BACKGROUND: Strong evidence supports positive correlation of physical activity with health benefits. Current recommendations by the American Heart Association are a minimum 30 minutes of moderate physical activity 5 days per week. This goal has been equilibrated with 10,000 steps per day. HYPOTHESIS: Work-related physical activity of cardiovascular (CV) specialists ...

PURPOSE: To examine the associations of age, lifestyle and work-related factors, and particularly work engagement with the work ability index (WAI) and its sub-dimensions. METHODS: Step-wise regression analysis with a sample of Finnish firefighters (n = 403) was used. The outcome variables were the WAI and its six sub-dimensions. The independent variables ...

During competitions, elite cross-country skiers produce higher external work rates on uphill than on flat terrain. However, it is not presently known whether this reflects solely higher energy expenditure. Furthermore, the kinematic factors associated with these higher rates of uphill work have not yet been examined. Therefore, in the present ...

Background and Objective The endurance time has been reported to be the most sensitive measure of improved exercise capacity in response to a variety of interventions for COPD. The aim of the present study was to determine whether the improvements in quadriceps force and measures obtained from a symptom-limited maximal ...

Exercise-induced pulmonary hypertension (PH) may represent an early but clinically relevant phase in the spectrum of pulmonary vascular disease. There are limited data on the prevalence of exercise-induced PH determined by right heart catheterization in scleroderma spectrum disorders. We undertook this study to describe the hemodynamic response to exercise in ...

Sodium balance is vital to maintaining normal physiological function. Imbalances can occur in a variety of diseases, during certain surgical operations or during rigorous exercise. There is currently no method to continuously monitor sodium concentration in patients who may be susceptible to hyponatremia. Our approach was to design sodium specific ...

Evaluation of pulmonary function in patients with spinocerebellar ataxias (SCA) 1, 2 and 3 without clinical evidence of pulmonary dysfunction. Thirty patients (F:M = 7:23; age: 35 ± 11.3 years; SCA1 - 13, SCA2 - 9 and SCA3 - 8) without clinical manifestations of respiratory dysfunction and 30 controls underwent ...

Pulmonary sarcoidosis shows a remarkable heterogeneity of phenotypes ranging from bihilar lymphadenopathy to progressive fibrosis. Individual disease assessment is demanding and requires sensible, practical measures. We tested whether gas exchange measurements during exercise reflects disease activity and clinical course in sarcoidosis. In 149 patients with proven pulmonary sarcoidosis the alveolar-arterial ...

Recent data show that there is an unexpectedly high prevalence of 'inappropriate' pulmonary responses to exercise among patients with systemic sclerosis (SS). However, no consensus exists as to which threshold of pulmonary artery systolic pressure (PASP) can be considered diagnostically relevant. To evaluate pulmonary vascular reserve and right ventricular function ...

Aging is associated with a progressive deterioration in the structure and function of the pulmonary circulation. Remodeling of the pulmonary vasculature occurs from maturity to senescence that is characterized by an increase in pulmonary vascular stiffness, pulmonary vascular pressures, and pulmonary vascular resistance along with increased heterogeneity of alveolar ventilation ...

Patients with anatomic repair of transposition of the great arteries (TGA) can present with branch pulmonary artery (PA) stenosis; however, its relation to an abnormal cardiopulmonary response to exercise is unknown. We investigated the relation between the PA anatomy and pulmonary blood flow (PBF) distribution and the cardiopulmonary response to ...

To establish high-resolution phase-contrast magnetic resonance imaging (PC-MRI) using a MRI compatible bicycle ergometer to quantify aortic and pulmonary blood flow during resting conditions and exercise. In 20 healthy volunteers (mean age, 26.8±5.0 years) high-resolution PC-MRI (mean temporal resolution, 7.4±3.2ms) was performed in the ascending aorta (AA) and main pulmonary ...

Pulmonary endarterectomy (PEA) provides a potential cure for patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, successfully operated patients can continue to suffer from a limitation of exercise capacity, despite normalization of pulmonary vascular resistance (PVR). The purpose of the present study was to explore the cardiopulmonary exercise test (CPET) ...

