SEARCH · PubMed Health

Results for “Exercise Tolerance”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,315 records · Page 73Linked to original sources

PubMed1977

Hemodynamics at rest and during exercise in 222 patients with coronary heart disease before and after aorto-coronary bypass surgery.

In 222 patients with coronary heart disease hemodynamics at rest and during exercise were measured before and after aortocoronary bypass surgery. A total of 552 grafts were constructed, i.e. an average of 2.47 grafts per patient. Only 10.8% of the patients had a 1-vessel-disease, 59.2% had a 3-vessel-disease. 10.8% of the patients were provided with one graft, 49.7% got 3 or 4 grafts. In 92.8% of the patients the r. desc. ant. was significantly stenosed, and in 94.2% this vessel has been provided with a graft. Preoperatively only 7 patients had no angina pectoris during exercise (bicycle ergometer in supine position, each load lasting 6 min), postoperatively 154 patients have been completely free of angina pectoris. The preoperative angina pectoris-free exercise tolerance was 27.4 +/- 27.4 W (means +/- SD), postoperatively it was 76.5 +/- 33.8 W. The largest increase of exercise tolerance was observed in patients with a 3-vessel-disease (208%). Preoperatively only 10.1% had normal values of pulmonary wedge pressure and cardiac output at rest and during exercise, postooperatively 51.5%. The postoperative normalization of hemodynamics depends on the number of vessels involved (1-vessel-disease 86%, 3-vessel-disease 39.8% normalization) and on the status of the left ventricle (without a previous transmural myocardial infarction 68.4%; with a previous myocardial infarction 41.0%). The effects of revascularization on myocardial ischemia can be evaluated by measurements of pulmonary wedge pressure and cardiac output at rest and during exercise.

Angina Pectoris↗

PubMed1993

Spinal cord stimulation in angina pectoris with normal coronary arteriograms.

BACKGROUND: Patients with angina pectoris with normal coronary arteriograms, also known as Syndrome X (typical exercise-induced angina pectoris, positive exercise testing, and normal coronary arteriograms), are often difficult to treat with conventional forms of medical therapy. Spinal cord stimulation has been used in recent years for the treatment of severe angina pectoris refractory to conventional medical and surgical therapy in coronary artery disease. The aim of this study was to investigate the effects of spinal cord stimulation on angina pectoris with normal coronary arteriograms. METHODS: Twelve patients underwent five bicycle exercise tests, three tests without (control), and two tests with spinal cord stimulation treatment. RESULTS: The exercise tolerance of the patients increased (108 +/- 22 W versus 96 +/- 21 W; P < 0.001), the magnitude of ST-segment depression at comparable work load decreased (1.0 +/- 0.6 mm versus 1.5 +/- 0.9 mm; P < 0.01), time to angina increased (5.4 +/- 2.2 min versus 2.7 +/- 1.9 min; P < 0.01), and time to the appearance of ST-segment depression increased (3.5 +/- 1.9 min versus 2.4 +/- 1.6 min; P < 0.01). The rate-pressure product at maximum work load during treatment increased, compared with the maximum work load during the control session (28,038 +/- 6124 mmHg x bpm versus 25,222 +/- 4519 mmHg x bpm; P < 0.05) and the comparable work load during treatment (28,038 +/- th 6124 mmHg x bpm versus 24,795 +/- 5022 mmHg x bpm; P < 0.01). CONCLUSIONS: Spinal cord stimulation has beneficial effects in angina pectoris with normal coronary arteriograms in terms of relief of symptoms of angina pectoris and improvement of exercise tolerance. These effects may be associated with a reduction in myocardial ischemia.

Aged↗

PubMed2004

Testing the functional status model in patients with chronic obstructive pulmonary disease.

