Manifestation of cardiopulmonary exercise testing in an HIV-infected patient with highly active anti-retroviral therapy: A Case Report

2021 ◽  
Vol 1 (2) ◽  
pp. 013-017
Author(s):  
Pei-Yun Chen ◽  
Shin-Tsu Chang ◽  
Ko-Long Lin
Keyword(s):  
Case Report ◽  
Exercise Testing ◽  
Aerobic Capacity ◽  
Highly Active Antiretroviral Therapy ◽  
Infected Patient ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Fitness ◽  
Cardiopulmonary Exercise ◽  
Highly Active ◽  
The Difference

Background: Human immunodeficiency virus (HIV) is a retrovirus that causes severe immunodeficiency syndrome in most patients if left untreated. It has been a reportable disease in Taiwan since 1984, and was diagnosed in 41,679 patients until June 2020. However, there is no previous study evaluating aerobic capacity in HIV-infected patient in Taiwan. Case report: A 50-year-old male with HIV infection visited our rehabilitation center for cardiopulmonary exercise testing (CPET) due to dyspnea on exertion sometimes. He received a highly active antiretroviral therapy (HAART) regimen since 2015. He could achieve VO2max during CPET. The maximal aerobic ability was about 91.95% of the predicted, and functional aerobic impairment (FAI) was within normal limit. His VO2 peak was 8.3 MET, equal to 29.05 mL/kg/min. Additionally, VO2 AT was 4.5 MET, equal to 15.75 mL/kg/min. We make recommendations of physical exercise training program according to CPET results. Conclusion: The difference of disease duration, HAART regimen and time of HAART will affect the cardiopulmonary fitness results. However, our HIV-infected patient showed normal aerobic fitness following the CPET, and aerobic capacity did not impair in HIV-infected patient receiving HAART due to personalized life-style modification.

PETCO2 gradient: a novel prognostic parameter in cardiopulmonary exercise testing

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I.D Poveda Pinedo ◽  
I Marco Clement ◽  
O Gonzalez ◽  
I Ponz ◽  
A.M Iniesta ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Proportional Hazards ◽  
Cardiopulmonary Exercise Testing ◽  
Cox Proportional Hazards ◽  
Prognostic Parameter ◽  
Cardiopulmonary Exercise ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Baseline Characteristics ◽  
The Difference

Abstract Background Previous parameters such as peak VO2, VE/VCO2 slope and OUES have been described to be prognostic in heart failure (HF). The aim of this study was to identify further prognostic factors of cardiopulmonary exercise testing (CPET) in HF patients. Methods A retrospective analysis of HF patients who underwent CPET from January to November 2019 in a single centre was performed. PETCO2 gradient was defined by the difference between final PETCO2 and baseline PETCO2. HF events were defined as decompensated HF requiring hospital admission or IV diuretics, or decompensated HF resulting in death. Results A total of 64 HF patients were assessed by CPET, HF events occurred in 8 (12.5%) patients. Baseline characteristics are shown in table 1. Patients having HF events had a negative PETCO2 gradient while patients not having events showed a positive PETCO2 gradient (−1.5 [IQR −4.8, 2.3] vs 3 [IQR 1, 5] mmHg; p=0.004). A multivariate Cox proportional-hazards regression analysis revealed that PETCO2 gradient was an independent predictor of HF events (HR 0.74, 95% CI [0.61–0.89]; p=0.002). Kaplan-Meier curves showed a significantly higher incidence of HF events in patients having negative gradients, p=0.002 (figure 1). Conclusion PETCO2 gradient was demonstrated to be a prognostic parameter of CPET in HF patients in our study. Patients having negative gradients had worse outcomes by having more HF events. Time to first event, decompensated heart Funding Acknowledgement Type of funding source: None

Impact of periodic breathing on measurement of oxygen uptake and respiratory exchange ratio during cardiopulmonary exercise testing

2002 ◽  
Vol 103 (6) ◽  
pp. 543-552 ◽  
Author(s):  
Darrel P. FRANCIS ◽  
L. Ceri DAVIES ◽  
Keith WILLSON ◽  
Roland WENSEL ◽  
Piotr PONIKOWSKI ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Exercise Testing ◽  
Respiratory Exchange Ratio ◽  
Cardiopulmonary Exercise Testing ◽  
Periodic Breathing ◽  
Moving Window ◽  
Carbon Dioxide Output ◽  
Cardiopulmonary Exercise ◽  
Peak Vo2 ◽  
The Difference

