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Glucose ingestion before and during exercise does not enhance performance of daily repeated endurance exercise.

The effect of glucose (Glc) ingestion before and during daily, repeated, prolonged exercise on metabolism and performance was tested. Seven young, healthy males performed cycling exercise in two series, with 1 month interval. Each exercise series consisted of 1 h/day on 3 successive days. On the 3rd day, exercise was continued until exhaustion. The intensity was 73.4 (7.7)% [mean (SD)] of maximal oxygen uptake (VO2max). Glucose (Glc) or placebo (P) drink was ingested 15 min before the start, and at 15 and 45 min of each daily exercise. The total amount of Glc ingested was 43.1 (4.2) g. During exercise, blood Glc concentrations were significantly higher (P < 0.05) when Glc was ingested than when P was ingested [Glc 5.14 (0.32) and P 4.12 (4.17) mmol.l-1 at exhaustion]. However, Glc ingestion did not improve performance time to exhaustion [Glc 92.05 (29.55) and P 98.07 (27.33) min]. Free fatty acid concentrations were significantly lower when Glc was ingested than when P was ingested [Glc 0.63 (0.21) and P 1.39 (0.46) mmol.l-1 at exhaustion]. There were no significant differences in exercise heart rate, VO2, respiratory exchange ratio, blood lactate concentrations or rating of perceived exertion between the conditions nor were there any significant differences in these parameters on different days of exercise. It seems that ingestion of small amounts of Glc does not increase the metabolism of carbohydrate or improve the performance of intensive endurance exercise of poorly trained subjects, even when the exercise is repeated daily.

Adult↗

The role of exercising muscle length in the protective adaptation to a single bout of eccentric exercise.

The purpose of this study was to determine if the protective adaptation to a single bout of eccentric exercise (repeated bout effect) is dependent on the muscle length at which the eccentric contractions are performed. Ten subjects (six men, four women) performed two bouts of 120 isokinetic eccentric contractions separated by 2 weeks (target intensity was 90% of maximum isometric strength at 70 degrees). In the initial bout one limb exercised from 30 degrees to 70 degrees of knee flexion (short initial bout; SIB) and the contralateral limb exercised from 70 degrees to 110 degrees (long initial bout; LIB). For the repeated bout 2 weeks later, the limb that initially exercised at a short length now exercised at a long length (long repeated bout; LRB) and the limb that initially exercised at a long length now exercised at a short length (short repeated bout; SRB). Isometric strength and pain (scale 0-10) were assessed immediately post exercise and on the next 3 days. Strength loss and pain were greater following LIB versus SIB (strength loss P < 0.01; pain P < 0.001) and following LRB versus SRB (strength loss P < 0.01; pain P < 0.001). Strength loss and pain were not different between LIB and LRB. Pain was significantly greater following SIB compared with SRB (P < 0.05). Strength loss was not different between SIB and SRB. These results confirm that the symptoms of muscle damage are highly dependent on exercising muscle length and also demonstrate that the repeated bout effect is dependent on muscle length. Performing an initial bout of eccentric exercise at a shortened muscle length did not protect against strength loss and pain following a repeated bout at a longer muscle length. Data are given as mean (SE) unless otherwise stated.

Adaptation, Physiological↗

Exercise-induced oxyhemoglobin desaturation and pulmonary diffusing capacity during high-intensity exercise.

