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1.
Medicine (Baltimore) ; 100(35): e27099, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477146

RESUMO

ABSTRACT: Transcatheter occlusion and surgical ligation are the treatments of choice for most patent ductus arteriosus (PDA) in children. Fifty-five children who had PDA completed a pulmonary function test and a symptom-limited treadmill exercise test from 2016 to 2018 at 1 medical center in southern Taiwan. The study group was divided into surgical ligation and catheterization groups, which were compared to a healthy control group matched for age, sex, and body mass index. Data about the performance on the exercise test, including metabolic equivalent at anaerobic threshold and peak, were analyzed. No differences in the pulmonary function and ventilatory parameters were observed between the surgery, catheterization, and control groups. Heart rate at peak and at anaerobic threshold significantly differed in the investigated groups. The post hoc analysis showed that the surgery group had a lower heart rate at peak and threshold compared to the catheterization and control groups (P = .02, P < .001, respectively). No significant difference was found between the catheterization group and the control group. A larger and younger group of patients were recruited, allowing for newer data about the cardiopulmonary function to be obtained. The findings suggest that patients with PDA could undergo physical training after intervention. The imposition of restrictions to limit sports activities should be avoided.


Assuntos
Débito Cardíaco/fisiologia , Permeabilidade do Canal Arterial/complicações , Testes de Função Cardíaca/estatística & dados numéricos , Cateterismo Cardíaco/métodos , Cateterismo Cardíaco/estatística & dados numéricos , Criança , Permeabilidade do Canal Arterial/fisiopatologia , Feminino , Testes de Função Cardíaca/métodos , Humanos , Masculino , Pediatria/métodos , Resultado do Tratamento
2.
J Pediatr ; 2021 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-34228986

RESUMO

OBJECTIVE: To analyze the aerobic fitness and evolution of exercise tolerance in patients with single-ventricle physiology after total cavopulmonary connection (TCPC) with an extracardiac conduit (ECC). STUDY DESIGN: This retrospective cohort study included patients with previous ECC-TCPC who underwent cardiopulmonary exercise testing (CPET) between September 2010 and September 2019. Patients who completed at least 2 tests (≥6 months apart) with adequate levels of effort were recruited for the serial CPET evaluation. RESULTS: We identified 70 patients (50% male) with a mean age of 6.45 ± 5.14 years at ECC-TCPC and 15.67 ± 5.03 years at the initial CPET. The peak oxygen consumption (peak VO2) to predicted value (peak PD) was 55.90 ± 16.81%. Twenty of the 70 identified patients (50% male) were recruited for serial analysis. The average number of CPETs was 2.6 per patient. The average duration from the first CPET to the last CPET was 3.64 years. The peak VO2 and PD increased slowly, with mean rates of 38.77 ± 129.01 mL/min and 1.66 ± 6.40%, respectively, during the study period. CONCLUSIONS: Although the patients had lower exercise tolerance after ECC-TCPC compared with their normal peers, exercise tolerance appears to have been preserved over the adolescent period in those who underwent serial testing after ECC-TCPC.

3.
Front Pediatr ; 9: 657551, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34123966

RESUMO

Objective: Studies among Western children have observed that the peak oxygen consumption (peak V ˙ O2) of boys is higher than that of girls, and this difference increases as children progress through adolescence. However, the maturation process and social expectation toward Eastern boys and girls are much different from their Western counterparts. This study aimed to provide baseline information on cardiopulmonary fitness (CRF) of Taiwanese children and adolescents in relation to age and sex. We also evaluated the correlation between body mass and CRF and compared the CRF between non-obese and overweight/obese children. Methods: We conducted a retrospective study of children and adolescents aged 4-18 years in Taiwan. Participants were classified into four groups based on age (group 1, aged 4-6; group 2, aged 7-9; group 3, aged 10-13; and group 4, aged 14-18 years). All participants completed symptom-limited exercise test by treadmill and anthropometric measurements through bioelectrical impedance method. Results: In total, 897 (448 men, 449 women) participants were analyzed. Boys had higher peak V ˙ O2 (all p < 0.01) and peak metabolic equivalent (MET, all p < 0.05) than girls in all the four groups. Age significantly (P < 0.001) correlated with peak V ˙ O2 in all participants, boys, and girls, with coefficients of determination (R 2) of 0.9349, 0.9433, and 0.9085, respectively. The peak V ˙ O2 (all p < 0.001) of all the groups and peak MET (all p < 0.05) of group 2-4 associated with BMI and FMI modestly to moderately. Non-obese children had higher peak MET in group 1 (p = 0.049) and group 2-4 (all p < 0.001) than overweight/obese children significantly. Conclusions: The difference in peak V ˙ O2 and anthropometry-body composition between sexes was observed earlier in children in Taiwan than those in Western countries. Non-obese children had better CRF than overweight/obese children and the difference presented since preschool age.

