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Peak Exercise Oxygen Consumption (peak + exercise_oxygen_consumption)
Selected AbstractsBlunted Hemodynamic Response and Reduced Oxygen Delivery With Exercise in Anemic Heart Failure Patients With Systolic DysfunctionCONGESTIVE HEART FAILURE, Issue 2 2007Jennifer Listerman MD Anemic heart failure patients with systolic dysfunction are known to have reduced exercise capacity. Whether this is related to poor hemodynamic adaptation to anemia is not known. Peak exercise oxygen consumption (VO2) and hemodynamics at rest and peak exercise were assessed among 209 patients and compared among those who were (n=90) and were not (n=119) anemic. Peak VO2 was significantly lower among anemic patients (11.7±3.3 mL/min/kg vs 13.4±3.1 mL/min/kg; P=.01). At rest, right atrial pressure was higher (10±5 mm Hg vs 8±4 mm Hg; P=.02) and venous oxygen saturation lower (62%±8% vs 58%±10%; P<.01) among anemic patients. At peak exercise, anemic patients had a higher wedge pressure (27±9 mm Hg vs 24±10 mm Hg; P=.04). No significant differences in stroke volume, cardiac index, systemic vascular resistance, or oxygen saturation were noted between the 2 groups. In conclusion, the relative hemodynamic response to exercise among anemic heart failure patients appears blunted and may contribute to worse exercise tolerance. [source] Dynamic Analysis of Exercise Oxygen Consumption Predicts Outcomes in Advanced Heart FailureCONGESTIVE HEART FAILURE, Issue 6 2007Guy A. MacGowan MD It is unclear whether cardiopulmonary stress testing provides prognostic information in patients with very advanced heart failure receiving contemporary medical therapy. Analysis of cardiopulmonary treadmill stress data in a group of patients with advanced heart failure and severe functional impairment was performed (N=102, peak exercise oxygen consumption [VO2] ,14 mL/kg/min, 47% receiving ,-blockers). Dynamic variables (peak - baseline values) better predicted outcomes than did single value peak measurements, especially ,VO2. Multivariate analysis showed that usage of ,-blockers and ,VO2 (both P<.05) independently and significantly predicted outcomes. Subgroup analysis showed that ,VO2 was particularly useful in predicting outcomes in patients with ischemic cardiomyopathy or who were not receiving ,-blockers. Thus, in patients with very advanced heart failure, cardiopulmonary stress testing-derived ,VO2 provides important prognostic information useful to help predict clinical deterioration or death, particularly for patients with ischemic cardiomyopathy or who are not receiving ,-blockers. [source] Echocardiographic Doppler Evaluation of Left Ventricular Diastolic Filling in Older, Highly Trained Male Endurance AthletesECHOCARDIOGRAPHY, Issue 1 2000PETER R. JUNGBLUT M.D. Previously published data have suggested that endurance training does not retard the normative aging impairment of early left ventricular diastolic filling (LVDF). Those studies, suggesting no effect of exercise training, have not examined highly trained endurance athletes or their LVDF responses after exercise. We therefore compared LVDF characteristics in a group of older highly trained endurance athletes (n= 12, mean age 69 years, range 65,75) and a group of sedentary control subjects (n= 12, mean age 69 years, range 65,73) with no cardiovascular disease. For all subjects, M-mode and Doppler echocardiographic data were obtained at rest. After baseline studies, subjects underwent graded, maximal cardiopulmonary treadmill exercise testing using a modified Balke protocol. Breath-by-breath respiratory gas analysis and peak exercise oxygen consumption (VO2max) measurements were obtained. Immediately after exercise and at 3,6 minutes into recovery, repeat Doppler echocardiographic data were obtained for determination of LVDF parameters. VO2max (44 ± 6.3 vs 27 ± 4.2 mllkglmin, P< 0.001), oxygen consumption at anaerobic threshold (35 ± 5.4 vs 24 ± 3.8 mllkglmin, P< 0.001), exercise duration (24 ± 3 vs 12 ± 6 minutes, P< 0.001), and left ventricular mass index (61 ± 13 vs 51 ± 7.8 kglm2, P< 0.05) were greater in endurance athletes than in sedentary control subjects, whereas body mass index was lower (22 ± 1.7 vs 26 ± 3.4 kglm2, P< 0.001). No differences in any of the LVDF characteristics were observed between the groups with the exception of a trend toward a lower atrial filling fraction at rest in the endurance athlete group versus the control subjects (P= 0.07). High-intensity endurance exercise training promotes exceptional peak exercise oxygen consumption and cardiovascular stamina but does not appear to alter normative aging effects on left ventricular diastolic function. (ECHOCARDIOGRAPHY, Volume 17, January 2000) [source] Endurance Exercise Training in Older Patients with Heart Failure: Results from a Randomized, Controlled, Single-Blind TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2009Peter H. Brubaker PhD OBJECTIVES: To test the hypothesis that exercise training (ET) improves exercise capacity and other clinical outcomes in older persons with heart failure with reduced ejection fraction (HfrEF). DESIGN: Randomized, controlled, single-blind trial. SETTING: Outpatient cardiac rehabilitation program. PARTICIPANTS: Fifty-nine patients aged 60 and older with HFrEF recruited from hospital records and referring physicians were randomly assigned to a 16-week supervised ET program (n=30) or an attention-control, nonexercise, usual care control group (n=29). INTERVENTION: Sixteen-week supervised ET program of endurance exercise (walking and stationary cycling) three times per week for 30 to 40 minutes at moderate intensity regulated according to heart rate and perceived exertion. MEASUREMENTS: Individuals blinded to group assignment assessed four domains pivotal to HFrEF pathophysiology: exercise performance, left ventricular (LV) function, neuroendocrine activation, and health-related quality of life (QOL). RESULTS: At follow-up, the ET group had significantly greater exercise time and workload than the control group, but there were no significant differences between the groups for the primary outcomes: peak exercise oxygen consumption (VO2 peak), ventilatory anaerobic threshold (VAT), 6-minute walk distance, QOL, LV volumes, EF, or diastolic filling. Other than serum aldosterone, there were no significant differences after ET in other neuroendocrine measurements. Despite a lack of a group "training" effect, a subset (26%) of individuals increased VO2 peak by 10% or more and improved other clinical variables as well. CONCLUSION: In older patients with HFrEF, ET failed to produce consistent benefits in any of the four pivotal domains of HF that were examined, although the heterogeneous response of older patients with HFrEF to ET requires further investigation to better determine which patients with HFrEF will respond favorably to ET. [source] | ||||||||||