The purpose of this investigation was to examine if exercise-induced arterial oxyhemoglobin desaturation selectively observed in highly trained endurance athletes could be related to differences in the pulmonary diffusing capacity (DL) measured during exercise. The DL of 24 male endurance athletes was measured using a 3-s breath-hold carbon monoxide procedure (to give DLCO) at rest as well as during cycling at 60% and 90% of these previously determined VO2max. Oxyhemoglobin saturation (SaO2%) was monitored throughout both exercise protocols using an Ohmeda Biox II oximeter. Exercise-induced oxyhemoglobin desaturation (DS) (SaO2% < 91% at VO2max) was observed in 13 subjects [88.2 (0.6)%] but not in the other 11 nondesaturation subjects [NDS: 92.9 (0.4)%] (P < or = 0.05), although VO2max was not significantly different between the groups [DS: 4.34 (0.65) l/min vs NDS: 4.1 (0.49) l/min]. At rest, no differences in either DLCO [ml CO.mmHg-1.min-1: 41.7 (1.7) (DS) vs 41.1 (1.8) (NDS)], DLCO/VA [8.2 (0.4) (DS) vs 7.3 (0.9) (NDS)], MVV [l/min: 196.0 (10.4) (DS) vs 182.0 (9.9) (NDS)] or FEV1/FVC [86.3 (2.2) (DS) vs 82.9 (4.7) (NDS)] were found between groups (P > or = 0.05). However, VE/VO2 at VO2max was lower in the DS group [33.0 (1.1)] compared to the NDS group [36.8 (1.5)] (P < or = 0.05). Exercise DLCO (ml CO.mmHg-1.min-1) was not different between groups at either 60% VO2max [DS: 55.1 (1.4) vs NDS: 57.2 (2.1)] or at 90% VO2max [DS: 61.0 (1.8) vs NDS: 61.4 (2.9)]. A significant relationship (r = 0.698) was calculated to occur between SaO2% and VE/VO2 during maximal exercise. The present findings indicate that the exercise-induced oxyhemoglobin desaturation seen during submaximal and near-maximal exercise is not related to differences in DL, although during maximal exercise SaO2 may be limited by a relatively lower exercise ventilation.

Adolescent↗

Usefulness of QT dispersion immediately after exercise as an indicator of coronary stenosis independent of gender or exercise-induced ST-segment depression.

Several recent studies suggest that QT dispersion on a standard 12-lead electrocardiogram is a clinically useful indicator of significant coronary stenosis. In this study, we compared the diagnostic accuracy of QT dispersion immediately after exercise as an indicator of coronary stenosis in men and women, and in the presence or absence of exercise-induced significant ST-segment depression. The subjects were 273 consecutive patients (mean age 56 +/- 9 years; 190 men and 83 women) without a history of myocardial infarction who underwent treadmill exercise electrocardiography and coronary angiography for evaluation of angina. Of these, 146 patients had no significant coronary stenosis, 61 had single-vessel disease, 56 had multivessel disease, and 10 had left main coronary artery disease. QT dispersion immediately after exercise was significantly greater in patients with significant coronary stenosis than in those without (64 +/- 14 vs 39 +/- 14 ms, p <0.01). QT dispersion immediately after exercise was significantly more sensitive in men (sensitivity 75%; specificity 85%) and significantly more specific in women (sensitivity 77%, specificity 88%) than exercise-induced significant ST-segment depression (men: sensitivity 62%, specificity 74%; women: sensitivity 81%, specificity 68%) as an indicator of significant coronary stenosis. The addition of factors such as gender and the presence or absence of exercise-induced significant ST-segment depression did not significantly alter the sensitivity and specificity of QT dispersion immediately after exercise for detecting significant coronary stenosis (patients with significant ST-segment depression: sensitivity 77%, specificity 88%; patients without significant ST-segment depression: sensitivity 72%, specificity 86%). In conclusion, QT dispersion immediately after exercise is a clinically useful indicator of significant coronary stenosis independent of gender or the presence or absence of exercise-induced significant ST-segment depression.

Angina Pectoris↗

Accurate detection of coronary artery disease by integrated analysis of the ST-segment depression/heart rate patterns during the exercise and recovery phases of the exercise electrocardiography test.