The biomechanical forces associated with blood flow have been shown to play a role in pulmonary vascular cell health and disease. Therefore, the quantification of human pulmonary artery hemodynamic conditions under resting and exercise states can be useful in investigating the physiology of disease development and treatment outcomes. In this ...

Cystic fibrosis (CF) is the most common life-limiting, recessively inherited disease in the white population, associated with significantly high morbidity and mortality rates; CF pulmonary disease, assessed by pulmonary function tests, arterial blood gases and the Schwachman score, remains the most prevalent in terms of morbidity in the adult CF ...

BACKGROUND: End-stage lung disease patients who require a thoracic artificial lung (TAL) must be extubated and rehabilitated prior to lung transplantation. The purpose of this study is to evaluate hemodynamics and TAL function under simulated rest and exercise conditions in normal and pulmonary hypertension sheep models. METHODS: The TAL, the ...

To examine the role of cardiopulmonary exercise testing with right-heart catheterization (CPET/RHC) in patients with systemic sclerosis (SSc) with potentially multifactorial exertional limitation. This was a single-center retrospective cohort study of patients with SSc referred for CPET/RHC. A total of 19 patients with SSc [subtypes: 10 limited, 5 diffuse, 1 ...

Key elements for determining alveolar-capillary membrane conductance (Dm) and pulmonary capillary blood volume (Vc) from the lung diffusing capacity (Dl) for carbon monoxide (DlCO) or for nitric oxide (DlNO) are the reaction rate of carbon monoxide with hemoglobin (thetaCO) and the DmCO/DlNO relationship (alpha-ratio). Although a range of values have ...

This article reviews the benefits of pre-assessment with cardio-pulmonary exercise testing (CPX) and the effectiveness of preoperative interventions in high-risk patients undergoing major surgery. Three patient case studies will be presented from local practice, to give examples of how patients' co-morbidity has been improved prior to surgery or how decisions ...

Patients with cyanotic congenital heart disease without corrective surgery or palliation survive into adulthood, if they have a balanced pulmonary blood flow facilitated by pulmonary stenosis (PS) or Eisenmenger syndrome (ES). Both groups show cyanosis, diminished exercise performance and impaired quality of life. This study aimed to compare the functional ...

Immersion pulmonary edema (IPE) can occur in otherwise healthy swimmers and divers, likely because of stress failure of pulmonary capillaries secondary to increased pulmonary vascular pressures. Prior studies have revealed progressive increase in ventilation [minute ventilation (Ve)] during prolonged immersed exercise. We hypothesized that this increase occurs because of development ...

This study compared the results of exercise Doppler echocardiography (EDE) with right-sided heart catheterization (RHC) and evaluated the combination of EDE and cardiopulmonary exercise testing (CPET) as a screening method for early pulmonary vasculopathy in patients with connective tissue disease. Patients (N = 52) with connective tissue disease (predominantly systemic ...

In pulmonary arterial hypertension (PAH), the exercise-induced increase in stroke volume (SV) is limited by the increase in pulmonary artery pressure. In left heart failure (LHF), systemic arterial pressure increases little during exercise, and the SV increase is limited by the left ventricle itself. These differences might be reflected by ...

BACKGROUND: Pulmonary arterial hypertension (PAH) in dogs carries a poor prognosis. Sildenafil increases exercise capacity and improves hemodynamics in people with PAH. HYPOTHESIS/OBJECTIVES: Dogs receiving sildenafil will have lower pulmonary arterial pressure, increased exercise capacity, and better quality of life (QOL) than dogs receiving placebo. ANIMALS: Thirteen dogs with echocardiographic ...

We hypothesized that the longitudinal changes in peak oxygen uptake, ventilatory efficiency, and exercise-induced right-to-left shunting in patients with pulmonary arterial hypertension (PAH) would predict outcomes better than baseline measurements alone. Patients with PAH die prematurely. Identifying prognostic markers is critical for treating patients with PAH; however, longitudinal prognostic information ...

