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PubMed2005

Peripheral vascular endothelial function correlates with exercise capacity in women.

BACKGROUND: Vascular endothelial function has been observed to correlate with exercise capacity in predominantly male populations. Gender-based differences exist in the clinical course of coronary artery disease, and previous studies indicate that estrogen may influence endothelial function. These observations raise the possibility that the relationship between endothelial function and exercise capacity in women may differ from that in men. HYPOTHESIS: This study aimed to determine whether peripheral vascular endothelial function correlates with exercise capacity in women. METHODS: Women who were referred for clinically indicated exercise testing with technetium-99 myocardial perfusion imaging were consecutively recruited. To ensure a population free of exercise limitation due to ischemic heart disease, women without myocardial perfusion defects were included for analysis in this study (n = 105). Endothelial function was assessed by brachial artery ultrasound flow-mediated vasodilation (FMD). Exercise capacity was defined as the duration of exercise on a symptom-limited Bruce protocol. RESULTS: Mean FMD was 11.8 +/- 0.6%, and median FMD was 12%. Subjects with an FMD less than the median of 12% had a significantly shorter exercise time than those with FMD > or = 12% (411 +/- 17 vs. 482 +/- 24 s, p = 0.014). There was a significant correlation between FMD and exercise time (r = 0.34, p < 0.001). Age and body mass index were additional predictors of exercise time; however, the relationship between FMD and exercise time was independent of these variables. CONCLUSION: Brachial artery FMD correlates with exercise capacity in women, even in the absence of ischemic heart disease.

Adult↗

PubMed1997

Parkinson's disease: an investigation of exercise capacity, respiratory function, and gait.

OBJECTIVE: To evaluate the exercise capacity of subjects with mild to moderate Parkinson's disease and determine whether abnormalities in respiratory function and gait affect exercise capacity. DESIGN: Descriptive. Subjects were categorized according to exercise history, disease severity, and presence/absence of upper airway obstruction. SUBJECTS AND SETTING: Sixteen volunteers with mild to moderate idiopathic Parkinson's disease attended a university research laboratory. MAIN OUTCOME MEASURES: Subjects performed a maximum exercise test on a cycle ergometer, together with respiratory function tests and a walking test. Peak values for oxygen consumption and work rate were recorded for the maximum exercise test. Measures of respiratory function included spirometry, flow-volume loops, lung volumes, and mouth pressures. Velocity, stride length, and cadence were measured for preferred and fast speeds of walking. The values obtained on each of these tests were compared with published predicted age- and gender-matched normal values. RESULTS: Peak oxygen consumptions and peak work loads achieved by subjects with Parkinson's disease were not significantly different from normal values, despite evidence of respiratory and gait abnormalities typical of Parkinson's disease. Exercise category was significantly correlated with percent predicted VO2peak (r = .64, p < .01), with sedentary subjects producing lower scores than exercising subjects. There was no significant correlation between disease severity and percent predicted VO2peak. CONCLUSION: Despite their neurological deficit, individuals with mild to moderate Parkinson's disease have the potential to maintain normal exercise capacity with regular aerobic exercise.

Airway Obstruction↗

PubMed2000

Why is exercise capacity reduced in subjects with pectus excavatum?

BACKGROUND: Exercise capacity is often limited in subjects with pectus excavatum (PE), but the mechanism is unknown. OBJECTIVES: We attempted to quantify exercise capacity and to investigate whether limitation of venous return to the heart contributes to exercise intolerance in PE. METHODS: A total of 13 patients with PE (mean age, 19 +/- 6 years) and 20 control subjects (mean age, 25 +/- 11 years) underwent sitting and supine incremental cycling and exercise Doppler stroke volume (SV) measurements. RESULTS: Supine peak oxygen uptake (V'O(2)max) for the patients (1351 +/- 345 mL/min) and control subjects (1505 +/- 330 mL/min) was not different. In contrast, sitting V'O(2)max was lower in the patients than in the control subjects, 1480 +/- 462 and 1994 +/- 581 mL/min, respectively (P =.02). Supine exercise SV was not different between groups. Moreover, only in the patients with PE was supine exercise SV, 70 +/- 18 mL, higher than sitting exercise SV, 55 +/- 14 mL (P =.015). The corresponding values for the control subjects were 70 +/- 18 mL and 65 +/- 19 mL (P = NS). CONCLUSIONS: Patients with PE exercising in the sitting position have reduced V'O(2)max and SV, whereas during supine exercise they approached the control values. The supine advantage in PE suggests that upright exercise capacity in this disease is affected by reduced filling of the heart in the non-supine position.

