Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation: A randomized, controlled trial

Acanfora, Domenico; Scicchitano, Pietro; Casucci, Gerardo; Lanzillo, B.; Capuano, Nicola; Furgi, Giuseppe; Acanfora, Chiara; Longobardi, M.; Incalzi, Raffaele Antonelli; Piscosquito, Giuseppe; Ciccone, Marco Matteo

doi:10.1016/j.ijcard.2016.10.026

Cited by 40 publications

(29 citation statements)

References 45 publications

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“…The poor heart rate reserve seen in our population corresponds with prior work that reported chronotropic incompetence in both the COPD and interstitial lung disease (ILD) populations, which was associated with reduced exercise capacity 31,32 . Tools to measure cardiac function in the field, such as VEST 33 , the can be used to explore the role of cardiovascular limitations in frailty further.…”

Section: Discussionmentioning

confidence: 99%

Frailty and maximal exercise capacity in adult lung transplant candidates

Layton

Armstrong

Baldwin

et al. 2017

Respiratory Medicine

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Background Frail lung transplant candidates are more likely to be delisted or die without receiving a transplant. Further knowledge of what frailty represents in this population will assist in developing interventions to prevent frailty from developing. We set out to determine whether frail lung transplant candidates have reduced exercise capacity independent of disease severity and diagnosis. Methods Sixty-eight adult lung transplant candidates underwent cardiopulmonary exercise testing (CPET) and a frailty assessment (Fried’s Frailty Phenotype (FFP)). Primary outcomes were peak workload and peak aerobic capacity ( trueV˙normalO2). We used linear regression to adjust for age, gender, diagnosis, and lung allocation score (LAS). Results The mean ± SD age was 57 ± 11 years, 51% were women, 57% had interstitial lung disease, 32% had chronic obstructive pulmonary disease, 11% had cystic fibrosis, and the mean LAS was 40.2 (range 19.2 to 94.5). In adjusted models, peak workload decreased by 10 watts (95% CI 4.7 to 14.6) and peak trueV˙normalO2 decreased by 1.8 ml/kg/min (95% CI 0.6 to 2.9) per 1 unit increment in FFP score. After adjustment, exercise tolerance was 38 watts lower (95% CI 18.4 to 58.1) and peak trueV˙normalO2 was 8.5 ml/kg/min lower (95% CI 3.3 to 13.7) among frail participants compared to non-frail participants. Frailty accounted for 16% of the variance (R2) of watts and 19% of the variance of trueV˙normalO2 in adjusted models. Conclusion Frailty contributes to reduced exercise capacity among lung transplant candidates independent of disease severity.

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Section: Discussionmentioning

confidence: 99%

Frailty and maximal exercise capacity in adult lung transplant candidates

Layton

Armstrong

Baldwin

et al. 2017

Respiratory Medicine

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“…Recently, Acanfora et al demonstrated that middle-age patients with chronic heart failure show greater improvements in CPET parameters than elderly patients [12]. In our cohort, AATD and COPD patients were both middle-aged and age was not related to 6MWD outcome.…”

Section: Exercise Performance In Aatd Vs Copdmentioning

confidence: 38%

Comparison of exercise training responses in COPD patients with and without Alpha-1 antitrypsin deficiency

Jarosch

Hitzl

Koczulla

et al. 2017

Respiratory Medicine

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“…This contributes to the sensation of dyspnea which is closely related to respiratory muscle function [39]. As demonstrated by a recent study, [40] cardiac and pulmonary function may be improved by exercise training.…”

Section: Chronic Obstructive Pulmonary Diseasesmentioning

confidence: 91%

Acute Effects of Inspiratory Muscle Training on Pulmonary Arterial Pressure,Cardiac Output and Pulmonary Arterial Saturation Derived Oxygen Cost of Breathing

Stieglitz¹,

Matthes²,

Priegnitz³

et al. 2017

Chron Obstruct Pulmon Dis

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Respiration and respiratory maneuvers affect cardiac output. Inspiratory muscle training (IMT) increases the negative thoracic pressure, which could have an impact on intra-thoracic hemodynamics and thereby influence the cardiac output (CO). The objective of our study was to determine changes in pulmonary arterial (PA) hemodynamics and the CO during IMT in patients with suspected pulmonary hypertension. A new method for measuring the oxygen cost of breathing during IMT was also developed. 22 patients were included in this prospective study. They performed IMT during right heart catheterization. Mixed-venous blood gas analysis was performed before and at the end of IMT to calculate the oxygen cost of breathing. The baseline PA pressure was systolic/diastolic/mean (s/d/m) 41 ± 20/13 ± 20/25 ± 11 mmHg. The CO was 5.3 ± 1.5 l/min. The IMT was set to 2.3 ± 0.6 kPa (23.7 ± 5.7 cmH 2 O). The PA pressure at the end of IMT was s/d/m 44/10/22 mmHg s/d/m. Though there was a trend towards a lower diastolic pressure, this change was not statistically significant (p=0.06). CO (6.2 ± 1.1 l/min) did not change due to IMT. The mixed-venous hemoglobin oxygen saturation was 71.8 ± 2.3% before IMT, with a significant reduction to 65.8 ± 5.9% (p=0.027) at the end of IMT. IMT as performed in our study neither changed the mean PA pressure nor the CO. Measuring the oxygen cost of breathing is feasible by the method described in our paper.

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Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation: A randomized, controlled trial

Cited by 40 publications

References 45 publications

Frailty and maximal exercise capacity in adult lung transplant candidates

Frailty and maximal exercise capacity in adult lung transplant candidates

Comparison of exercise training responses in COPD patients with and without Alpha-1 antitrypsin deficiency

Acute Effects of Inspiratory Muscle Training on Pulmonary Arterial Pressure,Cardiac Output and Pulmonary Arterial Saturation Derived Oxygen Cost of Breathing

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