDM) is glucose intolerance, first recognised in pregnancy and usually resolving after birth. GDM is associated with both short- and long-term adverse effects for the mother and her infant. Lifestyle interventions are the primary therapeutic strategy for many women with GDM. OBJECTIVES: To evaluate the effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes. SEARCH METHODS: We searched the Pregnancy and Childbirth Group's Trials Register (14 May 2016), ClinicalTrials...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28465382/pulmonary-function-and-respiratory-health-of-military-personnel-before-southwest-asia-deployment
#11
Andrew J Skabelund, Frederic A Rawlins, Edward T McCann, Joshua A Lospinoso, Lorraine Burroughs, Roger A Gallup, Michael J Morris
BACKGROUND: Significant concern exists regarding the respiratory health of military personnel deployed to Southwest Asia, given their exposures to numerous environmental hazards. Although the deployed military force is generally assumed to be fit, the pre-deployment respiratory health of these individuals is largely unknown. METHODS: Soldiers deploying to Southwest Asia were recruited from the pre-deployment processing center at Fort Hood, Texas. Participants completed a general and respiratory health questionnaire and performed baseline spirometry...
May 2, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28456886/mutations-in-gmppb-presenting-with-pseudometabolic-myopathy
#12
Chiara Panicucci, Chiara Fiorillo, Francesca Moro, Guja Astrea, Giacomo Brisca, Federica Trucco, Marina Pedemonte, Paola Lanteri, Lucia Sciarretta, Carlo Minetti, Filippo M Santorelli, Claudio Bruno
Mutations in the guanosine diphosphate mannose (GDP-mannose) pyrophosphorylase B (GMPPB) gene encoding a key enzyme of the glycosylation pathway have been described in families with congenital (CMD) and limb girdle (LGMD) muscular dystrophy with reduced alpha-dystroglycan (α-DG) at muscle biopsy.Patients typically display a combined phenotype of muscular dystrophy, brain malformations, and generalized epilepsy. However, a wide spectrum of clinical severity has been described ranging from classical CMD presentation to children with mild, yet progressive LGMD with or without intellectual disability...
April 30, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28449951/inspiratory-muscle-function-and-exercise-capacity-in-patients-with-heart-failure-with-preserved-ejection-fraction
#13
Patricia Palau, Eloy Domínguez, Eduardo Núñez, Jose María Ramón, Laura López, Joana Melero, Alejandro Bellver, Francisco J Chorro, Vicent Bodí, Antoni Bayés-Genis, Juan Sanchis, Julio Núñez
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by impaired exercise capacity due to dyspnea and fatigue. The pathophysiological mechanisms underlying the exercise intolerance in HFpEF are not well established. We sought to evaluate the effects of inspiratory muscle function on exercise tolerance in symptomatic patients with HFpEF. METHODS AND RESULTS: A total of 74 stable symptomatic patients with HFpEF and NYHA II-III underwent a cardiopulmonary exercise test between June 2012 and May 2016...
April 24, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28443623/novel-slc25a32-mutation-in-a-patient-with-a-severe-neuromuscular-phenotype
#14
Debby M E I Hellebrekers, Suzanne C E H Sallevelt, Tom E J Theunissen, Alexandra T M Hendrickx, Ralph W Gottschalk, Janneke G J Hoeijmakers, Daphna D Habets, Jörgen Bierau, Kees G Schoonderwoerd, Hubert J M Smeets
In a 51-year-old patient of consanguineous parents with a severe neuromuscular phenotype of early-onset ataxia, myoclonia, dysarthria, muscle weakness and exercise intolerance, exome sequencing revealed a novel homozygous variant (c.-264_31delinsCTCACAAATGCTCA) in the mitochondrial FAD-transporter gene SLC25A32. Flavin adenine dinucleotide (FAD) is an essential co-factor for many mitochondrial enzymes and impaired mitochondrial FAD-transport was supported by a reduced oxidative phosphorylation complex II activity in the patient's muscle, decreased ATP production in fibroblasts, and a deficiency of mitochondrial FAD-dependent enzymes...
