Navegando por Palavras-chave "Cardiopulmonary exercise test"

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    Avaliação da capacidade física de crianças nascidas prematuras com muito baixo peso
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-11) Tsopanoglou, Sabrina Pinheiro [UNIFESP]; Santos, Amelia Miyashiro Nunes dos [UNIFESP]; http://lattes.cnpq.br/9925075057283150; http://lattes.cnpq.br/3509876657463607; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To compare aerobic capacity of children born prematurely with children born at term and to identify factors associated with aerobic capacity of these children during cardiopulmonary exercise test (CPET). Methods: Cross-sectional study with two groups of children aged 6-9 years: one group of children born prematurely with birth weight <1500g and followed at the Preterm out clinic of the Federal University of São Paulo. Children born at term composed the second group; brothers, friends or relatives of preterm children who did not presented clinical complications during neonatal period. Exclusion criteria were: congenital malformations, neuromuscular disorders, neurological, medical or developmental impairment that could compromise the results or safety of the child during the test and/or respiratory disease 15 days prior to testing. For CPET, it was adopted a quickly incremental symptom limited protocol with individualized load increase on treadmill. Variables measured were: oxygen pulse (PuO2), peak of heart rate (HR peak), percentage of maximum heart rate expected for age (% HR max), tidal volume/inspiratory capacity (VC/CI rest and peak), ventilatory equivalent for CO2 (VE/VCO 2 slope and lowest), oxygen consumption (VO2) peak and percentage of maximum predicted oxygen consumption for age (% VO2 max prev.), oxygen consumption at anaerobic threshold/anaerobic threshold (VO2 in LA), maximal oxygen and threshold of maximum percentage provided for oxygen-consuming for age ratio (VO2 @ LA/%VCO2 max. pred), Oxygen Uptake Efficiency Slope (OUES). The sample size calculation required 22 participants in each group, to evidence a difference of 7.3mL/kg/min. in VO2 between groups, considering alpha of 0.05 and beta of 0.80. Categorical variables were compared by chi-square or Fisher's exact test and numeric variables by the student t test or Mann-Whitney, according to their distribution evaluated by the Kolmogorov-Smirnov. Univariate and multiple linear regression analysis were applied to evaluate factors associated with aerobic capacity. Variables with clinical and statistical significance (p <0.2) detected by univariate regression were included in the multivariate model. Statistical analysis was performed using SPSS for Win / v.17.0, considering significant p <0.05. Results: Thirty-four preterm infants were included (gestational age 29.8 ± 2.5 weeks,birth weight 1131 ± 228g) and 32 term children. Among preterm children, 70.6% required mechanical ventilation and the length of stay in the unit neonatal was 61 ± 21 days. At inclusion in the study, both groups were similar in age, weight, height, body mass index and incidence of overweight/obesity, except for the z score for height/age (Preterm group: -0.35 ± 1.17 vs. Term group: 0.24 ± 0.96, p = 0.032). All parameters of aerobic capacity were similar in both groups. By multivariate linear regression: HR peak was positively associated with bronchopulmonary dysplasia and overweight/obesity; %Maximum heart rate was positively associated with broncopulmonary dysplasia, overweight/obesity; PuO2 was positively associated to the z-score for height/age and negatively to female; VO2 peak was positively associated with birth weight <1000 g, and negatively for female and overweight/obese. Conclusions: The parameters of aerobic capacity evaluated by the cardiopulmonary test were similar in both groups. Factors associated with aerobic capacity were female, broncopulmonary dysplasia and variables related to body growth, showing the influence of neonatal factors and postnatal growth on the aerobic capacity of children born prematurely.
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    Cardiorespiratory and electroencephalographic responses to exhaustive acute physical exercise in people with temporal lobe epilepsy
    (Elsevier B.V., 2010-11-01) Vancini, Rodrigo Luiz [UNIFESP]; Barbosa de Lira, Claudio Andre; Scorza, Fulvio Alexandre [UNIFESP]; Albuquerque, Manly de; Sousa, Bolivar Saldanha [UNIFESP]; Lima, Cristiano de [UNIFESP]; Cavalheiro, Esper Abrao [UNIFESP]; Silva, Antonio Carlos da [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Goiás (UFG); UMC
    We evaluated physiological and electroencephalographic responses during a cardiopulmonary exercise test (CPET) in people with epilepsy. Behavioral outcomes of people with epilepsy were also compared with those of healthy controls. Thirty-eight subjects (19 people with epilepsy and 19 controls) participated in this study. Poor outcomes in the behavioral analyses (habitual level of physical activity and quality of life) were observed in the people with epilepsy. With respect to the CPET, VO(2max) (14.6%) and VO(2) at anaerobic threshold (16.1%) were significantly lower in the epilepsy group than in the control group. Although not statistically significant, a decrease in the number of epileptiform discharges was observed between the rest state and exercise (82%) and between the rest state and recovery period (74%). in conclusion, the lower aerobic fitness in people with epilepsy observed may be associated with their sedentary habits. Moreover, our findings reinforce the hypothesis that exhaustive exercise is not a seizure-inducing factor. (C) 2010 Elsevier Inc. All rights reserved.
