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PubMed1998

Impaired exercise capacity late after cardiac transplantation: influence of chronotropic incompetence, hypertension, and calcium channel blockers.

BACKGROUND AND METHODS: Patients undergoing orthotopic cardiac transplantation manifest reduced exercise capacity during the first postoperative year, which is related primarily to chronotropic incompetence of the denervated heart. To determine whether exercise capacity improves during the long term after transplantation, we prospectively studied 45 patients from 1 month to 6 years after cardiac transplantation by use of maximal treadmill exercise testing for measurement of exercise duration, peak heart rate, and peak VO2. All had normal left ventricular ejection fractions. Patients were categorized according to length of time since transplant and compared to 14 untrained normal subjects. RESULTS: Peak exercise heart rate and exercise duration were progressively higher as time after transplantation increased. However, patients who had undergone transplantation more than 2 years earlier continued to manifest a significant reduction in peak exercise heart rate (157+/-3 beats/min vs 178+/-14 beats/min) and reduced exercise duration (8.6+/-0.5 minutes vs 13.2+/-2.0 minutes) compared with controls. In contrast, peak VO2 was similar at all times after transplant and remained markedly reduced in patients who underwent transplantation more than 2 years earlier as compared with controls (22.1+/-0.7 mL/kg/min vs 42.1+/-9.1 mL/kg/min). The potential effects of 14 clinical variables on exercise performance were evaluated by regression modeling. Patients with poorly controlled hypertension had a shorter median exercise duration (7.4 minutes vs 9.7 minutes) and a lower median peak VO2 (20.3 mL/kg/min vs 23.2 mL/kg/min) compared with patients with normal or well-controlled blood pressure. Patients treated with calcium channel blockers for hypertension had greater chronotropic incompetence during exercise (peak heart rate 139 beats/min vs 158 beats/min). There was no relation between exercise capacity and recipient age, donor age, recipient sex, donor ischemic time, pretransplant diagnosis, length of peritransplant hospitalization, percentage of ideal body weight, left ventricular ejection fraction, frequency or severity of allograft rejection, or long-term use of oral prednisone therapy. CONCLUSIONS: Exercise capacity, as measured by treadmill exercise time and peak heart rate, improves in the first 2 years after transplantation, but does not reach normal values in patients up to 6 years after transplant. Peak VO2 remains significantly reduced at all times after transplantation despite the presence of normal resting left ventricular systolic function.

Adult↗

PubMed2004

Disability evaluation in chronic fatigue syndrome: associations between exercise capacity and activity limitations/participation restrictions.

OBJECTIVE: In an attempt to examine whether impairments in cardiorespiratory fitness are associated with daily functioning in patients with chronic fatigue syndrome (CFS), this study addresses the correlations between exercise capacity and activity limitations/participation restrictions. DESIGN: Prospective observational study. SETTING: An outpatient tertiary care, chronic fatigue clinic at the Vrije Universiteit Brussel (VUB), Belgium. SUBJECTS: Seventy-seven patients fulfilling the 1994 Centers for Disease Control and Prevention (CDC) case definition for CFS. INTERVENTIONS: All patients filled in the Chronic Fatigue Syndrome Activities and Participation Questionnaire (CFS-APQ) and performed a maximal exercise stress test on a bicycle ergometer. Heart rate was monitored continuously by use of an electrocardiograph. Metabolic and ventilatory parameters were measured through spirometry. RESULTS: A statistically significant correlation between the score obtained with the CFS-APQ and the body weight-adjusted peak oxygen uptake (Spearman rho = -0.32; p = 0.005), functional aerobic impairment (rho = 0.33; p = 0.004), workload/body weight (rho = -0.30; p = 0.009), exercise duration (rho = -0.30; p = 0.008), and the percentage of target heart rate achieved (rho = -0.33; p = 0.004) was observed. The correlations between the remaining exercise capacity parameters and the scores obtained with the CFS-APQ all indicated a trend towards association (0.01 <p<0.05). CONCLUSIONS: These results suggest a moderate association between exercise capacity and activity limitations/participation restrictions in patients with CFS. The observed correlations lack strength to predict activity limitations/ participation restriction based on exercise capacity parameters. Disability evaluation in CFS should therefore encompass both exercise capacity testing and measurements at the activity/participation dimension.

