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Exercise intolerance

Robert E Kelly, Robert J Obermeyer, Donald Nuss
BACKGROUND: Recently, technical improvement in the ability to measure lung function and the severity of chest deformity have enabled progress in understanding the mechanism of limitations of lung function in pectus excavatum. METHODS: After establishing that most patients with pectus excavatum do have symptoms of exercise intolerance, easy fatigability, and shortness of breath with exertion, lung function has been evaluated by a variety of methods in different centers...
September 2016: Annals of Cardiothoracic Surgery
Tieh-Cheng Fu, Wen-Chen Lin, Jong-Shyan Wang, Chao-Hung Wang, Chun-Tien Chang, Cheng-Lun Tsai, Yun-Shien Lee, Kang-Ping Lin
Exercise periodic breathing (EPB) is associated with exercise intolerance and poor prognosis in patients with heart failure (HF). However, EPB detection during cardiopulmonary exercise test (CPET) is difficult. The present study investigated the use of a wireless monitoring device to record the EPB during CPET and proposed quantization parameter estimates for the EPB. A total of 445 patients with HF were enrolled and underwent exercise tests. The ventilation data from the wearable device were compared with the data obtained during the CPET and were analyzed based on professional opinion and on 2 automated programs (decision tree [DT] and oscillatory pattern methods)...
October 15, 2016: Medical & Biological Engineering & Computing
Ludovic Giloteaux, Maureen R Hanson, Betsy A Keller
BACKGROUND Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) present with profound fatigue, flu-like symptoms, pain, cognitive impairment, orthostatic intolerance, and post-exertional malaise (PEM), and exacerbation of some or all of the baseline symptoms. CASE REPORT We report on a pair of 34-year-old monozygotic twins discordant for ME/CFS, with WELL, the non-affected twin, and ILL, the affected twin. Both twins performed a two-day cardiopulmonary exercise test (CPET), pre- and post-exercise blood samples were drawn, and both provided stool samples for biochemical and molecular analysis...
October 10, 2016: American Journal of Case Reports
Masamichi Yamashita
Aspirin is the oldest non-steroidal anti-inflammatory drug (NSAID), and it sometimes causes asthma-like symptoms known as aspirin-exacerbated respiratory disease (AERD), which can be serious. Unwanted effects of aspirin (aspirin intolerance) are also observed in patients with food-dependent exercise-induced anaphylaxis, a type I allergy disease, and aspirin-induced urticaria (AIU). However the target and the mechanism of the aspirin intolerance are still unknown. There is no animal or cellular model of AERD, because its pathophysiological mechanism is still unknown, but it is thought that inhibition of cyclooxygenase by causative agents lead to an increase of free arachidonic acid, which is metabolized into cysteinyl leukotrienes (cysLTs) that provoke airway smooth muscle constriction and asthma symptoms...
October 5, 2016: Current Drug Targets
Akhilesh K Sista, Larry E Miller, Susan R Kahn, Jeffrey A Kline
Long-term right ventricular (RV) function, functional capacity, exercise capacity, and quality of life following pulmonary embolism (PE), and the impact of thrombolysis, are unclear. A systematic review of studies that evaluated these outcomes with ⩾ 3-month mean follow-up after PE diagnosis was performed. For each outcome, random effects meta-analyses were performed. Twenty-six studies (3671 patients) with 18-month median follow-up were included. The pooled prevalence of RV dysfunction was 18.1%. Patients treated with thrombolysis had a lower, but not statistically significant, risk of RV dysfunction versus those treated with anticoagulation (odds ratio: 0...
October 5, 2016: Vascular Medicine
Indumathi Chennamsetty, Michael Coronado, Kévin Contrepois, Mark P Keller, Ivan Carcamo-Orive, John Sandin, Giovanni Fajardo, Andrew J Whittle, Mohsen Fathzadeh, Michael Snyder, Gerald Reaven, Alan D Attie, Daniel Bernstein, Thomas Quertermous, Joshua W Knowles
We recently identified human N-acetyltransferase 2 (NAT2) as an insulin resistance (IR) gene. Here, we examine the cellular mechanism linking NAT2 to IR and find that Nat1 (mouse ortholog of NAT2) is co-regulated with key mitochondrial genes. RNAi-mediated silencing of Nat1 led to mitochondrial dysfunction characterized by increased intracellular reactive oxygen species and mitochondrial fragmentation as well as decreased mitochondrial membrane potential, biogenesis, mass, cellular respiration, and ATP generation...
