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1.
Am J Vet Res ; 81(10): 804-809, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32969728

RESUMO

OBJECTIVE: To investigate whether an actual improvement in gait could be differentiated from physiologic differences or habituation effects during gait analysis of dogs. ANIMALS: 11 healthy dogs. PROCEDURES: On 4 examination days, kinetic parameters were measured while dogs were walking on a treadmill. Differences in mean parameter values and habituation effects (ie, effect sizes) were quantified and compared among examination days. Coefficients of variation for repeated measurements were calculated to determine measurement reproducibility, and minimum differences were calculated to distinguish between physiologic fluctuation and an actual change in gait pattern. RESULTS: Among the 4 examination days, mean absolute differences in peak vertical force and vertical impulse (VI) varied from 1.5% to 5.3% of body weight (BW) and 0.9% to 1.8% of BW·s, respectively. Mean absolute differences in the percentage of stance-phase duration (%SPD) and relative stride length (RSL) varied from 0.9% to 3.2% and 1.7% to 3.0%, respectively. Reproducibility of parameter measurements was good. Values for %SPD had the lowest amount of dispersion and largest effect size, suggesting a habituation effect for this parameter. Calculated minimum differences among the days for peak vertical force, VI, %SPD, and RSL did not exceed 9.9% of BW, 3.3% of BW·s, 5.8 percentage points, and 5.2 percentage points, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The %SPD of healthy dogs walking on a treadmill was the most sensitive and diagnostically reliable of the measured kinetic parameters, in contrast to VI and RSL. Findings suggested that actual changes can be distinguished from random physiologic fluctuations during gait analysis of dogs.


Assuntos
Teste de Esforço/veterinária , Caminhada , Animais , Fenômenos Biomecânicos , Cães , Marcha , Cinética , Reprodutibilidade dos Testes
3.
Sensors (Basel) ; 20(18)2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32899946

RESUMO

Gait deterioration caused by prolonged walking represents one of the main consequences of multiple sclerosis (MS). This study aims at proposing quantitative indices to measure the gait deterioration effects. The experimental protocol consisted in a 6-min walking test and it involved nine patients with MS and twenty-six healthy subjects. Pathology severity was assessed through the Expanded Disability Status Scale. Seven inertial units were used to gather lower limb kinematics. Gait variability and asymmetry were assessed by coefficient of variation (CoV) and symmetry index (SI), respectively. The evolution of ROM (range of motion), CoV, and SI was computed analyzing data divided into six 60-s subgroups. Maximum difference among subgroups and the difference between the first minute and the remaining five were computed. The indices were analyzed for intra- and inter-day reliability and repeatability. Correlation with clinical scores was also evaluated. Good to excellent reliability was found for all indices. The computed standard deviations allowed us to affirm the good repeatability of the indices. The outcomes suggested walking-related fatigue leads to an always more variable kinematics in MS, in terms of changes in ROM, increase of variability and asymmetry. The hip asymmetry strongly correlated with the clinical disability.


Assuntos
Fadiga/fisiopatologia , Transtornos Neurológicos da Marcha/diagnóstico , Marcha/fisiologia , Esclerose Múltipla/diagnóstico , Índice de Gravidade de Doença , Caminhada/fisiologia , Adulto , Idoso , Fenômenos Biomecânicos/fisiologia , Estudos de Casos e Controles , Avaliação da Deficiência , Progressão da Doença , Teste de Esforço/métodos , Feminino , Transtornos Neurológicos da Marcha/etiologia , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/patologia , Esclerose Múltipla/fisiopatologia , Reprodutibilidade dos Testes , Projetos de Pesquisa , Fatores de Tempo
4.
J Cardiovasc Magn Reson ; 22(1): 64, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32892749