Adult↗

PubMed1996

Meta-analysis of morbidity and mortality in five exercise capacity trials evaluating ramipril in chronic congestive cardiac failure.

In 5 separate exercise capacity trials in similar patients with chronic congestive heart failure performed in Europe, the United States, and South Africa, 627 patients were randomized to ramipril and 428 to placebo. The dose of ramipril ranged from 1.25 to 20 mg/day. Follow-up was at 12 or 24 weeks. None of the trials were designed to assess efficacy with regard to clinical outcome. To assess in the combined experience whether there was an effect of ramipril on mortality, hospitalization, functional classification (New York Heart Association class), and exercise capacity, we pooled data from each trial and performed a mata-analysis. Of the patients randomized to ramipril and placebo, respectively, and based on intention to treat, 14 (2.2%) and 18 (3.8%) patients died (odds ratio 0.60, 95% confidence interval 0.28 to 1.29), and 59 (9.4%) and 67 (14.3%) patients died or were hospitalized (odds ratio 0.68, 95% confidence interval 0.46 to 1.00). The New York Heart Association class improved in 29% and 25% respectively, whereas 8% and 15% deteriorated (p=0.04, based on intention to treat; death and hospitalization considered as deterioration). In ranked comparisons based on intention to treat and with imputation of exercise time as 0 for patients who were unable to exercise because of death or who were hospitalized, exercise capacity was significantly improved by rampril. We concluded that rampiril is likely to have an effect on mortality, morbidity, and functional capacity in patients with chronic congestive heart failure similar to that of other angiotensin-converting enzyme inhibitors.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed1993

Endurance exercise capacity in adults with cystic fibrosis.

We have compared the maximal and endurance exercise capacities in 22 (15 male) adult cystic fibrosis (CF) patients with a resting oxygen saturation (SaO2) > or = 90%, with age and sex matched controls (CON). The maximum oxygen uptake (VO2max) and heart-rate were lower for the CF group whereas the maximum ventilation reached a higher percentage of predicted. Furthermore, for the CF group there was a relationship between the % predicted VO2max and measures of lung function, confirming a ventilatory limit to maximum exercise in patients with more severe disease and a near normal maximum exercise capacity in those with mild disease. Endurance capacity, defined as the duration of exercise at 80% of each individuals VO2max, was however similar for the two groups [CF: 22.21 (15.82) vs. CON: 24.94 (13.05) min]; despite the CF group exercising under less efficient ventilatory conditions. Endurance capacity was not related to the measurements of lung function. Of the seven CF patients desaturating at maximal exercise (SaO2 < 90%), five desaturated at a work load of 80% VO2max, whereas only one desaturated at 50% VO2max. This study confirms that with increasing severity of disease, maximal exercise capacity may be limited in adult CF patients, whereas endurance capacity (at the same relative work load) is unimpaired. Furthermore, CF patients who desaturate during a progressive maximal exercise test are likely to desaturate during constant work load exercise if the intensity is high but unlikely to do so if the intensity is low. The information from these exercise tests would be of value for prescribing individual training programmes and for evaluating the effects.

Adolescent↗

PubMed1999

Effects of L-arginine on lower limb vasodilator reserve and exercise capacity in patients with chronic heart failure.

