J Myers

....

..This article attempts to review the literature studying the physiology and pathophysiology of the BP response to exercise testing and summarize the evidence for its diagnostic and prognostic applications...

..We determined the extent to which noninvasive estimates of cardiac hemodynamics during exercise in combination with cardiopulmonary exercise test (CPX) responses improved the estimation of risk for adverse events in patients with HF...

..Such programs present more challenges than in ambulatory persons, and more intensive risk intervention may be required to appreciably reduce CVD risk in SCI...

..slope) and the oxygen uptake efficiency slope (OUES) have recently been shown to be strong prognostic markers in patients with heart failure. Little is known regarding the effects of exercise training on these indices...

..The effects of variations in exercise training on left ventricular (LV) remodeling in patients shortly after myocardial infarction (MI) are important but poorly understood...

..abstract:..

..Evidence has accumulated that CHF patients who participate in rehabilitation programs have better health outcomes in terms of reduced morbidity and mortality, as well as lower hospitalization rates and lower overall health care costs...

..However, the prognostic power of this index is unknown...

..Prospective comparison of spinal cord injured (SCI) subjects and ambulatory subjects...

..Among the factors suggested to explain the reduced exercise tolerance in CTX recipients is deconditioning. Little is known about the relation between physical activity patterns and exercise test responses in CTX patients...

..However, little is known about the association between ventricular performance and PetCO2 responses to exercise...

..The aim of this study is to evaluate the predictive accuracy of a cardiopulmonary exercise test (CPX) score...

..To compare the contributions of fitness level and physical activity patterns to all-cause mortality...

..Information from the test can also be used to support the important recommendation that the patient engage in an exercise program...

..Appropriate attention given to exercise testing methodology, including the choice of the exercise protocol, can help to assure the maximum functional, diagnostic, and prognostic yield of information...

..The 5% relative variation between tests suggests that the CO(2) rebreathing technique for estimating cardiac output can be performed in SCI individuals with acceptable reproducibility...

..Heart rate recovery (HRR) is a marker of vagal tone that is associated with survival, but little is known about the effects of exercise training on HRR in patients with heart failure (HF)...

..It is, however, unknown which of these responses more powerfully predicts risk, and few data are available on their association with cardiovascular mortality or how they are influenced by beta-blockade...

..Physicians and allied health professionals should expand their routine medical evaluations and coronary risk factor profiling to include these measures...

..As an interim analysis of our prospective, randomized, longitudinal trial of exercise for AAA suppression, we investigated whether subjects with early disease could safely achieve target metabolic and hemodynamic goals...

..The purpose of this study was to evaluate safety and to characterize the hemodynamic and cardiopulmonary (CPX) response to exercise in a large group of patients with AAA...

..There is also uncertainty regarding the predictive power of exercise capacity relative to other clinical and exercise-test variables...

..In the present study, we sought to determine the effect of exercise training on O(2) recovery kinetics in patients with reduced ventricular function...

....

..This article reviews these issues and discusses the evolution of ramp testing which has occurred in the 1990s...

..To examine the association between cardiac performance during recovery and the severity of heart failure, as determined by clinical and cardiopulmonary exercise test responses...

..One other proposed mechanism is cardiac denervation leading to silent ischemia...

..Despite a worse cardiovascular risk profile, the prevalence of cardiovascular disease is lower in Hispanics compared to non-Hispanics...

..Four simple variables combined as a score predict all-cause mortality after clinical decisions for therapy are prescribed...

..Four simple variables combined as a score powerfully stratified patients according to prognosis...

..We aimed to investigate the effects of 8 weeks of supervised, high-intensity exercise training on time- and frequency-domain measures of HRV in this selected patient population...

..CONCLUSIONS: Heart rate at 1 or 2 min of recovery has been validated as a prognostic measurement and should be recorded as part of all treadmill tests. This new measurement does not replace, but is supplemental to, established scores...

..BMI was chosen by the survival analysis, confirming its surprising inverse relationship to prognosis in CHF patients (i.e., heavier patients do better)...

..We aimed to assess the prognostic power of double product (DP) parameters in patients referred for standard exercise testing...

..A cardiopulmonary exercise test can supplement other clinical and exercise test information when precision is important, when the patient's symptoms are mixed, or when it is unclear why the patient was referred for testing...