4.
J Formos Med Assoc ; 120(4): 1143-1147, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33127273

RESUMO

A young female was diagnosed as classic cor triatriatum sinistrum (CTS) at 38 months old incidentally and she received percutaneous catheter-based balloon dilatation twice at 41 and 48 months old. She took regular follow-up by echocardiography biannually with no re-stenosis of the orifice in the membrane between two chambers in the left atrium and she denied any cardiac-related symptoms. Serial cardiopulmonary exercise testing (CPET) by treadmill under Ramped-Bruce protocol was done at her 13, 19, and 23-year old. She could reach maximal effort and complete the three CPETs. No significant change of metabolic equivalent at anaerobic (MET) threshold, peak MET, and pulmonary function were noted in the serial CPETs and all of them were within normal limits comparing to the reference values of Chinese specific to her age. Our case report demonstrated that the concept of percutaneous catheter-based balloon dilatation of obstructive membrane for classic CTS without other associated congenital heart diseases is sound and feasible. The prognosis is well without re-obstruction and the cardiopulmonary fitness after that could be maintain as healthy peers for up to 18 years.


Assuntos
Coração Triatriado , Adulto , Pré-Escolar , Coração Triatriado/diagnóstico por imagem , Coração Triatriado/terapia , Dilatação , Ecocardiografia , Teste de Esforço , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Adulto Jovem
5.
J Formos Med Assoc ; 120(1 Pt 1): 83-92, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32863084

RESUMO

The COronaVIrus Disease 2019 (COVID-19), which developed into a pandemic in 2020, has become a major healthcare challenge for governments and healthcare workers worldwide. Despite several medical treatment protocols having been established, a comprehensive rehabilitation program that can promote functional recovery is still frequently ignored. An online consensus meeting of an expert panel comprising members of the Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation was held to provide recommendations for rehabilitation protocols in each of the five COVID-19 stages, namely (1) outpatients with mild disease and no risk factors, (2) outpatients with mild disease and epidemiological risk factors, (3) hospitalized patients with moderate to severe disease, (4) ventilator-supported patients with clear cognitive function, and (5) ventilator-supported patients with impaired cognitive function. Apart from medications and life support care, a proper rehabilitation protocol that facilitates recovery from COVID-19 needs to be established and emphasized in clinical practice.


Assuntos
COVID-19 , Protocolos Clínicos/normas , Controle de Infecções , Reabilitação , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/reabilitação , Consenso , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Recuperação de Função Fisiológica , Reabilitação/métodos , Reabilitação/normas , SARS-CoV-2/isolamento & purificação , Taiwan
6.
PLoS One ; 15(8): e0237193, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780780

RESUMO

BACKGROUND: The myocardial adaptive mechanism in patients with repaired tetralogy of Fallot (rTOF) is less understood. We aimed to investigate biventricular myocardial adaptive remodeling in rTOF patients. METHODS: We recruited 32 rTOF patients and 38 age- and sex-matched normal controls. The pulmonary stenosis of rTOF patients was measured using catheterized pressure gradient between right ventricle (RV) and pulmonary artery (PGRVPA). rTOF patients with PGRVPA < 15 mmHg and ≥15 mmHg were classified as low pulmonary stenosis (rTOFlow, n = 19) and high pulmonary stenosis (rTOFhigh, n = 13) subgroups, respectively. Magnetic resonance imaging tissue phase mapping was employed to evaluate the voxelwise biventricular myocardial motion in longitudinal (Vz), radial (Vr), and circumferential (Vφ) directions. RESULTS: The rTOFlow subgroup presented higher pulmonary regurgitation fraction than rTOFhigh subgroup (p < 0.001). Compared with the normal group, only rTOFlow subgroup presented a decreased RV ejection fraction (RVEF) (p < 0.05). The rTOFlow subgroup showed decreased systolic and diastolic Vz in RV and LV, whereas rTOFhigh subgroup showed such change only in RV. In rTOFlow subgroup, RVEF significantly correlated with RV systolic Vr (r = 0.56, p < 0.05), whereas LVEF correlated with LV systolic Vz (r = 0.51, p = 0.02). Prolonged QRS correlated with RV systolic Vr (r = -0.58, p < 0.01) and LV diastolic Vr (r = 0.81, p < 0.001). No such correlations occurred in rTOFhigh subgroup. CONCLUSIONS: The avoidance of unfavorable functional interaction in RV and LV in rTOFhigh subgroup suggested that adequate pulmonary stenosis (PGRVPA ≥ 15 mmHg in this sereis) has a protective effect against pulmonary regurgitation.


