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PubMedDate not supplied

Medically and surgically treated coronary patients in cardiovascular rehabilitation: a comparative study.

Mood and physical performance were assessed in medically and surgically treated patients with coronary artery disease referred to a cardiovascular rehabilitation program early in convalescence. Surgically treated patients reported less mood disturbance prior to training and demonstrated greater gains in exercise tolerance. Medically managed patients had more mood disturbance prior to training and greater mood improvement in the six week rehabilitation program. Improvements in mood were independent of improvement in exercise tolerance. Group differences in mood state could not be attributed to the use of defensive denial, time from discharge, severity of coronary disease, or age of patient. The psychological and physical impact of bypass surgery contributes to the mood and physical performance of postoperative patients.

Adjustment Disorders↗

PubMed2002

[Dilzem-retard efficiency in patients with ischemic heart disease and heart failure].

Effectiveness of a prolonged form of diltiazem was studied in 20 patients with stable effort angina and chronic cardiac failure (NYHA functional class II). Dilcem-retard was given in a dose 180 mg/day for 6 months. Clinical condition, exercise tolerance, left ventricular functional and geometric parameters, heart rhythm variability, late potentials, Holter monitoring evidence were assessed before and after the treatment. Dilcem-retard improved the patients' condition, exercise tolerance, promoted normalization of left ventricular diastolic function, had no negative influence on cardiac output, reduced occurrence of sympathicotonia and late potentials.

Aged↗

PubMed2003

[Angiotensin-converting enzyme, quinapril, in treating chronic cardiac failure].

AIM: To assess effectiveness of ACE inhibitor quinapril in patients with moderate cardiac failure of ischemic etiology. MATERIAL AND METHODS: 20 patients received quinapril in a daily dose 20 mg for 6 months. Clinical condition, exercise tolerance, functional and geometric parameters of the left ventricle, Holter monitoring, heart rhythm variability, late potentials were studied before and after the treatment. RESULTS: The treatment relieved symptoms significantly, exercise tolerance increased, positive changes occurred in systotic, diastotic functions and left ventricular geometry. Ischemic episodes, supraventricular extrasystoles reduced in number and duration. CONCLUSION: Quinapril is an effective drug for treatment of moderate ischemic heart failure.

Aged↗

PubMed2003

The effect of montelukast on bronchial provocation tests and exhaled nitric oxide levels in asthmatic patients.

BACKGROUND: Leukotriene antagonist therapy in asthmatic patients alleviates symptoms and improves exercise tolerance, however the effect of these drugs on bronchial provocation tests and exhaled nitric oxide levels are less clearly established. OBJECTIVE: To determine the effect of montelukast treatment on airway hyperresponsiveness to exercise, methacholine and adenosine-5'-monophosphate and on exhaled nitric oxide levels in steroid-naive asthmatics. METHODS: Following a 2 week run-in period, 20 mild to moderate asthmatics were enrolled in an open label 6 week trial of oral montelukast-sodium therapy. Bronchial hyperreactivity (exercise, methacholine and adenosine-5'-monophosphate challenges) and exhaled nitric oxide levels were measured before and after the 6 week period. RESULTS: Montelukast treatment resulted in a significant improvement in exercise tolerance: median delta FEV1 20.0% (range 0-50) prior to treatment vs. 15.0% (range 0-50) post-treatment (P = 0.029). A significant difference was also observed for exhaled NO following therapy: median NO 16.0 ppb (range 7-41) vs. 13.0 (range 4.8-26) (P = 0.016). No change was seen in baseline lung function tests (FEV1, MEF50) or in the bronchial responsiveness (PC20) for methacholine and adenosine-5'-monophosphate. CONCLUSIONS: This study demonstrates that the leukotriene antagonist montelukast-sodium reduces bronchial hyperreactivity in response to exercise and reduces exhaled nitric oxide levels but has little effect on bronchial responsiveness to methacholine and adenosine challenges.

Acetates↗

PubMed1993

Ventilatory anaerobic threshold before and after cardiac valve surgery.

