Evaluation of exercise capacity and mechanisms of limitation during cardiopulmonary exercise testing (CPET) in patients with chronic hypersensitivity pneumonitis

Author(s):  
Olívia Dias ◽  
Bruno Baldi ◽  
Jeferson Pereira ◽  
Leticia Cadenas ◽  
Francesca Pennati ◽  
...  
2021 ◽  
Vol 10 (18) ◽  
pp. 4083
Author(s):  
Krzysztof Smarz ◽  
Tomasz Jaxa-Chamiec ◽  
Beata Zaborska ◽  
Maciej Tysarowski ◽  
Andrzej Budaj

Cardiac rehabilitation (CR) is indicated in all patients after acute myocardial infarction (AMI) to improve prognosis and exercise capacity (EC). Previous studies reported that up to a third of patients did not improve their EC after CR (non-responders). Our aim was to assess the cardiac and peripheral mechanisms of EC improvement after CR using combined exercise echocardiography and cardiopulmonary exercise testing (CPET-SE). The responders included patients with an improved EC assessed as a rise in peak oxygen uptake (VO2) ≥ 1 mL/kg/min. Peripheral oxygen extraction was calculated as arteriovenous oxygen difference (A-VO2Diff). Out of 41 patients (67% male, mean age 57.5 ± 10 years) after AMI with left ventricular ejection fraction (LVEF) ≥ 40%, 73% improved their EC. In responders, peak VO2 improved by 27% from 17.9 ± 5.2 mL/kg/min to 22.7 ± 5.1 mL/kg/min, p < 0.001, while non-responders had a non-significant 5% decrease in peak VO2. In the responder group, the peak exercise heart rate, early diastolic myocardial velocity at peak exercise, LVEF at rest and at peak exercise, and A-VO2Diff at peak exercise increased, the minute ventilation to carbon dioxide production slope decreased, but the stroke volume and cardiac index were unchanged after CR. Non-responders had no changes in assessed parameters. EC improvement after CR of patients with preserved LVEF after AMI is associated with an increased heart rate response and better peripheral oxygen extraction during exercise.


Author(s):  
Sandra Rozenštoka ◽  
Andrejs Ērglis

AbstractAmateur sport has significant influence on peoples’ physical activity and affects the prevalence of non-communicable diseases. The population of competing amateur athletes has not been sufficiently studied, and there is a huge gap between functional results of untrained individuals and professional athletes. The aim of the study was to evaluate the exercise capacity and chrono-tropic, inotropic capacity in amateur athletes with different training programmes, as assessed by cardiopulmonary exercise testing. In a longitudinal prospective study, 600 amateur athletes who performed high dynamic load sports, according to the Mitchell Classification of Sports, were assessed. The individuals underwent standard maximum cardiopulmonary exercise testing on the ISO certified Master screen CPX system. The exercise capacity was dependent on the training programme organisation, regularity and duration, but it was not dependent on age. During maximum work-rate, the functional parameters of the cardiorespiratory system and inotropic capacity were significantly dependent on duration of the training programme. Chronotropic and inotropic capacity, as well as cardiorespiratory adaptation were significantly higher for competing amateur athletes of both genders than for untrained individuals. The study showed that amateur athletes with a training programme 300 minutes per week had higher exercise capacity, which was based on the individually suitable training programme, and higher aerobic and anaerobic capacity. Regular pre-competition medical assessment of amateur athletes can be used to objectively evaluate their health condition, adaptation, cardiac risk and make changes in the athletes’ training programme.


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