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PubMed1983

Effect of attitudes and beliefs on exercise tolerance in chronic bronchitis.

In 50 patients with chronic bronchitis the relation was assessed between exercise tolerance and pulmonary function and psychological factors, including subjective perception of exertion, mood, general psychiatric disturbance, and the attitudes and beliefs held by patients concerning themselves, their illness, and its treatment. Ventilatory capacity was significantly correlated with but a poor predictor of exercise tolerance. Subjective perception of exertion was most closely correlated with exercise tolerance. The distance walked in a 12-minute exercise test was significantly correlated with measurements of mood and with several attitudes and beliefs. Attitudes and beliefs greatly outweighed measurements of mood and ventilatory capacity as components in a multiple regression predicting distance walked in 12 minutes. This method of psychological assessment emphasises the importance of attitudes and beliefs in respiratory disability and may have useful applications in rehabilitation in other chronic diseases.

Adult↗
PubMedDate not supplied

Cardiorespiratory exercise tolerance in asymptomatic children with Ebstein's anomaly.

The aim of the study was to evaluate cardiorespiratory exercise tolerance in asymptomatic children with Ebstein's anomaly. Eleven children with a mean age of 9.6 years were prospectively studied by spirometry, cardiopulmonary exercise testing (bicycle ergometer n = 8, treadmill test n = 3), and contrast echocardiography. A right-to-left atrial shunt was detected by contrast echocardiography in 7 children (group 1), whereas no shunt was found in 4 (group 2). VO2 max was decreased [84.5 (SD = 16.8)] and was strongly correlated to oxygen saturation in group 1 (p < 0.0001). Oxygen saturation at peak uptake was significantly decreased compared to baseline [97.4 (SD = 2.0) vs 90% (SD = 9.5%), p = 0.02] and was significantly lower in group 1 than in group 2 [85.7 (2.2) vs 98.2% (SD = 1.2%), p = 0. 03]. Oxygen desaturation was related to a right-to-left atrial shunt (p = 0.01). Decreased VO2 max was also correlated to the small size of the left ventricle (p = 0.05). We concluded that decreased exercise tolerance in children with asymptomatic Ebstein's anomaly is related to a right-to-left atrial shunt and to a small left ventricle. In case of poor exercise tolerance, a contrast echocardiography should be performed to detect an atrial septal defect.

Adolescent↗
PubMed1979

Persistence of improved exercise tolerance and degree of revascularization after coronary bypass surgery. A prospective randomized study.

Exercise tolerance was repeatedly determined over a 2-year period in a series of 100 patients with coronary heart disease randomly allocated for medical therapy and coronary bypass surgery. The surgical group had a consistently better exercise tolerance than the medical group during the whole follow-up. Completeness of the revascularization, assessed by repeated graft and native vessel angiography, resulted in a marked improvement whereas incompletely revascularized patients exhibited only a marginal improvement which, nevertheless, to some degree exceeded the result of medical management alone. It is concluded that coronary bypass surgery and medical therapy, when indicated, result in markedly better exercise tolerance than medical management alone. This improvement persists up two years after the operation and is largely dependent on the completeness of the revascularization.

Adrenergic beta-Antagonists↗
PubMed1994

Maximal exercise tolerance in chronic congestive heart failure. Relationship to resting left ventricular function.

The relationship between maximal exercise tolerance and resting radionuclide indexes of left ventricular systolic and diastolic function were evaluated in 20 ischemic and 44 idiopathic cardiomyopathy patients with New York Heart Association class 2-4 chronic congestive heart failure. Left ventricular ejection fraction, peak systolic ejection rate, peak diastolic filling rate, time to peak filling from end-systolic volume, and fractional filling in early diastole were measured from the radionuclide ventriculogram. All patients underwent symptom-limited exercise testing with on-line measurement of oxygen consumption. In the ischemic group, all of the radionuclide indexes correlated poorly with maximal exercise oxygen consumption (VO2max) except the peak systolic ejection rate which correlated modestly (r = 0.58, p < 0.05). Peak systolic ejection rate was significantly lower (p < 0.01) as were the peak diastolic filling rate and fractional filling in the first third of diastole (p < 0.05) in ischemic patients with marked exercise intolerance (VO2max < or = 14 mL/kg/min) compared with those with preserved exercise tolerance (VO2max > 14 mL/kg/min). In the idiopathic group, none of the radionuclide indexes correlated well with VO2max; and all indexes were similar in patients with and without marked exercise intolerance. These data suggest that (1) resting left ventricular ejection fraction poorly predicts maximal exercise capacity in both ischemic and idiopathic cardiomyopathy and (2) resting peak systolic ejection rate, peak diastolic filling rate, and fractional filling in early diastole may predict exercise tolerance in ischemic but not idiopathic cardiomyopathy.