BACKGROUND: Patients with chronic obstructive pulmonary disease usually experience gradual functional status degradation, especially dyspnoea, which may affect their daily activities and, eventually, quality of life. A full understanding of both their physiological and psychological functional status is therefore beneficial for effective treatment and helping patients regain or maintain control of their lives. METHOD: Based on a non-experimental research design, 138 patients to test a hypothesized model of functional status in patients with chronic obstructive pulmonary disease, using structural equation modelling, were recruited from a medical center. Data were collected using questionnaires, 6-minute walking distance measurement, and pulmonary function test results recorded in patients' medical records. The proposed functional status model incorporated the exogenous variables disease severity and dyspnoea, and the endogenous variables age, exercise tolerance, fatigue, depression, anxiety, health perception and functional performance. Structural equation modelling with the lisrel software was used to establish a functional status model with those exogenous and endogenous variables. RESULTS: The results indicated a good fit between the proposed functional status model and the data collected [chi(2) = 8.84, P = 0.64, chi(2)/d.f. = 0.80, Goodness of Fit Index (GFI) = 0.98, adjusted GFI (AGFI) = 0.95, root mean square residual (RMR) = 0.04, Critical N (CN) = 384.26]. Coefficients for paths in the functional status model all demonstrated statistical significance. CONCLUSION: The functional status model was shown to consist of functional performance, functional capacity and other concepts, including disease severity, dyspnoea, age, exercise tolerance, fatigue, depression, anxiety and health perception. These results can be used to develop a suitable functional status model for chronic obstructive pulmonary disease, and could act as a reference for formulating future strategies and intervention procedures for further development of functional status.

Activities of Daily Living↗

PubMed1982

Long-duration submaximal exercise conditioning in hemodialysis patients.

Objective changes in exercise tolerance were evaluated in five chronic hemodialysis patients (HD) following a ten week aerobic treadmill exercise conditioning program designed to exercise patients at a level approximating their anaerobic threshold (AT). This exercise conditioning program resulted in a 21% increase in peak oxygen consumption, an increase in test duration from 17.40 +/- 1.26 to 22.60 +/- 0.87 min (P less than 0.025), and an increase in AT from 0.81 +/- 0.08 to 0.97 +/- 0.08 1/min (P less than 0.05). These physiologic changes in exercise tolerance resulted in an overall increase in work capacity permitting the HD patient to perform a larger portion of the imposed work load aerobically.

Adult↗

PubMed2006

Long-term bosentan in chronic thromboembolic pulmonary hypertension.

BACKGROUND: There is no approved pharmacological treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are not suitable for pulmonary endarterectomy (PEA). OBJECTIVE: The study investigates the effect of the dual endothelin receptor antagonist bosentan on exercise tolerance (6-min walking distance, 6MWD) and right ventricular function (Tei index) in patients with CTEPH over 24 months. METHODS: Twelve consecutive patients (5 males and 7 females) with CTEPH not eligible for PEA or following partial or complete failure of PEA were included in a non-randomized, open-label prospective study. All patients were WHO class III. They were included, if progressive pulmonary hypertension was diagnosed despite best supportive treatment. Bosentan was started at 62.5 mg b.i.d. and increased to the final dose of 125 mg b.i.d. RESULTS: 6MWD and the Tei index were assessed every 6 months. We observed a significant increase in 6MWD from 319 +/- 85.0 m at baseline to 391 +/- 76.9 m at 6 months and a significant decrease in the Tei index from 0.39 +/- 0.10 at baseline to 0.34 +/- 0.08 at 6 months. This improvement was maintained over 24 months (6 MWD: 381 +/- 101 m; Tei index: 0.31 +/- 0.03). Six patients exhibited an improvement in WHO class at 6, 12 and 18 months, 5 demonstrated improvement at the 24-month follow-up. The remainder were stable throughout the study period. CONCLUSION: This is the first study demonstrating a long-term beneficial effect of bosentan on exercise tolerance (6MWD) and right heart function (Tei index) in CTEPH.

Antihypertensive Agents↗

PubMed2000

Supplemental oxygen during pulmonary rehabilitation in patients with COPD with exercise hypoxaemia.

