Long-term Reproducibility of Respiratory Gas Exchange Measurements during Exercise in Patients with Stable Cardiac Failure

Janicki, Joseph S.; Ferris, Scott T.; McElroy, Patricia A.

doi:10.1378/chest.97.1.12

Cited by 67 publications

(38 citation statements)

References 4 publications

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“…Other causes may include the amount of time spent sleeping on the previous day, the player's emotional status, and the time of day when the CPET was performed. Considering these factors, the scientific literature has reported (16,(24)(25)(26) that the coefficient of variation of VO 2 and HR at two consecutive CPETs is approximately 5%, with the possibility of a larger systematic variation at the beginning of exercise. However, even though such variations probably affect the stability of the maximum value and the shape of the relative O 2 pulse curve, no studies have directly evaluated the stability between two CPETs, separated by an interval of 1 year with a homogenous sample, as performed in our study.…”

Section: Discussionmentioning

confidence: 99%

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

Perim¹,

Signorelli²,

Araújo³

2011

Braz J Med Biol Res

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During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0.9 vs 63.5 ± 0.9 mL O2•kg-1•min-1), HR (190 ± 1 vs188 ± 1 bpm) and relative O2 pulse (32.9 ± 0.6 vs 32.6 ± 0.6 mL O2•beat-1•kg-1) were similar for the two CPETs (P > 0.05), while the final treadmill velocity increased from 18.5 ± 0.9 to 18.9 ± 1.0 km/h (P < 0.01). Relative O2 pulse increased linearly and similarly in both evaluations (r² = 0.64 and 0.63) up to 90% of the running time. Between 90 and 100% of the running time, the values were less stable, with up to 50% of the players showing a tendency to a plateau in the relative O2 pulse. In young healthy men in good to excellent aerobic condition, the morphology of the relative O2 pulse curve is consistent up to close to the peak effort for a CPET repeated within a 1-year period. No increase in relative O2pulse at peak effort could represent a physiologic stroke volume limitation in these athletes

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Section: Discussionmentioning

confidence: 99%

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

Perim¹,

Signorelli²,

Araújo³

2011

Braz J Med Biol Res

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“…Test-retest reliability using cycle ergometry has been examined before in healthy subjects [18][19][20] and in patients with cardiac [21][22][23] and pulmonary disease [24][25][26]. The majority of theses studies utilised maximal exercise testing, whereas our study concentrated on submaximal testing, making comparisons difficult.…”

Section: Discussionmentioning

confidence: 99%

Reliability of the anaerobic threshold in cardiopulmonary exercise testing of patients with abdominal aortic aneurysms*

Kothmann¹,

Danjoux²,

Owen

et al. 2008

Anaesthesia

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SummaryAnaerobic threshold (AT), determined by cardiopulmonary exercise testing (CPET), is a well-documented measure of pre-operative fitness, although its reliability in patient populations is uncertain. Our aim was to assess the reliability of AT measurement in patients with abdominal aortic aneurysms. Eighteen patients were recruited. CPET was performed four times over a 6-week period. We examined shifts in the mean AT to evaluate systematic bias with random measurement error assessed using typical within-patient error and intraclass correlation coefficient (ICC, 3,1) statistics. There was no significant or clinically substantial change in mean AT across the tests (p = 0.68). The typical within-patient error expressed as a percentage coefficient of variation was 10% (95% CI, 8-13%), with an ICC of 0.74 (95% CI, 0.55-0.89). We consider the reliability of the AT to be acceptable, supporting its clinical validity and utility as an objective marker of pre-operative fitness in this population.

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“…Later it was shown, mainly by cardiologists [134][135][136], that V 'O 2 ,max was more reproducible than duration of exercise. Most recently, CAHALIN et al [137] showed the distance ambulated in a 6 min walk test to be predictive of V'O 2 ,max and short-term event-free survival in patients with advanced heart failure.…”

Section: Maximal Testsmentioning

confidence: 99%

Functional evaluation of the lung resection candidate

Bolliger¹,

Perruchoud²

1998

Eur Respir J

163

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Advances in operative technique and perioperative care have considerably reduced surgical morbidity and mortality after pulmonary resections. Various single and combined parameters of functional operability have been proposed to assess the surgical risk. Pulmonary function tests adequately assess the pulmonary risk, and baseline or stress electrocardiography, echocardiography and nuclear cardiac studies assess the cardiac risk.Patients with normal or only slightly impaired pulmonary function (forced expiratory volume in one second (FEV1) and transfer factor of the lung for carbon monoxide (TL,CO) ≥80% of predicted) and no cardiovascular risk factors can undergo pulmonary resections up to a pneumonectomy without further investigation. For others, exercise testing, pulmonary split-function studies, or a combination of these two methods are recommended. Exercise testing, most frequently performed as a symptom-limited test with the measurement of maximal oxygen uptake (V 'O 2 ,max), assesses both the pulmonary and cardiovascular reserves. A V'O 2 ,max of <10 mL·kg -1 ·min -1 is generally considered prohibitive for any resection, a value of >20 mL·kg -1 ·min -1 or >75% of predicted normal, safe for major resections. Split-function studies are radionuclide-based estimations of the predicted postoperative (ppo) values of various parameters. The currently used ppo-parameters are FEV1-ppo, TL,CO-ppo and, most recently, V'O 2 ,max-ppo. Suggested cutoff values for safe resection are: for FEV1-ppo and TL,CO-ppo ≥40% pred; and for V 'O 2 ,max ≥35% pred, combined with an absolute value of ≥10 mL·kg -1 ·min -1 . The lowest acceptable ppo-values will still have to be established by additional prospective studies.In the long-term, resections involving not more than one lobe usually lead to an early functional deficit followed by later recovery. The permanent functional loss in pulmonary function is small (≤10%) and exercise capacity is only slightly reduced or not at all. Pneumonectomy, on the other hand, leads to an early permanent loss of about 33% in pulmonary function and 20% in exercise capacity. Thus, pulmonary function tests alone overestimate the functional loss after lung resection. Eur Respir J 1998; 11: 198-212 The dramatic increase in the incidence of bronchogenic carcinoma has made this disease the most frequent malignancy worldwide. In industrialized nations, the majority of lung resection candidates suffer from bronchogenic carcinoma, whereas only some decades ago benign conditions, such as destroyed lung parenchyma after tuberculosis, had to be removed. The prognosis of bronchogenic carcinoma remains sombre as about 75-85% are inoperable at the time of diagnosis [1], and despite recent advances in chemo-and radiotherapy regimens, surgical resection remains the only curative form of treatment [2].Depending on their extent, pulmonary resections lead to permanent loss of pulmonary function. In healthy people, resections up to a pneumonectomy are tolerated remarkably well. Lung cancer patients, however, are...

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Long-term Reproducibility of Respiratory Gas Exchange Measurements during Exercise in Patients with Stable Cardiac Failure

Cited by 67 publications

References 4 publications

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

Reliability of the anaerobic threshold in cardiopulmonary exercise testing of patients with abdominal aortic aneurysms*

Functional evaluation of the lung resection candidate

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