Assuntos
Imageamento por Ressonância Magnética/métodos , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/diagnóstico por imagem , Tetralogia de Fallot/diagnóstico por imagem , Tetralogia de Fallot/reabilitação , Adulto , Pressão Sanguínea , Estudos de Casos e Controles , Teste de Esforço , Feminino , Frequência Cardíaca , Humanos , Masculino , Insuficiência da Valva Pulmonar/fisiopatologia , Estenose da Valva Pulmonar/fisiopatologia , Volume Sistólico , Tetralogia de Fallot/fisiopatologia , Tetralogia de Fallot/cirurgia , Disfunção Ventricular Esquerda/fisiopatologia , Disfunção Ventricular Direita/fisiopatologia , Função Ventricular Esquerda , Função Ventricular Direita , Adulto Jovem
7.
J Rehabil Med Clin Commun ; 3: 1000028, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33884130

RESUMO

Objective: Fabry disease, a rare X-linked disorder, can lead to exercise intolerance. In Taiwan, the cardiac variant of Fabry disease has a significantly higher prevalence than the classic variant. The cardiac variant of Fabry disease primarily involves the heart. Enzyme replacement therapy has been used to treat both variants. We aimed to study the impact of enzyme replacement therapy on exercise and cardiac structures between the classic (CL-FD) and cardiac variant (CV-FD) Fabry disease. Design and methods: Retrospective analysis of 2 groups of patients with Fabry disease (5 patients with the classic variant and 5 with the cardiac variant), who were undergoing enzyme replacement therapy. Patients were assessed annually for 3 years using symptom-limited cycle ergometry and echocardiography. Results: Subjects were 5 women, mean age 53 (standard deviation (SD) 14.05) years with CL-FD Fabry disease, and 5 men, mean age 65 (SD 2.35) years with CV-FD. The percentage of peak oxygen consumption to predicted value for all included patients was significantly lower (78.78% (SD 12.72)) than 100%. Annual serial measurement showed that peak metabolic equivalent and percentage of peak oxygen consumptiondecreased significantly over a period of 3 years in patients with CV-FD (p = 0.002, and p =0.004, respectively), but not in those with CL-FD. There were no significant changes in annual serial measurements of left ventricular mass or interventricular septal thickness in patients with either variant of Fabry disease over a period of 3 years. Conclusion: Peak exercise capacity of the patients with Fabry disease was lower than that of normal peers. Peak exercise capacity decreased over time.

8.
PLoS One ; 14(10): e0223907, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603948

RESUMO

OBJECTIVE: Overweight and obesity in preschoolers might develop into childhood and even adulthood obesity. Overweight and obesity have been shown to be negatively related with cardiorespiratory fitness (CRF) in children and adults but few studies did among preschoolers. We aimed to evaluate whether excess body adipose is negatively associated with CRF in both the submaximal and maximal effort of preschool children in exercise testing and to examine if there is difference to achieve maximal effort during exercise testing between preschoolers with normal and excess body adipose. METHODS: Data of 106 preschoolers aged 4-6 that received symptom-limited treadmill exercise testing was analyzed. Anthropometry was measured by vector bioelectrical impedance analysis. Excess body adipose was defined as (1) 'overweight' and 'obesity' by body mass index (BMI), (2) fat mass index (FMI) greater than the sex- and age-specific 75th percentile of whole subjects, and (3) fat-free mass index (FFMI) smaller than the sex- and age-specific 25th percentile. CRF was indicated by metabolic equivalent (MET) at anaerobic threshold (AT MET), peak MET, oxygen uptake efficiency slope (OUES) calculated by the 50% (OUES-50) and the entire (OUES-100) duration of the exercise testing. RESULTS: Preschoolers with excess body adipose by three different definitions (BMI, FMI, and FFMI) all had poorer ability to perform maximal effort (p = 0.004, 0.043, and 0.007, respectively). Preschoolers with excess body adipose by BMI and FFMI classifications had lower OUES-50 (p = 0.018, and 0.001, respectively), and lower OUES-100 (p = 0.004, and 0.001, respectively) than peers with normal body adipose during exercise testing while those with excess body adipose by FMI classification showed no significant differences from peers with normal body adipose in both OUES-50 and OUES-100. CONCLUSIONS: Preschoolers with excess body adipose had lower CRF significantly during treadmill exercise testing. Weight control and health promotion should start as early as possible.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Antropometria , Composição Corporal , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Impedância Elétrica , Teste de Esforço , Feminino , Promoção da Saúde , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Estudos Retrospectivos
9.
Acta Cardiol Sin ; 35(4): 425-429, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31371904

RESUMO

Background: Cardiac rehabilitation is beneficial for patients after ST-segment elevation myocardial infarction (STEMI). However, most institutes perform outpatient training phase (phase II) of post-MI cardiac rehabilitation after 2-4 weeks. To evaluate the possibility of performing cardiac rehabilitation with an earlier schedule after STEMI. Methods: We conducted a series of early phase II cardiac rehabilitation starting from 5-7 days after STEMI, including the training group (n = 28) and the control group (n = 42). Results: The results showed an improved mental component summary of the SF-36 questionnaire after 6 months in the training group. No adverse event was noticed during this early phase II training. Conclusions: Cardiac rehabilitation after STEMI might be started earlier than previously thought for clinical use or further research.

