Multiparameter assessment of exercise capacity in patients with arterial hypertension

Kurpaska, Małgorzata; Krzesiński, Paweł; Gielerak, Grzegorz; Uziębło‐Życzkowska, Beata; Banak, Małgorzata; Piotrowicz, Katarzyna; Stańczyk, Adam

doi:10.1080/10641963.2018.1523917

Cited by 7 publications

(8 citation statements)

References 40 publications

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“…Twenty-four hours ADBP was negatively associated with exercise capacity in our study, indicating that exercise capacity declines with the increase of BP. A similar result was shown in adults: 43.9% of hypertensive patients failed to achieve the predictive distance of 6WMT ( 37 ). An animal model also suggested that hypertensive subjects had lower exercise capacity than healthy ones ( 38 ).…”

Section: Discussionsupporting

confidence: 74%

Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension

et al. 2022

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PurposeExercise training is crucial to the early intervention of pediatric primary hypertension (PHT). However, much less is known about exercise capacity in this disease. This work investigated the exercise capacity in pediatric PHT and analyzed the factors affecting exercise capacity.MethodsThe study enrolled children with PHT at the Children's Hospital Capital Institute of Pediatrics between July 2017 and July 2020. The Bruce protocol of the treadmill exercise test (TET) was used to assess exercise capacity. Multivariate ordinal logistic regression and generalized linear models were used to analyze factors affecting exercise capacity.ResultsOf 190 patients, 146 (76.8%) were male, and the median age was 13 (11, 14). Most children accomplished TET and achieved the submaximal heart rates (189 [99.5%]). Children with lower resting diastolic blood pressure (DBP) and 24 h average diastolic blood pressure (ADBP) could achieve a TET stage of 6 or more, whereas children with higher DBP and ADBP could only achieve a TET stage of 3 (P all < 0.05). Children with lower DBP and 24 h ADBP were also associated with greater metabolic equivalents (METs; r = −0.237, r = −0.179, P all < 0.05). The completion of TET stages was negatively associated with female (OR = 0.163), younger age (OR = 1.198), greater body mass index (BMI, OR = 0.921), and higher 24 h ADBP (OR = 0.952, P all < 0.05). In addition, METs were negatively associated with female (β = −1.909), younger age (β = 0.282), greater BMI (β = −0.134), and higher 24 h ADBP (β = −0.063, P all < 0.05).ConclusionsExercise capacity was impaired among pediatric PHT patients. Female gender, younger age, greater BMI, and higher 24 h ADBP are independently associated with the exercise capacity in pediatric PHT. These findings may help developing scientific exercise prescriptions for pediatric PHT.

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Section: Discussionsupporting

confidence: 74%

Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension

et al. 2022

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“…A relationship between low exercise capacity and the absence of SV increase during the nal phase of the exercise test, as well as between low exercise capacity and low absolute SV values at peak exercise, have been reported in nonathletic adults [21] and in patients with hypertension [12], diastolic left ventricular dysfunction [22] and HF [11,20]. Moreover, a number of authors have emphasized the association between regular physical exercise and SV improvement [23,24,25].…”

Section: Discussionmentioning

confidence: 91%

“…Exercise ICG was conducted with the use of a PhysioFlow monitor (Manatec, Paris, France). The methods employed during ICG were described in our earlier paper [12]. The device offered beat-to-beat acquisition of the following parameters: HR [bpm], SV [mL], CO [mL/min], and left cardiac work index (LCWi [kg•m/m 2 ]), with the last one de ned as the estimated energy requirement of the left ventricle to eject blood against the aortic pressure.…”

Section: Methodsmentioning

confidence: 99%

“…Preliminary research showed that ICG is a simple, accurate, and reproducible method of measuring these parameters over a wide range of workloads [11]. Our team's previous studies [12,13] demonstrated the usefulness of ICG in assessing the hemodynamic response to exercise in a group of hypertensive patients, by showing that ICG may complement traditional exercise testing and reveal an impaired hemodynamic response to exercise as a cause of unexplained dyspnea.…”

Section: Introductionmentioning

confidence: 95%

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Cardiopulmonary Exercise Testing and Impedance Cardiography in The Assessment of Exercise Capacity of Patients with Coronary Artery Disease

