SOSTIENICI
Pubblicazioni recenti - cardiopulmonary exercise
-
Recovery from Exercise in Persons with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
Medicina (Kaunas)2023 Mar;59(3):. doi: 571.
Moore Geoffrey E, Keller Betsy A, Stevens Jared, Mao Xiangling, Stevens Staci R, Chia John K, Levine Susan M, Franconi Carl J, Hanson Maureen R,
Abstract
: Post-exertional malaise (PEM) is the hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but there has been little effort to quantitate the duration of PEM symptoms following a known exertional stressor. Using a Symptom Severity Scale (SSS) that includes nine common symptoms of ME/CFS, we sought to characterize the duration and severity of PEM symptoms following two cardiopulmonary exercise tests separated by 24 h (2-day CPET). : Eighty persons with ME/CFS and 64 controls (CTL) underwent a 2-day CPET. ME/CFS subjects met the Canadian Clinical Criteria for diagnosis of ME/CFS; controls were healthy but not participating in regular physical activity. All subjects who met maximal effort criteria on both CPETs were included. SSS scores were obtained at baseline, immediately prior to both CPETs, the day after the second CPET, and every two days after the CPET-1 for 10 days. : There was a highly significant difference in judged recovery time (ME/CFS = 12.7 ± 1.2 d; CTL = 2.1 ± 0.2 d, mean ± s.e.m., Chi = 90.1, 22,
Guarda su PubMed
-
Post-COVID Syndrome and Cardiorespiratory Fitness-26-Month Experience of Single Center.
Life (Basel)2023 Mar;13(3):. doi: 684.
Sova Milan, Sovova Eliska, Ozana Jaromir, Moravcova Katarina, Sovova Marketa, Jelinek Libor, Mizera Jan, Genzor Samuel,
Abstract
INTRODUCTION:
Persistent post-COVID syndrome, also referred to as long COVID, is a pathologic entity that involves persistent physical, medical, and cognitive sequelae following COVID-19. Decreased fitness has repeatedly been reported in numerous studies dealing with post-COVID syndrome, however, it is still not fully clear which groups of patients may be more susceptible for persisting symptoms.
AIM:
The aim of our study was to evaluate the number of post-COVID patients with cardiac symptoms, where these patients were evaluated by CPET and the results compared with a control group of patients.
METHODS:
Follow-up of patients in post-COVID outpatient clinic from 1 March 2020 to 31 May 2022. Inclusion criteria were positive PCR test for SARS-CoV-2 and age 18-100. The initial examination was performed 4-12 weeks after the disease onset. All patients with possible cardiac symptoms had completed cardiopulmonary exercise testing. The control group was randomly selected from a database of clients in 2019, with the preventive reason for evaluation.
RESULTS:
From 1 March 2020 to 31 May 2022, 2732 patients (45.7% males) were evaluated with a mean age of 54.6 ± 14.7. CPET was indicated only in 97 patients (3.5%). Seventy-four patients (26 male) achieved the exercise maximum and a comparison were made with a control group (same age ( = 0.801), BMI ( = 0.721), and sex ratio). No significant dependence between the parameter VO max mL/kg/min and post-COVID disability was demonstrated ( = 0.412). Spearman's correlation analysis did not show a significant relationship between the parameter VO max mL/kg/min and the severity of COVID-19 ( = 0.285).
CONCLUSIONS:
Cardiac symptoms occurred in only a small percentage of patients in our study. There is a need for further studies that would objectively evaluate the effect of COVID-19 disease on the patient's health.
Guarda su PubMed
-
Assessment of Exercise Capacity in Post-COVID-19 Patients: How Is the Appropriate Test Chosen?
Life (Basel)2023 Feb;13(3):. doi: 621.
Torres-Castro Rodrigo, Núñez-Cortés Rodrigo, Larrateguy Santiago, Alsina-Restoy Xavier, Barberà Joan Albert, Gimeno-Santos Elena, García Agustin Roberto, Sibila Oriol, Blanco Isabel,
Abstract
There is a wide range of sequelae affecting COVID-19 survivors, including impaired physical capacity. These sequelae can affect the quality of life and return to work of the active population. Therefore, one of the pillars of following-up is the evaluation of physical capacity, which can be assessed with field tests (such as the six-minute walk test, the one-minute standing test, the Chester step test, and the shuttle walking test) or laboratory tests (such as the cardiopulmonary exercise test). These tests can be performed in different contexts and have amply demonstrated their usefulness in the assessment of physical capacity both in post-COVID-19 patients and in other chronic respiratory, metabolic, cardiologic, or neurologic diseases. However, when traditional tests cannot be performed, physical function can be a good substitute, especially for assessing the effects of an intervention. For example, the Short Physical Performance Battery assessment and the Timed Up and Go assessment are widely accepted in older adults. Thus, the test should be chosen according to the characteristics of each subject.
