P4431Cardiopulmonary exerscise stress tests vs standard exercise stress tests in the rational prescription of physical activity in men

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Stuto ◽  
B Armaro ◽  
E Cosentino ◽  
G Canonico ◽  
A Ambu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Oxygen Consumption ◽  
Heart Disease ◽  
Direct Measurement ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Sustained Load ◽  
Stress Tests ◽  
Group B

Abstract Background The standard exercise stress test (ET) provides direct measurement of the load tolerated by the subject, but the cardiopulmonary exercise stress test (CPET) in addition to the measurement of the work load also provides direct measurement of the corresponding oxygen consumption. Objective The aim of the present study was to estimate the differences between the estimated oxygen consumption based on the load (ET) and the one directly measured with the CPET, and to highlight and quantify the inaccuracies of the indirect estimate of oxygen consumption and its consequences on the rational prescription of physical activity. Material and method The tests performed on 7544 males from January 2007 to October 2018 were analyzed. For each test the sustained load, the consumption of direct oxygen, and the estimated oxygen consumption based on the load sustained with the use of a formula provided by the American College of Sports Medicine and reported below: VO2max (ml/kg/min) = (10.51 x Watt) + (6.35 x weight in kg) − (10.49 x Età) + 519.3. The total population of the subjects examined was divided into two groups: Group A: 1358 subjects without signs of heart disease, and Group B: 6186 subjects with heart disease. Results In the total population the oxygen consumption (VO2) estimated on the basis of the load was overestimated in 22% of subjects, underestimated in 55% of subjects and overlapping in 23% of subjects. In Group B the calculated VO2 was overestimated in 38%, underestimated in 54% and overlapping in 8% of the subjects. In group A the calculated VO2 was overestimated in 33%, underestimated in 54% and overlapping in 9% of subjects. Conclusions In subjects with heart disease the VO2 calculated on the basis of the sustained load is overestimated or underestimated in 92% of subjects. The CPET through direct measurement of oxygen consumption provides a precise estimate of functional capacity, an essential prerequisite for a correct rational prescription of physical activity. Because of this peculiarity, the CPET is absolutely irreplaceable in cardiac patients in which a correct rational prescription of physical activity is crucial.

Exercise performance in children and adolescents after the Ross procedure

2006 ◽  
Vol 16 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Bradley S. Marino ◽  
Sara K. Pasquali ◽  
Gil Wernovsky ◽  
John R. Bockoven ◽  
Michael McBride ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Exercise Performance ◽  
Stress Test ◽  
Ideal Body Weight ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Ross Procedure ◽  
Stress Tests ◽  
Primary Indication ◽  
Before And After

Objectives:The Ross procedure is increasingly utilized in the treatment of aortic valvar disease in children and adolescents. Our purpose was to compare pre- and post-operative exercise state in this population.Methods:We included patients who underwent the Ross procedure at our institution between January, 1995, and December, 2003, and in whom we had performed pre- and post-operative exercise stress tests. We used a ramp bicycle protocol to measure consumption of oxygen and production of carbon dioxide. Cardiac output was estimated from effective pulmonary blood flow by the helium acetylene re-breathing technique.Results:We studied 26 patients, having a median age at surgery of 15.7 years, with a range from 7.5 to 24.1 years. The primary indication for surgery in two-thirds was combined aortic stenosis and insufficiency. Median time from the operation to the post-operative exercise stress test was 17.4 months, with a range from 6.7 to 30.2 months. There was a trend toward lower maximal consumption of oxygen after the procedure, at 36.3 plus or minus 7.6 millilitres per kilogram per minute (83.9% predicted) as opposed to 38.6 plus or minus 8.4 millilitres per kilogram per minute (88.5% predicted, p equal to 0.06). Patients after the procedure, however, had significantly increased adiposity, so that there was no difference in maximal consumption of oxygen indexed to ideal body weight before and after the operation. In 20 of the patients, aerobic capacity improved or was stable after the operation. There was no post-operative chronotropic impairment.Conclusions:In the majority of patients following the Ross procedure, exercise performance is stable and within the normal range of a healthy age and sex matched population, despite sedentary lifestyles and increased adiposity.

scholarly journals Exercise recommendations in patients with valvular heart disease

Heart ◽  
2018 ◽  
Vol 105 (2) ◽  
pp. 106-110 ◽  
Author(s):  
Sabiha Gati ◽  
Aneil Malhotra ◽  
Sanjay Sharma
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Ventricular Function ◽  
Functional Capacity ◽  
Valvular Heart Disease ◽  
Stress Test ◽  
Exercise Stress ◽  
Competitive Sport ◽  
Increased Risk ◽  
The Impact