The purpose of this study was to objectively assess exercise tolerance before and after cardiac valve surgery by using an objectively determined ventilatory anaerobic threshold (AT). Nine patients (mean age: 38.2 +/- 8.1 years) with predominantly mitral regurgitant lesions were studied by a symptomatic maximal treadmill exercise test which included a determination of AT. The mean lengths of time from preoperative exercise testing to cardiac surgery, and from surgery to postoperative exercise testing were 5.9 +/- 4.0 and 12.1 +/- 8.3 months, respectively. The determination of AT on data plots was performed after blinding to patient identification and pre- vs postoperative status. After surgery, the clinical symptoms and NYHA class improved significantly with a decrease in the cardio-thoracic ratio and echocardiographic diastolic dimensions. The mean peak VO2 (ml/kg/min) increased significantly from 20.2 +/- 7.1 to 29.7 +/- 7.9 (p < 0.01). Together with these changes, AT (ml/kg/min in VO2) increased from a mean of 14.8 +/- 4.8 to 22.8 +/- 5.5 (p < 0.01). In conclusion, symptomatic improvement and an increase in peak oxygen uptake after cardiac valve surgery were accompanied by a significant increase in the objectively determined AT. AT determined in a blind manner provides an objective means of evaluating exercise tolerance when a double-blind intervention cannot be performed.

Adult↗

PubMedDate not supplied

Exercising to fitness on dialysis.

Exercise tolerance is a recognised consequence of chronic renal failure. Physical de-conditioning is an integral factor in preventing the achievement of an otherwise very acceptable quality of life which can be accomplished by good dialysis therapy. This paper reports on the implementation of an exercise programme in an ESRD setting with a patient population of over 1,100. Patients aged between 20 and 65 years were identified for phase one of the programme. All patients had an in-depth medical assessment to eliminate potential risks. The programme encompasses stretching, strengthening and aerobic exercises and a individualised exercise prescription was compiled for each participant. Twelve months after the initiation of this programme there is evidence of increased exercise tolerance, increased feelings of well-being and enhanced stability on dialysis.

Adult↗

PubMed2003

[Anti-ischemic effect of angiotensin-converting enzyme inhibitor, but not vitamin C, in patients with coronary artery disease treated with beta-blockers and nitrates. Randomized, cross-over, double-blind comparison].

Anti-ischemic effect of angiotensin-converting enzyme inhibitor--chinapril was examined by exercise tolerance test [ETT] in randomised, cross-over double blind comparison in 20 pts with coronary artery disease treated with beta-blockers and nitrates. After 8 weeks of chinapril treatment maximal work capacity and exercise duration were significantly greater in comparison with baseline values, respectively: 7,8 vs 6,7 METs (p < 0,05) and 416 vs 335 s (p < 0,05). Time to ST segment depression was significantly longer after chinapril treatment: 394 vs 298 s (placebo) p = 0,01) vs 277 s (baseline), p = 0,008. The number of patients with exercise ST depression was significantly lower (63% vs 100%). Rate pressure product wasn't changed after chinapril treatment. Vitamin C therapy did not have influence on ischemia signs in exercise tolerance test.

Adrenergic beta-Antagonists↗

PubMed1976

Design of exercise test, with special reference to heart patients.

Estimation of exercise tolerance in patients with heart disease and significant symptoms can usually not be expressed in terms of maximal oxygen uptake or power at a fixed heart rate calculated from a 'steady state' exercise test. The exercise tolerance can be expressed only by the maximal power developed, when limited by symptoms. For this purpose the level of tolerance is better assessed by a test with small increments and short duration of each work load. In clinical practice this type of almost continuous increase in load was found to be particularly useful in patients with ischaemic heart disease. Comparative studies showed that the work per heart beat at equal loads is significantly higher in the test with continuous increase in load than in the test with steps of 6 minutes duration, both in normal subjects and in heart patients. The difference, however, is small (7%) and for practical purposes these tests have equal validity as a measure of the circulatory capacity.

Adult↗

PubMed1992

Combined gallopamil and isosorbide-5-mononitrate in "mixed" angina pectoris.

The efficacy of combining gallopamil and isosorbide-5-mononitrate (IS-5-MN) was evaluated in 15 patients with "mixed" angina and documented coronary artery disease who participated in a 4-week, double-blind, double-dummy, crossover, placebo-controlled trial. After the first week of the placebo phase (single-blinded), all patients received in three different weeks IS-5-MN 20 mg three times daily, gallopamil 50 mg three times daily, and the same dosages of IS-5-MN and gallopamil three times daily. Exercise tolerance, and peak values of heart rate, systolic blood pressure, double product (DP/100), and ST-segment were evaluated with a treadmill test at the end of each phase. The improvement in exercise tolerance obtained by the combination of the two drugs was significantly greater (p < 0.01) than that achieved by IS-5-MN but not that by gallopamil monotherapy (NS). This effect was accompanied by significant (p < 0.05) reduction (-61%) in ST-segment and significant (p < 0.05) increment (+8%) in peak heart rate only after administration of the combination of the two drugs. The number of ST-depression (ST-) > 1 mm or ST-elevation (ST+) episodes on 24-h Holter monitoring lasting > or = 1 min were also noted in all patients at the end of each phase of the trial.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1982

The diagnostic significance of the correlation between the effectiveness of subendocardial perfusion and the energy output compatible with the coronary reserve.