Guarda su PubMed
-
Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?
J Clin Med2023 Mar;12(6):. doi: 2375.
Gentili Federica, Calcagni Giulio, Cantarutti Nicoletta, Manno Emma Concetta, Cafiero Giulia, Tranchita Eliana, Salvati Annamaria, Palma Paolo, Giordano Ugo, Drago Fabrizio, Turchetta Attilio,
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that imposes a long-term follow-up. The purpose of our pilot study is to evaluate the usefulness of the cardiopulmonary stress test (CPET) in the follow-up after MIS-C. All patients admitted for MIS-C in our hospital in the 12 months preceding the date of observation were considered for inclusion in the study. Pre-existing cardio-respiratory diseases and/or the lack of collaboration were the exclusion criteria. At enrolment, each subject passed a cardiological examination, rest ECG, echocardiogram, 24 h Holter-ECG, blood tests, and a CPET complete of spirometry. A total of 20 patients met the inclusion criteria (11.76 ± 3.29 years, 13 male). In contrast to the normality of all second-level investigations, CPET showed lower-than-expected peakVO and peak-oxygen-pulse values (50% of cases) and higher-than-expected VE/VCOslope values (95% of cases). A statistically significant inverse correlation was observed between P-reactive-protein values at admission and peakVO/kg values ( 0.034), uric acid values at admission, and peakVO ( 0.011) or peak-oxygen-pulse expressed as a percentage of predicted ( = 0.021), NT-proBNP values at admission and peakVO expressed as a percentage of predicted ( = 0.046). After MIS-C (4-12 months) relevant anomalies can be observed at CPET, which can be a valuable tool in the follow-up after this condition.
Guarda su PubMed
-
Feasibility of Seated Stepping and Handshaking as a Cardiopulmonary Exercise Testing: A Pilot Study.
J Clin Med2023 Mar;12(6):. doi: 2140.
Imashiro Kyosuke, Nishioka Yasuko, Teramura Kenzo, Hashimoto Hiromi, Kimura Hiroki, Tanabe Naoya, Taniguchi Yasuhiro, Nakai Koya, Umemoto Yasunori, Ito Tomoyuki, Tajima Fumihiro, Mikami Yasuo,
Abstract
Cardiopulmonary function is usually assessed by cardiopulmonary exercise testing (CPX) using a cycle ergometer (CE-CPX) or a treadmill, which is difficult in patients with lower extremity motor dysfunction. A stepping and handshaking (SHS) exercise has been developed that can be performed safely and easily while sitting on a chair. This study compared peak oxygen uptake (peak V.O2) between CE-CPX and SHS-CPX in healthy adults and investigated the safety and validity of SHS-CPX. Twenty young adults (mean age 27.8 ± 4.4 years) were randomly assigned to perform CE-CPX or SHS-CPX, with the other test to follow 1-2 weeks later. The peak V.O2, respiratory exchange ratio (RER), peak heart rate, blood pressure, and test completion time were compared between CE-CPX and SHS-CPX. All subjects completed the examination and met the criteria for peak V.O2. SHS-CPX and CE-CPX showed a strong correlation with peak V.O2 (r = 0.85,
Guarda su PubMed
-
Heart Rate Recovery Assessed by Cardiopulmonary Exercise Testing in Patients with Cardiovascular Disease: Relationship with Prognosis.
Int J Environ Res Public Health2023 Mar;20(6):. doi: 4678.
Dewar Amy, Kass Lindsy, Stephens Robert C M, Tetlow Nicholas, Desai Terun,
Abstract
BACKGROUND:
The use of exercise testing has expanded in recent decades and there is a wealth of information examining the prognostic significance of exercise variables, such as peak oxygen consumption or ventilatory measures whilst exercising. However, a paucity of research has investigated the use of recovery-derived parameters after exercise cessation. Heart rate recovery (HRR) has been considered a measure of the function of the autonomic nervous system and its dysfunction is associated with cardiovascular risk.
OBJECTIVES:
We aim to provide an overview of the literature surrounding HRR and its prognostic significance in patients with cardiovascular disease undertaking an exercise test.
DATA SOURCES:
In December 2020, searches of PubMed, Scopus, and ScienceDirect were performed using key search terms and Boolean operators.
STUDY SELECTION:
Articles were manually screened and selected as per the inclusion criteria.
RESULTS:
Nineteen articles met inclusion criteria and were reviewed. Disagreement exists in methodologies used for measuring and assessing HRR. However, HRR provides prognostic mortality information for use in clinical practice.
CONCLUSIONS:
HRR is a simple, non-invasive measure which independently predicts mortality in patients with heart failure and coronary artery disease; HRR should be routinely incorporated into clinical exercise testing.
Guarda su PubMed
-
Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Young Patients with Congenital Heart Disease.