BACKGROUND: Supplemental oxygen in patients with chronic obstructive pulmonary disease (COPD) and exercise hypoxaemia improves exercise capacity and dyspnoea. However, the benefit of oxygen during pulmonary rehabilitation in these patients is still unknown. METHODS: Twenty five patients with stable COPD (mean (SD) forced expiratory volume in one second (FEV(1)) 0.76 (0.29) l and 30.0 (9.89)% predicted, arterial oxygen tension (PaO(2)) 8.46 (1.22) kPa, arterial carbon dioxide tension (PaCO(2)) 6.32 (1.01) kPa) and significant arterial desaturation on exercise (82.0 (10.4)%) were entered onto a pulmonary rehabilitation programme. Patients were randomised to train whilst breathing oxygen (OT) (n = 13) or air (AT) (n = 12), both at 4 l/min. Assessments included exercise tolerance and associated dyspnoea using the shuttle walk test (SWT) and Borg dyspnoea score, health status, mood state, and performance during daily activities. RESULTS: The OT group showed a significant reduction in dyspnoea after rehabilitation compared with the AT group (Borg mean difference -1.46 (95% CI -2.72 to -0.19)) but there were no differences in other outcome measures: SWT difference -23.6 m (95% CI -70.7 to 23.5), Chronic Respiratory Disease Questionnaire 3.67 (95% CI -7.70 to 15.1), Hospital Anxiety and Depression Scale 1. 73 (95% CI -2.32 to 5.78), and London Chest Activity of Daily Living Scale -2.18 (95% CI -7.15 to 2.79). At baseline oxygen significantly improved SWT (mean difference 27.3 m (95% CI 14.7 to 39.8) and dyspnoea (-0.68 (95% CI -1.05 to -0.31)) compared with placebo air. CONCLUSIONS: This study suggests that supplemental oxygen during training does little to enhance exercise tolerance although there is a small benefit in terms of dyspnoea. Patients with severe disabling dyspnoea may find symptomatic relief with supplemental oxygen.

Activities of Daily Living↗

PubMed2005

[Effects of isosorbide-5-mononitrate on clinical condition, bicycle ergometry results, endothelium-dependent vasodilation in patients with ischemic heart disease with stable effort angina].

AIM: Assessment of efficacy of treatment of coronary heart disease (CHD) patients suffering from stable effort angina of functional class II-III with the drug isosorbide-5-mononitrate Mono Mac 50 depo (MM 50 D). MATERIAL AND METHODS: Clinical indices, exercise tolerance, endothelial function (the study of brachial artery in reactive hyperemia and sublingual intake of nitroglycerin) were studied in 30 patients with stable angina FC II-III before the treatment, 1 and 3 months after the treatment. RESULTS: MM 50D significantly widens diameter of the brachial artery (by 11.6%), lowers nitroglycerin-dependent vasodilation (from 16% to 10.4% in a month and to 10.2% in 3 months) and blood flow speed in reactive hyperemia. An absolute increment of the brachial artery diameter in reactive hyperemia test remained unchanged. The ratio flow-dependent vasodilation/nitroglycerin-dependent vasodilation increased in the course of therapy from 0.67 to 0.91. The drug produced clinical improvement (anginal attacks rate diminished by 70 and 85%, respectively) and increased exercise tolerance (the threshold performance rose by 28%, total load time--by 30%). CONCLUSION: It is important to use complex assessment of hemodynamic component of endothelial function in the treatment with nitrates.

Adult↗

PubMed2006

Effect of enhanced external counterpulsation on resting oxygen uptake in patients having previous coronary revascularization and in healthy volunteers.

This study analyzed the acute effects of enhanced external counterpulsation (EECP) on oxygen uptake (VO2) at rest in adults with symptomatic coronary artery disease (CAD) compared with healthy volunteers. EECP therapy increases exercise tolerance in patients with refractory angina pectoris. This may be attributed, at least in part, to a training effect, but measurement of VO2 during an EECP treatment session has not been previously reported. We measured VO2 continuously in 20 adults during a single treatment session of EECP, including 10 subjects with previous coronary revascularization who were referred for EECP therapy for refractory angina, and 10 healthy, sedentary volunteers. VO2 was measured for 10 minutes before EECP, during a 30-minute EECP treatment session, and for 10 minutes after cessation of EECP treatment. Patients with CAD were older (65.9 +/- 12 vs 38.5 +/- 7 years, p = 0.002) and had a higher body mass index (32.0 +/- 10.0 vs 25.5 +/- 3.0 kg/m2, p = 0.027) and percent body fat (37 +/- 7% vs 21+/-9%, p = 0.006). VO2 at rest, although slightly lower in the CAD group, was not significantly different (2.75 +/- 0.54 vs 3.19 +/- 0.51 ml/kg/min, p = 0.09). The 2 groups demonstrated a small, sustained increase in VO2 during EECP treatment (CAD +0.66 +/- 0.56 ml/kg/min, p < 0.005; healthy +0.72 +/- 0.40 ml/kg/min, p < 0.001; CAD vs healthy, p = 0.13), which returned to baseline levels during recovery. In conclusion, VO2 at rest is increased to the same degree during an EECP treatment session in healthy subjects and symptomatic patients with CAD. This effect may contribute to the increased exercise tolerance of patients with refractory angina after receiving EECP therapy.

