Whether reversible ischemia in patients referred for exercise stress testing and myocardial perfusion imaging (MPI) is associated with changes in circulating cardiac troponin levels is controversial. We measured cardiac troponin T (cTnT) with a sensitive assay before, immediately after peak exercise, and 1.5 h and 4.5 h after exercise stress ...

OBJECTIVE:To examine metabolism during exercise in 2 patients with muscle phosphorylase kinase (PHK) deficiency and to further define the phenotype of this rare glycogen storage disease (GSD). METHODS:Patient 1 (39 years old) had mild exercise-induced forearm pain, and EMG showed a myopathic pattern. Patient 2 (69 years old) had raised ...

During exercise, patients with cystic fibrosis (CF) dynamically hyperinflate, which imposes both elastic and threshold loads on the inspiratory muscles and places them at a mechanical disadvantage due to muscle shortening. Conversely, dynamic hyperinflation imposes a progressively resistive load and lengthens the expiratory muscles potentially increasing their susceptibility to develop ...

OBJECTIVE: This study attempted to determine whether exercise induced left ventricular (LV) diastolic dysfunction estimated by altered trans-mitral flow (TMF) velocity pattern after exercise is associated with increased risk of cardiac events including new-onset atrial fibrillation (AF) in elderly patients with impaired LV relaxation at rest. BACKGROUND: Diastolic stress echocardiography ...

OBJECTIVE: To determine the lifestyle behaviors of women before and during an IVF cycle. DESIGN: Prospective survey. SETTING: Private academically affiliated infertility center. PATIENT(S): One hundred eighteen women, ages 18-44, scheduled to undergo an assisted reproductive technology (ART) cycle using their own eggs. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Lifestyle history ...

A preliminary clinical prediction rule uses 3 patient attributes to predict who will fare better with alternative treatments.

Previous studies suggest that CRT may benefit narrow QRS patients with mechanical dyssynchrony (MD). We conducted an acute and chronic study, evaluating the response of heart failure patients with a narrow QRS to cardiac resynchronization therapy (CRT). ESTEEM-CRT was a multi-center, single-arm, feasibility study that evaluated ICD-indicated, medically-optimized patients with ...

BACKGROUND:: Patients with aortic coarctation (COA) have a reduced exercise capacity and seem to be more prone to adopt a sedentary lifestyle. During clinical practice, we often observe that patients seem to be overweight. However, data on physical activity and weight status in this population are currently not available. OBJECTIVE:: ...

BACKGROUND/OBJECTIVES: Improving patients' cardiorespiratory fitness is an important therapeutic outcome in cardiac rehabilitation. The ability of cardiac rehabilitation to reduce mortality and morbidity has been evidenced through several meta-analyses. Whether cardiac rehabilitation can increase cardiorespiratory fitness and which factors may influence such gains are less well quantified. METHODS: We performed ...

BACKGROUND: Clinical, hemodynamic and functional effects of tricuspid valve surgery in patients with Ebstein's anomaly are not well understood. METHODS: Sixteen patients (median age of 27.7years) were examined before and eight months after surgery by means of echocardiography, cardiovascular magnetic resonance (CMR) and cardiopulmonary exercise testing. RESULTS: Peak work load ...

AimsWe aimed to investigate the distribution of exercise capacity across the spectrum of adult congenital heart disease (ACHD) using own data and the published experience and to provide diagnosis, gender-, and age- specific reference values.Methods and resultsPublications describing exercise capacity in ACHD patients using cardiopulmonary exercise testing (CPET) were identified ...

PURPOSE:: The success of long-term exercise training (ExT) programs resides in the integration between exercise prescription and patient compliance with home training. One of the crucial issues for the patients is the understanding of appropriate exercise intensity. We compared 2 methods of home ExT, based on walking. METHODS:: Forty-seven patients ...

PURPOSE:: To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). METHODS:: Data on COPD patient health, exercise capacity, dyspnea, and HRQOL were collected at the start ...