The lungs are now recognized as an active metabolic organ that is a major determinant of the plasma concentrations of the vasoconstrictors endothelin (ET) and ANG II. Several studies have suggested a complex interaction between ET and ANG II in the systemic and coronary vascular beds that is different at ...

The data describing the change in exercise capacity after surgical or interventional management of the patient with right ventricular (RV) outflow tract (OT) dysfunction are conflicting. The pathophysiologic consequences of RVOT interventions and the subsequent change in exercise performance are still poorly understood. We sought to assess the effect of ...

Fontan patients have a reduced exercise capacity, primarily owing to limitations in the ability to augment pulmonary blood flow and stroke volume. To date, the mechanism of peak exercise pulmonary blood flow restriction has not been elucidated. We performed a single-center, prospective, crossover trial of supine and upright exercise in ...

INTRODUCTION: The mechanism of immersion pulmonary oedema occurring in healthy divers is a matter of debate. Among consecutive injured divers admitted to our hyperbaric centre, we analysed prospective data about pulmonary oedema. METHOD: A total of 22 divers suffering from immersion pulmonary oedema without cardiac disease were included. The occurrence ...

BACKGROUND: Pulmonary arterial hypertension (PAH) remains a poorly understood and frequently lethal disease with few treatment options. METHODS: We conducted a placebo-controlled trial of intravenous treprostinil, a prostacyclin analog, in treatment-naive PAH patients. During 12 weeks of treatment with treprostinil or placebo, we quantified 6-minute walk distance (6MW), clinical symptoms ...

BACKGROUND: Bosentan has an established role in the management of pulmonary arterial hypertension (PAH). This clinical trial assessed the benefits of bosentan in the Chinese population. METHODS: We investigated the efficacy and safety of bosentan in 92 Chinese citizens (mean +/- standard deviation age, 29.0 +/- 3.8 years) with PAH ...

OBJECTIVE: Pulmonary hypertension (PHT) is associated with high mortality and morbidity. Interest has increased in the use of drugs that, because of their neurohumoral inhibitory effects, inhibit the renin angiotensin system. In this study, we sought to examine whether losartan therapy is non-inferior to nifedipine in the treatment of secondary ...

Patients who have had the Fontan procedure report poor exercise performance. Fontan subjects can tolerate a higher level of sub maximal activity than might be anticipated from VO2, suggesting a different mechanism of exercise limitation. Near-infrared spectroscopy (NIRS) provides a non-invasive, continuous method to monitor regional tissue oxygenation (rSO2) and ...

A main purpose of this study was to compare the repeatability (2.77 multiplied by the within-subject SD) between two different rebreathing protocols on cardiac output (Q), pulmonary diffusing capacity for carbon monoxide (DL(CO)) and nitric oxide (DL(NO)), and pulmonary capillary blood volume (Vc). This study compared two bag volume conditions ...

Exercise is an important determinant of health but is significantly reduced in the patient with a univentricular circulation. Normal exercise physiology mandates an increase in pulmonary artery pressures which places an increased work demand on the right ventricle (RV). In a biventricular circulation with pathological increases in pulmonary vascular resistance ...

Risk assessment for pulmonary resection must include a preliminary cardiac evaluation. Patients deemed at prohibitive cardiac risk should be evaluated and treated as per American Heart Association/American Society of Cardiology guidelines. Those with low cardiac risk or with optimized treatment can proceed with pulmonary assessment. A systematic measurement of lung ...

The present paper provides a review of the literature regarding exercise testing, exercise capacity, and the role of exercise training in patients with congenital heart disease (CHD). Different measures of exercise capacity are discussed, including both simple and more advanced exercise parameters. Different groups of patients, including shunt lesions, pulmonary ...

With recent advances in our understanding of pulmonary hypertension and with ever increasing therapeutic options at our disposal, it remains disappointing that clinical markers of disease progression remain dated. There has long been a search for a more robust clinical correlate than the 6 minute walk test. Resting right heart ...