Adult↗

PubMed1987

Determination of the optimal dose of glyceryl trinitrate in the treatment of stable angina.

There has been recent controversy over the efficacy of transdermal glyceryl trinitrate (GTN) preparations in the treatment of angina and their effects on exercise tolerance. To determine the dose of GTN that produces significant anti-anginal effects, symptom limited exercise testing has been undertaken in seven patients with stable angina. Doses of 10, 20, 40 and 80 micrograms min-1 of GTN or placebo were infused during treadmill exercise until symptom limiting chest pain or greater than or equal to 3 mm ST segment depression occurred. Compared with placebo, total exercise time increased by 47% at 20 micrograms min-1 (P less than 0.05) with no further change at the higher doses. Duration of exercise before the onset of significant ST segment depression increased by 51% at 20 micrograms min-1 (P less than 0.05) with no further increase at the higher doses. These changes were accompanied by a 21% increase in double product (heart rate X systolic blood pressure) at 20 micrograms min-1 (P less than 0.05) reflecting a higher heart rate achieved as a result of the increased duration of exercise. These results suggest that 20 micrograms min-1 may be the optimal dose of GTN to achieve significant antianginal effects as demonstrated by the improved exercise tolerance and reduction of myocardial ischaemia. This implies that the dose of GTN delivered by transdermal preparations may be below the therapeutic level.

Angina Pectoris↗

PubMed1993

The effect of chordal preservation on late outcome after mitral valve replacement: a randomized study.

Postoperative survival, hemodynamic status and exercise tolerance with or without posterior chordal preservation were compared in a case-limited prospective randomized manner in 100 patients who underwent isolated mitral valve replacement with size 29mm or 31mm St. Jude Medical prostheses. The preoperative clinical and hemodynamic parameters were comparable in the two groups. The mean follow up was 293.3 months for those with and 263.1 months for patients without chordal preservation. Right heart cardiac catheterization was performed in every patients at the end of the follow up period and it demonstrated significantly better results with than without chordal preservation (cardiac index 2.81 +/- 0.47 vs. 2.63 +/- 0.52, p < 0.05; pulmonary arterial pressure 30 +/- 11 mmHg vs. 37 +/- 13 mmHg at 30 Watts bicycle exercise, p < 0.01; end-diastolic volume index 75 +/- 22 vs. 86 +/- 38 ml/m2, p < 0.02; and maximum exercise tolerance 1.8 +/- 0.3 vs. 1.2 +/- 0.5 Watt/kg, p < 0.01). Actuarial freedom from complications was 78.1 +/- 4.2% with and 70.7 +/- 6.2% without chordal preservation (p < 0.02). In particular, patients with severe mitral regurgitation benefited from the preservation of the posterior mitral leaflet with its chordal and papillary structure (p < 0.001).

Adult↗

PubMed1997

Administration of growth hormone to underweight patients with chronic obstructive pulmonary disease. A prospective, randomized, controlled study.