10.
Acta Cardiol Sin ; 35(1): 55-64, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30713400

RESUMO

Background: The 6-minute walk test (6MWT) and cardiopulmonary exercise test (CPET) are exercise tests associated with physical function, quality of life and hemodynamic data in patients with pulmonary arterial hypertension (PAH). This study was conducted to assess correlations between exercise capacity, quality of life and disease functional classification, and to analyze the value of comprehensive assessments in predicting mortality in patients with PAH. Methods: Fifty-four patients with PAH were enrolled. Comprehensive assessments including exercise capacity evaluated using the 6MWT and CPET, and health-related quality of life evaluated using the Short Form 36 (SF-36) questionnaire were performed in all participants. The patients were followed for 2 years with the end point of mortality. Results: The survivors had a longer 6-minute walking distance, higher peak oxygen uptake and higher physical component score of the SF-36 than the non-survivors. In addition, exercise capacity combined with SF-36 predicted 2-year mortality in the patients with PAH. The patients with lower peak oxygen uptake (peak VO2 < 11.03 mL/kg/ min) and lower physical component score (score < 44.54) had a higher mortality rate than those with a higher peak VO2 and higher physical component score (adjusted hazard ratio = 19.95, p = 0.011). Conclusions: Comprehensive assessments of exercise capacity and quality of life can be used to predict 2-year mortality in patients with PAH.

11.
Chin J Physiol ; 61(6): 341-348, 2018 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-30580504

RESUMO

Niflumic acid, a drug used for joint and muscular pain, affected Ca²âº signaling in different models. However, the effect of niflumic acid on Ca²âº homeostasis and Ca²âº-related physiology in human osteosarcoma cells is unknown. This study examined the effect of niflumic acid on cytosolic free Ca²âº concentrations ([Ca²âº]i) in MG63 human osteosarcoma cells. Intracellular Ca²âº concentrations in suspended cells were monitored by using the fluorescent Ca²âº-sensitive dye fura- 2. Cell viability was examined by using 4-[3-[4-lodophenyl]-2-4(4-nitrophenyl)-2H-5-tetrazolio- 1,3-benzene disulfonate] water soluble tetrazolium-1 (WST-1). In MG63 cells, niflumic acid at concentrations of 250-750 µM evoked [Ca²âº]i rises concentration-dependently. Niflumic acid-evoked Ca²âº entry was confirmed by Mn²âº-induced quenching of fura-2 fluorescence. This entry was inhibited by nifedipine, econazole, SKF96365, the protein kinase C (PKC) activator phorbol 12-myristate 13 acetate (PMA), but was not affected by the PKC inhibitor GF109203X. In Ca²âº- free medium, treatment with the endoplasmic reticulum Ca²âº pump inhibitor thapsigargin (TG) inhibited niflumic acid-evoked [Ca²âº]i rises. Conversely, treatment with niflumic acid abolished TG-evoked [Ca²âº]i rises. Inhibition of phospholipase C (PLC) with U73122 also partly reduced niflumic acid-evoked [Ca²âº]i rises. Niflumic acid killed cells at 200-500 µM in a concentration-dependent fashion. Chelating cytosolic Ca²âº with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid/ AM (BAPTA/AM) did not reverse niflumic acid-induced cytotoxicity. Collectively, our data suggest that in MG63 cells, niflumic acid induced [Ca²âº]i rises by evoking PLC-dependent Ca²âº release from the endoplasmic reticulum, and Ca²âº entry via PKC-sensitive store-operated Ca²âº entry. Niflumic acid also induced Ca²âº-independent cell death.