..CONCLUSION: This simplified exercise score that estimates the probability of CAD can be easily applied without a calculator and is a useful and valid tool that can help physicians manage patients presenting with chest pain...

..This study seeks to further characterize the role of exercise testing in the elderly for prognosis and diagnosis of coronary artery disease...

..The relative predictive power of computational analysis of HRR as a function of resting and maximum heart rate (HR) compared with direct measurement of the drop in HR has not been determined...

..These observations suggest that a relatively intensive rehabilitation program provided a catalyst to maintain physical activity patterns and exercise tolerance in the 2 years following a cardiac event...

..When used for estimating a patient's symptom limits to individualize ramp rates on a treadmill, this approach yields an appropriate test duration in accordance with recent exercise testing guidelines...

..CONCLUSIONS: EIVA are independent predictors of cardiovascular mortality after adjusting for other clinical and exercise test variables; combination with resting PVCs carries the highest risk...

..To assess exercise capacity and left ventricular function using magnetic resonance imaging (MRI) among patients with chronic heart failure randomized to a residential rehabilitation programme at baseline and six years after participation...

..The purpose of this study was to compare clinical characteristics, exercise test responses, and physical activity (PA) patterns in Q1 versus Q2 in patients with cardiovascular disease (CVD)...

..Electrocardiogram (ECG) scores have been demonstrated to predict CV mortality but they are rarely utilized clinically...

..The resting 12-lead electrocardiogram (ECG) remains the most commonly used test in evaluating patients with suspected cardiovascular disease. Prognostic values of individual findings on the ECG have been reported but may be of limited use...

..However, a number of methodological issues have not been fully explored, including differences in HRR 1 versus 2 min after exercise termination, absolute versus relative HRR, and the impact of beta-blockers...

..09 (*/ divided by 1.13) in controls. The ACSM equation is associated with a significant overestimation of mMETs in young and fit subjects, which is markedly more pronounced in older and less fit subjects with cardiovascular risk factors...

..SPONSORSHIP: Funded by the VA Rehabilitation Research and Development Service, Merit Review Grant #B2549R...

..To determine the short- and long-term effects of an intensive, concentrated rehabilitation programme in patients with chronic heart failure...

..We aimed to determine if age could improve the prognostic power of the DTS and if so, to modify the DTS nomogram to include age...

..This study aims to evaluate the prognostic value of rest PVCs on an electrocardiogram (ECG) in patients with a history of clinical HF...

..Achieved workload (in METs) was the major exercise testing variable associated with all-cause mortality. Its prognostic importance was the same in elderly as in younger men...

..The prognostic value of electrocardiographic abnormalities in subjects with spinal cord injury is similar to that observed in able-bodied subjects...

..The purpose of this study was to validate the prognostic value of computer-derived measurements of the spatial alignment of ventricular depolarization and repolarization from the standard 12-lead ECG in a general medical population...

..The corresponding bicycle work capacity nomogram (in watts) was derived by the following equation: (METs nomogram - 1) x body weight/3.486...

..CONCLUSION: Multivariate scores can empower the clinician to assure the cardiac patient with access to appropriate and cost-effective cardiological care...

..Differences in age of the subjects tested and/or the outcome selected as the end point can explain the differences in the studies using exercise testing to predict prognosis...

..There is an association between higher NT-proBNP and lower peak VO(2), indicating that NT-proBNP is a marker of cardiorespiratory fitness in patients with OSAS. However, the association is too weak to be clinically useful...

..Although these results generally confirm the beneficial effects of beta-blockade in patients with chronic heart failure, they show differential effects on systolic and diastolic function...

..The latter finding suggests an additional potential benefit of exercise training in patients with dilated cardiomyopathy...

..These findings suggest that exercise test responses, non-exercise test estimates of physical function, and quality of life indices reflect different facets of health status in HF and one should not be considered a surrogate for another...

..Multivariate survival analysis allowed the development of a T-wave amplitude graphic that provides clinicians with a simple method of estimating the relative risk for cardiovascular mortality from T-wave amplitude in limb lead I...

..However, treadmill exercise has been shown to elicit higher peak VO(2) values than bicycle exercise. We sought to assess whether the VE/VCO(2) slope and HRR in HF also depend on the exercise mode...

..Therefore, we aimed to evaluate the clinical correlates and prognostic significance of exercise-associated premature ventricular complexes (PVCs) during and after exercise testing...

