scholarly journals Impaired functional and hemodynamic response to graded exercise testing and its recovery in patients with subclinical hyperthyroidism

2011 ◽  
Vol 55 (3) ◽  
pp. 203-212 ◽  
Author(s):  
Patrícia dos Santos Vigário ◽  
Dhiãnah Santini de Oliveira Chachamovitz ◽  
Patrícia de Fátima dos Santos Teixeira ◽  
Mauro Augusto dos Santos ◽  
Fátima Palha de Oliveira ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Duration ◽  
Cross Sectional Study ◽  
Suppressive Therapy ◽  
Subclinical Hyperthyroidism ◽  
Hemodynamic Responses ◽  
Cross Sectional ◽  
Hemodynamic Variables ◽  
Response To Exercise

OBJECTIVE: To evaluate the functional and hemodynamic responses during exercise and its recovery in patients with subclinical hyperthyroidism (SCH). SUBJECTS AND METHODS: A cross-sectional study was carried out with 29 patients on TSH-suppressive therapy with levothyroxine for thyroid carcinoma and 35 euthyroid subjects. All volunteers underwent a cardiopulmonary exercise testing on a treadmill and functional and hemodynamic variables were measured during exercise and its recovery. RESULTS: SCH patients showed impaired functional response to exercise, marked by lower values for oxygen consumption and exercise duration in addition to premature achievement of the anaerobic threshold. Heart-rate and blood pressure recovery immediately after exercise were slower among SCH patients when compared to euthyroid subjects. CONCLUSION: SCH is associated with impaired functional and hemodynamic responses during exercise and its recovery.

scholarly journals Safety of Exercise Testing in the Clinical Chinese Population

2021 ◽  
Vol 8 ◽  
Author(s):  
Yaoshan Dun ◽  
Thomas P. Olson ◽  
Jeffrey W. Ripley-Gonzalez ◽  
Kangling Xie ◽  
Wenliang Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Confidence Interval ◽  
Exercise Testing ◽  
Chinese Population ◽  
Clinical Symptoms ◽  
Cardiopulmonary Exercise Testing ◽  
Safety Data ◽  
Cross Sectional Study ◽  
Exercise Tests ◽  
Cross Sectional

This 18-year cross-sectional study was conducted to provide data on the safety of exercise testing in the clinical Chinese population. We retrospectively identified exercise tests completed at Xiangya Hospital of Central South University from January 1, 2002 to December 31, 2019. From 43,130 unique individuals (50.9% female), a total of consecutive 50,142 tests (standard exercise testing 29,466; cardiopulmonary exercise testing 20,696) were retrieved. Demographics, patients' medical history, exercise testing characteristics, and exercise testing-related adverse events were described. Safety data is expressed as the number of adverse events per 10,000 tests, with 95% confidence interval. The average patients' age was 51 ± 13 years. The majority of patients were diagnosed with at least one disease (N = 44,941, 89.6%). Tests were maximal or symptom-limited. Common clinical symptoms included dizziness (6,822, 13.6%), chest pain or distress (2,760, 5.5%), and musculoskeletal limitations (2,507, 5.0%). Out of 50,142 tests, three adverse events occurred, including one sustained ventricular tachycardia, one sinus arrest with junctional escape rhythm at a rate of 28 bpm, and one syncopal event with fecal and urinary incontinence. The rate of adverse events was 0.8 events per 10,000 tests (95% confidence interval, 0.2–3.0) in men, 0.4 per 10,000 tests (0.7–2.2) in women, and 0.6 per 10,000 tests (0.21.8) total. This study represents the largest dataset analysis of exercise testing in the clinical Chinese population. Our results demonstrate that clinical exercise testing is safe, and the low rate of adverse events related to exercise testing might be due to the overall changes in clinical practice over time.

scholarly journals Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Kidney Transplant Recipients

2021 ◽  
Vol 18 (17) ◽  
pp. 9236
Author(s):  
Alessandro Patti ◽  
Daniel Neunhaeuserer ◽  
Andrea Gasperetti ◽  
Veronica Baioccato ◽  
Marco Vecchiato ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Exercise Testing ◽  
Respiratory Exchange Ratio ◽  
Cardiopulmonary Exercise Testing ◽  
Cross Sectional Study ◽  
Peak Exercise ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Linear Slope

