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Introduction: Community-acquired pneumonia (CAP) and acute cardiogenic pulmonary oedema (ACPO) are common clinical conditions requiring hospital admission, but require different treatment. To assess whether exhaled breath analysis can distinguish between these, we measured exhaled breath condensate biomarkers and fractional exhaled nitric oxide (F E NO) in 14 patients with CAP and 12 patients with ACPO admitted acutely to hospital via the Emergency Department, comparing profiles with 15 control subjects. Methods: F E NO was measured using a NO Breath analyser and exhaled breath condensate (EBC) was collected for analysis of EBC biomarkers. EBC pH was measured with pH meter. The EBC biomarkers C-reactive protein (CRP), neopterin and 5N-terminal pro-brain natriuretic peptide (5NT-proBNP) were quantified using enzyme linked immunosorbent assays. Results: EBC 5NT-proBNP was raised in ACPO, while EBC CRP was raised in CAP. However, neopterin and pH showed no differences between groups. F E NO levels were significantly higher in CAP than in ACPO (p=0.03). Conclusions: This study demonstrates that exhaled breath analysis may be useful in assessing the acutely breathless patient, but that even this easy non-invasive technique is difficult for sick patients. More rapid measurements, application of novel biomarkers and combined assessment of several EBC biomarkers are likely to improve diagnostic differentiation in the future.

Fifty-eight women (DH¼30, C¼28) completed baseline and 3-month testing. At baseline there were no differences in hypertension (52%), fasting glucose impairment (29%), or smoking history (31%). However, DH women were younger than C (52 vs 59 years, p¼0.007), and had lower 10-year ASCVD risk scores (6.2AE5.1% vs 3.7AE3.7, p¼0.042). Upon LEARN program completion, mean weight loss (2.9AE4.1 kg), was similar in both groups (p¼0.773), and there was no change in SBP or ASCVD risk scores for either group. Lipid profile parameters showed favorable trends for both groups. A significant reduction was seen only for triglycerides in DH group (119AE40 at baseline vs 98AE26 at 3 months, p¼0.0009). Similarly, NMR lipoprofile analysis showed a significant reduction in large VLDL particles for DH group (5.3AE3.6 at baseline vs 3.4AE2.2 at 3 months, p¼0.0188). CONCLUSION: In women with ASCVD risk completing a 3 month LEARN program, Digital Health administration resulted in similar decreases in weight loss as traditional methods, but more favorable cardiometabolic results. This study demonstrates the feasibility and effectiveness of novel Digital Health methods for a weight loss program with immediate beneficial impact on weight loss and triglyceride levels.

Background and Aim: Heart transplant recipients (HTR) have slower pulmonary oxygen uptake (VO 2p ) kinetics that is due, in part, to impaired cardiac output (Q) kinetics. A limitation of prior studies examining VO 2p kinetics in HTR was the primary focus on large muscle mass (cycling) exercise. The effects that small muscle mass (unilateral knee extension, UKE) exercise has on cardiovascular and gas exchange kinetics have not been studied. The purpose of this investigation was to examine VO 2p , Q, and muscle deoxygenation (HHb) kinetics during UKE exercise in HTR and healthy age and activity-matched controls (CON).Methods: Four clinically stable HTR (53 Ϯ 6 years) and 5 CON (53 Ϯ 7 years) performed 2 exercise tests on separate days. On the first day, an incremental UKE test was performed during which time expired gas analysis was acquired to measure peak VO 2p . On the second day, a square-wave moderate-intensity UKE protocol from a 0-Wt kicking baseline (3-minute duration) to approximately 50% of peak power output steady state (5-minute duration) was performed 4 times during which time continuous VO 2p , heart rate (HR), stroke volume (SV, impedance cardiography), and HHb (near infrared spectroscopy, Hamamatsu, NIRO 300) was obtained. Exercise repetitions were time aligned and averaged and VO 2p , HR, SV, Q, and HHb kinetics were quantified using nonlinear regression. Specifically, (seconds) for VO 2p , Q, SV, and HHb represented the time to achieve a 63% change from baseline. Furthermore, the HR 1/2 time (the time to 50% change of total response) was also calculated. Data were analyzed using independent t tests and the alpha level was set at P Ͻ .05.Results: VO 2p (HTR, : 58 Ϯ 20 vs CON, : 30 Ϯ 8 seconds, see the figure), Q (HTR, : 66 Ϯ 18 vs CON, : 29 Ϯ 14 seconds), and HHb kinetics (HTR, : 27 Ϯ 10 vs CON, : 13 Ϯ 6 seconds) were significantly slower in HTR than in CON. Furthermore, the prolonged Q kinetics were secondary to slower HR kinetics (HTR: 113 Ϯ 47 vs CON: 21 Ϯ 3 seconds, P Ϯ .05) as SV kinetics were not different between HTR (40 Ϯ 17 seconds) and CON (32 Ϯ 13 seconds). Conclusion:The prolonged VO 2p kinetics in HTR versus CON during UKE are due to slower Q and HHb kinetics. Moreover, the slower Q kinetics are secondary to the blunted HR kinetics as SV kinetics were not different between groups. During small muscle mass exercise, abnormalities in oxygen delivery and utilization result in slower VO 2p kinetics in HTR. (Mr McIlroy). Background and Aims:Stroke is the leading cause of adult disability in North America. There is increasing recognition of the importance of reductions in aerobic capacity poststroke as a factor limiting function and physical activity. While exercise has been shown to benefit stroke survivors, this population infrequently accesses community-based exercise programs such as cardiac rehabilitation (CR) despite the common cardiovascular etiology. The purpose of this study was to characterize and compare the effects of cardiac rehabilitation among individuals with primary diagnosi...