In this comparative cross-sectional study, we evaluated whether a novel computerized diagnostic variable, ST-segment depression/heart rate ST/HR analysis during both the exercise and postexercise recovery phases of the exercise electrocardiography (ECG) test, can detect coronary artery disease more accurately than methods using either exercise or recovery phase alone. The study population comprised 347 clinical patients referred for a routine bicycle exercise ECG test at Tampere University Hospital, Finland. Of these, 127 had angiographically proven coronary artery disease, whereas 13 had no coronary artery disease according to angiography, 18 had no perfusion defect according to technetium-99m sestamibi single-photon emission computed tomography, and 189 were clinically normal with respect to cardiac diseases. For each patient, the maximum values of the ST/HR hysteresis, ST/HR index, end-exercise ST depression, and recovery ST depression were determined from the Mason-Likar modification of the standard 12-lead exercise electrocardiogram [aVL, aVR, and V1 excluded]. The diagnostic performance of these continuous diagnostic variables was compared by means of receiver-operating characteristic analysis. The area under the receiver-operating characteristic curve of the ST/HR hysteresis was 89%, which was significantly larger than that of the end-exercise ST depression (76%, p < or = 0.0001), recovery ST depression (84%, p = 0.0063), or ST/HR index (83%, p = 0.0023), indicating superior diagnostic performance of the ST/HR hysteresis independent of the partition value selection. In conclusion, computerized analysis of the HR-adjusted ST depression pattern during the exercise phase, integrated with the HR-adjusted ST depression pattern during the recovery phase after exercise, can significantly improve the diagnostic performance and clinical utility of the exercise ECG test for the detection of coronary artery disease.

Adult↗

Hemodynamic, angiographic and scintigraphic correlates of positive exercise electrocardiograms: emphasis on strongly positive exercise electrocardiograms.

The results of treadmill exercise electrocardiograms were analyzed in 179 patients with coronary artery disease (greater than or equal to 50% diameter narrowing of one or more vessels). Exercise thallium-201 images were available in 141 of these patients. The exercise electrocardiograms were strongly positive in 51 patients, mildly positive (1 to 1.9 mm ST depression) in 28 patients, falsely negative in 23 patients and uninterpretable in 77 patients. The degree of exercise-induced ST depression did not correlate with left ventricular function, extent of coronary artery disease, exercise heart rates and rate-pressure product and extent of exercise-induced thallium-201 perfusion abnormality. However, the presence of a strongly positive exercise electrocardiogram only at heart rates of 140 beats/min or more or stage III or higher of the Bruce protocol was predictive of less extensive coronary disease and perfusion abnormalities. Thus, the magnitude of ST depression as such during exercise is not predictive of the extent of coronary disease, even in patients with 3 mm or greater ST depression. However, a strongly positive exercise electrocardiogram in the first two stages of the Bruce protocol or at a heart rate of less than 140 beats/min was related to the extent of coronary artery disease and impaired myocardial perfusion, and identified patients with more extensive coronary artery disease and jeopardized myocardium. Therefore, caution should be used in interpreting prognostic data on the basis of the degree of exercise-induced ST depression alone.

Adult↗

Exercise echocardiography versus exercise electrocardiography in the diagnosis of coronary artery disease in hypertension.

In hypertension, coronary artery disease (CAD) can be overestimated by stress electrocardiography (ECG) and scintigraphy due to frequent false-positive results. Exercise tests are also limited by an excessive blood pressure increase, and pharmacologic pressure normalization decreases the accuracy of the test. The aim of this study was to assess the accuracy of exercise echocardiography as an alternative test for CAD detection in hypertension, both before and after adequate blood pressure control. We studied 59 hypertensive and 59 normotensive patients undergoing coronary angiography for chest pain. Upright bicycle exercise ECG and echocardiographic tests were performed in each group in the absence of therapy; in hypertensives, the tests were repeated a day apart after blood pressure normalization with sublingual nifedipine. Significant CAD (lumen narrowing >50%) was detected in 22 hypertensive and 41 normotensive patients. In the two groups, sensitivity, specificity, and diagnostic accuracy of exercise echocardiography performed before treatment were not statistically different (95%, 94%, 94% in hypertensives and 82%, 77%, 83% in normotensives, respectively), but were significantly higher than for the exercise ECG test (68%, 70%, and 69%, respectively). After blood pressure lowering, exercise echocardiography sensitivity slightly decreased (91%), whereas specificity (100%) and diagnostic accuracy (96%) did not vary; on the contrary, exercise ECG sensitivity decreased to 45%. Therefore, according to our data, exercise echocardiography can be an accurate test and more reliable than exercise ECG to detect CAD in normotensives as well as in hypertensives. Normalization of blood pressure with nifedipine does not affect its accuracy, but markedly reduces the sensitivity of exercise ECG.

