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Exercise intolerance

Ryan Rosenberry, Susie Chung, Michael D Nelson
Exercise represents a major hemodynamic stress that demands a highly coordinated neurovascular response in order to match oxygen delivery to metabolic demand. Reactive hyperemia (in response to a brief period of tissue ischemia) is an independent predictor of cardiovascular events and provides important insight into vascular health and vasodilatory capacity. Skeletal muscle oxidative capacity is equally important in health and disease, as it determines the energy supply for myocellular processes. Here, we describe a simple, non-invasive approach using near-infrared spectroscopy to assess each of these major clinical endpoints (reactive hyperemia, neurovascular coupling, and muscle oxidative capacity) during a single clinic or laboratory visit...
February 20, 2018: Journal of Visualized Experiments: JoVE
Anna Suñol, Patricia Montoliu, Marta López, Joan Mascort, Carles Morales
Case summary: A 12-year-old neutered male domestic shorthair cat was presented to our referral hospital with a chronic history of tenesmus and lumbosacral pain. A diagnosis of degenerative lumbosacral stenosis (DLSS) was made and a standard dorsal L7-S1 laminectomy was performed uneventfully, with complete recovery within 1 month. The cat was brought back 4 months later for investigation of lumbosacral pain after having suffered a minor traumatic event. Neurological examination identified a low tail carriage, weakness, exercise intolerance, left pelvic limb lameness and diminished withdrawal reflexes in both pelvic limbs with severe sacrocaudal pain...
January 2018: JFMS Open Reports
Krzysztof Karpowicz, Katarzyna Krych, Małgorzata Karpowicz, Witold Nowak, Piotr Gronek
The map of candidate genes that can potentially affect physical fitness becomes larger every year, and they are associated with such aspects as respiratory and cardiovascular stability; body build and composition - especially muscle mass and strength; carbohydrate and lipid metabolism; response to training; and exercise intolerance.The aim of this study was to analyze the relationship between the CA repeat polymorphism of the P1 promoter of the IGF1 gene and the structure of motor skills in the two groups of Polish young athletes in 2011-2013...
March 15, 2018: Acta Biochimica Polonica
Maryam Nabavi Nouri, Anne-Marie Lamhonwah, Ingrid Tein
We present a 16-year-old girl with a unique clinical phenotype characterized by rapidly progressive exercise intolerance, transient exertional weakness, and progressive muscle cramps involving all limbs and bulbar muscles, following a first myoglobinuric episode at age 15 years, arising from homozygosity for a novel missense mutation (c.281G>C) in PYGM .
March 2018: Clinical Case Reports
Marco Herbsleb, Andy Schumann, Berend Malchow, Christian Puta, P Christian Schulze, Holger W Gabriel, Karl-Jürgen Bär
The elevated cardiovascular risk of patients with schizophrenia contributes to a reduced life expectancy of 15-20years. This study investigated whether cardiac autonomic dysfunction (CADF) in schizophrenia is related to chronotropic incompetence, an established cardiovascular risk marker. We investigated thirty-two patients suffering from paranoid schizophrenia and thirty-two control subjects matched for age, sex, body mass index and fat free mass. A cardiopulmonary exercise test (CPET) was performed to study heart rate responses to exercise as well as submaximal (ventilatory threshold 1, VT1 ) and maximal endurance capacities (peak oxygen consumption, VO2peak ; peak power output, Ppeak )...
March 8, 2018: Schizophrenia Research
Hester F Shieh, C Jason Smithers, Thomas E Hamilton, David Zurakowski, Gary A Visner, Michael A Manfredi, Russell W Jennings, Christopher W Baird
OBJECTIVE: Posterior descending aortopexy can relieve posterior intrusion of the left mainstem bronchus that may limit the effectiveness of posterior tracheobronchopexy. We review outcomes of patients undergoing both descending aortopexy and posterior tracheopexy for severe tracheobronchomalacia with posterior intrusion and left mainstem compression to determine if there were resolution of clinical symptoms and bronchoscopic evidence of improvement in airway collapse. METHODS: All patients who underwent both descending aortopexy and posterior tracheopexy from October 2012 to October 2016 were retrospectively reviewed...
