scholarly journals Predictors of deterioration in cardiorespiratory fitness among healthy adults: the importance of sex and obesity

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Kaplan ◽  
A Fardman ◽  
S Tiosano ◽  
S Segev ◽  
M Scheinowitz ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Study Endpoint ◽  
Primary Study ◽  
Baseline Visit ◽  
Bruce Protocol ◽  
Study Population ◽  
The Mean

Abstract Introduction Cardiorespiratory fitness (CRF) is associated with cardiovascular co-morbidities and is a strong predictor of adverse cardiovascular outcomes. However, data on the natural history of cardiorespiratory fitness among healthy subjects is limited. Purpose This study investigated what are the predictors of deterioration in CRF over time. Methods We investigated 36,239 men and women who were annually screened in a tertiary medical center and completed an exercise stress test in all visits, with a total of 175,596 annual visits. Subjects who failed to complete maximal exercise stress test according to the Bruce protocol at their first baseline visit were excluded. In addition, subjects with less than five visits to the center or those who developed ischemic heart disease during follow-up were excluded. Fitness was categorized into age- and sex-specific quintiles (Q) according to Bruce protocol treadmill time. Change in CRF between the first baseline visit and the fifth visit was used to calculate fitness deterioration. The primary study endpoint was defined as the lower sex-specific quintile of change in metabolic equivalents (METS) between visits 1 and 5. Logistic regression models were applied. Results Final study population included 10,841 subjects. The mean age of the study population was 49±10 years, the mean BMI was 26±4, and 8107 (75%) were men. Median METS at baseline were 10.8 (IQR 9–12.6) and 11.1 (IQR 9.4–13) at the first and fifth visit, respectively (p<0.001 for METS between visits). Overall, 2189 (20%) subjects met the study endpoint. CFR deterioration was higher among women as compared to men (p=0.023). Out of obesity, hypertension, fasting blood glucose, LDL, and HDL cholesterol, after adjustments for age, sex, and baseline CFR, only obesity was independently associated with fitness deterioration in the multivariate model (OR=1.4 95% CI 1.2–1.5, p<0.001). The association of obesity with fitness deterioration was modified by sex such that the risk of CRF deterioration was more pronounced in women (OR=1.6 95% CI 1.3–2, p<0.001) than in men (OR=1.3 95% CI 1.1–1.4, p<0.001). Conclusion Obesity is an independent predictor of future CRF deterioration. The effect of obesity on future CRF deterioration is more pronounced among women as compared to men. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals P1398 Echocardiographic continuous monitoring of exercise stress test using probe fixation device

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Wdowiak-Okrojek ◽  
P Wejner-Mik ◽  
Z Bednarkiewicz ◽  
P Lipiec ◽  
J D Kasprzak
Keyword(s):  
Image Quality ◽  
Physical Exercise ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Bicycle Ergometer ◽  
Exercise Stress ◽  
Fixation Device ◽  
The Mean ◽  
First Time

Abstract Background Stress echocardiography (SE) plays an important role among methods of noninvasive diagnosis of ischemic disease. Despite the advantages of physical exercise as the most physiologic stressor, it is difficult (bicycle ergometer) or impossible (treadmill) to obtain and maintain the acoustic window during the exercise. Recently, an innovative probe fixation device was introduced and a research plan was developed to assess the feasibility of external probe fixation during exercise echocardiography on a supine bicycle and upright treadmill exercise for the first time. Methods 37 subjects (36 men, mean age 39 ± 16 years, 21 healthy volunteers, 16 patients with suspected coronary artery disease) were included in this study. This preliminary testing stage included mostly men due to more problematic probe fixation in women. All subjects underwent a submaximal exercise stress test on a treadmill (17/37) or bicycle ergometer (11/37). Both sector and matrix probes were used. We assessed semi-quantitatively the quality of acquired apical views at each stage – the four-point grading system was used (0-no view, 1-suboptimal quality, 2-optimal quality, 3-very good quality), 2-3 sufficient for diagnosis. Results The mean time required for careful positioning of the probe and image optimization was 12 ± 3 min and shortened from 13,7 to 11,1 minutes (mean) in first vs second half of the cohort documenting learning curve. At baseline, 9 patients had at least one apical view of quality precluding reliable analysis. Those patients were excluded from further assessment. During stress, 17 patients maintained the optimal or very good quality of all apical views, whereas in 11 patients the quality significantly decreased during the stress test and required probe repositioning. The mean image quality score at baseline was 2,61 ± 0,48 and 2,25 ± 0,6 after exercise. Expectedly, good image quality was easier to obtain and maintain in the supine position (score 2,74 ± 0,44) points as compared with upright position (score 2,25 ± 0,57). Conclusion This preliminary, unique experience with external probe fixation device indicates that continuous acquisition and monitoring of echocardiographic images is feasible during physical exercise, and for the first time ever - also on the treadmill. This feasibility data stem from almost exclusively male patients and the estimated rate of sufficient image quality throughout the entire test is currently around 60%. We are hoping, that gaining more experience with the product could increase the success rate on exercise tests. Abstract P1398 Figure. Treadmill and ergometer stress test