OBJECTIVE: To determine whether the reactive hyperaemic response of the lower limb increases with improved exercise capacity after acute supplementation with L-arginine, the precursor of nitric oxide, in patients with chronic heart failure. METHODS: 19 patients with chronic heart failure were enrolled in the study. Rest calf blood flow and femoral occlusion induced calf blood flow changes were measured by venous occlusion plethysmography before and after intravenous infusion of 10% L-arginine solution (5 ml/kg for 30 minutes) or placebo. Postexercise calf blood flow was also measured after the experimental infusion. During both postinfusion periods, several exercise capacity indices were determined by a symptom limited cardiopulmonary exercise test using a bicycle ergometer. RESULTS: Baseline calf blood flow, systemic blood pressure, and heart rate showed no significant changes in either of the two experimental conditions. However, the occlusion induced blood flow response was significantly enhanced by L-arginine infusion (mean (SEM) peak flow, 19.6 (1.5) v 28.9 (3.1) ml/min/dl calf tissue; p < 0.01), but not by placebo (peak flow, 19.1 (1.4) v 20.9 (1.8) ml/min/dl calf tissue; NS). Calf blood flow response after exercise was also higher after L-arginine infusion than after placebo (peak flow, 4.8 (0.4) v 6.0 (0.8) ml/min/dl calf tissue; p < 0.05). L-arginine infusion had no significant effect compared with placebo on exercise capacity indices such as peak oxygen uptake (17.1 (1.0) v 15.8 (1.1) ml/min/kg; NS), anaerobic threshold (10.5 (0.6) v 10.4 (0.7) ml/min/kg; NS), and exercise time (296 (23) v 283 (22) s; NS). CONCLUSIONS: Acute supplementation with the nitric oxide precursor L-arginine increased lower limb reactive hyperaemia but did not lead to any significant improvement in exercise capacity in patients with chronic heart failure.

Adult↗

PubMed1997

Age and Gender Related Trends in Body Composition, Lipids, and Exercise Capacity During Cardiac Rehabilitation.

Age (40s, 50s, 60s, and 70s) and gender (125 females; 456 males) related trends for peak exercise capacity VO2peak, body composition, and lipids were reviewed for 581 cardiac rehabilitation patients. Groups were equivalent with regard to diagnoses, medications, and risk factors. Peak exercise capacity decreased with increasing age but the percentage improvement attributable to cardiac rehabilitation was similar across each age group (mean of 28.0%). The 70s group had the lowest weights (73.4 kg), similar %fat (31.0%), and the lowest LBM (50.4 kg). They also had lower triglyceride values (191 mg/dL), but the greatest degree of improvement (-23.3%). The percentage improvement for body composition and lipids was similar for the 70s, 60s, and 50s while the 40s group showed no change in weight, %fat, or LBM. Women had lower peak exercise capacities than men but similar relative improvements (26.6% and 28.8%, respectively) as a result of cardiac rehabilitation. Men had greater body weights (85.5 vs. 73.5 kg) and LBM (59.9 vs. 46.9 kg) while women had greater %fat (35.4% vs. 29.3%). Women had a greater percentage weight loss (-1.2% vs. 0.5%) but men had a greater increase in LBM (0.7% vs. 0.4%). Females tended to have higher cholesterol (220 vs. 203 mg/dL) and lower triglycerides (196 vs. 223 mg/dL) but had greater relative improvements in both when compared to men (-4.8% vs. -1.6%; -12.9% vs. -8.2%, respectively). Cardiac rehabilitation has favorable outcomes with regard to peak exercise capacity, body composition, and lipids, across each age group regardless of gender. There is a need for greater emphasis on body composition improvement for females (particularly decreases in %fat and increases in LBM), and lipid reduction (particularly in the younger age groups).

Journal Article↗

PubMed1991

The prognostic value of exercise capacity: a review of the literature.

