scholarly journals Low-technology exercise test in the preoperative evaluation of lung resection candidates

2016 ◽  
Vol 73 (2) ◽  
Author(s):  
A. Brunelli ◽  
C. Pompili ◽  
M. Salati
Keyword(s):  
Oxygen Consumption ◽  
Exercise Test ◽  
Screening Test ◽  
Lung Resection ◽  
Cardiopulmonary Exercise Test ◽  
Stair Climbing ◽  
Functional Evaluation ◽  
Exercise Tests ◽  
Walking Test ◽  
Cardiopulmonary Exercise

Exercise tests are increasingly used in the preoperative functional evaluation of lung resection candidates. Low-technology exercise tests include six minute walking, shuttle walking and stair climbing. Conflicting evidence has been reported regarding 6 minute walking test. This test should not be used to select patients for lung resection. An incremental shuttle walk test is easier to replicate than 6 minute walking test. Most patients achieving 25 shuttles or 400 m have a maximum oxygen consumption measured at cardiopulmonary exercise test greater than 15 l/Kg/min. Although this test tends to underestimate performance at the lower range compared to peak oxygen consumption it can be used a screening test before lung resection. Excluding patients from operation based on this test alone is however not recommended and a formal cardiopulmonary exercise test should be always used in those walking less than 400 m. Stair climbing has been extensively studied in thoracic surgery. Several studies have found that poor performance in this test is indicative of cardiopulmonary complications and mortality after lung resection. In particular, climbing less than 12 m represents very high risk, whereas climbing more than 22 m is associated with a favourable outcome. Recent guidelines recommend referring all patients climbing lower than 22 m to cardiopulmonary exercise test. Stair climbing can be used as a screening test in cases cardiopulmonary exercise test is not readily available. In general, patients climbing more than 22 m can proceed to surgery without further evaluation.

Peak Oxygen Consumption During Cardiopulmonary Exercise Test Improves Risk Stratification in Candidates to Major Lung Resection

CHEST Journal ◽  
2009 ◽  
Vol 135 (5) ◽  
pp. 1260-1267 ◽  
Author(s):  
Alessandro Brunelli ◽  
Romualdo Belardinelli ◽  
Majed Refai ◽  
Michele Salati ◽  
Laura Socci ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Risk Stratification ◽  
Exercise Test ◽  
Lung Resection ◽  
Cardiopulmonary Exercise Test ◽  
Peak Oxygen Consumption ◽  
Cardiopulmonary Exercise

Novel rehabilitation program after left ventricular assist device (LVAD) implantation improves functional tests and reduces levels of prognostic heart failure biomarkers

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Chwyczko ◽  
L Zalucka ◽  
E Smolis-Bak ◽  
I Kowalik ◽  
E Noszczak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Rehabilitation Program ◽  
Left Ventricular ◽  
Prognostic Biomarkers ◽  
Funding Source ◽  
Walking Test ◽  
Cardiopulmonary Exercise ◽  
Galectin 3

Abstract Background Rehabilitation after LVAD implantation is increasingly used. We developed the novel method of comprehensive rehabilitation starting directly after LVAD implantation. Study group 21 recent LVAD (15 Heart Mate III, 6 HeartWare) recipients (56.2±11.7 yrs, 100% men) were included to 5-week rehabilitation program, which included supervised endurance training on cycloergometer (5 times per week), resistance training, general fitness exercises with elements of equivalent and coordination exercises (every day). 6-minute walking test (6MWT), cardiopulmonary exercise test (CPET) and prognostic biomarkers: NT-proBNP, Galectin-3 and ST2 were investigated at the beginning and at the end of rehabilitation program. Results See Table 1. At the end of rehabilitation program, significant increase in 6MWT distance, maximum workload, peak VO2 and upward shift of anaerobic threshold in CPET were observed in all patients. Significant reductions of NTproBNP, ST2 and galectin-3 levels were observed. There were no major adverse events during rehabilitaton. Conclusions Comprehensive novel rehabilitation in LVAD recipients is safe and results in significant improvement of 6-minutes walking test distance and cardiopulmonary exercise test results. Moreover, this novel rehabilitation program reduces levels of prognostic biomarkers of heart failure: NT-proBNP, Galectin-3 and ST2. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Center for Research and Development - STRATEGMED II project