March 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Areeg El-Gharbawy, Jerry Vockley
Fatty acid oxidation disorders (FAODs) and carnitine shuttling defects are inborn errors of energy metabolism with associated mortality and morbidity due to cardiomyopathy, exercise intolerance, rhabdomyolysis, and liver disease with physiologic stress. Hypoglycemia is characteristically hypoketotic. Lactic acidemia and hyperammonemia may occur during decompensation. Recurrent rhabdomyolysis is debilitating. Expanded newborn screening can detect most of these disorders, allowing early, presymptomatic treatment...
April 2018: Pediatric Clinics of North America
Christina Tomei, Sophie Lebel, Christine Maheu, Monique Lefebvre, Cheryl Harris
PURPOSE: Among cancer survivors, fear of cancer recurrence (FCR) is the most frequently reported unmet need. Despite this, research on psychosocial interventions that target FCR is limited. To address this gap, an individual cognitive-existential psychotherapy intervention for FCR was pilot tested via small-scale RCT. METHODS: Participants were recruited via study posters, healthcare professionals' referrals, and an electronic hospital database. Twenty-five female cancer survivors were randomized to experimental or wait-list control groups...
March 2, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
C A L Deus, P S Vigário, F S Guimarães, A J Lopes
Pulmonary function tests (PFTs) traditionally used in clinical practice do not accurately predict exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess whether the nitrogen single-breath washout (N2SBW) test explains exercise intolerance and poor quality of life in stable COPD patients. This cross-sectional study included 31 patients with COPD subjected to PFTs (including the N2SBW test) and a cardiopulmonary exercise test (CPET). Patients were also evaluated using the following questionnaires: the COPD assessment test (CAT), the 36-Item Short Form Health Survey (SF36) and St...
2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Milton Packer
No abstract text is available yet for this article.
February 22, 2018: American Journal of Medicine
Mariela Dore, Paloma Triana Junco, Carlos De La Torre, Alejandra Vilanova-Sánchez, Monserrat Bret, Gaspar Gonzalez, Vanesa Nuñez Cerezo, Javier Jimenez Gomez, Jose Luis Encinas, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Introduction  Minimally invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored. Our aim is to describe a case of a patient with an extremely severe PE that underwent a minimally invasive approach. Case report  An 8-year-old girl with severe sternum depression was assessed. She had a history of exercise intolerance, nocturnal dyspnea, fatigue, and shortness of breath. Chest computed tomography showed that sternum depression was posterior to the anterior vertebral column; therefore, Haller and correction index could not be measured...
January 2018: European Journal of Pediatric Surgery Reports
Akamin Raymond, Ettore Pedretti, Giuseppina Privitera, Cristina Cicero, Giacomo Biasucci
BACKGROUND: Unilateral absence of the pulmonary artery (UAPA) is a rare congenital malformation often associated with other cardiac anomalies; however it may occur as an isolated lesion. Isolated absence of the right pulmonary artery is twice more frequent than that of the left pulmonary artery. Patients with isolated UAPA are usually asymptomatic at birth; thereafter they may develop a progression of symptoms such as exercise intolerance, dyspnea, chest pain, hemoptysis and recurrent pulmonary infections...
February 20, 2018: Italian Journal of Pediatrics
Stuart D Katz
Heart failure is a common form of heart disease associated with progressive exercise intolerance and high risk of adverse clinical outcome events. The pathophysiology of chronic systolic heart failure is fundamentally determined by the failure of the circulatory system to deliver oxygen sufficient for metabolic needs, and it is best explained by a complex interplay between intrinsic abnormalities of ventricular pump function and extracardiac factors that limit oxygen use in metabolically active tissues. This brief review highlights the role of extracardiac factors (peripheral factors) that may impact exercise capacity in patients with chronic systolic heart failure...
February 2018: Annals of the American Thoracic Society
Natalia Dłużniewska, Piotr Podolec, Tomasz Miszalski-Jamka, Maciej Krupiński, Paweł Banyś, Małgorzata Urbańczyk, Bogdan Suder, Grzegorz Kopeć, Maria Olszowska, Lidia Tomkiewicz-Pająk
OBJECTIVES: Investigate the effects of left and right ventricular function and severity of pulmonary valve regurgitation, quantified by cardiac magnetic resonance (CMR), on exercise tolerance in adult patients who underwent ToF repair at a young age. METHODS: This is a retrospective cohort study of 52 patients after ToF surgery and 33 age- and sex-matched healthy volunteers. CMR and cardiopulmonary exercise testing (CPET) were performed on all patients; CPET was performed on control subjects...
