BACKGROUND: Physical activity is a crucial demand on cystic fibrosis treatment management. The highest value of oxygen uptake (VO2peak) is an appropriate tool to evaluate the physical activity in these patients. However, there are several other valuable CPET parameters describing exercise tolerance (Wpeak, VO2VT1, VO2VT2, VO2/HRpeak, etc.), and helping to better understand the effect of specific treatment (VE, VT, VD/VT etc.). Limited data showed ambiguous results of this improvement after CFTR modulator treatment. Elexacaftor/tezacaftor/ivacaftor medication improves pulmonary function and quality of life, whereas its effect on CPET has yet to be sufficiently demonstrated. METHODS: We performed a single group prospective observational study of 10 adolescent patients with cystic fibrosis who completed two CPET measurements between January 2019 and February 2023. During this period, elexacaftor/tezacaftor/ivacaftor treatment was initiated in all of them. The first CPET at the baseline was followed by controlled CPET at least one year after medication commencement. We focused on interpreting the data on their influence by the novel therapy. We hypothesized improvements in cardiorespiratory fitness following treatment. We applied the Wilcoxon signed-rank test. The data were adjusted for age at the time of CPET to eliminate bias of aging in adolescent patients. RESULTS: We observed significant improvement in peak workload, VO2 peak, VO2VT1, VO2VT2, VE/VCO2 slope, VE, VT, RQ, VO2/HR peak and RR peak. The mean change in VO2 peak was 5.7 mL/kg/min, or 15.9% of the reference value (SD ± 16.6; p= 0.014). VO2VT1 improved by 15% of the reference value (SD ± 0.1; p= 0.014), VO2VT2 improved by 0.5 (SD ± 0.4; p= 0.01). There were no differences in other parameters. CONCLUSION: Exercise tolerance improved after elexacaftor/tezacaftor/ivacaftor treatment initiation. We suggest that the CFTR modulator alone is not enough for recovering physical decondition, but should be supplemented with physical activity and respiratory physiotherapy. Further studies are needed to examine the effect of CFTR modulators and physical therapy on cardiopulmonary exercise tolerance.
- MeSH
- aminofenoly * terapeutické užití MeSH
- benzodioxoly * terapeutické užití MeSH
- chinolony * terapeutické užití MeSH
- cystická fibróza * farmakoterapie patofyziologie MeSH
- dítě MeSH
- fixní kombinace léků * MeSH
- indoly * terapeutické užití MeSH
- kardiorespirační zdatnost MeSH
- lidé MeSH
- mladiství MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- pyrazoly * terapeutické užití MeSH
- pyridiny * terapeutické užití MeSH
- pyrrolidiny MeSH
- pyrroly terapeutické užití MeSH
- spotřeba kyslíku MeSH
- tolerance zátěže účinky léků MeSH
- zátěžový test MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
BACKGROUND: One of the major determinants of exercise intolerance and limiting symptoms among patients with obstructive hypertrophic cardiomyopathy (HCM) is an elevated intracardiac pressure resulting from left ventricular outflow tract obstruction. Aficamten is an oral selective cardiac myosin inhibitor that reduces left ventricular outflow tract gradients by mitigating cardiac hypercontractility. METHODS: In this phase 3, double-blind trial, we randomly assigned adults with symptomatic obstructive HCM to receive aficamten (starting dose, 5 mg; maximum dose, 20 mg) or placebo for 24 weeks, with dose adjustment based on echocardiography results. The primary end point was the change from baseline to week 24 in the peak oxygen uptake as assessed by cardiopulmonary exercise testing. The 10 prespecified secondary end points (tested hierarchically) were change in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS), improvement in the New York Heart Association (NYHA) functional class, change in the pressure gradient after the Valsalva maneuver, occurrence of a gradient of less than 30 mm Hg after the Valsalva maneuver, and duration of eligibility for septal reduction therapy (all assessed at week 24); change in the KCCQ-CSS, improvement in the NYHA functional class, change in the pressure gradient after the Valsalva maneuver, and occurrence of a gradient of less than 30 mm Hg after the Valsalva maneuver (all assessed at week 12); and change in the total workload as assessed by cardiopulmonary exercise testing at week 24. RESULTS: A total of 282 patients underwent randomization: 142 to the aficamten group and 140 to the placebo group. The mean age was 59.1 years, 59.2% were men, the baseline mean resting left ventricular outflow tract gradient was 55.1 mm Hg, and the baseline mean left ventricular ejection fraction was 74.8%. At 24 weeks, the mean change in the peak oxygen uptake was 1.8 ml per kilogram per minute (95% confidence interval [CI], 1.2 to 2.3) in the aficamten group and 0.0 ml per kilogram per minute (95% CI, -0.5 to 0.5) in the placebo group (least-squares mean between-group difference, 1.7 ml per kilogram per minute; 95% CI, 1.0 to 2.4; P<0.001). The results for all 10 secondary end points were significantly improved with aficamten as compared with placebo. The incidence of adverse events appeared to be similar in the two groups. CONCLUSIONS: Among patients with symptomatic obstructive HCM, treatment with aficamten resulted in a significantly greater improvement in peak oxygen uptake than placebo. (Funded by Cytokinetics; SEQUOIA-HCM ClinicalTrials.gov number, NCT05186818.).
