PubMed Health⌕ Search

Biomedical subjects

G J Balady

Publications and source records attributed to G J Balady.

At least 19 recordsLinked to original sources
PubMed2001

Echocardiographic examination of women previously treated with fenfluramine: long-term follow-up of a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Fenfluramine hydrochloride was withdrawn from the market in September 1997 after reports of heart valve abnormalities in patients who used it. The prevalence of echocardiographic abnormalities and the clinical cardiovascular status of patients who received fenfluramine monotherapy remains uncertain. METHODS: A long-term, follow-up evaluation was undertaken in subjects who were randomly assigned to receive either fenfluramine hydrochloride (60 mg daily) or placebo as part of a double-blind smoking cessation therapy study. Cardiovascular status was evaluated by echocardiography, medical history, and physical examination. RESULTS: From the group of 720 smokers who had originally participated in the smoking cessation therapy trial, 619 women were enrolled; data from 530 (276 in the fenfluramine group and 254 in the placebo group) were evaluable. No statistically significant differences were identified in the prevalence of aortic or mitral regurgitation by Food and Drug Administration criteria or by grade, aortic or mitral valve leaflet mobility restriction or thickening, elevated pulmonary artery systolic pressure, or abnormal left ventricular ejection fraction. No significant differences were demonstrated in cardiovascular status by physical examination, and no serious cardiac events were noted among fenfluramine-treated subjects. CONCLUSION: There was no evidence of drug-related heart disease up to 4.9 years after anorexigen therapy in subjects who were randomly assigned to receive fenfluramine at the recommended dose for up to 3 months.

Adolescent↗
PubMed2000

Comparison of cardiovascular adaptations to long-term arm and leg exercise in wheelchair athletes versus long-distance runners.

The effect of long-term arm exercise on cardiac morphology and function is unknown. To study these effects, highly trained wheelchair athletes were compared with long-distance runners and controls. In addition, the wheelchair athletes were compared with the long-distance runners to determine if long-term leg exercise confers a training effect during the performance of dynamic arm exercise. The study included 31 male subjects (mean age of 33+/-5 years), who comprised 3 groups matched for age and weight: wheelchair athletes (n = 9), long-distance runners (n = 12), and healthy controls (n = 10). All underwent echocardiography at rest and arm ergometry exercise testing with expiratory gas analysis. The peak work rate during arm exercise was highest among the wheelchair athletes, and was significantly higher in both groups of trained athletes compared with the control group (p<0.001). Runners demonstrated a significantly lower submaximal heart rate response to arm exercise compared with wheelchair and control subjects. Wheelchair athletes had increased left ventricular (LV) volume and mass by echocardiography compared with controls, but not to the same degree as that of runners. Although chamber dimensions and wall thickness did not differ among the groups, the LV volume index tended to be largest in the runners. Doppler indexes of diastolic LV filling were similar between the trained and untrained subjects. These data demonstrate that both long-term arm and leg exercise yield increases in LV volume and mass compared with untrained control subjects, although to a lesser degree in arm-trained athletes. Runners demonstrated a transfer of training effect in the performance of dynamic arm exercise, as demonstrated by their ability to achieve a higher peak work rate than controls, and showed a lower heart rate response to submaximal exercise than the wheelchair athletes and control subjects.

Adaptation, Physiological↗
PubMed2000

Accuracy of a pretest questionnaire in exercise test protocol selection.

Proper exercise test protocol selection is essential to allow adequate time for observation of subjective and physiologic responses to exercise, as well as provider-patient interaction and patient comfort. This study evaluates the accuracy of a pretest questionnaire in predicting exercise capacity for exercise test protocol selection and compares the accuracy of this questionnaire when ramp versus step protocols are used.

Activities of Daily Living↗
PubMed1999

Comparison of ramp versus step protocols for exercise testing in patients > or = 60 years of age.

