peak capacity
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The forced vital capacity (FVC) maneuver is the most common lung function test. One of its major prerequisites is that it be performed with sufficient effort to achieve the maximal flows that are due to expiratory flow limitation. To verify this, in nine normal subjects, short (0.25-s) pulses of negative pressure (-5 to -20 cmH2O) were applied at the mouth at different times (0.25-1 s) after the onset of 1) FVC maneuvers and 2) vital capacity expirations with submaximal expiratory efforts (SVC). All subjects were experienced in FVC maneuvers. With FVC, the expiratory flow did not change with application and removal of negative-pressure pulses, apart from brief flow transients, mainly reflecting displacement of air from the compliant oral and neck structures. With SVC, flow increased throughout the application of the negative-pressure pulses. Thus application of pulses of negative pressure provides a simple method for on-line recognition of whether an FVC maneuver is performed with sufficient effort to achieve flow limitation.
- MeSH
- cvičení fyziologie MeSH
- dospělí MeSH
- lidé MeSH
- respirační funkční testy * metody MeSH
- usilovný výdechový objem MeSH
- ventilátory s negativním tlakem MeSH
- vitální kapacita * MeSH
- vrcholová exspirační průtoková rychlost MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
Autoři monitorovali diurnální variabilitu jednovteřinové vitální kapacity (FEV1) a vrcholové výdechové rychlosti (PEF) u nemocných léčených pro exacerbaci CHOPN. Zjistili, že denní variabilita FEV1 větší než 15 % byla u 61,4 % nemocných, PEF u 78 % nemocných. Prokázali signifikantní vztah mezi denním kolísáním PEF a tíží obstrukce (r = -0,515: p < 0,01). Autoři došli k závěru, že diurnální variabilitu FEV1 i PEF nelze při těžké obstrukci doporučit jako znak, který by odlišil CHOPN od průduškového astmatu.
Authors monitored the daily variability of the one second forced vital capacity (FEVl) and peak exspiratory flow (PEF) in patients treated for exacerbation of chronic obstructive pulmonary disease (COPD). They found that the daily variability of FEV1 was higher than 15 % in 61.4 % of patients and that of PEF in 78 % of patients. They found a significant relationship between the daily fluctuation of PEF and the severity of airways obstruction (r = -0.515: p < 0.01). Authors conclude that diurnal variability of FEV1 and PEF can not be recommended in severe airways obstruction as a sign able to distinguish between COPD and bronchial asthma.
Rychlostní kanoistika je typickým sportem, kde se v zátěžové diagnostice uplatňují aerobní a anaerobní testy horních končetin. S cílem posoudit vliv věku a pohlaví na aerobní a anaerobní kapacitu horních končetin bylo celkem 306 vrcholových rychlostních kanoistů, z toho 99 kajakářek 135 mužů kajakářů a 72 mužů kanoistů ve věku 13 až 30 let vyšetřeno 30-s Wingate anaerobním testem horních končetin (při zatížení 4 W.kg‑1 resp. 0,68 N.kg‑1 u mužů a 3,3 W.kg-1 resp. 0,56 N.kg‑1 u žen) a stupňovaným testem do maxima na klikovém ergometru ke stanovení VO2peak. Výsledky byly ve skupinách kanoistů, kajakářů a kajakářek navzájem porovnány ve čtyřech věkových kategoriích, a to 13-14,9 let (žáci), 15-16,9 let (dorost) , 17-18,9 let (junioři) a 19 let a starší (senioři). Zatímco úroveň specifické aerobní kapacity (VO2peak) u mužů kanoistů a kajakářů se zvyšovala od kategorie 13-14,9, 15-16,9 let a juniory, ale hodnoty u juniorů a seniorů se navzájem nelišily, maximální resp. vrchový výkon (PP) a průměrný výkon (MP) resp. anaerobní kapacita (AnC) se u kanoistů a kajakářů zvyšovaly od nejmladších po nejstarší věkové kategorie. Uvedené ukazatele anaerobní kapacity vykazovaly závislost na množství tukuprosté hmoty (PP: r= 0,69 a MP: r= 0,72 u kanoistů a r= 0,62 a r= 0,71 u kajakářů). U kajakářek se také zvyšovaly ukazatele specifické aerobní a anaerobní kapacity s věkem, ale rozdíly mezi věkovými skupinami byly menší než u obou skupin mužů a relativně vyjádřené hodnoty nevykazovaly závislost na množství tukuprosté hmoty. Výsledky studie ukazují odlišný vývoj ukazatelů specifické aerobní a anaerobní kapacity u rychlostních kanoistů – mužů a žen.