RESUMO

BACKGROUND: Pediatric cancer survivors are at increased risk of cardiac dysfunction and heart failure. Reduced peak oxygen consumption (peak VO2) is associated with impaired cardiac reserve (defined as the increase in cardiac function from rest to peak exercise) and heart failure risk, but it is unclear whether this relationship exists in pediatric cancer survivors. This study sought to investigate the presence of reduced peak VO2 in pediatric cancer survivors with increased risk of heart failure, and to assess its relationship with resting cardiac function and cardiac haemodynamics and systolic function during exercise. METHODS: Twenty pediatric cancer survivors (8-24 years; 10 male) treated with anthracycline chemotherapy ± radiation underwent cardiopulmonary exercise testing to quantify peak VO2, with a value < 85% of predicted defined as impaired peak VO2. Resting cardiac function was assessed using 2- and 3-dimensional echocardiography, with cardiac reserve quantified from resting and peak exercise heart rate, stroke volume index (SVI) and cardiac index (CI) using exercise cardiovascular magnetic resonance (CMR). RESULTS: Twelve of 20 survivors (60%) had reduced peak VO2 (70 ± 16% vs. 97 ± 14% of age and gender predicted). There were no differences in echocardiographic or CMR measurements of resting cardiac function between survivors with normal or impaired peak VO2. However, those with reduced peak VO2 had diminished cardiac reserve, with a lesser increase in CI and SVI during exercise (Interaction P < 0.01 for both), whilst the heart rate response was similar (P = 0.71). CONCLUSIONS: Whilst exercise intolerance is common among pediatric cancer survivors, it is poorly explained by resting measures of cardiac function. In contrast, impaired exercise capacity is associated with impaired haemodynamics and systolic functional reserve measured during exercise. Consequently, measures of cardiopulmonary fitness and cardiac reserve may aid in early identification of survivors with heightened risk of long-term heart failure.


Assuntos
Antraciclinas/efeitos adversos , Antibióticos Antineoplásicos/efeitos adversos , Sobreviventes de Câncer , Aptidão Cardiorrespiratória , Teste de Esforço , Tolerância ao Exercício , Cardiopatias/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Lesões por Radiação/diagnóstico por imagem , Adolescente , Fatores Etários , Cardiotoxicidade , Criança , Feminino , Nível de Saúde , Cardiopatias/induzido quimicamente , Cardiopatias/fisiopatologia , Hemodinâmica , Humanos , Masculino , Consumo de Oxigênio , Valor Preditivo dos Testes , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Radioterapia/efeitos adversos , Fatores de Risco , Adulto Jovem
5.
J Cardiovasc Magn Reson ; 22(1): 65, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32907587

RESUMO

Stress cardiac imaging is the current first line investigation for coronary artery disease diagnosis and decision making and an adjunctive tool in a range of non-ischaemic cardiovascular diseases. Exercise cardiovascular magnetic resonance (Ex-CMR) has developed over the past 25 years to combine the superior image qualities of CMR with the preferred method of exercise stress. Presently, numerous exercise methods exist, from performing stress on an adjacent CMR compatible treadmill to in-scanner exercise, most commonly on a supine cycle ergometer. Cardiac conditions studied by Ex-CMR are broad, commonly investigating ischaemic heart disease and congenital heart disease but extending to pulmonary hypertension and diabetic heart disease. This review presents an in-depth assessment of the various Ex-CMR stress methods and the varied pulse sequence approaches, including those specially designed for Ex-CMR. Current and future developments in image acquisition are highlighted, and will likely lead to a much greater clinical use of Ex-CMR across a range of cardiovascular conditions.


Assuntos
Teste de Esforço , Cardiopatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Adulto , Idoso , Ciclismo , Feminino , Cardiopatias/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Valor Preditivo dos Testes , Adulto Jovem
6.
Clin Exp Rheumatol ; 38 Suppl 125(3): 85-91, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865173

