Navegando por Palavras-chave "Teste De Exercício Cardiopulmonar"

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    Efeitos da ventilação não invasiva nas respostas fisiológicas e sensoriais ao exercício em pacientes com insuficiência cardíaca associada à Doença Pulmonar Obstrutiva Crônica
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Souza, Aline Soares De [UNIFESP]; Serafini, Jose Alberto Neder [UNIFESP]; Sperandio, Priscila Cristina de Abreu [UNIFESP]; http://lattes.cnpq.br/8238787131403166; http://lattes.cnpq.br/5131155111475682; http://lattes.cnpq.br/5372408065858083; Universidade Federal de São Paulo (UNIFESP)
    Aims: To analyze the effects of NIV on the physiological, sensorial and effort tolerance responses in patients with HF and HF associated with COPD. Methods: Incremental cardiopulmonary testing was performed in 19 patients (9 with coexisting COPD but with similar low left ventricular ejection fraction) were submitted to a constant loading protocol with different intensities (20%, 40%, 60% and 80% Wpeak) with serial measures of inspiratory capacity (CI). The last W/peak intensity was maintained up to the limit of effort tolerance (Tlim). Patients received Sham or NIV (bi-level) ventilation that was adjusted according to individual comfort. Results: Tlim increased with NIV in relation to Sham ventilation only in HF+COPD (P <0.05). NIV provided higher tidal volume and lower respiratory rate, shorter duty cycle with longer expiratory time, and higher mean inspiratory flow in both groups (P <0.05), despite the absence of changes in minute ventilation. It is important to emphasize that NIV improved IC (by ~ 0.5 l) across all exercise intensities only in HF+COPD. Assuming constant total lung capacity, NIV reduced operant lung volumes, thus decreasing inspiratory constraints. These beneficial consequences of NIV were associated with lower dyspnea Borg scores at the 80% peak and at the end of the exercise (p <0.05). Conclusion: NIV resulted in lower operative lung volumes and lower dyspnea. Tlim was higher even under high ventilatory stress, therefore, there was a better "quality" in the ventilatory responses during exercise only in the IC+COPD patients.
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    Teste do degrau incremental em pacientes com hipertensão pulmonar: análise de concordância com o cicloergômetro
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-25) Vieira, Elaine Brito [UNIFESP]; Ramos, Roberta Pulcheri [UNIFESP]; Arakaki, Jaquelina Sonoe Ota [UNIFESP]; http://lattes.cnpq.br/4282849546206947; http://lattes.cnpq.br/3674430003360595; http://lattes.cnpq.br/4173382177484221; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Cardiopulmonary exercise testing (CPET) on a treadmill or cycle ergometer provides integrated assessment of the cardiorespiratory system during exertion and is widely used in clinical practice. An incremental step test (iStepT) can be an alternative for eliciting maximal exercise responses. Objectives: We sought to analyse the agreement of metabolic, cardiovascular, ventilatory and gas exchange between the incremental step test (iStepT) and incremental protocol performed in the cycloergometer (iCYCLE) in patients with pulmonary hypertension (PH). Methods: 20 patients with precapillary PH (65% female, 41±15 yrs) randomly performed a symptom-limited CPET on cycle ergometer (iCYCLE). Metabolic, cardiovascular, ventilatory and gas exchange variables were recorded during both tests. Bland Altman diagrams were used to verify the concordance between variables from iStepT and iCYCLE. Variable that was not stemming from gas analyser, as number of climbed steps, was analysed through corrrelation of it and known severity assessment markers in pulmonary hypertension. The linear regression analysis was used to establish an equation to predict VO2 from IST variables. Results: There was a greater dessaturation and V̇ O2PEAK in iStepT than cycloergometer. The V̇O2GET , FC PEAK (% pred), ΔV̇ E/ΔV̇ CO2 and ΔHR/Δ V̇ O2 were similar on iStepT and iCYCLE. By linear regression analyses, work of the IST [W = (mass x 9,8 m/s2 x vertical distance)] was a predictor of peak VO2 independent of the sex and age (r2= 0,77, p=0,001). Equation: Peak VO2 pred (mL) = 440,29 + (0,032 x work). Conclusions: iStepT elicited maximal cardiopulmonary responses and has a good agreement with known severity assessment markers in patients with pre capillary PH and the iStepT shown to have more abillity to detect dessaturation effort induced than iCYCLE.