Average Exercise Capacity in Men and Women >75 Years of Age Undergoing a Bruce Protocol Exercise Stress Test

2021 ◽  
Author(s):  
Bradley S. Lander ◽  
Aimee M. Layton ◽  
Robert P. Garofano ◽  
Allan Schwartz ◽  
David J. Engel ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Men And Women ◽  
Bruce Protocol

Cardiorespiratory fitness and left atrial strain in atrial fibrillation: A comparative study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
RS Mishima ◽  
JP Ariyaratnam ◽  
V Malik ◽  
BM Pitman ◽  
AD Elliott ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiorespiratory Fitness ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Volume Index ◽  
Left Atrial Strain ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is the most common clinically relevant arrhythmia, and its occurrence is associated with pathological left atrial (LA) remodelling. In these patients, low cardiorespiratory fitness (CRF) is associated with increased AF recurrence. Speckle tracking derived LA strain (LAS) permits chamber function quantification and provides angle-independent and highly reproducible measurements of chamber deformation. However, the relationship between CRF and LA function, amongst AF patients is poorly understood.  Purpose To compare LA function amongst AF patients stratified by cardiorespiratory fitness.  Methods Consecutive AF patients referred for treadmill exercise stress test (EST) and transthoracic echocardiogram (TTE) between March and December 2020 were screened for inclusion. Treadmill EST was symptom limited and age and gender predicted CRF was calculated with conventional formulas. Speckle tracking software was used to obtain LAS from apical 4 and 2 chamber views and mean measurements for LASr and LASb were calculated. Those achieving <100% (low CRF) and ≥100% (high CRF) of predicted CRF were compared.  Results After exclusions, 141 patients in sinus rhythm were included in the analysis. Baseline characteristics were not significantly different between groups. Ejection fraction (63.6 ± 4.7% vs 64.8 ± 8.4%, p = 0.3) and LA volume index (33.1 ± 6.9 vs 31.4 ± 9.4 mL/m2, p = 0.3) were not different between groups. Both LASr (22.9% ± 7.4% vs 27.6% ± 11.4%, p = 0.02) and LASb (8.2% ± 4.7% vs 12.1% ± 6.8%, p = 0.004) (figure 1) were significantly higher in the fitter group.  Conclusion Patients with higher CRF showed improved LA function as per strain measurement in the absence of AF. The relationship between CRF and left atrial function warrants further research. Abstract Figure. LASr and LASb by CRF

scholarly journals Attenuation of the Threshold for Myocardial Ischemia in Ramp vs Standard Bruce Protocol in Patients with Positive Exercise Stress Test and Angiographically Demonstrated Coronary Artery Narrowing?

2007 ◽  
Vol 30 (3) ◽  
pp. 45
Author(s):  
Martin Noel ◽  
Jean Jobin ◽  
Audrey Marcoux ◽  
Luce Boyer ◽  
Gilles R. Dagenais ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Random Order ◽  
Exercise Stress ◽  
Gas Exchange Parameters ◽  
Warm Up ◽  
Bruce Protocol ◽  
St Segment

Background: Gradual instead of abrupt increases in workload favour a more physiological response in terms of hemodynamic and gas exchange parameters. Therefore, we sought to determine whether myocardial ischemia is attenuated with a ramp compared to a standard Bruce exercise protocol in patients with coronary artery disease (CAD). Methods: We compared ischemic parameters on the Bruce protocol with an individualized ergocycle ramp protocol in 18 men with documented CAD (≥ 70% stenosis) and a reproducible ischemic ECG exercise test. These 2 symptom-limited tests were performed in random order 2 weeks apart. Oxygen consumption (VO2), ischemic threshold [systolic blood pressure x heart rate (RPP) at 1 mm ST-segment depression], and maximum ST-segment depression corresponding to the highest RPP common to the 2 tests (AdjSTmax) were determined. Results: While all subjects showed ischemia on the treadmill, 6/18 did not on the ergocycle. However, ischemic threshold was higher on the ramp than the Bruce protocol (23 420 ± 5 732 vs 20 018 ± 3 542 bpm•min-1•mmHg; P=0.007). Peak RPP was higher during the ramp than with the Bruce protocol (28 492 ± 6 450 vs 25 519 ± 6 067 bpm•min-1•mmHg, respectively; P=0.02), despite similar peak VO2 (25.59 ± 5.05 vs 26.39 ± 4.65 mlO2•kg-1•min-1, respectively; P=0.6). AdjSTmax was less on the ramp than the Bruce protocol (-1.2 ± 0.9 vs -1.9 ± 0.7 mm; P=0.003). Conclusion: Exercise-induced myocardial ischemia is markedly attenuated on the more gradually increasing workload of the individualized ramp ergocycle compared with the standard Bruce treadmill protocol. This effect is unexplained by energy expenditure (VO2) or myocardial work (RPP) and is consistent with a “warm-up” ischemic mechanism. The more gradually increasing workload of the ramp ergocycle protocol may have favoured a “warm-up” ischemic effect despite achieving higher RPP than the Bruce protocol treadmill suggesting it may be physiologically preferable for exercise prescription in patients with CAD.