Aged↗

Exercise-induced neutrophil activation in claudicants: a physiological or pathological response to exhaustive exercise?

OBJECTIVES: To assess the effect of exhaustive exercise on neutrophil activation and degranulation in claudicants and controls. We investigated the hypothesis that neutrophil activation and degranulation are normal responses to exhaustive exercise in healthy patients. DESIGN: This was a controlled experimental two-group study. MATERIALS: Exercise was performed using a fixed workload treadmill test. Neutrophil activation was assessed by flow cytometry of whole blood labelled with anti-CD11b mouse IgG, and neutrophil degranulation in terms of plasma elastase measured by enzyme-linked immunosorbent assay. METHODS: Twenty-eight claudicants with stage 1 chronic leg ischaemia, and 22 healthy controls were recruited. Blood and urine samples were collected before and after treadmill exercise. Claudicants exercised to their maximum walking distance, and controls at a higher "fatigue" workload for a maximum of 20 min. RESULTS: Exercise produced a brief but significant neutrophilia in both groups. Neutrophil CD11b expression increased significantly after exercise only in the claudicants, and was associated with a significant rise in plasma neutrophil elastase. These indices remained unchanged in the control group at all time points despite exercise at a fatigue level. CONCLUSION: The inflammatory response associated with exercise in claudicants is not simply a physiological response to exhaustive exercise.

Aged↗

Time course for changes in aerobic capacity and body composition in overweight men and women in response to long-term exercise: the Midwest Exercise Trial (MET).

OBJECTIVE: To determine the time course for changes in aerobic capacity, body weight (BW), and composition in overweight adults in response to a supervised exercise trial with a targeted energy expenditure of 2000 kcal week(-1). DESIGN: The Midwest Exercise Trial (MET) was a randomized, controlled, 16-month verified, supervised exercise trial. Aerobic exercise progressed to 45 min day(-1), 5 days week(-1) over 6-months and was then maintained for 10 months. Controls maintained their normal physical activity and all participants maintained ad libitum diets. SUBJECTS: A total of 131 participants were randomized to exercise or control groups and 74 completed the intervention and all laboratory testing. MEASUREMENTS: At baseline and months 4, 9, 12, and 16, aerobic capacity (VO(2max) ) was measured by indirect calorimetry, BW by digital scale, and fat weight and fat-free weight by hydrostatic weighing. RESULTS: Aerobic capacity (ml kg(-1) min(-1)) increased (P<0.05) from baseline (39.2+/-5.2, mean+/-s.d.) to 9 months (48.8+/-4.3) in exercising men as well as women (32.8+/-4.2-39.6+/-5.5) with no significant changes occurring at 12 or 16 months. From baseline to 9 months BW (94.0+/-12.6-88.7+/-9.7 kg) and fat weight (26.8+/-6.8-21.8+/-4.5 kg) significantly decreased in exercising men with no changes occurring at 12 or 16 months. There were no changes in fat-free weight across the 16 months for exercising men or for BW or composition in exercising women. Further, there were no significant changes for the control men for aerobic capacity, BW, or body composition across 16 months. Women in the control group showed significant increases in weight of 2.9+/-5.5 kg and fat weight of 2.1+/-4.8 kg at 16 months only. CONCLUSIONS: We recommend that investigations that use exercise without diet as the stimulus for weight loss have at least a 9-month duration to provide sufficient time for the full effects to be realized, should such effects be present.