Canoe and kayak flat water paddling are upper-body sports that make varying demands for upper body aerobic and anaerobic capacity. In order to evaluate the effect of age and gender on upper body aerobic and anaerobic capacity in flat water paddling, altogether 306 elite flat water paddlers (99 female kayak paddlers, 135 kayak and 72 canoe male paddlers) were tested by a 30-s Wingate anaerobic arm test at a resistance load 4 W.kg‑1 (=0.069 kg.kg‑1) in males and 3.3 W.kg-1 (=0.057 kg.kg‑1) in females, and an incremental aerobic test.and a maximum aerobic arm-cranking test. The results were compared canoe paddlers and in male and female kayak paddlers in four age categories 13 to 14.9, 15 to 16.9, 17 to 18.9 years of age and in seniors (19 years and older), respectively. Whereas maximum aerobic performance in male canoe and kayak paddlers increased from 13-14.9 to 15-16.9 age category and was not different in junior (17-18.9 years) and senior paddlers, in the anaerobic arm test, both peak power and mean power output increased wit age from the youngest to the oldest age categories. These anaerobic capacity indices were strongly related to the amount of fat-free mass (PP: r= 0,69 and r= 0,62; MP: r= 0.72 and r= 0.71 for the canoe and kayak paddlers, respectively). In female kayak paddlers, the indices of upper body aerobic and anaerobic capacity also increased with age, however the differences among the age groups were smaller than in male paddlers. In contrast to male paddlers, in female kayak paddlers the upper body aerobic and anaerobic capacity indices (relative to body mass) were unrelated to the amount of fat free mass. The results had demonstrated the differences in evolution of upper body aerobic and anaerobic capacity in male and female flat water paddlers.
- Klíčová slova
- kanoistika, aerobní kapacita, anaerobní kapacita, testy práce horních končetin,
- MeSH
- ergometrie využití MeSH
- financování organizované MeSH
- horní končetina fyziologie krevní zásobení MeSH
- kosterní svaly MeSH
- lidé MeSH
- respirační funkční testy * MeSH
- rozložení podle pohlaví MeSH
- sportovní výkon MeSH
- sporty * MeSH
- statistika jako téma MeSH
- věkové faktory MeSH
- vitální kapacita MeSH
- Check Tag
- lidé MeSH
The objective of this multicenter study was to compare the clinical efficacy, safety, and acceptability of Easyhaler and Turbuhaler for the delivery of budesonide 200 micrograms/dose twice daily in steroid-naive asthmatic patients. Three hundred and twenty-six newly diagnosed, steroid-naive adult patients with mild-to-moderate asthma were recruited into this randomized, double-blind, double-dummy, parallel-group study, comprising a 2-week run-in period and 8 weeks of treatment. Patients received budesonide inhalation powder 400 micrograms/day either via Easyhaler (n = 159) or via Turbuhaler (n = 167), plus salbutamol inhalation powder (100 micrograms/dose) via Easyhaler as rescue therapy. The study was completed by 292 patients: 143 in the Easyhaler group and 149 in the Turbuhaler group. The primary outcome variable, mean morning peak expiratory flow (PEF), improved significantly and almost similarly by 36.3 and 30.6 l/min, respectively, from run-in to weeks 7-8. At weeks 7-8, the mean (SE) difference in morning PEF between the two treatments was 7.1 (9.4) l/min (90% CI from -8.4 to 22.6) on per protocol analysis, which was within the defined limits for therapeutic equivalence. There were no significant differences between treatments in terms of secondary efficacy variables or adverse events. However, patients found Easyhaler more acceptable than Turbuhaler. The results show that budesonide via Easyhaler is clinically as effective as Pulmicort Turbuhaler when equal daily doses of budesonide are delivered to steroid-naive asthmatic patients. Moreover, patients found Easyhaler more acceptable than Turbuhaler, and a majority would prefer Easyhaler if given a choice.
- MeSH
- aplikace inhalační MeSH
- bronchiální astma * MeSH
- bronchodilatancia * aplikace a dávkování MeSH
- budesonid * aplikace a dávkování MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- lidé MeSH
- spokojenost pacientů MeSH
- usilovný výdechový objem fyziologie MeSH
- vitální kapacita fyziologie MeSH
- vrcholová exspirační průtoková rychlost fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinické zkoušky MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
The effect of gradient steepness on the kinetic performance limits and peak compression effects has been assessed in gradient mode for the separation of phenol derivatives using columns packed with 2.6μm core-shell particles. The effect of mobile-phase velocity on peak capacity was measured on a column with fixed length while maintaining the retention factor at the moment of elution and the peak-compression factor constant. Next, the performance limits were determined at the maximum system pressure of 100MPa while varying the gradient steepness. For the separation of small molecules applying a linear gradient with a broad span, the best performance limits in terms of peak capacity and analysis time were obtained applying a gradient-time-to-column-dead-time (tG/t0) ratio of 12. The magnitude of the peak-compression factor was assessed by comparing the isocratic performance with that in gradient mode applying different gradient times. Therefore, the retention factors for different analytes were determined in gradient mode and the mobile-phase composition in isocratic mode was tuned such that the difference in retention factor was smaller than 2%. Peak-compression factors were quantitatively determined between 0.95 and 0.65 depending on gradient steepness and the gradient retention factor.