RESUMO

OBJECTIVES: Major vascular complication, such as digital ulcers (DUs), pulmonary arterial hypertension (PAH) and scleroderma renal crisis (SRC) are hallmarks of systemic sclerosis (SSc). Interstitial lung disease (ILD) is the major cause of mortality in SSc. The aim of study is to identify cardiopulmonary exercise testing (CPET) variables that predict MVC and mortality for ILD in SSc patients. METHODS: In this cohort study, 45 SSc patients underwent clinical evaluation, echocardiography, pulmonary function tests (PFTs), high resolution computerised tomography (HRCT) and CPET. PFTs and echocardiography were performed annually for a 5-year follow-up. RESULTS: 16 (35.6%) SSc patients had MVC: 14 new DUs (31.1%), 1 PAH (2.2%) and 1 SRC (2.2%). At univariate regression analysis, mRss [HR 1.099 (1.008-1.199), p<0.05], NVC patterns (active and late) [HR 0.032 (0.004-0.250), p<0.001], V'E/V'CO2 slope [HR 1.123 (1.052-1.198), p<0.001] were predictive of new onset of MVC. In multivariate analysis, NVC patterns (active and late) (HR 0.044 (0.004-0.486), p<0.05), V'E/V'CO2 (HR 1.094 (1.020-1.198), p<0.05) were predictive of new onset of MVC. The 5-year mortality for ILD is 8.9%. In univariate analysis, DLco [(HR 0.927(CI 0.874- 0.983), p<0.05], V'E/V'CO2 slope and lung parenchymal with radiological patterns of ILD [(1.2.02 (CI 1.018-1.419), p<0.05], represent risk factors for 5-year mortality for ILD [HR 1.142 (1.030-1.267), p<0.05]. In multivariate analysis, only V'E/V'CO2 slope [1.268 (CI 1.003-1.602), p<0.05] represents a risk factor for 5-year mortality for ILD. CONCLUSIONS: V' E/V' CO2 slope is a prognostic marker of MVC and five-year mortality for ILD.


Assuntos
Doenças Pulmonares Intersticiais , Escleroderma Sistêmico , Estudos de Coortes , Teste de Esforço , Tolerância ao Exercício , Humanos
7.
PLoS One ; 15(8): e0238569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866216

RESUMO

Validation of heart rate responses in wearable technology devices is generally composed of laboratory-based protocols that are steady state in nature and as a result, high accuracy measures are returned. However, there is a need to understand device validity in applied settings that include varied intensities of exercise. The purpose was to determine concurrent heart rate validity during trail running. Twenty-one healthy participants volunteered (female n = 10, [mean (SD)]: age = 31 [11] years, height = 173.0 [7] cm, mass = 75.6 [13] kg). Participants were outfitted with wearable technology devices (Garmin Fenix 5 wristwatch, Jabra Elite Sport earbuds, Motiv ring, Scosche Rhythm+ forearm band, Suunto Spartan Sport watch with accompanying chest strap) and completed a self-paced 3.22 km trail run while concurrently wearing a criterion heart rate strap (Polar H7 heart rate monitor). The trail runs were out-and-back with the first 1.61 km in an uphill direction, and the 1.61 return being downhill in nature. Validity was determined through three methods: Mean Absolute Percent Error (MAPE), Bland-Altman Limits of Agreement (LOA), and Lin's Concordance Coefficient (rC). Validity measures overall are as follows: Garmin Fenix 5 (MAPE = 13%, LOA = -32 to 162, rC = 0.32), Jabra Elite Sport (MAPE = 23%, LOA = -464 to 503, rC = 0.38), Motiv ring (MAPE = 16%, LOA = -52 to 96, rC = 0.29), Scosche Rhythm+ (MAPE = 6%, LOA = -114 to 120, rC = 0.79), Suunto Spartan Sport (MAPE = 2%, LOA = -62 to 61, rC = 0.96). All photoplethysmography-based (PPG) devices displayed poor heart rate agreement during variable intensity trail running. Until technological advances occur in PPG-based devices allowing for acceptable agreement, heart rate in outdoor environments should be obtained using an ECG-based chest strap that can be connected to a wristwatch or other comparable receiver.


Assuntos
Determinação da Frequência Cardíaca/instrumentação , Determinação da Frequência Cardíaca/métodos , Frequência Cardíaca/fisiologia , Corrida/fisiologia , Tecnologia/instrumentação , Tecnologia/métodos , Adulto , Exercício Físico/fisiologia , Teste de Esforço/instrumentação , Teste de Esforço/métodos , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Fotopletismografia/métodos , Dispositivos Eletrônicos Vestíveis
8.
J Frailty Aging ; 9(4): 214-218, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32996557