While there is still much debate in the literature regarding the specific MET levels at which there are differences in survival, the following points have become clear with the growing body of reports in the literature. Exercise capacity seems to be an independent predictor of mortality, and when it is combined with other clinical, exercise, or angiographic data, it becomes very powerful in this regard. This relates to both overall mortality and to that from cardiovascular disease. There is still a need for the establishment of mortality data related to MET levels adjusted for age and activity status. A low exercise capacity of less than 6 METs indicates a higher mortality group, probably regardless of the underlying extent of coronary disease or left ventricular function. Analysis of the CASS data has indicated that these patients benefit from coronary artery bypass surgery with respect to survival. An exercise capacity of greater than 10 METs designates an excellent survival group, again despite the extent of coronary artery disease or left ventricular function. If 10 METs truly exerts a "protective effect" that obviates any survival benefit from coronary artery bypass surgery, this has enormous implications for cost containment and medical care. It is nonetheless important to remember that this level of exercise capacity does not imply the absence of either coronary disease or triple-vessel coronary disease. Exercise capacity is related to more than just cardiovascular fitness and integrity. It is dependent upon a combination of other physiologic components as well, including pulmonary function, health status of other organ systems, nitrogen balance, nutritional status, medications, orthopedic limitations, and others.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular Diseases↗

PubMed2005

[Relation between left atrial dimension and exercise capacity in endomyocardial fibrosis].

OBJECTIVE: To assess whether exercise capacity is related to left atrial dimension (LAD) in patients with biventricular endomyocardial fibrosis. METHODS: This study comprised 38 patients in sinus rhythm, with a mean age of 37.5 +/- 11.5 years (range, 11 to 59 years), 25 of whom were women. They were divided into 2 groups according to the NYHA functional class on hospital admission as follows: group A (12 patients) and group B (26 patients). All patients underwent cardiopulmonary exercise testing to determine their maximum oxygen consumption (VO2 max), and their left atrial dimension was determined on echocardiography. RESULTS: The VO2max values for groups A and B were 21.8 +/- 4.8 mL.kg(-1).min(-1) and 13.7 +/- 3.5 mL.kg(-1).min(-1), respectively, and the left atrial dimensions were 3.7 +/- 0.7 cm and 4.4 +/- 0.7 cm for groups A and B, respectively. A significant and inverse correlation was found between VO2max and LAD in the groups studied. CONCLUSION: The increase in left atrial dimension is associated with impairment in exercise capacity in patients with endomyocardial fibrosis. Our findings support the use of left atrial dimension to estimate a more complex and difficult to assess index of functional capacity, such as VO2max.

Adolescent↗

PubMed1998

Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with chronic heart failure.

BACKGROUND: The purpose of this study was to determine the effects of systemic exercise training on endothelium-mediated arteriolar vasodilation of the lower limb and its relation to exercise capacity in chronic heart failure (CHF). Endothelial dysfunction is a key feature of CHF, contributing to increased peripheral vasoconstriction and impaired exercise capacity. Local handgrip exercise has previously been shown to enhance endothelium-dependent vasodilation in conduit and resistance vessels in CHF. METHODS AND RESULTS: Twenty patients were prospectively randomized to a training group (n=10, left ventricular ejection fraction [LVEF] 24+/-4%) or a control group (n=10, LVEF 23+/-3%). At baseline and after 6 months, peak flow velocity was measured in the left femoral artery using a Doppler wire; vessel diameter was determined by quantitative angiography. Peripheral blood flow was calculated from average peak velocity (APV) and arterial cross-sectional area. After exercise training, nitroglycerin-induced endothelium-independent vasodilation remained unaltered (271% versus 281%, P=NS). Peripheral blood flow improved significantly in response to 90 microg/min acetylcholine by 203% (from 152+/-79 to 461+/-104 mL/min, P<0.05 versus control group) and the inhibiting effect of L-NMMA increased by 174% (from -46+/-25 to -126+/-19 mL/min, P<0.05 versus control group). Peak oxygen uptake increased by 26% (P<0.01 versus control group). The increase in peak oxygen uptake was correlated with the endothelium-dependent change in peripheral blood flow (r=0.64, P<0. 005). CONCLUSIONS: Regular physical exercise improves both basal endothelial nitric oxide (NO) formation and agonist-mediated endothelium-dependent vasodilation of the skeletal muscle vasculature in patients with CHF. The correction of endothelium dysfunction is associated with a significant increase in exercise capacity.