To evaluate whether individualized ramp protocols may be better than step protocols in patients > or = 60 years of age referred for exercise testing, peak cardiopulmonary responses and accuracy in prediction of oxygen uptake (VO2) for individualized ramp and step protocols (Bruce or modified Bruce) were compared. Twenty-four subjects (67+/-3 years) with known or suspected coronary artery disease performed both tests in random order. Protocols were selected based on estimated exercise capacity using a pretest activity questionnaire. No differences were observed between peak VO2 (19.3+/-6.3 and 19.1+/-6.4 ml/kg/min), heart rate (127+/-15 and 126+/-16 beats/min), rate-pressure product (24.0+/-4.8 and 23.4+/-4.9 beats/min x mm Hg x 10(3)) and anaerobic threshold (16.6+/-3.7 and 16.0+/-4.7 ml/kg/min) for the ramp and step protocols, respectively. The relation between measured submaximal VO2 and American College of Sports Medicine (ACSM)-predicted VO2 during the ramp protocol is demonstrated by the regression coefficient (beta), where beta = 0.92 (95% confidence intervals [CI] 0.85 to 0.99) and for the step protocols where beta = 1.02 (95% CI 0.84 to 1.20). Peak cardiopulmonary responses in the elderly are similar during individualized ramp and step protocols when appropriately selected based on a pretest activity questionnaire. Both protocols appear to provide clinically reasonable estimates of VO2 when gas exchange analysis is not used.

Aged↗
PubMed1999

Effect of body composition on oxygen uptake during treadmill exercise: body builders versus weight-matched men.

Oxygen uptake (VO2) during treadmill exercise is directly related to the speed and grade, as well as the participant's body weight. To determine whether body composition also affects VO2 (ml.kg-1.min-1) during exercise, we studied 14 male body builders (M weight = 99 kg, SD = 7; M height = 180 cm, SD = 8; M body fat = 8%, SD = 3; M fat free mass = 91 kg, SD = 7) and 14 weight-matched men (M weight = 99 kg, SD = 9; M height = 179 cm, SD = 5; M body fat = 24%, SD = 5; M fat free mass = 73 kg, SD = 9). Percentage of body fat, t(13) = 8.185, p < .0001, and fat free mass, t(13) = 5.723, p < .0001, were significantly different between groups. VO2 was measured by respiratory gas analysis at rest and during three different submaximal workrates while walking on the treadmill without using the handrails for support. VO2 was significantly greater for the lean, highly muscular men at rest: 5.6 +/- 1 vs. 4.0 +/- 1 ml.kg-1.min-1, F(1, 26) = 21.185, p < .001; Stage 1: 1.7 mph/10%, 18.5 +/- 2 vs. 16.1 +/- 2 ml.kg-1.min-1, F(1, 26) = 6.002, p < .05; Stage 2: 2.5 mph/12%, 26.6 +/- 3 vs. 23.1 +/- 2 ml.kg-1.min-1, F(1, 26) = 7.991, p < .01; and Stage 3:3.4 mph/14%, 39.3 +/- 5 vs. 33.5 +/- 5 ml.kg-1.min-1, F(1, 26) = 7.682, p < .01, body builders versus weight-matched men, respectively. However, net VO2 (i.e., exercise VO2 - rest VO2) was not significantly different between the two groups at any of the matched exercise stages. The findings from this study indicate that VO2 during weight-bearing exercise performed at the same submaximal workrate is higher for male body builders compared to that measured in weight-matched men and that which is predicted by standard equations. These observed differences in exercise VO2 appear to be due to the higher resting VO2 in highly muscular participants.

Adult↗
PubMed1998

Exercise training in the treatment of heart failure: what is achieved and how?

Exercise intolerance is present in most patients with left ventricular dysfunction. Factors affecting the central and peripheral circulation, ventilatory system and skeletal muscles limit the exercise capacity in varying degrees within each patient. Exercise training is now being applied with growing enthusiasm to patients with heart failure. Improvements in the peripheral circulation and skeletal muscle structure and function appear to account for the observed benefit in exercise tolerance after training. Exercise programmes in these patients should be initially conducted with close supervision and tailored to the individual patient.

Exercise↗