Children (Basel)2023 Mar;10(3):. doi: 521.
Vecchiato Marco, Ermolao Andrea, Zanardo Emanuele, Battista Francesca, Ruvoletto Giacomo, Palermi Stefano, Quinto Giulia, Degano Gino, Gasperetti Andrea, Padalino Massimo A, Di Salvo Giovanni, Neunhaeuserer Daniel,
Abstract
INTRODUCTION:
The overshoot of the respiratory exchange ratio (RER) after exercise is reduced in patients with heart failure.
AIM:
The present study aimed to investigate the presence of this phenomenon in young patients with congenital heart disease (CHD), who generally present reduced cardiorespiratory fitness.
METHODS:
In this retrospective study, patients with CHD underwent a maximal cardiopulmonary exercise testing (CPET) assessing the RER recovery parameters: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot and the linear slope of the RER increase after the end of the exercise.
RESULTS:
In total, 117 patients were included in this study. Of these, there were 24 healthy age-matched control subjects and 93 young patients with CHD (transposition of great arteries, Fontan procedure, aortic coarctation and tetralogy of Fallot). All patients presented a RER overshoot during recovery. Patients with CHD showed reduced aerobic capacity and cardiorespiratory efficiency during exercise, as well as a lower RER overshoot when compared to controls. RER magnitude was higher in the controls and patients with aortic coarctation when compared to those with transposition of great arteries, previous Fontan procedure, and tetralogy of Fallot. The RER magnitude was found to be correlated with the most relevant cardiorespiratory fitness and efficiency indices.
CONCLUSIONS:
The present study proposes new recovery indices for functional evaluation in patients with CHD. Thus, the RER recovery overshoots analysis should be part of routine CPET evaluation to further improve prognostic risk stratifications in patients with CHD.
Guarda su PubMed
-
Effect of 11 Weeks of Physical Exercise on Physical Fitness and Executive Functions in Children.
Children (Basel)2023 Mar;10(3):. doi: 485.
Zhang Mingyang, Garnier Hanna, Qian Guoping, Li Shunchang,
Abstract
OBJECT:
The aim of our study was to evaluate and compare the effects of physical exercise interventions on physical fitness and executive functions in children.
METHODS:
Six-year-old children participated in the study and were randomly divided into physical exercise group (PE group, = 43) and control group (C group, = 46). The children in the PE group participated in a physical exercise program for 45 min daily, four days a week for 11 weeks. The children in the C group continued with their usual routines. Then, all the children were tested before and after the experiment for body composition (height, weight, BMI), physical fitness (20-m shuttle run test, standing long jump test, grip strength test, 4 × 10 m shuttle run test and sit and reach tests), and executive functions test (animal go/no-go task, working memory span task, simple reaction test and flexible item selection task) before and after the 11-week period.
RESULTS:
The 11 weeks of physical exercise did not significantly affect the body composition of the children ( > 0.05). The physical fitness and executive functions test results showed that 11 weeks of physical exercise interventions improves physical fitness (cardiopulmonary fitness, muscle strength, speed sensitivity and flexibility quality) and executive functions parameters (inhibitory control, working memory, the reaction time, and cognitive flexibility) in children (
CONCLUSION:
11 weeks of physical exercise can improve the physical fitness and executive functions of six-year-old children.
Guarda su PubMed
-
L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure.
Biomolecules2023 Feb;13(3):. doi: 423.
Drohomirecka Anna, Wa? Joanna, Wiligórska Natalia, Rywik Tomasz M, Komuda Krzysztof, Soko?owska Dorota, Luty?ska Anna, Zieli?ski Tomasz,
Abstract
Methylated arginine metabolites interrupt nitric oxide synthesis, which can result in endothelium dysfunction and inadequate vasodilation. Since little is known about the dynamics of arginine derivatives in patients with heart failure (HF) during physical exercise, we aimed to determine this as well as its impact on the patient outcomes. Fifty-one patients with HF (left ventricle ejection fraction-LVEF ? 35%, mean 21.7 ± 5.4%) underwent the cardiopulmonary exercise test (CPET). Plasma concentrations of L-arginine, citrulline, ornithine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) were measured before and directly after CPET. All patients were followed for a mean of 23.5 ± 12.6 months. The combined endpoint was: any death, urgent heart transplantation, or urgent LVAD implantation. L-arginine concentrations increased significantly after CPET ( = 0.02), when ADMA ( = 0.01) and SDMA ( = 0.0005) decreased. The parameters of better exercise capacity were positively correlated with post-CPET concentration of L-arginine and inversely with post-CPET changes in ADMA, SDMA, and baseline and post-CPET SDMA concentrations. Baseline and post-CPET SDMA concentrations increased the risk of endpoint occurrence (HR 1.02, 95% CI 1.009-1.03, = 0.04 and HR 1.02, 95% CI 1.01-1.03, = 0.02, respectively). In conclusion, in patients with HF, extensive exercise is accompanied by changes in arginine derivatives that can reflect endothelium function. These observations may contribute to the explanation of the pathophysiology of exercise intolerance in HF.