ABSTRACT: BACKGROUND: Non-invasive ventilation (NIV) can increase exercise tolerance, reduce exercise induced desaturation and improve the outcome of pulmonary rehabilitation in patients with chronic respiratory disease. It is not known whether it can be applied to increase exercise capacity in patients admitted with non-hypercapnic acute exacerbations of COPD (AECOPD). We ...

To better understand the metabolic implications of a higher ATP cost of contraction in chronic obstructive pulmonary disease (COPD), we used (31)P-magnetic resonance spectroscopy ((31)P-MRS) to examine muscle energetic and pH in response to graded exercise. Specifically, in 6 patients and 6 well-matched healthy controls, we determined the intracellular threshold ...

ABSTRACT: BACKGROUND: Although implementers' experiences of exercise referral schemes (ERS) may provide valuable insights into how their reach and effectiveness might be improved, most qualitative research has included only views of patients. This paper explores exercise professionals' experiences of engaging diverse clinical populations in an ERS, and emergence of local ...

We aimed to identify whether N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) at peak exercise can provide incremental clinical information over resting levels. A total of 90 patients with systolic heart failure were prospectively studied. Levels of plasma NT-proBNP were assessed at rest and at peak exercise during a cardiopulmonary ...

BACKGROUND: Parameters of cardiopulmonary exercise testing (CPX) were recently identified as strong predictors of mortality in adults with congenital heart disease (ACHD). We hypothesized that combinations of CPX parameters may provide optimal prognostic information on mid-term survival in this population. METHODS AND RESULTS: 1,375 consecutive ACHD patients (age 33±13 years) ...

PURPOSE: Pulmonary rehabilitation (PR) has positive effects on exercise capacity in Chronic Obstructive Pulmonary Disease (COPD). However, not all COPD patients benefit from PR to the same extent. We investigated whether there is a patient profile, which is associated with the improvement in endurance exercise capacity. METHODS: In this observational ...

Exercise capacity and muscular strength are predictors of outcome in a number of clinical populations. Advanced liver disease is a catabolic state and patients often have muscle wasting. However, the relationships between exercise capacity, strength and outcomes in patients undergoing liver transplantation are poorly understood. Thirteen studies have examined the ...

While emerging studies have demonstrated the benefit of exercise in early recovery from substance use disorders, recruitment and adherence to exercise interventions have been challenging. Tailoring interventions based on patient exercise preferences may address these concerns. Ninety-seven (N=97; age=41.6 years; 44% female) patients were recruited from an intensive substance abuse ...

BACKGROUND: Although exercise echocardiography may assess left ventricular (LV) function and LV outflow tract (LVOT) gradients during exercise in patients with hypertrophic cardiomyopathy (HCM), its value for predicting outcomes has not been studied. The aim of this study was to determine whether exercise echocardiography predicts outcomes in patients with HCM. ...

Although pulmonary rehabilitation is recommended for patients undergoing lung volume reduction surgery, the optimal method of pulmonary rehabilitation is unclear. The aim of this study was to determine the feasibility and safety of perioperative short-term pulmonary rehabilitation. We enrolled candidates for lung volume reduction surgery from 1999 to 2006 and ...

The aim this study is to update the diagnostic implementation of a costly scan strategy in chest pain (CP) patients. Low-risk CP patients with a negative first-line work-up including clinical evaluation, serial ECGs, and serial troponins underwent stress myocardial perfusion imaging (MPI). Those with perfusion defects underwent angiography, whereas the ...

Muscle phosphofructokinase (PFKM) deficiency, a rare disorder of glycogen metabolism also known as glycogen storage disease type VII (GSDVII), is characterized by exercise intolerance, myalgias, cramps and episodic myoglobinuria associated with compensated hemolytic anaemia and hyperuricemia. We studied five patients with PFKM deficiency coming from different Italian regions. All probands ...

