Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

BACKGROUND Refractory angina is a chronic condition that implies significant impairment in quality of life; its management is a challenge. Current therapies are limited, and new approaches to treatment are needed that target symptoms and quality of life. Evidence is lacking regarding exercise-based cardiac rehabilitation safety and beneficial effects in patients with refractory angina. OBJECTIVE The aim of the present study is to evaluate the safety and feasibility of exercise-based cardiac rehabilitation in patients with refractory angina, and its effects on angina symptoms, functional capacity, and ischemic burden. METHODS This study is an ongoing prospective randomized controlled trial enrolling 52 patients with refractory angina randomized into 2 groups: optimal medical treatment (MT) or MT + exercise-based cardiac rehabilitation (CR) over 12 weeks (36 exercise sessions). Clinical evaluation, cardiopulmonary exercise testing, laboratory tests, and exercise echocardiography are performed before and after intervention. The CR group performs in-hospital exercise sessions. The aerobic training protocol is based on CPT parameters or ischemia/angina threshold. Each cardiac rehabilitation session is 60 minutes long (5 minutes of warm-up, 30 minutes of continuous aerobic exercise based on target heart rate corresponding to anaerobic threshold (AT) obtained in the cardiopulmonary exercise testing OR angina/ischemia threshold if it occurs before the AT, 5 minutes of cooling-down, 15 minutes of resistance training, and 5 minutes of stretching). RESULTS This research study is in progress, with 42 patients recruited as of August 2019. Data collection is expected to be finished before December 2020. No clinical adverse events related to CR have occurred. CONCLUSIONS The findings of this study will have important clinical implications in the treatment of refractory angina patients. CLINICALTRIAL NCT03218891

Download Full-text

Does reduced cardiopulmonary exercise testing performance predict poorer quality of life in adult patients with Fontan physiology?

Cardiology in the Young ◽

10.1017/s1047951120003339 ◽

2020 ◽

pp. 1-7

Author(s):

Blair Suter ◽

William A. Kay ◽

Alisha M. Kuhlenhoelter ◽

Eric S. Ebenroth

Keyword(s):

Quality Of Life ◽

Exercise Testing ◽

Exercise Performance ◽

School Quality ◽

Cardiopulmonary Exercise Testing ◽

Cardiopulmonary Exercise ◽

Testing Performance ◽

Fontan Physiology

Abstract Background: Cardiopulmonary exercise testing performance has been shown to be a predictor of morbidity, mortality, and quality of life in patients with Fontan physiology; however, the role of exercise performance along with other diagnostics is not fully understood. We evaluated the hypothesis that reduced exercise performance correlates with poorer quality of life in Fontan patients as they continue to age. Methods: Chart review was performed on patients 12 years and older with Fontan who had completed cardiopulmonary exercise testing and age-appropriate quality of life surveys. Quality of life outcomes were analysed against exercise performance and other descriptive data. Results: For the younger cohort (n = 22), exercise performance predicted quality of life with different measures across domains and had a stronger correlation than echocardiographic parameters. For the older cohort (n = 34), exercise performance did not predict quality of life. Conclusions: Objective exercise performance was a useful marker for general, physical, emotional, social, and school quality of life in a younger cohort but less helpful in older adults. This is perhaps due to older patients accommodating to their conditions over time. The role of exercise performance and objective data in predicting quality of life in patients with Fontan physiology is incompletely understood and additional prospective evaluation should be undertaken.

Download Full-text

Effect of modality on cardiopulmonary exercise testing in male and female COPD patients

Respiratory Physiology & Neurobiology ◽

10.1016/j.resp.2013.11.009 ◽

2014 ◽

Vol 192 ◽

pp. 30-38 ◽

Cited By ~ 12

Author(s):

Siri M. Holm ◽

Wendy Rodgers ◽

Robert G. Haennel ◽

G. Fred MacDonald ◽

Tracey L. Bryan ◽

...