Blood Flow Velocity↗

PubMed1996

Role of pulmonary vascular disorder in determining exercise capacity in patients with severe chronic obstructive pulmonary disease.

In patients with chronic obstructive pulmonary disease (COPD), the primary cardiovascular complication is the development of pulmonary hypertension, especially during exercise. The purpose of this study was to determine whether pulmonary vascular disorder plays an important role in determining exercise capacity in patients with severe COPD. Twenty-one male patients with severe COPD (mean FEV1 = 0.91 +/- 0.26 1) performed a progressive incremental exercise test, until symptom-limited maximum, to determine maximal exercise capacity, and then a constant-load exercise test for 5 min at a workload (20-60 W) corresponding to 60% of maximal workload during right heart catheterization to characterize the haemodynamic behavior of pulmonary circulation during exercise. The severity of the pulmonary vascular disorder was assessed using the slope of the mean pulmonary arterial pressure (PAP) - cardiac index (CI) relationship during constant-load exercise (P-Q slope). A significant inverse correlation was found between the maximal oxygen consumption (VO2max) and P-Q slope (r = -0.669), but not between VO2max and indices of expiratory airflow obstruction. In addition, the P-Q slope was inversely correlated with mixed venous oxygen tension (PvO2) at the end of constant-load exercise (r = -0.679) and with the change in oxygen delivery relative to oxygen consumption (delta DO2/delta VO2) during constant-load exercise (r = -0.671). These findings suggest that in patients with COPD, the functional impairment of the pulmonary vasculature is associated with disturbance in oxygen transport to the peripheral muscle during exercise, resulting in reduction of exercise capacity. We conclude that pulmonary vascular disorder may be an important factor in determining the exercise capacity of patients with severe COPD.

Aged↗

PubMed2007

Cardiopulmonary exercise capacity, muscle strength, and physical activity in children and adolescents with achondroplasia.

OBJECTIVE: To study in children with achondroplasia the response to exercise and muscle strength compared with healthy peers and to describe the relation between exercise capacity, anthropometric factors, and physical activity. STUDY DESIGN: Patients (7 boys and 10 girls; mean age, 11.8 +/- 3.3 years) with achondroplasia performed a maximal treadmill exercise test. Anthropometric variables and muscle strength were measured and compared with the general population. The level of everyday physical activity was measured by using a diary. Functional ability was measured by using the Activity Scale for Kids. RESULTS: The exercise capacity of the children with achondroplasia was significantly reduced compared with reference values. All anthropometrical measurements differed significantly from reference values. There was a decrease in muscle strength in almost all muscle groups. We found a reduced physical activity level and impairments in functional ability. CONCLUSIONS: Cardiopulmonary exercise capacity and muscle strength in children with achondroplasia was reduced compared with reference values. Children with achondroplasia have a unique response to exercise. Clinicians should take these characteristic differences into account when the exercise capacity of subjects with achondroplasia is being tested.

Achondroplasia↗

PubMed1992

Increased exercise capacity in hypoxemic patients after long-term oxygen therapy.