The effectivity of subendocardial perfusion was investigated in 266 probands aged 40-68 years (112 patients with ischaemic heart disease, 116 patients with essential hypertension, and 38 practically healthy persons) by a noninvasive technique - the myocardial vitality index (MVI) or the quotient of the diastolic and systolic tension-time indexes (DTTI/STTI). The close and statistically significant correlation was found between the MVI, findings of selective coronarography, and total physical performance (exercise tolerance threshold) in per cent of the maximal oxygen consumption (MOC) adequate to the given subject's age, sex, and body mass. Attention is drawn to the diagnostic potential of the novel mode of a rapid assessment of the expected exercise tolerance threshold in per cent of the admissible MOC, determined by the magnitude of the coronary reserved of energy output (in kcal/min or kJ/min), and to the possibilities of predicting the maximal admissible heart rate during exercise on the basis of the myocardial oxygen supply/consumption quotient during a state of relative muscular rest, reflecting the MVI.

Adult↗

PubMed1987

A comparison of verapamil and digoxin in the treatment of atrial fibrillation.

Twelve patients (including 2 females) with chronic atrial fibrillation were entered into a randomized, double blind crossover study to compare the effects of digoxin and verapamil upon heart rate, exercise tolerance and symptom control. The dose of digoxin was adjusted so as to give serum concentrations within the range 1.3 to 2.6 nmol l-1 between four and six hours after dosing, and was continued for six weeks. The dose of verapamil was increased from 40 mg tds to 80 mg tds to 120 mg tds at fortnightly intervals. Three patients did not complete the study; two because of adverse effects attributable to verapamil. In the remaining nine patients, mean post exercise heart rates were significantly lower during treatment with verapamil 80 mgs tds (126.7 bpm) than with verapamil 40 mg tds (148.6 bpm) or digoxin (146.7 bpm). However, exercise tolerance was similar with both verapamil and digoxin and the superior control of exercise induced tachycardia achieved with higher doses of verapamil was not associated with improved exercise endurance. Visual analogue scale scores for constipation were significantly higher during treatment with verapamil; scores for other possible side effects and for overall wellbeing were similar. The results do not confirm the findings of others who have reported that verapamil is superior to digoxin in the treatment of atrial fibrillation.

Aged↗

PubMed1984

Clinical experience with inspiratory resistive breathing training.

Seventy-seven outpatients with disabling chronic obstructive pulmonary disease have been subjected to a 3-month regimen of inspiratory resistive breathing training using the PEP/RMT set (Astra Meditec). Pulmonary function and exercise tolerance on a cycle ergometer or the 12 min. walking distance were obtained pre- and post-training. A special dyspnoea scoring system was also applied. Sixty-three patients experienced significant benefit from training. Pulmonary function did not change, but a substantial increase in exercise tolerance and a decrease of dyspnoea were apparent, where training was successful.

Breathing Exercises↗

PubMed1998

[Prediction of exercise capacity after lung resection in patients with chronic airflow limitation].

To assess the usefulness of a method for predicting postoperative peak oxygen uptake based on lost lung function after lung resection (VO2peak-PPO) and to establish the underlying physiological foundation for the relation between VO2peak-PPO and the measured postoperative value VO2peak-PO), we studied 29 patients (26 men) [age 60 (SD9)] with chronic airflow limitation [FEV1 = 66 (SD13)%] undergoing lobectomy or major pulmonary resection to treat lung cancer. The patients were assigned to groups according to whether postoperative exercise tolerance was considered to be limited by exhaustion of ventilatory reserve (LV) or not (NLV). Data to estimate postoperative pulmonary function was obtained one week before surgery: patients performed pulmonary function tests and exercise tests on a treadmill; dyspnea was also evaluated and perfusion scintigraphs were obtained. Pulmonary function, exercise tolerance and dyspnea were evaluated again approximately five months after surgery. The mean difference between VO2peak-PPO and VO2peak-PO was -0.034 (CI 0.293 to -0.348) l.min-1 and the between-group correlation coefficient was 0.76. The correlation between VO2peak-PPO and VO2peak-PO was 0.86 (SE 0.1) [0.89 (SE 0.13) for LV (n = 14) patients and 0.85 (SE 0.16) for NLV (n = 15) patients]. The correlations after adjusting for preoperative VO2peak-PPO were 0.73 (SE 0.2) and 0.35 (SE 0.27) for LV and NLV patients, respectively. We conclude that VO2peak-PPO provides a valid but only moderately precise estimate of VO2peak-PO. Only in LV patients is there a true relation between a decrease in VO2peak and loss of lung function.