The role of pulmonary rehabilitation (PR) in COPD patients with lung hyperinflation has not yet been fully investigated. We retrospectively evaluated the effect of a standard PR course on exercise tolerance and symptoms according to the presence or absence of associated lung hyperinflation, as defined by lung function parameters in ...

BACKGROUND: In the end of the last century arterial switch operation (ASO) replaced atrial redirection according to Senning or Mustard as the surgical technique for infants with transposition of the great arteries (TGA). Better survival with the new technique has been shown. However, exercise performance and quality of life have ...

BACKGROUND: Patients with pulmonary arterial hypertension often present with a mild obstructive lung pattern, however, the functional consequences are not known. METHODS: We analysed flow volume loops during exercise in 61 patients with precapillary pulmonary hypertension (PH) (age 55 ± 14 years) in comparison with 21 patients with COPD (60 ± 12 years), 39 ...

ABSTRACT: BACKGROUND: Neuropeptide Y (NPY) is an important central orexigenic hormone predominantly produced by the hypothalamus, and recently found to be secreted in adipose tissue (AT). Acipimox (Aci) inhibits lipolysis in AT and reduces plasma glycerol and free fatty acid (FFA) levels. Exercise and Aci are enhancers of growth hormone ...

Fall prevention is a major area of concern in inpatient settings. This article reports on the feasibility of implementing a daily exercise program that features line dancing to promote stability, balance, and flexibility in adult psychiatric patients and describes the impact of that program. Six hundred sixty-five patient charts drawn ...

In the care of coronary artery disease (CAD) patients, the benefits of exercise therapy are generally established. Even though the selected endurance exercise intensity might affect medical safety, therapy adherence and effectiveness in the rehabilitation of CAD patients in how to determine endurance exercise intensity properly remains difficult. The aim ...

Eur J Clin Invest 2011 ABSTRACT: Background  Primary ciliary dyskinesia (PCD) is a rare, usually autosomal recessive disorder of ciliary dysfunction associated with lung involvement, which has a great impact on health. There is limited information concerning the aerobic fitness of children and adolescents with PCD. The aim of this ...

ABSTRACT: BACKGROUND: Pulmonary hyperinflation has the potential for significant adverse effects on cardiovascular function in COPD. The aim of this study was to investigate the relationship between dynamic hyperinflation and cardiovascular response to maximal exercise in COPD patients. METHODS: We studied 48 patients (16F; age 68 yrs +/- 8; BMI ...

Six-minute walk distance (6MWD) is used in the REVEAL equation to predict 1-year survival for patients with pulmonary arterial hypertension. We sought to determine whether exercise treadmill testing (ETT) could be used in its place. This was a single-center study in which 449 patients were enrolled. The variables predictive of ...

Background: Endothelial and microvascular dysfunction have been implicated in slow coronary flow (SCF). How and to what extent do these etiological factors affect left ventricular (LV) function and exercise capacity? Aim: The aim of the study was to evaluate LV systolic and diastolic function by pulsed tissue Doppler imaging (TDI) ...

The effect of an interval exercise training (ITE) program on heart rate variability (HRV) was studied in 8 patients with Charcot-Marie-Tooth (CMT) disease and 8 healthy controls. At baseline, all subjects underwent ambulatory 24-hour Holter electrocardiographic (ECG) monitoring to evaluate HRV. HRV analysis was repeated on CMT patients after they ...

Aim: We examined whether activation of serotonergic descending pathways improves pain inhibition during exercise in patients with chronic fatigue syndrome (CFS) and comorbid fibromyalgia (FM) in comparison with rheumatoid arthritis (RA) and sedentary, healthy controls in a double-blind randomized controlled trial with cross-over design. Three female CFS/FM patients, one female ...

Objectives.  To investigate functional health status among adults previously operated for aortic coarctation (CoA) compared with healthy subjects; to assess the influence of medication and exercise capacity on patients' functional health. Design.  Questionnaire-based investigation among 119 patients who underwent surgical repair of CoA during 1965-1985 and 36 age- and gender-matched ...