The overshoot of the respiratory exchange ratio (RER) during recovery from exercise has been found to be reduced in magnitude among patients with heart failure. The aim of this study is to investigate whether this phenomenon could also be present in patients with peripheral, and not cardiac, limitations to exercise such as kidney transplant recipients (KTRs). In this retrospective cross-sectional study, KTRs were evaluated with maximal cardiopulmonary exercise testing (CPET) assessing the RER overshoot parameters during recovery: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot (RER mag = (RER max-peak RER)/peak RER%) and the linear slope of the RER increase after the end of exercise. A total of 57 KTRs were included in the study (16 females), all of them showing a significant RER overshoot (RER mag: 28.4 ± 12.7%). Moreover, the RER mag showed significant correlations with the fitness of patients (peak VO2: ρ = 0.57, p < 0.01) and cardiorespiratory efficiency (VE/VCO2 slope: r = −0.32, p < 0.05; oxygen uptake efficiency slope (OUES): r = 0.48, p < 0.01). Indeed, the RER mag was significantly different between the subgroups stratified by Weber’s fitness class or a ventilatory efficiency class. Our study is the first to investigate recovery of the RER in a population of KTRs, which correlates well with known prognostic CPET markers of cardiorespiratory fitness, determining the RER mag as the most meaningful RER overshoot parameter. Thus, the RER recovery might be included in CPET evaluations to further improve prognostic risk stratifications in KTRs and other chronic diseases.

Periodontitis Is Related to Exercise Capacity: Two Cross-sectional Studies

2021 ◽  
pp. 002203452199542
Author(s):  
B. Holtfreter ◽  
B. Stubbe ◽  
S. Gläser ◽  
J. Trabandt ◽  
H. Völzke ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Disease Severity ◽  
Cardiorespiratory Fitness ◽  
Large Scale ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Duration ◽  
Cross Sectional ◽  
Sample Mean ◽  
Cardiometabolic Diseases ◽  
Number Of Teeth

Although a potential link between periodontitis and cardiorespiratory fitness might provide a reasonable explanation for effects of tooth-related alterations seen on cardiometabolic diseases, evidence is currently limited. Thus, we investigated the association between clinically assessed periodontitis and cardiopulmonary exercise testing (CPET). Data from 2 independent cross-sectional population-based studies (5-y follow-up of the Study of Health in Pomerania [SHIP-1; N = 1,639] and SHIP-Trend-0 [ N = 2,439]) were analyzed. Participants received a half-mouth periodontal examination, and teeth were counted. CPET was based on symptom limited-exercise tests on a bicycle ergometer. Associations of periodontitis parameters with CPET parameters were analyzed by confounder-adjusted multivariable linear regression. In the total sample, mean pocket probing depth (PPD), mean clinical attachment levels, and number of teeth were consistently associated with peak oxygen uptake (peakVO2) and exercise duration in both studies, even after restriction to cardiorespiratory healthy participants. Statistically significant associations with oxygen uptake at anaerobic threshold (VO2@AT), slope of the efficiency of ventilation in removing carbon dioxide, and peak oxygen pulse (VÉ/VCO2 slope) occurred. Further, interactions with age were identified, such that mainly older individuals with higher levels of periodontal disease severity were associated with lower peakVO2. Restricted to never smokers, associations with mean clinical attachment levels and the number of teeth mostly diminished, while associations of mean PPD with peakVO2, VO2@AT, VÉ/VCO2 slope, and exercise duration in SHIP-1 and SHIP-Trend-0 were confirmed. In SHIP-1, mean peakVO2 was 1,895 mL/min in participants with a mean PPD of 1.6 mm and 1,809 mL/min in participants with a mean PPD of 3.7 mm. To conclude, only mean PPD reflecting current disease severity was consistently linked to cardiorespiratory fitness in 2 cross-sectional samples of the general population. If confirmed in well-designed large-scale longitudinal studies, the association between periodontitis and cardiorespiratory fitness might provide a biologically plausible mechanism linking periodontitis with cardiometabolic diseases.

scholarly journals Previous Leisure-Time Physical Activity Dose Dependently Decreases Ischemic Stroke Severity