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    Comparação das respostas fisiológicas do teste cardiopulmonar de membros superiores e inferiores em pacientes com hipertensão pulmonar tromboembólica crônica e controles saudáveis
    (Universidade Federal de São Paulo (UNIFESP), 2020) Ivanaga, Ivan Teruaki [UNIFESP]; Nascimento, Oliver Augusto [UNIFESP]; Arakaki, Jaquelina Sonoe Ota [UNIFESP]; Ramos, Roberta Pulcheri [UNIFESP]; http://lattes.cnpq.br/4282849546206947; http://lattes.cnpq.br/3674430003360595; http://lattes.cnpq.br/2225674564595145; http://lattes.cnpq.br/8171795027183234; Universidade Federal de São Paulo
    Introdução: Indivíduos com hipertensão pulmonar (HP) apresentam limitação na capacidade de exercício. No teste cardiopulmonar, o consumo de oxigênio (v̇O2) está diminuído tanto no limiar anaeróbio quanto no pico do exercício. Em outras variáveis, como por exemplo na carga de trabalho, eficiência ventilatória, frequência cardíaca pico, saturação pulso de oxigênio estão piores e podem estar reduzidas com a gravidade da doença. Acreditamos que essa limitação ao exercício pode comprometer não só os membros inferiores, mas também os membros superiores. Objetivos: Comparar a capacidade de exercício de membros superiores e inferiores de indivíduos com hipertensão pulmonar tromboembólica crônica (HPTEC) e controles saudáveis. Casuística e método: Foram avaliados 33 indivíduos com HPTEC (46,5 anos e 45,5% mulheres) e 22 controles (39,8 anos e 59,1% mulheres). Todos os participantes realizaram avaliação clínica (dispneia, Classe Funcional e medicação), testes de exercícios (testes cardiopulmonares em cicloergômetro de membros superiores e inferiores, teste da caminhada de seis minutos), testes de função pulmonar (espirometria, plestismografia) em três dias de avaliações. Resultados: o v̇O2 PICO nos testes cardiopulmonares de membros superiores (815,9mL/min versus 1066,8mL/min) e membros inferiores (967,3mL/min versus 1570,4mL/min) estavam reduzidos no grupo HPTEC em comparação ao grupo controle, respectivamente. Porém, o v̇O2 PICO de membros superiores são menos reduzidos do que os membros inferiores no grupo HPTEC. As respostas cardiovasculares, ventilatórias e de trocas gasosas ao teste de exercício são piores no grupo HPTEC em comparação ao grupo controle, tanto para os testes cardiopulmonares de membros superiores quanto membros inferiores. Conclusão: Pacientes com HPTEC apresentam redução da capacidade de exercício tanto de membros superiores quanto membros inferiores comparados ao grupo controle, sendo mais evidente nos membros inferiores. Porém, uma redução aeróbia proporcionalmente menor nos membros superiores em comparação aos membros inferiores.
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    Does Exercise Ventilatory Inefficiency Predict Poor Outcome in Heart Failure Patients With COPD?
    (Lippincott Williams & Wilkins, 2016) Alencar, Maria Clara Noman de [UNIFESP]; Arbex, Flavio Ferlin [UNIFESP]; Souza, Aline [UNIFESP]; Mazzuco, Adriana; Sperandio, Priscila Abreu [UNIFESP]; Rocha, Alcides [UNIFESP]; Hirai, Daniel Müller [UNIFESP]; Mancuso, Frederico José Neves [UNIFESP]; Berton, Danilo Cortozi [UNIFESP]; Borghi-Silva, Audrey; Almeida, Dirceu Rodrigues de [UNIFESP]; O'Donnell, Denis Eunan; Neder, Jose Alberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To investigate whether the opposite effects of heart failure (HF) and chronic obstructive pulmonary disease (COPD) on exercise ventilatory inefficiency (minute ventilation [(V) over dot(E)]-carbon dioxide output [(V) over dotCO(2)] relationship) would negatively impact its prognostic relevance. METHODS: After treatment optimization and an incremental cardiopulmonary exercise test, 30 male patients with HF-COPD (forced expiratory volume in 1 second [FEV1] = 57% +/- 17% predicted, ejection fraction = 35% +/- 6%) were prospectively followed up during 412 +/- 261 days for major cardiac events. RESULTS: Fourteen patients (46%) had a negative outcome. Patients who had an event had lower echocardiographically determined right ventricular fractional area change (RVFAC), greater ventilatory inefficiency (higher (V) over dot(E)/(V) over dotCO(2) nadir), and lower end-tidal CO2 (PETCO2) (all P < .05). Multivariate Cox models revealed that (V) over dot(E)/(V) over dotCO(2) nadir > 36, Delta P-ET CO2(PEAK-REST)>= 2 mm Hg, and PETCO2PEAK <= 33 mm Hg added prognostic value to RVFAC <45%. Kaplan-Meyer analyses showed that although 18% of patients with RVFAC > 45% had a major cardiac event after 1 year, no patient with RVFAC > 45% and (V) over dot(E)/ (V) over dotCO(2) nadir = 36 (or PETCO2PEAK>33 mm Hg) had a negative event. Conversely, although 69% of patients with RVFAC <= 45% had a major cardiac event after 1 year, all patients with RVFAC <= 45% and. PETCO2(PEAK-REST)>= 2 mm Hg had a negative event. CONCLUSION: Ventilatory inefficiency remains a powerful prognostic marker in HF despite the presence of mechanical ventilatory constraints induced by COPD. If these preliminary findings are confirmed in larger studies, optimal thresholds for outcome prediction are likely greater than those traditionally recommended for HF patients without COPD.