Adult↗

PubMed1975

Symptomatic and puomonary response to acute phlebotomy in secondary polycythemia.

A double-blind study of the effects of phlebotomy was carried out in 18 patients with polycythemia secondary to severe hypoxemic lung disease. Eleven subjects underwent a single phlebotomy of 10 percent of their blood volume, and eight patients serving as controls underwent a sham procedure. Eight of the phlebotomized subjects, but none of the controls, reported subjective clinical improvement (P less than 0.005). Subjects who noted improvement after venesection had higher hematocrit readings than those who did not (P less than 0.02). Symptomatic relief seemed to be most dramatic in those with clinical evidence of congestive heart failure. In contrast to this clear-cut subjective improvement, phlebotomy did not alter objective indices of airway obstruction, lung elastic recoil, pulmonary gas exchange, or exercise tolerance in either the phlebotomized or the control group. Thus, although phlebotomy produced subjective benefit in the majority of patients studied, it was not associated with objective improvement in lung function or exercise tolerance.

Adult↗

PubMed1989

[School sports and the assessment of physical endurance of healthy and performance handicapped children and adolescents].

Physical training and education of children are essential components of the educational process. Regular athletic activities (sport at school, extra-curricular sport activities) in childhood and adolescence promote harmonic growth, physical performance, and the development of personality. Exercise tolerance depends on biological and calendar age, on sex, on the state of health, and on general physical strength. Sports medicine creates the preconditions for the application of the means and methods of physical culture and sports for the consolidation of health. After prolonged disease or because of chronic disease pupils are given a partial exemption from school sports. The sports physicians and teachers have to engage these young people in a regular physical training adjusted to their reduced exercise tolerance.

Adolescent↗

PubMed1997

[Cardicap treatment of ischemic heart disease in aged patients].

The paper presents the results obtained in the study of efficacy of a new antianginal drug cardicap, a long acting isosorbide dinitrate (Natko, India). Changes in the clinical symptoms, exercise tolerance, ECG monitoring and echo-CG parameters in 27 patients (mean age 63 years) with ischemic heart disease, class II and III angina pectoris enable the conclusion on marked antianginal, vasodilatating effect of cardicap, on a rise in the exercise tolerance, reduction in the myocardial power consumption. The effect of cardicap was time-related.

Administration, Oral↗

PubMed1984

Exercise testing in lower-extremity arterial occlusive disease.

Exercise tolerance testing has wide application in the detection and quantitation of lower-extremity claudication. Serial follow-up after operative or nonoperative therapy permits an accurate, objective assessment of the course of the disease in each limb. Unmasking of occult aortoiliac disease, identification of pseudoclaudication, and assessment of the relative contribution of other systemic disorders in exercise limitation are further advantages of this technique. Routine exercise tolerance testing has merit for the initial and subsequent evaluations when symptoms of leg pain are produced solely by exercise.

Arteriosclerosis Obliterans↗

PubMed1988

Combination therapy with diltiazem and nifedipine in patients with effort angina pectoris.

The antianginal effects of diltiazem and nifedipine alone and in combination were evaluated in a double-blind, randomized, placebo-controlled trial in 11 patients (nine men and two women, 57 +/- 8 years old) with stable effort angina. Each patient received placebo, 30 mg of diltiazem, 10 mg of nifedipine, and 30 mg of diltiazem plus 10 mg of nifedipine four times daily for 1 week each. Antianginal efficacy was assessed by means of a treadmill exercise test. The exercise tolerance time was significantly prolonged from 235.1 +/- 52 (placebo period) to 342.2 +/- 101 sec by diltiazem (p less than .01) and to 325.6 +/- 73 sec by nifedipine (p less than .01). The drug combination further prolonged exercise time to 451.1 +/- 103 sec, which was significantly longer than the interval attained with either diltiazem (p less than .01) or nifedipine (p less than .01) alone. The plasma concentration of diltiazem was unaffected by the addition of nifedipine, whereas the plasma nifedipine concentration was significantly increased from 34.8 +/- 11 to 106.4 +/- 37 ng/ml (p less than .001) by the concomitant administration of diltiazem. These data suggest that exercise tolerance in patients with effort angina is increased by the concomitant administration of diltiazem and nifedipine associated with an increase in the nifedipine plasma concentration.

Adult↗