Adult↗

PubMed1997

Relationship between dyspnoea, pulmonary function and exercise capacity in patients with cystic fibrosis.

The median age of survival in patients with cystic fibrosis (CF) has improved considerably. Despite this improvement, deterioration of pulmonary function and decrease in exercise capacity are still the main problems for many patients. Although dyspnoea is a common complaint in CF patients, relatively little regard has been paid to this symptom. This study examined the relationship between dyspnoea, bicycle exercise capacity and pulmonary function in patients with CF. In 14 patients in a stable clinical condition, pulmonary function [forced expiratory volume in 1 s (FEV1), inspiratory vital capacity (IVC)], bicycle exercise capacity [maximum exercise capacity (Wmax)], subjective degree of dyspnoea during daily living [Medical Research Council (MRC) dyspnoea scale], and during exercise (Borg scale) were assessed. The mean (SD) age of the patients was 25 (6.8) years, FEV1 was 41 (19)% predicted, IVC was 63 (17)% predicted and FEV1/IVC ratio was 47 (10)%; median (range) Wmax was 55 (0-79)% predicted. Bicycle exercise test performance appeared to be mainly determined by pulmonary function and MRC dyspnoea grade; multiple regression equation containing FEV1 and dyspnoea accounted for 76% of the variance in Wmax (% predicted) (Wmax = -7.9 dysp + 1.1 FEV1, +24). Exercise dyspnoea, assessed by the Borg scale, showed a significant linear correlation with minute ventilation. (VE), maximal voluntary ventilation (MVV) (%) (r = 0.76; P < 0.001). Medical Research Council dyspnoea score correlated relatively poorly with FEV1 (% predicted) (r = -0.17; n.s.) and IVC (% predicted) (r = -0.48; n.s.). Borg score at maximal exercise did not correlate with MRC dyspnoea score (r = -0.07). Borg50% score correlated significantly with MRC dyspnoea score (r = 0.61; P < 0.05). These results show that dyspnoea has an influence on exercise capacity. Dyspnoea score showed a large inter-individual variation, not strongly related to pulmonary function. It is concluded that dyspnoea deserves more attention in CF patients and needs to be assessed in rehabilitation programmes and other intervention studies in these patients.

Adolescent↗

PubMed2005

Exercise capacity deterioration in patients with COPD: longitudinal evaluation over 5 years.

BACKGROUND: Although exercise capacity is an important outcome measure in patients with COPD, its longitudinal course has not been analyzed in comparison to the change in pulmonary function. PURPOSES: To examine how exercise capacity would deteriorate over time in patients with COPD, and what factors would contribute to it. METHODS: A total of 137 male outpatients with moderate-to-very-severe COPD were examined. The average age was 69.0 +/- 6.6 years (+/- SD), and the mean postbronchodilator FEV(1) was 45.9 +/- 15.4% predicted. Progressive cycle ergometry and pulmonary function testing were performed at entry, and every 6 months thereafter over 5 years. Due to the presence of missing data, a mixed-effect model analysis was then used to estimate the longitudinal changes in various clinical parameters. RESULTS: Peak oxygen uptake (Vo(2)), peak minute ventilation (Ve), and peak tidal volume (Vt) during exercise declined significantly over time (p < 0.0001), which was no less rapid than the deterioration in FEV(1). The mean decline rates for peak Vo(2) were 32 +/- 60 mL/min/yr and 0.5 +/- 1.0 mL/min/kg/yr. Multiple regression analysis revealed that the changes in peak Ve, peak Vt, and peak respiratory rates were significant predictors for the change in peak Vo(2). CONCLUSION: We demonstrated clear evidence of measurable and progressive deterioration in exercise capacity in COPD patients, which was no less rapid than the decline in airflow limitation. Dynamic ventilatory constraints during exercise also deteriorated over time, which most significantly contributed to this exercise capacity deterioration. In addition to pulmonary function, the longitudinal follow-up of exercise capacity is important not to miss the overall deterioration in COPD.

Aged↗

PubMed2006

Is there any difference between effects of ipratropium bromide and formoterol on exercise capacity in moderate COPD patients?