Keyword(s):

Exercise Testing ◽

Cardiopulmonary Exercise Testing ◽

Male And Female ◽

Cardiopulmonary Exercise ◽

Copd Patients

Download Full-text

Ventilatory compensation during the incremental exercise test is inversely correlated with air trapping in COPD

F1000Research ◽

10.12688/f1000research.20444.2 ◽

2020 ◽

Vol 8 ◽

pp. 1661

Author(s):

Rottem Kuint ◽

Neville Berkman ◽

Samir Nusair

Keyword(s):

Gas Exchange ◽

Exercise Testing ◽

Exercise Test ◽

Cardiopulmonary Exercise Testing ◽

Incremental Exercise ◽

Peak Exercise ◽

Air Trapping ◽

Incremental Exercise Test ◽

Cardiopulmonary Exercise ◽

Copd Patients

Background: Air trapping and gas exchange abnormalities are major causes of exercise limitation in chronic obstructive pulmonary disease (COPD). During incremental cardiopulmonary exercise testing, actual nadir values of ventilatory equivalents for carbon dioxide (V E/VCO 2) and oxygen (V E/VO 2) may be difficult to identify in COPD patients because of limited ventilatory compensation capacity. Therefore, we aimed in this exploratory study to detect a possible correlation between the magnitude of ventilation augmentation, as manifested by increments in ventilatory equivalents from nadir to peak exercise values and air trapping, detected with static testing. Methods: In this observational study, we studied data obtained previously from 20 COPD patients who, during routine follow-up, underwent a symptom-limited incremental exercise test and in whom a plethysmography was obtained concurrently. Air trapping at rest was assessed by measurement of the residual volume (RV) to total lung capacity (TLC) ratio (RV/TLC). Gas exchange data collected during the symptom-limited incremental cardiopulmonary exercise test allowed determination of the nadir and peak exercise values of V E/VCO 2 and V E/VO 2, thus enabling calculation of the difference between peak exrcise value and nadir values of V E/VCO 2 and V E/VO 2, designated ΔV E/VCO 2 and ΔV E/VO 2, respectively. Results: We found a statistically significant inverse correlation between both ΔV E/VCO 2 (r = -0. 5058, 95% CI -0.7750 to -0.08149, p = 0.0234) and ΔV E/VO 2 (r = -0.5588, 95% CI -0.8029 to -0.1545, p = 0.0104) and the degree of air trapping (RV/TLC). There was no correlation between ΔV E/VCO 2 and forced expiratory volume in the first second, or body mass index. Conclusions: The ventilatory equivalents increment to compensate for acidosis during incremental exercise testing was inversely correlated with air trapping (RV/TLC).

Download Full-text

Ventilatory compensation during the incremental exercise test is inversely correlated with air trapping in COPD

F1000Research ◽

10.12688/f1000research.20444.1 ◽

2019 ◽

Vol 8 ◽

pp. 1661

Author(s):

Rottem Kuint ◽

Neville Berkman ◽

Samir Nusair

Keyword(s):

Gas Exchange ◽

Exercise Testing ◽

Exercise Test ◽

Cardiopulmonary Exercise Testing ◽

Incremental Exercise ◽

Peak Oxygen Consumption ◽

Air Trapping ◽

Incremental Exercise Test ◽

Cardiopulmonary Exercise ◽

Copd Patients

Background: Air trapping and gas exchange abnormalities are major causes of exercise limitation in chronic obstructive pulmonary disease (COPD). During incremental cardiopulmonary exercise testing, ventilatory equivalents for carbon dioxide (VE/VCO2) and oxygen (VE/VO2) may be difficult to identify in COPD patients because of limited ventilatory compensation capacity. Therefore, we aimed to detect a possible correlation between the magnitude of ventilation augmentation, as manifested by increments in ventilatory equivalents from nadir to peak effort values and air trapping, detected with static testing. Methods: In this observational study, we studied data obtained previously from 20 COPD patients who, during routine follow-up, underwent a symptom-limited incremental exercise test and in whom a plethysmography was obtained concurrently. Air trapping at rest was assessed by measurement of the residual volume (RV) to total lung capacity (TLC) ratio (RV/TLC). Gas exchange data collected during the symptom-limited incremental cardiopulmonary exercise test allowed determination of the nadir and peak effort values of VE/VCO2 and VE/VO2, thus enabling calculation of the difference between peak effort value and nadir values of VE/VCO2 and VE/VO2, designated ΔVE/VCO2 and ΔVE/VO2, respectively. Results: We found a statistically significant inverse correlation between both ΔVE/VCO2 (r = -0. 5058, 95% CI -0.7750 to -0.08149, p = 0.0234) and ΔVE/VO2 (r = -0.5588, 95% CI -0.8029 to -0.1545, p = 0.0104) and the degree of air trapping (RV/TLC). There was no correlation between ΔVE/VCO2 and peak oxygen consumption, forced expiratory volume in the first second, or body mass index. Conclusions: The ventilatory equivalents increment to compensate for acidosis during incremental exercise testing was inversely correlated with air trapping (RV/TLC) and may be a candidate prognostic biomarker.

Download Full-text