- MeSH
- aplikace orální MeSH
- benzylaminy MeSH
- dvojitá slepá metoda MeSH
- hypertrofická kardiomyopatie * farmakoterapie patofyziologie MeSH
- kardiovaskulární látky * farmakologie terapeutické užití MeSH
- kontrakce myokardu účinky léků fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- obstrukce výtoku ze srdeční komory farmakoterapie patofyziologie etiologie MeSH
- senioři MeSH
- spotřeba kyslíku účinky léků MeSH
- srdeční myosiny antagonisté a inhibitory MeSH
- tolerance zátěže účinky léků MeSH
- uracil analogy a deriváty MeSH
- Valsalvův manévr MeSH
- zátěžový test * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
S odvoláním na práci Yanga et al. (36) se v odborném tisku objevila doporučení jak odhalit riziko náhlé srdeční příhody pomocí jednoduchého motorického testu – schopnosti provést určitý počet kliků. Uvedená studie ukázala, že vyšší počet nepřetržitě provedených kliků (40 kliků a více) je v kohortě hasičů spojen s nižším výskytem kardiovaskulárních onemocnění (KVO) ve srovnání s těmi, kteří dosáhli méně než 10 kliků. Vyšší incidence KVO u skupiny nejméně výkonných hasičů však pravděpodobně souvisela také s dalšími zdravotními problémy a naopak, vyšší silově-vytrvalostní výkonnost v prevenci KVO není tím rozhodujícím faktorem. Navržený „klikový“ test tak může sloužit jako orientační snadno proveditelný screening k odhalení ohrožených osob.
Referring to the work of Yang et al. (36) several professional sources recommended how to detect the risk of a sudden heart attack using a simple motor test – the ability to perform a certain number of push-ups. The study showed that higher baseline push-up capacity (40 push-ups and more) in the cohort of firefighters is associated with lower incidence of cardiovascular diseases (CVD) compared with those completing less then 10 push-ups. However, the higher incidence of CVD events in the group of least powerful firefighters is probably also related to other health problems, and conversely, higher strength endurance performance in the prevention of CVD diseases is not the decisive factor. The proposed push-up test can thus serve as an orientation easy-to-perform screening to detect endangered persons.
- Klíčová slova
- "test 40 kliků",
- MeSH
- hasiči MeSH
- kardiovaskulární nemoci * prevence a kontrola MeSH
- lidé MeSH
- spotřeba kyslíku MeSH
- věkové faktory MeSH
- zátěžový test * metody MeSH
- Check Tag
- lidé MeSH
The purpose of this study was to investigate the acute effect of low, moderate, or high doses of taurine on anaerobic and physiological performance in female rugby players. A total of 16 sub-elite female rugby athletes (21.3 ± 1.5 yr, 168.0 ± 4.9 cm, 62.1 ± 3.5 kg mean ± SD) participated in this research. Following familiarization, participants attended 4 successive tests separated by 72 h in a randomized, counter-balanced, crossover research design. Following an over night fast, participants completed a 5-min 60 Watt warm-up followed by a 30-s Wingate anaerobic test on a cycle ergometer after ingestion of either 2 g taurine (LOWTAU), 4 g (MODTAU), 6 g (HIGHTAU) or placebo (PLA) 1 h before the test. Peak (PP) and mean power (MP) along with heart rate (HR), rating of perceived exertion (RPE), capillary lactate and blood glucose were measured. LOWTAU did not affect PP, MP, HR, lactate and glucose compared to PLA (p > 0.05), while MODTAU improved MP and HIGHTAU improved PP and MP compared to PLA and LOWTAU (p < 0.05). MODTAU and HIGHTAU had little effect on HR, blood lactate and glucose (p > 0.05). A single dose of taurine (MODTAU or HIGHTAU) 1 h prior to competition or training would provide an ergogenic effect on subsequent power output.