RESUMO

BACKGROUND: It is known that maintenance of muscle mass cannot prevent loss of muscle strength in older adults. Recent evidence suggests that fat mass can weaken the relationship between muscle mass and functional performance. No information exists if fat mass can independently affect muscle strength and jump test performance in middle-aged and older adults. OBJECTIVE: To assess the independent relationships between fat mass, leg muscle mass, lower extremity muscle strength, and jump test performance in adults, 55-75 years of age. DESIGN: Cross-sectional. SETTING: University laboratory. PARTICIPANTS: Fifty-nine older adults (men, n = 27, age = 64.8 ± 6.5 years; women, n = 32, age = 62.5 ± 5.1 years) participated in this study. MEASUREMENTS: Dual energy X-ray absorptiometry was used to measure fat mass and leg muscle mass. An average of 3 maximal countermovement jumps was used to calculate jump power and jump height. Two leg press and hip abduction strength were assessed by 1-repetition maximum testing. RESULTS: Stepwise sequential regression analysis of fat mass and leg muscle mass versus jump test performance and measures of muscle strength after adjusting for age, height, and physical activity revealed that fat mass was negatively associated with jump height (p = 0.047, rpartial = -0.410) in men. In women, fat mass was negatively associated with jump height (p = 0.003, rpartial = -0.538), leg press (p = 0.002, rpartial = -0.544), and hip abduction strength (p < 0.001, rpartial = -0.661). Leg muscle mass was positively associated with jump power in women (p = 0.047, rpartial = 0.372) only. CONCLUSIONS: Fat mass has an independent negative relationship with jump test performance in middle-aged and older men and women. This has clinical implications for rehabilitating neuromuscular performance in middle-aged and older adults.


Assuntos
Tecido Adiposo/fisiologia , Teste de Esforço , Força Muscular/fisiologia , Desempenho Físico Funcional , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Medicine (Baltimore) ; 99(37): e21663, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925713

RESUMO

BACKGROUND: The incidence of heart failure with normal ejection fraction (HFNEF) is increasing yearly, accounting for approximately half of all heart failure cases. Even after standardized treatment, the patient's prognosis is not good. Therefore, it is necessary to explore new treatment methods for HFNEF. Yangyin Shuxin Decoction, a traditional Chinese medicine prescription from our clinical experience in the treatment of HFNEF, has a potential cardioprotective effect. Preliminary clinical trials have shown that this prescription can improve the quality of life of HFNEF. This prompted us to use more objective indicators to further evaluate whether Yangyin Shuxin Decoction can improve the exercise capacity in HENEF patients. METHODS: This is a single-center parallel randomized controlled trial. The 64 patients who met the inclusion criteria were from the Cardiovascular Clinic. They will be randomly assigned to the treatment group (Yangying Shuxin Decoction combined with standard treatment) or the control group (standard treatment) according to the ratio of 1:1. The course of treatment will be 2 weeks. Both groups were interviewed at the following time points: of at enrollment (V1), and week 2 (V2), week 4 (V3), week 8 (V4), and week 12 (V5) after enrollment. The primary indicator is the peak oxygen consumption (Peak VO2) of the cardiopulmonary exercise test (CPET). Secondary indicators include CPET indicators such as anaerobic threshold oxygen consumption, carbon dioxide ventilation equivalent slope, echocardiographic indicators such as the ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity(E/e'), left atrial volume index (LAVI), left ventricular mass index (LVMI), the peak velocity of tricuspid regurgitation (TR), B-type natriuretic peptide (BNP), New York Heart Association (NYHA) cardiac function grading, and so on. These indicators will be used to evaluate the effect of Yangyin Shuxin Decoction on exercise capacity in patients with HFNEF. DISCUSSION: At present, it is unclear whether the exercise capacity can be maintained after long-term use of Yangyin Shuxin Decoction. In this study, we will evaluate whether Yangyin Shuxin Decoction can improve the exercise capacity and quality of life of patients with HFNEF. This will provide an objective basis for the therapeutic effect of traditional Chinese medicine on HFNEF. TRIAL REGISTRATION: This study protocol has been listed in the Chinese Clinical Trial Registry (registration number: ChiCTR-IOR-17014206, http://www.chictr.org.cn/showproj.aspx?proj=24304) on December 28, 2017.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Volume Sistólico/fisiologia , Adulto , Idoso , Ecocardiografia , Teste de Esforço , Tolerância ao Exercício , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio/efeitos dos fármacos , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Síndrome , Resultado do Tratamento
10.
Medicine (Baltimore) ; 99(37): e22167, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925783