Guarda su PubMed
-
Sildenafil and Kidney Function in Heart Failure with Preserved Ejection Fraction.
Kidney3602023 Mar;():. doi: 10.34067/KID.0000000000000103.
Edmonston Daniel, Sparks Matthew, Rajagopal Sudarshan, Wolf Myles,
Abstract
BACKGROUND:
Chronic kidney disease (CKD) worsens the prognosis for people with heart failure with preserved ejection fraction (HFpEF). In the RELAX trial, sildenafil decreased estimated glomerular filtration rate (eGFR) compared to placebo despite favorable kidney effects in preclinical models. Since acute eGFR decline precedes long-term kidney benefits for select medications, we assessed the influence of sildenafil on acute and chronic eGFR slopes.
METHODS:
The RELAX trial randomized 216 participants to placebo or sildenafil and assessed 24-week changes in cardiopulmonary exercise testing, cardiovascular imaging, and laboratory data. We applied linear mixed modeling to calculate the total, acute (0-12 weeks), and chronic (3-24 weeks) eGFR slopes by treatment. Using regression modeling, we assessed respective associations between eGFR slope and baseline data and clinical endpoints. We repeated the analyses using a binary outcome based on a substantial (?20%) decline in eGFR.
RESULTS:
The mean baseline eGFR was 60.8 ml/min/1.73 m2, and the mean eGFR slope during follow-up was -3.21 ml/min/1.73 m2/year. Sildenafil did not alter total eGFR slope compared to placebo (difference +0.47 ml/min/1.73 m2/year, 95% CI -6.63 - 7.57 ml/min/1.73 m2/year). Sildenafil users tended to experience a more negative acute eGFR slope (difference -3.15 ml/min/1.73 m2/year) and more positive chronic slope (+2.06 ml/min/1.73 m2/year) compared to placebo, but neither difference reached statistical significance. Baseline NT-proBNP and loop diuretic use were associated with worse eGFR trajectory regardless of treatment. Substantial eGFR decline was associated with increase in endothelin-1 and a greater risk of hospitalization or death (HR 2.34, 95% CI 1.21-4.53, p=0.01).
CONCLUSIONS:
Sildenafil induced an acute effect on eGFR without change in the overall eGFR slope after 24 weeks in a HFpEF cohort, suggesting lack of long-term risk related to early reduction in eGFR after initiating treatment. Long-term studies are needed to determine the effect of sildenafil on kidney function in HFpEF.
Copyright © 2023 by the American Society of Nephrology.
Guarda su PubMed
-
Maximal Exercise Improves the Levels of Endothelial Progenitor Cells in Heart Failure Patients.
Curr Issues Mol Biol2023 Feb;45(3):1950-1960. doi: 10.3390/cimb45030125.
Cavalcante Suiane, Viamonte Sofia, Cadilha Rui S, Ribeiro Ilda P, Gonçalves Ana Cristina, Sousa-Venâncio João, Gouveia Marisol, Teixeira Manuel, Santos Mário, Oliveira José, Ribeiro Fernando,
Abstract
The impact of exercise on the levels of endothelial progenitor cells (EPCs), a marker of endothelial repair and angiogenesis, and circulating endothelial cells (CECs), an indicator of endothelial damage, in heart failure patients is largely unknown. This study aims to evaluate the effects of a single exercise bout on the circulating levels of EPCs and CECs in heart failure patients. Thirteen patients with heart failure underwent a symptom-limited maximal cardiopulmonary exercise test to assess exercise capacity. Before and after exercise testing, blood samples were collected to quantify EPCs and CECs by flow cytometry. The circulating levels of both cells were also compared to the resting levels of 13 volunteers (age-matched group). The maximal exercise bout increased the levels of EPCs by 0.5% [95% Confidence Interval, 0.07 to 0.93%], from 4.2 × 10 ± 1.5 × 10% to 4.7 × 10 ± 1.8 × 10% ( = 0.02). No changes were observed in the levels of CECs. At baseline, HF patients presented reduced levels of EPCs compared to the age-matched group ( = 0.03), but the exercise bout enhanced circulating EPCs to a level comparable to the age-matched group (4.7 × 10 ± 1.8 × 10% vs. 5.4 × 10 ± 1.7 × 10%, respectively, = 0.14). An acute bout of exercise improves the potential of endothelial repair and angiogenesis capacity by increasing the circulating levels of EPCs in patients with heart failure.
Guarda su PubMed
-
Cardiorespiratory Fitness and Cardiac Magnetic Resonance Imaging in Childhood Acute Lymphoblastic Leukemia Survivors.
