Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. Background Cardiopulmonary exercise test (CPET) is the reference method for assessing gas exchange threshold (GET), a surrogate of the anaerobic threshold (AnT). However, muscle oxygenation has been shown as an additional tool for AnT determination, using the lower limb threshold (LLT). Besides, Talk Test (TT), a tool used to assess, prescribe, and monitor exercise intensity through speech comfort level, has shown a correlation with GET as well. Purpose To identify the AnT obtained from the traditional method from CPET (GET) and the LLT; to compare heart rate (HR) and tissue saturation index (TSI) data at AnT (GET and LLT); to compare the parameters of LLT on CPET and TT, and to correlate LLT and TT stages in cardiovascular disease (CVD) patients. Methods CVD patients underwent CPET and TT, both on a treadmill, in two distinctive days. During those tests, peripheral muscle oxygenation was assessed by the near-infrared spectroscopy method. GET (CPET) was determined by the V-slope method; LLT (CPET and TT) was determined by the visual inspection of oxyhemoglobin and deoxyhemoglobin curves. A TT protocol based on the prediction equation for the covered distance of the six-minute walk test (6MWD) was applied. TT protocol was incremental, with two-minutes stages starting at 70% of the average velocity predicted and 2% of inclination, increasing velocity in 10 percentage points (p.p.) at each stage, until the fifth stage, at which the inclination was increased in 2 p.p. until test completion. At the end of each stage, patients read a standardized paragraph and were asked about speech comfort. Shapiro-Wilk test was performed to assess data distribution. Wilcoxon test was applied to compare physiological variables (HR and TSI) at GET and LLT. Repeated measures analysis of variance (ANOVA), followed by Bonferroni post-hoc test was assessed to compare the variables at LLT and TT stages (last TT+ and first TT±). Spearman correlation coefficient was used to assess the relationship between variables. Statistical significance was set at 5%. Results 24 cardiovascular patients were included. Similar values of HR (GET vs. LLT: 102 ± 15 bpm vs. 99 ± 14 bpm, p = 0,08), and TSI (GET vs. LLT: 64,6 ± 8,2% vs. 66,4 ± 7,8%, p = 0,09) were observed during CPET. Regarding LLT at CPET and TT, there was no difference between HR (CPET vs. TT: 99 ± 14 bpm vs. 100 ± 12 bpm, p = 1,00) and TSI (CPET vs. TT: 66,4 ± 7,8% vs. 65,3 ± 4,9%, p = 1,00). Furthermore, good relationship between HR in LLT and TT stages (LLT vs. TT+: r = 0,79; LLT vs. TT±: r = 0,76; p < 0,05 for both) was found. Conclusions Our results showed similarity between LLT and GET. Besides, TT showed a similar response of muscle oxygenation and heart rate comparing to CPET, with a good correlation between LLT and TT stages. These results endorse the validity of TT as an auxiliary and low-cost tool to identify the AnT.
Funding Acknowledgements Type of funding sources: None. Background Frailty has a high prevalence of heart failure (HF). It is believed that existing circulatory disturbance increase oxidative stress and chronic inflammation, predisposing to anabolic-catabolic imbalance. Thus, there is impairment of the efficient use of oxygen by skeletal muscles, limiting the physical-functional performance in these individuals. However, little is known about the influence of frailty on endothelial function in the elderly. Purpose To analyze the influence of frailty on endothelial function in the elderly with and without HF. Methods This was a descriptive cross-sectional study, which included individuals aged ≥60 years, with or without HF, who did not have diabetes, anemia, peripheral obstructive arterial disease and/or congenital heart disease. The Cardiovascular Health Study (CHS) frailty scale criteria were used to assess frailty (phenotype). Endothelial function at rest was evaluated by near-infrared spectroscopy ([NIRS]; slope 1, lowest tissue oxygen saturation [StO2], area under the curve [AUC] of StO2, slope 2, StO2 peak, overshoot, ΔStO2nadir_peak and Δtime nadir_peak) during arterial occlusion maneuver on the forearm. Results were grouped according to the frailty phenotype: robust, pre-frail and frail. Shapiro-Wilk test was used to assess the normality of data. Quantitative data were compared using a two-way analysis of variance plus Bonferroni post hoc test to determine the influence of the frailty or HF on endothelial function variables. A p-value <0.05 was considered statistically significant. Results Fifty-two elderly people (61% women) participated in the study, with a mean age of 70.3 ± 7.1 years. Of these, 52% (n = 27) had a diagnosis of HF. Among the sample, 35% (n = 18) were robust, 45% (n = 23) pre-frail, and 20% (n = 11) frail. Endothelial function analysis identified that there was an influence of frailty on reperfusion rate (slope 2 and ΔStO2 nadir-peak; p < 0.05) and desaturation during arterial occlusion (AUC StO2; p < 0.05) only in the HF group. Conclusion The coexistence of frailty and HF seems to impair endothelial function since frail elderly with HF had lower reperfusion rate and higher desaturation during the arterial occlusion test. Abstract Figure. Endothelial function assessment by NIRS
Funding Acknowledgements Type of funding sources: None. Background Talk test (TT) is an alternative and accessible tool for prescribing and monitoring aerobic training intensity. Although the TT is reliable and valid for cardiorespiratory assessment, its responsiveness to exercise training remains unexplored. Purpose To evaluate the responsiveness of TT in cardiovascular disease (CVD) patients who underwent an exercise training program. Methods Twenty-one CVD patients (61.7 ± 8.4 years) performed an exercise-training program on phase II of cardiac rehabilitation (45-min 3-times a week). The six-minute walk test (6MWT) and TT were done to assess functional capacity at baseline and after 8 weeks. In the individualized TT the treadmill’s speed and/or grade were increased every 2-min, with speed changes based on a reference equation for the 6MWT distance (6MWD). The subjects were asked to read a 38 words standard paragraph at the last 30s of each stage and to answer if they could talk comfortably. Answer options were i) YES (TT+), ii) UNCERTAIN (TT±), or iii) NO (TT-). The first ventilatory threshold (VT1) was identified by two reviewers using the heart rate variability analysis. A paired t-test was applied to analyze the TT duration and 6MWD. The VT1 and TT workload were analyzed by the Wilcoxon test. Spearman correlation was adopted to compare the TT± and VT1 stages. Results Improvement in the VT1 (2.9 ± 1.2 vs 4.4 ± 1.4 min; p < 0.001), duration (12.1 ± 4.4 vs 14.9 ± 5.2 min; p < 0.001), workload at TT- (67.8 ± 48.4 vs 104.5 ± 65.9 w; p < 0.001), and in the 6MWD (471.5 ± 100.3 vs 533.7 ± 92.9 m; p < 0.001) were observed. There was strong correlation between TT± and VT1 in pre (r = 0.613; p < 0.05) and post-rehabilitation (r = 0.678; p < 0.05). Conclusion Talk test performed on a treadmill showed responsiveness after eight weeks of exercise training, being sensitive to the physiological changes provided by the rehabilitation program in CVD patients.