The effects of anticholinergic agents or long acting beta(2)-agonists on exercise capacity in chronic obstructive pulmonary disease (COPD) improves various out come measures but there is not enough double-blind study which included comparison of different medications. The aim of this study was to compare the effect of ipratropium bromide and formoterol on exercise capacity and also to determine the relationship between this improvement in functional parameters and exercise capacity for each treatment in patients with COPD. This study was performed as randomized, double blind and two period crossover design. Ten volunteer stable COPD patients were recruited from outpatient COPD clinic. At the initial visit medical data were recorded. One week later baseline measurements; pulmonary function tests and cardiopulmonary exercise testing were performed, afterwards, patients received ipratropium bromide 40 microg four times a day or formoterol 12 microg two times a day for two weeks. After a washout period, medications were crossed for another two weeks. After each of treatment period, all tests were performed. Nine subjects were male and mean age was 51.1 +/- 5.45 years, all of them were heavy smokers, level of COPD was mild to moderate (FEV(1)= 69%, FEV(1)/FVC= 68%). While formoterol significantly improved FEV(1), FEV(1)/FVC %, ipratropium significantly improved FEV(1), FEF(25-75), peak oxygen uptake and minute ventilation. Moreover, both of the medications increased exercise time. There were no differences between effects of ipratropium bromide and formoterol on exercise capacity and functional parameters. We observed that ipratropium bromide and formoterol have similar improvement in exercise capacity in COPD patients. The improvement in exercise capacity also correlated with increase in FEV(1).

Administration, Inhalation↗

PubMed1985

Relative value of glucose and amino acids in preserving exercise capacity in the postoperative period.

The value of crystalline amino acids compared with glucose in maintaining functional muscle mass (maximum exercise capacity) in the perioperative period was studied. Twelve surgical patients received 100 g of glucose (Group 1) for 7 to 10 days perioperatively, and 12 (Group 2) received 90 g of crystalline amino acids for a similar period. Maximum exercise capacity, nitrogen balance, and serum albumin were studied. The use of amino acids instead of glucose spared nitrogen. Net nitrogen loss was 64.7 +/- 6.7 g in Group 1 compared with 34.7 +/- 4 g in Group 2 (p less than or equal to 0.001). Exercise capacity decreased 13.8 +/- 4.5 percent in Group 1 and 13.3 +/- 2.9 percent in group 2. The serum albumin level decreased by 0.30 +/- 0.2 g/100 ml in Group 1 compared with 0.34 +/- 0.15 g/100 ml in Group 2. These differences were not significant. Changes in serum albumin were correlated with changes in exercise capacity (r = 0.7, p less than or equal to 0.002), but neither was significantly correlated with nitrogen loss. We concluded that the use of amino acids instead of glucose during moderate periods of semi-starvation associated with moderate trauma will not influence loss of exercise capacity significantly, although some nitrogen will be spared; patients undergoing moderately severe surgical procedures accompanied by moderate periods of semistarvation will lose approximately 14 percent of their exercise capacity; and loss of exercise capacity is not correlated with loss of nitrogen under these conditions but is loosely correlated with changes in serum albumin levels.

Adult↗

PubMed2005

Association of metabolic syndrome with exercise capacity and heart rate recovery in patients with coronary heart disease in the heart and soul study.

It is not known whether the metabolic syndrome is associated with poor exercise capacity among patients who have established coronary heart disease. We evaluated the association of the metabolic syndrome with treadmill exercise capacity and heart rate recovery among patients who had coronary heart disease. We measured treadmill exercise capacity (METs) and heart rate recovery (beats per minute) in 943 subjects who had known coronary heart disease. Of these, 377 (40%) had the metabolic syndrome as defined by criteria of the National Cholesterol Education Program. Participants who had the metabolic syndrome were more likely to have poor exercise capacity (METs <5, 33% vs 18%, p <0.0001) and poor heart rate recovery (<or=16 beats/min, 34% vs 21%, p <0.0001) than those who did not have the metabolic syndrome. In ordinal logistic regression analyses, the metabolic syndrome was associated with decreased exercise capacity (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.7 to 2.8, p <0.0001) and decreased heart rate recovery (OR 1.8, 95% CI 1.4 to 2.3, p <0.0001). These associations remained strong after adjusting for potential confounding variables (OR 1.6, 95% CI 1.2 to 2.1, p = 0.003 for decreased exercise capacity; OR 1.4, 95% CI 1.1 to 1.9, p = 0.02 for decreased heart rate recovery). The metabolic syndrome is independently associated with poor exercise capacity and poor heart rate recovery in patients who have established coronary heart disease. Decreased exercise capacity may contribute to the adverse outcomes associated with the metabolic syndrome.