J Phys Act Health2023 Mar;():1-9. doi: 10.1123/jpah.2022-0179.
Caru Maxime, Curnier Daniel, Dubois Pierre, Friedrich Matthias G, Andelfinger Gregor, Krajinovic Maja, Laverdière Caroline, Sinnett Daniel, Périé Delphine,
Abstract
BACKGROUND:
Childhood acute lymphoblastic leukemia survivors' anthracycline-induced cardiotoxicity could be prevented with good cardiorespiratory fitness levels and regular physical activity. This cross-sectional study aimed to assess the association between cardiorespiratory fitness and physical activity with cardiac magnetic resonance parameters.
METHODS:
A total of 96 childhood acute lymphoblastic leukemia survivors underwent a maximal cardiopulmonary exercise test and answered physical activity questionnaires. We calculated the odds ratio of the preventive fraction of regular physical activity (?150 min/wk) and adequate cardiorespiratory fitness levels (above the median ?31.4 mL·kg-1·min-1) on cardiac magnetic resonance parameters (left ventricular [LV] and right ventricular [RV] morphological and functional parameters).
RESULTS:
An adequate cardiorespiratory fitness was associated with a significant preventive fraction for LV (up to 84% for LV end-diastolic volume) and RV volumes (up to 88% for RV end-systolic volume). The adjusted analyses highlighted a preventive fraction of 36% to 91% between an adequate cardiorespiratory fitness and LV and RV parameters, late gadolinium enhancement fibrosis, and cardiac magnetic resonance relaxation times. No associations were reported with regular physical activity.
CONCLUSIONS:
This study provides additional evidence regarding the benefits of an adequate cardiorespiratory fitness level for childhood cancer survivors' cardiac health.
Guarda su PubMed
-
Effect of Acute Exercise on 12,13-Dihydroxy-9Z-Octadecenoic Acid (12,13-diHOME) Levels in Obese Male Adolescents.
Clin Endocrinol (Oxf)2023 Mar;():. doi: 10.1111/cen.14914.
Gurup Aybüke, Yakal Sertaç, Tarç?n Gürkan, Ayla Sibel ?ahinler, Turan Hande, Toprak Muhammed Sait, Gungor Zeynep B, Ercan Oya,
Abstract
AIM:
12,13-dihydroxy-9Z-octadecenoic acid (12,13-diHOME) is a lipokine secreted from brown adipose tissue, and it has positive effects on dyslipidemia. Acute exercise has been shown to lead to an increase in its secretion. In this study, it was aimed to investigate the relationship of 12,13-diHOME with obesity, exercise and dyslipidaemia for the first time in the adolescent age group.
METHODS:
This is a prospective study including a total of 28 male adolescents with obesity and the same number of age-matched healthy normal-weight male controls. Fasting serum glucose, insulin, lipid and 12,13-diHOME levels were measured. Cardiopulmonary exercise testing was performed in all subjects using a stress test treadmill. Peak oxygen consumption (peak VO2) and anaerobic threshold heart rate (ATHR) were measured.
RESULTS:
Adolescents with obesity had lower 12,13-diHOME levels than normal-weight adolescents both before and after acute exercise (p=0.025 and p=0.019, respectively), and after acute exercise, 12,13-diHOME levels significantly increased in both groups (p=0.001 for both). 12,13-diHOME levels negatively correlated with triglyceride, total cholesterol, LDL-C, and positively correlated with HDL-C. Also, peak VO2 and ATHR levels showed positive correlation with 12,13-diHOME levels.
CONCLUSION:
12,13-diHOME levels were found to be lower in adolescents with obesity than normal-weight adolescents and increased with acute exercise. Also, the close relationship of this molecule with dyslipidaemia in addition to that with obesity suggests that it has an important role in the pathophysiology of these disorders. Further molecular studies will further elucidate the role of 12,13-diHOME in obesity and dyslipidaemia. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Guarda su PubMed
-
High Intensity Interval Training Versus Moderate Continuous Training in Patients with Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-analysis.
Curr Probl Cardiol2023 Mar;():101720. doi: 10.1016/j.cpcardiol.2023.101720.
Siddiqi Tariq Jamal, Rashid Ahmed Mustafa, Javaid Syed Sarmad, Siddiqi Ahmed Kamal, Usman Muhammad Shariq, Hervir Oliver, Kamimura Daisuke, Lavie Carl J, Mentz Robert J, Butler Javed, Hall Michael E,
Abstract
BACKGROUND:
High-intensity interval training (HIIT) is a novel training approach that improves cardiopulmonary fitness and functional capacity in numerous chronic conditions, however its impact in patients with heart failure (HF) with preserved ejection fraction (HFpEF) is uncertain. We evaluated data from prior studies reporting the effects of HIIT versus moderate continuous training (MCT), on cardiopulmonary exercise outcomes in patients with HFpEF.