Adipose Tissue↗

Long-term effects of exercise on blood pressure and lipids in healthy women aged 40-65 years: The Sedentary Women Exercise Adherence Trial (SWEAT).

OBJECTIVES: To evaluate the long-term effects of regular moderate or vigorous intensity exercise on blood pressure and blood lipids in previously sedentary older women. DESIGN: Subjects were randomly assigned to either a supervised centre-based (CB) or a minimally supervised home-based (HB) exercise program, initially for 6 months. Within each program, subjects were further randomized to exercise either at moderate (40-55% heart rate reserve, HRres) or vigorous intensity (65-80% HRres). After 6 months, all groups continued a HB moderate or vigorous exercise program for another 12 months. METHODS: Healthy, sedentary women (aged 40-65 years) (n = 126) were recruited from the community. Subjects exercised three times per week for 30 min. They were evaluated at baseline, 6, 12 and 18 months. RESULTS: There was a significant fall of 2.81 mmHg in systolic blood pressure (P = 0.049) and 2.70 mmHg in diastolic blood pressure (P = 0.004) after correction for age and baseline values with moderate exercise, but not with vigorous-intensity exercise. When this analysis was repeated with the change in body mass included, the results were unchanged. After correction for potential confounding factors, there was a significant fall in total cholesterol and low density lipoprotein cholesterol with vigorous but not moderate exercise at 6 months (P < 0.05) but not at 18 months. CONCLUSIONS: In this largely normotensive population of older women, a moderate, but not vigorous exercise program, achieved sustained falls in resting systolic and diastolic blood pressure over 18 months. The study demonstrates that, in older women, moderate intensity exercise is well accepted, sustainable long-term and has the health benefit of reduced blood pressure.

Adult↗

Relationships between exercise self-definitions and exercise participation among urban women in primary care.

Exercising prevents the development of coronary artery disease and reduces the incidence of cardiovascular risk factors; however, the mechanisms that underlie participation in an exercise program are not well understood. On the basis of theories of the self, we hypothesized that exercise self-definitions would be significantly related to exercise participation and that such definitions would increase over time. The study sample consisted of 192 middle-aged to older women who were leading a mostly sedentary life and the majority had at least one cardiovascular risk factor. Exercise participation was defined as the number of exercise sessions completed at 8 and 24 weeks. We found an interesting pattern of significant relationships between exercise definitions and exercise participation. Six-month scores were significantly higher than baseline scores, suggesting that exercise self-definitions strengthened over time. If this result is found to be supported in future studies, nurses may want to consider assessing self-definitions when helping patients initiate and maintain an exercise program.

Black or African American↗

Special feature for the Olympics: effects of exercise on the immune system: exercise-induced modulation of macrophage function.

Macrophages are important effector cells involved in phagocytosis, microbial killing and antitumour activity. Macrophages also display accessory cell function, in that they can present antigen to foster the development of T lymphocyte-mediated immunity. Recent work, including studies from this group, has demonstrated that acute and chronic exercise can affect many facets of macrophage biology. Manifestation of these effects depends on exercise intensity and duration, the function measured, the timing of measurement in relation to exercise and the concentration of the macrophage-activating stimulus. Exercise has potent stimulatory effects on phagocytosis, antitumour activity, reactive oxygen and nitrogen metabolism, and chemotaxis. Indeed, it has been shown that exercise training can increase macrophage antitumour activity in mice of different ages. However, not all functions are enhanced by exercise. Exercise-induced reductions in macrophage MHC II expression and antigen-presentation capacity have been documented. These findings bring up the possibility that exercise, and perhaps other stressors, activate macrophages for effector functions while downregulating accessory cell functions. To a large extent, the mechanisms responsible for the exercise-induced changes in macrophage function remain unknown, but may depend on exercise-induced changes in neuroendocrine factors. Future studies need to explore the effects in a mechanistic way and provide documentation as to their physiological significance.

Animals↗

Damage to human muscle from eccentric exercise after training with concentric exercise.