October 4, 2016: Cell Reports
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
Djurdja Djordjevic, Lauren Brady, Renkui Bai, Mark A Tarnopolsky
We describe here two novel mitochondrial mutations associated with a complex mitochondrial encephalopathy. An A to G transition at position 7495 (MT-TS1 (MT-tRNSer(UCN))) was identified at 83% heteroplasmy in the muscle of a four year old female with ptosis, hypotonia, seizures, and dilated cardiomyopathy (Case 1). A homoplasmic C to T transition at position 5577 (MT-TW (MT-tRNATrp)) was found in a twenty-four year old woman with exercise intolerance, mild muscle weakness, hearing loss, seizures, and cognitive decline (Case 2)...
September 28, 2016: Mitochondrion
Richard B Thompson, Corey R Tomczak, Mark J Haykowsky
Impaired exercise tolerance is a major determinant of decreased quality of life and survival in individuals with cardiovascular disease. The relative contribution that abnormal cardiac, vascular, and skeletal muscle function plays in limiting exercise tolerance and its improvement with exercise training in patients with cardiovascular disease is not fully known. In this review, we provide an overview of the functional impairment of these systems as they relate to exercise capacity and the emerging role of magnetic resonance imaging as a comprehensive tool to evaluate mechanisms that may explain exercise intolerance...
October 2016: Canadian Journal of Cardiology
Li Guo, Yong Yuan, Rui Bi
Essential hypertension (EH) is a common complex disorder with high heritability. Maternal inherited pattern was observed in some families with EH, which was known as maternally inherited essential hypertension (MIEH). Mitochondrial DNA (mtDNA) mutations were identified to account for some MIEH in previous studies. In the present study, we characterized clinical manifestations and the complete mitochondrial genome of a Chinese family with MIEH. Through analyzing the whole mtDNA genome of the proband, we identified a mutation m...
October 28, 2016: Biochemical and Biophysical Research Communications
Susan Taylor, Katie Minor, Cindy L Shmon, G Diane Shelton, Edward E Patterson, James R Mickelson
Completed surveys were obtained from owners of 165 border collies experiencing repeated episodes of abnormal gait or collapse during strenuous exercise. Unremarkable veterinary evaluation and lack of disease progression over time made common systemic, cardiac, and neurologic causes of exercise intolerance unlikely. Survey questions addressed signalment, age of onset, description of episodes, and owner perception of factors associated with collapse. Most dogs were young adults (median 2 y) when episodes began, and they had experienced from two to more than 100 episodes (median six) prior to their owners completing the survey...
September 29, 2016: Journal of the American Animal Hospital Association
A Young Lim, Chunghun Kim, Sung-Ji Park, Jin-Oh Choi, Sang-Chol Lee, Seung Woo Park
AIMS: Recent studies have shown that exercise-induced pulmonary hypertension (EIPH) is not rare in patients with preserved left ventricular ejection fraction (LVEF). However, the determinants and clinical implication of EIPH in these patients are unclear. METHODS AND RESULTS: This study included 1383 patients who were referred for exercise echocardiography to evaluate unexplained exertional dyspnoea or chest discomfort. Pulmonary artery systolic pressure (PASP) was estimated from the maximal velocity of the tricuspid regurgitant jet added to a right atrial pressure of 10 mmHg...
September 27, 2016: European Heart Journal Cardiovascular Imaging
Dan Xu, Yingshuo Wang, Zhimin Chen, Shuxian Li, Yungai Cheng, Li Zhang, Lingzhi Zhao
BACKGROUND: Asthma is a global problem. Prevalence varies among different countries and cities. We aimed to obtain the prevalence, describe the characteristics, and discover factors that may relate to asthma in Hangzhou. METHODS: This cross-sectional study was conducted in Hangzhou. The subjects were children aged 14 years and younger. A control group of non-asthma children that matched in age and sex with each asthmatic patient was also randomly selected and interviewed...
September 27, 2016: Respiratory Research
Tiphaine Bourseau, Flavie Fremondière, Valérie Dubus, Bénédicte Gohier, Dewi Le Gal, Fabien Cave, Isabelle Richard, Nicolas Lerolle
OBJECTIVE: After critical illness, some survivors experience long-term physical, functional, neurocognitive and/or mental health impairments, which has been termed "Post-Intensive Care syndrome" (PICS) [1]. A specific follow-up is required and many specialized follow-up clinics have been created both abroad and in France. The aim of this study is to evaluate long-term outcomes after critical illness, through the International Classification of Functioning, Disability and Health, and to analyse rehabilitation needs after intensive care unit (ICU) discharge...