Low-flow continuous oxygen can lead to significant improvement in exercise capacity in selected patients with stable hypoxemic pulmonary disease. Although the mechanisms of improvement are incompletely understood, two tenable hypotheses are (1) the relief of hypoxic pulmonary vasoconstriction and (2) improved peripheral oxygen delivery. This prospective study was performed to examine these two hypotheses. Stable patients with hypoxemic lung disease performed symptom-limited ergometry with hemodynamic monitoring before and after greater than one month of long-term home oxygen therapy. There were 22 patients who increased exercise capacity by greater than 100 KPM/min and greater than 4 min duration and 11 patients who did not increase their exercise capacity greater than 2 min or in KPM/min. Neither the responders nor the nonresponders had significant changes in pulmonary pressures or resistances or effective arterial volume elastances at exercise after long-term O2 therapy. The responders had significant increases in oxygen delivery during exercise (148 +/- 33 ml/min vs 184 +/- 51 ml/min, p = 0.004), cardiac output (7.7 +/- 1.6 L/min vs 8.7 +/- 2.1 L/min, p = 0.003), and arterial oxygen content (18.6 +/- 2.6 ml/dl vs 20.2 +/- 2.8 ml/dl, p = 0.02). The nonresponders had no significant changes in these parameters during exercise. Increased exercise capacity in response to long-term O2 therapy is associated with increased O2 delivery not relief of hypoxic vasoconstriction (in terms of pressure or resistance or arterial elastance). Increased O2 delivery can accrue from both increased cardiac output and increased arterial O2 content. Increase in arterial O2 content is unique to O2 relative to all vasodilator drugs.

Exercise↗

PubMed1996

Relationship between exercise capacity and left ventricular function in aortic and mitral regurgitation.

The exercise capacity as assessed by treadmill exercise or functional class from clinical history cannot predict standard echocardiographic findings in patients with AR/MR, in terms of EF, LVDs, ESVI. Therefore, exercise capacity cannot be used to predict the timing for surgery in those patients. However, symptomatic patients with dilated LV usually have low LVEF such as in our group.

Adolescent↗

PubMed1992

Effect of erythropoietin treatment on physical exercise capacity and on renal function in predialytic uremic patients.

Anemia is already present in patients with moderate renal failure and is a major cause of the decline in exercise capacity seen in these patients. We examined the effects of erythropoietin (EPO) treatment in 12 predialytic uremic patients (EPO group: mean age 46 +/- 12 years; 6 men, 6 women) with a mean glomerular filtration rate (GFR) of 10 +/- 4 ml/min x 1.73 m2. These patients were compared to a control group of 8 patients (5 men, 3 women). The observation period was 3 months. The EPO group received 300 U/kg body weight i.v. once a week. The EPO group increased their total hemoglobin (THb) from 323 +/- 89 to 466 +/- 128 g (p less than 0.001) and their hemoglobin concentration from 86 +/- 8 to 117 +/- 11 milligrams (p less than 0.001). Their exercise capacity, measured by a standardized exercise test on a bicycle ergometer, increased from 128 +/- 45 to 147 +/- 57 W (p less than 0.01). The control group did not change their THb (349 +/- 124 and 357 +/- 131 g), hemoglobin (93 +/- 8 and 94 +/- 10 milligrams) or exercise capacity (98 +/- 49 and 101 +/- 50 W) during the observation period. There was a significant correlation between the increase in THb and the increase in exercise capacity in the EPO group (r = 0.81, p less than 0.005). The GFR was unchanged in both groups (EPO group: 10 +/- 4 and 10 +/- 6 ml/min x 1.73 m2; control group: 8 +/- 3 and 8 +/- 3 ml/min x 1.73 m2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1999

Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer.

BACKGROUND: Resection is the treatment of choice for lung cancer, but may cause impaired cardiopulmonary function with an adverse effect on quality of life. Few studies have considered the effects of thoracotomy alone on lung function, and whether the operation itself can impair subsequent exercise capacity. METHODS: Patients being considered for lung resection (n = 106) underwent full static and dynamic pulmonary function testing which was repeated 3-6 months after surgery (n = 53). RESULTS: Thoracotomy alone (n = 13) produced a reduction in forced expiratory volume in one second (FEV1; mean (SE) 2.10 (0.16) versus 1.87 (0.15) l; p<0.05). Wedge resection (n = 13) produced a non-significant reduction in total lung capacity (TLC) only. Lobectomy (n = 14) reduced forced vital capacity (FVC), TLC, and carbon monoxide transfer factor but exercise capacity was unchanged. Only pneumonectomy (n = 13) reduced exercise capacity by 28% (PVO2 23.9 (1.5) versus 17.2 (1.7) ml/min/kg; difference (95% CI) 6.72 (3.15 to 10.28); p<0.01) and three patients changed from a cardiac limitation to exercise before pneumonectomy to pulmonary limitation afterwards. CONCLUSIONS: Neither thoracotomy alone nor limited lung resection has a significant effect on exercise capacity. Only pneumonectomy is associated with impaired exercise performance, and then perhaps not as much as might be expected.