Assuntos
Neoplasias Ósseas , Osteossarcoma , Apoptose , Cálcio , Sinalização do Cálcio , Linhagem Celular Tumoral , Sobrevivência Celular , Humanos , Ácido Niflúmico , Fosfolipases Tipo C
12.
Medicine (Baltimore) ; 97(46): e13296, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30431617

RESUMO

The oxygen uptake efficiency slope (OUES) is a well-established substitute for maximum oxygen uptake ((Equation is included in full-text article.)O2 max) in submaximal exercise effort among adolescents and adults. Few studies have analyzed the exercise capacity (EC) and OUES of children aged 4 to 6 (preschoolers). Body fat has been proved to negatively affect EC among schoolchildren. The purposes of this study were to assess the capacity of preschoolers in achieving (Equation is included in full-text article.)O2 max and evaluate the correlation of peak metabolic equivalent (peak MET) and peak oxygen consumption (peak O2) with OUES. We also evaluated if body fat affected EC among preschoolers.Forty-three preschoolers under the ramped Bruce protocol of treadmill exercise testing had been retrospectively studied. The criteria for achieving (Equation is included in full-text article.)O2 max included respiratory exchange ratio (RER) >1.1, heart rate (HR) >85% of age-predicted maximum, and HR >200 bpm. OUES was calculated by the 75% (OUES-75) and the entire (OUES-100) duration of the testing and normalized by body surface area. Body fat was measured using vector bioelectrical impedance analysis. The fat mass (FM) index and fat-free mass index (FFMI) were defined as FM or FFM (kg) divided by height squared (m), respectively.The mean age of the participants was 5.70 ±â€Š0.56. Seventy-nine percent of preschoolers met at least 1 criterion, 36.84% met 2 criteria, and none met all 3 criteria for (Equation is included in full-text article.)O2. OUES-75 was moderately positively correlated with peak MET (P = .034; Spearman's rho = 0.324) and peak O2 (P <.001; Spearman's rho = 0.667). OUES-100 was moderately to highly positively correlated with peak MET (P <.001; Spearman's rho = 0.592) and peak O2 (P <.001; Spearman's rho = 0.825). There were moderate to high positive correlations between FFMI and peak O2 (P <.001; Spearman's rho = 0.668), OUES-75 (P <.001; Spearman's rho = 0.642), and OUES-100 (P < .001; Spearman's rho = 0.670).None of the preschoolers reached all 3 criteria for (Equation is included in full-text article.)O2max. OUES-75 and OUES-100 might be indicators of peak O2 at submaximal effort. Preschoolers with higher FFMI had better EC during treadmill exercise testing.


Assuntos
Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Equivalente Metabólico/fisiologia , Consumo de Oxigênio/fisiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Retrospectivos
13.
J Pediatr ; 201: 128-133, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30029863

RESUMO

OBJECTIVE: To compare exercise capacity measured by direct cardiopulmonary exercise testing (CPET) of children with Kawasaki disease with different coronary artery diameter z scores (CA z score). STUDY DESIGN: This was a retrospective study that recruited children with Kawasaki disease after the acute stage receiving CPETs determined by CPET with treadmill. CA z score was based on a model using the Lambda-Mu-Sigma method. Max-Z was defined as the maximum z score of the proximal left anterior descending CA (LCA) or right CA (RCA). Children with Kawasaki disease with a Max z <2.0 and ≥2.0 were defined as Kawasaki disease group 1 and Kawasaki disease group 2, respectively. RESULTS: We recruited 32 boys and 17 girls with a mean age of 12.39 ± 3.61 years. Kawasaki disease group 1 (n = 36) had significantly higher peak metabolic equivalent (peak-MET) and peak rate pressure product (PRPP) than Kawasaki disease group 2 (n-13) (P = .046, P < .001). Max-Z correlated with peak-MET moderately and negatively (P < .001, Spearman rho= - .506). Max-Z correlated with PRPP modestly and negatively (P = .011, Spearman rho= - .360). CONCLUSIONS: Children after Kawasaki disease with a coronary artery Max-Z ≥ 2.0 had significantly lower peak exercise capacity than those with a Max-Z < 2.0. Max-Z might be used as an indicator of CA reserve and exercise capacity during peak exercise after the acute stage of Kawasaki disease.


Assuntos
Vasos Coronários/diagnóstico por imagem , Teste de Esforço/métodos , Tolerância ao Exercício , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Adolescente , Criança , Pré-Escolar , Vasos Coronários/fisiopatologia , Ecocardiografia Doppler em Cores , Eletrocardiografia , Feminino , Seguimentos , Humanos , Masculino , Síndrome de Linfonodos Mucocutâneos/fisiopatologia , Estudos Retrospectivos , Espirometria
14.
Int J Rehabil Res ; 40(3): 215-219, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28410336