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Dominique Deplanque ◽  
Isabelle Masse ◽  
Christian Libersa ◽  
Didier Leys ◽  
Régis Bordet
Keyword(s):  
Physical Activity ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Exercise Duration ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Favorable Effect ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Cross Sectional

In the present subanalysis of a cross-sectional study showing the favorable effect of prior transient ischemia, leisure-time physical activity, and lipid-lowering drug therapy on stroke severity, we aimed to evaluate whether previous physical activity was dose dependently associated to minor stroke (NIHSS 0–3) and to identify possible underlying factors. Among 362 consecutive patients, less severe stroke was related to weekly exercise duration prior to stroke (no exercise: 36.1%; <2 hours: 49.3%; 2–5 hours: 58.8%; >5 hours: 64.0%; ). Only weak and moderate exercise practices were protective (weak: 50.0%; moderate: 79.3%; heavy: 22.2%; ). Such a beneficial effect was observed independently of age and was associated with a trend to a lower frequency of arterial hypertension, alcohol abuse, and a better metabolic profile. Besides other therapeutic approaches, physical activity may be a simple way to decrease cerebral ischemia severity.

Nutritional Supplement Use by Dutch Elite and Sub-Elite Athletes: Does Receiving Dietary Counseling Make a Difference?

2017 ◽  
Vol 27 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Floris C. Wardenaar ◽  
Ingrid J.M. Ceelen ◽  
Jan-Willem Van Dijk ◽  
Roland W.J. Hangelbroek ◽  
Lore Van Roy ◽  
...  
Keyword(s):  
Nutritional Supplements ◽  
Exercise Duration ◽  
Nutritional Supplement ◽  
Cross Sectional Study ◽  
Sport Nutrition ◽  
Dietary Counseling ◽  
Cross Sectional ◽  
Supplement Use ◽  
Elite Status ◽  
Almost All

The use of nutritional supplements is highly prevalent among athletes. In this cross-sectional study, we assessed the prevalence of nutritional supplement use by a large group of Dutch competitive athletes in relation to dietary counseling. A total of 778 athletes (407 males and 371 females) completed a web-based questionnaire about the use of nutritional supplements. Log-binomial regression models were applied to estimate crude and adjusted prevalence ratios (PR) for the use of individual nutritional supplements in athletes receiving dietary counseling as compared with athletes not receiving dietary counseling. Of the athletes, 97.2% had used nutritional supplements at some time during their sports career, whereas 84.7% indicated having used supplements during the last 4 weeks. The top ranked supplements used over the last 4 weeks from dietary supplements, sport nutrition products and ergogenic supplements were multivitamin and mineral preparations (42.9%), isotonic sports drinks (44.1%) and caffeine (13.0%). After adjustment for elite status, age, and weekly exercise duration, dietary counseling was associated with a higher prevalence of the use of vitamin D, recovery drinks, energy bars, isotonic drinks with protein, dextrose, beta-alanine, and sodium bicarbonate. In contrast, dietary counseling was inversely associated with the use of combivitamins, calcium, vitamin E, vitamin B2, retinol, energy drinks and BCAA and other amino acids. In conclusion, almost all athletes had used nutritional supplements at some time during their athletic career. Receiving dietary counseling seemed to result in better-informed choices with respect to the use of nutritional supplements related to performance, recovery, and health.

scholarly journals Pulmonary haemodynamic response to exercise in highlanders versus lowlanders

2021 ◽  
Vol 7 (2) ◽  
pp. 00937-2020
Author(s):  
Silvia Ulrich ◽  
Stéphanie Saxer ◽  
Michael Furian ◽  
Patrick R. Bader ◽  
Paula Appenzeller ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Index ◽  
Cross Sectional Study ◽  
Haemodynamic Response ◽  
Cross Sectional ◽  
Pressure Flow ◽  
Central Asian ◽  
Significant Difference ◽  
Exercise Induced ◽  
Response To Exercise