Aged↗

PubMed2004

Relation of biventricular function quantified by stress echocardiography to cardiopulmonary exercise capacity in adults with Mustard (atrial switch) procedure for transposition of the great arteries.

BACKGROUND: Mustard repair for transposition of the great arteries (TGA) is frequently associated with impaired systemic (right) ventricular function and sometimes exercise intolerance. We hypothesized that a simple quantitative measurement of ventricular function, during rest and pharmacological stress, could identify abnormalities and predict objective exercise capacity. METHODS AND RESULTS: We quantified the performance of systemic and pulmonary (left) ventricles by using echocardiography, at rest and during dobutamine stress, in 27 adults who had undergone Mustard repair for TGA. Systolic and diastolic function of the systemic ventricle were markedly disturbed with respect to pulmonary ventricular function. We also measured exercise capacity by cardiopulmonary exercise testing for peak oxygen uptake. Exercise capacity was significantly predicted by systemic ventricular long-axis excursion both at rest (r=0.66, P<0.001) and at peak dobutamine stress (r=0.53, P=0.006) but not by pulmonary ventricular long-axis excursion at rest (r=0.04) or on stress (r=0.11). Exercise capacity was also predicted by the septal long-axis excursion at rest (r=0.61, P=0.001) but not pulmonary ventricular free wall excursion (P>0.05) or fractional shortening (P>0.05). Peak aortic velocity at maximum dobutamine stress correlated with exercise capacity (r=0.46, P=0.029) but not at rest (r=0.36). Multivariate analysis revealed systemic ventricular long-axis excursion to be the sole significant independent predictor of exercise capacity. CONCLUSIONS: Systemic ventricular function is depressed in most patients with Mustard repair. Quantitative echocardiographic evaluation shows systemic ventricular function to be a key determinant of exercise capacity.

Adrenergic beta-Agonists↗

PubMed1999

Effects of resistive breathing on exercise capacity and diaphragm function in patients with ischaemic heart disease.

BACKGROUND: Muscle weakness has been suggested to result from the deconditioning that accompanies decreased activity levels in chronic cardiopulmonary diseases. The benefits of standard exercise programmes on exercise capacity and muscular strength in disease and health are well documented and exercise capacity is a significant predictor of survival in patients with chronic heart failure (CHF). Selective respiratory muscle training has been shown to improve exercise tolerance in CHF and such observations have been cited to support the suggestion that respiratory muscle weakness contributes to a reduced exercise capacity (despite biopsies showing the metabolic profile of a well trained muscle). AIMS: This study aimed to determine the effects of selective inspiratory muscle training on patients with chronic coronary artery disease to establish if an improved exercise capacity can be obtained in patients that are not limited in their daily activities. METHODS: Nine male patients performed three exercise tests (with respiratory and diaphragm function assessed before the third test) then undertook a 4-week programme of inspiratory muscle training. Exercise tolerance, respiratory and diaphragmatic function were re-assessed after training. RESULTS: Exercise capacity improved from 812+/-42 to 864+/-49 s, P<0.05, and velocity of diaphragm shortening increased (during quiet breathing from 12.8+/-1.6 to 19.4+/-1.1 mm s(-1), P<0.005, and sniffing from 71.9+/-9.4 to 110.0+/-12.3 mm s(-1), P<0.005). In addition, five from nine patients were stopped by breathlessness before training; whereas only one patient was stopped by breathlessness after training. CONCLUSION: The major findings in this study were that a non-intensive 4-week training programme of resistive breathing in patients with chronic coronary artery disease led to an increase in exercise capacity and a decrease in dyspnoea when assessed by symptom limited exercise testing. These changes were associated with significant increases in the velocity of diaphragmatic excursions during quiet breathing and sniffing. Patients that exhibited small diaphragmatic excursions during quiet breathing were most likely to improve their exercise capacity after the training programme. However, the inspiratory muscle-training programme was not associated with any significant changes in respiratory mechanics when peak flow rate, forced expiratory volume and forced vital capacity were measured. The resistive breathing programme used here resulted in a significant increase in the velocity of diaphragm movement during quiet breathing and sniffing. In other skeletal muscles, speed of contraction can be determined by the relative proportion of fibre types and muscle length (Jones, Round, Skeletal Muscle in Health and Disease. Manchester: University Press, 1990). The intensity of the training programme used here, however, is unlikely to significantly alter muscle morphology or biochemistry. Short-term training studies have shown that there can be increases in strength and velocity of shortening that do not relate to changes in muscle biochemistry or morphology. These changes are attributed to the neural adaptations that occur early in training (Northridge et al., Br. Heart J. 1990; 64: 313-316). Independent of the mechanisms involved, this small, uncontrolled study suggests that inspiratory muscle training may improve exercise capacity, diaphragm function and symptoms of breathlessness in patients with chronic coronary artery disease even in the absence of heart failure.