Studies conducted so far have shown that patients with left ventricular hypertrophy have increased adiponectin levels; however, these studies were performed only in resting condition. The aim of the study was to compare adiponectin, resistin, and leptin levels (at rest and after exercise) between patients with hypertrophic cardiomyopathy (HCM) and ...

ABSTRACT: Temporomandibular joint (TMJ) sounds are frequent in patients. The aim of this study was to analyze patients with clicking at the end of opening and at the beginning of closing their mouths treated by muscular exercises through chewing and by occlusal splints. Fifteen patients with clinically verified clicking and ...

Patients with Heart Failure (HF) display numerous derangements in ventilatory function, which together serve to increase the work of breathing (Wb) during exercise. However, the extent to which the resistive and elastic properties of the respiratory system contribute to the higher Wb in these patients is unknown.We quantified the resistive ...

Abstract Objective. To explore possible differential effects between metoprolol and atenolol in patients with coronary artery disease. Design. The study was randomized, double blind, two-way crossover with the Y1 antagonist AR-H040922 given as IV infusion for 2 h or placebo. Most patients were treated with metoprolol or atenolol. In a ...

Autonomic dysfunction, including baroreceptor attenuation and sympathetic activation, has been reported in patients with myocardial infarction (MI) and has been associated with increased mortality. We tested the hypotheses that exercise training (ET) in post-MI patients would normalize arterial baroreflex sensitivity (BRS) and muscle sympathetic nerve activity (MSNA), and long-term ET ...

Aim.  (1) To explore the prognostic factors of patients with chronic obstructive pulmonary disease. (2) To calculate the recrudescence time (the time from discharge to acute exacerbation again) of postdischarge patients with chronic obstructive pulmonary disease. Background.  Chronic obstructive pulmonary disease is an airflow limitation illness that is preventable and ...

SUMMARY AT A GLANCE: Exercise responses under hyperoxic conditions in patients with COPD were investigated in a single-blind, randomized trial. Regardless of whether they were breathing compressed air or 24% O(2) , these patients did not develop ventilatory compensation in response to exertional acidosis and stopped exercising when a similar ...

OBJECTIVE: Evaluate the influence of ventilatory inefficiency over exercise capacity in COPD patients. Rationale: Ventilatory inefficiency increase ventilatory demand. Corresponds to an abnormal increased in VE/VCO₂ and represents increased dead space, deregulation of respiratory control and early lactic threshold. Associated with expiratory flow limitation enhance DH and may limitate exercise ...

Objective: To analyze the clinical significance of postoperative back muscle exercises after percutaneous vertebroplasty for spinal osteoporotic compression fracture patients. Design: Clinical randomized controlled trials of parallel group nonpharmacologic study. Setting: Patients practised back muscle exercises in the spinal surgery department, rehabilitation department and at their residences. Subjects: Osteoporotic compression ...

AIMS: Peak oxygen uptake (VO(2)) is diminished in patients with heart failure with preserved ejection fraction (HFpEF) suggesting impaired cardiac reserve. To test this hypothesis, we assessed the haemodynamic response to exercise in HFpEF patients. METHODS AND RESULTS: Eleven HFpEF patients (73 ± 7 years, 7 females/4 males) and 13 ...

The purpose of this study was to determine the association between cardiac compression and exercise impairment in patients with a large hiatal hernia (HH). Dyspnea and exercise impairment are common symptoms of a large HH with unknown pathophysiology. Studies evaluating the contribution of cardiac compression to the pathogenesis of these ...

Cardiac rehabilitation programmes result in reduced morbidity and mortality and improvement of functional class. Behaviour of natriuretic peptides coupled to these programmes is not well established. Our study's objective is to evaluate the behaviour of natriuretic peptides in a sample of patients undergoing a cardiac rehabilitation programme. Moderate to high-risk ...