The aim of the study was to investigate the pulmonary haemodynamic response to exercise in Central Asian high- and lowlanders.This was a cross-sectional study in Central Asian highlanders (living >2500 m) compared with lowlanders (living <800 m), assessing cardiac function, including tricuspid regurgitation pressure gradient (TRPG), cardiac index and tricuspid annular plane systolic excursion (TAPSE) by echocardiography combined with heart rate and oxygen saturation measured by pulse oximetry (SpO2) during submaximal stepwise cycle exercise (10 W increase per 3 min) at their altitude of residence (at 760 m or 3250 m, respectively).52 highlanders (26 females; aged 47.9±10.7 years; body mass index (BMI) 26.7±4.6 kg·m−2; heart rate 75±11 beats·min−1; SpO2 91±5%;) and 22 lowlanders (eight females; age 42.3±8.0 years; BMI 26.9±4.1 kg·m−2; heart rate 68±7 beats·min−1; SpO2 96±1%) were studied. Highlanders had a lower resting SpO2 compared to lowlanders but change during exercise was similar between groups (highlanders versus lowlanders −1.4±2.9% versus −0.4±1.1%, respectively, p=0.133). Highlanders had a significantly elevated TRPG and exercise-induced increase was significantly higher (13.6±10.5 mmHg versus 6.1±4.8 mmHg, difference 7.5 (2.8 to 12.2) mmHg; p=0.002), whereas cardiac index increase was slightly lower in highlanders (2.02±0.89 L·min−1versus 1.78±0.61 L·min−1, difference 0.24 (−0.13 to 0.61) L·min−1; p=0.206) resulting in a significantly steeper pressure–flow ratio (ΔTRPG/Δcardiac index) in highlanders 9.4±11.4 WU and lowlanders 3.0±2.4 WU (difference 6.4 (1.4 to 11.3) WU; p=0.012). Right ventricular-arterial coupling (TAPSE/TRPG) was significantly lower in highlanders but no significant difference in change with exercise in between groups was detected (−0.01 (−0.20 to 0.18); p=0.901).In highlanders, chronic exposure to hypoxia leads to higher pulmonary artery pressure and a steeper pressure–flow relation during exercise.

Chronotropic incompetence in paediatric heart transplant recipients with prior congenital heart disease

2019 ◽  
Vol 29 (5) ◽  
pp. 667-671 ◽  
Author(s):  
Nikki M. Singh ◽  
Rohit S. Loomba ◽  
Joshua R. Kovach ◽  
Steven J. Kindel
Keyword(s):  
Heart Rate ◽  
Exercise Testing ◽  
Heart Transplant ◽  
Heart Rate Response ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Duration ◽  
Cardiopulmonary Exercise Test ◽  
Primary Diagnosis ◽  
Chronotropic Incompetence ◽  
Cardiopulmonary Exercise

AbstractBackground:Cardiopulmonary exercise testing has been used to measure functional capacity in children who have undergone a heart transplant. Cardiopulmonary exercise testing results have not been compared between children transplanted for a primary diagnosis of CHD and those with a primary diagnosis of cardiomyopathy despite differences in outcomes. This study is aimed to compare cardiopulmonary exercise testing performance between these two groups.Methods:Patients who underwent heart transplant with subsequent cardiopulmonary exercise testing at least 6 months after transplant at our institution were identified. They were then divided into two groups based on primary cardiac diagnosis: CHD or cardiomyopathy. Patient characteristics, echocardiograms, cardiac catheterisations, outcomes, and cardiopulmonary exercise test results were compared between the two groups.Results:From the total of 35 patients, 15 (43%) had CHD and 20 (57%) had cardiomyopathy. Age at transplant, kidney disease, lung disease, previous rejection, coronary vasculopathy, catheterisation, and echocardiographic data were similar between the groups. Mean time from transplant to cardiopulmonary exercise testing, exercise duration, and maximum oxygen consumption were similar in both groups. There was a difference in heart rate response with CHD heart rate response of 63 beats per minute compared to cardiomyopathy group of 78 (p = 0.028). Patients with CHD had more chronotropic incompetence than those with cardiomyopathy (p = 0.036).Conclusion:Primary diagnosis of CHD is associated with abnormal heart rate response and more chronotropic incompetence compared to those transplanted for cardiomyopathy.