Aged↗

PubMedDate not supplied

Maintenance of exercise capacity and physical activity patterns 2 years after cardiac rehabilitation.

BACKGROUND: The benefits of exercise training for postmyocardial infarction and postcoronary artery bypass surgery patients are well established, but little is known about the effects of rehabilitation in the months or years following the program. The purpose of this study was to assess exercise capacity, blood lipids, and physical activity patterns 2 years after completing a concentrated residential rehabilitation program in Switzerland. METHODS: Seventy-eight patients (86% males, mean age = 56 +/- 10, mean ejection fraction = 64% +/- 12%) were referred to a residential rehabilitation program after a myocardial infarction or coronary artery bypass surgery between January 2001 and June 2001. Patients lived at the center for 1 month, during which time they underwent educational sessions, consumed a low-fat diet, and exercised 2 hours daily. Two years after completing the program, patients returned to the hospital and underwent a maximal exercise test, an assessment of recent and adulthood physical activity patterns, and evaluation of blood lipids. RESULTS: During the 2-year follow-up period, there were 5 deaths, and 70 of the remaining 73 patients returned for repeat testing. Mean exercise capacity increased 27% during the rehabilitation program (P < .01). Gains in exercise capacity during rehabilitation were maintained after the follow-up period; mean exercise capacity after 2 years was 34% higher compared with that at baseline (P < .01). At the 2-year evaluation, patients were expending a mean of 3127 +/- 1689 kcals/wk during recreational activities compared with 977 +/- 842 kcals/wk during adulthood prior to their cardiac event (P < .001). Between the completion of rehabilitation and the 2-year follow-up, total cholesterol, total cholesterol/high-density lipoprotein ratio, and triglycerides increased significantly. CONCLUSIONS: Two years after a cardiac event and participation in a concentrated residential rehabilitation program, patients maintained their exercise capacity and engaged in physical activities that exceed the levels recommended by guidelines for cardiovascular health. These observations suggest that a relatively intensive rehabilitation program provided a catalyst to maintain physical activity patterns and exercise tolerance in the 2 years following a cardiac event.

Analysis of Variance↗

PubMed2005

Exercise capacity in patients with beta-thalassaemia intermedia.

Thalassaemia intermedia patients can suffer fatigue and exercise capacity reduction, possibly because of anaemia, deconditioning and lack of exercise-induced haemoconcentration. We studied 21 beta-thalassaemia intermedia patients, 10 splenectomised (group A) and 11 not splenectomised (group B). Patients were evaluated by cardiopulmonary exercise test with blood sampling for haemoglobin and plasma protein measurements at rest and peak. During exercise, an isolated increase of haemoglobin suggested spleen contraction while a parallel increase of haemoglobin and proteins suggested fluid filtration through capillary wall. Groups were homogeneous for age and gender. Peak oxygen consumption (VO2) was 22.5 +/- 4.4 ml/min/kg (51 +/- 14%) and 24.3 +/- 7.0 (53 +/- 12%) in groups A and B respectively [not significant (NS)]. At rest, haemoglobin was 8.8 g/dl in both groups. Exercise-induced increment was 0.4 +/- 0.2 and 1.0 +/- 0.4 g/dl (P < 0.001) for haemoglobin and 4.0 +/- 3.0 and 5.0 +/- 4.0 g/l (NS) for proteins, in groups A and B respectively. Anaemia was the major cause of peak VO2 reduction (1097 +/- 260 ml/min). However, anaemia did not explain the entire exercise capacity reduction, suggesting the presence of muscular deconditioning. Exercise capacity is reduced in beta-thalassaemia intermedia because of anaemia and muscular deconditioning. Spleen contraction does not significantly influence exercise capacity although exercise-induced haemoconcentration was greater in patients with spleen.