- MeSH
- americký fotbal * fyziologie MeSH
- anaerobní práh účinky léků MeSH
- dvojitá slepá metoda MeSH
- klinické křížové studie * MeSH
- krevní glukóza účinky léků metabolismus MeSH
- kyselina mléčná * krev MeSH
- látky zvyšující výkon aplikace a dávkování farmakologie MeSH
- lidé MeSH
- mladý dospělý MeSH
- potravní doplňky MeSH
- sportovní výkon * fyziologie MeSH
- srdeční frekvence * účinky léků MeSH
- taurin * aplikace a dávkování farmakologie MeSH
- tělesná námaha fyziologie účinky léků MeSH
- zahřívací cvičení MeSH
- zátěžový test MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION: The subject of this study was the creation of a new type of laboratory walking stress test for the Special Forces of the Army of the Czech Republic. This study developed a test model that has been validated in practice and that reflects the fact that the performance of endurance without and with a load varies considerably. Especially, if we focus on operators, as their activities are always performed with loads/full gear (equipment, weapons, equipment, etc.). MATERIALS AND METHODS: 24 men/operators from the Special Forces of the Army of the Czech Republic volunteered for this study. The maximal exercise test/spiroergometry was designed to include performance at a load of 55 kg/121 lb, a constant speed of 5.3 km/h, and an increase in incline angle of 1 degree after each elapsed minute. The test was performed on a treadmill under standard time, location, and temperature conditions. During the test, the following values were recorded: VO2 = oxygen consumption indicating the intensity of the exercise was monitored, VO2/kg = oxygen consumption converted to body weight, VO2/HR = pulse oxygen (the amount of oxygen converted in one heartbeat), HR = heart rate, VE = ventilation, volume of air exhaled in 1 min, breathe frequency (BF) = respiratory rate in 1 min. RESULTS: Out of the total number of 24 respondents, the study found these mean values of variables. The variable mapping the oxygen consumption, which indicates the intensity of VO2 loading, was 3.8, with the lowest value being 3.2 and the highest being 4.5. After converting oxygen consumption to bodyweight, VO2/kg was 46, the lowest value of 38.8, and the highest 53.0 were measured for this variable. Pulse oxygen, i.e., the amount of oxygen calculated per heart contraction VO2/HR, was 20.5, the lowest value 16.0, and the highest 26.0. The average HR heart rate was 183.5, with the lowest value being recorded at 164 and the highest value is 205. Ventilation, i.e., the amount of exhaled air per minute in VE, was measured at 144.9, the lowest value was 114.7, and the highest was 176.6. The BF in 1 min was 58.5, the lowest value 35, and the highest 70. The mean time load was 10:20 min, the shortest test length was 7:25 min, and the longest was 13:23 min. These values correspond to the degree of inclination of the ascent, i.e., the mean value was 10 degrees, the smallest achieved slope was 7 degrees, and the largest 13 degrees. CONCLUSION: The designed weighted walking test proved to be fully functional and effective in measurement. The further established protocol corresponds to the requirements of the current needs of the Special Forces of the Army of the Czech Republic. Last but not least, the walking stress test is applied for the external and internal selection and screening of operators. Data obtained from testing were used to develop deployment requirements for patrol/nuclear combat missions.