RESUMO

BACKGROUND: The prevalence of cardiac syndrome X (CSX) is considerable. Some patients show recurrent angina attacks and have a poor prognosis. However, the knowledge of CSX pathophysiological mechanism is still limited, and the treatment fails to achieve a satisfactory suppression of symptoms. Nicorandil has a beneficial effect on improving coronary microvascular dysfunction (CMD). This study aims to evaluate the clinical effects and safety of nicorandil on CSX patients. METHODS: The Cochrane Library, Pubmed, EMBASE, ClinicalTrials.gov and 4 Chinese databases were searched to identify relevant studies. The Cochrane "Risk of bias" tool was used to assess the methodological quality of eligible studies. Meta-analysis was performed by RevMan 5.3 software. The Eggers test and meta-regression were performed by software Stata 14.0. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Twenty four randomized controlled trials (RCTs) involving 2323 patients were included. Most of the included studies were classified as having an unclear risk of bias because of poor reported methodology. The main outcomes are angina symptoms improvement, resting electrocardiogram (ECG) improvement, treadmill test result, and endothelial function. Meta-analysis showed that nicorandil had some benefit on improving angina symptoms (RR 1.24, 95% CI 1.19 to 1.29, I = 20%, P < .00001), resting ECG (RR = 1.24, 95% IC: 1.15 to 1.33, I = 0%, P < .00001), and prolonged the time to 1 mm ST-segment depression in treadmill test result (WMD = 38.41, 95% IC: 18.46 to 58.36, I = 0%, P = .0002). Besides nicorandil could reduce the level of endothelin-1 (ET-1) (SMD = -2.22, 95% IC: -2.61 to -1.83, I = 77%, P < .00001) and increase the level of nitric oxide (NO) (WMD = 27.45, 95% IC: 125.65 to 29.24, I = 81%, P < .00001). No serious adverse drug event was reported. The Eggers test showed that significant statistical publication bias was detected (Eggers test P = .000). The quality of evidence ranged from very low to low. CONCLUSIONS: Nicorandil shows the potential of improving angina symptoms, ECG, and endothelial dysfunction in patients with CSX. However, there is insufficient evidence for the clinical benefits of nicorandil due to the very low-quality evidence.


Assuntos
Angina Microvascular/tratamento farmacológico , Nicorandil/uso terapêutico , Vasodilatadores/uso terapêutico , Eletrocardiografia , Endotelina-1/sangue , Endotélio Vascular/efeitos dos fármacos , Teste de Esforço , Humanos , Óxido Nítrico/sangue , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Klin Monbl Augenheilkd ; 237(9): 1117-1123, 2020 Sep.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-32967033

RESUMO

BACKGROUND: Glaucoma is one of the most common causes of blindness worldwide. The only evidence-based treatment to slow down the progression of glaucoma is the reduction of intraocular pressure (IOP) using local medication or through surgery. During the last years, a large number of microinvasive glaucoma surgery techniques (MIGS) has been developed, in order to reduce the IOP in glaucoma patients safely and effectively. Until now, efficacy of MIGS has been assessed mainly according to the postoperative IOP and the number of medications used. Results from long-term studies are rare or not available in the majority of the cases. In order to better evaluate the functionality of MIGS, a new examination method has been developed with the help of a new oculopressor device. In this study the efficacy of different MIGS techniques will be examined using the new oculopressor. MATERIAL/METHODS: At first, glaucoma patients that had previously received a MIGS surgery (iStent inject, XEN Stent, ELT) were examined with the new oculopression test. Their results were compared with those of non-operated patients and healthy individuals. Overall, 38 healthy subjects (group 1), 10 non-operated patients (group 2), 19 patients after iStent inject implantation (group 3), 14 patients after XEN Stent implantation (group 4) and 5 patients after ELT (group 5) were examined. The new examination measures the IOP-reduction that occurs after oculopression and can be seen as an indirect measurement of the outflow facility of the eye. RESULTS: The IOP-reduction after oculopression differed among the study groups. Non-operated patients showed a significantly lower IOP-reduction compared to healthy individuals. Patients after iStent inject and XEN stent implantation showed a larger reduction of IOP after oculopression in relation to non-operated patients and their results approximated those of healthy individuals. These patients needed fewer medications postoperatively in relation to non-operated patients. Patients after ELT showed postoperatively a smaller reduction of IOP after oculopression compared to iStent inject and XEN stent patients. CONCLUSION: MIGS can increase the outflow facility of the eye in patients with glaucoma. Though ELT had the lowest impact on the aqueous outflow among the studied procedures in this study. The new test can help in the evaluation of current and further development of new MIGS in the future.