RESUMO

A predischarge submaximal exercise test is often recommended after acute myocardial infarction (AMI) as part of phase I cardiac rehabilitation. In this study, a submaximal exercise parameter, oxygen uptake efficiency slope (OUES), was used to monitor the benefit of early mobilization within 48 h after AMI. An early mobilization protocol within 48 h after AMI has been initiated since 1 September 2012 in our center. Patients with onset time of AMI within 1 year before and 1 year after initiation of the early mobilization protocol were recruited for comparisons. Sixty patients were analyzed on the basis of this criterion, and were subjected to predischarge submaximal exercise tests. The OUES calculated with 100% exercise duration (OUES100) and calculated with the first 50% of exercise duration (OUES50) were obtained and analyzed. Both OUES100 and OUES50 of the AMI patients with early mobilization were significantly higher than those without early mobilization (P=0.025 and 0.007, respectively). The OUES100 and OUES50 were also highly correlated (r=0.891, P<0.001). The subgroup analysis using patients within 3 months before and 3 months after initiation of the protocol also showed a significant difference. OUES could be used to measure the exercise capacity and monitor the effect of phase I cardiac rehabilitation in patients soon after AMI. Early mobilization within 48 h following AMI significantly enhanced the patient's exercise capacity.


Assuntos
Reabilitação Cardíaca/métodos , Teste de Esforço/métodos , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/reabilitação , Consumo de Oxigênio/fisiologia , Idoso , Deambulação Precoce , Tolerância ao Exercício/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Retrospectivos
15.
Chin J Physiol ; 60(1): 32-40, 2017 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-28052644

RESUMO

Thymol is a phenolic compound that affects physiology in different cell models. However, whether thymol affects Ca²âº homeostasis in prostate cancer cells is unknown. The action of this compound on cytosolic Ca²âº concentrations ([Ca²âº]i) and viability in PC3 human prostate cancer cells was explored. The results show that thymol at concentrations of 100-1500 µM caused [Ca²âº]i rises in a concentration-dependent manner. Removal of extracellular Ca²âº reduced thymol's effect by approximately 80%. Thymol-induced Ca²âº entry was confirmed by Mn²âº entry-induced quench of fura-2 fluorescence, and was inhibited by approximately 30% by Ca²âº entry modulators (nifedipine, econazole, SKF96365), and the protein kinase C (PKC) inhibitor GF109203X. In Ca²âº-free medium, treatment with the endoplasmic reticulum Ca²âº pump inhibitor thapsigargin abolished thymol-induced [Ca²âº]i rises. Treatment with thymol also abolished thapsigargin-induced [Ca²âº]i rises. Thymol-induced Ca²âº release from the endoplasmic reticulum was abolished by the phospholipase C (PLC) inhibitor U73122. Thymol at 100-900 µM decreased cell viability, which was not reversed by pretreatment with the Ca²âº chelator 1,2-bis(2-aminophenoxy) ethane-N,N,N',N'-tetraacetic acid-acetoxymethyl ester (BAPTA/AM). Together, in PC3 cells, thymol induced [Ca²âº]i rises by inducing PLC-dependent Ca²âº release from the endoplasmic reticulum and Ca²âº entry via PKC-sensitive store-operated Ca²âº channels and other unknown channels. Thymol also induced Ca²âº-dissociated cell death.


Assuntos
Adenocarcinoma/tratamento farmacológico , Antifúngicos/uso terapêutico , Sinalização do Cálcio/efeitos dos fármacos , Neoplasias da Próstata/tratamento farmacológico , Timol/uso terapêutico , Antifúngicos/farmacologia , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais , Homeostase/efeitos dos fármacos , Humanos , Masculino , Timol/farmacologia
16.
Toxicol Mech Methods ; 26(8): 580-587, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27790936

RESUMO

Tricyclic antidepressants (TCA) have been clinically prescribed in the auxiliary treatment of cancer patients. Although protriptyline, a type of TCA, was used primarily in the clinical treatment of mood disorders in cancer patients, the effect of protriptyline on physiology in human osteosarcoma is unknown. This study examined the effect of protriptyline on cytosolic free Ca2+ concentrations ([Ca2+]i) and viability in MG63 human osteosarcoma cells. Protriptyline between 50 and 250 µM evoked [Ca2+]i rises concentration-dependently. Protriptyline induced influx of Mn2+, indirectly implicating Ca2+ influx. Protriptyline-evoked Ca2+ entry was inhibited by nifedipine by 20% but was not altered by econazole, SKF96365, GF109203X, and phorbol-12-myristate-13-acetate (PMA). In Ca2+-free medium, treatment with protriptyline inhibited the endoplasmic reticulum Ca2+ pump inhibitor thapsigargin-evoked [Ca2+]i rises. Conversely, treatment with thapsigargin inhibited 45% of protriptyline-evoked [Ca2+]i rises. Inhibition of phospholipase C (PLC) with U73122 failed to alter protriptyline-evoked [Ca2+]i rises. Protriptyline at 50-250 µM decreased cell viability, which was not reversed by pretreatment with the Ca2+ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-acetoxymethyl ester (BAPTA/AM). Collectively, our data suggest that in MG63 cells, protriptyline induced [Ca2+]i rises by evoking Ca2+ release from the endoplasmic reticulum and other stores in a PLC-independent manner, and Ca2+ entry via a nifedipine-sensitive Ca2+ pathway. Protriptyline also caused Ca2+-independent cell death.