Adult↗
PubMed2004

Effect of physical exercise training on health-related quality of life and exercise tolerance in patients with left ventricular dysfunction.

OBJECTIVES: The improvement of exercise tolerance and quality of life (QOL) are essential in the treatment of patients with heart failure. The influence of physical exercise training on QOL was investigated in patients with left ventricular dysfunction. METHODS: Health-related QOL was evaluated using the Medical Outcomes Study Short-Form 36 Health Status Survey (SF-36) before and 3 months after individualized exercise training determined by cardiopulmonary exercise testing in 65 patients. The 44 patients who could carry out more than two-thirds of the prescribed exercise were classified into two groups: Group A (11 patients)with left ventricular ejection fraction < 40% and Group B (33 patients) with left ventricular ejection fraction > or = 40%. The remaining 21 patients served as the control group. RESULTS: The mean value of SF-36 improved significantly with exercise training only in Group A (50.8 +/- 25.3 to 62.1 +/- 22.2, p < 0.05). Group A also had an increase in peak Vo2 (18.9 +/- 3.5 to 21.4 +/- 3.6 ml/min/kg, p < 0.005) and a decrease in brain natriuretic peptide. The 24 patients (9 in Group A, 15 in Group B) with improved SF-36 values after the exercise training showed a negative correlation between the change of the mental component summary and the peak Vo2 (r = - 0.606, p < 0.05). CONCLUSIONS: Exercise training improves both the QOL, especially the mental component, and the exercise tolerance in patients with left ventricular dysfunction.

Adult↗
PubMed1994

Effects of breathing a normoxic helium mixture on exercise tolerance of patients with cystic fibrosis.

Breathing helium-oxygen (He-O2) mixtures of 20.9% O2/79.1% He has been shown to increase exercise ventilation and peak oxygen uptake in healthy subjects. The improved exercise performance is thought to be due to the reduced density of He-O2 compared to air and the resulting increases in ventilation. Patients with cystic fibrosis (CF) frequently have abnormal pulmonary function test results, low exercise ventilations and diminished exercise tolerance. This led to the hypothesis that in CF the exercise tolerance of patients might improve when breathing He-O2. To test this hypothesis, 11 patients with CF or mild to severe airway obstruction performed spirometry and progressive maximal exercise tests while breathing air or He-O2. The He-O2 mixture significantly increased (P < 0.05) forced expiratory volume in 1 sec (FEV1) by 8.2%, peak expired flow by 39%, and maximal voluntary ventilation (MVV) by 17.9% compared to air, while forced vital capacity (FVC) and forced mid-expiratory flow rate (FEF25-75%) were unchanged by breathing He-O2. Ventilation and oxygen uptake at matched submaximal power outputs were not increased while breathing He-O2, nor were peak exercise ventilation (VEpeak) or peak exercise oxygen uptake (VO2peak). Estimated hemoglobin saturation and total exercise time were also unchanged during He-O2 breathing. However, there was a trend for the subjects with the better FEV1 to increase VO2peak. Increases in VO2peak when breathing He-O2 and air were correlated (r = 0.67, P < 0.05) with the percent of predicted FEV1 values. Still, in the 11 patients as a group, breathing He-O2 did not significantly improve VO2peak, VEpeak, or exercise tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Factors influencing exercise tolerance in patients with myocardial infarction as elucidated by Tl-201 myocardial scintigraphy].

Measurements of O2 consumption during treadmill exercise tests and Tl-201 myocardial scintigraphy were performed in 17 cases of myocardial infarction to elucidate O2 consumption at an anaerobic threshold ATVO2 as an adequate index of exercise tolerance, and the scintigraphic indices influencing the exercise tolerance. ATVO2 was obtained using the method of Wasserman and Davisand corrected by body weight. The scintigraphic indices such as the location, extent (residual myocardium), and severity (% uptake) of myocardial infarction were obtained from SPECT and bull's eye displays on Tl-201 myocardial scintigraphy. ATVO2 was correlated with theoretical VO2max as obtained by the predicted maximal heart rate (r = 0.56, p less than 0.01) and with left ventricular ejection fraction as obtained by radionuclide left ventriculography (r = 0.59, p less than 0.01). There was no significant difference between ATVO2 in cases of anterior wall infarction and those of inferior (and/or lateral wall) infarction. There was no significant correlation between % uptake and ATVO2. However, the residual myocardium showed a significant correlation with ATVO2 (r = 0.61, p less than 0.01). In conclusion, 1) ATVO2 is an adequate index of exercise tolerance and reflects cardiac function. 2) The extent of the residual myocardium is most strongly influenced by ATVO2 among the indices of myocardial damage as obtained by Tl-201 myocardial scintigraphy.