Cardiopulmonary exercise test for risk assessment in lung resection surgery

2018 ◽  
Author(s):  
Danielle Cristine Campos Bedin ◽  
Roberta Pulcheri Ramos ◽  
Elaine Brito Vieira ◽  
Sonia Maria Faresin ◽  
Luiz Eduardo Nery
Keyword(s):  
Risk Assessment ◽  
Exercise Test ◽  
Lung Resection ◽  
Cardiopulmonary Exercise Test ◽  
Cardiopulmonary Exercise

scholarly journals Cardiopulmonary exercise tests of adolescent elite sport climbers—a comparison of the German junior national team in sport climbing and nordic skiing

2020 ◽  
Author(s):  
Isabelle Schöffl ◽  
Jan Wüstenfeld ◽  
Gareth Jones ◽  
Sven Dittrich ◽  
Chris Lutter ◽  
...  
Keyword(s):  
Exercise Test ◽  
Time Frame ◽  
Cardiopulmonary Exercise Test ◽  
Cycle Ergometer ◽  
Peak Oxygen Consumption ◽  
Exercise Tests ◽  
National Team ◽  
Cardiopulmonary Exercise ◽  
Sport Climbing ◽  
Nordic Skiing

Abstract Background: All the research investigating the cardiopulmonary capacity in climbers focused on predictors for climbing performance. The effects of climbing on the cardiovascular system in adolescents climbing at an elite level (national team) have not been evaluated.A retrospective analysis of the cardiopulmonary exercise test (CPET) performed on a cycle ergometer during the yearly medical examination of the entire German Junior National climbing team on one occasion and for a selected subgroup on two occasions spaced two years apart was undertaken. The data from the subgroup was compared to an age- and gender-matched control of nordic skiers from the German Junior National nordic skiing team.Results: 47 climbers (20 girls, 27 boys) were examined once. The peak oxygen consumption (B achieved by the athletes was 41.3 mL kg-1 min-1 (boys) and 39.8 mL kg-1 min-1 (girls). 8 boys and 6 girls were tested twice over a time-frame of 27.5 months. The parameters of the exercise test measured on both occasions were significantly lower than those of the 14 nordic skiers. There was no change with respect to any variables over the examined time-frame. Conclusions: The elite climbers investigated in this study showed comparable a-values to athletes from team and combat sports. The nordic skiers to which they were compared showed significantly higher values consistant with the fact that this is an endurance sport. Even though the cardiopulmonary measurements of the nordic skiers still improved after two years of training, no adaptations could be observed in the elite climbers.

scholarly journals Cardiopulmonary Exercise Test in Patients with Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2312
Author(s):  
Adrián Bayonas-Ruiz ◽  
Francisca Muñoz-Franco ◽  
Vicente Ferrer ◽  
Carlos Pérez-Caballero ◽  
María Sabater-Molina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oxygen Consumption ◽  
Hypertrophic Cardiomyopathy ◽  
Functional Capacity ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Cycle Ergometer ◽  
Left Ventricular ◽  
Exercise Intolerance ◽  
Cardiopulmonary Exercise