- MeSH
- chůze MeSH
- cvičení * fyziologie MeSH
- kyslík MeSH
- lidé MeSH
- spotřeba kyslíku * fyziologie MeSH
- srdeční frekvence MeSH
- zátěžový test MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: To investigate the effect of 12 weeks of rehearsals on cardiorespiratory parameters and body composition in Brazilian samba dancers belonging to a first-league samba school. METHODS: Twenty-six women were divided into a Samba Group (n=13) and a Control Group (n=13). Cardiorespiratory parameters (cardiopulmonary exercise test) and body composition (skinfold assessment) were assessed before and after the 12 weeks of rehearsals. The Samba Group rehearsed three times per week for 30-60 minutes, and the Control Group participated in no physical activity. A comparison test was performed within and between groups, with p<0.05 indicating statistical significance. RESULTS: Compared with the Control Group, the Samba Group showed a significant increase in maximal oxygen uptake (19%), oxygen pulse (13%), and lean body mass (3%) and a decrease in body fat percentage (11%) and fat mass (12%). CONCLUSION: Twelve weeks of samba dance rehearsals improved the cardiorespiratory and body composition parameters in women dancers compared with the Control Group. These findings suggest that dancing samba regularly can increase physical activity levels and positively affect the health parameters of samba dancers.
- MeSH
- kardiorespirační zdatnost * MeSH
- kyslík MeSH
- lidé MeSH
- složení těla MeSH
- spotřeba kyslíku MeSH
- tělesná výkonnost MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Brazílie MeSH
Úvod: Studie se zabývala vztahem mezi subjektivní klasifikací New York Heart Association (NYHA) a objektivní zátěžovou kapacitou (měřenou pomocí vrcholového příjmu kyslíku [VO2peak]) u pacientů se srdečním selháním a dále tím, zda je tento vztah ovlivněn adherencí k medikaci. Metody: Byly analyzovány údaje 170 pacientů se srdečním selháním z registru Level-CHF. Adherence byla hodnocena pomocí testování koncentrace léků v séru. Objektivní zátěžová kapacita byla hodnocena pomocí spiroergometrie na bicyklovém ergometru. Výsledky: Hodnota objektivní maximální spotřeby kyslíku často převyšovala odpovídající subjektivní třídu NYHA se 46% shodou, rozdíly se projevovaly zejména na krajních koncích spektra. Byly zaznamenány drobné odchylky v subjektivním hodnocení třídy NYHA v souvislosti s adherencí k medikaci, ale nebyly pozorovány žádné podstatné rozdíly. Závěr: Výsledek upozorňuje na rozdíly mezi subjektivním a objektivním hodnocením funkční kapacity u pacientů se srdečním selháním. To by mělo vést k většímu využívání objektivních měření při klinickém rozhodování na základě funkční kapacity a k využívání přímo měřených hodnot VO2peak nad subjektivní třídou NYHA. Dodržování medikace významně nezměnilo subjektivně-objektivní trendy NYHA
Introduction: This study investigated the relationship between the subjective New York Heart Association (NYHA) class and objective exercise capacity (VO2peak) in patients with heart failure and whether it is influenced by medication adherence. Methods: Data from 170 heart failure patients in the Level-CHF register were analysed, and adherence was assessed by serum drug level testing. Objective exercise capacity was assessed by cardiopulmonary exercise testing using a bicycle ergometer. Results: Objective VO2peak frequently exceeded the subjective NYHA class with 46% concordance, especially at the extreme ends of the spectrum. Minor differences in subjective NYHA class in relation to medication adherence were noted, but no substantial disparity was observed. Conclusion: These findings highlight the discrepancies between subjective and objective assessments of functional capacity in patients with heart failure. This calls for a greater use of objective measurements in clinical decision-making based on functional capacity and for preference of direct VO2peak values over subjective NYHA categories. Medication adherence did not significantly alter the subjective-objective NYHA trends.
- Klíčová slova
- NYHA,
- MeSH
- adherence k farmakoterapii MeSH
- lidé MeSH
- spotřeba kyslíku účinky léků MeSH
- srdeční selhání * patofyziologie prevence a kontrola MeSH
- zátěžový test metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
Stroke volume (SV), heart rate (HR) and arterio-venous O2 difference (a-vO2diff) responses to heavy and severe-intensity exercise have been well documented; however, there is a lack of information on the SV, HR and a v-O2diff responses of work rates within extreme exercise domain. The aim of this study was, therefore, to focus on central and peripheral components of VO2 responses to exercises performed within the heavy, severe and extreme exercise domain. Eight well-trained male cyclists participated in this study. Maximal O2 consumption (VO2max) and corresponding work rate (P@VO2max) were determined by multisession constant work rate exercises. Cardiovascular responses to exercises were evaluated by nitrous-oxide rebreathing method with work rates from 40 % to 160 % of P@VO2max, VO2max corresponded to 324+/-39.4 W; however, maximal SV responses occurred at 205+/-54.3 W (p<0.01). Maximal cardiac output (Q), HR, and a vO2diff responses were revealed by the P@VO2max. VO2 response to exercise significantly decreased from severe-intense exercises to the first work rate of extreme exercise domain due to significant decreases in Q, SV, and HR responses (p<0.05), except a v-O2diff (p>0.05). Moreover, non-significant decreases in Q, SV, and a v-O2diff were evaluated as response to increase in work rate belonging to extreme work rates (p>0.05), except the HR (p<0.05). Work rates within the lower district of the extreme exercise domain have an important potential to improve peripheral component of VO2, while the P@VO2max seems the most appropriate intensity for aerobic endurance development as it maximizes the central component of VO2max.