Adaptation, Physiological↗
PubMed2001

Reproducibility of exercise tolerance in patients with end-stage renal disease.

OBJECTIVE: To determine the interday reproducibility of peak and submaximal exercise tolerance of patients with end-stage renal disease (ESRD). DESIGN: Repeated measures. SETTING: Day-patient rehabilitation center. PARTICIPANTS: Twelve consecutively presenting, self-selected patients with ESRD. INTERVENTIONS: All patients performed peak exercise tolerance assessments on a cycle ergometer up to the point of volitional fatigue, with a 1-week interval between the 2 tests. MAIN OUTCOME MEASURES: Cardiopulmonary, hemodynamic, and physical performance parameters were assessed at peak exercise and at the lactate threshold. Standard error of measurement, percentage coefficient of variation (CV%), intraclass correlation coefficient (ICC), and limits of agreement (LOA) were calculated to determine the reproducibility of all variables. RESULTS: CV% (range, 5%-7%) and ICCs (range, .94 - .98) for oxygen uptake and heart rate at peak exercise and lactate threshold indicated highly acceptable levels of group mean reproducibility. LOA analysis revealed satisfactory levels of reproducibility for individual patients. CONCLUSION: Taken together, these reproducibility data may be applied to clinical work, requiring the quantification of changes in the exercise tolerance of patients with ESRD after short-term interventions (eg, exercise training, therapeutic use of recombinant erythropoietin).

Exercise Tolerance↗
PubMed1983

Breathlessness and exercise tolerance in chronic airflow obstruction: 2-hourly versus 4-hourly salbutamol by inhalation.

Breathlessness, exercise tolerance, and spirometry were measured in 12 patients whose major symptom was breathlessness, secondary to severe chronic airflow limitation, during a double-blind crossover comparison of inhaled salbutamol in two dosages (200 micrograms 4-hourly and 200 micrograms 2-hourly) with placebo. Daily visual analogue scores of breathlessness, exercise tolerance and spirometry were all significantly improved with salbutamol in both dosages compared to placebo. The 2-hourly regimen was superior to the 4-hourly regimen only in terms of exercise tolerance. Walking distance had deteriorated significantly 2 hours after salbutamol on the 4-hourly regimen and was usefully increased by an extra dose of salbutamol on the 2-hourly regimen at the equivalent time, without side-effects. Salbutamol provided considerable symptomatic relief in addition to spirometric improvement in patients with chronic airflow limitation.

Aged↗
PubMedDate not supplied

Inspiratory capacity and exercise tolerance in chronic obstructive pulmonary disease.

During the past half-century, many studies have investigated the correlation of exercise tolerance to routine lung function in patients with obstructive pulmonary disease. In virtually all of these studies, the degree of airway obstruction was assessed in terms of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Because in most studies only a weak correlation was found between exercise tolerance and degree of airway obstruction, it has been concluded that factors other than lung function impairment (eg, deconditioning and peripheral muscle dysfunction) play a predominant role in limiting exercise capacity in patients with chronic airway obstruction. Recent work, however, suggests that in patients with chronic obstructive pulmonary disease, the inspiratory capacity is a more powerful predictor of exercise tolerance than FEV1 and FVC.

Exercise Tolerance↗
PubMed2005

Does delayed correction interfere with pulmonary functions and exercise tolerance in patients with tetralogy of fallot?