Assuntos
Antidepressivos Tricíclicos/toxicidade , Cálcio/metabolismo , Osteoblastos/efeitos dos fármacos , Protriptilina/toxicidade , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Citosol/efeitos dos fármacos , Citosol/metabolismo , Relação Dose-Resposta a Droga , Retículo Endoplasmático/efeitos dos fármacos , Retículo Endoplasmático/metabolismo , Humanos , Osteoblastos/metabolismo , Osteoblastos/patologia
17.
Medicine (Baltimore) ; 95(2): e2444, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26765431

RESUMO

Coronary artery (CA) abnormalities influence exercise capacity (EC) of patients with Kawasaki disease (KD), and Z-score of CA is a well established method for detecting CA aneurysm. We studied the influence of KD on cardiopulmonary function and EC; meanwhile we analyzed echocardiographic findings of KD patients. We also assessed the correlation between CA Z-score and EC of KD patients to see if CA Z-score of KD patients could reflect EC during exercise.Sixty-three KD patients were recruited as KD group 1 from children (aged 5-18 y) who received transthoracic echocardiographic examinations and symptom-limited treadmill exercise test for regular follow-up of KD from January 2010 to October 2014 in 1 medical center. We then divided KD group 1 into KD group 2 (<5 y, n = 12) and KD group 3 (≥5 y, n = 51) according to time interval between KD onset to when patients received test. Control groups were matched by age, sex, and body mass index. Max-Z of CA was defined as the maximal Z-score of the proximal LCA or RCA by Dalliarre equation or Fuse calculator.All routine parameters measured during standard exercise test were similar between KD and control groups, except that peak rate pressure products (PRPPs) in KD group 1 to 3 were all lower than corresponding control groups significantly (P = 0.010, 0.020, and 0.049, respectively). PRPPs correlated with Max-Z of CA by both equations modest inversely (by Dallaire, P = 0.017, Spearman rho = -0.301; by Fuse, P = 0.014, Spearman rho = -0.309).Our study recruited larger number of KD patients and provided a newer data of EC of KD patients. Our finding suggests that after acute stage of KD, patients could maintain normal cardiorespiratory fitness. Therefore, we believe that it is important to promote cardiovascular health to KD patients and KD patients should exercise as normal peers. However, since KD patients might still have compromised coronary perfusion during exercise, it remains crucial to assess and monitor cardiovascular risk of KD patients. Max-Z of CA correlates with PRPP modest inversely and might be used as a follow-up indicator of CA reserve during exercise after acute stage of KD.


Assuntos
Ecocardiografia Doppler/métodos , Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Adolescente , Fatores Etários , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Testes de Função Cardíaca , Humanos , Masculino , Prognóstico , Valores de Referência , Testes de Função Respiratória , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais
18.
Eur J Prev Cardiol ; 23(10): 1045-50, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26701873

RESUMO

BACKGROUND: Oxygen uptake efficiency slope (OUES) and peak oxygen consumption (VO2peak) are exercise parameters that can predict cardiac morbidity in patients with numerous heart diseases. But the predictive value in patients with tetralogy of Fallot is still undetermined, especially in children. We evaluated the prognostic value of OUES and VO2peak in children with total repair of tetralogy of Fallot. DESIGN: Retrospective cohort study. METHODS: Forty tetralogy of Fallot patients younger than 12 years old were recruited. They underwent a cardiopulmonary exercise test during the follow-up period after total repair surgery. The results of the cardiopulmonary exercise test were used to predict the cardiac related hospitalization in the following two years after the test. RESULTS: OUES normalized by body surface area (OUES/BSA) and the percentage of predicted VO2peak appeared to be predictive for two-year cardiac related hospitalization. Receiver operating characteristic curve analysis demonstrated that the best threshold value for OUES/BSA was 1.029 (area under the curve = 0.70, p = 0.03), and for VO2peak was 74% of age prediction (area under the curve = 0.72, p = 0.02). The aforementioned findings were confirmed by Kaplan-Meier plots and log-rank test. CONCLUSIONS: OUES/BSA and VO2peak are useful predictors of cardiac-related hospitalization in children with total repair of tetralogy of Fallot.