1. It is known that a period of eccentric exercise provides protection against damage to muscle from subsequent eccentric exercise. Here we ask, does concentric exercise do the opposite, make muscle more prone to damage? 2. The triceps surae muscle group of one leg in each of eight human subjects was subjected to 30 min of concentric exercise per day, for 5 days. At the end of the training period there was a small but significant increase in passive torque in the exercised muscle (P < 0.05), with no changes in the untrained muscle. 3. After a single period of eccentric exercise, angle-torque curves for muscles of both legs shifted in the direction of longer muscle lengths, suggestive of an increase in series compliance. The shift in the concentrically trained muscle was significantly greater over the first 48 h post-exercise (P < 0. 05). 4. The volume of the trained leg increased significantly more than the untrained leg for five subjects over 72 h post-exercise (P < 0.05). Peak torque fell, passive stiffness increased and both muscles became sore, but with no significant differences between the two legs. 5. It is concluded that a period of concentric exercise increases the susceptibility of muscle to changes associated with the damage from eccentric exercise.

Adult↗

Effect of pre-exercise carbohydrate ingestion on plasma cytokine, stress hormone, and neutrophil degranulation responses to continuous, high-intensity exercise.

The purpose of the present study was to examine the effect of pre-exercise carbohydrate (CHO) ingestion on circulating leukocyte numbers, plasma interleukin (IL)-6, plasma cortisol, and lipopolysaccharide (LPS)-stimulated neutrophil degranulation responses in moderately trained male cyclists who completed approximately 1-h of high-intensity cycling. The influence of the timing of pre-exercise CHO ingestion was investigated in 8 subjects who consumed 75 g CHO as a glucose solution at either 15 (-15 trial), or 75 (-75 trial) min before the onset of exercise. The influence of the amount of pre-exercise CHO ingestion was investigated in a further 10 subjects who consumed either 25 g or 200 g CHO as a glucose solution or a placebo 45 min before the onset of exercise. At the onset of exercise in the timing experiment, the plasma glucose concentration was significantly (p < .05) lower on the -75 trial compared with pre-drink values, and the plasma cortisol concentration and neutrophil to lymphocyte (N/L) ratio were significantly (p < .05) elevated in the post-exercise period. In the -15 trial, plasma glucose level was well maintained, and the plasma cortisol concentration and N/L ratio were not significantly elevated above resting levels. However, LPS-stimulated neutrophil degranulation was similar in the -15 and -75 trials. The amount of CHO ingested had no effect on the magnitude of the rise in the N/L ratio compared with placebo when consumed 45 min pre-exercise. Finally, although an exercise-induced increase in the plasma IL-6 concentration was observed, this effect was independent of pre-exercise CHO ingestion.

Adult↗

Exercise radionuclide ventriculography in children: normal values for exercise variables and right and left ventricular function.

Thirty two children (aged 5-19 years) with no clinical evidence of significant cardiovascular disease undertook continuous staged supine exercise on a bicycle ergometer. Multigated radionuclide ventriculography was performed at rest and during each exercise stage. Exercise duration and total workload both increased with age. Aerobic work correlated better with age than did total work. In most children the ejection fraction for both ventricles increased by at least 5% with exercise. Right ventricular ejection fraction did not decrease with exercise in any subject but left ventricular ejection fraction decreased by 2% and 9% in two. The response of end diastolic volume to exercise was variable, but there was a consistent decrease in mean (SD) end systolic volume of the left (29(22)%) and right (30(19)%) ventricles. Cardiac index (mean (SD)) increased by 234(65)% with exercise. The left ventricular:right ventricular end diastolic volume ratio (mean (SD)) at rest was 1.26(0.26). It is concluded that exercise radionuclide ventriculography is an excellent technique for a combined assessment of exercise capacity and an evaluation of ventricular size and performance in children. These values for supine bicycle exercise in children without significant cardiovascular disease will be useful for future comparisons with other groups.

Adolescent↗

Circulating adrenaline and noradrenaline concentrations during exercise in patients with exercise induced asthma and normal subjects.