Kurpaska¹,

Krzesiński²,

Prof³

et al. 2021

Preprint

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Background Patients with coronary artery disease (CAD) are characterized by different levels of physical capacity, which depends not only on the anatomical advancement of atherosclerosis, but also on the individual cardiovascular hemodynamic response to exercise. The aim of this study was to evaluate the relationship between parameters of exercise capacity assessed via cardiopulmonary exercise testing (CPET) and impedance cardiography (ICG) hemodynamics in patients with CAD. Methods Exercise capacity was assessed in 54 patients with CAD (41 men, aged 59.5 ± 8.6 years) within 6 weeks after revascularization by means of oxygen uptake (VO2), assessed via CPET, and hemodynamic parameters (heart rate (HR), stroke volume (SV), cardiac output (CO), left cardiac work index (LCWi)), measured by ICG. Correlations between these parameters at anaerobic threshold (AT) and at the peak of exercise as well as their changes (Δpeak–rest, Δpeak–AT) were evaluated. Results A large proportion of patients exhibited reduced exercise capacity, with 63% not reaching 80% of predicted peak VO2. Clinically relevant correlations were noted between the absolute peak values of VO2 vs. HR, VO2 vs. CO, and VO2 vs. LCWi (R = 0.45, p = 0.0005; R = 0.33, p = 0.015; and R = 0.40, p = 0.003, respectively). There was no correlation between AT VO2 and hemodynamic parameters at the AT time point. Furthermore ΔVO2(peak–AT) correlated with ΔHR(peak–AT), ΔCO(peak–AT) and ΔLCWi(peak–AT) (R = 0.52, p < 0.0001, R = 0.49, p = 0.0001; and R = 0.49, p = 0.0001, respectively). ΔVO2(peak–rest) correlated with ΔHR(peak–rest), ΔCO(peak–rest), and ΔLCWi(peak–rest) (R = 0.47, p < 0.0001; R = 0.41, p = 0.002; and R = 0.43, p = 0.001, respectively). Conclusion ICG is a reliable method of assessing the cardiovascular response to exercise in patients with CAD. Some ICG parameters show definite correlations with parameters of cardiovascular capacity of proven clinical utility, such as peak VO2.

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“…Preliminary research showed that ICG is a simple, accurate, and reproducible method of measuring these parameters over a wide range of workloads [ 12 ]. Our team’s previous studies [ 13 , 14 ] demonstrated the usefulness of ICG in assessing the hemodynamic response to exercise in a group of hypertensive patients, by showing that ICG may complement traditional exercise testing and reveal an impaired hemodynamic response to exercise as a cause of unexplained dyspnea.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary exercise testing and impedance cardiography in the assessment of exercise capacity of patients with coronary artery disease early after myocardial revascularization

Kurpaska

Krzesiński

Gielerak

et al. 2022

BMC Sports Sci Med Rehabil

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Background Patients with coronary artery disease (CAD) are characterized by different levels of physical capacity, which depends not only on the anatomical advancement of atherosclerosis, but also on the individual cardiovascular hemodynamic response to exercise. The aim of this study was evaluating the relationship between parameters of exercise capacity assessed via cardiopulmonary exercise testing (CPET) and impedance cardiography (ICG) hemodynamics in patients with CAD. Methods Exercise capacity was assessed in 54 patients with CAD (41 men, aged 59.5 ± 8.6 years) within 6 weeks after revascularization by means of oxygen uptake (VO2), assessed via CPET, and hemodynamic parameters [heart rate (HR), stroke volume, cardiac output (CO), left cardiac work index (LCWi)], measured by ICG. Correlations between these parameters at anaerobic threshold (AT) and at the peak of exercise as well as their changes (Δpeak–rest, Δpeak–AT) were evaluated. Results A large proportion of patients exhibited reduced exercise capacity, with 63% not reaching 80% of predicted peak VO2. Clinically relevant correlations were noted between the absolute peak values of VO2 versus HR, VO2 versus CO, and VO2 versus LCWi (R = 0.45, p = 0.0005; R = 0.33, p = 0.015; and R = 0.40, p = 0.003, respectively). There was no correlation between AT VO2 and hemodynamic parameters at the AT time point. Furthermore ΔVO2 (peak–AT) correlated with ΔHR (peak–AT), ΔCO (peak–AT) and ΔLCWi (peak–AT) (R = 0.52, p < 0.0001, R = 0.49, p = 0.0001; and R = 0.49, p = 0.0001, respectively). ΔVO2 (peak–rest) correlated with ΔHR (peak–rest), ΔCO (peak–rest), and ΔLCWi (peak–rest) (R = 0.47, p < 0.0001; R = 0.41, p = 0.002; and R = 0.43, p = 0.001, respectively). Conclusion ICG is a reliable method of assessing the cardiovascular response to exercise in patients with CAD. Some ICG parameters show definite correlations with parameters of cardiovascular capacity of proven clinical utility, such as peak VO2.

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Multiparameter assessment of exercise capacity in patients with arterial hypertension

Cited by 7 publications

References 40 publications

Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension

Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension

Cardiopulmonary Exercise Testing and Impedance Cardiography in The Assessment of Exercise Capacity of Patients with Coronary Artery Disease

Cardiopulmonary exercise testing and impedance cardiography in the assessment of exercise capacity of patients with coronary artery disease early after myocardial revascularization

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