Assuntos
Exercício Físico/fisiologia , Hospitalização/estatística & dados numéricos , Consumo de Oxigênio/fisiologia , Oxigênio/metabolismo , Tetralogia de Fallot/metabolismo , Procedimentos Cirúrgicos Cardíacos , Criança , Pré-Escolar , Teste de Esforço/métodos , Feminino , Seguimentos , Humanos , Masculino , Período Pós-Operatório , Prognóstico , Curva ROC , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Taiwan/epidemiologia , Tetralogia de Fallot/mortalidade , Tetralogia de Fallot/cirurgia
19.
J Recept Signal Transduct Res ; 35(5): 429-34, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26096164

RESUMO

Protriptyline, a tricyclic anti-depressant, is used primarily to treat the combination of symptoms of anxiety and depression. However, the effect of protriptyline on prostate caner is unknown. This study examined whether the anti-depressant protriptyline altered Ca(2+) movement and cell viability in PC3 human prostate cancer cells. The Ca(2+)-sensitive fluorescent dye fura-2 was used to measure [Ca(2+)](i). Protriptyline evoked [Ca(2+)](i) rises concentration-dependently. The response was reduced by removing extracellular Ca(2+). Protriptyline-evoked Ca(2+) entry was inhibited by store-operated channel inhibitors (nifedipine, econazole and SKF96365), protein kinase C activator (phorbol 12-myristate 13 acetate, PMA) and protein kinase C inhibitor (GF109203X). Treatment with the endoplasmic reticulum Ca(2+) pump inhibitor 2,5-di-tert-butylhydr-oquinone (BHQ) in Ca(2+)-free medium inhibited 60% of protriptyline-evoked [Ca(2+)](i) rises. Conversely, treatment with protriptyline abolished BHQ-evoked [Ca(2+)](i) rises. Inhibition of phospholipase C with U73122 suppressed 50% of protriptyline-evoked [Ca(2+)](i) rises. At concentrations of 50-70 µM, protriptyline decreased cell viability in a concentration-dependent manner; which were not reversed by chelating cytosolic Ca(2+) with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-acetoxymethyl ester (BAPTA/AM). Collectively, in PC3 cells, protriptyline evoked [Ca(2+)](i) rises by inducing phospholipase C-associated Ca(2+) release from the endoplasmic reticulum and other stores, and Ca(2+) influx via protein kinase C-sensitive store-operated Ca(2+) channels. Protriptyline caused cell death that was independent of [Ca(2+)](i) rises.


Assuntos
Apoptose/efeitos dos fármacos , Sinalização do Cálcio/efeitos dos fármacos , Cálcio/metabolismo , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Protriptilina/administração & dosagem , Transporte Biológico Ativo/efeitos dos fármacos , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Humanos , Masculino , Neoplasias da Próstata/tratamento farmacológico
20.
Neurorehabil Neural Repair ; 29(1): 3-12, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24788580

RESUMO

Background and Purpose. Patients with chronic stroke may benefit from continuing rehabilitation training after hospital discharge. This study examined whether caregiver-mediated, home-based intervention (CHI) could improve physical functioning and social participation in these patients. Methods. A single-blind, randomized, controlled 12-week trial conducted with 51 patients from 3 hospitals in Taiwan who had chronic stroke (>6 months; Brunnstrom recovery stages III-V). Patients and their caregivers in the intervention arm (n = 25) were given weekly personalized CHI trainings designed by a physical therapist. Patients in the control arm (n = 26) received visits from the therapist without intervention. All were evaluated for physical recovery through the Stroke Impact Scale, Berg Balance Scale, 10-Meter Walk Test, 6-Minute Walk Test, and Barthel Index at baseline and endpoint. Caregivers were evaluated with the Caregiver Burden Scale. Results were analyzed through Mann-Whitney U test. Results. CHI significantly improved scores of the Stroke Impact Scale: strength (control vs intervention, respectively: 1.4 vs 15.5; P = .002), mobility (-0.5 vs 13.7; P < .001), composite physical (-0.7 vs 11.2; P < .001), and general recovery domain (0.2 vs 17.4; P < .001). CHI also significantly improved free-walking velocity (-1.4 vs 7.5 cm/s; P = .006), 6-minute walk distance (-10.5 vs 15.8 m; P = .003), Berg Balance Scale score (-0.8 vs 4.5; P = .006), and Barthel Index score (0.6 vs 7.2; P = .008). CHI did not significantly increase caregiver burden at endpoint. Conclusion. CHI can improve physical functional recovery and, possibly, social participation in patients with chronic stroke.


Assuntos
Cuidadores , Modalidades de Fisioterapia , Recuperação de Função Fisiológica/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/enfermagem , Atividades Cotidianas , Idoso , Doença Crônica , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Método Simples-Cego , Estatísticas não Paramétricas , Acidente Vascular Cerebral/fisiopatologia , Taiwan , Caminhada/fisiologia
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