scholarly journals AN ANALYSIS OF THE LEVEL OF FITNESS, PHYSICAL PERFORMANCE AND CONCENTRATION OF THE BRAIN-DERIVED NEUROTROPHIC FACTOR IN SALIVA IN ADOLESCENTS PRACTICING COMPETITIVE SPORTS AND THEIR PEERS

2021 ◽  
pp. 90-97
Author(s):  
Ewa Gajewska ◽  
Ida Laudańska- Krzemińska ◽  
Katarzyna Domaszewska ◽  
Mariusz Naczk ◽  
Paweł Kroll ◽  
...  
Keyword(s):  
Body Composition ◽  
Physical Fitness ◽  
Cardiorespiratory Fitness ◽  
Stress Test ◽  
Exercise Stress Test ◽  
The Body ◽  
Exercise Stress ◽  
Trunk Muscles ◽  
Before And After ◽  
Level Of Training

The purpose of the study was to compare BDNF in saliva before and after a maximum physical effort in adolescents practicing sports and their non-training peers, related to the body composition and physical fitness. The study comprised 64 individuals aged 13-14 (39 practicing sports). Physical fitness was measured using the EUROFIT test. The maximum oxygen uptake was determined on a mechanical treadmill. Saliva BDNF concentration was measured (R&D, USA) at rest and after an exercise. The research results prove that body composition was different depending on the sex, the EUROFIT results were not. The percentage of body fat correlated negatively with the strength of the lower body and the strength of the trunk muscles. There was a positive relationship between the muscle mass and the cardiorespiratory fitness, regardless of the level of training. BDNF in saliva was comparable in non-training and training individuals. BDNF was significantly dependent on the body composition only in girls and negatively correlated with the content of adipose tissue. Training and non-training teenagers did not differ in fitness, but in the level of cardiorespiratory fitness. Non-training teenagers showed a higher concentration of BDNF in saliva and further increase after the exercise stress test. In the training individuals, the exercise stress test did not lead to an increase in BDNF concentration.

scholarly journals Cardiac Rehabilitation and Physical Performance in Patients after Myocardial Infarction: Preliminary Research

2021 ◽  
Vol 10 (11) ◽  
pp. 2253
Author(s):  
Agnieszka Grochulska ◽  
Sebastian Glowinski ◽  
Aleksandra Bryndal
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Stress Test ◽  
Maximal Oxygen Consumption ◽  
Exercise Stress Test ◽  
Health Condition ◽  
Exercise Stress ◽  
Test Time ◽  
Before And After

(1) Background: Cardiovascular diseases, in particular, myocardial infarction (MI), are the main threats to human health in modern times. Cardiac rehabilitation (CR), and especially increased physical activity, significantly prevent the consequences of MI. The aim of this study was to assess physical performance in patients after MI before and after CR. (2) Methods: 126 patients after MI were examined. They were admitted to the cardiac rehabilitation ward twice: in the 3rd month after MI, and then in the 6th month after the last rehabilitation session. CR lasted 20 treatment days (4 weeks with 5 treatment days and 2 days’ break). The exercise stress test on the treadmill and a 6-minute walk test (6MWT) were used to assess physical performance. Patients were assigned to an appropriate rehabilitation model due to their health condition. (3) Results: In the studied group, the exercise stress test time and the metabolic equivalent of task (MET), the maximal oxygen consumption (VO2max), and 6MWT score increased significantly (p = 0.0001) at two time-points of observation. (4) Conclusion: CR significantly improves physical performance in patients after MI.

scholarly journals Systolic Blood Pressure Response to Exercise Stress Test and Risk of Stroke

Stroke ◽  
2001 ◽  
Vol 32 (9) ◽  
pp. 2036-2041 ◽  
Author(s):  
S. Kurl ◽  
J.A. Laukkanen ◽  
R. Rauramaa ◽  
T.A. Lakka ◽  
J. Sivenius ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Response ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Pressure Response ◽  
Exercise Stress ◽  
Response To Exercise
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