September 2016: Annals of Physical and Rehabilitation Medicine
B Schmitz, L Thorwesten, M Lenders, T Duning, J Stypmann, E Brand, S-M Brand
The aim of this study was to assess the extent of exercise intolerance in Fabry disease (FD) patients and to report individual effects of physical exercise. Exercise capacity and strength of 14 patients (mean age 46 years, 6 females) were determined using cycle ergometry and isokinetic measurements. Patients performed a strength/circuit exercise training protocol for 12 months. The mean relative maximum performance of the group was low at baseline and increased by 12.1% (baseline: 1.9 [0.9-3.4] W·kg(-1) vs...
September 27, 2016: International Journal of Sports Medicine
N C Voermans, M Snoeck, H Jungbluth
Mutations in the skeletal muscle ryanodine receptor (RYR1) gene are associated with a wide spectrum of inherited myopathies presenting throughout life. Malignant hyperthermia susceptibility (MHS)-related RYR1 mutations have emerged as a common cause of exertional rhabdomyolysis, accounting for up to 30% of rhabdomyolysis episodes in otherwise healthy individuals. Common triggers are exercise and heat and, less frequently, viral infections, alcohol and drugs. Most subjects are normally strong and have no personal or family history of malignant hyperthermia...
October 2016: Revue Neurologique
Daniel T Cannon, Ana Claudia Coelho, Robert Cao, Andrew Cheng, Janos Porszasz, Richard Casaburi, Harry B Rossiter
Muscle fatigue (a reduced power for a given activation) is common following exercise in COPD. Whether muscle fatigue, and reduced maximal voluntary locomotor power, are sufficient to limit whole-body exercise in COPD is unknown. We hypothesized in COPD: 1) exercise is terminated with a locomotor muscle power reserve; 2) reduction in maximal locomotor power is related to ventilatory limitation; and 3) muscle fatigue at intolerance is less than age-matched controls. We used a rapid switch from hyperbolic to isokinetic cycling to measure the decline in peak isokinetic power at the limit of incremental exercise ('performance fatigue') in 13 COPD (FEV1 49±17 %pred) and 12 controls...
September 22, 2016: Journal of Applied Physiology
Alessandra Adami, Robert Cao, Janos Porszasz, Richard Casaburi, Harry B Rossiter
Low muscle oxidative capacity contributes to exercise intolerance in chronic obstructive pulmonary disease (COPD). Near-infrared spectroscopy (NIRS) allows non-invasive determination of the muscle oxygen consumption (mV̇O2) recovery rate constant (k), which is proportional to oxidative capacity assuming two conditions are met: 1) exercise intensity is sufficient to fully-activate mitochondrial oxidative enzymes; 2) sufficient O2 availability. We aimed to determine reproducibility (coefficient of variation, CV; intraclass correlation coefficient, ICC) of NIRS k assessment in the gastrocnemius of 64 participants with (FEV1 64±23%predicted) or without COPD (FEV1 98±14%predicted)...
September 19, 2016: Respiratory Physiology & Neurobiology
G J Wesseling
Hyperinflation is an important element in chronic obstructive pulmonary disease (COPD), contributing significantly to dyspnoea and exercise intolerance. Bronchodilators have some, albeit slight, effect on hyperinflation. Lung volume reduction surgery has been advocated in a highly select group of patients with heterogeneous, predominantly upper lobe, emphysema but morbidity and mortality associated with this intervention have hampered its widespread use in respiratory medicine. Bronchoscopic lung volume reduction has recently been introduced...
2016: Nederlands Tijdschrift Voor Geneeskunde
T Arpaci, E Kilicarslan Toruner
Significant physical and psychosocial problems and related symptoms are observed in cancer survivors after treatment as well as during the treatment period. This study was aimed to assess problems and symptoms in childhood acute lymphoblastic leukaemia (ALL) survivors. Study was applied in three hospitals in Ankara/Turkey with 91 children who were diagnosed and treated with ALL and with their family. Data were collected using the data collection form developed by the researchers. The variables were investigated using the Mann-Whitney U and chi-square test...
September 20, 2016: European Journal of Cancer Care
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