Patients with chronic obstructive pulmonary disease (COPD) often develop weight loss, which is associated with increased mortality. Recombinant human growth hormone (rhGH) treatment has been proposed to improve nitrogen balance and to increase muscle strength in these patients. The aim of this study was to assess the effects of rhGH administration on the nutritional status, resting metabolism, muscle strength, exercise tolerance, dyspnea, and subjective well-being of underweight patients with stable COPD. Sixteen patients attending a pulmonary rehabilitation program (age: 66 +/- 9 yr; weight: 77 +/- 7% of ideal body weight; FEV1: 39 +/- 13% of predicted) were randomly treated daily with either 0.15 IU/kg rhGH or placebo during 3 wk in a double-blind fashion. Measurements were made at the beginning (DO) and at the end (D21) of treatment and 2 mo later (D81). Body weight was similar in the two groups during the study, but lean body mass was significantly higher in the rhGH group at D21 (p < 0.01) and D81 (p < 0.05). The increase in lean body mass was 2.3 +/- 1.6 kg in the rhGH group and 1.1 +/- 0.9 kg in the control group at D21 and 1.9 +/- 1.6 kg in the rhGH group and 0.7 +/- 2.1 kg in the control group at D81. At D21, the resting energy expenditure was increased in the rhGH group (107.8% of DO, p < 0.001 compared with the control group). At D21 and D81, the changes in maximal respiratory pressures, handgrip strength, maximal exercise capacity, and subjective well-being were similar in the two groups. At D21, the 6-min walking distance decreased in the rhGH group (-13 +/- 31%) and increased in the control group (+10 +/- 14%; p < 0.01). We conclude that the daily administration of 0.15 IU/kg rhGH during 3 wk increases lean body mass but does not improve muscle strength or exercise tolerance in underweight patients with COPD.

Aged↗

PubMed1985

[Importance of combined instrumental study methods in the expertise of the work capacity of ischemic heart disease patients with stable stenocardia].

Working capacity of 87 coronary patients with stable angina was assessed on the basis of a functional classification of the results of non-invasive investigations (resting ECG, bicycle ergometry, echocardiography). Bicycle ergometry proved to be the most informative method providing indirect evidence of coronary reserve. An objective assessment of the condition of coronary patients can be made using values of exercise tolerance (threshold capacity and volume of work), heart rate and double product at the peak of exercise. A close correlation exists between the severity of atherosclerotic affection of coronary arteries and individual exercise tolerance, which can be used in the medical evaluation of the working capacity of coronary patients with stable angina pectoris.

Adult↗

PubMed2006

Bronchoscopic lung volume reduction for end-stage emphysema: report on the first 98 patients.

OBJECTIVES: To report the first multicenter experience on the treatment of end-stage emphysema using an endobronchial valve (EBV) [Emphasys EBV; Emphasys Medical; Redwood City, CA]. DESIGN: Retrospective analysis from prospective multicenter registry. PATIENTS AND INTERVENTIONS: This is a study of the use of EBVs in the treatment of end-stage emphysema at nine centers in seven countries. Ninety-eight patients with mean FEV(1) of 0.9 +/- 0.3 L (30.1 +/- 10.7% of predicted) [+/- SD] and residual volume (RV) of 5.1 +/- 1.3 L (244.3 +/- 0.3% of predicted) were treated over a period of 20 months. Spirometry, plethysmography, and diffusing capacity of the lung for carbon monoxide (Dlco) and exercise tolerance testing were performed at 30 days and 90 days after the procedure. RESULTS: RV decreased by 4.9 +/- 17.4% (p = 0.025), FEV(1) increased by 10.7 +/- 26.2% (p = 0.007), FVC increased by 9.0 +/- 23.9% (p = 0.024), and 6-min walk distance increased by 23.0 + 55.3% (p = 0.001). There was a trend toward improvement in Dlco, but this did not reach statistical significance (17.2 +/- 52.0%, p = 0.063). Patients treated unilaterally showed a trend toward greater improvement than those treated bilaterally. A similar trend toward improvement was observed in patients who had one entire lobe treated compared to those with just one or two bronchopulmonary segments treated. Eight patients (8.2%) had serious complications in the first 90 days, including one death (1.0%). CONCLUSION: This multicenter analysis confirms that improvement in pulmonary function and exercise tolerance can be achieved in emphysematous patients using EBVs. Future efforts should be directed to determining how to select those patients who would benefit most from this procedure and the best endobronchial treatment strategy.