A failure of the usual increase in plasma adrenaline and noradrenaline concentrations during submaximal exercise has been suggested as a contributory cause of exercise induced asthma. Six normal subjects and six asthmatic patients underwent a standard graded maximal exercise test. Measurements of oxygen consumption, minute ventilation, exercise time, blood lactate concentration, and heart rate indicated that the two groups achieved similarly high work loads during exercise. Mean FEV1 fell by 20% in asthmatic patients after exercise. Basal plasma adrenaline concentrations (nmol/l) increased in normal subjects from 0.05 to 2.7 and in asthmatic patients from 0.12 to 1.6 at peak exercise. Noradrenaline concentrations (nmol/l) increased in normal subjects from 2.0 to 14.3 and in asthmatic patients from 1.9 to 13.7 at peak exercise. The increases in adrenaline and noradrenaline in the asthmatic patients did not differ significantly from the increases in normal subjects. Thus a reduced sympathoadrenal response to exercise seems unlikely to be an important mechanism in the pathogenesis of exercise induced asthma.

Adolescent↗

Acute effects of exercise timing and breakfast meal glycemic index on exercise-induced fat oxidation.

Fat balance is an important determinant of energy balance. Exercise after an overnight fast can significantly increase fat oxidation; however, little information pertaining to the effects of exercise and meal glycemic index on fat oxidation under these conditions is available. The objective of this investigation was to study the acute effects of exercise timing and meal glycemic index (GI) on whole-body fat oxidation. Eight apparently healthy young men completed 4 randomly ordered trials during which measurements were made at rest, during exercise, and for 2 h post-exercise and (or) post-prandial. After an overnight fast, subjects were required to perform 400 kcal (1 kcal = 4.184 kJ) of treadmill exercise (at FATmax) either before consuming a 400 kcal low-GI (Ex-LG) or high-GI (Ex-HG) oatmeal breakfast, or after consuming the low-GI (LG-Ex) or high-GI (HG-Ex) meal. The amount of fat oxidized during exercise was significantly greater during Ex-LG and Ex-HG (17.2 +/- 4.0 and 17.5 +/- 4.7 g, respectively) than during LG-Ex and HG-Ex (10.9 +/- 3.7 and 11.7 +/- 3.5 g, respectively) (p < 0.001), as was the amount of fat oxidized during the entire trial (Ex-LG: 23.4 +/- 4.7 g; Ex-HG: 23.4 +/- 6.5 g; LG-Ex: 18.4 +/- 4.7 g; HG-Ex: 19.6 +/- 4.9 g) (p < 0.05), even though energy expenditure was not different across experimental conditions. No significant effect of meal GI on the amount of fat oxidized was noted. Total fat oxidized during exercise, and for 2 h after exercise, was greatest when morning exercise was performed in the fasted state, independently of meal GI.

Adult↗

The false positive exercise test: usefulness of sublingual nitroglycerin exercise test and cardiac scintigraphy for differentiating from patients with coronary artery disease.

Exercise tests with sublingual nitroglycerin were performed on 7 patients with true positive and 8 patients with false positive exercise test results. Four of 7 patients with true positive changes and 8 patients with false positive changes underwent exercise cardiac scintigraphy. Scintigrams showed perfusion defects in 4 patients with true positive outcomes, and no perfusion defect in 8 patients with false positive outcomes. Exercise tests with sublingual nitroglycerin were performed with the same load as that without nitroglycerin. In all 7 patients with true positive exercise test results, ST segment depression observed in the control exercise test was not observed in the nitroglycerin exercise test. In the false positive patients, ST segment depression observed in the control exercise test remained unchanged in 7 of 8 patients receiving nitroglycerin. Exercise tests with sublingual nitroglycerin as well as exercise cardiac scintigraphy are valuable tods in differentiating false positive from true positive patients. Furthermore, these data suggest that ST segment depression in the false positive patients may not be related to myocardial ischemia.

Administration, Oral↗