Adult↗

PubMed1993

Influence of antihypertensive drugs on exercise capacity.

Both single dose and short term diuretic treatment adversely affect maximal exercise capacity and the duration of prolonged submaximal exercise. However, insufficient data are available to establish the effect of long term diuretic treatment on exercise capacity. beta-Blockade reduces maximal aerobic power by approximately 7%. In addition, the capacity for prolonged submaximal exercise appears to be markedly impaired in normotensive and hypertensive patients, particularly when nonselective beta-blockers are prescribed. Fewer data are available for other drugs, but, whatever the mechanism of vasodilation, drugs that reduce systemic vascular resistance do not seem to have any effect on exercise capacity.

Antihypertensive Agents↗

PubMed2003

Aerobic exercise capacity in patients with juvenile dermatomyositis.

OBJECTIVE: To examine the feasibility of maximum exercise testing in patients with juvenile dermatomyositis (JDM), characterize the maximum oxygen consumption (VO2peak) of these patients, and determine if exercise time could be used as an surrogate index for VO2peak. METHODS: Fifteen patients diagnosed with JDM (age 5-14) performed a graded, maximum exercise test using a motor driven treadmill and metabolic cart to volitional exhaustion conforming to the Bruce protocol. RESULTS: All patients were able to perform the exercise test. Ten of the 15 patients performed a maximal effort (heart rate > 180 beats/min or respiratory exchange ratio > 1.0). The patients who had a maximal exercise performance, the mean absolute VO2peak, relative VO2peak (related to body mass), and exercise time were respectively -1.82 (+/- 1.5), -2.83 (+/- 1.9), and -3.65 (+/- 1.9) standard deviations lower compared to age and sex matched reference values (p < 0.05). Z scores for exercise time were significantly lower compared to Z scores for absolute and relative VO2peak, an indication of reduced muscular economy. When exercise time was converted to VO2peak using the equation: VO2peak = 0.1583 (exercise time) + 0.0828, the VO2peak values were not significantly different from the measured VO2peak values. CONCLUSION: Aerobic exercise testing on a treadmill was possible in patients with JDM and revealed an impairment in their maximal aerobic exercise capacity. Exercise time can be used as an indicator of VO2peak, when converted to VO2peak using a regression equation. VO2peak, measured or estimated, has the potential to be a good indicator of muscle function in patients with JDM.

Adolescent↗

PubMed1998

Exercise training in heart failure improves quality of life and exercise capacity.

AIMS: Benefit from exercise training in heart failure has mainly been shown in men with ischaemic disease. We aimed to examine the effects of exercise training in heart failure patients < or = 75 years old of both sexes and with various aetiology. METHODS AND RESULTS: Fifty-four patients with stable mild-to-moderate heart failure were randomized to exercise or control, and 49 completed the study (49% > or = 65 years; 29% women; 24% non-ischaemic aetiology; training, n = 22; controls, n = 27). The exercise programme consisted of bicycle training at 80% of maximal intensity over a period of 4 months. Improvements vs controls were found regarding maximal exercise capacity (6 +/- 12 vs -4 +/- 12% [mean +/- SD], P < 0.01) and global quality-of-life (2 [1] vs 0 [1] units [median ¿inter-quartile range¿], P < 0.01), but not regarding maximal oxygen consumption or the dyspnoea-fatigue index. All of these four variables significantly improved in men with ischaemic aetiology compared with controls (n = 11). However, none of these variables improved in women with ischaemic aetiology (n = 5), or in patients with non-ischaemic aetiology (n = 6). The training response was independent of age, left ventricular systolic function, and maximal oxygen consumption. No training-related adverse effects were reported. CONCLUSION: Supervised exercise training was safe and beneficial in heart failure patients < or = 75 years, especially in men with ischaemic aetiology. The effects of exercise training in women and patients with non-ischaemic aetiology should be further examined.

Activities of Daily Living↗

PubMed2006

Lung function and exercise capacity in young adults born prematurely.