Aged↗

PubMed1981

Oxygen relieves breathlessness in "pink puffers".

The effect of oxygen on breathlessness and exercise tolerance was examined in "pink and puffing" patients with fixed airways obstruction. When breathing oxygen, patients were less breathless and walked further. This was true whether the cylinder was carried by the patient or by an assistant. It was not possible to identify those patients who would benefit most. The best method of assessing improvement was by comparing breathlessness on a standardised progressive exercise test on a treadmill. Four patients had a greater than 30% reduction in breathlessness on submaximum exercise when breathing oxygen. Breathing oxygen for five or fifteen minutes before exercise but not during exercise (predose) resulted in a similar improvement in exercise tolerance. For short periods of exercise predosing with oxygen provides a convenient alternative to continuous oxygen. For longer periods of exercise the benefits of portable oxygen in selected patients have been previously underestimated.

Adult↗

PubMed2002

Mid term effects of pulmonary thromboendarterectomy on clinical and cardiopulmonary function status.

BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) can be successfully treated surgically by pulmonary thromboendarterectomy (PTE) but there are few data on mid-term cardiopulmonary function, particularly on exertion, and clinical benefits following pulmonary PTE. METHODS: A 2 year follow up study was undertaken of clinical status, haemodynamic and lung function indices, gas exchange, and exercise tolerance in 38 patients of mean (SD) age 50 (15) years who had undergone PTE. RESULTS: In-hospital mortality was about 10%. Before PTE all the patients were severely impaired (NYHA classes III-IV). There was no time difference in the improvement in the parameters: nearly all the improvement in cardiac output, gas exchange, and clinical status was achieved in the first 3 months as a result of the relief of pulmonary obstruction. At 3 months the percentage of patients with normal cardiac output and PaO(2) and of those with reduced clinical impairment increased to 97%, 59%, and 87%, respectively, without any further change. Only mean pulmonary artery pressure (mPAP), carbon monoxide transfer factor (TLCO), and exercise tolerance improved gradually during the second year, probably due to the recovery of the damaged small vessels. TLCO was overestimated before PTE but afterwards the trend was similar to that of mPAP. CONCLUSIONS: At mid term only a few patients did not have a satisfactory recovery because of lack of operative success, hypertension relapse, or the effect of preoperative hypertension on vessels in non-obstructed segments. Most of the patients, even the more compromised ones, had excellent long lasting results.

Blood Pressure↗

PubMed2004

Pulmonary rehabilitation: analysis of a clinical service.

BACKGROUND AND PURPOSE: There is significant research supporting the role of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD). However, less is known about real-life clinical rehabilitation services. Data were analysed from a clinical pulmonary rehabilitation service provided in the UK, consisting of seven weeks' twice-weekly training and education. METHOD: A retrospective study. Baseline measures consisted of activity of daily living, mood state, spirometry, exercise tolerance using the Incremental Shuttle Walk Test (ISWT) and health status using the St George's Hospital Respiratory Questionnaire (SGRQ). Responders to pulmonary rehabilitation were defined as those with a mean reduction of four points on the SGRQ and a mean increase of 48 metres on the ISWT. RESULTS: One hundred and eight patients entered the programme and 91 completed it. All outcomes showed statistically and clinically significant change after the rehabilitation programme. Responder analysis showed that 37% of patients achieved benefits for both the SGRQ and the ISWT. Twenty-eight per cent of patients were non-responders for both; 17% benefited for the SGRO only and 14% improved their exercise tolerance. Patients with restrictive disease (n = 11) showed large mean ISWT score of 98.2 m (Standard deviation (SD) 69.4 m) (p < 0.01), as did patients with moderate COPD (n = 30), who scored a mean ISWT change of 77.3 m (SD 92.0 m) (p < 0.01) and a SGRQ score of -7.6 (SD 13.7) (p < 0.01), and those with mild COPD (n = 12), who scored a mean ISWT change of 62.5 m (SD 87.4 m) (p < 0.01) and a mean SGRQ change of -3. 7 (SD 8.1) (p < 0.01). Patients with severe COPD (n = 23) showed a smaller mean change in ISWT of 32.6 m (SD 79.4 m) and in SGRQ of -2.8 (SD 7.1). However, analysis of variance (ANOVA) showed no statistical differences between the groups (p = 0.13). CONCLUSIONS: Clinical pulmonary rehabilitation programmes are effective for most patients. However for patients with more severe impairment, maximal gains may be harder, or take longer, to achieve. Patients with restrictive disease appear to do well, although future trials will be needed to test this supposition.