Funding Acknowledgements Type of funding sources: None. OnBehalf Research Group on Cardiovascular Health and Exercise - gepCARDIO Introduction Cardiovascular disease is the main cause of morbidity and mortality worldwide, accounting for about 31% of deaths, in addition to leading to disabilities and worsening quality of life. The diagnosis of the disease and the response to treatments can be evaluated with functional tests. The most used are the incremental tests, such as the cardiopulmonary exercise test, a reference standard for diagnostic evaluation and exercise prescription. Constant workload tests or endurance tests report the efforts in daily activities and are especially applied to assess the effects of therapeutic procedures, such as physical training and drug therapy. Porpuse: Compare incremental exercise tests with constant workload tests for the assessment of functional performance in response to therapeutic interventions in individuals with cardiovascular disease. Methods: The systematic review was registered on the PROSPERO (CRD42020190214). The search was conducted in July 2020, in ten databases (PubMed, Scopus, Web of Science, Embase, CINAHL, LILACS, PEDro, SPORTDiscus, Livivo and Cochrane Library), and the Google Scholar search. Combinations of terms of related to the PECO strategy were used: (P) individuals with cardiovascular disease undergoing therapeutic procedure; (E) who were exposed to the evaluation with constant workload test; (C) compared to an incremental exercise test; (O) to assess functional capacity outcomes. Results: 9.453 studies were identified, of which 24 were included in the qualitative analysis and 19 in the meta-analysis. The interventions found were exercise training (71%) and drug therapy (29%). Heart failure was the prevalent diagnosis (54%), followed by coronary artery disease (17%). The constant workload test showing an improvement of 83% (MD 8.62, 95% CI 5.85–11.38) in test duration. The incremental tests showed changes of 12% (MD 1.98, 95% CI 5.85–11.38) for oxygen uptake, and 23% (MD 2.15, 95% CI 1.60–2.71) in oxygen uptake at the anaerobic threshold. In the comparisons between the tests performed in the meta-analysis, the duration of the constant workload test was more responsive than the oxygen uptake in the incremental test (SMD 1.59, 95% CI 0.88 - 2.29). In the analysis of subgroups of clinical diagnosis, the constant workload test was more responsive in the groups of heart failure, coronary artery disease and peripheral arterial disease. In the analysis by type of intervention, the studies with constant workload test also showed superior results. Conclusion: Tests with constant workload are more responsive in detecting changes in functional capacity in individuals with cardiovascular disease after a therapeutic intervention. Future studies with better methodological quality are recommended to increase the certainty of the evaluated evidence. Constant workload tests may have more use in clinical practice, facilitating the assessment of functional outcomes for cardiac patients.
Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CAPES and FAPERGS. Background Exercise oscillatory ventilation (EOV) is an abnormal ventilatory phenomenon observed in chronic heart failure (HF) patients usually defined as EOV-positive or EOV-negative based on a dichotomous diagnosis. Minute ventilation variability (vVE) can quantify the presence of these oscillations and assist the prognosis of patients. Purpose To analyse the sensitivity and specificity of vVE to predict 2-year all-causes of death in HF patients. Methods Data from 233 cardiopulmonary exercise tests from HF patients performed between 2011 and 2014 at an Italian heart centre were analysed. The vVE was defined by the standard deviation (SD) of VE normalized by the number of respiratory cycles (SD/n) during the exercise tests. The cut-off to predict 2-year mortality was determined by the receiver-operating characteristic (ROC) curve. Results Thirty-five deaths were registered at 2-years. The ROC curve indicated ≤ 54.9 as the better cut-off for vVE (32 deaths were registered in follow-up; Figure 1). The relative risk was 3.9 (1.3 to 12.4) with a hazard ratio of 2.7 (1.3 to 5.6) for 2-year mortality. Conclusion The vVE appears to be a sensitive alternative to quantify EOV and stratify high-risk cases from 2-year all-cause mortality.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.