Professional classical ballet dancers typically face long working days, and many complain of fatigue, particularly as a possible cause of injury. However, little information exists regarding the true physiological demands on dancers. The aim of the present study was therefore to ascertain the daily workload of professional female ballet dancers ...

Submaximal exercise gas exchange may be a useful tool to track responses to therapy in pulmonary arterial hypertension (PAH) patients. Three patients diagnosed with idiopathic PAH, on differing therapies, were included. Standard clinical tests (echocardiography; 6 minute walk) were performed pre and 3-5 months after treatment. Gas exchange was measured ...

Purpose: To describe the benefits of a feasible, outpatient exercise training program on exercise tolerance and health-related quality of life (HRQL) in individuals with pulmonary arterial hypertension (PAH). Methods: Case report on two subjects recruited from a tertiary care pulmonary hypertension clinic. Subject 1 was a 50-year-old male with idiopathic ...

RATIONALE: There is evidence that endothelin plays a key role in the development of pulmonary hypertension (PH) in pulmonary fibrosis (PF). However, the functional consequence of the unselective endothelin receptor antagonist Bosentan in PH and PF has not yet been studied. Therefore, we investigated the effects of Bosentan on the ...

Exercise stress tests have been used for the diagnosis of pulmonary hypertension, but with variable protocols and uncertain limits of normal. The pulmonary haemodynamic response to progressively increased workload and recovery was investigated by Doppler echocardiography in 25 healthy volunteers aged 19-62 yrs (mean 36 yrs). Mean pulmonary artery pressure ...

AIM: We sought to determine whether pulmonary diffusing capacity for nitric oxide (DLNO), carbon monoxide (DLCO) and pulmonary capillary blood volume (Vc) at rest predict peak aerobic capacity (O(2peak)), and if so, to discern which measure predicts better. METHODS: Thirty-five individuals with extreme obesity (body mass index or BMI = ...

RATIONALE: Sildenafil, a phosphodiesterase-5 inhibitor, could be useful for treating pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD). However, vasodilators may inhibit hypoxic pulmonary vasoconstriction and impair gas exchange in this condition. OBJECTIVES: To assess the acute hemodynamic and gas exchange effects of sildenafil in patients with COPD-associated PH. ...

The demands for pulmonary O(2) and CO(2) transport in the exercising human are substantial. Fortunately, the regulatory and architectural limits of the pulmonary system meet the requirements of heavy exercise in most individuals. However, in some highly trained athletes the high metabolic demand of intense exercise is in excess of ...

BACKGROUND: Chronic mountain sickness (CMS) is an important public health problem and is characterized by exaggerated hypoxemia, erythrocytosis, and pulmonary hypertension. While pulmonary hypertension is a leading cause of morbidity and mortality in patients with CMS, it is relatively mild and its underlying mechanisms are not known. We speculated that ...

Exercise presents a considerable stress to the pulmonary system and ventilation-perfusion (Va/Q) heterogeneity increases with exercise, affecting the efficiency of gas exchange. In particular, prolonged heavy exercise and maximal exercise are known to increase Va/Q heterogeneity and these changes persist into recovery. We hypothesized that the spatial heterogeneity of pulmonary ...

BACKGROUND: Patients with idiopathic pulmonary fibrosis (IPF) present an important ventilatory limitation reducing their exercise capacity. Non-invasive ventilatory support has been shown to improve exercise capacity in patients with obstructive diseases; however, its effect on IPF patients remains unknown. OBJECTIVE: The present study assessed the effect of ventilatory support using ...

RATIONALE: Pulmonary arterial hypertension is associated with impaired exercise capacity and decreased survival in patients with scleroderma. Randomized controlled studies showed significant benefit of targeted therapies in patients with a resting mean pulmonary arterial pressure (MPAP) greater than 25 mm Hg. The clinical relevance of pulmonary arterial pressure values in ...