Aged↗

PubMed1997

[Effects of physical training on autonomic nerve activity in patients with acute myocardial infarction].

The effects of early physical training on heart rate variability and autonomic nerve activity in acute myocardial infarction were studied in 20 patients (men, mean age 57 +/- 11 years) successfully treated by direct coronary angioplasty. Patients were randomly divided into the physical training group (training group: 10 patients) and conventional rehabilitation group (non-training group: 10 patients). Exercise tolerance (VO2 peak and anaerobic threshold: AT), heart rate variability indices, serum levels of catecholamines, and 24-hour urinary excretion of catecholamines were measured on the 14th and 28th days. The conventional cardiac rehabilitation program was followed by each group, and the training group patients were also instructed to follow a training program using the bicycle ergometer (80% AT, 10 min, 2 times a day) for 2 weeks from the 15th day. Autonomic nerve activity was assessed by non-spectral (24-hour averaged normal RR intervals: mean NN, standard deviation of normal RR intervals over 24 hours: SDNN and standard deviation of the mean RR intervals for each 5 min periods over 24 hours: SDANN) and spectral [high frequency power (HF) 0.15-0.40 Hz; represents parasympathetic activity, and the low/high frequency power (L/H ratio); represents sympathetic activity] indices of heart rate variability. There were no cardiac events during physical training. Comparison of the 14th and 28th day in the training group showed that the VO2 peak and VO2 AT significantly increased, SDNN and SDANN significantly increased, HF (82.5 +/- 56.2 to 131.1 +/- 99.8 msec2) increased and the L/H ratio (3.9 +/- 2.2 to 2.6 +/- 1.3) decreased significantly during the night-time, and serum noradrenalin concentration (0.47 +/- 0.11 to 0.35 +/- 0.13 ng/ml) and urinary noradrenalin excretion (195.6 +/- 130.7 to 139.6 +/- 73.3 micrograms/day) significantly decreased. In contrast, the non-training group showed no significant changes. These results suggest early physical training may be safe and improves the autonomic nerve balance and exercise tolerance in patients with acute myocardial infarction.

Aged↗

PubMed1986

Breathing pattern during and after maximal exercise in patients with chronic obstructive lung disease, interstitial lung disease, and cardiac disease, and in normal subjects.

Inspiratory muscle fatigue and pulmonary edema are both known to cause rapid shallow breathing. It has been suggested that exercise tolerance in patients with pulmonary disease and cardiac disease may be limited by the development of inspiratory muscle fatigue and pulmonary edema, respectively, at maximal exercise. If these hypotheses are correct, breathing pattern during recovery from maximal exercise in these patients should be rapid and shallow compared with that during exercise. This study was performed to test these hypotheses. Seven patients with chronic obstructive pulmonary disease (COPD), 8 patients with interstitial lung disease (ILD), 7 patients with cardiac disease (CD) (mitral valve disease or left ventricular dysfunction) and 8 normal (NR) subjects each performed maximal incremental exercise on a cycle ergometer. Exercise breathing pattern was compared with that during recovery by calculating the mean difference in tidal volume (at the same levels of minute ventilation) between exercise and recovery for each subject. Recovery breathing pattern was similar to that during exercise for the COPD, ILD, and NR subjects. In contrast, breathing pattern during recovery was rapid and shallow compared with that during exercise for the CD patients; recovery tidal volume was less than that during exercise for the same level of minute ventilation. The fact that rapid shallow breathing does not develop during recovery from maximal exercise in patients with COPD or ILD suggests that inspiratory muscle fatigue does not limit their exercise tolerance. The relative rapid shallow breathing during recovery from maximal exercise in patients with CD is probably due to the development of pulmonary edema at maximal exercise, but further studies are needed to confirm this.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