Assuntos
Glaucoma de Ângulo Aberto , Glaucoma/cirurgia , Teste de Esforço , Humanos , Pressão Intraocular , Stents , Resultado do Tratamento
12.
PLoS One ; 15(8): e0236986, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866198

RESUMO

White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain imaging. Results indicated that age was a predictor of WMH volume (beta = .32, p = .015). However, an age-by-CRF interaction was observed such that higher CRF was associated with lower WMH volume in older participants (beta = -.25, p = .040). Our findings suggest that higher levels of aerobic fitness may protect cerebrovascular health in older adults.


Assuntos
Envelhecimento/patologia , Envelhecimento/fisiologia , Aptidão Cardiorrespiratória/fisiologia , Substância Branca/diagnóstico por imagem , Idoso , Circulação Cerebrovascular/fisiologia , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/patologia , Transtornos Cerebrovasculares/fisiopatologia , Teste de Esforço , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Fatores de Risco , Substância Branca/irrigação sanguínea , Substância Branca/patologia
13.
Medicine (Baltimore) ; 99(31): e21485, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756176

RESUMO

BACKGROUND: Exercise intolerance is very common in patients with coronary heart disease (CHD). Although some researches confirming the validation of traditional Chinese medicine (TCM) on CHD treatment, the effect of TCM on improving the exercise tolerance of patients with CHD remains unclear so far. Our trial is to investigate whether the Yangxinshi (YXS) tablet can improve exercise tolerance as well as the quality of life among CHD patients. METHODS: It is a randomized, double-blind, placebo-controlled, multi-center trial. A total of 90 patients with CHD from 3 hospitals in China will be enrolled and randomly assigned to one of 2 groups: YXS group, N = 45; placebo group, N = 45. The 2 groups will simultaneously receive standardized western medicine and exercise-based cardiac rehabilitation program for 12 weeks. The primary outcome measure is the exercise capacity, which will be evaluated by the cardiopulmonary exercise test and 6-minute walking test. The 2nd outcomes include symptom improvement, psychologic issues, laboratory tests, side effects, and adverse events. DISCUSSION: To our knowledge, it is the 1st randomized controlled trial to evaluate the effect of TCM YXS tablet on exercise tolerance in patients with CHD. The results will provide more evidence for future studies in this area. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry5752).


Assuntos
Doença das Coronárias/terapia , Medicamentos de Ervas Chinesas/administração & dosagem , Tolerância ao Exercício/efeitos dos fármacos , Medicina Tradicional Chinesa/métodos , Adulto , Idoso , China , Doença das Coronárias/fisiopatologia , Método Duplo-Cego , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Teste de Caminhada
14.
Int J Cardiovasc Imaging ; 36(10): 1953-1962, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32757119