STUDY OBJECTIVES: To assess exercise tolerance and determine the distinct role of cardiac, respiratory, or peripheral factors on it after delayed surgical repair in patients with tetralogy of Fallot. DESIGN: The aerobic exercise capacity of 15 adult patients (mean [+/- SD] age, 21 +/- 6; age range, 9 to 30 years) undergoing successful total correction at a mean age of 12 +/- 5 years (patients) was compared to healthy, matched control subjects by using right ventricle echocardiography, resting spirometry, and cardiopulmonary exercise tests at a mean postoperative time of 7.5 +/- 4.6 years. SETTING: Tertiary care referral centers. PATIENTS: Fifteen adult patients (mean age, 21 +/- 6 years; age range, 9 to 30 years) undergoing successful total correction at a mean age of 12 +/- 5 (patients) and 15 healthy, matched volunteers (control subjects). RESULTS: There was evidence for a slight right ventricular diastolic dysfunction in the patients. Mean FVC (88 +/- 9% vs 109 +/- 12% predicted, respectively) and FEV1 (89 +/- 9% vs 109 +/- 12% predicted, respectively), although being within the normal range, were also decreased in comparison to those of control subjects (p < 0.0001). Maximal oxygen consumption (V(O2max) decreased in both groups (55 +/- 16% vs 61 +/- 23% predicted, respectively; p = 0.5); however, there were more individuals with severely decreased values among the patients (p = 0.05). V(O2) at the anaerobic threshold was also decreased in patients (33 +/- 15% vs 51 +/- 8% predicted, respectively; p = 0.004). The maximum tolerable exercise time was 17.3 +/- 4.5 min in patients vs 21.2 +/- 6.4 min in control subjects (p = 0.06). CONCLUSIONS: The exercise capacity after delayed repair was good in general compared to matched control subjects; however, exercise capacity may be slightly limited by ventilatory dysfunction, low anaerobic threshold, and lack of physical fitness despite New York Heart Association class improvement after undergoing the operation.

Adolescent↗
PubMed2005

[Exercise tolerance in patients with chronic obstructive pulmonary disease].

Limitation of exercise tolerance, especially activities of daily living, is the most significant clinical experience, which greatly affects quality of life of patients with chronic obstructive pulmonary disease (COPD). Many advances in the understanding of the pathophysiological mechanisms of bronchial obstruction in patients with COPD and their meanings for diagnosis and monitoring of the disease have occurred during the last two decades. The author discusses the most significant factors, which influence tolerance of physical exercise in patients with more advanced forms of COPD, and brings the attention to a practical test of physical capacity.

Exercise Tolerance↗
PubMed1996

Ineffectiveness of intravenous beta 2-agonists on improving exercise tolerance in patients with reversible chronic airway obstruction.

The effects on exercise tolerance after acute administration of beta 2-agonists were investigated in 11 patients with partly reversible chronic airway obstruction after 400 micrograms of salbutamol (S) given intravenously (i.v.) and after 400 micrograms i.v. of a new selective beta 2-agonist, broxaterol (B), by a cardiopulmonary incremental exercise test. At rest, while VE increased in respect to basal conditions (C) after S (from 13.3 +/- 2.2 to 14.4 +/- 2.8 l/min; p < 0.05) and after B (from 13.6 +/- 3.1 to 15.5 +/- 3.6 l/min; p < 0.05), VO2, VCO2 and VO2/HR showed no substantial variations. A small, not significant reduction of PaO2 was observed both after S (from 82.7 +/- 11.7 to 79.1 +/- 16.7 mm Hg) and B (from 81.6 +/- 10.5 to 78.0 +/- 11.0 mm Hg). The maximum workload increased neither after S (from 67.5 +/- 39.1 to 66.6 +/- 37.0 W) nor after B (from 65.7 +/- 39.3 to 60.0 +/- 35.8 W). At peak of exercise, VO2, VCO2 and VO2/HR did not change after S and B as compared with C, whereas VE remained higher after both beta 2-agonists throughout the effort. VO2 at ventilatory anaerobic threshold (AT) was significantly greater either after S (from 744 +/- 378 to 815 +/- 302 ml/min; p < 0.05) and after B (from 756 +/- 290 to 842 +/- 292 ml/min; p < 0.05). The PaO2 increase shown by these patients during effort was greater after beta 2-agonists administration, delta PaO2 from rest to peak of exercise amounting to 14.9 +/- 14.3 vs. 7.8 +/- 8.2 mm Hg after S and to 17.8 +/- 15.1 vs. 8.8 +/- 10.9 mm Hg after B, in respect to relative baseline (p < 0.05). We conclude that beta 2-agonists, when given acutely, do not improve exercise tolerance in patients with reversible chronic airflow obstruction, although these drugs can induce a small increment of ventilatory AT. In addition, arterial blood gases do not deteriorate at rest and are better preserved during exercise after beta 2-agonists.

Adrenergic beta-Agonists↗
PubMed1982

[Exercise tolerance for indicating of aortocoronary bypass surgery (author's transl)].