Background: Patients with chronic diseases frequently adapt their lifestyles to their functional limitations. Functional capacity in Hypertrophic Cardiomyopathy (HCM) can be assessed by stress testing. We aim to review and analyze the available data from the literature on the value of Cardiopulmonary Exercise Test (CPET) in HCM. Objective measurements from CPET are used for evaluation of patient response to traditional and new developing therapeutic measurements. Methods: A systematic review of the literature was conducted in PubMed, Web of Science and Cochrane in Mar-20. The original search yielded 2628 results. One hundred and two full texts were read after the first screening, of which, 69 were included for qualitative synthesis. Relevant variables to be included in the review were set and 17 were selected, including comorbidities, body mass index (BMI), cardiac-related symptoms, echocardiographic variables, medications and outcomes. Results: Study sample consisted of 69 research articles, including 11,672 patients (48 ± 14 years old, 65.9%/34.1% men/women). Treadmill was the most common instrument employed (n = 37 studies), followed by upright cycle-ergometer (n = 16 studies). Mean maximal oxygen consumption (VO2max) was 22.3 ± 3.8 mL·kg−1·min−1. The highest average values were observed in supine and upright cycle-ergometer (25.3 ± 6.5 and 24.8 ± 9.1 mL·kg−1·min−1; respectively). Oxygen consumption in the anaerobic threshold (ATVO2) was reported in 18 publications. Left ventricular outflow tract gradient (LVOT) > 30 mmHg was present at baseline in 31.4% of cases. It increased to 49% during exercise. Proportion of abnormal blood pressure response (ABPRE) was higher in severe (>20 mm) vs. mild hypertrophy groups (17.9% vs. 13.6%, p < 0.001). Mean VO2max was not significantly different between severe vs. milder hypertrophy, or for obstructive vs. non-obstructive groups. Occurrence of arrhythmias during functional assessment was higher among younger adults (5.42% vs. 1.69% in older adults, p < 0.001). Twenty-three publications (9145 patients) evaluated the prognostic value of exercise capacity. There were 8.5% total deaths, 6.7% cardiovascular deaths, 3.0% sudden cardiac deaths (SCD), 1.2% heart failure death, 0.6% resuscitated cardiac arrests, 1.1% transplants, 2.6% implantable cardioverter defibrillator (ICD) therapies and 1.2 strokes (mean follow-up: 3.81 ± 2.77 years). VO2max, ATVO2, METs, % of age-gender predicted VO2max, % of age-gender predicted METs, ABPRE and ventricular arrhythmias were significantly associated with major outcomes individually. Mean VO2max was reduced in patients who reached the combined cardiovascular death outcome compared to those who survived (−6.20 mL·kg−1·min−1; CI 95%: −7.95, −4.46; p < 0.01). Conclusions: CPET is a valuable tool and can safely perform for assessment of physical functional capacity in patients with HCM. VO2max is the most common performance measurement evaluated in functional studies, showing higher values in those based on cycle-ergometer compared to treadmill. Subgroup analysis shows that exercise intolerance seems to be more related to age, medication and comorbidities than HCM phenotype itself. Lower VO2max is consistently seen in HCM patients at major cardiovascular risk.

scholarly journals How Patients With Heart Failure Perform Daily Life Activities

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Massimo Mapelli ◽  
Elisabetta Salvioni ◽  
Alice Bonomi ◽  
Paola Gugliandolo ◽  
Fabiana De Martino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Oxygen Uptake ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Peak Oxygen Consumption ◽  
Borg Scale ◽  
Walking Test ◽  
Cardiopulmonary Exercise ◽  
Stable Conditions

Background: Cardiopulmonary exercise test and 6-minute walking test are frequently used tools to evaluate physical performance in heart failure (HF), but they do neither represent activities of daily living (ADLs) nor fully reproduce patients’ symptoms. We assessed differences in task oxygen uptake, both as absolute value and as percentage of peak oxygen consumption (peakVO 2 ), ventilation efficiency (VE/VCO 2 ratio), and dyspnea intensity (Borg scale) in HF and healthy subjects during standard ADLs and other common physical actions. Methods: Healthy and HF subjects (ejection fraction <45%, stable conditions) underwent cardiopulmonary exercise test. All of them, carrying a wearable metabolic cart, performed a 6-minute walking test, two 4-minute treadmill exercises (at 2 and 3 km/h), and ADLs: ADL1 (getting dressed), ADL2 (folding 8 towels), ADL3 (putting away 6 bottles), ADL4 (making a bed), ADL5 (sweeping the floor for 4 minutes), ADL6 (climbing 1 flight of stairs carrying a load). Results: Sixty patients with HF (age 65.2±12.1 years; ejection fraction 30.4±6.7%, peakVO 2 14.2±4.0 mL/[min·kg]) and 40 healthy volunteers (58.9±8.2 years, peakVO 2 28.1±7.4 mL/[min·kg]) were enrolled. For each exercise, patients showed higher VE/VCO 2 ratio, percentage of peakVO 2 , and Borg scale value than controls, while absolute values of task oxygen uptake and exercise duration were lower and higher, respectively, in all activities, except for treadmill (fixed execution time and intensity). Differently from Borg Scale data, metabolic values and exercise time length changed in parallel with HF severity, except for ADL duration in very short (ADL3) and composite (ADL1) activities. Borg scale values correlated with percentage of peakVO 2 . Conclusions: During ADLs, patients self-regulated activities in parallel with HF severity by decreasing intensity (VO 2 ) and prolonging the effort.

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