METHODS:
PubMed and SCOPUS were queried from inception till February 1, 2022 for all randomized controlled trials (RCT) comparing the effect of HIIT versus MCT in patients with HFpEF on peak oxygen consumption (peak VO), left atrial volume index (LAVI), respiratory exchange ratio (RER), and ventilatory efficiency (VE/CO slope). A random-effects model was applied, and the weighted mean difference (WMD) of each outcome was reported with 95% confidence intervals (CI).
RESULTS:
Three RCTs (total N=150 patients with HFpEF), with a follow-up of 4 - 52 weeks were included in our analysis. Our pooled analysis demonstrated that HIIT significantly improved peak VO (WMD?=?1.46 mL .kg .min (0.88, 2.05); p
CONCLUSION:
Across current RCT data, HIIT, compared to MCT, had a significant impact on improving peak VO. Conversely, there was no significant change in LAVI, RER, and VE/CO2 slope between HFpEF patients undertaking HIIT as opposed to MCT.
Copyright © 2023. Published by Elsevier Inc.
Guarda su PubMed
-
Correlation between three-dimensional echocardiography and cardiopulmonary fitness in patients with univentricular heart: A cross-sectional multicentre prospective study.
Arch Cardiovasc Dis2023 Mar;():. doi: S1875-2136(23)00055-4.
Femenia Valentin, Pommier Victor, Huguet Helena, Iriart Xavier, Picot Marie-Christine, Bredy Charlene, Lorca Laura, De La Villeon Gregoire, Guillaumont Sophie, Pasquie Jean-Luc, Matecki Stefan, Roubertie François, Leobon Bertrand, Thambo Jean-Benoît, Jalal Zakaria, Thomas Julie, Mouton Jean-Baptiste, Avesani Martina, Amedro Pascal,
Abstract
BACKGROUND:
The prognosis of patients with a functional single ventricle has improved, with better cardiopulmonary fitness, health-related quality of life and survival. Conventional echocardiography remains the first-line technique in single ventricle follow-up. Three-dimensional (3D) echocardiography has shown recent value in congenital cardiology, but its ability to predict functional status in patients with a single ventricle remains unknown.
AIM:
To evaluate, in patients with a single ventricle, the association between 3D echocardiography variables and functional status determined by cardiopulmonary fitness.
METHODS:
Children and adults with a functional single ventricle were prospectively enrolled in this multicentre study. Cardiopulmonary fitness was assessed by cardiopulmonary exercise test, with measures of maximum oxygen uptake (VO) and ventilatory efficiency (VE/VCO slope). 3D echocardiography was performed with off-line reproducibility analyses, using TomTec Arena? software. Health-related quality of life was assessed using the SF-36 questionnaire.
RESULTS:
A total of 33 patients were screened, and 3D echocardiography analyses were feasible in 22 subjects (mean age 28±9years). 3D echocardiography ejection fraction correlated with percent-predicted VO (r=0.64, P
CONCLUSIONS:
Single ventricle ejection fraction and volumes measured by 3D echocardiography correlated with cardiopulmonary fitness, as determined by two main prognostic cardiopulmonary exercise test variables: VO and VE/VCO slope. Despite good reproducibility, 3D echocardiography feasibility remained limited. 3D echocardiography may be of value in single ventricle follow-up, provided that the technique and analysis software are improved.
Copyright © 2023 Elsevier Masson SAS. All rights reserved.
Guarda su PubMed
-
The concept of detection of dynamic lung hyperinflation using cardiopulmonary exercise testing.
Medicine (Baltimore)2023 Mar;102(12):e33356. doi: e33356.
Kominami Kazuyuki, Noda Kazuki, Minagawa Nanaho, Yonezawa Kazuya, Akino Masatoshi,
Abstract
Dynamic lung hyperinflation (DLH) caused by air trapping, which increases residual air volume, is a common cause of shortness of breath on exertion in chronic obstructive pulmonary disease (COPD). DLH is commonly evaluated by measuring the decrease in maximal inspiratory volume during exercise, or using the hyperventilation method. However, only few facilities perform these methods, and testing opportunities are limited. Therefore, we investigated the possibility of visually and qualitatively detecting DLH using data from a cardiopulmonary exercise test (CPET). Four men who underwent symptom-limiting CPET were included in this study, including a male patient in his 60s with confirmed COPD, a 50s male long-term smoker, and 2 healthy men in their 20s and 70s, respectively. We calculated the difference between the inspiratory tidal volume (TV I) and expiratory tidal volume (TV E) per breath (TV E-I) from the breath-by-breath data of each CPET and plotted it against the time axis. No decrease in TV E-I was observed in either of the healthy men. However, in the patient with COPD and long-term smoker, TV E-I began to decrease immediately after the initiation of exercise. These results indicate that DLH can be visually detected using CPET data. However, this study was a validation of a limited number of cases, and a comparison with existing evaluation methods and verification of disease specificity are required.