In order to evaluate effects of aortocoronary bypass grafting on exercise tolerance, we analyzed the data of 109 patients who performed exercise tests before and one month or one year after surgery. Subgroups of patients were formed on the basis of preoperative exercise tolerance. Previously severely impaired patients benefited from surgery by an improvement of exercise capacity, whether preoperative left ventricular enddiastolic pressure at rest exceeded 16 mm Hg and left ventricular ejection fraction was below 50% or not. On the other hand, exercise capacity of patients who were comparable in respect to the numbers of coronary lesions and bypass grafts but whose exercise tolerance was less impaired preoperatively did not improve after surgery. Because in such patients, independent of coronary anatomy, surgery has been reported to be ineffective for prolongation of life, indication for aortocoronary bypass grafting in the presence of "good" exercise capacity must be questioned for symptomatic as well as for prognostic reasons.

Aged↗
PubMed1999

[Trimetazidine effects on exercise tolerance and left ventricular diastolic function in patients with coronary heart disease].

AIM: Trial of trimetasidine effects on exercise tolerance (ET) and left ventricular diastolic function (LVDF) in patients with coronary heart disease (CHD). MATERIALS AND METHODS: The study group included 40 CHD patients. Of them 10, 18 and 12 had myocardial infarction, unstable angina pectoris and stable angina, respectively. 38 CHD patients of the control group had these disorders, respectively, in 5, 15 and 18 cases. 2-3-month therapy with nitrates, beta-blockers (BB) and inhibitors of angiotensin-converting enzyme (ACE) was given to both groups with adjuvant trimetasidine (60 mg/d) given to patients of the study group. The effects were judged by the results of cycle exercise tests and echo-CG including the loading one. RESULTS: Adjuvant use of trimetasidine improved exercise tolerance, mean threshold capacity, LVDF. When added to BB treatment, trimetasidine reduced damage to LVDF under dipiridamol test. CONCLUSION: Trimetasidine addition to combined treatment of CHD raises exercise tolerance and improves LVDF.

Adrenergic beta-Antagonists↗
PubMed1997

Good exercise tolerance and impaired lung function after atrial repair of transposition.

OBJECTIVE: Evaluation of long-term results of atrial correction of transposition of the great arteries (TGA), focusing on the relationship between pulmonary function and exercise tolerance. METHODS: A prospective population-based study-56 out of 60 survivors of Mustard/Senning repair, born in Bohemia in 1980-1984 (median age at surgery 0.85 years) were followed up over 13.4 +/- 1.2 years and studied by complete lung function and bicycle exercise testing. RESULTS: Maximum heart rate on exercise reached 181 +/- 14 bpm (Z-score: -1.06 +/- 1.66, range -6.7 to +1.6); VO2max: 40.6 +/- 6.7 ml/kg per min (Z-score: -0.97 +/- 1.4, range -5 to +1.8). A total of 73.6% had abnormal lung function, most frequently features of stiff lung (39.6%) and lung restriction (32.1%). Static recoil pressure of the lungs measured at 100, 90 and 60% of total lung capacity reached 137, 126 and 130%, respectively (Z-score: 1.93 +/- 2.33, 1.64 +/- 1.96, and 1.14 +/- 1.95, respectively). There was an inverse relationship between static recoil pressure of the lungs and VO2max (r = -0.306, P = 0.043), indicating the impact of lung function abnormalities on exercise tolerance. Comparison with lung function study of the group of 'pioneer' Mustard patients operated at the mean age of 4.4 years revealed a similar pattern and frequency (73.6% in current series vs. 88%, NS). CONCLUSIONS: Long-term follow-up has shown good exercise tolerance in the majority of patients after atrial correction of TGA performed in infancy. Many of them, however, have impaired lung function, especially stiff lung, although less frequently than original patients operated at a later age. The stiff lung can impair the exercise tolerance.

Analysis of Variance↗
PubMed1978

Comparative effects of placebo and plain and slow-release tablets of xanthinol nicotinate on exercise tolerance in normal human subjects.

The effects of placebo and plain and slow-release xanthinol nicotinate on exercise tolerance were studied in 6 normal human subjects. Placebo administration had no significant effect on exercise tolerance. Administration of plain and slow-release xanthinol nicotinate significantly increased exercise tolerance at 1 hour and 1--9 hours respectively from ingestion of the drug. The intensity and duration of action correlated well with the blood levels of nicotinic acid reported earlier. Four subjects experienced moderate to severe side-effects with plain xanthinol nicotinate. Only 1 subject experienced mild side-effects with slow-release xanthinol nicotinate. Slow-release tablets of xanthinol nicotinate may prove useful in the treatment of angina pectoris.

Adolescent↗