AIMS: Fontan palliation is a surgical strategy for patients with complex congenital heart disease, in whom biventricular circulation cannot be achieved. Long-term survival is negatively affected by the absence of sub-pulmonary ventricle and increased systemic venous pressure. Exercise capacity is a known predictor of overall survival and quality of life in congenital heart defects. We aim to track individual trends of peak oxygen uptake (V̇O2 peak) after total cavopulmonary connection (TCPC), identify predictors of deterioration, and derive a disease-specific reference V̇O2 peak dataset. METHODS AND RESULTS: A retrospective study of serial cardiopulmonary exercise testing (CPET) data, gathered from all patients who underwent TCPC in the Czech Republic between 1992 and 2016. Of 354 consecutive patients with TCPC, 288 (81.4%) patients underwent one or more CPETs yielding 786 unique V̇O2 peak values used as a reference dataset. Longitudinal data were available in 206 (58.2%) patients, who underwent a median (inter-quartile range) of 3.0 (2.0-5.0) CPETs over a mean (standard deviation) of 8.9 (5.5) years. The decline of exercise capacity with age was linear and not faster than in healthy peers (P = 0.47), but relative values of V̇O2 peak in TCPC patients were 12.6 mL/min/kg lower. Single ventricular morphology and pulmonary artery size had no significant influence on the exercise capacity dynamics. V̇O2 peak decline correlated negatively with the trend of body mass index z-score (P = 0.006) and was faster in women than men (P = 0.008). CONCLUSIONS: Total cavopulmonary connection patients have significantly reduced exercise capacity. The age-related decline paralleled the healthy population and correlated negatively with the body mass index trend. The presented V̇O2 peak reference dataset may help the clinicians to grade the severity of exercise capacity impairment in individual TCPC patients.
- MeSH
- bypass pravého srdce metody MeSH
- dítě MeSH
- dospělí MeSH
- Fontanova operace * metody MeSH
- kvalita života MeSH
- lidé MeSH
- longitudinální studie MeSH
- retrospektivní studie MeSH
- spotřeba kyslíku MeSH
- tolerance zátěže * fyziologie MeSH
- vrozené srdeční vady * patofyziologie rehabilitace chirurgie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinická studie MeSH
- práce podpořená grantem MeSH
- MeSH
- antiastmatika terapeutické užití MeSH
- bronchiální astma farmakoterapie patofyziologie MeSH
- činnosti denního života MeSH
- lidé MeSH
- směrnice jako téma MeSH
- stupeň závažnosti nemoci MeSH
- usilovný výdechový objem fyziologie MeSH
- vrcholová exspirační průtoková rychlost fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- komentáře MeSH
- úvodní články MeSH
BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of >= 4% desaturations/h) was >= 10. Peak oxygen consumption (VO2 peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 +/- 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased VO2 peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P < .001). SDB remained significantly associated with VO2 peak after accounting for confounding clinical variables (P < .001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased VO2 peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.
- MeSH
- dospělí MeSH
- hypertrofická kardiomyopatie * epidemiologie patofyziologie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- oxymetrie MeSH
- prevalence MeSH
- průřezové studie MeSH
- senioři MeSH
- spánková apnoe centrální * MeSH
- spotřeba kyslíku fyziologie MeSH
- srdeční frekvence fyziologie MeSH
- stupeň závažnosti nemoci MeSH
- tepový objem fyziologie MeSH
- tolerance zátěže * fyziologie MeSH
- zátěžový test MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
Favorable effects of exercise training on cardiovascular prognosis have been reported repeatedly in patients with diabetes mellitus type 2 (DM2). However, little is known about the cardiovascular rehabilitation effects in diabetic patients with coronary artery disease (CAD). This study has evaluated the benefits of combined aerobic-resistance training in two groups of patients--diabetics and non-diabetics--after percutaneous coronary intervention (PCI). Changes in exercise capacity parameters, resting cardiovascular and anthropometrical parameters were evaluated in 77 patients who completed 12-weeks of combined aerobic-resistance training: 32 patients with DM2 (DM) and 45 patients without DM2 (NDM). Significant improvements in exercise capacity (total peak workload [W(peak)], peak workload per kg of body weight [W(peak)/kg], total peak oxygen uptake [VO(2peak)], peak oxygen uptake per kg of body weight [VO(2peak)/kg]) were found in both DM and NDM (p < 0.01 and p < 0.001, respectively). The decrease in resting heart rate (HR(rest)), resting systolic (SBP(rest)) resting diastolic (DBP(rest)) blood pressures, body weight (BW) and BMI in the DM group was not statistically significant. However, there was a statistically significant decrease in SBP(rest), BW and BMI in the NDM group. In conclusion, this study demonstrated similar beneficial effects of combined cardiovascular training on exercise capacity in patients with or without type 2 diabetes mellitus. Our results suggest that the combined cardiac training is well tolerated and useful in secondary prevention in patients with DM2 and CAD.
- MeSH
- akutní koronární syndrom patofyziologie rehabilitace MeSH
- cvičení fyziologie MeSH
- diabetes mellitus 2. typu patofyziologie rehabilitace MeSH
- financování organizované MeSH
- klinické zkoušky, fáze II jako téma MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- odpočinek MeSH
- terapie cvičením MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
