scholarly journals Exercise intolerance due to chronotropic incompetence uncovered by cardiopulmonary exercise test: an often overlooked manifestation of ischaemic heart disease

2021 ◽  
Vol 9 (8) ◽  
Author(s):  
Sharlene Ho ◽  
Danqing Qi ◽  
Geak Poh Tan
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Exercise Intolerance ◽  
Chronotropic Incompetence ◽  
Cardiopulmonary Exercise

scholarly journals Cardiopulmonary Exercise Test in heart failure: A Sine qua non

2020 ◽  
Vol 9 (2) ◽  
pp. 1-8 ◽  
Author(s):  
Stefanos Sakellaropoulos ◽  
Dimitra Lekaditi ◽  
Stefano Svab
Keyword(s):  
Heart Failure ◽  
Exercise Test ◽  
Exercise Physiology ◽  
Cardiopulmonary Exercise Testing ◽  
Critical Evaluation ◽  
Research Area ◽  
Cardiopulmonary Exercise Test ◽  
Exercise Intolerance ◽  
Reduced Ejection Fraction ◽  
Cardiopulmonary Exercise

A robust literature, over the last years, supports the indication of cardiopulmonary exercise testing (CPET) in patients with cardiovascular diseases. Understanding exercise physiology is a crucial component of the critical evaluation of exercise intolerance. Shortness of breath and exercise limitation is often treated with an improper focus, partly because the pathophysiology is not well understood in the frame of the diagnostic spectrum of each subspecialty. A vital field and research area have been cardiopulmonary exercise test in heart failure with preserved/reduced ejection fraction, evaluation of heart failure patients as candidates for LVAD-Implantation, as well as for LVAD-Explantation and ultimately for heart transplantation. All the CPET variables provide synergistic prognostic discrimination. However, Peak VO2 serves as the most critical parameter for risk stratification and prediction of survival rate.

Effect of Masks on Cardiopulmonary Exercise Test and Lower Limb Muscle Performance for Evaluating the Safety of Wearing Surgical Masks During Aerobic Exercise in Normal Subjects: Study Protocol for A Randomized Cross-Over Trial

2020 ◽  
Author(s):  
Haojie Huang ◽  
Yuxin Zheng ◽  
Mei Li ◽  
Lingzi Zhang ◽  
Junjie Liang ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Exercise Test ◽  
Normal Subjects ◽  
Surface Emg ◽  
Cardiopulmonary Exercise Test ◽  
Exercise Intolerance ◽  
Median Frequency ◽  
Cardiopulmonary Exercise ◽  
Intervention Protocol ◽  
The Impact

Abstract Background: Face masks are an important mitigation strategy against respiratory virus contact and community transmission. Sometimes, people must wear surgical mask at rest or during exercise to minimize the risk of cross-infection, but it is unclear whether wearing a surgical mask during exercise can impact cardiopulmonary health. Thus, we designed this study using the cardiopulmonary exercise test (CPET) with simultaneous surface electromyography (EMG) to objectively evaluate the impact of mask-wearing on ventilation, exercise intolerance, and aerobic functional capacity.Methods: Healthy young subjects without professional sports experience will be recruited in this randomized cross-over clinical study. The recruited subjects will be randomly allocated into two groups: Group 1 will first receive an intervention protocol (CPET wearing surgical mask) followed by 2-7days of washout. This will be followed by a control protocol (CPET without wearing surgical mask). Group 2 will receive the opposite sequence of interventions. The surface EMG data will be simultaneously collected. The primary outcome is the maximum oxygen uptake (VO2max) between the two CPETs (with or without a mask). The secondary outcomes are peak oxygen consumption (VO2), volume of carbon dioxide released (VCO2), tidal volume (VT), and EMG parameters including root mean square (RMS), and median frequency (MF). An ANOVA with a two-stage crossover will be used. Three factors will be considered for the experimental effect: the type of intervention (wearing masks or not wearing masks), the experimental periods (period I and period II), and individual differences in subjects. The paired t-test will be used to compare the differences of CPET parameters and surface EMG values between subjects with and without a mask. Discussion: This study offers insight on the use of surgical mask during aerobic exercise by CPET in the normal subjects. The data expand on the use of CPET with surface EMG for insight into the pathophysiological relationship between cardiopulmonary function and muscular motor performance.Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR2000033449. Data of registration: June 1, 2020.

Pre-test assessment

2021 ◽  
pp. 7-12
Author(s):  
William J.M. Kinnear ◽  
James H. Hull
Keyword(s):  
Heart Disease ◽  
Side Effects ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
End Points ◽  
Cardiopulmonary Exercise ◽  
Test Assessment ◽  
Viral Illness ◽  
The Subject ◽  
Electrocardiogram Ecg

Pre-test assessment describes the next step after deciding to do a cardiopulmonary exercise test (CPET). The indication for the test must be defined, with clear end points. A CPET is a very safe test. There are well-defined conditions which increase the risk. The most serious side effects are related to heart problems, most commonly seen in subjects with unstable heart disease. Careful scrutiny of the resting electrocardiogram (ECG) is imperative prior to the test. If the subject is unwell, e.g. with a viral illness or an exacerbation of asthma, the test should be postponed. On the day of the test, the subject should take their usual medication. Caffeine and alcohol should be avoided on the day of a CPET. A light meal should be taken at least 30 minutes beforehand.

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.

Usefulness of the Cardiopulmonary Exercise Test in Congenital Heart Disease

2007 ◽  
Vol 37 (10) ◽  
pp. 489 ◽  
Author(s):  
Gi Beom Kim ◽  
Bo Sang Kwon ◽  
Eun Young Choi ◽  
Eun Jung Bae ◽  
Chung Il Noh ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Exercise Test ◽  
Congenital Heart ◽  
Cardiopulmonary Exercise Test ◽  
Cardiopulmonary Exercise
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