RESUMO

Negative stress echocardiography (NSE) is associated with low cardiovascular morbidity and overall mortality. We aimed to determine the clinical and echocardiographic predictors of overall and cardiovascular outcomes following NSE. Patients who underwent SE between 2013 and 2017 were reviewed. Patients with a history of solid organ transplant or being evaluated for transplant, history of end-stage renal or liver disease, and positive SE were excluded. NSE results were divided into negative diagnostic if patient reached target heart rate (THR) and had no wall motion abnormality (WMA) at rest or stress; negative non-diagnostic if patient had no WMA but did not reach THR or if image quality was non-diagnostic; and abnormal non-ischemic if patient had a resting WMA not worsened at stress along with a personal history of coronary artery disease (CAD). New CAD lesion at 1 year was defined as ≥ 50% stenosis on cardiac catheterization. Of 4119 patients with SE, 2575 were included. All-cause mortality rate was 1.1%/year and CAD rate was 3.1%/year. Predictors of all-cause mortality were age, male gender, history of smoking and being selected for dobutamine SE. Predictors of a new CAD lesion at 1 year were male gender, diabetes, personal history of CAD and abnormal non-ischemic SE. We identified clinical and echocardiographic characteristics in a subset of NSE patients who are at higher risk for subsequent adverse events. These characteristics should be accounted for during the clinical interpretation of SE, and patients found at increased risk for morbidity and mortality warrant continued follow-up.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Ecocardiografia sob Estresse , Teste de Esforço , Agonistas de Receptores Adrenérgicos beta 1/administração & dosagem , Idoso , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/fisiopatologia , Dobutamina/administração & dosagem , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
15.
Medicina (B Aires) ; 80(4): 339-347, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32841137

RESUMO

The six-minute walk test has been generally applied in people with pathologies and some studies have proposed models to predict maximum oxygen consumption. Our objective was to elaborate on an equation to predict the maximum oxygen consumption in the six-minute walking test for university students. A hundred and forty people participated in this study. The six-minute walking test was applied and after on a gradual exercise test was performed to determine the maximum oxygen consumption. A multivariate equation was developed and the analysis was done using the SPSS v.22 program (p < 0.05). The predictive model include gender, age, body mass index, distance performed and heart rate recovery (r = 0.83; p < 0.001). The equation fulfilled the assumptions of independence (p = 0.13), normality (p = 0.49) and homoscedasticity (p = 0.64). The Bland-Altman diagram indicated that there were no significant differences between the equation and the measurement of the maximum oxygen consumption (p = 0.89), with a confidence interval of 0.054 ml·kg·min-1 (95% CI [-0.72; 0.83]). The equation predicts the maximum oxygen consumption. It is suggested to evaluate university students considering biological and environmental differences between countries.


Assuntos
Teste de Esforço , Tolerância ao Exercício , Voluntários Saudáveis , Frequência Cardíaca , Humanos , Consumo de Oxigênio , Teste de Caminhada , Caminhada
16.
Medicine (Baltimore) ; 99(34): e21794, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846812

RESUMO

Patients with cardiovascular diseases frequently experience exertional dyspnea. However, the relationship between respiratory muscle strength including its fatigue and cardiovascular dysfunctions remains to be clarified.The maximal inspiratory pressure/maximal expiratory pressure (MIP/MEP) before and after cardiopulmonary exercise testing (CPX) in 44 patients with heart failure and ischemic heart disease were measured. Respiratory muscle fatigue was evaluated by calculating MIP (MIPpost/MIPpre) and MEP (MEPpost/MEPpre) changes.The mean MIPpre and MEPpre values were 67.5 ±â€Š29.0 and 61.6 ±â€Š23.8 cm H2O, respectively. After CPX, MIP decreased in 25 patients, and MEP decreased in 22 patients. We evaluated the correlation relationship between respiratory muscle function including respiratory muscle fatigue and exercise capacity evaluated by CPX such as peak VO2 and VE/VCO2 slope. Among MIP, MEP, change in MIP, and change in MEP, only the value of change in MIP had an association with the value of VE/VCO2 slope (R = -0.36, P = .017). In addition, multivariate analysis for determining factor of change in MIP revealed that the association between the change in MIP and eGFR was independent from other confounding parameters (beta, 0.40, P = .017). The patients were divided into 2 groups, with (MIP change < 0.9) and without respiratory muscle fatigue (MIP change > 0.9), and a significant difference in peak VO2 (14.2 ±â€Š3.4 [with fatigue] vs 17.4 ±â€Š4.7 [without fatigue] mL/kg/min; P = .020) was observed between the groups.Respiratory muscle fatigue demonstrated by the change of MIP before and after CPX significantly correlated with exercise capacity and renal function in patients with cardiovascular disease.