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Guarda su PubMed
-
COVID-19 and its continuing burden after 12?months: a longitudinal observational prospective multicentre trial.
ERJ Open Res2023 Mar;9(2):. doi: 00317-2022.
Sahanic Sabina, Tymoszuk Piotr, Luger Anna K, Hüfner Katharina, Boehm Anna, Pizzini Alex, Schwabl Christoph, Koppelstätter Sabine, Kurz Katharina, Asshoff Malte, Mosheimer-Feistritzer Birgit, Coen Maximilian, Pfeifer Bernhard, Rass Verena, Egger Alexander, Hörmann Gregor, Sperner-Unterweger Barbara, Helbok Raimund, Wöll Ewald, Weiss Günter, Widmann Gerlig, Tancevski Ivan, Sonnweber Thomas, Löffler-Ragg Judith,
Abstract
BACKGROUND:
Recovery trajectories from coronavirus disease 2019 (COVID-19) call for longitudinal investigation. We aimed to characterise the kinetics and status of clinical, cardiopulmonary and mental health recovery up to 1?year following COVID-19.
METHODS:
Clinical evaluation, lung function testing (LFT), chest computed tomography (CT) and transthoracic echocardiography were conducted at 2, 3, 6 and 12?months after disease onset. Submaximal exercise capacity, mental health status and quality of life were assessed at 12?months. Recovery kinetics and patterns were investigated by mixed-effect logistic modelling, correlation and clustering analyses. Risk of persistent symptoms and cardiopulmonary abnormalities at the 1-year follow-up were modelled by logistic regression.
FINDINGS:
Out of 145 CovILD study participants, 108 (74.5%) completed the 1-year follow-up (median age 56.5?years; 59.3% male; 24% intensive care unit patients). Comorbidities were present in 75% (n=81). Key outcome measures plateaued after 180?days. At 12?months, persistent symptoms were found in 65% of participants; 33% suffered from LFT impairment; 51% showed CT abnormalities; and 63% had low-grade diastolic dysfunction. Main risk factors for cardiopulmonary impairment included pro-inflammatory and immunological biomarkers at early visits. In addition, we deciphered three recovery clusters separating almost complete recovery from patients with post-acute inflammatory profile and an enrichment in cardiopulmonary residuals from a female-dominated post-COVID-19 syndrome with reduced mental health status.
CONCLUSION:
1?year after COVID-19, the burden of persistent symptoms, impaired lung function, radiological abnormalities remains high in our study population. Yet, three recovery trajectories are emerging, ranging from almost complete recovery to post-COVID-19 syndrome with impaired mental health.
Copyright ©The authors 2023.
Guarda su PubMed
-
Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis.
Front Physiol2023 ;14():1155281. doi: 1155281.
Ito Wataru, Uchiyama Kiyotaka, Mitsuno Ryunosuke, Sugita Erina, Nakayama Takashin, Ryuzaki Toshinobu, Takahashi Rina, Katsumata Yoshinori, Hayashi Kaori, Kanda Takeshi, Washida Naoki, Sato Kazuki, Itoh Hiroshi,
Abstract
Diminished physical capacity is common and progressive in patients undergoing dialysis, who are also prone to deficiency in carnitine, which plays a pivotal role in maintaining skeletal muscle and cardiac function. The present study aimed to evaluate the association of carnitine profile with exercise parameters in patients with incident dialysis. This was a single-center cross-sectional study including 87 consecutive patients aged 20-90 years who were initiated on dialysis in Keio University Hospital between December 2019 and December 2022 and fulfilled the eligibility criteria. Exercise parameters were evaluated cardiopulmonary testing (CPX) using the electronically braked STRENGTH ERGO 8 ergometer, whereas the carnitine profile was assessed by determining serum free carnitine (FC), acylcarnitine (AC) levels and AC/FC ratio. The mean cohort age was 62.1 ± 15.2 years, with male and hemodialysis predominance (70% and 73%, respectively). AC/FC was 0.46 ± 0.15, and CPX revealed peak oxygen consumption (VO) of 13.9 ± 3.7 (mL/kg/min) with percent-predicted peak VO of 53.6% ± 14.7% and minute ventilation (VE)/carbon dioxide output (VCO) slope of 35.1 ± 8.0. Fully-adjusted multivariate linear regression analysis showed that AC/FC was significantly associated with decreased peak VO (?, -5.43 [95% confidence interval (CI), -10.15 to -0.70]) and percent-predicted peak VO (?, -19.98 [95% CI, -38.43 to -1.52]) and with increased VE/VCO slope (?, 13.76 [95% CI, 3.78-23.75]); FC and AC did not exhibit similar associations with these parameters. Moreover, only AC/FC was associated with a decreased peak work rate (WR), percent-predicted WR, anaerobic threshold, delta VO/delta WR, and chronotropic index. In patients on incident dialysis, exercise parameters, including those related to both skeletal muscle and cardiac function, were strongly associated with AC/FC, a marker of carnitine deficiency indicating altered fatty acid metabolism. Further studies are warranted to determine whether carnitine supplementation can improve exercise capacity in patients on incident dialysis.