Valvular heart disease affects 1%–2% of young individuals, many of whom aspire to partake in competitive sport or high intensity recreational exercise. There are limited reports on the impact of intensive physical activity on the progression of valvular heart disease; therefore, current recommendations are based on consensus opinion. The management of exercising individuals with valvular heart disease requires a structured approach that incorporates several key factors including symptomatic status, functional capacity, type and nature of the valvular lesion, impact on ventricular structure and function and effect on pulmonary artery pressure. Asymptomatic individuals with minor valvular abnormalities may engage in all forms of competitive sport, whereas those with lesions of moderate severity may exercise intensively if an exercise stress test tailored to the relevant physical activity reveals good functional capacity without myocardial ischaemia, haemodynamic disturbances or arrhythmia. Symptomatic athletes and those with severe valvular heart disease, impaired ventricular function, pulmonary hypertension and arrhythmias should refrain from most competitive sports. Athletes with a bicuspid aortic valve and aortic root diameter >40 mm should avoid sport with a strong isometric component even with minimal valvular dysfunction. There is an association between mitral valve prolapse and sudden cardiac death in the general population; however, there is limited evidence of increased risk with competitive sport. Athletes undergoing corrective surgery may return to exercise after 3 months if ventricular function and exercise capacity are preserved. Individuals anticoagulated for mechanical bioprosthetic valves should avoid contact or collision sport to minimise the risk of bleeding.

Elevated CK-MB Isoenzyme after Exercise Stress Test and Atrial Pacing in Patients with Ischemic Heart Disease

CHEST Journal ◽  
1988 ◽  
Vol 94 (6) ◽  
pp. 1216-1220 ◽  
Author(s):  
Alon T. Marmor ◽  
Roberto Klein ◽  
Michael Plich ◽  
David Groshar ◽  
Adam Schneeweiss
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Ischemic Heart ◽  
Exercise Stress ◽  
Atrial Pacing

scholarly journals A Method for Predicting the Main Indicators of Cardiopulmonary Stress Testing for Patients with Chronic Heart Failure

2020 ◽  
Vol 23 (1) ◽  
pp. 96-104
Author(s):  
A. S. Krasichkov ◽  
E. Mbazumutima ◽  
F. Shikama ◽  
E. M. Nifontov
Keyword(s):  
Heart Failure ◽  
Oxygen Consumption ◽  
Chronic Heart Failure ◽  
Stress Testing ◽  
Stress Test ◽  
Significant Risk ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Peak Oxygen Consumption ◽  
Prognostic Information

Introduction. Cardiopulmonary stress test provides significant diagnostic and prognostic information of the condition of patients with cardiovascular and pulmonary diseases. There is a serious problem, that final phase of stress testing is a physically difficult exercise for a person. There is a significant risk of occurrence and development of pathological conditions of the patient's cardiovascular system. One of the solutions is the development of methods for assessing the biological parameters of the patients at the end of a load protocol based on data from the initial stages of the test.Aim. Development of a method for finding an estimate of the maximum heart rate (HR) and of the peak oxygen consumption (OC) for the patients with chronic heart failure at the end of a cardiorespiratory exercise stress test, based on the results of the study obtained at the first initial stages of the test.Materials and methods. For the study, 149 anonymized records of rhythmograms and data of changes in the oxygen consumption of the patients with chronic heart failure were used. The patients underwent a cardiopulmonary stress test by a bicycle ergometer using step-by-step load protocol (the load power increase at each stage was 10 W, the duration of the load stage was 1 min)Results. Based on the analysis of the data obtained, a method for assessing the peak values of HR and of PC of the patients with chronic heart failure was developed.Conclusion. The relative error of the proposed estimate of the HR peak in most cases was no more than 10 %, which allows it to be used for practical purposes. It was established that when performing 70 % of the stress protocol, the error of the proposed estimate of the OC peak in most cases did not exceed 20 %. More research is needed to improve the accuracy of the assessment for using in medical applications aimed to the modernization of methods and equipment for stress testing of the patients.

Does Insistence on Medical Clearance Inhibit Adoption of Physical Activity in the Elderly?

2000 ◽  
Vol 8 (4) ◽  
pp. 301-311 ◽  
Author(s):  
Roy J. Shephard
Keyword(s):  
Physical Activity ◽  
High Performance ◽  
Stress Test ◽  
Exercise Stress Test ◽  
The Elderly ◽  
Cardiac Risk ◽  
Exercise Stress ◽  
Medical Clearance ◽  
Potential System ◽  
Careful Clinical Examination

During the 1970s, the U.S. policy of requiring a negative exercise stress test for all adults >35 years old proved expensive. It also discouraged exercise adoption, was ineffective in detecting high-risk individuals, and led to much iatrogenic disease. In the age range of 15–69 years, a better alternative is triage, based on responses to the revised Physical Activity Readiness Questionnaire (PAR-Q), supplemented by considerations of age and cardiac risk factors. But most people older than 70 years have one or more clinical conditions; in this age group, any potential system of triage excludes an excessive proportion of potential exercisers and thus does not appear warranted. An increase in habitual physical activity increases quality-adjusted life span, and it might also enhance total longevity. Restriction of physical activity remains advisable in a few individuals, but they are already under medical care. The one small group who need medical clearance includes those who decide to prepare themselves for some high-performance event. They are highly motivated, and their activity will not be discouraged by the need for a careful clinical examination.

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