Assuntos
Insuficiência Cardíaca/fisiopatologia , Fadiga Muscular , Isquemia Miocárdica/fisiopatologia , Músculos Respiratórios/fisiopatologia , Idoso , Exercício Físico/fisiologia , Teste de Esforço , Tolerância ao Exercício , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Masculino , Pressões Respiratórias Máximas , Pessoa de Meia-Idade
17.
Chron Respir Dis ; 17: 1479973120952418, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32840385

RESUMO

OBJECTIVES: To identify exercise tests that are suitable for home-based or remote administration in people with chronic lung disease. METHODS: Rapid review of studies that reported home-based or remote administration of an exercise test in people with chronic lung disease, and studies reporting their clinimetric (measurement) properties. RESULTS: 84 studies were included. Tests used at home were the 6-minute walk test (6MWT, two studies), sit-to-stand tests (STS, five studies), Timed Up and Go (TUG, 4 studies) and step tests (two studies). Exercise tests administered remotely were the 6MWT (two studies) and step test (one study). Compared to centre-based testing the 6MWT distance was similar when performed outdoors but shorter when performed at home (two studies). The STS, TUG and step tests were feasible, reliable (intra-class correlation coefficients >0.80), valid (concurrent and known groups validity) and moderately responsive to pulmonary rehabilitation (medium effect sizes). These tests elicited less desaturation than the 6MWT, and validated methods to prescribe exercise were not reported. DISCUSSION: The STS, step and TUG tests can be performed at home, but do not accurately document desaturation with walking or allow exercise prescription. Patients at risk of desaturation should be prioritised for centre-based exercise testing when this is available.


Assuntos
Infecções por Coronavirus , Teste de Esforço/métodos , Serviços de Assistência Domiciliar/organização & administração , Pneumopatias , Pandemias , Pneumonia Viral , Telemedicina/métodos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Pneumopatias/reabilitação , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Reprodutibilidade dos Testes
18.
PLoS One ; 15(8): e0237388, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760167

RESUMO

INTRODUCTION: The heart rate (HR) method is a promising approach for evaluating oxygen uptake ([Formula: see text]), energy demands and exercise intensities in different forms of physical activities. It would be valuable if the HR method, established on ergometer cycling, is interchangeable with other regular activities, such as level walking. This study therefore aimed to examine the interchangeability of the HR method when estimating [Formula: see text] for ergometer cycling and level treadmill walking in submaximal conditions. METHODS: Two models of [Formula: see text] regression equations for cycle ergometer exercise (CEE) and treadmill exercise (TE) were established with 34 active commuters. Model 1 consisted of three submaximal intensities of ergometer cycling or level walking, model 2 included also one additional workload of maximal ergometer cycling or running. The regression equations were used for estimating [Formula: see text] with seven individual HR values based on 25-85% of HR reserve (HRR). The [Formula: see text] estimations were compared between CEE and TE, within and between each model. RESULTS: Only minor, and in most cases non-significant, average differences were observed when comparing the estimated [Formula: see text] levels between CEE and TE. Model 1 ranged from -0.4 to 4.8% (n.s.) between 25-85%HRR. In model 2, the differences between 25-65%HRR ranged from 1.3 to -2.7% (n.s.). At the two highest intensities, 75 and 85%HRR, [Formula: see text] was slightly lower (3.7%, 4.4%; P < 0.05), for CEE than TE. The inclusion of maximal exercise in the [Formula: see text] relationships reduced the individual [Formula: see text] variations between the two exercise modalities. CONCLUSION: The HR methods, based on submaximal ergometer cycling and level walking, are interchangeable for estimating mean [Formula: see text] levels between 25-85% of HRR. Essentially, the same applies when adding maximal exercise in the [Formula: see text] relationships. The inter-individual [Formula: see text] variation between ergometer cycling and treadmill exercise is reduced when using the HR method based on both submaximal and maximal workloads.


Assuntos
Ergometria/instrumentação , Teste de Esforço/instrumentação , Frequência Cardíaca , Caminhada/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/metabolismo
19.
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
Imagem 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
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