Metabolic exercise testing is valuable in patients with chronic heart failure (CHF), but periodic breathing may confound the measurements. We aimed to examine the effects of periodic breathing on the measurement of oxygen uptake (VO2) and respiratory exchange ratio (RER). First, we measured the effects of different averaging procedures on peak VO2 and RER values in 122 patients with CHF undergoing cardiopulmonary exercise testing. Secondly, we studied the effects of periodic breathing on VO2 and RER in healthy volunteers performing computer-guided periodic breathing. Thirdly, we used a Fourier analysis to study the effects of periodic breathing on gas exchange measurements. The first part of the study showed that 1min moving window gave a mean peak VO2 of 13.8mlμmin-1μkg-1 for the CHF patients. A 15s window gave significantly higher values. The difference averaged 1.0mlμmin-1μkg-1 (P<0.0001), but varied widely: 41% of subjects showed a difference greater than 1.0mlμmin-1μkg-1. RER values were also higher by an average of 0.09 (P<0.0001); in 20% of subjects the difference was greater than 0.10. In the second part of the study, we found artefactual elevations of peak VO2 (without averaging) of 2.9mlμmin-1μkg-1 (P<0.01) and of peak RER of 0.13 (P<0.001), which were still significant when 30s averaging was applied [Δ(peak VO2) = 1.8mlμmin-1μkg-1, P<0.01; ΔRER = 0.08, P<0.001]. The third, theoretical, part of the study showed that values of carbon dioxide output and VO2 oscillate with different phases and amplitudes, resulting in oscillations in their ratio, RER. Averaging over 15s or 30s can be expected to give only 10% or 36% attenuation respectively. Thus periodic breathing causes variable artefactual elevations of measured peak VO2 and RER, which can be attenuated by using longer averaging periods. Clinical reports and research publications describing peak VO2 in CHF should be accompanied by details of the averaging technique used.

scholarly journals The risks of applying normative values in paediatric cardiopulmonary exercise testing: a case report

2020 ◽  
Vol 6 (4) ◽  
pp. 00333-2020
Author(s):  
Jessica L. Waterfall ◽  
Paul Burns ◽  
Dawn Shackell ◽  
Joanna Pepke-Zaba ◽  
Katrina E. Oates ◽  
...  
Keyword(s):  
Case Report ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Normative Values ◽  
Cardiopulmonary Exercise

scholarly journals CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities

Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 80 ◽  
Author(s):  
Ioana Mădălina Zota ◽  
Cristian Stătescu ◽  
Radu Andy Sascău ◽  
Mihai Roca ◽  
Radu Sebastian Gavril ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Metabolic Rate ◽  
Exercise Testing ◽  
Functional Capacity ◽  
Aerobic Capacity ◽  
Basal Metabolic Rate ◽  
Cardiopulmonary Exercise Testing ◽  
Short Term ◽  
Cardiopulmonary Exercise ◽  
Before And After

Background and Objectives: Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic dysfunctions negatively influence exercise tolerance in moderate-severe OSA patients. The cardiopulmonary exercise testing (CPET) offers an integrated assessment of the individual’s aerobic capacity and helps distinguish the main causes of exercise limitation. The purpose of this study is to evaluate the aerobic capacity of OSA patients, before and after short-term continuous positive airway pressure (CPAP). Materials and Methods: Our prospective study included 64 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) 39.96 ± 19.04 events/h) who underwent CPET before and after CPAP. Thirteen patients were unable to tolerate CPAP or were lost during follow-up. Results: 49.29% of our patients exhibited a moderate or severe decrease in functional capacity (Weber C or D). CPET performance was influenced by gender but not by apnea severity. Eight weeks of CPAP induced significant improvements in maximal exercise load (Δ = 14.23 W, p = 0.0004), maximum oxygen uptake (Δ = 203.87 mL/min, p = 0.004), anaerobic threshold (Δ = 316.4 mL/min, p = 0.001), minute ventilation (Δ = 5.1 L/min, p = 0.01) and peak oxygen pulse (Δ = 2.46, p = 0.007) as well as a decrease in basal metabolic rate (BMR) (Δ = −8.3 kCal/24 h, p = 0.04) and average Epworth score (Δ = −4.58 points, p < 0.000001). Conclusions: Patients with moderate-severe OSA have mediocre functional capacity. Apnea severity (AHI) was correlated with basal metabolic rate, resting heart rate and percent predicted maximum effort but not with anaerobic threshold or maximum oxygen uptake. Although CPET performance was similar in the two apnea severity subgroups, short-term CPAP therapy significantly improved most CPET parameters, suggesting that OSA per se has a negative influence on effort capacity.

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