Protocols of exercise testing in athletes and cardiopulmonary testing: assessment of fitness

2019 ◽  
pp. 87-97
Author(s):  
Marco Guazzi ◽  
Paolo Emilio Adami
Keyword(s):  
Exercise Testing ◽  
Cardiovascular Response ◽  
Cardiopulmonary Exercise Testing ◽  
Gas Analysis ◽  
Fundamental Information ◽  
Expired Gas Analysis ◽  
Expired Gas ◽  
Exercise Induced ◽  
Response To Exercise ◽  
Cardiopulmonary Testing

Exercise and cardiopulmonary exercise testing are essential in the evaluation of the cardiovascular response to exercise. They are clinically used to evaluate the subject’s capacity to tolerate increasing work loads. Throughout the tests electrocardiographic, haemodynamic, and symptomatic responses are monitored to assess ischaemic, hypertensive, and arrhythmic manifestations of disease. Ventilatory expired gas analysis may also be performed, as it provides fundamental information, particularly in patients with congestive heart failure or other exercise-induced limitations.

scholarly journals Measures of excess $$ \dot{\mathrm{V}} $$CO2 and recovery $$ \dot{\mathrm{V}} $$CO2 as indices of performance fatigability during exercise: a pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Liana C. Wooten ◽  
Brian T. Neville ◽  
Randall E. Keyser
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Work Rate ◽  
Cross Sectional ◽  
Muscle Energetics ◽  
Testing Procedures ◽  
Severity Scores ◽  
And Performance

Abstract Background The severity of performance fatigability and the capacity to recover from activity are profoundly influenced by skeletal muscle energetics, specifically the ability to buffer fatigue-inducing ions produced from anaerobic metabolism. Mechanisms responsible for buffering these ions result in the production of excess carbon dioxide (CO2) that can be measured as expired CO2 ($$ \dot{\mathrm{V}} $$ V ̇ CO2) during cardiopulmonary exercise testing (CPET). The primary objective of this study was to assess the feasibility of select assessment procedures for use in planning and carrying out interventional studies, which are larger interventional studies investigating the relationships between CO2 expiration, measured during and after both CPET and submaximal exercise testing, and performance fatigability. Methods Cross-sectional, pilot study design. Seven healthy subjects (30.7±5.1 years; 5 females) completed a peak CPET and constant work-rate test (CWRT) on separate days, each followed by a 10-min recovery then 10-min walk test. Oxygen consumption ($$ \dot{\mathrm{V}} $$ V ̇ O2) and $$ \dot{\mathrm{V}} $$ V ̇ CO2 on- and off-kinetics (transition constant and oxidative response index), excess-$$ \dot{\mathrm{V}} $$ V ̇ CO2, and performance fatigability severity scores (PFSS) were measured. Data were analyzed using regression analyses. Results All subjects that met the inclusion/exclusion criteria and consented to participate in the study completed all exercise testing sessions with no adverse events. All testing procedures were carried out successfully and outcome measures were obtained, as intended, without adverse events. Excess-$$ \dot{\mathrm{V}} $$ V ̇ CO2 accounted for 61% of the variability in performance fatigability as measured by $$ \dot{\mathrm{V}} $$ V ̇ O2 on-kinetic ORI (ml/s) (R2=0.614; y = 8.474x − 4.379, 95% CI [0.748, 16.200]) and 62% of the variability as measured by PFSS (R2=0.619; y =  − 0.096x + 1.267, 95% CI [−0.183, −0.009]). During CPET, $$ \dot{\mathrm{V}} $$ V ̇ CO2 -off ORI accounted for 70% (R2=0.695; y = 1.390x − 11.984, 95% CI [0.331, 2.449]) and $$ \dot{\mathrm{V}} $$ V ̇ CO2 -off Kt for 73% of the variability in performance fatigability measured by $$ \dot{\mathrm{V}} $$ V ̇ O2 on-kinetic ORI (ml/s) (R2=0.730; y = 1.818x − 13.639, 95% CI [0.548, 3.087]). Conclusion The findings of this study suggest that utilizing $$ \dot{\mathrm{V}} $$ V ̇ CO2 measures may be a viable and useful addition or alternative to $$ \dot{\mathrm{V}} $$ V ̇ O2 measures, warranting further study. While the current protocol appeared to be satisfactory, for obtaining select cardiopulmonary and performance fatigability measures as intended, modifications to the current protocol to consider in subsequent, larger studies may include use of an alternate mode or measure to enable control of work rate constancy during performance fatigability testing following initial CPET.

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