Exercise Test↗

PubMed2005

Left atrial index is a predictor of exercise capacity in patients with hypertrophic cardiomyopathy.

BACKGROUND: Left atrial (LA) enlargement is related to diastolic dysfunction and mitral regurgitation (MR), both of which are common in patients with hypertrophic cardiomyopathy (HCM). This study investigates the association between LA size and exercise capacity in patients with HCM. METHODS: All HCM patients who underwent a treadmill test with direct measurement of oxygen consumption (VO2) and a standard transthoracic echocardiography within 30 days in the years 2001-2003 were identified. Patients with significant comorbidities were excluded. Exercise capacity was defined as percentage of predicted peak VO2. Clinical and echocardiographic parameters were compared with those of a group of normal subjects. RESULTS: Compared with normal subjects, HCM patients had increased left atrial (LA) volume index (36 vs 21 mL/m2; P < .0001) and mitral E/e' ratio (14 vs 9; P < .0001); 27% of the patients had at least moderate MR. LA volume index demonstrated borderline correlation with exercise capacity (r = -.20; P = .06) but was an independent predictor of exercise capacity in a multivariate linear analysis, together with body mass index, heart rate at rest, and left ventricular end-systolic diameter. Including the parameters E/e' ratio or moderate or severe MR did not add incremental value to the model. CONCLUSION: LA volume index, reflecting the combined influences of MR and diastolic dysfunction, was independently associated with objective measures of exercise capacity in patients with isolated HCM.

Cardiomyopathy, Hypertrophic↗

PubMed1994

Exercise capacity in patients with left ventricular dysfunction following acute myocardial infarction: relation to systolic and diastolic function and intervention with captopril.

Patients with acute or chronic heart disease may have limited exercise capacity if they have reduced left ventricular function. Indexes of reduced left ventricular function during exercise are a predictor of subsequent survival although left ventricular ejection fraction is a poor predictor of physical endurance. We evaluated the effect of captopril on physical endurance in 48 males with left ventricular dysfunction following myocardial infarction. On the 7th day following myocardial infarction patients were randomized to either captopril 50 mg daily or corresponding placebo. Patients were followed up by means of serial echocardiography and exercise stress testing for a period of 180 days. Exercise capacity was significantly improved in the captopril group. Changes in exercise capacity were significantly correlated to changes in left ventricular (LV) volumes and compliance. The beneficial effect of captopril on exercise capacity was probably mediated via improvement in LV performance and compliance.

Captopril↗

PubMed2005

Right ventricular myocardial performance index and exercise capacity in athletes.

Right ventricular function is important for exercise capacity in athletes. The aim of this study was to investigate the effects of habitual exercise training on right ventricular global function. Fifty-two male athletes (25 runners, 27 wrestlers) and 43 age-matched sedentary male subjects were studied. All subjects in the study underwent an echocardiography examination and cardiopulmonary exercise test. Maximal oxygen consumption, right ventricular cavity diameters, and diastolic parameters were higher in the athletes than in controls. However, the right ventricular myocardial performance index was lower in athletes compared with controls. Therefore, the right ventricular myocardial performance index showed a negative correlation with maximal oxygen consumption (r=-0.61; P<0.001). The right ventricular myocardial performance index may reflect changes in right ventricular function and exercise capacity in athletes.

Adaptation, Physiological↗