Navegando por Palavras-chave "cardiopulmonary exercise testing"

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    Exercise Capacity in Polycystic Kidney Disease
    (Elsevier B.V., 2014-08-01) Reinecke, Natalia Lopes [UNIFESP]; Cunha, Thulio Marquez [UNIFESP]; Heilberg, Ita Pfeferman [UNIFESP]; Suemitsu Higa, Elisa Mieko [UNIFESP]; Nishiura, Jose Luiz [UNIFESP]; Neder, Jose Alberto [UNIFESP]; Almeida, Waldemar Silva [UNIFESP]; Schor, Nestor [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Reports about exercise performance in autosomal dominant polycystic kidney disease (ADPKD) are scarce. We aimed to evaluate exercise capacity and levels of nitric oxide and asymmetric dimethylarginine (ADMA) in normotensive patients with ADPKD.Study Design: Prospective controlled cohort study.Setting & Participants: 26 patients with ADPKD and 30 non-ADPKD control participants (estimated glomerular filtration rate > 60 mL/min/1.73 m(2), aged 19-39 years, and blood pressure [BP], < 140/85 mm Hg). We excluded smokers, obese people, and individuals with associated diseases.Predictor: ADPKD versus control.Outcomes: Exercise capacity and nitric oxide and ADMA levels in response to exercise.Measurements: Cardiopulmonary exercise testing and serum and urinary nitric oxide, plasma ADMA, and BP levels before and after exercise.Results: Mean basal systolic and diastolic BP, estimated glomerular filtration rate, and age did not differ between the ADPKD and control groups (116 +/- 12 vs 110 +/- 11 mm Hg, 76 6 11 vs 71 +/- 9 mm Hg, 113 +/- 17 vs 112 6 +/- 9.6 mL/min/1.73 m(2), and 30 +/- 8 vs 28.9 +/- 7.3 years, respectively). Peak oxygen uptake and anaerobic threshold were significantly lower in the ADPKD group than in controls (22.2 +/- 3.3 vs 31 +/- 4.8 mL/kg/min [P < 0.001] and 743.6 +/- 221 vs 957.4 +/- 301 L/min [P = 0.01], respectively). Postexercise serum and urinary nitric oxide levels in patients with ADPKD were not significantly different from baseline (45 +/- 5.1 vs 48.3 +/- 4.6 mu mol/L and 34.7 +/- 6.5 vs 39.8 +/- 6.8 mu mol/mg of creatinine, respectively), contrasting with increased postexercise values in controls (63.1 +/- 1.9 vs 53.9 +/- 3.1 mu mol/L [P = 0.01] and 61.4 +/- 10.6 vs 38.7 +/- 5.6 mu mol/mg of creatinine [P = 0.01], respectively). Similarly, whereas postexercise ADMA level did not change in the ADPKD group compared to those at rest (0.47 +/- 0.04 vs 0.45 +/- 0.02 mu mol/L [P = 0.6]), it decreased in controls (0.39 +/- 6 0.02 vs 0.47 6 0.02 mu mol/L [P = 0.006]), as expected. A negative correlation between nitric oxide and ADMA levels after exercise was found in only the control group (r = -0.60; P < 0.01).Limitations: Absence of measurements of flow-mediated dilatation and oxidative status.Conclusions: We found lower aerobic capacity in young normotensive patients with ADPKD with preserved kidney function and inadequate responses of nitric oxide and ADMA levels to acute exercise, suggesting the presence of early endothelial dysfunction in this disease. (C) 2014 by the National Kidney Foundation, Inc.
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    The pattern and timing of breathing during incremental exercise: a normative study
    (European Respiratory Soc Journals Ltd, 2003-03-01) Neder, Jose Alberto [UNIFESP]; Dal Corso, Simone [UNIFESP]; Malaguti, Carla [UNIFESP]; Reis, Sandra [UNIFESP]; De Fuccio, Marcelo Bicalho de [UNIFESP]; Schmidt, H. [UNIFESP]; Fuld, J. P.; Nery, Luiz Eduardo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Glasgow
    Clinical evaluation of the pattern and timing of breathing during submaximal exercise can be valuable for the identification of the mechanical ventilatory consequences of different disease processes and for assessing the efficacy of certain interventions.Sedentary individuals (60 male/60 female, aged 20-80 yrs) were randomly selected from >8,000 subjects and submitted to ramp incremental cycle ergometry. Tidal volume (V-T)/ resting inspiratory capacity, respiratory frequency, total respiratory time (Trot), inspiratory time (T-I), expiratory time (T-E), duty cycle (TI/Ttot) and mean inspiratory flow (V-T/T-I) were analysed at selected submaximal ventilatory intensities.Senescence and female sex were associated with a more tachypnoeic breathing pattern during isoventilation. the decline in T-tot was proportional to the TI and TE P reductions, i.e. T-I/T-tot was remarkably constant across age strata, independent of sex. the pattern, but not timing, of breathing was also influenced by weight and height; a set of demographically and anthropometrically based prediction equations are therefore presented.These data provide a frame of reference for assessing the normality of some clinically useful indices of the pattern and timing of breathing during incremental cycle ergometry in sedentary males and females aged 20-80 yrs.
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    A simplified strategy for the estimation of the exercise ventilatory thresholds
    (Lippincott Williams & Wilkins, 2006-05-01) Neder, Jose Alberto [UNIFESP]; Stein, R.; Universidade Federal de São Paulo (UNIFESP); Univ Fed Rio Grande Sul
    Purpose: To analyze the limits of agreement between exercise ventilatory threshold values (VT1 and VT2) estimated from a combination of pulmonary gas exchange and ventilatory variables (cardiopulmonary exercise testing) and those derived from an alternative approach based oil the ventilatory response only (VE. ventilometry). Methods: Forty-two nontrained subjects (24 males, aged 18-48, peak VO2 = 33.1 +/- 8.6 mL(.)min(-1.)kg(-1)) performed a maximum incremental cardiopulmonary exercise testing on all electromagnetically braked cycle ergometer. the participants breathed through a Pilot tube (Cardio(2) System (TM), MGC) and a fixed-resistance ventilometer (Micromed, Brazil), which were connected in series. HR values at the estimated VT (VTHR1 and VTHR2) were obtained by the conventional method (ventilatory equivalents. end-expiratory pressures for O-2 and CO2 and the V-slope procedure) and an experimental approach (VE vs time, VE/time vs time. and breathing frequency vs time). Results: There were no significant between-method differences on VTHR1, VTHR2, VTVE1, VTVE2, and peak VE (P > 0.05). After certification of data normality, a Bland-Altman analysis revealed that the mean bias 95% confidence interval of the between-method differences were lower for VTHR2 than VTHR1 (2 +/- 9 and 0 +/- 17 bpm, respectively). VTHR2 according to ventilometry differed more than 10 bpm from the standard procedure in 3 out of 42 subjects (9%). Between-method differences were independent of the level of fitness, as estimated from peak VO2 (P > 0.05). Conclusions: A simplified approach, based oil the ventilatory response as a function of time, call provide acceptable estimates of the exercise ventilatory thresholds-especially VT2-during ramp-incremental cycle ergometry. This new strategy might prove to be useful for exercise training prescription in nontrained adults.