January 2018: Indian Heart Journal
Julian W Sacre, Chiew Wong, Yih-Kai Chan, Melinda J Carrington, Simon Stewart, Bronwyn A Kingwell
OBJECTIVES: This study aimed to determine the association of stage B heart failure (SBHF) and its constituent left ventricular (LV) abnormalities with trajectory of exercise capacity over time, and assess whether this association is modified by reversion of these LV abnormalities to normal. BACKGROUND: The LV abnormalities of SBHF may coincide with a reduction in exercise capacity that precedes the overt exercise intolerance of clinical heart failure (HF). Determining the predictive capacity of established and novel SBHF criteria for exercise capacity decline may improve HF risk stratification...
February 9, 2018: JACC. Cardiovascular Imaging
William M Oldham, Rudolf K Oliveira, Rui-Sheng Wang, Alexander R Opotowsky, David M Rubins, Jon Hainer, Bradley M Wertheim, George A Alba, Gaurav Choudhary, Adrienn Tornyos, Calum A MacRae, Joseph Loscalzo, Jane A Leopold, Aaron Waxman, Horst Olschewski, Gabor Kovacs, David M Systrom, Bradley A Maron
<u>Rationale:</u> Current methods assessing clinical risk due to exercise intolerance in cardiopulmonary disease patients rely on a small subset of traditional variables. Alternative strategies incorporating the spectrum of factors underlying prognosis in at-risk patients may be useful clinically, but are lacking. <u>Objective:</u> Use unbiased analyses to identify variables that correspond to clinical risk in patients with exercise intolerance. <u>Methods and Results:</u> Data from 738 consecutive patients referred for invasive cardiopulmonary exercise testing (iCPET) at a single center (2011-2015) were analyzed retrospectively (derivation cohort)...
February 5, 2018: Circulation Research
José M Martín, Catalina Torres, Pilar Cordero, Sara Sánchez, Liria Terradez, Dolores Ramón
Bascule syndrome is a recently described benign vasomotor dermatosis characterized by Bier anemic spots, cyanosis, and urticaria-like eruption. We report a case of a 13-year-old girl with cutaneous lesions consistent with Bascule syndrome who had had three exercise-related syncopal episodes. It would be recommended to exclude orthostatic intolerance or postural orthostatic tachycardia syndrome when evaluating patients with Bascule syndrome.
February 13, 2018: Pediatric Dermatology
Christopher W Follansbee, Lee Beerman, Gaurav Arora
We describe a 17-year-old female who presented with 3 weeks of abdominal pain, exercise intolerance, and an episode of altered mental status found to have marked first-degree atrioventricular block. Exercise stress test and cardiac catheterization demonstrated pseudo-pacemaker syndrome, and a permanent pacemaker was placed. Following placement, she has resolution of symptoms and markedly improved exercise tolerance.
February 12, 2018: Pediatric Cardiology
Iraklis Pozios, Aurelio Pinheiro, Celia Corona-Villalobos, Lars L Sorensen, Zeina Dardari, Hong-Yun Liu, Kenneth Cresswell, Susan Phillip, David A Bluemke, Stefan L Zimmerman, M Roselle Abraham, Theodore P Abraham
BACKGROUND: Exercise intolerance is the most common symptom in hypertrophic cardiomyopathy (HCM). We examined whether inability to augment myocardial mechanics during exercise would influence functional performance and clinical outcomes in HCM. METHODS: Ninety-five HCM patients (32 nonobstructive, 32 labile-obstructive, 31 obstructive) and 26 controls of similar age and gender distribution were recruited prospectively. They underwent rest and treadmill stress strain echocardiography, and 61 of them underwent magnetic resonance imaging...
February 6, 2018: Journal of the American Society of Echocardiography
Paolo Ruggeri, Federica Lo Bello, Francesco Nucera, Michele Gaeta, Francesco Monaco, Gaetano Caramori, Giuseppe Girbino
We present here the case of a 30-year-old man with a long term history of nephrotic syndrome (NS) who developed an episode of acute left main pulmonary artery thrombosis complicated by a lung abscess. During the hospital admission was also identified a concomitant hyperhomocysteinemia. After an atypical resection of the left upper pulmonary lobe and the starting of long term anticoagulation the patient was discharged but did not attend the planned follow up visits until one year later when he was seen again for severe dyspnea and exercise intolerance...
December 19, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
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