..This suggests that close heart rate monitoring may not always be necessary for many stable patients with cardiovascular disease to achieve the benefits of a rehabilitation program...

..The association between elevated hemodynamic pressures and mortality, although weak, suggests that ventricular compliance, pulmonary vascular resistance, or both, may predict long-term survival after CTX...

..Hemodynamic responses to exercise were assessed in patients with varying degrees of chronic heart failure (CHF) to determine the feasibility of using bioreactance during exercise testing in multicenter studies of CHF...

..CONCLUSION: Our findings demonstrate that the health care provided to veterans referred for routine ECG or exercise testing is not associated with poorer survival in ethnic minorities...

..However, previous methods to determine individualized ramp rates and comparisons between ramp and standardized protocols have been limited to clinically referred populations...

..The purpose of this study was to investigate the phenomenon of left ventricular (LV) dysfunction after ultraendurance exercise...

..Estimates of prognosis provided by scores were similar to the estimates made by expert cardiologists and more accurate than the estimates made by most other physician groups...

....

..Epidemiological findings, based largely on middle-aged populations, support an inverse and independent association between exercise capacity and mortality risk. The information available in older individuals is limited...

..Veterans had to have met military fitness requirements at the time of their enlistment. Therefore, we assessed the relation of body mass index (BMI) to mortality in a clinical cohort of non-HF veterans, adjusting for fitness...

..The intensity level should be targeted to about 50%-70% of peak VO2 and/or Borg ratings of 12-14 ("walk and talk")...

..To determine the relation between echocardiogram findings and exercise capacity in hypertrophic cardiomyopathy (HCM)...

..We aimed to evaluate the prognostic power of exercise-induced HRV during and after standard exercise testing...

..9 (CI 1.6-2.3). CONCLUSION: While both ST segment depression and abnormal T-wave amplitude are clinically important, T-wave abnormalities appear to be greater predictors of cardiovascular mortality...

..We examined this blood marker in persons with spinal cord injury (SCI) in order to determine its potential for predicting elevated cardiac risk...

..Theoretically, predictive accuracy is dependent on disease prevalence while AUC assessments are not...

..Cardiopulmonary exercise testing (CPX) is widely used to evaluate heart failure (HF) patients, but lacks information about ventricular performance. There is a need for a noninvasive cardiac output (CO) measurement...

..It appears that either enhanced vagal tone or loss of sympathetic tone is responsible for ST elevation...

..Research continues seeking to refine these exercise measurements and further define their prognostic value. Future findings should augment the power of the exercise test in risk-stratifying cardiovascular patients...

..However, the method by which the VE/VCO(2) slope is expressed has been inconsistent...

....

..The purpose of the present study is to refine the prognostic power of the VE/VCO2 slope by developing a ventilatory class system that correlates VE/VCO2 cut points to cardiac-related events...

..The purpose of the present study is to assess the ability of resting end-tidal carbon dioxide partial pressure (PETCO2) to predict cardiac-related events in patients with HF...

..However, they explain some of the previous controversy and highlight the need to consider resting PVCs and follow-up duration in assessing the clinical implications of EIVAs...

..The impact this pharmacological approach has on the prognostic information gained from cardiopulmonary exercise testing (CPX) is, however, unclear...

..Since there is an uncertainty regarding which of the 12 leads provides the most information, we investigated the association between repolarization phenomenon in all of the 12 leads and cardiovascular (CV) mortality...

..Our aim was to evaluate the prognostic value of early heart rate parameters in patients referred for routine clinical treadmill testing...

..In the present study, we investigated the effect of HF etiology on the prognostic applications of peak V(O2) and Ve/V(CO2) slope...

..We sought to assess the prognostic utility of heart rate recovery (HRR) in patients with HF...

..The VSAQ is a useful adjunct to clinical and exercise test data for stratifying risk in patients undergoing exercise testing for clinical reasons...

..CONCLUSIONS: Both peak VO(2) and VE/VCO(2) slope are significant predictors of cardiac-related events in HF. However, the prognostic characteristics of these variables following CPET appear to be time-sensitive...

..The purpose of this investigation was to examine the prognostic value of the largest ventilatory oscillation characteristics in HF patients...

..In conclusion, the findings of the present study indicate that VE/VCO2 slope maintains prognostic value irrespective of BMI in patients with HF...