RATIONALE: Limited information is available about the long-term outcome of lung function and exercise capacity in young adults born prematurely. OBJECTIVE: To determine long-term effects of prematurity on lung function (volumes, diffusing capacity) and exercise capacity in ex-preterms compared with healthy peers. METHODS: In a prospective cohort study, children born with a gestational age of less than 32 wk and/or a birth weight under 1,500 g were followed up for 19 yr. Participants (n=42; mean gestational age, 30 wk, and mean birth weight, 1,246 g) and healthy term control subjects (n=48) were recruited for lung function and exercise tests. MEASUREMENTS: Spirometry, bodybox (TLC(box)), diffusing capacity (Dl(CO)), bicycle ergometer test. MAIN RESULTS: Preterm birth was associated with lower FEV(1) (preterms, 95% predicted, vs. controls, 110% predicted; p<0.001), DL(CO)sb (88% predicted vs. 96% predicted, p=0.003), and exercise capacity (load, 185 vs. 216 W; p<0.001; anaerobic threshold: mean, 1,546 vs. 1,839 ml/min; p<0.001) compared with control subjects at follow-up. No differences between the groups were found in TLC(box), peak oxygen consumption (Vo(2)), and breathing reserve. No significant differences in lung function and exercise parameters were found between preterms with and without bronchopulmonary dysplasia. CONCLUSIONS: Long-term effects of prematurity were airway obstruction and a lower CO diffusing capacity compared with control subjects, although mean lung function parameters were within the normal range. Ex-preterms had a lower exercise level, which could not be explained by impaired lung function or smoking habits, but might be due to impaired physical fitness.

Adolescent↗

PubMed1993

Treatment of anaemia in haemodialysis patients with erythropoietin: long-term effects on exercise capacity.

1. The effects of correcting anaemia on exercise capacity were evaluated in 21 haemodialysis patients (aged 39 +/- 12 years) before starting treatment with recombinant human erythropoietin (Hb concentration, 73 +/- 10 g/l; total Hb, 59 +/- 12% of expected), after correction of the anaemia to a Hb concentration of 108 +/- 7 g/l and a total Hb 82 +/- 10% of expected, and in 13 of the patients after 12 months on maintenance recombinant human erythropoietin treatment (Hb concentration 104 +/- 14 g/l, total Hb 79 +/- 17% of expected). Fifteen healthy subjects (aged 41 +/- 9 years), who took no regular exercise, constituted the control group. Maximal exercise capacity was determined on a bicycle ergometer. Oxygen uptake, respiratory quotient, blood lactate concentration, heart rate and blood pressure were measured at rest and at maximal workload. 2. After 6 +/- 3 months on recombinant human erythropoietin, maximal exercise capacity increased from 108 +/- 27 W to 130 +/- 36W (P < 0.001) and the maximal oxygen uptake increased from 1.24 +/- 0.39 litres/min to 1.50 +/- 0.45 litres/min (P < 0.001). No significant changes in respiratory quotient (1.16 +/- 0.13 versus 1.18 +/- 0.13) and blood lactate concentration (4.0 +/- 1.8 versus 3.6 +/- 1.1 mmol/l) at maximal workload were observed, but the blood lactate concentration in the patients was significantly lower than that in the control subjects (6.7 +/- 2.3 mmol/l, P < 0.01). After the correction of anaemia, the aerobic power was still 38% lower in the patients than in the control subjects and 17% lower than the reference values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Exercise capacity during the first year after cardiac transplantation.

Few data are available examining the influence of perioperative clinical parameters on exercise capacity after cardiac transplantation. Accordingly, 40 patients were studied by metabolic exercise testing early (1 to 3 months) and late (6 to 12 months) after cardiac transplantation. Various clinical parameters, including congestive heart failure class, length of hospital stay, age, cold ischemic time and histologic evidence of rejection were correlated with exercise capacity after transplantation. As expected, peak exercise capacity correlated inversely with both age and length of hospital stay. There was no correlation with preoperative congestive heart failure class or heart rate at rest. Interestingly, there was a statistically significant correlation between cold ischemic time and exercise capacity after transplantation. In addition, increased episodes of rejection during the first 6 months after transplantation resulted in statistically lower exercise capacity at 6 to 12 months after the operation. Thus, ischemic damage during transport of the donor organs and subclinical damage during early rejection may affect clinical status after heart transplantation and may only be apparent during increased physical demand such as exercise.

Adult↗