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    Limiares clínicos de capacidade funcional e recomendações de exercícios para pacientes com doenças valvares cardíacas
    (Universidade Federal de São Paulo, 2022-07-19) Paiva, Georgia Ávila de Oliveira [UNIFESP]; Guizilini, Solange [UNIFESP]; Rocco, Isadora Salvador [UNIFESP]; http://lattes.cnpq.br/0371943115335917; http://lattes.cnpq.br/1563905009199506; http://lattes.cnpq.br/1109901860837898; Universidade Federal de São Paulo (UNIFESP)
    As doenças valvares cardíacas vêm aumentando sua prevalência ao redor do mundo nos últimos anos, em decorrência do aumento da expectativa de vida e aprimoramento dos métodos diagnósticos. A evolução da doença valvar pode afetar a função cardíaca de maneira a deteriorar a capacidade funcional e influenciar negativamente a qualidade de vida. Os parâmetros obtidos durante a avaliação de aptidão física do indivíduo podem auxiliar o processo de tomada de decisão no tratamento das doenças valvares e possibilitar intervenção cirúrgica antes do agravamento da doença. A manutenção adequada do nível de atividade física pode impactar diretamente o desfecho clínico desses pacientes. O presente estudo aborda atualizações no tratamento das doenças valvares e a influência do condicionamento cardiorrespiratório sobre os desfechos clínicos nas doenças valvares cardíacas. Método: trata-se de uma revisão de escopo. Categorização dos resultados e análise da evidência: A promoção da atividade física e a RCV (reabilitação cardiovascular) baseada em exercícios nesses pacientes tem se mostrado relevante para redução de morbi-mortalidade e deve ser um dos focos do tratamento das valvopatias.
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    A symptom-limited incremental step test determines maximum physiological responses in patients with chronic obstructive pulmonary disease
    (W B Saunders Co Ltd, 2013-12-01) Dal Corso, Simone [UNIFESP]; Camargo, Anderson Alves de; Izbicki, Meyer [UNIFESP]; Malaguti, Carla [UNIFESP]; Nery, Luiz Eduardo [UNIFESP]; Univ Nove Julho UNINOVE; Universidade Federal de São Paulo (UNIFESP); Univ Fed Juiz de Fora
    Background: Step tests have been used to evaluate exercise tolerance and effort-related hypoxemia in different diseases. A symptom-limited incremental step test (IST) has never been tested in COPD patients.Aim: To compare maximal physiological responses between an IST and cardiopulmonary exercise testing (CPET), to test the reproducibility of the IST on different days, and to provide a predict equation to estimate VO2 from the IST in patients with COPD.Material and methods: At the same day, thirty-four patients (VEF1 46 +/- 14% of pred) underwent a CPET on cycle ergometer and the first 151 (IST-1) (1 h apart). After 2-5 days, patients repeated the IST (IST-2). Pulmonary gas exchange was measured during all tests.Results: Peak VO2 was significantly higher in IST-1 and IST-2 than in CEPT (Mean +/- SD: 1.19 +/- 0.39 L, 1.20 +/- 0.40 L, 1.07 +/- 0.35 L) with no difference for ventilation (VE), heart rate (HR), and perception of effort. ISTs were highly reproducible, with significant intraclass correlation coefficient (CCI [95% confidence interval]) for number of steps (0.98[0.95-0.99]), VO2 (0.99 [0.98-0.99]), VE (0.97[0.93-0.99]), HR (0.92[0.81-0.97]), and SpO(2) (0.96[0.90-0.98]). Desaturation was significantly higher for IST-1 and IST-2 compared with cycling (Mean +/- SD: -6 +/- 5%, -6 +/- 4%, - 3 +/- 3%). Number of steps and patient weight explained 81% of the variance in peak VO2 (p < 0.001).Conclusion: A symptom-limited incremental step test, externally paced, elicits maximal cardiopulmonary and metabolic responses, and is well tolerated and reproducible in patients with COPD. (C) 2013 Elsevier B.V. All rights reserved.