Copyright © 2023 Ito, Uchiyama, Mitsuno, Sugita, Nakayama, Ryuzaki, Takahashi, Katsumata, Hayashi, Kanda, Washida, Sato and Itoh.
Guarda su PubMed
-
Cardiopulmonary exercise testing in the follow-up after acute pulmonary embolism.
Eur Respir J2023 Mar;():. doi: 2300059.
Farmakis Ioannis T, Valerio Luca, Barco Stefano, Alsheimer Eva, Ewert Ralf, Giannakoulas George, Hobohm Lukas, Keller Karsten, Mavromanoli Anna C, Rosenkranz Stephan, Morris Timothy A, Konstantinides Stavros V, Held Matthias, Dumitrescu Daniel,
Abstract
BACKGROUND:
Cardiopulmonary exercise testing (CPET) may provide prognostically valuable information during follow-up after pulmonary embolism (PE).
OBJECTIVE:
To investigate the association of patterns and degree of exercise limitation, as assessed by CPET, with clinical, echocardiographic, laboratory abnormalities and quality of life (QoL) after PE.
METHODS:
In a prospective cohort study of unselected consecutive all-comers with PE, survivors of the index acute event underwent 3-month and 12-month follow-up, including CPET. We defined cardiopulmonary limitation as ventilatory inefficiency or insufficient cardiocirculatory reserve. Deconditioning was defined as peak VO
RESULTS:
Overall, 396 patients were included. At 3?months, prevalence of cardiopulmonary limitation and deconditioning was 50.1% (34.7% mild/moderate; 15.4% severe) and 12.1%, respectively; at 12?months, it was 44.8% (29.1% mild/moderate 15.7% severe) and 14.9%. Cardiopulmonary limitation and its severity were associated with age (OR per decade 2.05; 95% CI 1.65-2.55), history of chronic lung disease (OR 2.72; 95% CI 1.06-6.97), smoking (OR 5.87; 2.44-14.15), and intermediate- or high-risk acute PE (OR 4.36; 95% CI 1.92-9.94). Severe cardiopulmonary limitation at 3?months was associated with the prospectively defined, combined clinical-haemodynamic endpoint of "post-PE impairment" (OR 6.40, 95% CI 2.35-18.45) and with poor disease-specific and generic health-related QoL.
CONCLUSION:
Abnormal exercise capacity of cardiopulmonary origin is frequent after PE, being associated with clinical and hemodynamic impairment as well as long-term QoL reduction. CPET can be considered for selected patients with persisting symptoms after acute PE to identify candidates for closer follow-up and possible therapeutic interventions.
Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.
Guarda su PubMed
-
Athlete's heart or heart disease in the athlete? Evaluation by cardiopulmonary exercise testing.
J Sports Med Phys Fitness2023 Mar;():. doi: 10.23736/S0022-4707.23.14536-1.
Segreti Andrea, Picarelli Francesco, DI Gioia Giuseppe, Coletti Federica, Crispino Simone P, Fanale Valerio, Fossati Chiara, Antonelli Incalzi Raffaele, Pigozzi Fabio, Grigioni Francesco,
Abstract
Routine or vigorous training, particularly in competitive and elite athletes practicing dynamic sports, leads to a constellation of structural and functional cardiovascular adaptations, facilitating an increased capacity to deliver oxygen to the working muscles during sustained physical exertion. Cardiopulmonary exercise testing is the most accurate and objective method to assess performance in athletes. Although still underutilized, it provides a window into the unique cardiovascular response to exercise in athletes, integrating parameters obtained by the traditional exercise test with breath-by-breath analysis of oxygen consumption, carbon dioxide production, ventilation, and other derived parameters. This review aimed to describe the several applications of cardiopulmonary exercise testing in athletes with a principal focus on the ability to identify cardiovascular adaptations and differentiate an athlete's heart from early cardiomyopathy. In this context, cardiopulmonary exercise testing provides many applications involving exercise physiology in athletes, allowing a precise evaluation of cardiovascular efficiency, the entity of the adaptations, the response to a training program, and identifying early modifications that could reveal early cardiomyopathy. Therefore, thanks to its several applications, this pivotal test allows us to obtain essential information about the athlete's physiology and differentiate between the expected response of a trained athlete from early cardiomyopathy.
Guarda su PubMed