April 26, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28436549/atrial-undersensing-secondary-to-quiet-timer-blanking-in-pediatric-and-congenital-heart-disease-patients
#15
Johannes C von Alvensleben, Michael Schaffer, Caitlin Brateng, Kathryn K Collins
BACKGROUND: Atrial undersensing despite normal atrial lead parameters and high amplitude electrograms has been described in adult patients as a consequence of atrial amplifier saturation. Repetitive inputs cause amplifier ringing and undersensing occurs as consequence of quiet timer blanking. High amplitude ventricular electrograms can also result in atrial blanking secondary to cross chamber effect. This has not been described in pediatric patients or epicardial pacing systems and specific risk factors are not known...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28433478/investigation-on-acute-effects-of-enzyme-replacement-therapy-and-influence-of-clinical-severity-on-physiological-variables-related-to-exercise-tolerance-in-patients-with-late-onset-pompe-disease
#16
Annalisa Sechi, Desy Salvadego, Alessandro Da Ponte, Nicole Bertin, Andrea Dardis, Silvia Cattarossi, Grazia Devigili, Federico Reccardini, Bruno Bembi, Bruno Grassi
Exercise intolerance is one of the clinical hallmarks of late-onset Pompe disease (LOPD). We studied the acute effects of ERT on the physiological variables associated with exercise tolerance in patients chronically ERT treated. Moreover, we assessed the influence of clinical severity on the investigated variables. The day before (B) and the day after (A) ERT injection, 11 LOPD patients performed on a cycle-ergometer an exercise tolerance test to voluntary exhaustion; VO2, HR, RPE, and GAA activity were determined in B and A...
March 10, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28415135/the-effects-of-enteral-feeding-improvement-massage-efim-on-premature-infants-a-randomized-controlled-trial
#17
Heeyoung Kim, Kyoung Sook Bang
AIMS AND OBJECTIVES: This study was conducted to prove the effects of an enteral feeding improvement massage (EFIM) for premature infants with regard to their feeding, growing, and superior mesenteric blood flow (SMA) blood flow aspect by a randomized control trial. BACKGROUND: Premature infants have feeding-related problems related to eating and absorbing nutrition due of their immature GI function. Studies regarding the effectiveness of premature infants' enteral feeding improvement by tactile stimulation massage are rare...
April 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28415098/p569diastolic-dyssynchrony-is-associated-with-exercise-intolerance-in-hypertensive-patients-with-left-ventricular-hypertrophy
#18
I H Jung, H S Seo, M J Kim
Background: Left ventricular hypertrophy (LVH) is associated with intra-ventricular dyssynchrony at systolic phase during exercise in hypertensive patients. However, dypsnea on exertion is much more correlated with diastolic phase. We investigated whether LVH is associated with diastolic dyssynchrony during exercise in patients with hypertension. Methods: Ninety hypertensive patients with exertional dyspnea and 30 control individuals were enrolled. Exercise stress echocardiography was performed using a symptom limited, multistage supine bicycle test...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28414396/postural-tachycardia-syndrome-diagnosis-and-management-in-adolescents-and-young-adults
#19
Geoffrey L Heyer
Postural tachycardia syndrome (POTS) represents a common form of orthostatic intolerance that disproportionately affects young women from puberty through adulthood. Patients with POTS have day-to-day orthostatic symptoms with the hallmark feature of an excessive, sustained, and symptomatic rise in heart rate during orthostatic testing. Although considerable overlap exists, three subtypes of POTS have been described: neuropathic, hyperadrenergic, and hypovolemic forms. The wide spectrum of symptoms and comorbidities can make treatment particularly challenging...
April 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28400468/the-diagnostic-value-of-hyperammonaemia-induced-by-the-non-ischaemic-forearm-exercise-test
#20
Jean-Yves Hogrel, Jorien B E Janssen, Isabelle Ledoux, Gwenn Ollivier, Anthony Béhin, Tanya Stojkovic, Bruno Eymard, Nicol C Voermans, Pascal Laforet
AIMS: The non-ischaemic forearm exercise test (NIFET) is used as a diagnostic tool for the screening of patients with exercise intolerance and for the diagnosis of various metabolic muscle disorders. The production of lactate and ammonia are generally analysed to guide the diagnosis. The aim of this retrospective study was to determine the level of ammonia rise, which can be suggestive of a muscle disease. METHODS: This retrospective study involved 1440 patients who underwent NIFET...
April 11, 2017: Journal of Clinical Pathology
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