BACKGROUND: COVID-19 survivors may experience long-term health problems, including deterioration of cardiorespiratory fitness (CRF), as demonstrated by several cross-sectional studies that compared the results of cardiopulmonary exercise tests (CPET) performed only after COVID-19 with predicted values. This study aimed to analyze a change in CRF between repeated CPETs in response to suffered COVID-19. METHODS: A total of 127 healthcare workers (HCWs; mean age 55.7 years) underwent two CPETs with a mean interval of 762 days. Forty HCWs suffered from COVID-19 (mild to moderate severity) in the interim (321 days before the second CPET), and 87 HCWs formed a control group. Mixed-effects regression with multiple adjustment and interaction terms was used for two response variables - maximum oxygen uptake (VO2 max) and power output. RESULTS: Between both CPETs, mean VO2 max decreased statistically significantly in the COVID-19 subgroup (by 3.12 mL/kg/min, p = .034) and insignificantly in controls (by 0.56 mL/kg/min, p = .412). The proportion of HCWs achieving predicted VO2 max decreased from 75.9% to 59.5% (p = .161) in COVID-19 survivors, while it increased from 73.8% to 81% (p = .274) in controls. COVID-19 (β = -0.66, p = .014) and body mass index (β = -0.49, p < .001) were independent negative predictors of VO2 max change. COVID-19 was not associated with a change in power output. CONCLUSIONS: On the basis of repeated CPETs, COVID-19 significantly, albeit rather modestly, reduces CRF almost one year after infection. The reduction persists even after the acute phase with mild or moderate severity.
Walking or balancing on a slackline has gained increasing popularity as a recreational and school sport, and has been found to be suitable for developing neuromuscular control. The metabolic requirements for neuromuscular control on slackline, however, have not been well described. Therefore, the aim of the study was to determine the metabolic demands of slacklining in less and more advanced slackliners. Nineteen slackliners performed several 4 min balance tasks: parallel and one-leg stance on stable platform (2LS and 1LS), 1 leg stance on a slackline (1LSS), walking at a self-selected speed and at a given speed of 15 m min-1 on a slackline (WSS and WGS). Expired gas samples were collected for all participants and activities using a portable metabolic system. During1 LS and 1LSS, there were 140% and 341% increases in oxygen uptake (V̇O2) with respect to V̇O2 rest, respectively. During slackline walking, V̇O2 increased by 460% and 444% at self-selected and given speed, respectively. More advanced slackliners required mean metabolic demands 0.377 ± 0.065 and 0.289 ± 0.050 kJ·kg-1·min-1 (5.7 ± 0.95 and 3.9 ± 0.6 MET) for WGS and 1LSS, respectively, whilst less advanced slackliners, 0.471 ± 0.081 and 0.367 ± 0.086 kJ·kg-1·min-1 (6.4 ± 1.2 and 5.0 ± 1.1 MET) for WGS and 1LSS, respectively. Our data suggest that balancing tasks on slackline require V̇O2 corresponding to exercise intensities from light to moderate intensity. More advanced slackliners had a ∼25% reduced energy expenditure when compared with lower ability counterparts during simple balance tasks on the slackline.HighlightsBalancing on a slackline is metabolically demanding and slackline training is suitable not only to develop neuromuscular control but also to meet cardiovascular fitness demands.Improved postural control demonstrated by skilled slackliners reduces by ∼25% metabolic cost of balancing tasks on a slackline when compared to less skilled counterparts.Falls during slacklining increase the metabolic demands of the activity. Three falls per minute during walking on a slackline increase the oxygen uptake by ∼50%.
